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(1) Background&mdash, low-dose radioiodine ablation is an accepted strategy for the treatment of low- and intermediate-risk thyroid carcinomas, although there is no international consensus. The aim of this study is to describe the clinical experience with low-dose radioiodine ablation in patients with low- and intermediate-risk thyroid cancer compared to high-dose ablation. (2) Methods&mdash, 174 patients with low- and intermediate-risk thyroid cancer, 90 treated with low-dose ablation and 84 treated with high-dose ablation, were included. The primary endpoint was response to treatment one year after ablation, defined by stimulated thyroglobulin, whole body scan and ultrasound imaging. (3) Results&mdash, an excellent response rate of 79.8% in the low-dose group and 85.7% in the high-dose group was observed (p = 0.049). Stimulated thyroglobulin at the moment of ablation (p = 0.032) and positive antithyroglobulin antibodies (p &lt, 0.001) were independent predictive factors for nonexcellent response. Young age (p = 0.023), intermediate initial recurrence risk (p &lt, 0.001) and low-dose ablation (p = 0.004) were independent predictive factors for recurrence. (4) Conclusion&mdash, low-dose ablation seemed to be less effective than high-dose ablation, especially in those patients with positive antithyroglobulin antibodies or higher stimulated thyroglobulin levels at the moment of ablation. Low dose was associated with higher recurrence rates, and lower age and intermediate initial recurrence risk were independent risk factors for recurrence in our sample.

Introduction: Antibiotic treatments modify gut microbiota. Microbiota alterations (in composition and biodiversity) are fundamental pieces in the development of metabolic disorders (T2DM and obesity). Objective: To evaluate the relationship between microbiota changes due to antibiotic treatment in patients colonized by H. pylori and GLP-1 secretion. Methods: A prospective case control study was assessed. We evaluated a H. pylori positive patient model before and two months after a short-term eradication therapy and a control group. Anthropometric measurements, carbohydrate and lipid metabolisms, GLP-1 levels and fecal microbiota composition (determined by 16S rRNA gene (V3-V4) sequencing with an Illumina Miseq) were analyzed. Results: We studied 40 cases and 20 controls (60% women, respectively). Average age was 47.0±2 vs. 43.6±2.7 years. 42.5% vs. 40% had clinical history of gastrointestinal disease. After eradication treatment, we found significant changes in microbiota profile at phylum, family, genus and species levels. The Chao1 and Shannon indices showed a decreased in bacterial richness and diversity in patients (pre and post H. pylori eradication) compared to controls. GLP-1 secretion and carbohydrate metabolism were improved after antibiotic treatment. GLP-1 changes were related to microbial community disturbances through correlation analysis, specifically with Bifidobacterium adolescentis (r=0.354, p=0.034), Lachnobacterium (r=-0.332, p=0.048) and Coriobacteriaceae (r=0.372, p=0.026). Conclusions: Antibiotic treatment to eradicate H. pylori increased the secretion of GLP-1 and improved the carbohydrate metabolism. This GLP-1 secretion improvement was related to changes in microbial community because of the antibiotic treatment, particularly in Bifidobacterium adolescentis, Lachnobacterium and Coriobacteriaceae. These taxa could play their roles through the production of short chain fatty acids (SCFA) and/or bile acid metabolism. Disclosure I. Cornejo-Pareja: None. G. Martin-Nuñez: None. I. Moreno-Indias: None. F.F. Cardona-Díaz: None. M. Roca-Rodriguez: None. L. Coin-Arangüez: None. I. Mancha-Doblas: None. F. Tinahones: Advisory Panel; Self; Lilly Diabetes, Novo Nordisk A/S, Regeneron Pharmaceuticals, Sanofi-Aventis. Consultant; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker’s Bureau; Self; Danone Nutricia Research, Lilly Diabetes, Novo Nordisk A/S, Regenerative Medical Solutions, Sanofi-Aventis.

Objective MircroRNAs (miR) are small, noncoding RNA molecules of 18-25 nucleotides. Their dysregulation has been widely studied in many human tumours including differentiated thyroid cancer (DTC). miRs more frequently associated with these kinds of tumours are miR-146, miR-221 and miR-222. Our objective was to assess the relationship among circulating miR levels and the evolution and outcomes of disease. Design We analysed a sample of 60 patients with DTC assigning them to one of three groups according to the dynamic scale of risk (excellent response, incomplete biochemical response and incomplete structural response). Patients and measurements At study inclusion, we determined thyroid-stimulating hormone, thyroxine, thyroglobulin, antithyroglobulin antibodies and plasma levels of miR-146, miR-221 and miR-222. Results Male sex and advanced age at diagnosis were associated with the worst disease progression. miR-222 was twofold to threefold higher in tall cell papillary carcinomas (P = 0.038). miR-146 (P = 0.016) and miR-221 (P = 0.050) had a positive correlation with thyroglobulin at the time of sampling. In regression analysis, miR-146 (P = 0.006), miR-221 (P = 0.004) and miR-222 (P = 0.007) predicted more than 70% of the variation in thyroglobulin levels at the time of sampling. Conclusions Elevated miR-222 and miR-146 levels are associated with poorer outcomes of the disease and may have a prognostic value in the management and follow-up of DTC.

