Clinical Endocrinology最新文献

{"title":"The Efficacy and Safety of Pembrolizumab in Anaplastic Thyroid Carcinoma: A Systematic Review and Meta-Analysis","authors":"Langyu Xu,&nbsp;Xingxing Dong,&nbsp;Tong Deng,&nbsp;Fang Lu,&nbsp;Weizhen Chen,&nbsp;Gaosong Wu","doi":"10.1111/cen.15291","DOIUrl":"10.1111/cen.15291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In most existing clinical studies, Pembrolizumab combined therapy has shown good efficacy for ATC. However, the results of this therapy in some other studies have been controversial, and there is a lack of relevant evidence. In this study, we conducted a meta-analysis of survival data, tumor responses, and adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The online databases (PubMed, EMBASE, and Cochrane Library) were thoroughly searched to collect eligible studies fully. The data were extracted and combined into the meta-analysis. The main outcomes included objective response rate (ORR), stable disease (SD), disease control rate (DCR), median overall survival (mOS), and adverse events (AEs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>Our meta-analysis included 8 studies. The pooled ORR, SD, and DCR were 46.0%, 20%, and 74%. Pooled mOS was 9.62 months. Most patients went through grades 1 or 2 AEs. The incidence of grade ≥ 3 Ads was significantly lower, rarely exceeding 5%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our meta-analysis showed that Pembrolizumab has potential antitumor implications in ATC and is extremely well tolerated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 3","pages":"281-289"},"PeriodicalIF":2.4,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Update on Reducing Adverse Events Associated With the Glucagon Stimulation Test for the Assessment of Growth Hormone Deficiency in Adults.","authors":"Philippa Trevella, Carmela Caputo, Caroline Jung, Balasubramanian Krishnamurthy, Kylie McLachlan, Nirupa Sachithanandan, Maresa Derbyshire, Richard J MacIsaac, Alice Hong","doi":"10.1111/cen.15292","DOIUrl":"https://doi.org/10.1111/cen.15292","url":null,"abstract":"","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CD105 (Endoglin) Expression as a Prognostic Marker in Aggressive Papillary Thyroid Carcinoma.","authors":"İlker Çordan, Tuğba Günler","doi":"10.1111/cen.15290","DOIUrl":"https://doi.org/10.1111/cen.15290","url":null,"abstract":"<p><strong>Background: </strong>Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy, with a generally favourable prognosis. However, a subset of PTC cases exhibit aggressive behaviour, including lymph node and distant organ metastases. Identifying biomarkers that can differentiate between benign and malignant lesions, as well as predict tumour aggressiveness, is crucial for improving diagnosis and management. CD105 (endoglin), a marker of neoangiogenesis, has shown promise in various solid tumours as a prognostic factor. Its role in PTC, particularly in distinguishing between metastatic and non-metastatic cases, remains underexplored.</p><p><strong>Aims: </strong>To investigate the role of CD105 (endoglin) expression in the differential diagnosis and prognostic evaluation of patients with benign thyroid nodules, non-metastatic PTC, and PTC with lymph node metastasis (LNM).</p><p><strong>Methods: </strong>Thyroid tissues from 148 patients were retrospectively analyzed for CD105 expression, including 49 with thyroid follicular nodular disease (TFND), 48 with PTC without LNM [LNM(-) PTC], and 51 with PTC and LNM [LNM(+) PTC]. Tissues were classified based on CD105 expression, and microvascular density (MVD) scores were calculated using the Weidner method in positive cases. Clinical and pathological features were compared across TFND, LNM(-), and LNM(+) groups.</p><p><strong>Results: </strong>The rates of CD105 expression significantly differed between the TFND, LNM(-) PTC, and LNM(+) PTC groups (8.2%, 64.6%, and 80.4%, respectively). The CD105 MVD score was significantly higher in the LNM(+) PTC, unifocal LNM(+) PTC, and multifocal LNM(+) PTC groups, in favour of metastasis (p < 0.001). CD105 expression was detected in all patients with distant organ metastasis, and these patients also exhibited significantly higher MVD scores (p < 0.001).