Evaluation of the Malignancy Risk in Nodules Expanding the Thyroid Gland Capsule.

There has been an increase in the diagnosis of thyroid nodules in recent years. In addition to the well-known criteria, features that are likely to increase the risk of malignancy are in the research process. In this study, we aimed to evaluate the malignant potential of nodules that expand the thyroid capsule ultrasonographically. A total of 109 patients with thyroid capsule-expanding nodules and 288 patients with non-expanding nodules were included in the study. Demographical data, ultrasonography features, and cytology results were noted and histopathological findings were determined in operated patients. While malignant cytology was detected in 5.5% of capsule-expanding nodules in FNAB results, this rate was 0.7% in the non-capsule expanding group (p<0.001). According to the histopathological results, the incidence of malignancy was 15.6% in the capsule-expanding nodule group, while it was 3.1% in the other group (p=0.001). As a result of logistic regression analysis, it was determined that the risk of malignancy increased by 4.44-fold (95% CI 1.4-13.8, p=0.01) in patients with capsule-expanding nodules. Other features that increased the risk of malignancy were hypoechogenicity, microcalcification, and irregular margin presence. In this study, we found that the risk of malignancy increased in nodules expanding the thyroid capsule. In case of increasing study data on this subject, monitoring thyroid capsule expansion in nodules may take its place among the criteria for malignancy in future evaluations.

Impact of 24-week dapagliflozin treatment on body weight, body composition, and cardiac risk indicators of patients with type-2 diabetes mellitus.

Background/aim: To reveal the impacts of dapagliflozin, a sodium glucose transporter-2 inhibitor (SGLT-2i), on body weight and body composition, cardiovascular risk indices, and carotid intima-media thickness (CIMT). Materials and methods: The data of patients with type-2 diabetes mellitus (T2DM) who applied to Department of Endocrinology and Metabolic Disorders between September 2019 and 2020, and had started dapagliflozin treatment along with their current medications were recorded retrospectively. Body weights, body compositions measured through bioelectrical impedance, and CIMT with T2DM receiving SGLT-2i treatment and medication were measured at weeks 1, 12, and 24 of 42. The visceral adiposity index (VAI), lipid accumulation product (LAP), and atherogenic index of plasma (AIP) were used to determine the lipid measurements and anthropometric values. Results: The mean change in the total body weight and total fat mass was -2.96 and -1.97 kg, respectively (p < 0.001). There was a reduction in total fat mass of 1.23 kg (from 31.4 to 29.3 kg, p < 0.001) and in body fat percentage of 2.5% (from 35.8% to 34.4%, p < 0.001) in the first 12 weeks. A mild increase was observed in both the total fat mass and body fat percentage between weeks 12 and 24, which was not statistically significant (p = 0.783 and p = 0.925, respectively), whereas there was a statistically significant reduction in high-sensitive C-reactive protein (hsCRP), AIP, and CIMT values (p = 0.006, p = 0.035, and p = 0.007, respectively). No changes were observed in the VAI and LAP values (p = 0.985 and p = 0.636, respectively). Conclusion: It was observed that dapagliflozin not only contributes to weight and fat loss but also has positive impacts on cardiovascular and atherosclerotic indicators.

The Assessment of Ventricular Arrhythmia Indicators Based on Electrocardiography in Patients With Differentiated Thyroid Cancer Followed Up With Levothyroxine Suppression.

Levothyroxine suppression therapy (LST) can cause some unfavorable effects on the cardiovascular system in patients with differentiated thyroid cancer (DTC). The aim of this study was to evaluate ventricular arrhythmia predictors based on electrocardiography (ECG) in patients with DTC with LST. The ECG parameters including QT, corrected QT (QTc), Tp-e intervals, Tp-e/QT, and Tp-e/QTC ratios of 265 patients with DTC who met the inclusion criteria were compared with 100 controls. No difference was observed in the number of patients with DTC and controls with prolonged and borderline QTc interval (P = .273). Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were significantly higher in patients (P = .002, P = .02, P = .003; respectively). Linear regression analysis suggested that male gender was a predictor of higher Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios (ß = 4.322, R2 = 0.024, P = .042; ß = 0.016, R2 = 0.048, P = .005; ß = 0.015, R2 = 0.044, P = .006, respectively). A higher serum fT4 level was found to be associated with a higher Tp-e/QT ratio (ß = 0.018, R2 = 0.089, P = .007). Ventricular arrhythmia indicators were found to be higher in patients with DTC with LST. Defining ventricular arrhythmia predictors through ECG, an easily accessible cardiac diagnostic tool, can be potentially useful in raising awareness of the possible cardiac harm of LST.

Diabetic Peripheral Neuropathic Pain From the Perspective of Turkish Patients: A Qualitative Study.

INTRODUCTION: Diabetic peripheral neuropathy (DPN) affects almost 30% to 50% of patients with diabetes, 40% to 60% of whom suffer from diabetic peripheral neuropathic pain (DPNP). Few studies have focused on individual experiences of DPNP in patients with diabetes. The purpose of this qualitative study was to elucidate the effects of DPNP on daily life and individual feelings regarding living with DPNP from the perspective of Turkish patients. METHOD: A total of 14 patients were interviewed, and interpretative phenomenological analysis was used to identify themes. RESULTS: Findings indicated four main themes, including (a) physical limitations, (b) difficulties with daily routines, (c) social limitations, and (d) psychological impacts such as emotional changes, and being a burden on family. CONCLUSION: This study revealed that the majority of patients carry significant concerns about becoming a burden on their family and are afraid of becoming dependent on others because of DPNP. IMPLICATION FOR PRACTICE: For the effective management of DPNP, health professionals need to consider using a holistic approach to address difficulties in daily living such as physical limitations and sexual problems.

Aromatherapy Massage for Neuropathic Pain and Quality of Life in Diabetic Patients.

PURPOSE: This study aimed to examine the effects of aromatherapy massage on neuropathic pain severity and quality of life (QoL) in patients suffering from painful diabetic neuropathy. DESIGN AND METHODS: This open-label randomized controlled clinical study was conducted in a university hospital endocrine outpatient clinic in Turkey. The study sample consisted of 46 patients, randomly allocated to an intervention group (n = 21) and a control group (n = 25). The intervention group received aromatherapy massage three times per week for a period of 4 weeks. The control group received only routine care. Data were collected from patients using the Douleur Neuropathique questionnaire, the visual analog scale, and the Neuropathic Pain Impact on Quality of Life questionnaire. FINDINGS: Neuropathic pain scores significantly decreased in the intervention group compared with the control group in the fourth week of the study. Similarly, QoL scores significantly improved in the intervention group in the fourth week of the study. CONCLUSIONS: Aromatherapy massage is a simple and effective nonpharmacological nursing intervention that can be used to manage neuropathic pain and improve QoL in patients with painful neuropathy. CLINICAL RELEVANCE: Aromatherapy massage is a well-tolerated, feasible, and safe nonpharmacological method that can be readily integrated into clinical settings by nursing staff. The essential oils rosemary, geranium, lavender, eucalyptus, and chamomile can be safely used by nurses in the clinical setting, if applicable. However, training and experience of nurses in aromatherapy massage is critical to achieving positive results.