Prolonged excess of glucocorticoids (GCs) has adverse systemic effects leading to significant morbidities and an increase in mortality. Metabolic alterations associated with the high level of the GCs are key risk factors for the poor outcome. These include GCs causing excess gluconeogenesis via upregulation of key enzymes in the liver, a reduction of insulin sensitivity in skeletal muscle, liver and adipose tissue by inhibiting the insulin receptor signalling pathway, and inhibition of insulin secretion in beta cells leading to dysregulated glucose metabolism. In addition, chronic GC exposure leads to an increase in visceral adipose tissue, as well as an increase in lipolysis resulting in higher circulating free fatty acid levels and in ectopic fat deposition.Remission of hypercortisolism improves these metabolic changes, but very often does not result in full resolution of the abnormalities. Therefore, long-term monitoring of metabolic variables is needed even after the resolution of the excess GC levels.

This study compared mortality rates and decline in life expectancy of Iranian patients with type 2 diabetes (T2DM) with the general population. A retrospective study of 2451 patients with T2DM was conducted in the Isfahan Endocrine and Metabolism Research Center, Iran, between 1992 and 2010. The mean (SD) of diabetes duration and median (Q1,Q3) of follow-up period were 15.5(8.0) and 8(5, 10) years. The main outcome was all-cause mortality. 732(29.87%) of patients died during the follow-up. Overall mortality rates (95%CI) per 1000 person-years in men and women were 56.3(52.0-62.1) and 27.3(24.5-30.4), respectively. The relative risks (95%CI) of all-cause mortality in males vs. females with T2DM aged 45-49, 50-54, 55-59, 60-64, 65-69, 70-74 were [3.02(1.49-6.11) vs. 2.09(0.96-4.57)], [4.05(2.73-6.01) vs. 2.29(1.52-3.45)], [4.13(3.26-5.24) vs. 1.70(1.23-2.35)], [2.42(1.90-3.07) vs. 1.82(1.46-2.27)], [2.36(2.02-2.76) vs. 1.49(1.25-1.78)] and [1.71(1.50-1.95) vs. 1.04(0.88-1.23)] times more than the general population, respectively. Men and women living with diabetes lost an average of 13.2(6.3) and 13.9(6.0) life-years from the year of diagnosis, respectively (p = 0.101). The estimated life-years lost were greater in younger patients and a gradual decline was observed with increasing the age at diagnosis. In conclusion, Iranians with diabetes had higher risk of death and lower life expectancy compared to the general population.Type 2 diabetes mellitus (T2DM) is one of the most common health issues. There is a growing prevalence of T2DM, worldwide. In general, diabetes and its complications are leading causes of mortality in most countries 1-4 . Approximately 5.0 million deaths in 2015 was attributed to people, 20-79 years of age with diabetes, equivalent to one death in every six seconds 1 . The global all-cause mortality rate attributed to diabetes is 14.5% among people within this range of ages. This is higher than the combined number of deaths occurred by the infectious diseases 1 .Studies have shown that the age-adjusted all-cause mortality in patients with diabetes is higher than the general population or people without diabetes 2,5-10 . Therisk of mortality tends to increase with diabetes duration and decreases with increasing age at which diabetes is diagnosed 2,6,7,9,10 . Lower life expectancy is reported for people with diabetes compared to people without diabetes 2,7,8 . However, majority of these studies were performed in Western populations 2,5-8,10 and to our best of knowledge, there is no published data available for the excess risk of death and potential years of life lost in Iranian patients with T2DM.The aim of the present study was to evaluate the mortality rates among people with diabetes compared to the general population of Iran according to age and sex. We also estimated the effect of diabetes on the expected life years by using clinical data registry records for patients with diabetes at the Isfahan Endocrine and Metabolism Research Center, Iran. Material and MethodsThis retrospective database ...

Background:The complications in thyroid surgery have been reported variable in literature. The aim of this study was to evaluate the early and late (3 months after surgery) complication rates of thyroidectomy in a cohort of patients undergoing thyroid surgery at two hospitals of Isfahan University of Medical Science, Iran.Materials and Methods:This study included 204 patients who candidates for thyroidectomy presenting at Medical Educational Centers of Al-Zahra and Kashani hospitals in Isfahan between March 2016 and March 2017. Clinical data are collected for all patients by continuous enrollment. The patients examined before and after thyroid surgery and the findings were recorded.Results:The highest prevalence of thyroidectomy was in women (81.9%). The most frequent thyroid surgery was total thyroidectomy and the most common indication for thyroid surgery was suspicious fine-needle aspiration for thyroid malignancy. Hypocalcemia was the most common complication with a frequency of 54.4%. The odds ratios for early complications were 2.375 and 2.542 for intermediate- and low-volume surgeons, respectively, compared to high-volume surgeons.Conclusions:According to the results of this study, the high level of surgeon's skill is effective to reduce the likelihood of late and early complications; furthermore, the chance of late complications increases with age.

The results show a U-shaped association of BMI with all-cause mortality in patients with type 2 diabetes with the lowest risk observed among the overweight patients.