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Introduction: Shear wave elastography (SWE) is an ultrasound diagnostic method used to measure tissue stiffness. Since the mechanical properties of tissue involved in the pathological process change, SWE might indicate regions of the examined tissue covered by the disease. It is well documented that SWE helps to differentiate benign and malignant nodules in thyroid glands in adults, however, there are few studies on the application of SWE in thyroid diagnosis in children. The purpose of the study was to assess the application of SWE based on Young's modulus expressed in kPa in the management of thyroid nodules in children and adolescents. Methods: In total, 116 pediatric patients (81 girls and 35 boys) with 168 thyroid nodules were enrolled in the study and qualified for SWE followed by fine needle aspiration biopsy. Results: According to the result of the cytological examination presented in the Bethesda System, nodules were classified as benign (147 nodules classified as category II according to the Bethesda System) or indeterminate or suspicious (21 nodules classified as categories III, IV, and V according to the Bethesda System). Benign cytological diagnoses were nodular goiter, parenchymal goiter, nodular colloid goiter, or lymphocytic inflammation. Among the indeterminate or suspicious nodules, 15 were diagnosed as category III according to the Bethesda System (atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS) in cytology), 1 nodule was diagnosed as category IV according to the Bethesda System (suspicious for follicular neoplasm – oxyphilic cell tumor), and 5 as category V according to the Bethesda System (suspicious for malignancy). There were no significant differences in thyrotropin (TSH) and free thyroxine (fT4) concentrations between the benign and suspicious groups. Patients with benign and indeterminate or suspicious thyroid nodules were of comparable age. Mean SWE in benign nodules was statistically significantly lower than in nodules with indeterminate or suspicious cytology (42.22 ± 16.69 vs. 57.4 ± 24.0 kPa, p =0.0004). Six patients from the indeterminate or suspicious group were revealed to be malignant in the final histopathological examination. Conclusion: Our results suggest that SWE is a viable diagnostic method, however, it still seems to need some adjustment for pediatric patients. [ABSTRACT FROM AUTHOR]

Hashimoto's thyroiditis (HT) and Graves' disease (GD) are common autoimmune endocrine disorders in children. Studies indicate that apart from environmental factors, genetic background significantly contributes to the development of these diseases. This study aimed to assess the prevalence of selected single-nucleotide polymorphisms (SNPs) of Il7R, CD226, CAPSL, and CLEC16A genes in children with autoimmune thyroid diseases. We analyzed SNPs at the locus rs3194051, rs6897932 of IL7R, rs763361 of CD226, rs1010601 of CAPSL, and rs725613 of CLEC16A gene in 56 HT patients, 124 GD patients, and 156 healthy children. We observed significant differences in alleles IL7R (rs6897932) between HT males and the control group (C > T, p = 0.028) and between all GD patients and healthy children (C > T, p = 0.035) as well as GD females and controls (C > T, p = 0.018). Moreover, the C/T genotype was less frequent in GD patients at rs6897932 locus and in HT males at rs1010601 locus. The presence of the T allele in the IL7R (rs6897932) locus appears to have a protective effect against HT in males and GD in all children. Similarly, the presence of the T allele in the CAPSL locus (rs1010601) seems to reduce the risk of HT development in all patients. [ABSTRACT FROM AUTHOR]

Introduction: Forkhead box P3 (Foxp3) is an important regulatory factor for the development and function of T regulatory (Treg) cells. Moreover, it has been established that deficiency of the Foxp3 gene in Treg cells suppresses their regulatory function leading to the development of autoimmune diseases especially autoimmune thyroid diseases. The aim of our study was to estimate the association of three polymorphism of FOXP3 gene with the predisposition to Graves' disease (GD) and Hashimoto's thyroiditis (HT) in children and adolescents. Materials and methods: The study was performed in the group consisting of 145 patients with GD (mean age, 16.5 ± 2 years), 87 patients with HT (mean age, 15.2 ± 2.2 years) sequentially recruited from the endocrinology outpatient clinic and 161 healthy volunteers (mean age, 16.3 ± 3 years). DNA was extracted from the peripheral blood leukocytes using a classical salting-out method. The three single nucleotide polymorphisms (SNPs) rs3761549 (−2383C/T), rs3761548 (−3279G/T) and rs3761547 (−3499T/C) in the FOXP3 gene were genotyped by TaqMan SNP genotyping assay using the real-time PCR method. The levels of thyroid hormones, TSH and anti-thyroid autoantibody were determined using chemiluminescence method. Results: In our study, rs3761549G/A genotype was more frequent in female patients with GD in comparison to healthy female (15% vs. 7%, p = 0.033) with OR = 2.15 and 95% confidence interval for OR: 1.07-4.63. We have also observed rs3761547T/C to be more frequent in females with GD in comparison to control females, and this difference was close to statistically important (13% vs. 7%, p = 0.066) with OR = 1.99 and 95% confidence interval for OR: 0.96-4.48. There were no significant differences in males in analyzed SNPs and in females with rs3761548 SNP. Conclusion: In conclusion, these results may suggest that rs3761549G/A polymorphism in Foxp3 gene could contribute to GD development in females. [ABSTRACT FROM AUTHOR]

