Background: In this study, we aimed to investigate the relationship between diabetic nephropathy (DN) and triglyceride/glucose (TyG) index and triglyceride/high-density lipoprotein cholesterol ratio (Tg/HDL-C) as surrogate markers of insulin resistance. Method: Medical records of 15,378 individuals between February 2019 and May 2024 were examined. Serum glucose, Tg, HDL-C, HbA1c, estimated glomerular filtration rate (eGFR), and urine albumin/creatinine ratio (UACR) were evaluated and the TyG index and TG/HDL-C ratios were calculated for each individual. DN was defined as a UACR ≥ 30 mg/g and/or eGFR <60 mL/min/1.73 m². Results: Of 10,714 patients, DN was detected in 3763 (35.1%). Females had 10% higher odds of developing DN compared to males. A TyG index at or above the determined cutoff point (9.58) indicated a risk of DN and the sensitivity and specificity values were 44.01% and 71.28%, respectively. The risk of DN was 1.95 times higher in individuals with a TyG index value of ≥9.58 compared to those with a TyG index <9.58. While the Tg/HDL ratio was significant in detecting DN in the univariate analysis (odds ratio (OR) 1.59; 95% confidence interval 1.46–1.73), this significance was not found in the multivariate analysis (OR 1.15; 95% confidence interval 0.94–1.40). Conclusions: A high TyG index is associated with DN in patients with type 2 diabetes and it might be a potential marker in predicting DN.

Aims: There have been reports about various thyroid autoimmune events after SARS-CoV-2 vaccinations. There is limited data on the extent to which vaccines for COVID-19 are effective on thyroid autoimmunity. This study investigates how COVID-19 vaccination affects thyroid antibodies and functions in individuals without any thyroid disease history. Methods: The study evaluated individuals aged 18-65 with no previous COVID-19 history or thyroid disease who had at least two COVID-19 vaccine doses (CoronaVac + Pfizer-BioNTech or Pfizer-BioNTech alone) between October 2021 and October 2022. All participants' thyroid hormone (free triiodothyronine, thyroid-stimulating hormone, and free thyroxine) and thyroid autoantibody (anti-thyroglobulin, antithyroid peroxidase, and TSH receptor antibody) levels were measured. Results: The study included 92 individuals in total. Thyroid functions and antithyroid antibody levels were found to be in the normal range before the implementation of the SARS-CoV-2 vaccine. Of the study participants, 42 received the Sinovac + BioNTech vaccine, and 50 received the BioNTech vaccine alone. While a decrease in st4 value was observed only in the BioNTech group after vaccination (p=0.007), thyroid dysfunction was not observed in any participant. After vaccination, TRAB positivity was observed in one participant, ANTI-TPO positivity in six participants, and ANTI-TG positivity in eight participants. No statistically significant antibody positivity was detected. No participants with antibody positivity displayed thyroid dysfunction. Conclusion: Although some positivity in terms of antithyroid antibodies was observed after COVID-19 vaccination, this antibody positivity did not have a statistically significant level, and thyroid dysfunction was not detected in any participant. The COVID-19 vaccine is safe for thyroid function and autoimmunity.

Introduction The aim of our study was to investigate the effect of thyroid dysfunction on tendons and the contribution of Acoustic Radiation Force Impulse (ARFI) elastography to the diagnosis of tendinopathy. Methods Eighty Achilles tendons of 40 patients under levothyroxine treatment, who had previously known hypothyroidism but high serum thyroid stimulating hormone levels, and 80 Achilles tendons of 40 healthy individuals were evaluated with ARFI (Virtual Touch Quantification®). 19 of 40 of the patients with hypotiroidism’ Achilles tendons were re-evaluated after thyroid stimulating hormone levels reached to normal limits following the adjustments in thyroid hormone replacement therapy. The middle portion of the each Achilles tendon was chosen for the examination. Every examination consisted of three to five independent measurements (shear wave velocity- meters per second). The mean shear wave velocity value was calculated for each tendon, and used for statistical analysis. Results The stiffness values of both left and right Achilles tendons, represented as shear wave velocity, were similar in patients with hypothyroidism and control group. There was no significant difference between the Achilles tendon shear wave velocity measurements of 19 of 40 hypothyroidism patients who were re-evaluated after the adjustments in thyroid hormone replacement therapy. Conclusions The lack of significant difference in Achilles tendon stiffness between non-naive hypothyroid patients and the control group may be explained as a positive clinical effect of thyroid hormone replacement therapy.

