Yusuf Aydin - Academia.edu (original) (raw)

Papers by Yusuf Aydin

Research paper thumbnail of Evaluation of hearing loss in patients with Graves’ disease

Endocrine

Hearing loss has commonly been reported in association with thyroid disorders and during treatmen... more Hearing loss has commonly been reported in association with thyroid disorders and during treatment with propylthiouracil. The relationship between hyperthyroidism and the auditory system has not been previously investigated. The aim of this cross-sectional, case–control study was to investigate hearing loss in patients with Graves’ disease (GD). The study population consisted of patients with newly diagnosed GD and healthy controls. Pure tone audiometry at frequencies of 250, 500, 1000, 2000, 4000 and 8000 Hz, along with immittance measures including tympanometry and acoustic reflex tests, were performed in all participants. Twenty-two GD patients and 22 healthy controls consented to inclusion in the study. The differences between groups with regards to age and gender distribution were statistically insignificant (P = 0.567 and P = 0.757, respectively). The hearing thresholds of right and left ears were also similar in both groups (P > 0.05). When single-ear evaluations were taken into account (total of 44 ears for both groups), hearing thresholds in the GD group were significantly higher than healthy controls at all frequencies (P

Research paper thumbnail of Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus

Anadolu Kardiyoloji Dergisi-the Anatolian Journal of Cardiology, 2010

Objective: Atherosclerosis is the major cause of the morbidity and mortality in type 1 diabetes m... more Objective: Atherosclerosis is the major cause of the morbidity and mortality in type 1 diabetes mellitus (DM). Carotid intima-media thickness (CIMT) is the early sign of atherosclerosis and thereby, also the sign of macrovascular diseases. In this study, we aimed to evaluate the CIMT in patients with type 1 DM, and its association with diabetic microvascular complications (nephropathy-retinopathy). Methods: One hundred and thirteen consecutive patients with type 1 DM without macrovascular disease were enrolled into this cross-sectional study. Age, gender, and body mass index matched 59 healthy subjects, were taken as the control group. Microvascular complications in diabetic patients were scanned. Ultrasonographic analysis of the carotid artery was performed with a high-resolution ultrasound scanner. Student's t, Mann Whitney U, Chi-square and Kruskal-Wallis tests, as well as multiple linear regression analysis were used for the statistical analysis. Results: Patients with type 1 DM had significantly higher CIMT compared to control group (p<0001). The CIMT of the patients with microvascular complications (nephropathy and/or retinopathy) was significantly increased (0.70±0.11 mm) compared with the patients without complications (0.63 ± 0.09 mm) (p=0.001). The increase in CIMT in type 1 DM in multiple regression analysis was dependent on the presence of proliferative retinopathy (beta=0.037, 95%CI 0.010-0.065, p=0.008), macroalbuminuria (beta=0.043, 95%CI 0.019-0.068, p=0.001), increased urinary albumin excretion (beta=0.00003, 95%CI 0.00001-0.00005, p=0.005) and duration of diabetes (beta=0.002, 95%CI 0.001-0.003, p=0.009). Conclusions: Increment of CIMT in type 1 diabetic patients was associated with microvascular complications, suggesting that diabetic microangiopathy is related with macroangiopathy. Therefore, there is a need for prospective studies to show the effect of increased CIMT on prognosis of type 1 DM. (Anadolu Kardiyol Derg 2010; 10: 52-8)

Research paper thumbnail of Early severe pre-eclamptic findings in a patient with Cushing's syndrome

Early severe pre-eclamptic findings in a patient with Cushing's syndrome

Gynecological Endocrinology, 2006

Cushing&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;a... more Cushing&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome occurs rarely in pregnancy because of ovulatory disturbances including anovulation which is caused by hypercortisolism, but it can cause maternal complications such as hypertension, gestational diabetes, spontaneous abortion, premature birth, pre-eclampsia and stillbirth. Herein we present the case of a 22-year-old patient in the 11th week of pregnancy who was admitted to our hospital with Cushing&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome complicated by early pre-eclampsia. Severe pre-eclampsia has high maternal and perinatal morbidities, and therefore the possibility of this complication requires that Cushing&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome, although rare in pregnancy, be given a high clinical suspicion. Medical therapy and/or surgical therapy should be considered promptly to influence outcome favorably.

