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Bearing in the mind that a variety of agents can contribute to genome instability, including viral infections, the aim of this study was to analyze DNA damage in hospitalized COVID-19 patients and its relationship with certain laboratory parameters. The potential impact of applied therapy and chest X-rays on DNA damage was also estimated. The study population included 24 severely COVID-19 patients and 15 healthy control subjects. The level of DNA damage was measured as genetic damage index (GDI) by comet assay. The standard laboratory methods and certified enzymatic reagents for the appropriate autoanalyzers were performed for the determination of the biochemical and hematological parameters. COVID-19 patients had significantly higher level of DNA damage compared with control subjects. The absolute number of neutrophil leukocytes was statistically higher, while the absolute number of lymphocytes was statistically lower in COVID-19 patients than in healthy controls. The analysis of the relationship between DNA damage and laboratory parameters indicated that GDI was positively correlated with interleukin 6 (IL-6) concentration and negatively with platelet count in COVID-19 patients. The level of DNA damage was slightly higher in female patients, in whom it was demonstrated a positive correlation of GDI with C-reactive protein (CRP) and procalcitonin. Likewise, there was a negative relationship of GDI and platelet count, and positive relationship of GDI and activated partial thromboplastin time (aPTT) in female population. The applied therapy (antibiotics, corticosteroid, anticoagulant, and antiviral therapy) as well as chest X rays has been shown to have genotoxic potential. The level of DNA damage significantly corresponds to the inflammatory markers and parameters of hemostasis in COVID-19 patients. In conclusion, inflammation, smoking habit, applied therapy, and chest X rays contribute to a higher level of DNA damage in COVID-19 patients.

Perturbations of peripheral T cell homeostasis and dysregulation of the immune response to SARS-CoV-2, especially in severely ill patients, were observed. The aim of this study was to analyze the cytokine producing ability of peripheral blood cells from severely ill COVID-19 patients upon non-specific in vitro stimulation with phytohemagglutinin (PHA). Possible associations of cytokine levels with patients' age and gender, glucocorticosteroid therapy, as well as the trend of the inflammatory process at the time of sampling (increased or decreased) were also analyzed.The study included 23 COVID-19 patients and 17 healthy control subjects. The concentrations of selected Th1/Th2/Th9/Th17/Th22 cytokines were determined using a multi-analyte flow assay kit.Our results showed that peripheral blood cells from severely ill COVID-19 patients had a much reduced ability to produce cytokines in comparison to healthy controls. When inflammation was raised, blood cells produced more IL-6 and IL-17, which led to increases of some Th17/Th1 and Th17/Th2 ratios, skewing towards the Th17 type of response. The methylprednisolone used in the treatment of patients with COVID-19 influences the production of several cytokines in dose dependent manner.Our results indicate that the stage of the inflammatory process at the time of sampling and the dose of the applied glucocorticosteroid therapy might influence cytokine producing ability upon non-specific stimulation of T cells in vitro.

Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours. In this retrospective, international, cross-sectional study, centres were invited to participate in June 22, 2022; each centre joining the study was asked to provide data from medical records on all surgical thyroidectomies consecutively performed from Jan 1, 2019, to Dec 31, 2021. Patients with indeterminate thyroid nodules were divided into three groups according to when they underwent surgery: from Jan 1, 2019, to Feb 29, 2020 (global prepandemic phase), from March 1, 2020, to May 31, 2021 (pandemic escalation phase), and from June 1 to Dec 31, 2021 (pandemic decrease phase). The main outcomes were, for each phase, the number of surgeries for indeterminate thyroid nodules, and in patients with a postoperative diagnosis of thyroid cancers, the occurrence of tumours larger than 10 mm, extrathyroidal extension, lymph node metastases, vascular invasion, distant metastases, and tumours at high risk of structural disease recurrence. Univariate analysis was used to compare the probability of aggressive thyroid features between the first and third study phases. The study was registered on ClinicalTrials.gov, NCT05178186. Data from 157 centres (n=49 countries) on 87 467 patients who underwent surgery for benign and malignant thyroid disease were collected, of whom 22 974 patients (18 052 [78·6%] female patients and 4922 [21·4%] male patients) received surgery for indeterminate thyroid nodules. We observed a significant reduction in surgery for indeterminate thyroid nodules during the pandemic escalation phase (median monthly surgeries per centre, 1·4 [IQR 0·6-3·4]) compared with the prepandemic phase (2·0 [0·9-3·7]; p

