Personality traits in acromegalic patients: Comparison with patients with non-functioning adenomas and healthy controls.

OBJECTIVES: Pituitary diseases may cause psychiatric and personality alterations. We aimed to compare the personality traits of acromegalic patients with those of patients with non-functioning pituitary adenomas and a healthy control group. DESIGN: Fifty-eight acromegalic patients, 45 patients with non-functioning adenoma, and 40 healthy subjects were enrolled in the study. Cloninger's Temperament and Character Inventory (TCI), Beck Depression Inventory, Beck Anxiety Inventory, and Rosenberg Self-Esteem Scale (RSES) were used to assess personality, depression, anxiety, and self-esteem. RESULTS: Depression score was higher in acromegaly and non-functioning adenoma groups than healthy controls. RSES scores were similar among the three groups. Regarding the scales of TCI, only novelty-seeking was significantly reduced in acromegaly and non-functioning adenoma than the control group. Pairwise comparisons revealed that the difference was due to the difference between acromegalic patients and controls. Scales of TCI were correlated with depression and anxiety in patients with acromegaly and non-functioning adenoma but not in healthy controls. CONCLUSION: This study showed that novelty-seeking was reduced in patients with acromegaly. Both the hormonal lack and excess and structural changes can lead to cognitive and personality changes in acromegaly. More studies are needed to be carried out about personality characteristics in pituitary diseases.

Presence of thyroid-associated ophthalmopathy in Hashimoto's thyroiditis.

AIM: To determine the prevalence of ophthalmopathy in Hashimoto's patients and to make a comparison in subgroups of patients. METHODS: The study involved 110 Hashimoto's thyroiditis patients and 50 control subjects attending to the endocrinology department of the hospital. Subgroup classification of patients was made as euthyroid, subclinic and clinic in Hashimato's thyroiditis. All patients were evaluated by a single experienced ophthalmologist for the prevalence and characteristics of eye signs. RESULTS: The overall prevalences of eye changes were 22.7% (25 patients) in patients and 4% (2 persons) in control subjects respectively (P=0.002). In patients the most common symptom was retrobulbar eye pain with or without any eye movement. Thirteen patients had significant upper eyelid retraction (11.8%). Six patients had eye muscle dysfunction as reduced eye movements in up gaze. In control patients one person had proptosis and another had lid retraction. The clinical activity score and classification of the ophthalmopathy did not show any significant differences among subgroups. CONCLUSION: The eye signs were mostly mild (22.7%) and the most common eye sign was the presence of upper eyelid retraction (11.8%). Additionally six patients had eye muscle dysfunction as reduced eye movements in up gaze. Therefore we recommend to make a routine ophthalmic examination in Hashimoto's thyroiditis patients in order not to omit the associated ophthalmopathy.

VEGF and GM-CSF levels in nodular thyroid diseases.

VEGF is a specific mitogen for endothelial cells. GM-CSF is a key player in the regulation of steady-state functions. The aim of this study was to evaluate VEGF and GM-CSF levels in thyroid nodules >1 cm, which are negative for malignancy with fine needle aspiration biopsy. Age, serum VEGF, GM-CSF, TSH, fT3, fT4, anti-TG, anti-TPO, thyroid size, and thyroid volume were compared between 41 female patients and 20 healthy female volunteers. This study was performed with 41 female patients who were euthyroid and whose nodules were benign. Twenty healthy female volunteers were enrolled as the control group. VEGF and GM-CSF were assayed by ELISA; TSH, fT3, and fT4 were detected by electrochemiluminescence method and anti-TPO and anti-TG were detected by competitive immunoassay method. Only thyroid volume and anti-TG levels were significantly different between the two groups (p < 0.007 and p < 0.026, respectively). Other parameters including VEGF and GM-CSF were not significantly different. VEGF has a weak positive correlation only with anti-TPO levels in the patient group (r = 0.325, p = 0.036). There was a weak positive correlation between anti-TPO and anti-TG (r = 0.388, p = 0.007). There was a positive correlation between nodule size and thyroid volume (r = 0.464, p = 0.015). GM-CSF was not correlated with any parameters. VEGF and GM-CSF were not found to be increased in euthyroid patients with benign nodules and they do not seem to play a role in development of simple nodular goiter.

Personality characteristics and body image in obese individuals.