Research paper thumbnail of Serum Matrix Metalloproteinase-9 Levels in the Diagnosis of Functioning Adrenal Tumors

Serum Matrix Metalloproteinase-9 Levels in the Diagnosis of Functioning Adrenal Tumors

Endocrine Practice, 2010

To investigate whether serum matrix metalloproteinase-9 (MMP-9) levels can be used as a diagnosti... more To investigate whether serum matrix metalloproteinase-9 (MMP-9) levels can be used as a diagnostic tool in determining the functioning status of benign adrenal tumors. In this case-control study, medical records of patients with adrenal tumors who consecutively presented to an endocrinology clinic between August 2005 and October 2008 were evaluated. Operation was recommended when the incidentaloma was larger than 4 cm or when a hypersecreting tumor was suspected. A control group of healthy persons matched for age, body mass index, and sex was also enrolled. Patients underwent routine endocrinologic examinations. MMP-9 levels were compared preoperatively and postoperatively. Findings were compared among patients with functioning adrenal tumors, patients with nonfunctioning adrenal tumors, and control participants. Of 370 patients with adrenal tumors, 50 with adrenal incidentaloma met the inclusion criteria. Twenty-five healthy individuals were enrolled as controls. Group 1 included 20 patients with functioning adrenal tumors (14 with Cushing syndrome and 6 with pheochromocytoma), and Group 2 included 30 patients with nonfunctioning adrenal tumors. MMP-9 levels were higher in patients with nonfunctioning adrenal tumors and functioning adrenal tumors than in control participants (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001). MMP-9 levels in patients with functioning adrenal tumors were significantly higher than those in patients with nonfunctioning adrenal tumors (P = .002). After operation, MMP-9 levels decreased significantly in patients with Cushing syndrome and in those with pheochromocytoma; however, patients with Cushing syndrome and pheochromocytoma had similar MMP-9 levels preoperatively and postoperatively. No significant linear correlation existed between tumor volume and MMP-9 levels. A significant positive correlation was determined between preoperative MMP-9 concentrations and 24-hour urinary fractionated metanephrine and epinephrine (r = 0.938, P = .006; r = 0.965, P = .002, respectively), between MMP-9 levels and baseline cortisol levels (r = 0.402, P = .003), and between MMP-9 levels and cortisol levels obtained after dexamethasone suppression testing (r = 0.357, P = .006). Our data suggest that serum MMP-9 levels may be useful in differentiating benign subclinical functioning adrenal tumors from benign nonfunctioning adrenal tumors.

Research paper thumbnail of Serum transforming growth factor-beta levels in patients with vitamin D deficiency

European Journal of Internal Medicine

Research paper thumbnail of Severe hyperphosphatemia and symptomatic hypocalcemia after bowel cleansing with oral sodium phosphate solution in a patient with postoperative hypoparathyroidism

Central European Journal of Medicine, 2010

Oral sodium phosphate (NaP) is increasingly being used for bowel preparation. There are several r... more Oral sodium phosphate (NaP) is increasingly being used for bowel preparation. There are several reports of significant serum electrolyte changes after the administration of oral NaP solution in renal failure. We report a case of postoperative hypoparathyroidism who developed severe hyperphosphatemia and associated hypocalcemia after bowel preparation with oral NaP. A 39-year old woman was admitted to the hospital because of multiple bone fractures. The diagnosis of primary hyperparathyroidism was confirmed. Further assays suggested Cushing’s disease and MRI disclosed a pituitary microadenoma. Considering the diagnostic suspect of multiple endocrine neoplasia type 1, computed tomography of abdomen was performed, showing a mass in the right adrenal. The patient underwent transsphenoidal surgery and then total parathyroidectomy. Despite total removal of the microadenoma by transsphenoidal surgery, there was no suppression in serum cortisol levels. So, an operation was scheduled for the adrenal tumor. The patient was administered 45 mL oral NaP solution for bowel cleansing before the surgery. Although her calcium and phosphorus levels were normal before NaP administration, four hours later she developed respiratory distress and tetany. Laboratory studies revealed severe hyperphosphatemia and hypocalcemia. We conclude that the use of NaP for bowel preparation should be avoided in patients with hypoparathyroidism.

