Diabetes and depression are serious chronic conditions. As a result of their increasing prevalence, diabetes and depression, together with population growth and aging, are public health issues. The rate of depression in adults with either type 1 diabetes or type 2 diabetes is high relative to the general population. The coexistence of diabetes and depression has attracted much interest. Although it is unclear whether diabetes and depression are causally linked, most studies have shown that the association between diabetes and depression might be bidirectional. Currently, emotional well-being is becoming an increasingly important aspect of diabetes care and self-management. Psychiatric disorders and diabetic distress among people with diabetes may increase the risk of diabetes complication and mortality. Thus, assessment and appropriate management of depression in people with diabetes should be considered to achieve psychological well-being and optimize medical outcomes.
Adult ; Aging ; Depression ; Diabetes Complications ; Humans ; Mental Health ; Mortality ; Population Growth ; Prevalence ; Public Health ; Self Care

Diabetes and depression are serious chronic conditions. As a result of their increasing prevalence, diabetes and depression, together with population growth and aging, are public health issues. The rate of depression in adults with either type 1 diabetes or type 2 diabetes is high relative to the general population. The coexistence of diabetes and depression has attracted much interest. Although it is unclear whether diabetes and depression are causally linked, most studies have shown that the association between diabetes and depression might be bidirectional. Currently, emotional well-being is becoming an increasingly important aspect of diabetes care and self-management. Psychiatric disorders and diabetic distress among people with diabetes may increase the risk of diabetes complication and mortality. Thus, assessment and appropriate management of depression in people with diabetes should be considered to achieve psychological well-being and optimize medical outcomes.

No abstract available.
Humans ; Thyroid Neoplasms*

The occurrence of Graves' disease following subacute thyroiditis (SAT) is rare. The pathophysiology of it is not well known. We report a case of Graves' disease following SAT presented with creeping. A 45-year-old woman presented with neck pain, and thyrotoxic symptoms. Neck pain migrated from left lobe to right lobe of the thyroid. Thyroid scan revealed decreased uptake in the both lobes except the superior portion of the right thyroid gland. Initially, the patient was diagnosed with SAT and treated with steroid therapy. Four months later, thyroid function test showed suppressed thyroid-stimulating hormone (TSH), elevated free thyroxine (T4) and TSH receptor antibody. Thyroid scan revealed increased uptake compatible with Graves' disease. The autoimmune alteration after SAT may lead to the development of Graves' disease in the susceptible patients. These patients should be monitored for the development of Graves' disease.
Female ; Graves Disease* ; Humans ; Middle Aged ; Neck Pain ; Receptors, Thyrotropin ; Thyroid Function Tests ; Thyroid Gland ; Thyroiditis, Subacute* ; Thyrotropin ; Thyroxine

No abstract available.
Cystatin C* ; Hemoglobin A, Glycosylated* ; Humans

BACKGROUND: A diagnostic whole-body scan (WBS) is recommended 6 to 12 months after total thyroidectomy and radioactive iodide ablation in intermediate- or high-risk patients with differentiated thyroid cancer (DTC). The aim of this study was to evaluate the necessity of a diagnostic WBS after radioactive iodide ablation in intermediate-risk patients with DTC. METHODS: A total of 438 subjects were included in the study: 183 low-risk subjects and 255 intermediate-risk subjects according to the American Thyroid Association guideline. All subjects diagnosed with DTC received 1,100 MBq (30 mCi) activity of radioiodine (I-131) following total thyroidectomy. On follow-up, all subjects underwent a diagnostic I-131 WBS after thyroid hormone withdrawal. RESULTS: After initial radioactive iodide ablation, 95.1% of low-risk patients and 91.4% of intermediate-risk patients showed no uptake on diagnostic WBS (P=0.135). Intermediate-risk patients with stimulated thyroglobulin (Tg) levels higher than 2.0 ng/mL showed a greater rate of radioactive iodine uptake on diagnostic WBS. Four intermediate-risk patients showed recurrence during the 16 to 80 months follow-up period. Three of the four patients with recurrence showed no uptake on diagnostic WBS and had a stimulated Tg level less than 2.0 ng/mL. CONCLUSION: A diagnostic I-131 WBS after radioactive iodide ablation in intermediate-risk patients with DTC may not be necessary. A large prospective study is necessary to determine the necessity of diagnostic WBS in intermediate-risk patients with DTC.
Follow-Up Studies ; Humans ; Iodides ; Iodine ; Radioactivity ; Recurrence ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

