Our data indicate that weight loss causes bone loss. The bone loss is independent of the method of weight reduction. However, the mechanism of the bone loss is not clear. It may be explained partly by reduced estradiol levels in female patients. Because the mechanisms of bone disease after weight loss remain unclear, it is difficult to determine the most effective treatment. It is important to detect osteopenia early, before fractures occur. Measuring BMD appears to be the only reliable method for screening.

The aims of the study were to identify medullary thyroid cancer (MTC) in its earliest stages by screening patients with basal calcitonin measurements and to determine whether basal serum calcitonin measurements should be a part of the routine evaluation of a nodular goiter. Basal serum calcitonin levels were obtained from 75 patients (female:male 57:18, mean age 42.8 years, range with 18-76 years) with nonnodular thyroid disease as controls. Their mean basal calcitonin level was 7.8+/-0.4 pg/mL with a range of 5-27 pg/mL. Seven hundred seventy-three patients with nodular goiter were included in the study (female:male 586:187) with the mean age of 46.1 years (range 17-78). Four patients had elevated basal serum calcitonin levels ranging between 150-1000 pg/mL. These 4 patients underwent surgery. MTC was confirmed by histopathology in all 4. One patient's mother and brother were also diagnosed as MTC as a result of family screening. Basal serum calcitonin levels were higher than 150 pg/mL in these patients. Fine needle aspiration biopsy (FNAB) of 2 of 4 MTC patients were incorrectly diagnosed as papillary carcinoma; another had malignant cytology and the fourth had benign cytology. None were diagnosed as MTC on the basis of FNAB. In conclusion, calcitonin measurement is an effective method for the diagnosis of MTC. Measurement of basal calcitonin levels in patients with malignant or suspicious FNAB may be a cost-effective approach to screen for MTC. High basal serum calcitonin levels increase the chance of curative therapy by diagnosing MTC in the early stages. It is superior to FNAB for diagnosis of MTC.

With the exception of ESR, demographic, clinical, laboratory, and imaging findings and prognoses of our patients were comparable to the previous reports.

We investigated the demographic and clinical features of patients with Hashimoto's thyroiditis who had been diagnosed and treated in Ege University, the main referral center in the Aegean region of Turkey. Medical records of patients who had been followed in the endocrinology clinic of Ege University were retrospectively evaluated. Patients who had been diagnosed as having any thyroid disorder were determined. Patients with Hashimoto's thyroiditis were selected among those patients. Seven hundred and sixty-nine patients fulfilled diagnostic criteria for Hashimoto's thyroiditis (725 females, 44 males; mean age 41.76 ± 12.49 years). 62.7% of patients were between 30 and 50 years of age. 53.3% of females and 63.6% of males had diffuse enlargement of the thyroid gland. TSH level was above 4.0 IU/l in 25.6% of females and 27.4% of males. Anti-tyroglobulin antibody was positive in 92% of females and 93.2 % of males. Anti-thyroid peroxidase antibody was positive in 98.4 % of females (713 patients) and 100% of males. Thyroid ultrasonography demonstrated single nodule in 52.2% and multiple nodules in 11.3% of female patients; and single nodule 32% and multiple nodules in 20% of male patients. Fine-needle aspirations of the nodules were performed in 207 patients, and none of those biopsies was diagnosed as malignant. Women with suspicious biopsis were operated. After surgery, we found that, 2% (n = 4) of patients with FNAC diagnosis of suspicious biopsies were papillary carcinoma and the other patients (3% (n = 6)) were lymphocytic thyroiditis. Age and sex distribution and laboratory findings of our patients were comparable to the previous reports. Nodule formation was the most common ultrasonographic finding in our patients, probably due to pseudonodularity. We found four women patients with thyroid cancer in our population.

There is an increased incidence of thyroid nodules and cancer. In this article, the reasons for this increase are evaluated and discussed. The factors causing increases in the incidence of nodules are the same as those causing increases in thyroid cancer. There are publications from all over the world regarding the rising incidence of thyroid cancer; it is especially associated with papillary cancer. The literature was reviewed and evaluated with regard to this significant phenomenon. Thyroid-stimulating hormone (TSH) is the main mitotic factor. Any agent that elevates TSH will stimulate nodule formation. Therefore, the incidence of thyroid nodules is high in endemic goiter regions due to iodine deficiency. This paper has described many of the factors causing this higher incidence. Of note, metabolic syndrome and insulin resistance are important factors associated with the increased incidence of nodular goiter and papillary thyroid cancer today. However, these data must be confirmed by other studies in the future.