Research paper thumbnail of Pericardial Tamponade in a Patient with Thalassemia Major due to Hypothyoridism

Pericardial Tamponade in a Patient with Thalassemia Major due to Hypothyoridism

Acta Haematologica, 2006

-Thalassemia major (BTM) still remains a disease that displays a surplus of clinical complication... more -Thalassemia major (BTM) still remains a disease that displays a surplus of clinical complications during its follow-up. Pericardial effusion has been mentioned to oc-cur in these patients whereby pericardial tamponade is quite rare. On the other hand, hypothyroidism secondary to iron ...

Research paper thumbnail of Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus Tip 1 diyabetes mellituslu hastalarda karotis intima-media kalinliği ve komplikasyonlarla ilişkisi

Objective: Atherosclerosis is the major cause of the morbidity and mortality in type 1 diabetes m... more Objective: Atherosclerosis is the major cause of the morbidity and mortality in type 1 diabetes mellitus (DM). Carotid intima-media thickness (CIMT) is the early sign of atherosclerosis and thereby, also the sign of macrovascular diseases. In this study, we aimed to evaluate the CIMT in patients with type 1 DM, and its association with diabetic microvascular complications (nephropathy-retinopathy). Methods: One hundred and thirteen consecutive patients with type 1 DM without macrovascular disease were enrolled into this cross-sectional study. Age, gender, and body mass index matched 59 healthy subjects, were taken as the control group. Microvascular complications in diabetic patients were scanned. Ultrasonographic analysis of the carotid artery was performed with a high-resolution ultrasound scanner. Student's t, Mann Whitney U, Chi-square and Kruskal-Wallis tests, as well as multiple linear regression analysis were used for the statistical analysis. Results: Patients with type 1 DM had significantly higher CIMT compared to control group (p<0001). The CIMT of the patients with microvascular complications (nephropathy and/or retinopathy) was significantly increased (0.70±0.11 mm) compared with the patients without complications (0.63 ± 0.09 mm) (p=0.001). The increase in CIMT in type 1 DM in multiple regression analysis was dependent on the presence of proliferative retinopathy (beta=0.037, 95%CI 0.010-0.065, p=0.008), macroalbuminuria (beta=0.043, 95%CI 0.019-0.068, p=0.001), increased urinary albumin excretion (beta=0.00003, 95%CI 0.00001-0.00005, p=0.005) and duration of diabetes (beta=0.002, 95%CI 0.001-0.003, p=0.009). Conclusions: Increment of CIMT in type 1 diabetic patients was associated with microvascular complications, suggesting that diabetic microangiopathy is related with macroangiopathy. Therefore, there is a need for prospective studies to show the effect of increased CIMT on prognosis of type 1 DM. (Anadolu Kardiyol Derg 2010; 10: 52-8)

Research paper thumbnail of Kalp hastaliklarinda diyabet yönetimi

Kalp hastaliklarinda diyabet yönetimi

ÖZET Tip 2 diyabetes mellitus (DM) dünyada en sik görülen hastaliklardan birisidir ve sikliği gid... more ÖZET Tip 2 diyabetes mellitus (DM) dünyada en sik görülen hastaliklardan birisidir ve sikliği giderek artmaktadir. Kardiyovasküler hastaliklar, tip 2 diyabetik hastalardaki mortalite ve morbiditenin en önemli nedenidir. Kardiyovasküler mortalite diyabetik olmayanlara göre diyabetli hastalarda belirgin olarak artmiştir. Diyabet ve bozulmuş glukoz toleransina genelde metabolik sendrom komponenti olarak veya olmadan siklikla eşlik eden hiperlipidemi, hipertansiyon ve obezite gibi diğer kardiyovasküler

Research paper thumbnail of Prevalence and recurrence rate of colonic lesions in acromegalic patients

