Biochemical characteristics and clinical manifestation of normocalcemic primary hyperparathyroidism.

Background: Normocalcemic primary hyperparathyroidism (nPHPT) is a condition characterized by persistently high levels of parathyroid hormone (PTH) and normal serum calcium levels in the absence of other causes for secondary hyperparathyroidism. The aim of the present study was to assess the clinical presentation and the biochemical characteristics in patients with nPHPT and to compare them with those in patients with hypercalcemic PHPT (hPHPT).

Materials And Methods: The study included 316 patients (277 women and 39 men, average age 58.

Evaluation of disease-specific quality of life and its influencing factors in Bulgarian patients with Graves' orbitopathy.

Purpose: Graves' orbitopathy (GO) profoundly affects patients' quality of life (QoL). Our aim was to assess QoL in patients with different forms of GO and to search for predictors of QoL.

Methods: This was a cross-sectional study involving 221 consecutive unselected GO patients (77.

Comparison of the efficacy of two different glucocorticoid regimens for treatment of active moderate-to-severe Graves' orbitopathy.

Purpose: Intravenous glucocorticoids (GCs) are the mainstay of treatment for severe forms of Graves' orbitopathy (GO). Our aim was to assess the effectiveness and safety of a modified monthly regimen (mMR) and to compare them with those of the established weekly regimen (WR).

Methods: This was a prospective non-randomized single-center study involving 62 patients, divided into two therapeutic groups depending on their referral time.

Occupational health assessment summary designed for semantic interoperability.

Background: Geopolitical and economic crises force a growing number of people to leave their countries and search better employment opportunities abroad. Meanwhile, the highly competitive labor market provides opportunities for employees to change workplaces and job positions. Health assessment data collected during the occupational history is an essential resource for developing efficient occupational disease prevention strategies as well as for ensuring the physical and psychological well-being of newly appointed workers.

Changes in therapeutic response, ocular manifestations of Graves' orbitopathy and quality of life during the first year after orbital radiotherapy.

Purpose: The aim of our study was to assess the changes in the therapeutic response, ocular manifestations of GO and quality of life during the first year after OR.

Methods: The study involved 26 consecutive patients with active moderate-to-severe GO indicated for OR, 18 females, mean age 57 ± 12.5.

THYROTROPIN-RECEPTOR ANTIBODIES, IMMUNOGLOBULIN E AND ANTINUCLEAR ANTIBODIES IN PATIENTS WITH GRAVES' DISEASE AND GRAVES' ORBITOPATHY.

Context: Thyrotropin-receptor antibodies (TRAb) are biomarkers of Graves' disease (GD) and Graves' orbitopathy (GO). Elevated immunoglobulin E (IgE) and antinuclear antibodies (ANA) were also found in GD patients.

Objective: We aimed to assess TRAb, IgE and ANA in GD and GO patients and to evaluate the relationship between the immunological markers and smoking.

D-Chiro-Inositol improves testosterone levels in older hypogonadal men with low-normal testosterone: a pilot study.

Background: Several recent journal articles report that D-chiro-inositol (DCI), primarily known as insulin second messenger, influences steroidogenesis. In particular, new evidence is arising on DCI ability to regulate aromatase expression and testosterone biosynthesis. In this regard, DCI administration could represent a good therapeutic opportunity in case of reduced levels of testosterone.

Medication-taking behaviour in Bulgarian women with postmenopausal osteoporosis treated with denosumab or monthly oral bisphosphonates.

Unlabelled: Persistence with osteoporosis therapy is critical for fracture risk reduction. This observational study evaluated medication-taking behaviour of women with postmenopausal osteoporosis receiving denosumab or oral ibandronate in real-world clinical practice in Bulgaria. Compared with ibandronate, densoumab was associated with a lower discontinuation rate and greater increases in bone mineral density.

Autoimmune hypothyroidism is three times more frequent in female prolactinoma patients compared to healthy women: data from a cross-sectional case-control study.

Background: The potent immunomodulatory action of prolactin has been demonstrated in many experimental in vitro studies. In accordance with these data, our retrospective analyses revealed higher prevalence of autoimmune thyroid diseases in prolactinoma patients compared to general population.

Purpose: A cross-sectional case-control study was carried out in a single tertiary referral centre.

Long-term efficacy of ultrasound-guided high-intensity focused ultrasound treatment of breast fibroadenoma.

Background: To assess the long term efficacy and tolerability of one or two ultrasound (US)-guided high-intensity focused ultrasound (HIFU) treatment in patients with breast fibroadenoma (FA).

Methods: Twenty patients with 26 FA were selected for US-guided HIFU. The therapy was performed in one or two sessions.

Baseline Characteristics and Changes in Bone Mineral Density T-Scores of Bulgarian Women with Postmenopausal Osteoporosis Receiving Denosumab in Routine Clinical Practice.

Background: Postmenopausal osteoporosis (PMO) is common among women over 50 years of age and is associated with an increased risk of fracture. Bone-targeted agents, such as denosumab, can reduce fracture risk in patients with PMO.

Objective: The aim was to describe baseline characteristics and changes in bone mineral density (BMD) T-scores among women with PMO receiving denosumab in Bulgaria.

