Higher failure of female older asthma patients in use of inhalants: is it due to older age and/or cognition problems?

Ozlem Soyluk,1 Gulistan Bahat2 1Division of Endocrinology and Metabolism, 2Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, Istanbul, TurkeyWe read the article entitled “Sex differences in use of inhalants by elderly patients with asthma” by Hirose et al with interest.1 In this study, the authors examined the relationship between inhalation procedure and sex difference in elderly patients with asthma. They reported that females failed more in “breath holding”. Therefore, they suggested that elderly female patients with asthma have less understanding of inhaled steroid therapy and thus it is particularly important to confirm that the correct inhalation procedure is used by elderly female patients with asthma.View original paper by Hirose and colleagues

Is it the resistance training itself or the combined associated weight loss that improves the metabolic syndrome-related phenotypes in postmenopausal women?

Ozlem Soyluk,1 Gulistan Bahat21Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, Istanbul, Turkey; 2Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, Istanbul, TurkeyWe read the article entitled “Resistance training improves isokinetic strength and metabolic syndrome-related phenotypes in postmenopausal women” by Oliveira et al1 with great interest. In the study, the authors examined the effects of 12 weeks of resistance training (RT) on metabolic syndrome-related phenotypes in postmenopausal women. They reported that total cholesterol, low-density lipoprotein cholesterol levels, total cholesterol/high-density lipoprotein cholesterol ratio, blood glucose, basal insulin, and homeostatic model assessment of insulin resistance were all significantly reduced with RT (P<0.01). Accordingly, they concluded that a 12-week progressive RT program induces beneficial alterations on metabolic syndrome-related phenotypes in postmenopausal women. View original paper by Oliveira and colleagues

Importance of hypoglycemia on the risk of Alzheimer’s disease in elderly subjects with diabetes mellitus

Sevilay Muratli,1 Fatih Tufan,2 Ozlem Soyluk,2 Gulistan Bahat,1 M Akif Karan11Division of Geriatrics, Department of Internal Medicine, 2Department of Gerontology, Faculty of Medical Sciences, Istanbul University, Istanbul, TurkeyWe read the article on the study of "Link between type 2 diabetes and Alzheimer’s disease: from epidemiology to mechanism and treatment" by Li et al.1 The review is very detailed and rational, considering the link between diabetes and Alzheimer’s disease and giving a new outlook as type 3 diabetes. It provides important information about the effects of the hyperglycemic complications of diabetes and treatment of dementia.View original paper by Li et a

Potential contribution of diabetes mellitus to orthostatic blood pressure fall and conversion of mild cognitive impairment to dementia

Sevilay Muratli,1 Fatih Tufan,1 Ozlem Soyluk,2 Gulistan Bahat,1 Mehmet Akif Karan1 1Department of Geriatrics, 2Department of Endocrinology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyWe read the article “Orthostatic blood pressure in people with mild cognitive impairment predicts conversion to dementia” by Hayakawa et al1 with interest. It is well-known that many individuals with mild cognitive impairment (MCI) progress to dementia.2 However, we do not exactly know which risk factors increase this risk and to what extent. Hypertension is a risk factor for Alzheimer’s disease and vascular dementia. However, the findings of this study make us consider hypotension as a new risk factor for dementia. Furthermore, a recently published 6-year prospective general population cohort study suggested that not only orthostatic hypotension (OH), but also symptoms of OH seemed to be risk factors for cognitive decline.3 Notably, in the study by Elmstahl et al3, hypertension and diabetes mellitus (DM) were more common in subjects with dementia. We would like to make some comments on this well-designed study

Prognostic factors in patients with papillary thyroid carcinoma

Background: Papillary thyroid carcinomas are associated with metastases and decreased survival in a small group of patients. Aim: The aim of this study is to determine the factors associated with recurrences/metastases in papillary thyroid carcinoma patients. Subjects and methods: One hundred and thirty-one patients with papillary thyroid carcinoma were evaluated retrospectively. The diagnosis was papillary microcarcinoma (PMC) in 48 patients. All patients had undergone near-total/total thyroidectomy. Radioactive iodine was given to 103 patients. Age at diagnosis, gender, previous history of thyroid disease, tumor stage, histopathological characteristics of tumor and initial treatment strategies were evaluated. Results: Recurrences/metastases developed in 17 patients during follow-up. Recurrences developed at a significantly higher percentage in patients with a tumor stage >T1 and patients with lymph node metastasis at presentation. No significant difference was observed in recurrence ratio between patients with PMC and patients with a tumor diameter 21 cm. In the Cox-regression analysis only the advanced tumor stage (>T1) and presence of lymph node metastases were found to be significant predictors for recurrence (univariate analysis, odds ratio =4.02 and 3.15, respectively). However, multivariate analysis did not reveal any significant independent predictors. According to the Kaplan-Meier survival analysis, lymph node metastases at presentation were associated with a decrease in recurrence-free survival at statistical significance (p=0.05). No mortality was observed during follow-up. Conclusion: Papillary thyroid carcinoma leads to recurrences/metastases in a small group of patients. Initial characteristics of the patients - i.e. presence of lymph node metastases - may predict recurrences/metastases in these patients. (J. Endocrinol. Invest. 31: 1032-1037, 2008) (C) 2008, Editrice Kurti

A rare post-transplant malignancy, cerebellar hemangioblastoma: A case report

Introduction: Post-transplant malignancies are among the most important complications in organ transplantation. Hemangioblastoma (HB) is especially prevalent in the cerebellum

Management and follow-up results of an incidental thyroid carcinoma in a young woman with ovarian teratoma

Thyroid cancer in ovarian teratoma is reported to be rare and experiences are limited. A 26-year-old woman had undergone bilateral cystectomy and omentectomy for bilateral cystic adnexial masses. Pathological examination showed 1.5 cm follicular variant papillary thyroid carcinoma on the basis of unilateral mature cystic teratoma. Increased CA-125 and CA19-9 levels decreased to normal reference ranges after surgery, but postoperative magnetic resonance imaging indicated multiple abdominal cystic loci. After total thyroidectomy, high dose I-131 was administered to ablate thyroid tissue. Thereafter, levothyroxine was started to achieve subclinical hyperthyroidism. No iodine uptake was detected in post-therapeutic whole body scan (WBS) other than thyroid bed. This finding supported that tumor did not show dissemination to abdomen. No uptake on the first-year evaluation with low-dose I-131 WBS suggested the complete ablation of the thyroid gland. It is recommended that thyroid carcinoma arising from ectopic thyroid tissue in a teratoma should be managed as thyroid carcinoma in thyroid. However, direct dissemination to contiguous regions in abdomen and hematogenous dissemination to distant organs should be in mind. Radical surgery including total abdominal hysterectomy, bilateral salphingo-oopherectomy, pelvic and paraaortic lymph node excision and thyroidectomy is recommended. Fertility preserving surgery may be the surgical procedure as in the present case