Prevalence and recurrence rate of colonic lesions in acromegalic patients

Central European Journal of Medicine, 2010

Acromegaly is associated with an increased prevalence of colonic polyps. The aim of this study wa... more Acromegaly is associated with an increased prevalence of colonic polyps. The aim of this study was to evaluate the prevalence and recurrence rate of colonic polyps in acromegalic patients. Ninety-six acromegalic patients and 100 irritable bowel syndrome patients (IBS) were enrolled in the study. Twenty patients who were cured exclusively by surgery, and 20 patients that could not be hormonally controlled were re-examined colonoscopically after 36 months. Twenty-nine of 96 acromegalic patients (30.2%) had colonic polyps. In the IBS group, 10 (10.0%) had colonic polyps. The prevalence of colonic polyps was significantly higher in acromegaly. The group of acromegalic patients with and without polyps did not differ significantly with regard to plasma GH, IGF-I, fasting insulin levels and glycemic status. The presence of colonic polyps was correlated with increased patient age and male gender. We did not observe a difference in terms of polyp recurrence frequencies in the patients cured by surgery compared to uncontrolled patients. Acromegalic patients have a higher prevalence of colonic polyps than that of control subjects. We could not identify any factors that could predict polyps within the acromegalic patients - but age and male sex.

Research paper thumbnail of A report of ten patients with thyroid hemiagenesis: ultrasound screening in patients with thyroid disease

Background: Thyroid hemiagenesis (TH) is a rare congenital abnormality of the thyroid gland, char... more Background: Thyroid hemiagenesis (TH) is a rare congenital abnormality of the thyroid gland, characterised by the absence of one lobe. The true prevalence of this congenital abnormality is not known because the absence of one thyroid lobe usually does not cause clinical symptoms by itself. This study aims to identify the frequency of TH and associated diseases in outpatients referred to our clinic for the first time.

Research paper thumbnail of Endocrinological Approach to the Asymptomatic Primary Hyperparathyroidism

Research paper thumbnail of Compatibility of different methods for the measurement of visceral fat in different body mass index strata

Diagnostic and Interventional Radiology, 2009

Research paper thumbnail of Thyrotropin secreting pituitary adenoma accompanying a silent somatotropinoma

Turkish Neurosurgery, 2010

Thyroid stimulating hormone (TSH) secreting pituitary adenomas are rare tumors manifested as hype... more Thyroid stimulating hormone (TSH) secreting pituitary adenomas are rare tumors manifested as hyperthyroidism with goiter in the presence of elevated TSH. We present a case with pituitary adenoma secreting both TSH and growth hormone (GH) with the prominent clinical findings of hyperthyroidism but without clinical findings of acromegaly. Pituitary magnetic resonance imaging revealed a macroadenoma. Transsphenoidal surgery was performed twice. The immunohistochemical staining showed that tumor cells were strongly reactive to GH and relatively mildly reactive to TSH. Control pituitary imaging revealed a residual macroadenoma, and long acting octreotide treatment was administered. After two years of the treatment, tumor size remained the same while thyroid function tests and insulin-like growth factor 1 (IGF-I) values returned to normal ranges. In conclusion, we always recommend hormonal examinations for all patients who have pituitary adenoma without signs and symptoms of acromegaly.

Research paper thumbnail of Comparison of antithyroid drugs efficacy on P wave changes in patients with Graves' disease Graves hastalarinda antitiroid ilaçlarin P dalga değişiklikleri üzerine etkilerinin karşilaştirilmasi