</p><p><strong>Conclusion: </strong>This study supports the potential use of CD105 expression and its quantitative indicator, the CD105 MVD score, as biomarkers for distinguishing benign thyroid nodules from malignant ones and for evaluating the prognosis of PTC.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genotype–Phenotype Correlation in Germline TSH Receptor Activating Mutation Associated Hyperthyroidism: A Systematic Review","authors":"Chethan Yamichannaiah,&nbsp;Saba Samad Memon,&nbsp;Vijaya Sarathi,&nbsp;Anurag Ranjan Lila,&nbsp;Swati Ramteke Jadhav,&nbsp;Puja Thadani,&nbsp;Samiksha Chandrashekhar Hegishte,&nbsp;Rohit Barnabas,&nbsp;Manjiri Karlekar,&nbsp;Aditya Phadte,&nbsp;Anima Sharma,&nbsp;Tushar Bandgar","doi":"10.1111/cen.15288","DOIUrl":"10.1111/cen.15288","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Germline TSHR activating mutation-associated hyperthyroidism (GTAMH) manifests as sporadic or familial forms. Studies have shown poor correlation between receptor activity and clinical manifestations, highlighting a knowledge gap in understanding genotype–phenotype relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A classification based on age of symptom onset: infantile (<i>n</i> = 36), childhood (<i>n</i> = 33) and adulthood (&gt; 18 years, <i>n</i> = 13) was attempted by performing a systematic review of literature of GTAMH (<i>n</i> = 82 probands, including a 25-year-old woman with TSHR p.Ile640Val variant and subclinical hyperthyroidism managed at our centre). Patients were analysed for various parameters such as demographic, clinical, biochemical and genotype–phenotype correlation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-two probands harbouring 47 different TSHR variants are reported. Probands with infantile-onset were less often familial (19.4%, <i>p</i> = 0.00) than childhood (93.9%) and adult-onset (84.6%) cases. Median serum free-T3 and T4 were highest in infantile (3.1 and 3.4 XULN) followed by childhood (1.6 and 1.9 X-ULN) and adult-onset (1.2 and 0.8 X-ULN) cases. All infant/childhood onset probands had overt hyperthyroidism, whereas 1/3 of adult-onset cases were subclinical. Most (15/18) recurrent variants were exclusive to infantile, childhood or adult-onset disease groups, except for p.Ser505Asn, p.Asp619Gly and p.Asn670Ser. Including data for probands and genetically affected family members, there was a moderate correlation for the age at diagnosis (infancy, childhood or adulthood), among family members (<i>r</i> = 0.40, <i>p</i> = 0.00), and members of multiple families harbouring the same TSHR variants (<i>r</i> = 0.46, <i>p</i> = 0.00).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A phenotypic classification of GTAMH into infantile-onset severe hyperthyroxinemia (mostly due to de novo variants), childhood-onset overt hyperthyroidism or adulthood-onset overt/subclinical hyperthyroidism correlates with the genotype of TSHR variants, may guide patient management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 2","pages":"119-128"},"PeriodicalIF":3.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15288","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining Procalcitonin and Calcitonin for the Diagnosis of Medullary Thyroid Cancer: A Two-Step Approach.","authors":"Cristina Clausi, Simona Censi, Emma Zanin, Giulia Messina, Ilaria Piva, Daniela Basso, Isabella Merante Boschin, Loris Bertazza, Francesca Torresan, Maurizio Iacobone, Fiammetta Battheu, Susi Barollo, Jacopo Maria Arnone, Caterina Mian","doi":"10.1111/cen.15287","DOIUrl":"https://doi.org/10.1111/cen.15287","url":null,"abstract":"<p><strong>Objective: </strong>Calcitonin (CT) represents the most important biochemical marker of medullary thyroid cancer (MTC), but has certain limits. Procalcitonin (ProCT) has been recognized as an alternative or additional marker for MTC. The aim of the study is to evaluate prospectively the role of ProCT combined with CT in the identification of MTC.</p><p><strong>Design: </strong>Patients and measurements: 478 patients undergoing thyroidectomy in Padua between January 2023 and June 2024 were enrolled to investigate ProCT levels in comparison with CT for MTC diagnosis. Serum levels of ProCT and CT were dosed preoperatively.