Introduction and objective: Insulin resistance is a state of reduced tissue sensitivity to insulin action despite normal or elevated serum insulin levels. Liraglutide (a GLP-1 receptor agonist) stimulates insulin secretion from the pancreas while decreasing excessive glucagon release. GLP-1...

Background: Coronavirus disease 2019 (COVID-19) has been associated with thyroid dysfunction; however, evidence from primary care settings remains limited. Given that most patients with COVID-19 are managed outside hospital settings, understanding thyroid function changes in real-world primary care is clinically relevant. Methods: This retrospective study included 373 adult outpatients with confirmed COVID-19 and no prior thyroid disease, who were managed in a Family Medicine Clinic in Warsaw between January of 2022 and December of 2024. Thyroid function tests (yielding TSH, fT3, and fT4 levels) obtained within three months before and after infection were analyzed. Subacute thyroiditis (SAT) was assessed in symptomatic patients via thyroid ultrasound. Paired comparisons were performed, with p < 0.05 considered statistically significant. Results: A significant reduction in the mean TSH level was observed following COVID-19 compared with pre-infection values (mean 2.39 vs. 2.17 mIU/L; p < 0.05), while fT3 (2.93 vs. 2.98 pg/mL) and fT4 (1.31 vs. 1.30 ng/dL) concentrations remained unchanged. No significant associations were found between thyroid function changes and age or sex. Conclusions: In this real-world primary care population, lower TSH concentrations were observed following COVID-19 while peripheral thyroid hormone levels remained unchanged, suggesting predominantly modest changes in thyroid function parameters. Given the retrospective study design and the absence of a control group, these findings should be interpreted with caution. Further prospective studies are needed to clarify the clinical significance of post-COVID-19 thyroid function changes.

Background: Thyroid cancer (TC) is the most common endocrine malignancy, with a steadily increasing incidence observed worldwide. However, temporal trends and demographic patterns may vary across populations. Objectives: To assess hospital-based incidence rates, demographic characteristics, and selected epidemiological patterns of TC in Poland between January 2012 and December 2024. Material and Methods: This population-based, retrospective study utilized hospitalization records of TC patients in Poland obtained from the Nationwide General Hospital Morbidity Study. Only first-time hospitalizations in the study period with reported primary or secondary diagnoses of TC were included in the study. Results: The study cohort included 60,604 patients, and the mean annual hospital-based incidence rate was 12.2 per 100,000 inhabitants (95% CI: 11.0–13.4). The hospital-based incidence rate decreased from 15.2 in 2012 to 9.8 per 100,000 in 2020, followed by a marked increase, peaking to 16.6 per 100,000 in 2024. Women constituted 82.2% of cases, indicating a strong sex-related disparity. The mean age at diagnosis was 51.1 years (SD: 15.9). The mean age at diagnosis was 51.1 years (SD: 15.9), and a greater proportion of hospitalized thyroid cancer patients were urban than rural residents (67.4% vs. 32.6%). Marked regional variation was observed, with the highest rates recorded in selected northern and central voivodeships. Conclusions: TC hospitalization hospital-based incidence rates in Poland showed significant temporal variability, with the lowest rate in 2020, which may reflect disruptions in healthcare access during the COVID-19 pandemic and a possible diagnostic catch-up effect in subsequent years. Regional disparities may suggest the potential influence of environmental, socioeconomic, or healthcare-related factors.

Background: Thyroid cancer (TC) is the most common endocrine malignancy worldwide. Although the burden of thyroid-related disorders accompanying TC has been extensively studied, less is known about the overall pattern of multimorbidity present at the time of diagnosis. The aim of this study was to characterize hospital-recorded comorbidities among patients during their first hospitalization associated with thyroid cancer in Poland and to evaluate temporal changes in these patterns between 2012 and 2024. Methods: This nationwide retrospective cohort study included 60,604 patients with a first thyroid-cancer-associated hospitalization recorded in Poland between 2012 and 2024 using data from the Nationwide General Hospital Morbidity Study. The study included all first hospitalizations with ICD-10 code C73 recorded in the database during the study period. Diagnoses accompanying thyroid cancer were classified according to ICD-10 chapters and analyzed descriptively. For the purposes of this study, incident cases were operationally defined as patients with a first hospitalization associated with ICD-10 code C73 recorded in the database during the study period. Temporal trends in age and major comorbidity groups were assessed using linear regression models. Results: A total of 60,604 patients with a first recorded hospitalization associated with TC were identified, including 49,794 women (82.2%) and 10,810 men (17.8%). The mean age at diagnosis was 51.1 ± 15.9 years. Endocrine, nutritional, and metabolic disorders constituted the most common comorbidity group, affecting 20,792 patients (34.3%), followed by cardiovascular diseases (13.6%) and neoplasms other than TC (5.0%). Hypothyroidism was the most frequent endocrine disorder, occurring in 11.5% of patients. During the study period, the mean age at diagnosis decreased from 53.7 years to 49.8 years (p < 0.001). A marked temporal decline in the prevalence of recorded comorbidities was observed during the study period, with endocrine/metabolic disorders decreasing from 52.0% to 25.3% and cardiovascular diseases from 19.9% to 7.7% (both p < 0.001). Additional malignancies most commonly involved the breast, lung, kidney and ovary. Conclusions: Patients with first thyroid-cancer-associated hospitalization recorded in the database frequently present with concomitant endocrine, cardiovascular, and oncological disorders. Over the study period, a substantial decline in the prevalence of recorded comorbidities was accompanied by a reduction in age at diagnosis, suggesting changes in the characteristics of patients recorded during thyroid-cancer-associated hospitalizations over time. These findings may have implications for healthcare planning and survivorship care by highlighting the evolving clinical profile of patients undergoing thyroid-cancer-associated hospitalization.

