Metformin appears to reduce TSH levels in untreated hypothyroid patients. In contrast, in euthyroid patients with type 2 diabetes mellitus (T2DM), metformin is initially devoid of effects on TSH. However, it is followed by a significant reduction in TSH level after twelve months of treatment. Additionally, some evidence suggests that metformin may also improve thyroid morphological abnormalities. This study aimed to evaluate the effects of metformin not only on TSH and thyroid hormone values, but also on thyroid volume and nodules. A total of 50 patients (mean age: 36.9 ± 12.8 years) with insulin resistance (homeostatic model assessment (HOMA) index ≥2.5) and with thyroid uninodular disease were recruited for this study. They were prescribed slow-acting metformin at a daily dose of 500 mg for six months. Treatment with metformin in euthyroid patients with uninodular thyroid disease and insulin resistance reduces TSH levels, increases FT4 and FT3 values, and decreases thyroid and nodule volumes. These data suggest that metformin may be an effective drug not only for the treatment of T2DM and metabolic syndrome, but also for thyroid disease.

Several antioxidants are available for the treatment of male infertility. Although the benefit of myo-inositol (MYO) and D-chiro-inositol (DCI) for female infertility is recognized, their role in m...

Background/Objectives: visceral leishmaniasis (VL) remains an important zoonotic disease in endemic Mediterranean regions, where children represent one of the populations at highest risk of developing symptomatic infection. Although pentavalent antimonials have historically been considered first-line therapy for VL, their use in Italy has become increasingly limited because of restricted availability, safety concerns, and the widespread adoption of liposomal amphotericin B (L-AmB). Methods: this multicentre retrospective observational study evaluated the contemporary management of paediatric VL in three tertiary referral centres in Catania, Southern Italy, between January 2016 and December 2025. Results: 19 children were included, with a mean age of 4.13 years. The most common clinical manifestations were prolonged fever, pancytopenia, and hepatosplenomegaly. Three different L-AmB regimens were identified, with the 10 mg/kg/day for two consecutive days schedule representing the most frequently adopted protocol. L-AmB was well tolerated; three patients (15.8%) experienced disease relapse during follow-up, all of whom responded successfully to additional L-AmB treatment, resulting in an overall clinical cure rate of 100%. Notably, no patient received pentavalent antimonials, reflecting their complete replacement in routine clinical practice. Conclusions: these findings provide real-world evidence that L-AmB has effectively become the contemporary first-line treatment and standard of care for paediatric VL in an endemic Mediterranean setting, highlighting the discrepancy between historical therapeutic paradigms and current clinical practice.