</p><p><strong>Results: </strong>At histological diagnosis, 23/478 (4.8%) patients tested positive for MTC. CT with a cut-off > 10 pg/mL performed as follows: sensitivity 0.91, specificity 0.98, positive predictive value (PPV) 0.7, negative predictive value (NPV) 0.99. CT with a cut-off > 10 pg/mL performed better than ProCT both using the cut-off of 0.04 ng/mL (sensitivity 0.87; specificity 0.96; PPV 0.56; NPV 0.99) and the cut-off of 0.07 ng/mL (sensitivity 0.78; specificity 0.98; PPV 0.72; NPV 0.99). Within the sample of patients with a CT value between 10 and 100 pg/mL, 17/21 (80.9%) patients would have been correctly identified as MTC or non-MTC based on a positive or negative ProCT using the 0.04 ng/mL cut-off.</p><p><strong>Conclusions: </strong>CT is more sensitive than ProCT as a diagnostic marker for MTC. However, a two-step approach using ProCT as a supplementary marker can help to refine the diagnosis avoiding overtreatment, particularly when CT serum levels lie between 10 and 100 pg/mL.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Data Mining in the Establishment of Reference Intervals for Albumin-Adjusted Calcium.","authors":"Esra Paydaş Hataysal, Ferruh Kemal İşman","doi":"10.1111/cen.15289","DOIUrl":"https://doi.org/10.1111/cen.15289","url":null,"abstract":"<p><strong>Background: </strong>Calcium homeostasis is critical for numerous physiological functions, and while total calcium is commonly measured in clinical practice, albumin-adjusted calcium is widely used to account for protein binding, despite concerns about its accuracy and lack of standardized reference intervals. This study aims to establish a reliable reference range for albumin-adjusted calcium using real-world data from a high-volume tertiary care laboratory.</p><p><strong>Methods: </strong>This study analyzed data from 33,159 individuals aged 18-80 years, selected from an initial population of 106,920 patients based on specific biochemical and clinical exclusion criteria. Statistical analysis involved outlier detection, partitioning, and calculation of age-specific reference intervals using the 2.5th and 97.5th percentiles.</p><p><strong>Results: </strong>The study established age-stratified reference intervals for albumin-adjusted calcium (18-49 years: 2.17-2.55 mmol/L; 50-79 years: 2.20-2.61 mmol/L) and total calcium (18-49 years: 2.17-2.56 mmol/L; 50-79 years: 2.17-2.62 mmol/L).</p><p><strong>Conclusions: </strong>Our study reveals that albumin-adjusted calcium reference intervals are age-dependent, with slightly higher upper limits (≈0.05 mmol/L) than traditionally used total calcium ranges, potentially reducing overdiagnosis of hypercalcemia. Further studies are needed to validate these reference intervals across different automated analyzers and diverse patient populations to ensure broader clinical applicability.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyrotrophs in PIT1-lineage Pituitary Neuroendocrine Tumours Without Syndrome of Inappropriate Secretion of Thyrotropin Stimulating Hormone.","authors":"Eri Kasuga, Naoko Inoshita, Noriaki Tanabe, Atsushi Ishida, Masataka Kato, Haruko Yoshimoto, Hideki Shiramizu, Go Matsuoka, Koji Takano, Shozo Yamada, Rimei Nishimura","doi":"10.1111/cen.15283","DOIUrl":"https://doi.org/10.1111/cen.15283","url":null,"abstract":"<p><strong>Objective: </strong>Many patients with pituitary neuroendocrine tumours (PitNETs) containing beta (β) thyroid-stimulating hormone (TSH)-immunopositive cells, without syndrome of inappropriate secretion of TSH (SITSH), show a significant reduction in TSH levels following surgical removal of the tumour-like functioning thyrotroph PitNET. We evaluated the pathophysiological and clinical characteristics of TSH-positive cells in PIT1-lineage PitNETs in patients without the syndrome of inappropriate secretion of TSH.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Patients and mesurements: </strong>Overall, 165 patients diagnosed with PIT1-lineage PitNETs without SITSH between April 2018 and July 2023 at Moriyama Memorial Hospital were reviewed. They were categorised into three groups based on the rate of βTSH-immuno-positive cells in their PitNETs: strongly positive group with 10% or more βTSH-immuno-positive cells, weakly positive group with less than 10%, and negative group. Clinical data from these groups were compared.