Introduction. Diabetes mellitus is a common metabolic disorder with more than 1.7% of the world population. Diabetes mellitus affects 3% of Serbian population. Stroke is one of the major macrovascular complications of Diabetes mellitus. Aim. Determining what additional intervention, care and treatment of diabetic patients with stroke needs, when comparing patients with stroke who have other risk factors. Material and Methods. The research was conducted in the Specialized Hospital "Sveti Sava", at the Intensive Care B, during the period from the 1 November 2019 th to the 31 December 2019. Total number of patients was 40. Subjects were divided into two equal groups of 20 patients: the first group the experimental group with diabetic patients with acute stroke, and the second group the control, with patients with acute stroke who have other risk factors. The study was based on general standards of nursing interventions, and advanced standards in the care and treatment of diabetic patients with stroke were used. Results. According to "Nursing activities score" of basic nursing interventions: continuous monitoring was present in 13 (65%) patients in the experimental group whereas the control group had 5 (25%) patients. Monitoring of vital parameters and the number of nursing interventions were much higher in the experimental group. Conclusions. Using the common standards of nursing interventions in the care and treatment of diabetic patients with acute stroke is not enough. Their demands are highlighted and they require a longer time and the increased number of nurses for the implementation of the plan of care and treatment for these patients. Patients with stroke are complex and prone to numerous complications and serious approach to each patient individually is needed.

BACKGROUND AND AIMS Chronic kidney disease (CKD) has been linked with an increased risk of cardiovascular events, especially in dialysis population. According to literature data, in the patients with CKD heart function disturbances are twice as common as in the general population [1]. Bearing in the mind that left ventricular hypertrophy (and abnormal left ventricular relaxation) is considered to be one of the most important parameters for the occurrence of cardiovascular disease in CKD [2], the aim of our study was to evaluate the association of left ventricular diastolic dysfunction with heart failure in CKD patients. METHOD The research was conducted as a prospective observational study which included 30 patients with CKD, stage III and IV according KDIGO [3], and left ventricular diastolic dysfunction, and 30 control subjects who also had left ventricular diastolic dysfunction but without CKD. Pulse-wave (PW) Doppler echocardiography in the apical four-chamber view and tissue Doppler imaging were performed to assess left ventricular function [4]. The measurements of mitral inflow by PW Doppler covered early (E-wave) and late (A-wave) diastolic feeling velocities, peak early diastolic velocity at the septal (e′septal) and lateral (e′lateral) mitral annular sites, and E/A ratio. RESULTS A comparison of left ventricular function parameters between two groups of study participants indicated that left ventricular ejection fraction (0.57 ± 0.05% versus 0.61 ± 0.03%) was statistically reduced in CKD patients compared to control subjects (P CONCLUSION Heart failure is more common in patients with CKD than in patients with normal kidney function. There is a positive relationship between the presence of left ventricular diastolic dysfunction and the occurrence of heart failure in patients with CKD.

The aim of this study was to analyze the prevalence of Helicobacter pylori infection and gastroduodenal lesions in Montenegrin patients with chronic kidney disease on hemodialysis. The study included 55 hemodialysis patients with dyspeptic symptoms and 50 control subjects with normal kidney function who had also dyspepsia. After dyspepsia assessment by an interview, all subjects underwent gastroduodenoscopy and histopathological analysis of biopsy specimens, taken from the corpus and antrum of the stomach. Helicobacter pylori was confirmed in 50.9% of corpus mucosa i.e. 60.6% of antrum mucosa of maintenance hemodialysis patients. There were no significantly differences in endoscopic findings of the stomach and bacterial presence between the two study groups of participants (p = 0.451), while duodenal lesions were prevalent in control subjects (p < 0.001). The atrophy of corpus mucosa was more common in hemodialysis patients (p = 0.007), especially in those who have been on hemodialysis for a longer time (p < 0.001) and had lower pH (p = 0.011). The prevalence of Helicobacter pylori infection shown an inverse relationship with dialysis duration. Contrary, a positive relationship between Helicobacter pylori and the concentration of bicarbonate was demonstrated (p = 0.031). The prevalence of Helicobacter pylori and atrophic mucosal changes in Montenegrin hemodialysis patients depends on dialysis duration and acid-base balance.