Objective: Some precursor P wave changes on electrocardiogram (ECG) before the atrial fibrillatio... more Objective: Some precursor P wave changes on electrocardiogram (ECG) before the atrial fibrillation (AF) episodes occur in the hyperthyroidism. Our aim was to compare the effect of two antithyroid drugs (ATD) on P wave duration and dispersion (PWD) in patients with hyperthyroidism. Methods: Fifty patients (13 men, 37 women; mean age 39.2±13.2 years) with newly diagnosed overt hyperthyroid patients with Graves' disease (GD) were enrolled in the prospective, randomized study. The maximum P wave duration (Pmax) and the minimum P wave duration (Pmin) were measured in all 12-lead surface ECGs. The patients were consecutively randomized to propylthiouracil (PTU) (n=24) and methimazole (MMZ) (n=26) groups. Electrocardiogram was repeated within euthyroid state after the 18-month ATD treatment. Student t-test, Mann-Whitney U and Pearson Chi-square tests were used for comparisons of the data between groups. The differences between pre-and post-treatment measurements within groups were evaluated by Wilcoxon Sign Rank test. The correlation of data was tested by using Spearman correlation analysis. Results: The maximum P wave duration (Pmax) was 90 (80-110) and 90 (90-110) msec, (p=0.586), and PWD was 35 (22.5-48.7) and 40 (30-40) msec, respectively (p=0.952) in PTU and MMZ groups. After euthyroidism was achieved, Pmax was 80 (80-90) and 87.5 (80-90) msec (p=0.676), and PWD was 27.5 (20-35) and 27.5 (20-30) msec in PTU and MMZ groups, respectively (p=0.540). After ATD treatment PWD decreased (p=0.009 and p<0.001, respectively) in both of PTU and MMZ groups. However effects of ATD on PWD change were similar (p=0.486). Conclusion: P wave duration and PWD are found to be prolonged in hyperthyroid patients with GD. Both propylthiouracil and methimazole reduce the P wave duration and dispersion. Thus, we can conclude that improvements in atrial conduction properties are not associated with the type of ATD but with only achievement of euthyroidism. (Ana do lu Kar di yol Derg 2009; 9: 298-303) ÖZET Amaç: Atryial fibrilasyonun (AF) henüz ortaya çıkmadan önce hipertiroidinin yüzey elektrokardiyogramına (EKG), P dalga parametrelerinde bazı değişiklikler ile yansıdığı düşünülmektedir. Çalışmamızda hipertiroidli hastalarda iki antitiroid ilacın P dalga süresi ve dispersiyonu üzerindeki etkilerinin karşılaştırılması amaçlanmıştır. Yöntemler: Yeni tanı almış hipertiroidli 50 Graves hastası prospektif, randomize çalışmaya dâhil edildi (13 erkek, 37 kadın; ortalama yaş 39.2±13.2 yıl). On iki derivasyonlu yüzey EKG' den en uzun P (Pmax) ve en kısa P (Pmin) uzunluğu belirlendi. Hastalar sırayla propiltiyourasil (PTU) (n=24) ve metimazol (MMZ) (n=26) gruplarına randomize edildi. On sekiz aylık antitiroid tedavi sonrası, hastalar ötiroid halde iken EKG tekrarlandı. Gruplar arası verilerin karşılaştırması için Student t-testi, Mann-Whitney U ve Pearson Ki-kare testleri kullanıldı. Tedavi öncesi ve sonrası gruplar arası farklılıklar Wilcoxon Sign Rank testi ile değerlendirildi. Verilerin korelasyonu Spearman analizi yardımıyla test edildi. Bulgular: Tedavi öncesi PTU ve MMZ tedavi gruplarında Pmax (sırasıyla 90 (80-110) ve 90 (90-110) ms, p>0.05) ile P dalga dispersiyonu (PWD) değerleri (sırasıyla 35 (22.5-48.7) ve 40 (30-40) ms, p>0.05) benzerdi. Tedavi sonrası PTU ve MMZ gruplarındaki Pmax (sırasıyla 80 (80-90) ve 87.5 (80-90) ms, p=0.676) ve PWD değerleri (sırasıyla 27.5 (20-35) ve 27.5 (20-30) ms, p=0.540) idi. Ötiroidizmin sağlanması ile PWD değerlerinde hem PTU grubunda, hem de MMZ grubunda istatistiksel olarak anlamlı düşüş tespit edildi (sırasıyla p=0.009 ve p<0.001). Ancak antitiroid ilaç gruplarının PWD değişiklik oranları benzerdi (p=0.486). Sonuç: Hipertiroidili Graves hastalarında P dalga süresi ve PWD artmaktadır. Propiltiyourasil ve metimazol tedavileri P dalga süresi ve dispersiyonunu azaltmaktadırlar. İlaç tedavisi ile ötiroidizm sağlandığında, atriyal ileti parametrelerinde ilacın cinsinden bağımsız olarak düzelme görülmektedir. (Ana do lu Kar di yol Derg 2009; 9: 298-303) Anah tar ke li me ler: Graves hastalığı, atriyal fibrilasyon, P dalga dispersiyonu, antitiroid ilaçlar Original Investigation Özgün Araşt›rma 298

Research paper thumbnail of Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus

