Thyroid fine needle aspiration reporting rates and outcomes before and after Bethesda implementation: A single-center experience over 8 years

Aimː To evaluate data from our hospital system before and after the implementation of the Bethesda System for Reporting Thyroid Cytology (TBSRTC) and comparison of our data with the previously published studies. Methods: Seven hundred seventy-one patients with thyroid nodules who underwent fine needle aspiration biopsy (FNAB) and surgery at our institution were analyzed retrospectively. FNAB results were divided into two parts in terms of the period they related to: pre-TBSRTC (between 2005 and 2010) and TBSRTC (between 2011 and 2013). Results: 341 FNAB were applied in the period of TBSRTC. Of the 341 FNAB, 53(16%) were non diagnostic, 82(24%) were benign, 62(18%) were atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS), 28(8%) were follicular neoplasms and/or suspicion of follicular neoplasms (FN/SFN), 95(28%) were suspicion for malignancy (SuspM), and 21(6%) were malignant. Rates of malignancy reported on follow-up histopathological examination were non diagnostic in 11%, benign in 4.9%, AUS/FLUS in 23%, FN/SFN in 32%, SuspM in 44%, and malignant in 95.3%. Conclusions: In this study, the distribution of cases in TBSRTC categories and malignancy rates, differed from, recommended by TBSRTC and some studies. Implementation of TBSRTC did significantly affect our institution’s reporting rates

Pituitary hypoplasia and growth hormone deficiency in a woman with glycogen storage disease type Ia: a case report

<p>Abstract</p> <p>Introduction</p> <p>Growth retardation is one of the cardinal manifestations of glycogen storage disease type Ia. It is unclear which component of the growth hormone and/or insulin-like growth factor axis is primarily disrupted, and management of growth impairment in these patients remains controversial. Here we report the first case in the literature where glycogen storage disease type Ia is associated with pituitary hypoplasia and growth hormone deficiency.</p> <p>Case presentation</p> <p>A 20-year-old woman with glycogen storage disease type Ia was admitted to our endocrinology department because of growth retardation. Basal and overnight growth hormone sampling at 2-hour intervals demonstrated low levels; however, provocative testing revealed a relatively normal growth hormone response. A hypoplastic anterior pituitary with preserved growth hormone response to provocative testing suggested the possibility of growth hormone neurosecretory dysfunction and/or primary pituitary involvement.</p> <p>Conclusion</p> <p>Pituitary hypoplasia may result from growth hormone-releasing hormone deficiency, a condition generally known as growth hormone neurosecretory dysfunction. It is an abnormality with a spontaneous and pulsatile secretion pattern, characterized by short stature, growth retardation and normal serum growth hormone response to provocative testing. However, in the case described in this report, a normal although relatively low growth hormone response during insulin tolerance testing and pituitary hypoplasia suggested that primary pituitary involvement or growth hormone neurosecretory dysfunction may occur in glycogen storage disease type Ia. This is a potential cause of growth failure associated with a lower somatotroph mass, and may explain the variable responsiveness to growth hormone replacement therapy in people with glycogen storage disease.</p

The effects of zoledronic acid treatment on depression and quality of life in women with postmenopausal osteoporosis: A clinical trial study

Background: Osteoporosis affects quality of life (QoL) and may lead to depression in women. he purpose of this study was to evaluate the effects of zoledronic acid (ZA) treatment on depression and QoL in women with postmenopausal osteoporosis (PO). Materials and Methods: A total of 88 newly diagnosed women with PO were included in this study. All patients were treated with once-yearly ZA (5 mg). A QoL questionnaire from the European Foundation for Osteoporosis and Beck Depression Inventory were given to patients at baseline and at 12 months. he results for baseline and post - 12th month were compared, and bone mineral density (BMD) levels were compared. Results: he consumption of once-yearly ZA (5 mg) treatment increases BMD at levels of lumbers 1-4 (P = 0.026), total Hip T score's P value is same as femoral neck (P: 0,033). ZA 5 mg treatment also improved QoL (P = 0.001) and reduced depression (P = 0.001). Conclusion: ZA treatment increases BMD levels and QoL while reducing depression. Once-yearly ZA (5 mg) may be considered for postmenopausal women as a first-line treatment

Efficiency of inferior petrosal sinus sampling in the diagnosis of Cushing's disease and comparison with magnetic resonance imaging

