IntroductionDiabetes mellitus (DM), a major global health problem, is commonly associated with increased risk of developing micro-and macrovascular disease. Despite its clinical importance, the pathophysiology of diabetic complications is not completely understood. Platelets have been thought to be involved in these complications. Diabetic retinopathy (DR) is one of those important complications and leads to a considerable increase in morbidity.Platelet volume is a marker of platelet activation and function that can be measured easily as mean platelet volume (MPV) by clinical analyzers. It is now known that larger platelets are more reactive and produce more prothrombotic factors (1,2). Increased MPV has been demonstrated in diabetes (3-9). There are conflicting results about the relation of MPV with diabetic nephropathy/microalbuminuria (MA) (10-17), diabetic neuropathy (18-20), coronary artery disease (4,13,18,(21)(22)(23)(24)(25), and cerebrovascular disease (3-5,26) in diabetic patients. Large platelets may play a role in the development of vascular damage in DR by being more active, forcing the production of more prothrombotic factors, or causing endothelium-dependent vasomotor dysfunction.Keeping in mind these complex relations between MPV, diabetes, and its complications, in the present study we aimed to: 1) compare the MPV in diabetic patients with that in healthy controls; 2) determine if there is a difference in MPV between diabetic patients with and without DR, and also with and without proliferative retinopathy; 3) compare MPV levels of diabetic patients with or without hypertension (HTA), hyperlipemia (HL), and HTA with HL, and 4) see if there is a correlation of MPV with HbA1c and body mass index (BMI) in diabetic patients. Material and methods PatientsA total of 102 type 2 DM (T2DM) patients [65 female (63.7%), 35 male (36.3%)], 50 of them without retinopathy [31 female (62.0%), 19 male (38.0%)] and 52 with retinopathy [34 female (65.4%), 18 male (34.6%)], aged 22-90 years, were recruited from the Clinic of Ankara Education and Research Hospital from June 2009 to June Background/aim: Patients with diabetes mellitus have an increased risk of developing micro-and macrovascular complications. Retinopathy is one of the most important complications of diabetes whose pathophysiological cause has not yet been determined. One candidate may be platelet volume. In this study we aimed to investigate the association between mean platelet volume and diabetic retinopathy.Materials and methods: Mean platelet volume levels were investigated in type 2 diabetic patients with and without retinopathy, and in healthy participants. After reclassifying our diabetics in terms of the presence or absence of hypertension and hyperlipidemia, we compared their mean platelet volumes. We then checked to see if the mean platelet volume correlated with hemoglobin A1c and body mass index. Results:The mean platelet volume levels were higher in all diabetic patients, and they were highest in diabetics with retinopathy. The mean plate...

Mean platelet volume values of diabetic patients were higher than those of nondiabetics, the highest levels being in diabetics with microalbuminuria. Our results suggest that microalbuminuria might be related with mean platelet volume in diabetic patients.

Acute suppurative thyroiditis is a very rare and life-threatening endocrine emergency. Thyrotoxicosis is a rare condition accompanying acute suppurative thyroiditis. While the majority of the cases in the literature are caused by different reasons, spontaneous development is very rare. We present a patient with acute suppurative thyroiditis who presented to our clinic with thyrotoxic findings, and we compared the case to the literature. A 31-year-old male patient was admitted to our clinic with a complaint of progressive neck pain, swelling and redness on midline neck, fever, and palpitations. On physical examination, swelling, redness and tenderness were detected on the neck region that was consistent with the thyroid location. He presented with tremor on the hands, tachycardia and agitation. Thyroid function tests were compatible with thyrotoxicosis, but there were findings supporting the presence of infection in biochemistry tests. On his radiological evaluations, a heterogeneous lesion divided with small septs was observed, with consolidation areas in the left thyroid lobe. In fine needle aspiration biopsy, 2mL of purulent fluid could be aspirated due to the presence of small, separated consolidation areas. He initiated on antibiotic therapy, propranolol, steroid and symptomatic treatment. Eikenella corrodens was detected on the culture antibiogram. Antibiotic therapy was continued for 14 days due to less symptoms and better biochemical values. After treatment, the patient had normal thyroid function, had relief of fever and redness of the neck, and was followed-up. It should be kept in mind that acute suppurative thyroiditis may develop spontaneously with the findings of thyrotoxicosis, with no risk factors.

