ULTRASOUND EVALUATION OF DIFFUSE THYROID DISEASES

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SCREENING OF THE THYROID PATHOLOGY IN THE POPULATION OVER 60 YEARS

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DIAGNOSTIC VALUE OF THYROID ULTRASONOGRAPHY IN THE COMPLEX EXAMINATION OF THYROIDITIS

Thyroiditis is a substantial part of thyroid pathology. Sixty-eight patients with thryroiditis were investigated hy means of real-time ultrasonography. Echographic data were analyzed according to the following diagnostic subgroups: acute suppurative thyroiditis, silent thyroiditis, subacute thyroiditis, and Hashimoto thyroiditis. Ultrasonography enabled the visualization of local changes in cases with acute inflammation of the thyroid gland and the differentiating the thyroid from the extrathyroid inflammatory processes. The typical diffuse or localized hypoechogenecity was a valuable sonographic feature of a possible subacute or Hashimoto thyroiditis. The relatively rapid normalization of echostructure during glucocorticoid treatment in cases with subacute thyroiditis was a specific ultrasonographic finding, while, however, there were no similar changes in patients with Hashimoto thyroiditis

HYPERPROLACTINAEMIA - ETIOLOGY, DIAGNOSIS AND TREATMENT

The problem of hyperprolactinaemia is a relatively new and the information regarding it is still controversial. The aim of the present investigation is to analyze a five-year experience of the Clinic of Endocrinology and Metabolic Diseases, Prof. Paraskev Stoyanov Medical University of Varna in this field. Eighty-six patients with high prolactin levels are analyzed: 81 females at a mean age of 32.4 years and 5 males at a mean age of 37.3 years. The patients are grouped as follows: 25 with prolactinomas, 23 with hypothalamic hyperprolactinaemia, 14 with empty sella syndrome, 6 with another hormone-secreting pituitary tumor, 4 with primary hypothyroidism and 5 with drug-induced hyperprolactinaemia. The diagnosis is based on clinical features, hormone levels, computer assisted tomography and magnetic resonance imaging. The main principles of treatment, their side effects and the results are discussed

INTRATHYROID LYMPHOCYTE SUBSETS IN PATIENTS WITH AUTOIMMUNE THYROID DISEASE

Thyroid gland is an easily approachable for direct examination by aspiration biopsy organ. This fact gives a possibility for serial examination of liable disturbances in the immune regulation, connected with autoimmune thyroid disease and their response to the relevant therapy. Twenty-six patients with Basedow's disease (BD) and 12 patients with Hashimoto's thyroiditis (HT) - 34 women and 4 men (mean age 47,3 years) were studied. For determination of superficial markers of intrathyroidal mononuclear cells (ITMC) were used monoclonal antibodies for identification of total T-lymphocytes (CD3+), Т-helper/ inducer cells (CD4+), T-suppressor/cytotoxic eels (CD8+), B-lymphocytes (CD 19+), Nklymphocytes (CD16+56+), activated Т-lymphocytes (CD3+/HLA-DR+), interleukin-2 receptors (CD 25+), and the adhesion molecule ICAM-1 (CD54+). In the patients with BD the main lymphocyte subset was CD3+ with increased number of activated T-lymphocytes and CD4/CD8 ratio (2,22) due to the decreased number of T-suppressor/cytotoxic cells. After the thyreostatic therapy there was a normalization of B-lymphocytes, activated Tlymphocytes and reduction of CD4/CD8 ratio, due to the increased number of T-suppressor/ cytotoxic cells. In patients with HT and hypothyroidism the main cell population consisted of CD3+cells and increased number of CD16+56+ cells as the CD4/CD8 ratio was decreased (0,98). The presence of increased percentage ofIL-2 receptors and of adhesion molecules ICAM-1 in these patients suggests a more pronounced activity of the autoimmune process

EFFECTIVENESS OF DIABETIC KETOACIDOSIS TREATMENT WITH LOW-DOSIS VENOUS INSULIN INFUSIONS

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Concern-driven integrated approaches to nanomaterial testing and assessment - report of the NanoSafety Cluster Working Group

Abstract Bringing together topic-related European Union (EU)-funded projects, the so-called "NanoSafety Cluster" aims at identifying key areas for further research on risk assessment procedures for nanomaterials (NM). The outcome of NanoSafety Cluster Working Group 10, this commentary presents a vision for concern-driven integrated approaches for the (eco-)toxicological testing and assessment (IATA) of NM. Such approaches should start out by determining concerns, i.e., specific information needs for a given NM based on realistic exposure scenarios. Recognised concerns can be addressed in a set of tiers using standardised protocols for NM preparation and testing. Tier 1 includes determining physico-chemical properties, non-testing (e.g., structure-activity relationships) and evaluating existing data. In tier 2, a limited set of in vitro and in vivo tests are performed that can either indicate that the risk of the specific concern is sufficiently known or indicate the need for further testing, including details for such testing. Ecotoxicological testing begins with representative test organisms followed by complex test systems. After each tier, it is evaluated whether the information gained permits assessing the safety of the NM so that further testing can be waived. By effectively exploiting all available information, IATA allow accelerating the risk assessment process and reducing testing costs and animal use (in line with the 3Rs principle implemented in EU Directive 2010/63/EU). Combining material properties, exposure, biokinetics and hazard data, information gained with IATA can be used to recognise groups of NM based upon similar modes of action. Grouping of substances in return should form integral part of the IATA themselves