Thyroid hormone alterations in critically and non-critically ill patients with SARS-CoV-2 infection

Objective: Following the evolution of COVID-19 pandemic, reports pointed on a high prevalence of thyroiditis-related thyrotoxicosis. Interpretation of thyroid tests during illness, however, is hampered by changes occurring in the context of non-thyroidal illness syndrome (NTIS). In order to elucidate these findings, w e studied thyroid function in carefully selected cohorts of COVID-19 positive and negative patients. Design: Cohort observational study. Methods: We measured TSH, FT4, T3 within 24 h of admission in 196 patients without thyroid disease and/or confounding medications. In this study, 102 patients were SARS-CoV-2 positive; 41 admitted in the ICU, 46 in the ward and 15 outpatients. Controls consisted of 94 SARS-CoV-2 negative patients; 39 in the ICU and 55 in the ward. We designated the thyroid hormone patterns as consistent with NTIS, thyrotoxicosis and hypothyroidism. Results: A NTIS pattern was encountered in 60% of ICU and 36% of ward patients, with similar frequencies between SARS-CoV-2 positive and negative patients (46.0% vs 46.8%, P = NS). A thyrotoxicosis pattern was observed in 14.6% SARS-CoV-2 ICU patients vs 7.7% in ICU negative (P = NS) and, overall in 8.8% of SARS-CoV-2 positive vs 7.4% of neg ative patients. In these patients, thyroglobulin levels were similar to those with normal thyroid function or NTIS. The hypothyroidism pattern was rare. Conclusions: NTIS pattern is common and relates to the severity of disease rather than SARS-CoV-2 infection. A thyrotoxicosis pattern is less frequently observed with similar frequency between patients with and without COVID-19. It is suggested that thyroid hormone monitoring in COVID-19 should not differ from other crit ically ill patients

Management of adrenal incidentalomas - a European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors

Diabetes mellitus: pathophysiological changes and therap

Significant benefits of AIP testing and clinical screening in familial isolated and young-onset pituitary tumors

Context Germline mutations in the aryl hydrocarbon receptor-interacting protein (AIP) gene are responsible for a subset of familial isolated pituitary adenoma (FIPA) cases and sporadic pituitary neuroendocrine tumors (PitNETs). Objective To compare prospectively diagnosed AIP mutation-positive (AIPmut) PitNET patients with clinically presenting patients and to compare the clinical characteristics of AIPmut and AIPneg PitNET patients. Design 12-year prospective, observational study. Participants & Setting We studied probands and family members of FIPA kindreds and sporadic patients with disease onset ≤18 years or macroadenomas with onset ≤30 years (n = 1477). This was a collaborative study conducted at referral centers for pituitary diseases. Interventions & Outcome AIP testing and clinical screening for pituitary disease. Comparison of characteristics of prospectively diagnosed (n = 22) vs clinically presenting AIPmut PitNET patients (n = 145), and AIPmut (n = 167) vs AIPneg PitNET patients (n = 1310). Results Prospectively diagnosed AIPmut PitNET patients had smaller lesions with less suprasellar extension or cavernous sinus invasion and required fewer treatments with fewer operations and no radiotherapy compared with clinically presenting cases; there were fewer cases with active disease and hypopituitarism at last follow-up. When comparing AIPmut and AIPneg cases, AIPmut patients were more often males, younger, more often had GH excess, pituitary apoplexy, suprasellar extension, and more patients required multimodal therapy, including radiotherapy. AIPmut patients (n = 136) with GH excess were taller than AIPneg counterparts (n = 650). Conclusions Prospectively diagnosed AIPmut patients show better outcomes than clinically presenting cases, demonstrating the benefits of genetic and clinical screening. AIP-related pituitary disease has a wide spectrum ranging from aggressively growing lesions to stable or indolent disease course

Length–weight relations of 16 mesopelagic fishes (Actinopterygii: Myctophiformes and Stomiiformes) from the eastern Mediterranean Sea

For many mesopelagic fishes, even basic knowledge regarding their biology is missing, greatly impeding their effective management. Here we present length–weight relations for 16 mesopelagic fishes sampled during research surveys in the Greek seas (eastern Mediterranean). The following species were studied: Benthosema glaciale (Reinhardt, 1837); Ceratoscopelus maderensis (Lowe, 1839); Diaphus holti Tåning, 1918; Diaphus metopoclampus (Cocco, 1829); Diaphus rafinesquii (Cocco, 1838); Hygophum benoiti (Cocco, 1838); Hygophum hygomii (Lütken, 1892); Lampanyctus crocodilus (Risso, 1810); Lobianchia dofleini (Zugmayer, 1911); Myctophum punctatum Rafinesque, 1810; Notoscopelus elongatus (Costa, 1844); Symbolophorus veranyi (Moreau, 1888) [Myctophidae]; Argyropelecus hemigymnus Cocco, 1829; Maurolicus muelleri (Gmelin, 1789) [Sternoptychidae]; Stomias boa (Risso, 1810); Chauliodus sloani Bloch et Schneider, 1801 [Stomiidae].With the exception of Diaphus holti and Symbolophorus veranyi, parameter b diverged significantly from isometry. Only two species (Benthosema glaciale and Chauliodus sloani) displayed negative allometry, while for the remaining 12 species a positive allometry was found, with the highest parameter b values estimated for Stomias boa and Diaphus rafinesquii. The median value of parameter b for all species was 3.236 and 50% of its values ranged from 3.173 to 3.323. Some variations of the parameter b were observed between our findings and other studies from the Atlantic and the western Mediterranean