Central European Journal of Medicine, 2009

The aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-T... more The aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-TPO), anti-thyroglobulin (Anti-TG), and anti-glutamic acid decarboxylase (Anti-GAD) antibodies in Turkish patients with type 1 diabetes mellitus (DM), and to compare the frequency of anti-TPO and anti-TG titers in the presence or absence of anti-GAD. A total of 104 patients including 56 males and 48 females with type 1 DM and their age-, gender-, and body mass index-matched control group, including 31 males and 27 females, 58 cases in total with an age range of 15-50 years, were recruited into this study. In patients with type 1 DM, positive anti-GAD was detected in 30.8% (n=32). In patients with positive anti-GAD, rate of positive anti-TPO was 37.5%; however, in patients with negative anti-GAD, the rate of positive anti-TPO was 9.7% and the difference was statistically significant (p=0.001). In patients with positive anti-GAD, the rate of positive anti-TG was 18.8%. In patients with negative anti-GAD, the rate of positive anti-TG was 2.8%, and the difference between them was statistically significant (p=0.005). In patients with positive and negative anti-GAD, rates of both positive anti-TPO and anti-TG were 15.6% and 1.4%, respectively, with the difference showing statistical significance (p=0.004). Thyroid autoimmunity in type 1 DM patients with positive anti-GAD was apparently higher; therefore, these patients should be followed more frequently and carefully.

Research paper thumbnail of The Effect of Thyroxine-Suppressive Therapy in Patients With Euthyroid Nodular Disease: A Randomized Controlled Study

The Effect of Thyroxine-Suppressive Therapy in Patients With Euthyroid Nodular Disease: A Randomized Controlled Study

Endocrinologist, 2010

... Çakir Özkaya, Evrim MD*; Aydin, Yusuf MD†; Özkan, Betül MD‡; Karaahmetoğlu Özkan, Selma MD‡; ... more ... Çakir Özkaya, Evrim MD*; Aydin, Yusuf MD†; Özkan, Betül MD‡; Karaahmetoğlu Özkan, Selma MD‡; Eskioğlu, Erdal MD‡; Güler, Serdar MD†. Article Outline. Collapse Box ... REFERENCES. 1. Rojeski MT, Gharib H. Nodular thyroid disease: evaluation and management. ...

Research paper thumbnail of Tip 2 Diyabetli Bireylerde Mthfr C677T ve A1298C Gen Polimorfizmleri ile Diyabetik Retinopati Arasindaki İlişkinin İncelenmesi (Evaluation of the Association of Mthfr C677T and A1298C Gene Polymorphisms with Diabetic Retinopathy in Type 2 Diabetes Patients

ÖZET Amaç: Bu çalışma, tip 2 diabetes mellituslu hastalarda diyabetik retinopati ile metilen tetr... more ÖZET Amaç: Bu çalışma, tip 2 diabetes mellituslu hastalarda diyabetik retinopati ile metilen tetrahidrofolat redüktaz C677T ve A1298C gen polimorfizmleri arasındaki ilişkiyi incelemek amacıyla yapılmıştır. Gereç ve Yöntemler: Çalışmaya, tip 2 diabetes mellitus tanısı ile takip edilen toplam 35 hasta alınmıştır. Bu hastalardan 21'i diyabetik retinopatisi bulunan, 14'ü ise kontrol grubu olarak diyabetik retinopatisi bulunmayan hastalardan seçilmiştir. Metilen tetrahidrofolat redüktaz C677T ve A1298C mutasyonları gerçek-zamanlı polimeraz zincir reaksiyonu yöntemiyle araştırılmıştır. Homosistein düzeyleri yüksek performans likit kromatografi yöntemi ile çalışılmıştır. Bulgular: Metilen tetrahidrofolat redüktaz mutasyonu açısından diyabetik retinopatisi bulunan ve bulunmayan gruplar arasında anlamlı bir farklılık tespit edilememiştir (p>0.05). Diyabetik retinopati grubunda 1 (% 4.8) hastada, kontrol grubunda ise 2 (% 14.3) hastada metilen tetrahidrofolat redüktaz C677T homozigot mutasyonu bulunmuştur. Her iki grup arasında mutasyonun bulunup bulunmaması açısından istatistiksel olarak anlamlı bir fark tespit edilememiştir (χ 2 =0.555, p>0.05). Metilen tetrahidrofolat redüktaz A1298C homozigot mutasyonu diyabetik retinopati grubunda 4 (% 19.0) hastada saptanmıştır. Kontrol grubunda ise A1298C homozigot mutasyonu hiç görülmemiştir (χ 2 =0.180, p>0.05). Diyabetik retinopatisi bulunan ve bulunmayan gruplar arasında biyokimyasal parametreler içinden; homosistein düzeylerinde anlamlı bir fark bulunamamıştır (p>0.05), kreatinin (p=0.043), mikroalbuminüri (p=0.036) ve folik asit (p=0.015) düzeyleri arasında ise anlamlı bir farklılık olduğu gözlenmiştir (p<0.05). Sonuçlar: Tip 2 diyabet hastalarında, diyabetik retinopati gelişimi ile metilen tetrahidrofolat redüktaz C677T ve A1298C gen mutasyonları arasında anlamlı bir ilişki bulunamamıştır. Daha fazla sayıda vakanın katılımıyla oluşturulacak gruplarda çalışmanın genişletilmesi uygun bir yaklaşım olacaktır.