Introduction: Antibiotic treatments cause changes in gut microbiota. Dysbiosis of gut microbiota has been linked to metabolic diseases such as type 2 diabetes mellitus (T2DM). Objective: To evaluate whether changes in gut microbiota due to antibiotic treatment in patients colonized by H. pylori, could be related to improvements in carbohydrate metabolism. Material and Method: A prospective case-control study were performed. Clinical data, carbohydrate metabolism, and microbiota composition in feces (determined by 16S rRNA gene (V3-V4) sequencing using the Illumina Miseq) before and 2 months after eradication treatment were analyzed. Results: We studied 40 cases and 20 controls (60% women, respectively). Average age was 47.0 ± 2 vs. 43.6 ± 2.7 years old. 70% vs. 60% had family history of digestive disorders and 42.5% vs. 40% clinical history of gastrointestinal disease. After antibiotics, we found significant changes in gut microbiota profile at phylum, family, genus and species levels. The Chao and Shannon indices showed a decreased in bacterial richness and diversity in patients (pre and post H. pylori eradication) compared to controls. We observed an improvement in glucose homeostasis in cases 2 month after H. pylori eradication treatment, with decrease in HbA1c (p=0.014), 60’ (p=0.018) and 120’ (p=0.019) glucose post OGTT. Changes in Rikenellaceae, Butyricimonas, E. biforme, B. fragilis, and Megamonas were inversely associated with changes in glucose level and Hb1Ac in patients which got H. pylori eradication. Conclusion: H. pylori eradication treatment causes alteration in human gut microbiota. The glucose homeostasis improvement found after antibiotic treatment was related to changes in microbial community, particularly in Megamonas and Butyricimonas genus, Rikenellaceae family and E. biforme and B. fragilis species. SCFA-producing and glucose remover bacterias could play an important role in these associations. Disclosure I. Cornejo-Pareja: None. G. Martin-Nuñez: None. M. Roca-Rodriguez: None. I. Moreno-Indias: None. L. Vinuela: None. L. Coin-Arangüez: None. I. Mancha-Doblas: None. F. Tinahones: None.

La diabetes mellitus, enfermedad cronica caracterizada por hiperglucemia, se ha convertido en uno de los mayores problemas de salud publica del siglo XXI. Su prevalencia alcanza cifras alarmantes, afectando a cerca de 382 millones de personas alrededor del mundo. Las perspectivas futuras, ademas, son realmente desalentadoras, ya que se estima que para el ano 2035 el numero de personas con diabetes mellitus aumentara hasta los 592 millones. La diabetes mellitus tipo 2 (DM2) aglutina el 90-95% de los diagnosticos de diabetes mellitus. La hiperglucemia cronica de la DM2, incluso en ausencia de sintomas, conlleva lesiones en multiples tejidos, siendo especialmente sensibles los pequenos vasos de la retina, los rinones y los nervios perifericos. En practicamente todas las sociedades desarrolladas, la

Background and objectives The finding of a thyroid nodule is a very common occurrence in clinical practice. Management of thyroid nodules requires a multidisciplinary approach that may be eased by a high-resolution thyroid nodule clinic. We report our clinical experience and outcomes in a high-resolution thyroid nodule clinic. Patients and methods All patients referred to Virgen de la Victoria Hospital (Malaga) from 2005 to 2007 were evaluated following thyroid nodule guidelines. Statistical analysis was performed using SPSS software. Results In the study period, 658 patients (mean age 48.6 years, 89.8% females) were seen at the thyroid nodule clinic. Thyroid nodules were discovered in 85.5% of patients. Mean nodule diameter was 1.96 cm. Of these nodules, 74.2% were solid, 55.8% hypoechogenic, and 4.7% showed microcalcifications. Fine needle aspiration (FNA) was performed in 475 patients (76.5% of all cytological samples were benign, 19.1% had suspected malignancy, 2.1% were malignant, and 2.3% inadequate). Referral for surgery was required in 23.3% of patients (mainly because of nodule size or suspected malignancy). Malignancy was confirmed in 24.9% of nodules. Sensitivity and specificity of cytology (considering biopsy as gold standard) were 81.8% and 94.7% respectively. Conclusions Implementation of a high-resolution thyroid nodule clinic decreases delay in diagnosis and optimizes available resources, thus providing for satisfactory clinical outcomes.

Appearance of a thyroid nodule has become a daily occurrence in clinical practice. Adequate thyroid nodule assessment requires several diagnostic tests and multiple medical appointments, which results in a substantial delay in diagnosis. Implementation of a high-resolution thyroid nodule clinic largely avoids these drawbacks by condensing in a single appointment all tests required for adequate evaluation of thyroid nodule. This paper reviews the diagnostic and functional structure of a high-resolution thyroid nodule clinic.