SUMMARY Malignant mesenchymal thyroid tumors are one of the rarest types of thyroid cancer. Clinically, these tumors present as a rapidly growing thyroid mass. Due to their rarity and nonspecific findings, they are not the first conditions that come to mind during differential diagnosis. We report herein the case of an 87-year-old woman presenting with a rapidly growing thyroid mass in whom the differential diagnosis of anaplastic cancer was challenging. Following work up, the patient was diagnosed with primary fibrosarcoma [...] SUMMARY Malignant mesenchymal thyroid tumors are one of the rarest types of thyroid cancer. Clinically, these tumors present as a rapidly growing thyroid mass. Due to their rarity and nonspecific findings, they are not the first conditions that come to mind during differential diagnosis. We report herein the case of an 87-year-old woman presenting with a rapidly growing thyroid mass in whom the differential diagnosis of anaplastic cancer was challenging. Following work up, the patient was diagnosed with primary fibrosarcoma

Objective: The 2022 WHO classification introduced differentiated high-grade thyroid carcinoma (DHGTC) as a distinct category characterized by high-grade features despite maintained differentiation. Therefore, this study aims to evaluate its clinical characteristics, treatment responses, and the prognostic impact of the Ki-67 proliferation index in this patient population. Methods: We retrospectively reviewed 3100 patients with differentiated thyroid carcinoma (DTC) between 2017 and 2024. From this baseline pool, a total of 56 patients (1.8%) were identified and re-classified as DHGTC based on mitotic count (≥5/2 mm²) and/or tumor necrosis. Additionally, 69 DTC patients (2.2%) with an elevated Ki-67 index (>5%) identified from the same baseline pool—representing an overlapping group with the DHGTC cohort—were analyzed to evaluate its clinical significance. Results: In the DHGTC group, tumor necrosis was present in 87.5% and high mitotic activity in 19.6% of cases. While all DHGTC patients were classified as high-risk under 2025 American Thyroid Association (ATA) guidelines, 42.8% showed biochemical or structural incomplete response at the last follow-up and 28.6% required additional salvage interventions. In the broader DTC cohort, Ki-67 ≥ 15% was significantly associated with older age, larger tumor size, extensive invasion, and poorer treatment response (p < 0.05). However, within the DHGTC subset, Ki-67 ≥ 15% was only significantly associated with increased lymphovascular invasion and more extensive surgery. Conclusions: DHGTC carries a significant burden of aggressive histopathological features and a high risk of structural disease persistence or recurrence. While an elevated Ki-67 index (≥15%) serves as an adverse marker in general DTC, its additional prognostic value within the high-grade DHGTC cohort remains inconclusive, potentially obscured by limited statistical power due to small subgroup sizes.

AIM: The primary purpose of our study was to understand the damage in the peripheral nerves of patients with diabetes and to determine the change in patients’ reaction rates and perceptions by the age groups, duration of diabetes, fasting plasma glucose and HbA_1c values, and compare these with those of the healthy individuals.METHODS: This study was carried out at the Baskent University Hospital Endocrinology and Metabolic Diseases Outpatient Clinic. A total of 64 patients diagnosed with type 2 diabetes and 64 healthy controls were included in the study. Finger tapping, visual, and auditory reaction time tests were performed on the subjects, respectively. The subjects’ fasting plasma glucose and HbA_1c levels, and the duration of their diabetes were recorded. Analyses were performed using the SPSS version 25. Differences were considered statistically significant when the p-value is <0.05.RESULTS: It was observed that the participants in the control group between the ages of 18-34 showed a faster reaction in all tests (p=0.01), but the difference in reaction rates in both groups decreased as the age increased. There were positive correlations between the duration of type 2 diabetes and the visual and auditory examination results (r= 0.69, p<0.05, r=0.52, p<0.05, respectively). There was also a positive correlation between the HbA1c (%) and the visual (r=0.97, p<0.05) examination results.CONCLUSIONS: As the patients’ HbA_1c levels and the time spent with type 2 diabetes increased, their reaction rate and perception skills decreased. Especially in the early stages of the disease, cognitive decline was observed to be rapid. It is thought that early diabetic control is significant.