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It has been suggested that type 2 diabetes mellitus may affect breast cancer prognosis, possibly due to increased diabetes-related comorbidity, or direct effects of insulin resistance and/or hyperinsulinemia. The aim of this study was to determine the impact of diabetes on disease-free survival (DFS) following mastectomy for breast cancer patients. The cases included in this retrospective study were selected from breast cancer women who had undergone mastectomy and completed adjuvant chemotherapy from 1998 to 2010. Patients were classified into two groups: diabetic and non-diabetic. Patients' age, sex, menopausal status, body mass index (BMI), histopathological features, tumor size, lymph node involvement, hormone receptor and HER2-neu status, and treatment types were recorded. There were 483 breast cancer patients included in the study. Postmenopausal patients' rate (53.7% vs. 36.8%, P = 0.016) and mean BMI levels were statistically higher (32.2 vs. 27.9, P = 0.007) in diabetic patients. There was no statistical difference for histological subgroup, grade, ER and PR positivity, HER2-neu overexpression rate, and tumor size between the diabetic and non-diabetic group. Lymph node involvements were statistically higher in diabetic patients compared with non-diabetic patients (P = 0.013). Median disease-free survival is 81 months (95% CI, 61.6-100.4) in non-diabetic patients and 36 months (95% CI, 13.6-58.4) in diabetic patients (P < 0.001). The odds ratio of recurrence was significantly increased in those with HER2-neu overexpression and lymph node involvement and decreased with PR-positive tumors. Our results suggest that diabetes is an independent prognostic factor for breast cancer.

Introduction: Carpal tunnel syndrome (CTS) is one of the most common entrapment neuropathies of the upper limbs. It results from compromised median nerve function of the wrist that is caused by increased pressure in the carpal tunnel. Repetitive use of the hand and wrist, obesity, pregnancy, rheumatoid diseases, trauma and endocrinopathies are some of the risk factors for CTS. Aim:The purpose of this study was to find out whether patients with diabetes mellitus (DM), hypothyroidism and acromegaly have an increased incidence of carpal tunnel syndrome compared to each other and normal population. Materials and Methods:Patients were assigned into three groups as follows: patients with type II DM n: 100, patients with hypothyroidism n:48 and patients with acromegaly n:36. In addition, 50 healthy individuals were included in the study as control subjects. Patients were asked if they had any pain, symptoms of paraesthesia and numbness. Patients with peripheral neuropathy were excluded from the study. Boston Symptom Severity Scale and Functional Capacity Scale were used to assess symptom severity and functional capacity. CTS was investigated by performing electrophysiological study for both hands.results: The incidence of CTS was significantly higher in all three groups compared to the control group (p>0.05). In addition, the incidence of CTS was significantly higher in the DM group compared to the hypothyroid and acromegaly groups (p<0.001). The incidence of bilateral CTS in the DM group was significantly higher compared to both hypothyroid and acromegaly groups and the control group (p<0.001).conclusion: CTS has a higher incidence in DM, hypothyroid and acromegaly patients compared to healthy individuals. Clinicians should be careful about development of CTS in DM, hypothyroidism and acromegaly. They should adopt a multidisciplinary approach and co-operate with the psychiatrist.www.jcdr.net Pelin Oktayoglu et al., Carpal Tunnel Syndrome Andendocrinological Diseases

Objective:Subclinical hypothyroidism (SH) is defined as an elevated serum thyroid-stimulating hormone (TSH) level with free thyroxine (fT4) level in the normal range. There are very few studies in the literature reporting on the effect of SH on lipid metabolism and carotid intima-media thickness (CIMT) in children.Methods:The study included 38 children diagnosed with SH and a control group comprising 38 healthy, euthyroid children. SH was diagnosed based on an elevated TSH level (4.2-20 mIU/L) and normal fT4 level measured in two morning fasting blood samples obtained at an interval of 2 to 6 weeks. Blood samples were collected by venipuncture in the morning after an overnight fast.Results:The patient group included 38 children (16 male, 22 female) with SH and the control group -38 healthy, euthyroid children (20 male, 18 female). Mean age was 8.1±3.6 (range, 3.5-15) years in the patient group and 8.9±2.4 (range, 4.5-15) years in the control group. In the patient group, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), TC/high-density lipoprotein cholesterol (HDL-C), and LDL-C/HDL-C were higher compared to the control group (p=0.049, p=0.014, p=0.002, and 0.003, respectively). In the patient group, CIMT was also significantly higher compared to the control group (p=0.001). The patient group was further divided into two subgroups based on their serum TSH level: (I) patients with mildly elevated TSH (TSH=4.2±10 mIU/L) (n=33) and (II) patients with high TSH (TSH≥10 mIU/L) (n=5). However, no significant difference was found between the patients with mild and severe SH with regard to TC, LDL-C, HDL-C, triglyceride level and CIMT levels (p=0.635, p=0.424, p=0.310, p=0.342, and 0.610, respectively).Conclusion:Subclinical hypothyroidism leads to increased dyslipidemia (increased TC and LDL) and increased CIMT, which leads to increased risk of cardiovascular disease. Further studies are needed to substantiate these findings in children with SH.