WOS: 000460612600009PubMed: 31180374OBJECTIVE: The purpose of this study is to assess the efficiency of inferior petrosal sinus sampling (IPSS) in the diagnosis of adrenocorticotropic hormone-dependent Cushing's disease and to compare it with magnetic resonance imaging (MRI). METHODS: The diagnostic efficiency of IPSS in the differentiation of pituitary Cushing's disease from ectopic Cushing's disease was retrospectively evaluated in 37 patients who had IPSS in our clinic. Six patients were excluded from the study due to missing data. Hypophysis MRI examinations of 31 patients before IPSS were also evaluated. The contributions of MRI and IPSS to the detection of pituitary adenoma and the determination of lateralization were researched. RESULTS: Bilateral IPSS was successfully performed in 30 patients of the 31 patients in the study group. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of IPSS in differentiating between central and ectopic Cushing's syndrome before corticotrophin-releasing hormone (CRH) stimulation were 93.3%, 100%, 100%, 33.3%, and 93%, respectively, whereas after CRH stimulation were 100%, 100%, 100%, 100%, and 100%, respectively. The accuracy of both the rates was significantly higher compared with MRI. CONCLUSION: IPSS has the highest diagnostic efficiency in differentiating central Cushing's disease from ectopic Cushing's disease

Predictive value of hemogram parameters in malignant transformation of the endometrium in patients with different risk factors

Objectives To investigate whether the pretreatment hemogram parameters and their ratios can be used in predicting the endometrial transformation in patients with abnormal uterine bleeding. Material and methods Records of all patients who underwent an endometrial histopathological evaluation between 2011 and 2021 were investigated. Hemogram, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were analyzed. Chi square and Mann Whitney U tests were used for analysis. PResults 427 patients were included, of whom 117 were presented with endometrial hyperplasia without atypia (27.4%; mean age, 42±9.7; Group II), 70 with atypia (16.3%; mean age, 53.4±9; Group III), 102 with early endometrial cancer (EC) (23.8%; mean age, 63±7.8; Group IV) and 38 with advanced disease (8.8%; mean age, 63.3±10.5; Group V). Patients without pathology constituted the control group (23.4%; mean age, 42.2±9.5; Group I). Risk factors for atypia and carcinoma were determined as age, postmenopausal state, obesity, diabetes, and increased estrogen exposure (each, p0.05). However, hemoglobin and hematocrit levels were higher in Groups IV and V (13.9 vs 13.1 mg/dL, and 39.1 vs 38.8%, respectively; pConclusions Our findings support the impact of inflammation on malign transformation from normal endometrial mucosa to atypia and carcinoma. NLR and PLR values showed no statistical difference. Instead, thrombocytosis may have a predictive role in EC

Expression profiling of stem cell signaling alters with spheroid formation in CD133(high)/CD44(high) prostate cancer stem cells

WOS: 000336555200071Cancer stem cells (CSC) isolated from multiple tumor types differentiate in vivo and in vitro when cultured in serum; however, the factors responsible for their differentiation have not yet been identified. The first aim of the present study was to identify CD133(high)/CD44(high) DU145 prostate CSCs and compare their profiles with non-CSCs as bulk counterparts of the population. Subsequently, the two populations continued to be three-dimensional multicellular spheroids. Differentiation was then investigated with stem cell-related genomic characteristics. Polymerase chain reaction array analyses of cell cycle regulation, embryonic and mesenchymal cell lineage-related markers, and telomerase reverse transcriptase (TERT) and Notch signaling were performed. Immunohistochemistry of CD117, Notch1, Jagged1, Delta1, Sox2, c-Myc, Oct4, KLF4, CD90 and SSEA1 were determined in CSC and non-CSC monolayer and spheroid subcultures. Significant gene alterations were observed in the CD133(high)/CD44(high) population when cultured as a monolayer and continued as spheroid. In this group, marked gene upregulation was determined in collagen type 9 a1, Islet1 and cyclin D2. Jagged1, Delta-like 3 and Notch1 were respectively upregulated genes in the Notch signaling pathway. According to immunoreactivity, the staining density of Jagged1, Sox2, Oct4 and Klf-4 increased significantly in CSC spheroids. Isolated CSCs alter their cellular characterization over the course of time and exhibit a differentiation profile while maintaining their former surface antigens at a level of transcription or translation. The current study suggested that this differentiation process may be a mechanism responsible for the malignant process and tumor growth.Ege University Scientific Research Project FundEge University [Ege-BAP 2008 Tip-019]The authors would like to thank Professor Benjamin Bonavida for his editorial expertise; Assistant Professor Ogun Sercan for statistical analysis; Ummu Guven and Turker Cavusoglu for their support in Cell Culture Laboratory maintenance and inter-laboratory correlations; and Tayyibe Yeni and Merve Kursuner for flow cytometry and cell-sorting experiments in AREL. The current study was funded by a grant from the Ege University Scientific Research Project Fund (no. Ege-BAP 2008 Tip-019)