Subacute thyroiditis (also known as granulomatous thyroiditis, giant cell thyroiditis, de Quervain's disease, or SAT) is an inflammatory disease of the thyroid gland, usually spontaneously remitting, that lasts for weeks to months. However, recurrent forms sometimes occur which may have a genetic basis. In our paper, we have focused on the pathogenetics, symptoms, and treatment of SAT. We have described the 17-month disease course of a woman with persistent recurrent steroid-resistant SAT. SAT was well established and the patient's symptoms were not only recurrent neck pain with fever, but also recurrent chronic urticaria, which are symptoms that fulfil the criteria for the diagnosis of Schnitzler syndrome. Schnitzler syndrome occurred after vaccination with COVID-19 in the mechanism of ASIA syndrome. In our patient, Schnitzler syndrome involved the thyroid gland, causing persistent subacute thyroiditis, and the pituitary gland, causing transient swelling of the pituitary, which, to our knowledge, is the first reported case in the literature. Also unprecedented, as far as we know, is the fact that we performed thyroidectomy in the above patient, which reduced systemic inflammation and caused SAT to resolve, although only the inclusion of anakinra treatment resulted in resolution of the underlying condition.

It is not clear whether response to initial treatment in papillary thyroid carcinoma (PTC) patients is best evaluated by measuring thyroglobulin (Tg) in the presence of levothyroxine (BTg) or when stimulated by elevated TSH (STg). The aim of this study was to evaluate whether response to therapy 1year after initial treatment changes with the use of STg in relation to BTg in PTC patients treated with total thyroidectomy (TT) and radioiodine (131I), and, if observed, to assess which response is better associated with clinical course. This is a retrospective study of 148 PTC patients submitted to TT and 131I. We analyzed the response to therapy (excellent, biochemical incomplete, or indeterminate) at 1year after initial treatment, using BTg or STg, and compared which method was better associated with "excellent response at final evaluation." Twenty-eight patients (20.4%) presented change in response to therapy, with 17 of these (60.7%) presenting a worse response. Response using STg was 1.6 times better associated with proposed outcome [odds ratio (OR) = 4.61; confidence interval 95% (IC95%): 2.13-9.98] than with BTg (OR = 2.84; IC95%: 1.33-6.06). Response to therapy at 1year using STg was altered in approximately 20% of cases and therefore proved to be a better predictor of excellent response in the last evaluation.

To investigate hormonal status in patients with long-COVID and explore the interrelationship between hormone levels and long-COVID symptoms. Prospective observational study. Patients who visited our long-COVID outpatients' clinic due to long-COVID symptoms from February 2021 to December 2022. Total triiodothyronine, free thyroxine, thyrotropin, thyroglobulin, anti-thyroperoxidase, and antithyroglobulin autoantibodies were measured for thyroid assessment. Other hormones measured were growth hormone, insulin-like growth factor 1 (IGF-1), adrenocorticotropic hormone (ACTH), serum cortisol, dehydroepiandrosterone sulfate (DHEA-S), total testosterone, plasma insulin, and C-peptide. Blood glucose and glycosylated hemoglobin were also measured. To assess adrenal reserve, an ACTH stimulation test was performed. The fatigue assessment scale (FAS) was used to evaluate fatigue severity. Eighty-four adult patients were included. Overall, 40.5% of the patients had at least one endocrine disorder. These included prediabetes (21.4%), low DHEA-S (21.4%), subclinical hypothyroidism (3.6%), non-specific thyroid function abnormality (7.1%), thyroid autoimmunity (7.1%), low testosterone in males (6.6%), and low IGF-1 (3.6%). All patients had normal adrenal reserve. Long-COVID-19 symptoms were present in all patients and the most commonly reported symptom was fatigue (89.3%). The FAS score was higher than normal (≥ 22) in 42.8% of patients. There were no associations between patients' symptoms and hormone levels. Diabetic patients reported confusion (p = 0.020) and hair loss (p = 0.040) more often than non-diabetics. The evaluation of endocrine function 3months after a positive SARS-CoV2 test revealed only subclinical syndromes. The vast majority of patients reported mainly fatigue, among other symptoms, which were unrelated, however, to endocrine function.