Background: The aim of this study was to compare serum sclerostin concentrations in patients with thyroid dysfunction with euthyroid control subjects and to assess the relationship between sclerostin and markers of bone metabolism (osteocalcin and beta-cross-laps). Methods: The study included 30 patients with thyroid dysfunction (hypothyroidism, hyperthyroidism and subclinical hyperthyroidism) and ten euthyroid controls. Free thyroxine (FT4) was measured by radioimmunoassay, while thyroid stimulating hormone (TSH) concentration was determined immunoradiometrically. We used an ELISA kit to determine the sclerostin level. The electrochemiluminescence method was applied for measuring the bone markers. Results: Sclerostin levels were significantly lower in hypothyroid patients (p=0.009) and significantly elevated in hyperthyroid patients (p=0.008) compared to control values. Hyperthyroid patients also had higher sclerostin than patients with subclinical hyperthyroidism (p=0.013). Sclerostin concentrations were negatively correlated with TSH levels (r=-0.746, p lt 0.001), but positively with FT4 (r=0.696, p lt 0.001). Moreover, sclerostin was positively associated with osteocalcin (r=0.605, p=0.005) and beta-cross-laps levels (r=0.573, p=0.008) in all thyroid patients. Conclusions: Serum sclerostin is significantly affected in subjects with thyroid dysfunction. Both sclerostin and thyroid status affect bone homeostasis, which is reflected through the significant correlations with osteocalcin and beta-cross-laps. Uvod: Cilj ove studije bio je da uporedimo serumske koncentracije sklerostina kod pacijenata sa disfunkcijom štitaste žlezde u odnosu na eutiroidne kontrolne ispitanike, i da procenimo odnos između sklerostina i markera koštanog metabolizma (osteokalcina i beta-cross-lapsa) u istoj populaciji. Metode: Studijom je obuhvaćeno 30 pacijenata sa disfunkcijom štitaste žlezde (hipotireozom, hipertireozom i supkliničkom hipertireozom) i 10 eutiroidnih kontrola. Slobodni tiroksin (FT4) meren je radioimunološkom metodom, dok je koncentracija tireostimulišućeg hormona (TSH) određivana imunoradiometrijski. Za merenje nivoa sklerostina koristili smo ELISA-test. Metoda elektrohemiluminiscencije primenjena je za merenje koncentracije koštanih markera. Rezultati: Nivo sklerostina bio je značajno niži kod bolesnika sa hipotireozom (p = 0,009) odnosno značajno viši kod bolesnika sa hipertireozom (p = 0,008) u poređenju sa vrednostima kod eutiroidnih kontrolnih ispitanika. Pacijenti sa hipertireozom su takođe imali statistički značajno viši nivo sklerostina u odnosu na bolesnike sa supkliničkom hipertireozom (p = 0,013). Pokazana je negativna korelacija koncentracije sklerostina i TSH (r = -0,746, p lt 0,001), odnosno pozitivna korelacija sa FT4 (r = 0,696, p lt 0,001) kod pacijenata sa tireoidnom disfunkcijom. Štaviše, sklerostin pozitivno korelira sa koncentracijom osteokalcina (r = 0,605, p = 0,005) i beta-cross-lapsa (r = 0,573, p = 0,008) kod ovih pacijenata. Zaključak: Serumski nivoi sklerostina izmenjeni su kod osoba sa disfunkcijom štitaste žlezde. Sklerostin zajedno sa tireoidnim statusom utiče na koštani metabolizam, što se ogleda u njegovoj značajnoj korelaciji sa osteokalcinom i beta-cross-lapsom.