INTRODUCTION: The aim of this study was to determine the personality characteristics of obese and morbidly obese individuals with no psychiatric disorder and the correlation between these characteristics and body image and self-esteem. METHODS: Sixty-nine obese individuals and 69 healthy controls, matched in age, sex and marital status, were included in the study. Psychiatric disorders were excluded for all participants using SCID-I and II. Obese and healthy volunteers were compared in terms of body image, self-esteem and personality characteristics. RESULTS: TCI harm avoidance scores were higher in obese individuals compared to healthy controls. Harm avoidance scores were also higher in individuals with morbid obesity compared to non-morbid individuals, while self-directedness and persistence scores were lower. Body image dissatisfaction was higher in obese individuals. There was a negative correlation in obese individuals between body image and self-esteem scale scores and harm avoidance scores, and a positive correlation with self-directedness scores. DISCUSSION: An elevated harm avoidance temperament characteristic may be correlated with obesity. Furthermore, high harm avoidance, low self-directedness and low persistence may be significant personality characteristics in a process leading to morbid obesity. In addition, harm avoidance temperament and self-directedness personality characteristics may be correlated with body image dissatisfaction and self-esteem in obese individuals.

Presence of Dry Eye in Patients with Hashimoto's Thyroiditis.

Purpose. To evaluate the tear function tests in patients with Hashimoto's thyroiditis and to compare the results with healthy subjects. Methods. A hundred and ten patients with Hashimoto's thyroiditis and 100 healthy subjects were included in this study. The presence of thyroid-associated ophthalmopathy and tear function tests were evaluated clinically. The results were first compared between the patients and the control groups and then compared between patients with NOSPECS and patients without NOSPECS. Logistic regression analyses of the risk factors for dry eye including sex, gender, free plasma thyroxine, proptosis, upper eyelid margin-reflex distance, and duration of the disease were also evaluated. Results. The mean ocular surface disease index score was significantly higher and mean Schirmer and mean tear break-up time scores were significantly lower in patients compared to control subjects. Mean Schirmer and tear break-up time scores were found to be significantly lower in patients with NOSPECS when compared to the patients without NOSPECS. Both proptosis and free plasma thyroxine levels were significantly associated with dry eye. Conclusions. Patients with Hashimoto's thyroiditis tend to develop dry eye more common than healthy subjects. Proptosis and lower free plasma thyroxine levels were found to be risk factors for the presence of dry eye.

Radiation-associated secondary brain tumors after conventional radiotherapy and radiosurgery.

Although there is not enough strong molecular evidence for radiation to be a causal factor for the development of secondary brain tumors, a relationship has still been found. There is a slight but significant 2-2.7% increased risk of secondary brain tumors after conventional radiotherapy. However, this risk is small and should not preclude the use of radiotherapy as an effective treatment for uncontrolled pituitary tumors. The risk of radiosurgery-associated secondary brain tumors has not been precisely determined. Taking into account the considerable number of patients who received radiosurgery worldwide and the small number of secondary brain tumors, radiosurgery seems to be a safe treatment modality. This review summarizes the pathogenesis, prevalence and characteristics of secondary brain tumors after conventional radiotherapy and stereotactic radiosurgery for pituitary adenomas.

Evaluation of body weight, insulin resistance, leptin and adiponectin levels in premenopausal women with hyperprolactinemia.

The effects of hyperprolactinemia on metabolic parameters are not clear and a few data evaluating adiponectin levels in prolactinoma and idiopathic hyperprolactinemia exist. The aim of this study was to evaluate the effects of hyperprolactinemia on body weight, insulin resistance, beta cell function, and leptin and adiponectin levels in premenopausal women with hyperprolactinemia. Forty premenopausal women with prolactinoma or idiopathic hyperprolactinemia were compared to 41 age-matched healthy premenopausal women with regard to body weight, body mass index, waist and hip circumferences, waist to hip ratio, fasting plasma glucose, insulin levels, insulin resistance measured by homeostasis model assessment (HOMA)-insulin resistance index, beta cell function measured by HOMA-ß index, leptin and adiponectin levels. Plasma insulin levels and HOMA indexes (both insulin resistance and beta indexes) were significantly higher in hyperprolactinemic women. The other parameters were similar between both groups. There was a positive correlation between prolactin levels and fasting plasma glucose in hyperprolactinemic women. The results of this study showed that high prolactin levels may be associated with hyperinsulinemia and insulin resistance in premenopausal women. This effect seems to be independent of body weight, leptin and adiponectin levels. High prolactin levels may directly stimulate insulin secretion from pancreas and directly cause hepatic and whole-body insulin resistance.