Background and Aim: Recent data have shown that olfactory dysfunction is strongly related to Alzheimer’s Disease (AD) that is often preceded by olfactory deficits suggesting that olfactory dysfunction might represent an early indicator of future cognitive in prediabetes. Methods: We have applied to a group of normal (n=15), prediabetic (n=16) and type 2 diabetic outpatients (n=15) olfactory testing, 1.5-T MRI scanner and detailed cognitive evaluation including the standard Mini-Mental State Examination (MMSE) form, Short Blessed Test (SBT), Letter Fluency Test (LFT) and the category fluency test with animal, Fruit and Vegetable Naming (CFT). Results: We have shown that Odour Threshold (OT), Discrimination (OD), and Identification (OI) scores and most cognitive test results were significantly different in the prediabetes and diabetes group compared to those in the control group. OD and OT were significantly different between the prediabetes and diabetes group, although the cognitive test results were only significantly different in the prediabetes and diabetes group compared to those in the control group. In evaluating the association between OI, OT, OD scores and specific cognitive tests, we have found, that impaired olfactory identification was the only parameter that correlated significantly with the SBT both in the pre-diabetes and diabetes group. Although spot glucose values were only correlated with OT, HbA1c levels were correlated with OT, OD, and OI, as well as results of the letter fluency test suggesting that HbA1c levels rather than the spot glucose values play a critical role in specific cognitive dysfunction. Conclusion: To the best of our knowledge, this is the first prospective study to demonstrate a strong association between olfactory dysfunction and specific memory impairment in a population with prediabetes and diabetes suggesting that impaired olfactory identification might play an important role as a specific predictor of memory decline.

Rosai-Dorfman disease, formerly known as 'sinus histiocytosis with massive lymphadenopathy', is a rare self-limiting histiocytic proliferative disorder typically presenting early in life with cervical lymphadenopathy and nonspecific systemic symptoms. Although it is usually a nodal disease, extranodal lesions may be encountered in some cases. The gastrointestinal tract is uncommonly affected in Rosai-Dorfman disease and its diagnosis depends on clinical suspicion and careful histopathological examination of biopsy samples taken from involved gastrointestinal segments. Here, we report a case of atypical Rosai-Dorfman disease with systemic symptoms and diffuse gastrointestinal involvement that led to a diagnostic and therapeutic challenge.

Objective: Coronavirus disease 2019 has placed an unprecedented burden on healthcare systems and restricted resources for non-COVID patients worldwide. Treatment approaches and follow-up plans have been modified to prevent the risk of infection for patients and healthcare workers. Patients prefer to delay or cancel their treatments during the peak period of infection. Materials and Methods:We retrospectively reviewed the characteristics of patients with breast cancer who were consulted at our outpatient clinic right after early COVID-19 peak in May and June 2020 and compared them with the same period in 2017 to 2019. Results:The number of patients who consulted at our outpatient medical oncology clinic declined in May and June 2020. This decline was regardless of stage and was larger in May than in June 2020. In general, the distribution of tumor subtypes [luminal, human epidermal growth factor receptor 2 (HER-2) positive, and triple negative] was not different from 2017 to 2020. Less than half of the patients received adjuvant chemotherapy following early COVID-19 peak in May and June 2020. Few patients received chemotherapy for metastatic disease, whereas many metastatic patients received endocrine therapy. None of the consulted new patients had a non-invasive disease. More patients received endocrine therapy than chemotherapy. Conclusion:The presentation patterns of patients with breast cancer after early COVID-19 peak differed from those during the same period in the last 3 years. The pandemic affected the number of new patients consulted and the way medical oncologists treat their patients.

Introduction The COVID-19 pandemic has a worldwide negative impact on healthcare systems. This study aims to determine how the diagnosis, clinicopathological features, and treatment approaches of patients with breast cancer diagnosed at ≥65 years old were affected during the pandemic. This survey has shown that patients, especially the elderly, had to postpone their breast cancer health problems or delay their routine controls due to the risk of COVID-19 transmission, high mortality rates due to comorbidity, and restrictions. Materials and Methods The medical records of 153 patients with breast cancer diagnosed at ≥65 years old before (January to December 2019; group A, n = 61) and during (March 2020 to May 2021; group B, n = 92) the COVID-19 pandemic were retrospectively analyzed. In addition, clinicopathological features of patients, including age, admission form, clinical stage, tumor size–grade–histology–subtype, lymph node involvement, surgery type, and treatment protocols were evaluated. Results Patients mostly applied for screening purposes group A and frequently applied for diagnostic purposes due to their existing breast cancer or other complaints group B (p = 0.009). Group B patients had higher clinical stage (p = 0.026) and had commonly larger (p = 0.020) and high-grade (p = 0.001) tumor. Thus, mastectomy and neoadjuvant systemic therapy were more commonly performed in group B (p = 0.041 and p = 0.005). Conclusion The survey showed significant changes in breast cancer diagnosis and treatment protocols for patients diagnosed at ≥65 years old during the COVID-19 pandemic. Postponing screening and delaying treatment leads to more advanced breast cancer stages in elderly patients.

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