</p><p><strong>Results: </strong>Patient age, sex, and tumour size did not differ significantly among the groups. Most of the weakly positive cases had acromegaly, whereas many of the strongly positive cases had clinically nonfunctioning tumours. Preoperative TSH levels were slightly higher in strongly positive cases than in the other groups but fell within the normal range postoperatively, whereas postoperative TSH levels were significantly lower across all groups. The degree of TSH reduction postoperatively was significantly higher in the strongly positive group.</p><p><strong>Conclusions: </strong>In the strongly positive group, TSH levels decreased significantly after surgery, whereas no such decrease was observed in the other two groups, suggesting that thyrotrophs in strongly positive PitNETs are TSH-producing, similar to clinically functioning thyrotroph PitNETs.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Adrenal Insufficiency and Adrenal Morphology in Treatment-Naïve Tuberculosis Patients: A Cross-Sectional Study From a High-Burden Region.","authors":"Ajeesh Thulaseedharan, Puthiyaveettil Khadar Jabbar, Sanjeev Nair, Chellamma Jayakumari, Sree Priya Pankajakshan Rema, Darvin Vamadevan Das, Ramesh Gomez, Sankar Sethuraman, Soumya Sarayu, Abilash Nair","doi":"10.1111/cen.15282","DOIUrl":"https://doi.org/10.1111/cen.15282","url":null,"abstract":"<p><strong>Background and objectives: </strong>Adrenal insufficiency (AI) is a recognized complication in tuberculosis (TB), with previous studies reporting a highly variable prevalence (0%-76%), primarily during or after antitubercular treatment (ATT). However, data on AI prevalence in treatment-naïve TB patients remains scarce. This study aimed to determine the prevalence of AI and adrenal gland morphology in adult patients with newly diagnosed, treatment-naïve TB.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 100 treatment-naïve adult TB patients attending the Revised National Tuberculosis Control Program (RNTCP) clinic at Government Medical College Hospital, Thiruvananthapuram, and Chest Disease Hospital, Pulayanarkotta. Patients with HIV, uncontrolled diabetes, critical illness, or recent steroid use were excluded. Due to the COVID-19 pandemic, patient attendance was limited. Clinical features suggestive of AI were assessed based on symptoms and laboratory findings, including hyponatremia and hyperkalemia. An ACTH stimulation test was performed using 0.5 mL (30 units) of long-acting porcine ACTH (Acton Prolongatum) intramuscularly. Serum cortisol levels were measured at 60 and 120 min after administration. AI was defined as a peak cortisol level below 17 μg/dL at 60 min and below 19.5 μg/dL at 120 min. Contrast-enhanced CT (CECT) Abdomen or Thorax images were analyzed for adrenal morphology in one AI-diagnosed TB patient and a subset of 14 TB patients without AI, and 18 age-matched healthy controls without TB or chronic lung pathology.</p><p><strong>Results: </strong>Among 100 patients (88% pulmonary TB [PTB], 12% extrapulmonary TB[EPTB]) with a mean age of 50 ± 15.4 years and a male-to-female ratio of 3.1:1, 27 patients (27%) exhibited clinical features suggestive of AI. The mean peak serum cortisol levels were 35.17 ± 10.77 μg/dL at 60 min and 39.67 ± 10.84 μg/dL at 120 min. AI was diagnosed in one patient with EPTB (1%), while none of the patients with PTB had AI. CT analysis revealed significantly reduced right adrenal Hounsfield unit (HU) density (p = 0.02) and lateral limb thickness (p = 0.01) in TB patients versus controls, despite absent adrenal enlargement.</p><p><strong>Conclusion: </strong>AI is rare (1%) in treatment-naïve TB patients despite the overlapping clinical features in a significant proportion. Subtle adrenal morphological changes without enlargement suggest early TB-related alterations without overt dysfunction. Future research should prioritize larger TB cohorts including Extrapulmonary TB to enhance detection of adrenal pathology while minimizing radiation exposure with detailed immune assessments.