Background/Objective: Ultrasound is the first-line imaging modality for thyroid nodule assessment; however, it remains highly operator-dependent and subject to interobserver variability. Artificial intelligence (AI)-based systems have been proposed to improve reproducibility, yet evidence regarding their agreement with clinician assessment—particularly at the level of individual sonographic features—remains limited. Importantly, most available studies evaluate concordance rather than true diagnostic accuracy against an independent reference standard. To evaluate agreement between an AI-based ultrasound system and expert clinician assessment in thyroid nodule evaluation, focusing on concordance of size measurements, agreement in sonographic feature classification, and exploratory diagnostic performance relative to cytological outcomes. Methods: This retrospective single-center study included 74 thyroid nodules from adult patients undergoing routine ultrasound examination. Archived ultrasound images were independently assessed by an experienced clinician and an AI-based system. Agreement for quantitative measurements was evaluated using Bland–Altman analysis, while categorical features were assessed using percent agreement and Cohen’s kappa coefficients. Calibration was examined using scatter plots with the line of identity. Cytological results, when available, were used as a non-uniform exploratory reference standard for diagnostic analyses. Exploratory diagnostic performance was assessed using receiver operating characteristic (ROC) curves and area under the curve (AUROC) estimates. Given the study design, analyses primarily reflect agreement and measurement concordance rather than true diagnostic accuracy. Results: AI-derived and clinician measurements demonstrated strong agreement across all dimensions, with minimal systematic bias and stable calibration patterns. A small but consistent underestimation of one measurement axis by approximately 1 mm was observed. For categorical features, agreement ranged from fair to moderate (κ = 0.196–0.368), with the highest concordance for echogenic foci and lowest for echogenicity. Exploratory analyses showed variable diagnostic discrimination, with the best performance observed for size measurements and selected sonographic features. Conclusions: AI-based ultrasound analysis demonstrates robust agreement with clinician assessment for quantitative thyroid nodule measurements, while agreement for categorical feature classification remains moderate and variable. The findings highlight that the present study evaluates concordance rather than definitive diagnostic accuracy, particularly given the lack of a uniform independent reference standard. These results support the role of AI as an assistive tool in thyroid ultrasound practice, improving measurement reproducibility while requiring ongoing clinician oversight for qualitative interpretation.

Hashimoto’s thyroiditis (HT) is a chronic autoimmune thyroid disease in which natural product-derived compounds may influence both immune-mediated injury and thyroid-specific physiology. This critical narrative review integrated molecular, cellular, animal, and human evidence using a dual-axis framework: H1, covering anti-inflammatory, immunomodulatory, antioxidant, and cytoprotective effects; and H2, covering direct effects on thyroid peroxidase, sodium–iodide symporter activity, thyroglobulin, thyroid-specific gene expression, and hormone synthesis. PubMed/MEDLINE, Scopus, and Web of Science searches identified 687 records; after deduplication, 356 unique publications were screened and 79 were retained for final synthesis. Human evidence was limited to three independent HT trials evaluating curcumin, Nigella sativa, and genistein. These studies reported preliminary immunological and/or biochemical thyroid-function signals, including changes in thyroid autoantibodies, inflammatory markers, TSH, or thyroid hormones. Reductions in TPOAb or TgAb are surrogate immunological outcomes and should not be interpreted as evidence of disease modification. None of the available trials established preservation of thyroid functional reserve, prevention or delay of hypothyroidism, reduced levothyroxine requirements, or improvement in patient-important outcomes. Preclinical studies supported biological plausibility but also identified direct thyroid modulation whose clinical relevance depends on exposure and context. Natural products should currently be regarded as investigational adjuncts rather than established disease-modifying therapies.