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Introduction: Childhood obesity is becoming a worldwide epidemic and its metabolic and cardiovascular complications may already be evident at a young age. Several epidemiologic studies in adults have clearly demonstrated that obesity and overweight increase the risk of kidney disease and urolithiasis., Aim of the Study: The purpose of this study was to evaluate the relationship between overweight and obesity and urolithiasis risk factors in children., Materials and Methods: The main kidney stones risk factors in urine such as calcium concentration, oxalate concentration, citrate concentration, pH of urine as well as BRI (Bonn Risk Index) were analyzed in 249 overweight and obese children (study group) and in 281 children with normal weight (control) at the age of 3 to 18 years old., Results: In the study group the mean oxalate concentration was significantly higher than in the control (0.52±0.48 vs. 0.26±0.12; p <0.05). The mean calcium concentration of overweight/obese patients was higher than that of normal body weight and the difference was close to statistically significant (3.23±2.55 vs 2.58±1.59; p=0.0537). The mean urine pH in the study group was 6.28±0.46 and was significantly lower (p <0.05) than the mean urine pH in the control, witch was 6.40±0.47. The mean citrate concentration among overweight/obese patients was significantly lower than in control (431,2±309,5 vs. 637,2±310,7; p <0.05)., Conclusions: Our results suggest that obesity or overweight at a young age are associated with an increased risk of kidney stones. Weight loss might be explored as a potential treatment to prevent kidney stone formation.

Introduction: Up till now, altered balance of Th1 and Th2 immune cells has been postulated to play an important role in the pathogenesis of autoimmune thyroid diseases (AITD). However, recent studies on thyroid diseases suggest a new role for Th17 (T helper 17) cells that have been classified as a new lineage, distinct from Th1, Th2 and Treg cells. Despite wide interest, the role of Th17 cells in the pathogenesis of inflammatory and autoimmune diseases is still being debated. Th17 cells are involved in immune responses against extracellular pathogens and have the ability to secrete cytokines: IL-17, IL-17F, IL-22 and IL-21. Th17 cells can be characterized by several surface markers, i.e. CCR6 (CD196), IL-23R, IL-12Rbeta2 and CD161., Aim of the Study: Was to estimate the frequencies of circulating CD4+CD161+CD196+ and CD4+IL-17+ Th17 cells in patients with Graves' disease (GD, n=20, mean age ± SEM 14.9 ± 6 years), Hashimoto's thyroiditis (HT, n=20, mean age ± SEM 15.2±3 yrs) and in healthy controls (C, n=20, mean age ± SEM 15.4 ± 2 yrs)., Material and Methods: Polychromatic flow cytometry and several fluorochrome-conjugated monoclonal antibodies were applied to delineate Th17 cells with either CD4+CD161+CD196+ or CD4+IL-17+ phenotype using apparatus FACSCalibur (BD Biosciences). Thyroid anti-TSH receptor immunoglobulins (TRAK), anti-thyroperoxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies were measured in all the samples using electrochemiluminescence "ECLIA" with Modular Analytics E170 analyzer (Roche Diagnostics, Poland)., Results: In untreated HT children we observed an increased percentage of CD4+CD161+CD196+ (7.1 ± 3.5 vs. 3.7 ± 1.8; p <0.04) and CD4+IL-17+ (3.7 ± 2.7 vs. 1.4±0.4; p <0.01) Th17 lymphocytes in comparison to the healthy controls. In untreated and treated GD children we did not reveal such abnormalities in the population of these cells compared to the controls. In cases with HT, a positive correlation between the percentage of CD4+IL-17+ and CD4+CD161+CD196+ T cells and serum level of anti-TPO antibodies (r=0.48; p <0.025; r=0.65; p <0.01; respectively) was detected., Conclusions: We conclude that the increased percentage of Th17 cells in children with untreated Hashimoto's thyroiditis can suggest their role in initiation and development of immune and inflammatory processes in this endocrinopathy.

Cytokine and growth factor--erythropoietin (EPO)--apart from it's hematopoietic function is now considered to be a cytoprotective agent in a variety of vascular diseases, nervous system disorders and metabolic impairments. Recent work has elucidated that erythropoietin controls a variety of signal transduction pathways involving Janus-tyrosine kinase 2, protein kinase B, signal transducer and activator of transcription, Wnt proteins, forkhead transcription factors, caspases, and nuclear factor kappaB. Further investigations of cellular pathways controlled by erythropoietin can be the base for therapeutic applicability of this cytokine throughout the body.

Cytoprotection can be defined as the ability to protect cells against wide variety of damaging agents. A series of recent studies indicate that many substances participate in this process. It has been proved that different mechanisms as inhibition of oxidative stress or apoptosis mediate in cytoprotection. However, a number of mechanisms responsible for this extremely compound process remain still unknown. In this revew we discuss the scientific evidence documenting cytoprotective agents and pathways of their activity.