Vitamin D (VD) plays a crucial role in regulating calcium homeostasis, while the wealth of its pleiotropic actions is gaining increasing research interest. Sufficient VD concentrations are of clinical relevance, particularly in the context of physiological alterations, such as those occurring during pregnancy when maternal VD is the sole source for the developing fetus. As a result, inadequate VD concentrations in pregnancy have been associated with perinatal complications and adverse neonatal outcomes, including preeclampsia, gestational diabetes mellitus, increased rates of cesarean section, low birth weight, small-for-gestational-age infants, poor immune and skeletal growth, allergies, and respiratory infections. Over the past few decades, several observational studies have underlined the important role of maternal VD in the neural, musculoskeletal, and psychomotor growth and bone health of the offspring. However, the complexity of the factors involved in regulating and assessing VD homeostasis, including race, sun exposure, dietary habits, and laboratory measurement techniques, makes the interpretation of relevant research findings challenging. The aim of this narrative review is to summarize the evidence on the importance of VD in maintaining optimal health during pregnancy, infancy, childhood, and adolescence.

Erectile dysfunction (ED) and diabetic foot (DF) are common complications in patients with diabetes. However, the relationship between ED and DF has been little studied. In particular, no study has evaluated whether ED is associated with the outcomes of DF. The aim of this retrospective cohort study was to investigate whether ED is a predictor of the outcomes of DF in a large population of men with DF. Three hundred and twenty-six consecutive men with type 2 diabetes and a recent and single DF ulcer were recruited and followed up for 41.7 ± 22.7months. Among men with DF, 56.1% had ED (ED group) and 43.9% did not (NO ED group). Wound healing rate was significantly higher in the NO ED than in the ED group (90.2 versus 73.3%; p = 0.0001). Minor amputation rate (13.7 versus 4.8%; p = 0.007) and mortality (25.7 versus 0.7%; p < 0.001) were significantly greater in the ED than in the NO ED group. Among 263 patients with healed ulcers, recurrence rate was significantly higher in the ED than in the NO ED group (51.5 versus 26.3%; p < 0.001). Multivariate analysis showed that the absence of ED was associated with wound healing (OR: 0.459; 95% CI: 0.213-0.993; p = 0.048), while the presence of ED predicted mortality (OR: 22.644; 95% CI: 2.976-34.271; p = 0.002) and DF recurrence (OR: 3.498; 95% CI: 1.882-6.499; p < 0.001). Our data show that among men with DF the prevalence of ED is very high. Moreover, ED may be a strong predictor of wound healing, mortality, and ulcer recurrence.

The purpose of this study was to determine adropin, NO, MR-proADM, and copeptin changes following four different types of high-intensity interval training (HIIT) in men with overweight. In the current study, 45 overweight participants were included in the pre-intervention assessments and randomly assigned to the following groups: (1) control, (2) HIIT bike, (3) HIIT short-treadmill, and (4) HIIT long-treadmill groups. The participants were given 10-min sessions of HIIT intervention between 85 and 95% of VO2peak, followed by 1-min inactive recovery at three sessions/week for 8weeks. Body composition, VO2peak, ultrasound imaging, diabesity-related risk factors, adropin, NO, MR-proADM, and copeptin were also assessed before and following the HIIT interventions. There was a statistically significant elevation in adropin and NO levels (p < 0.05), while MR-proADM and copeptin were notably more decreased than those of the control group following the 8weeks of HIIT interventions (p < 0.01). However, no statistically significant decrease was observed in carotid/femoral intima-media thickness (c/f-IMT) values following the 8-week HIIT interventions, while statistically significant reductions were demonstrated in participants who had no atherosclerotic plaque or IMT < 0.9mm (p < 0.05). In conclusion, HIIT had a greater effect on IMT remodeling of the femoral artery than of the carotid artery. Decreased MR-proADM and copeptin and increased adropin levels might act as a physiological surrogate of endothelial dysfunction through increased NO-related signaling pathways in participants with overweight following high-intensity interval training.