Tip 1 diabetes mellitus (T1DM) pankreasta bulunan beta hücrelerinin hasarı sonucu gelişen ve insülin eksikliği ile karakterize kronik metabolik bir hastalıktır. Nefropati, retinopati ve nöropati diyabetin bilinen mikrovasküler komplikasyonlarıdır. T1DM hastalarında serum ürik asit (SÜA) düzeyini değerlendiren az sayıda çalışma mevcuttur ve SÜA düzeyinin mikrovasküler komplikasyonlar ile ilişkisi tartışmalıdır. Bu çalışmada T1DM hastalarında SÜA düzeyini değerlendirmeyi ve SÜA düzeyinin mikrovasküler komplikasyonlar ile ilişkisini incelemeyi amaçladık. Bu çalışma 18 yaşından büyük T1DM tanısı ile takipli 160 hastanın ve 85 sağlıklı kontrolün dosyalarının retrospektif değerlendirilmesi ile yapıldı. T1DM hastalarında kontrol grubuna göre SÜA düzeyi düşük bulundu (p:0.035) ve SÜA düzeyi ile HbA1c arasında negatif kolerasyon saptandı (r:-0.172, p:0.03). SÜA ile kreatinin düzeyi arasında pozitif kolerasyon saptandı (r:0.269, p:0.001). Nefropati gelişen hastalarda SÜA düzeyi diyabet süresinden bağımsız olarak yüksek saptanırken (r2:0.185, p:0.027) nöropati ve retinopatisi mevcut olan hastalarda SÜA yüksekliği bağımsız bir risk faktörü olarak saptanmadı. Sonuç olarak T1DM hastalarında kontrol grubuna göre daha düşük SÜA düzeyi bulunmasına rağmen diyabetik nefropati gelişen hastalarda SÜA düzeyinin yüksek olduğu saptandı. Yüksek SÜA düzeyinin diyabetik nefropati gelişiminde risk faktörü olup olmadığını belirlemek için daha ileri prospektif çalışmalar gereklidir.

Introduction: Type 1 diabetes mellitus (DM) is characterized by selective autoimmune destruction of pancreatic b-cells, resulting in insulin deficiency and associated autoimmune disorders, such as celiac disease, autoimmune thyroiditis, and gastritis, can coexist in patients with type 1 DM. These disorders are characterized by the presence of antibodies against tissue transglutaminase, thyroglobulin, and thyroid peroxidase (TPO), as well as antibodies against gastric parietal cells. Cross-sectional studies have reported that the risk of autoimmune thyroid diseases in patients with type-1 DM is two- to threefold higher than in the general population. However, there are a few studies in the literature investigating the relationship between malignancy and type-1 DM, and it has been shown that type-1 DM does not increase thyroid cancer. Furthermore, there is a lot of controversy regarding the role of thyroid autoimmunity in the pathogenesis of thyroid cancer. Here we present a type-1 DM patient diagnosed with papillary thyroid cancer. Case report: Herein, we aimed to present a 20-year-old female patient diagnosed with type-1 DM and subsequently diagnosed as papillary thyroid carcinoma (PTC). Thyroid ultrasound revealed a 10×12×18 mm hypoechoic irregular edges nodule with macrocalcification and microcalcification foci in the left lobe and pathological lymph nodes without echogenic hilus were detected at the fourth level of the left cervical chain. Fine needle aspiration biopsy from nodule was consistent with papillary thyroid carcinoma. Total thyroidectomy, bilateral central lymph node dissection, and left neck dissection (level II to IV) were performed. Pathological examination revealed a 1.4× 0.9 cm diameter papillary carcinoma located in the left lobe of the thyroid gland with 13 lymph node metastases Conclusion: Patients with type 1 DM should be examined for thyroid diseases, and patients with suspected thyroid disease should be evaluated with a thyroid ultrasound. Type 1 DM and PTC coexistence albeit very rare; It should be known that type 1 diabetes can be seen together with thyroid cancer.