PURPOSE The main purpose of this study was to analyze the characteristics of dyspepsia and contributing factors in Montenegrin maintenance hemodialysis patients. METHODS The study included 43 patients undergoing hemodialysis with symptoms of dyspepsia and 40 control dyspeptic subjects with preserved kidney function. All subjects underwent an interview about dyspeptic symptoms, physical and biochemical examination, and upper gastrointestinal endoscopy with pathohistological analysis of biopsy specimens. RESULTS Early satiety, bloating and heartburn were the most common symptoms in hemodialysis patients but without significant difference in frequency in relation to controls. Chronic kidney disease patients had statistically lower concentration of total proteins and albumin (p

Background: Patients with oncological diseases often have mental disorders in the form of comorbidity. The aim of this study was to research the association of cancer with the presence of symptoms of depression and anxiety in primary health care patients. Methods: This prospective observational study done in 2020 included adult users of health care at the Health Center Trstenik, Central Serbia, aged 19 and over, both sexes, with a diagnosis of oncological disease. A research instrument to assess depressive symptoms is used PHQ-9 (The Patient Health Questionnaire) questionnaire, derived from PRIME MD- and (The Primary Care Evaluation of Mental Disorders), and the Beck Anxiety Scale (BAI) to register the presence of certain anxiety symptoms. Results: The largest percentage of patients had symptoms of mild (27.2%) or moderate depression (22%), while 18% reported symptoms of major depression. The level of depression was higher in older subjects, in the presence of chronic diseases with greater limitations of activity and the presence of difficulties in performing daily activities, with a more pronounced effect of pain on activity, the presence of stress. All subjects were characterized as persons with severe anxiety (score 26-63). The level of anxiety was higher in older respondents, in the presence of long-term illness, with greater limitations of activities and difficulties in performing daily activities, with a more pronounced influence of pain on performing activities and the influence of the media. Conclusion: Caring for the mental health of cancer patients must occupy a significant part of each country's national health policy.

The radioactive iodine (131I) ablation is a well-accepted treatment modality for differentiated thyroid cancer patients. Unfortunately, the radiation induces the oxidative stress and damages cells and tissues, simultaneously activating the mechanisms of antioxidative defense. Since the mechanisms of those processes are not completely known, we wanted to examine the changes in the most important reactive oxygen species and antioxidative components, as well as their correlation and significance for lipid peroxidation. Our results showed that the level of thiobarbituric acid reactive substances was increased during the first 30 days after the radiotherapy. Among antioxidant components, superoxide dismutase was increased in the 3rd and 30th day; catalase in 7th and reduced glutathione in 3rd and 7th day after the radiotherapy. As regards the prooxidants, the reduction of hydrogen peroxide (H2O2) was recorded in 7th and 30th day, and superoxide anion radical (O×-) was unchanged after the exposure to 131I. These results indicate that differentiated thyroid cancer patients are under constant oxidative stress despite the observed increase in antioxidative and reduction in prooxidative parameters. The understanding of these early processes is important since their progress determines the latter effects of 131I therapy. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III41007 and Grant no. 175007]

As it is known that genetic polymorphisms of glutathione S-transferases (GST) have been associated with a variety of human diseases including cancer, we have analyzed the impact of GSTT1 and GSTM1 null genotypes on the risk of development of differentiated thyroid cancer (DTC) and cytogenetic changes in peripheral blood lymphocytes of DTC patients before and after radioiodine therapy. The polymorphism of GSTT1 and GSTM1 genes were genotyped using multiplex polymerase chain reaction (PCR) and cytokinesis - block micronucleus (MN) assay to assess cytogenetic changes. GSTT1 and GSTM1 null were predominantly found in patients, but statistical significance was observed only for GSTT1 null. The null genotypes increased risk of development of DTC; GSTT1 null a 4.5 times (p < 0.05), GSTM1 null about 3 times but on the border of statistical significance (p = 0.057), while combination of dual null genotypes almost 7 times (p < 0.05) increased risk. No significant effects of the null genotypes as well as their interactions with potential modifiers of MN (diagnose, age, gender and smoking habits) were observed on both baseline and radioiodine-induced values of MN and cytokinesis block proliferation index (CBPI) in DTC patients. Results suggest that both GSTT1 and GSTM1 null genotypes increased risk for DTC but to a greater extent GSTT1 null. Null genotypes of GSTT1 and GSTM1 did not have potential to influence baseline and radioiodine-induced values of MN and CBPI, so that absence of T1 and M1 isoenzymes did not cause increased mutagen sensitivity of PBLs of DTC patients. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III41010 and Grant no. ON175103]