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ramadan Fasting Improves Health-Related Quality of Life in Patients With Secondary Adrenal Insufficiency: A Prospective Interventional Case-Control Study.","authors":"Mariam Mabrouk, Melika Chihaoui, Jameleddine Sta, Chayma Belhadj Slimane, Ibtissem Oueslati, Meriem Yazidi, Fatma Chaker","doi":"10.1111/cen.15286","DOIUrl":"https://doi.org/10.1111/cen.15286","url":null,"abstract":"<p><strong>Introduction: </strong>Intermittent fasting (IF) exposes patients with adrenal insufficiency (AI) to complications related to undertreatment. We aimed to determine the effect of IF during Ramadan on the quality of life of patients with secondary adrenal insufficiency (SAI) compared to healthy controls.</p><p><strong>Subjects and methods: </strong>It is a prospective case-control study conducted at the Department of Endocrinology of La Rabta University Hospital in Tunisia. Fifty patients with SAI and 100 age-, sex- and body mass index-matched controls were enrolled and followed up throughout Ramadan 2023. All participants answered the Addison's disease quality of life questionnaire (AddiQoL) before Ramadan and during the third week of fasting.</p><p><strong>Results: </strong>There were 33 women and 17 men, median age: 43 years (IQR: 34-55), median duration of SAI: 7.5 years (IQR: 4-12.5), treated with hydrocortisone at a median dose of 0.24 mg/kg/day (IQR: 0.20-0.27). Before Ramadan, there was no significant difference between patients and controls in the global AddiQoL score, fatigue score, and emotional sphere score (89 vs. 93, p = 0.196; 24 vs. 24, p = 0.354, and 24 vs. 25, p = 0.536, respectively). The score of AI symptoms was altered in patients (27 vs. 30, p = 0.021). During fasting, the global AddiQoL score (8.2% vs. 0%, p = 0.005), the fatigue score (8% vs. -1.7%, p = 0.003), the emotional sphere score (4.2% vs. 0%, p = 0.009), and the AI symptoms' score (9.1% vs. 0%, p = 0.017) improved in patients compared to controls.</p><p><strong>Conclusion: </strong>Ramadan fasting improved the quality of life in SAI patients by reducing fatigue, emotional stress, and AI symptoms.</p><p><strong>Trial registration: </strong>Registered on 'ClinicalTrials.gov' under the identifier ID: NCT05827965.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignancy Risk of Paediatric Thyroid Nodules Classified According to the Bethesda System.","authors":"Katia Averbukh-Oren, Sabri El-Saied, Roy Hod, Amit Ritter, Ben-Zion Joshua, Liran Stiler-Timor, Hagit Shoffel-Havakuk, Liora Lazar, Gideon Bachar","doi":"10.1111/cen.15280","DOIUrl":"https://doi.org/10.1111/cen.15280","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid nodules are less common in children than in adults; however, when diagnosed, they carry a greater risk of malignancy. The Bethesda System for Reporting Thyroid Cytopathology uses six cytological categories to predict thyroid nodule malignancy using fine-needle aspiration. This study aimed to estimate the malignant potential of thyroid nodules in children using the Bethesda system.</p><p><strong>Methods: </strong>We conducted a retrospective study of 121 patients aged ≤ 19 years who underwent thyroid surgery following fine-needle aspiration (FNA) of a suspicious nodule between 2001 and 2019 at two tertiary medical centres. All FNA specimens were evaluated and categorised according to the Bethesda classification system. The prevalence of malignancy for each cytological category was calculated and subsequently compared with the findings of the final pathology.</p><p><strong>Results: </strong>The mean age at the time of operation was 14.8 years, and 79.5% of the patients were female. The mean nodule size was 24.8 mm. The distribution of nodules across Bethesda cytological categories, from B1 to B6, was as follows: 2, 50, 19, 17, 10, 23 nodules. An analysis of the final pathology reports revealed 66 malignant nodules (54.5%). The malignancy risk was 24% for nodules categorised as B2, 52.6% for nodules categorised as B3, 58.8% for nodules categorised as B4, and 100% each for nodules categorised as B5-B6.</p><p><strong>Conclusions: </strong>Our findings indicate that the malignancy rates for all categories of the Bethesda system were higher in paediatric patients than in adults, including a substantial proportion of cytologically benign nodules. Moreover, our observed rates exceeded those previously reported in comparable studies of the paediatric population, as indicated by the American Thyroid Association guidelines. We propose a more intensive approach for paediatric patients with suspected clinical or sonographic features.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}