With the exception of HIV-associated lipodystrophy, lipodystrophy syndromes are rare conditions characterized by a lack of adipose tissue, which is not generally recovered. As a consequence, an ectopic deposition of lipids frequently occurs, which usually leads to insulin resistance, atherogenic dyslipidemia, and hepatic steatosis. These disorders include certain accelerated aging syndromes or progeroid syndromes. Even though each of them has unique clinical features, most show common clinical characteristics that affect growth, skin and appendages, adipose tissue, muscle, and bone and, in some of them, life expectancy is reduced. Although the molecular bases of these Mendelian disorders are very diverse and not well known, genomic instability is frequent as a consequence of impairment of nuclear organization, chromatin structure, and DNA repair, as well as epigenetic dysregulation and mitochondrial dysfunction. In this review, the main clinical features of the lipodystrophy-associated progeroid syndromes will be described along with their causes and pathogenic mechanisms, and an attempt will be made to identify which of López-Otín's hallmarks of aging are present.

In gestational diabetes mellitus (GDM), a postpartum oral glucose tolerance test (OGTT) is recommended. However, poor adherence to this procedure has been described, and the time required is one of the reasons. Our aims were to identify predictive factors for abnormal 2-h reclassification OGTT values, including OGTT 1-h glucose, and, if it was a factor, to determine the 1-h cutoff point that best identifies abnormal values at 2h. This was a retrospective study of 769 patients diagnosed with GDM between 2014 and 2019 in a tertiary center. The sample was divided into two groups according to the presence/absence of abnormal 2-h reclassification values, and predictive factors were studied. To determine the 1-h glycemia cutoff point capable of identifying 2-h changes, a ROC curve was drawn and the Youden index was used. The mean age of included women was 33.6 ± 4.95years: 70 of them (9.1%) had an abnormal 2-h test result. Women with a history of GDM (OR = 3.41, p = .012) and higher 1-hglycemia value (OR = 1.05, p < .001) had a higher risk of developing an abnormal 2-h test result. One-hour glycemia ≥ 142mg/dL had a sensitivity of 91.4% and specificity of 75.1% to identify changes in the test at 2h; area under the curve to predict 2-h changes was 0.90 (CI 95%: 0.86 - 0.93). Glucose measurement at 1h predicts alterations at 2h in the reclassification test with excellent diagnostic accuracy, and the cutoff point of ≥ 142mg/dL presents high sensitivity. These findings could serve as a foundation for a possible future redefinition of the OGTT procedure, but further investigation is required.

Giant prolactinomas are rare in childhood and adolescence and represent a challenge in diagnosis and management. A 15.7-year-old male adolescent presented with short stature and delayed puberty. On clinical examination, mild right central VII paresis, gait instability, decreased visual acuity, and impaired visual fields were noted. Investigations showed hyperprolactinemia (2209ng/mL), secondary hypothyroidism, hypogonadotropic hypogonadism, and growth hormone deficiency. Imaging studies showed an enormous invasive skull base mass. Craniotomy was undertaken to debulk the tumor and perform biopsies. Histology revealed a very large atypical, prolactin-secreting pituitary macroadenoma, i.e., a giant prolactinoma. After commencing cabergoline treatment, prolactin concentrations decreased in 5months and normalized 18months later, while significant shrinkage of the tumor was observed. The diagnostic work-up for genetic syndromes often associated with sporadic macroadenomas was negative. Giant prolactinomas presenting with multiple pituitary hormone deficiencies in childhood or adolescence are rare and require prompt diagnosis and multidisciplinary management.