The present study examines the effects of divalent metals, cadmium (Cd2+) and manganese (Mn2+), on the outward potassium currents of Retzius cells in the hirudinid leeches Haemopis sanguisuga using conventional two-microelectrode voltageclamp techniques. The outward potassium current is activated by depolarization and plays an important role in determining both the neuronal excitability and action potential duration. A strong inhibition of the fast current and a clear reduction in the late currents of the outward current with 1 mM Cd2+were obtained, which indicated that both components are sensitive to this metal. Complete blockage of the fast and partial reduction of the slow outward currents was observed after adding 1 mM Mn2+to the extracellular fluid. These data show that the outward K+current in leech Retzius nerve cells comprises at least two components: a voltage-dependent K+current and a Ca2+- activated K+current. These observations also indicate that Cd2+is more eff ective than Mn2+in blocking ion fl ow through these channels and that suppressing Ca2+-activated K+outward currents can prolong the action potential in nerve cells.

As apoptosis and genome instability in children with autoimmune diseases (AIDs) are insufficiently investigated, we aimed to analyse them in peripheral blood lymphocytes (PBLs) of children and adolescents with Hashimoto's thyroiditis (HT), Graves' disease (GD) and type 1 diabetes mellitus (T1DM), including possible factors that could affect their occurrence. The study population included 24 patients and 19 healthy controls. Apoptotic cells were detected using an Annexin V-FITC/7-AAD kit. Genome instability was measured as micronuclei (MNs) frequency using the cytokinesis-block MN assay. In addition, comet assay was performed for determination of genome instability as genome damage index (GDI) in new subpopulation of patients with T1DM. The percentage of apoptotic PBLs in patients with AID was significantly lower than in control subjects. There was a positive correlation between thyroid-stimulating homone (TSH) concentration and the proportion of cells in late stage apoptosis in patients with autoimmune thyroid diseases (AITDs). The MN frequency in patients was significantly higher than in controls. Individuals with HT or T1DM had a significantly higher MN frequency than those with GD. Similarly, the value of GDI in patients with T1DM was significantly higher than in controls. The level of apoptosis was positively correlated with MN frequency as well as with GDI in patients with AID. In conclusion, children with AITD (HT and GD) and T1DM have a significantly lower level of apoptosis in PBLs and significantly higher MN frequency as GDI than healthy subjects. Apoptosis and the level of genome instability in these patients with AID are positively correlated.

Published data indicate the involvement of eosinophil granulocytes and eosinophil cationic protein (ECP) in tumor defense. The aim of this study was to analyze serum ECP concentrations in patients with differentiated thyroid cancer (DTC) before, 3 days and 7 days after radioactive iodine (131-I) therapy. Association of ECP concentrations with histological type of tumor, stage of disease and/or levels of selected T-helper 2 (Th2) cytokines was examined. The study population included 17 DTC patients and 10 control subjects. ECP was measured by fluoroimmunoassay (FIA). Th2 (cytokines interleukin 4 (IL-4), interleukin 5 (IL-5), and interleukin 13 (IL-13)) were determined by enzyme-linked immunosorbent assays (ELISA). We found that ECP values in DTC patients before radioactive iodine therapy were approximately two-fold higher than in the controls, but the difference was statistically significant only if the patients with DTC and associated Hashimoto thyroiditis (HT) were included. There was no correlation between the serum concentrations of IL-5 and ECP. Radioactive iodine therapy led to a decrease in serum ECP level which did not follow the decline in serum protein levels. Additional studies are needed to determine the significance of these findings.

Short-term, overt hypothyroidism in patients with differentiated thyroid cancer (DTC) before radioiodine (131-I) therapy might be accompanied by a number of metabolic changes, including altered protein and lipid metabolism. Protein concentrations and their relationship to lipids in the serum of DTC patients have not been fully elucidated. The aim of our study was to evaluate the protein and lipid concentrations in 24 DTC patients before and 3 and 7 days after 131-I therapy compared with those of 20 healthy control subjects. After radioiodine therapy, the mean protein concentration (78.71 ± 6.71 g/L vs. 87.16 ± 6.04 g/L; p = 0.003) and cholesterol level (8.12 ± 2.13 mmol/L vs. 8.84 ± 2.09 mmol/L; p = 0.001) were lower 3 days after therapy; this persisted up to 7 days after therapy, whereas triglyceride concentrations were higher 3 days after therapy (2.44 ± 1.07 mmol/L vs. 2.26 ± 1.08 mmol/L; p = 0.041) and returned towards the pretreatment values at 7 days after 131-I therapy. There was an indirect correlation between the protein and triglyceride concentrations 3 days after 131-I therapy in patients over 50 years old (Spearman’s r = - 0.583, p = 0.048) but not in patients under 50 years old (Pearson’s r = - 0.277, p = 0.384). Radioiodine therapy of DTC patients led to decreased serum protein and cholesterol concentrations, accompanied by increased triglyceride levels; these changes were especially evident in older subjects with metastases.