Research paper thumbnail of Effects of combined female sex hormone replacement therapy on body fat percentage and distribution

Effects of combined female sex hormone replacement therapy on body fat percentage and distribution

Advances in Therapy, 2006

The effectiveness of hormone replacement therapy for patients with cardiovascular disease and for... more The effectiveness of hormone replacement therapy for patients with cardiovascular disease and for postmenopausal women with associated cardiovascular risks is currently under wide investigation. Among the cardiovascular risks are those related to body fat percentage and distribution. The present study undertook to investigate the effects of combined hormone replacement therapy on body fat percentage and distribution in postmenopausal women. Data for the present study were collected via retrospective analyses of 287 healthy postmenopausal women (146 as a study group, 141 as controls). Participants in the study group received 0.625 mg conjugated equine estrogen combined with 2.5 mg medroxyproges-terone acetate per day for 18 months. Body fat percentage and fat distribution were evaluated through the electrical impedance method and measurements of skinfold thickness, respectively. Two indices of centripetal fat distribution were defined: ratio of trunk-to-extremity skinfold thickness (T/E index), and ratio of upper-to-lower body skinfold thickness (U/L index). Investigators found that a daily dose of 0.625 mg of conjugated equine estrogen combined with 2.5 mg of medroxyprogesterone acetate taken for 18 months increased body fat percentage by decreasing lean body mass and by affecting upper-to-lower body fat distribution, without producing significant changes in overall weight. A slight decrease in the trunk-to-extremity body fat ratio was noted at 18 months of treatment, but this decrease did not reach statistical significance. Data related to the effects of hormone replacement therapy on body fat percentage and distribution in postmenopausal women are scarce. Additional research is needed to clarify the possible health benefits of hormone replacement therapy.

Research paper thumbnail of Prevalence of incidental thyroid cancer and its ultrasonographic features in subcentimeter thyroid nodules of patients with hyperthyroidism

Prevalence of incidental thyroid cancer and its ultrasonographic features in subcentimeter thyroid nodules of patients with hyperthyroidism

Endocrine, 2011

In patients, who undergo surgery for hyperthyroidism, many cases of incidental thyroid cancer (IT... more In patients, who undergo surgery for hyperthyroidism, many cases of incidental thyroid cancer (ITC) have been detected. In the literature, there is no study about ITC in subcentimeter nodules in these patients. We performed this study to determine the frequency of ITC in subcentimeter nodules and ultrasonographic features that can predict malignancy in the patients with hyperthyroidism. We retrospectively reviewed our database about 3114 patients, who underwent thyroidectomy in our hospital. Among 869 patients (27.9%), who were operated because of hyperthyroidism, we enrolled 337 patients, who underwent total thyroidectomy and had subcentimeter nodule [59 Graves’ disease (GD) 98 subcentimeter nodule; 278 toxic multinodular goitre (TMNG), 359 subcentimeter nodule], in this study. Twenty-five nodules with ITC and 432 benign nodules have been detected and compared for ultrasonographic (US) features. Incidental thyroid cancer detection ratio was 5.4% [10.2% (10/98) in subcentimeter thyroid nodules in individuals with GD, and 4.1% (15/359) in individuals with TMNG, P = 0.018)]. Significant differences have been observed between the groups in terms of microcalcification in US examination of malign and benign subcentimeter thyroid nodules and the ratio of anterioposterior diameter to transverse diameter (A/T) ≥1 [(OR = 5.172; 95% CI: 1.495–17.886, P = 0.015), and (OR = 5.930; 95% CI: 1.531–22.971, P = 0.007), respectively]. We detected a higher incidence of ITC in subcentimeter thyroid nodules in GD compared to TMNG. US examination of subcentimeter nodules in hyperthyroid individuals has indicated that microcalcification and ratio of A/T ≥1 are the parameters that predict malignancy.