Differences in the prevalence of vitamin D deficiency and hip fractures in nursing home residents and independently living elderly.

Objective: To compare the prevalence of vitamin D deficiency and fracture history in nursing home residents and community-dwelling elderly subjects and to explore the association of vitamin D levels with various characteristics.

Materials And Methods: Sixty-six nursing home residents and 139 community-dwelling elderly subjects participated. Marital status, medical history, medication including vitamin D supplements, smoking, past fractures were assessed.

High prevalence of autoimmune thyroid diseases in patients with prolactinomas: A cross-sectional retrospective study in a single tertiary referral centre.

Background: Prolactin has been shown to exert potent immunomodulatory activities.

Design: Retrospective cross-sectional study examining the prevalence of autoimmune thyroid diseases (AITD) in patients with prolactinomas. The medical files of 462 patients (367 women and 95 men) followed up at a single tertiary referral centre were analyzed.

Changes in the prevalence of diabetes mellitus in bulgaria (2006-2012).

Aim: The aim of this study was to compare two nationwide cross-sectional studies of diabetes prevalence in Bulgaria (2006 and 2012) and to assess its dynamics.

Material And Methods: The two studies included 2396 and 2033 subjects, respectively. The International Diabetes Federation (IDF) diagnostic criteria were applied, and the data were weighed for type of settlement and age.

Benign Solid Thyroid Nodules: US-guided High-Intensity Focused Ultrasound Ablation-Initial Clinical Outcomes.

Purpose: To assess the short-term efficacy and safety of ultrasonographically (US)-guided high-intensity focused ultrasound (HIFU) ablation for treatment of benign solid thyroid nodules.

Materials And Methods: This prospective study was approved by the institutional ethics committee, and written informed consent was acquired. HIFU ablation was performed in one session with US guidance and conscious sedation in 20 euthyroid patients (mean age, 44.

Ultrasound-guided high-intensity focused ultrasound treatment of breast fibroadenoma-a multicenter experience.

Background: The aim of our multicenter study was to assess the clinical outcome and safety of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) in patients with breast fibroadenoma (FA).

Methods: From May 2011 to February 2013, 42 women with 51 FA in one or both breasts were selected for treatment with US-guided HIFU. Eight of 51 FA were treated twice.

The prevalence of the metabolic syndrome increases through the quartiles of thyroid stimulating hormone in a population-based sample of euthyroid subjects.

Objective: The aim of the study was to assess the prevalence and characteristics of metabolic syndrome (MetS) and its elements in relation to TSH in euthyroid subjects.

Materials And Methods: In the cross-sectional study, 2,153 euthyroid adults, 47.2 ± 14.

Age and menopausal status affect osteoprotegerin and osteocalcin levels in women differently, irrespective of thyroid function.

Unlabelled: Osteoprotegerin (OPG) and osteocalcin (OC) are essential bone proteins. Recent studies have demonstrated that they are not secreted solely by bone cells; they play roles in the vascular function and energy metabolism, and they are influenced by multiple factors. The aim of the current study was to investigate the influence of menopause and age on OPG and OC in women with different thyroid-stimulating hormone (TSH) levels.

Winter 25-hydroxyvitamin D levels in young urban adults are affected by smoking, body mass index and educational level.

Background/objectives: To study the relationship of winter 25-hydroxycholecalciferol (25-OHD) levels with age, education, place of residency, marital status and body mass index (BMI) as they may affect sun exposure, vitamin D synthesis and metabolism.

Subjects/methods: Subjects (1952) answered a structured questionnaire concerning education, marital status and smoking; and body weight/height, and parathyroid hormone and 25-OHD were measured.

Results: 25-OHD levels were higher in the males with elementary and secondary education compared with higher education (46.

US-guided high-intensity focused ultrasound as a promising non-invasive method for treatment of primary hyperparathyroidism.

Objectives: To investigate the long-term efficacy and safety of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) treatment in patients with primary hyperparathyroidism (PHPT).

Methods: In our prospective study, 13 of 72 screened patients with PHPT were eligible for HIFU treatment, which was performed in one or two sessions. Parathyroid adenoma size and function were evaluated at baseline, 1, 3, 6, 9, and 12 months after the final HIFU session.

Male gender differences in the thyroid ultrasound features, thyroid peroxidase antibodies and thyroid hormone levels: a large population-based study.

Unlabelled: Anti-thyroid antibodies and thyroid ultrasound (US) are currently the methods for diagnosing autoimmune thyroid disease. Few data exist on their utility in males. The aim of the study was to investigate the gender-specific relationship between the Anti-TPO levels, thyroid ultrasound features, and thyroid function in a population with no known thyroid disorder.

Vitamin D status in Bulgaria--winter data.

Unlabelled: We assume that 25(OH)D level >50 nmol/l is necessary for adequate parathyroid hormone (PTH) suppression in our population. The epidemiology of vitamin D status in Bulgarian population shows deficiency in 21.3 %, insufficiency in 54.

Assessment of HbA1c as a diagnostic tool in diabetes and prediabetes.

To evaluate HbA1c as a diagnostic tool in prediabetes-impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), and newly detected diabetes (NDD), defined by plasma glucose and OGTT. 2,231 subjects, of mean age 50.3 ± 13.