Because Artemisia vulgaris L. and Artemisia alba Turra are traditional medicinal plants used for the treatment of different diseases, we evaluated the cytotoxic/apoptotic activity of ethyl acetate extracts from these natural products against human colon cancer cells SW-480. The extracts contained a large amount of the total polyphenols and flavonoids. The phenolic profile showed the presence of phenolic acids (gallic, p-coumaric, vanillic, and ferulic acids) and flavonoids (rutin, myricetin, luteolin, quercetin, and apigenin). 3-[4,5-Dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay indicated that antiproliferative activities of both A. vulgaris and A. alba extracts increased with the extension of time exposure, with decreasing IC50 values. Mitomycin C (MMC) alone had antiproliferative activity, but in combination with plant extracts caused stronger effect with lower IC50 values. Flow cytometry analyses showed that A. alba extract induced higher percentage of SW-480 cells in the early stage of apoptosis (33.5 ± 1.6 vs 0.7 ± 0.1, P < 0.05), whereas the A. vulgaris extract significantly increased the percentage of cells in necrosis (82.4 ± 5.0 vs 53.9 ± 2.3, P < 0.05). In conclusion, A. alba extract can be considered a potential source of bioactive components with anticancer activity or be used as a dietary food supplement or supplement to chemotherapy due to its synergistic effect with the MMC.

Differentiated thyroid carcinomas (DTCs) present more than 90% of all thyroid tumours and include papillary and follicular carcinomas. Females suffer 2-3 times more often than men. Radiation is considered to be one of the most important etiological factors for the appearance of differentiated thyroid carcinomas, especially papillary carcinomas. DTCs may have a hereditary character in about 3% of cases. Disease usually presents in the form of slow growing thyroid nodules. The diagnostics is based on clinical examination, completed with ultrasonography and fine needle aspiration biopsy with cytological findings. DTCs patients require multidisciplinary therapeutic approach including total or near-total thyreoidectomy with postoperative application of radioactive iodine 131 for ablation of residual tumor as well as normal thyroid tissue. After that, the administration of L-thyroxine is required, at dose which inhibits the secretion of TSH. All patients require continuous monitoring, which also includes the determination of serum concentration of thyroglobulin. The prognosis is generally good, and the ten-year survival rate is over 90%. Recurrence is present in 10-15% of all patients, mainly in the neck, lymph nodes or thyroid region.

Fatigue is a common feature in a wide variety of chronic inflammatory and autoimmune diseases, but fatigue in autoimmune thyroid disease (AITD) has not been investigated so far. The aim of this study was to examine fatigue in patients with AITD and to analyse the correlation between fatigue and the serum concentrations of thyroid antibodies, thyroid function and depression. This cross-sectional clinical study included 62 patients with increased concentrations of thyroperoxidase antibodies (TPOAbs) as confirmation of AITD and 52 healthy individuals who were negative for thyroid antibodies; all controls were euthyroid. Thyroid antibodies, free thyroxine and thyroid-stimulating hormone were measured in the sera of all subjects. The Fatigue Severity Scale was used to measure the severity of fatigue; the level of depression was measured by the Beck Depression Inventory. Eight (12.9%) patients had evident fatigue, 7 (11.3%) patients had fatigue limit values, and 47 (75.8%) patients had no fatigue. The frequency of fatigue was highly significant and almost three times higher in the AITD patients compared to the control group, in which only 2 (3.8%) patients had evident fatigue. The majority of patients with fatigue had normal thyroid function, and only one (1.6%) patient had overt hypothyroidism. Seven (11.3%) patients had both fatigue and depression, whereas one (1.6%) patient had fatigue without depression. We did not find significant correlations between fatigue and the concentrations of thyroid antibodies, but we found statistically significant correlations between fatigue and depression in AITD patients.

