Miscellaneous
	Thyroid associated ophthalmopathy (TAO) Terwee et al., Amsterdam, The Netherlands, assessed the test-retest reliability of the GO-QOL which is a disease-specific quality of life questionnaire for patients with TAO. The GO-QOL is a short, self-administered questionnaire, including aspects of visual functioning and psychological consequences of TAO, indicated by TAO patients as being important. In the study 89 consecutive patients (mean age 50 yrs, 66 women) with varying degrees of TAO were included. The questionnaire was repeated after 2 weeks. Validity of the questionnaire was assessed by correlating the results with two generic quality of life questionnaires and the questionnaire was subdivided in two subscales, one related to visual functioning and the other to appearance. Mean scores for visual functioning was 64.3 and for appearance 61.1, indicating that patients were on average impaired on two thirds of all items. The results also indicated that the test-retest reliability was good. The authors conclude that the self- administered questionnaire is a promising tool for self-assessment of visual and psychosocial consequences of patients with TAO. (Comment: This questionnaire is also important in evaluation of treatment results of TAO.) T4 treatment and the heart Pigliaru et al., Cagliari, Italy, assessed cardiac function by echocardiographic, ergometabolic, and clinical (Symptom Rating Scale-Klein) criteria in 19 patients receiving long term L-T4 at a fixed TSH-suppressive daily dose of 1.5-1.8 µg/kg, such that serum TSH was below 0.02 µU/ml. FT3 levels in these subjects were between 2.0-3.7 pg/ml (normal range 2.8-5.6 pg/ml). Results were compared to healthy controls matched for age and sex. Interventricular septal thickness, left ventricular posterior wall diastolic thickness, left ventricular end-diastolic dimension, left ventricular mass index, were all increased in T4 treated subjects versus controls, whereas maximal oxygen consumption per kg bodyweight and an aerobic threshold were significantly decreased in T4 treated subjects. In 4 subjects the T4 dose was reduced to a minimal TSH-suppressive amount and echocardiographic data were accumulated 6 months later. It appeared that the abnormal findings were diminished or had disappeared. (Comment: There is still controversy in the literature with regard to cardiac effects of TSH-suppressive doses of T4. This study suggests that, if T4 is titrated to a minimal TSH-suppressive dose, cardiac effects are less or even absent. The results of this study, however, are preliminary in that only 4 patients were tested being on the titrated T4 dose.) Chernobyl accident Vermiglio et al., Messina, Italy and Tula, Russia, measured serum antibodies against thyroglobulin (TgAb) and to thyroperoxidase (TPOAb), FT3, FT4, and TSH levels in children and adolescents from a moderately iodine deficient area, exposed to a moderate dose of radioactivity by the Chernobyl accident (1.5 Ci/km2 of Caesium), n = 143, and in a group living in the same iodine deficient area without radioactive exposure, n = 40. Goiter prevalence was the same in both groups, 42 vs 45% respectively. Also FT3, FT4, and TSH levels or prevalence of hypothyroidism (13.9 vs 12.5% respectively) were not different. However, a 4- fold increase in prevalence of one or both antibodies was present in the exposed group as compared to the non-exposed group: 19.5 vs 5% respectively. (Comment: This report confirms others that also show increased thyroid autoimmunity in subjects in contaminated areas by the Chernobyl accident.)