Fine-needle aspiration (FNA) with ultrasonography is considered a minimally invasive and safe procedure. Complications of it are infrequent and occur immediately or within a few days after FNA. Such complications may occur mainly in patients with underlying problems. We here report a rare case of thyroid cystic nodule infection occurring 1 month after FNA in an immunocompetent patient and serial sonographic findings in this patient. A 33-year-old woman with a cystic nodule including partially isoechoic solid areas on the right thyroid gland complained of difficulty swallowing and painful sensations in the right neck 1 month after FNA. On follow-up examination, the cystic nodule and perithyroidal soft tissue were suspicious of infection. The possibility of infection after FNA should be considered even if the patient is immunocompetent in order to prompt evaluation and immediate management with empirical antibiotic therapy to avoid life-threatening complications.
Adult ; Biopsy, Fine-Needle ; Deglutition ; Female ; Follow-Up Studies ; Humans ; Neck ; Sensation ; Thyroid Gland ; Ultrasonography

No abstract available.
Adipokines ; Diabetes, Gestational ; Female ; Humans ; Insulin Resistance ; Insulin ; Pregnancy ; Pregnant Women

BACKGROUND: The aim of this study was to evaluate adipokines concentration and insulin resistance according to maternal age or obesity at pregnancy and weight change at diagnosed gestational diabetes mellitus (GDM) in pregnant women with GDM. METHODS: This study included 57 pregnant women who were diagnosed with GDM at 24 to 28 weeks of gestation. The subjects were classified into two or three groups according to pre-pregnancy body mass index (BMI, < 25 kg/m² vs. ≥25 kg/m²), maternal age at pregnancy (< 35 years old vs. ≥35 years old), and weight change during pregnancy at screening for GDM (weight change below, within, and in excess of the recommended range). They were respectively compared in each group. RESULTS: Leptin, homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA2-%B were increased in the group with pre-pregnancy BMI ≥25 kg/m². Leptin and HOMA-IR were positively correlated with BMI both before pregnancy and at screening for GDM. There were no significant correlations between HOMA-IR and adipokines. HOMA-IR showed positive correlation with HOMA2-%B and negative correlation with HOMA2-%S. CONCLUSION: Leptin and HOMA-IR at diagnosed GDM were increased in the GDM patients with obesity before pregnancy. They were positively correlated with BMI both before pregnancy and at screening for GDM. The effect of maternal age at pregnancy and weight change during pregnancy at GDM screening on adipokines and insulin resistance might be less pronounced than the effect of maternal obesity.
Adipokines* ; Body Mass Index ; Diabetes, Gestational* ; Female ; Homeostasis ; Humans ; Insulin Resistance* ; Insulin* ; Leptin ; Mass Screening ; Maternal Age ; Obesity ; Pregnancy ; Pregnant Women*

The natural history of primary hyperparathyroidism, due to parathyroid adenoma, is unknown. Furthermore, spontaneous resolution of parathyroid necrosis or hemorrhage is rare and usually asymptomatic. Here, we report a case of parathyroid apoplexy of primary hyperparathyroidism, presenting as auditory hallucinations, accompanied with hypocalcemia. A 39-year-old man who was incidentally diagnosed with primary hyperparathyroidism, and waiting surgery for parathyroidectomy presented to psychiatric service with auditory hallucinations. He developed tetany, while taking psychiatric drugs. On a follow-up investigation, his serum calcium level fell from 11.8 to 5.8 mg/dL. His intact parathyroid hormone level also decreased from 1,017 pg/mL to 71.1 pg/mL. The parathyroid apoplexy was confirmed after a surgical removal of the infarcted adenoma. The auditory hallucinations disappeared, and serum calcium level was returned to within the normal range.
Adenoma ; Adult ; Calcium ; Follow-Up Studies ; Hallucinations ; Hemorrhage ; Humans ; Hyperparathyroidism, Primary ; Hypocalcemia ; Natural History ; Necrosis ; Parathyroid Hormone ; Parathyroid Neoplasms ; Parathyroidectomy ; Reference Values ; Stroke ; Tetany