Transforming growth factor beta (TGF-β) plays an important role in many pathophysiological conditions, including cancer. The level of TGF-β in patients with differentiated thyroid cancer (DTC) has not been examined so far. The aim of this study was to measure TGF-β concentration in serum samples and in PHA-stimulated whole blood culture in vitro and to analyze possible associations of TGF-β1 levels with leukocyte, lymphocyte and platelets counts, the histological type of thyroid cancer, and stage of disease. TGF-β1 was measured in 22 DTC patients and 20 healthy controls using the duoSet ELISA Development kit for human TGF-β1. The concentration of TGF-β1 in serum samples from both groups correlated positively with the platelet counts. There was no statistically significant difference in the serum concentrations of TGF-β1 between DTC patients and control subjects, but PHA stimulated whole blood cultures of DTC patients produced less TGF-β1 than those from controls. Additional studies are needed to determine the significance of these in vitro findings.

Hashimoto thyroiditis (HT) is the most frequent thyroid autoimmune disease, while papillary thyroid cancer (PTC) is one of the most common endocrine malignancies. A few patients with HT also develop PTC. The aim of this study was to analyze cytokine profiles in patients with PTC accompanied with autoimmune HT in comparison with those in patients with PTC alone or HT alone and healthy subjects. Cytokine levels were determined in supernatants obtained from phytohemagglutinin (PHA)-stimulated whole blood cultures in vitro. The concentrations of selected cytokines: Th1-interferon gamma (IFN-γ); Th2-interleukin 4 (IL-4), interleukin 5 (IL-5), interleukin 6 (IL-6), interleukin 10 (IL-10) and interleukin 13 (IL-13); Th9-interleukin 9 (IL-9); and Th17-interleukin 17 (IL-17A) were measured using multiplex cytokine detection systems for human Th1/Th2/Th9/Th17/Th22. We found that PTC patients with HT produced significantly higher concentrations of IL-4, IL-6, IL-9, IL-13 and IFN-γ than PTC patients without HT. In conclusion, autoimmune HT affects the cytokine profile of patients with PTC by stimulating secretion of Th1/Th2/Th9 types of cytokines. Th1/Th2 cytokine ratios in PTC patients with associated autoimmune HT indicate a marked shift toward Th2 immunity.

Cytokines play a key role in the regulation of cells of the immune system and also have been implicated in the pathogenesis of malignant diseases. The aim of this study was to evaluate cytokine profiles in patients with differentiated thyroid cancer (DTC) before and 7 days after radioactive iodine (131-I) therapy. Cytokine levels were determined in supernatants obtained from phytohemagglutinin-stimulated whole blood cultures of 13 patients with DTC and 13 control subjects. The concentrations of selected cytokines: Th1-interferon gamma (IFN-γ), interleukin 2 (IL-2) and tumor necrosis factor alpha (TNF-α); Th2-interleukin 4 (IL-4), interleukin 5 (IL-5), interleukin 13 (IL-13) and interleukin 10 (IL-10); Th9-interleukin-9 (IL-9); and Th17-interleukin 17 (IL-17A) were measured using multiplex cytokine detection systems for Human Th1/Th2/Th9/Th17/Th22. We have shown that peripheral blood cells of DTC patients produce significantly higher concentrations of Th2/Th9 cytokines (IL-5, IL-13 and IL-9) than control subjects. The 131-I therapy led to reduced secretion of Th2 cytokines (IL-4, IL-5 and IL-13). Despite this, the calculated cytokine ratios (Th1/Th2) in DTC patients before and 7 days after 131-I therapy were not different from those in healthy subjects. DTC patients have significantly higher concentrations of Th2/Th9 cytokines (IL-5, IL-13 and IL-9) than control subjects. There is no influence of hypothyroidism or stage of disease on cytokine production in DTC patients before 131-I therapy. The radioactive 131-I therapy leads to reduced secretion of Th2 cytokines (IL-4, IL-5 and IL-13). Additional studies are needed to determine the significance of these findings.