Research paper thumbnail of Evaluation of hearing loss in patients with Graves’ disease

Endocrine

Hearing loss has commonly been reported in association with thyroid disorders and during treatmen... more Hearing loss has commonly been reported in association with thyroid disorders and during treatment with propylthiouracil. The relationship between hyperthyroidism and the auditory system has not been previously investigated. The aim of this cross-sectional, case–control study was to investigate hearing loss in patients with Graves’ disease (GD). The study population consisted of patients with newly diagnosed GD and healthy controls. Pure tone audiometry at frequencies of 250, 500, 1000, 2000, 4000 and 8000 Hz, along with immittance measures including tympanometry and acoustic reflex tests, were performed in all participants. Twenty-two GD patients and 22 healthy controls consented to inclusion in the study. The differences between groups with regards to age and gender distribution were statistically insignificant (P = 0.567 and P = 0.757, respectively). The hearing thresholds of right and left ears were also similar in both groups (P > 0.05). When single-ear evaluations were taken into account (total of 44 ears for both groups), hearing thresholds in the GD group were significantly higher than healthy controls at all frequencies (P

Research paper thumbnail of Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus

Anadolu Kardiyoloji Dergisi-the Anatolian Journal of Cardiology, 2010

Objective: Atherosclerosis is the major cause of the morbidity and mortality in type 1 diabetes m... more Objective: Atherosclerosis is the major cause of the morbidity and mortality in type 1 diabetes mellitus (DM). Carotid intima-media thickness (CIMT) is the early sign of atherosclerosis and thereby, also the sign of macrovascular diseases. In this study, we aimed to evaluate the CIMT in patients with type 1 DM, and its association with diabetic microvascular complications (nephropathy-retinopathy). Methods: One hundred and thirteen consecutive patients with type 1 DM without macrovascular disease were enrolled into this cross-sectional study. Age, gender, and body mass index matched 59 healthy subjects, were taken as the control group. Microvascular complications in diabetic patients were scanned. Ultrasonographic analysis of the carotid artery was performed with a high-resolution ultrasound scanner. Student's t, Mann Whitney U, Chi-square and Kruskal-Wallis tests, as well as multiple linear regression analysis were used for the statistical analysis. Results: Patients with type 1 DM had significantly higher CIMT compared to control group (p<0001). The CIMT of the patients with microvascular complications (nephropathy and/or retinopathy) was significantly increased (0.70±0.11 mm) compared with the patients without complications (0.63 ± 0.09 mm) (p=0.001). The increase in CIMT in type 1 DM in multiple regression analysis was dependent on the presence of proliferative retinopathy (beta=0.037, 95%CI 0.010-0.065, p=0.008), macroalbuminuria (beta=0.043, 95%CI 0.019-0.068, p=0.001), increased urinary albumin excretion (beta=0.00003, 95%CI 0.00001-0.00005, p=0.005) and duration of diabetes (beta=0.002, 95%CI 0.001-0.003, p=0.009). Conclusions: Increment of CIMT in type 1 diabetic patients was associated with microvascular complications, suggesting that diabetic microangiopathy is related with macroangiopathy. Therefore, there is a need for prospective studies to show the effect of increased CIMT on prognosis of type 1 DM. (Anadolu Kardiyol Derg 2010; 10: 52-8)

Research paper thumbnail of Early severe pre-eclamptic findings in a patient with Cushing's syndrome

Early severe pre-eclamptic findings in a patient with Cushing's syndrome

Gynecological Endocrinology, 2006

Cushing&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;a... more Cushing&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome occurs rarely in pregnancy because of ovulatory disturbances including anovulation which is caused by hypercortisolism, but it can cause maternal complications such as hypertension, gestational diabetes, spontaneous abortion, premature birth, pre-eclampsia and stillbirth. Herein we present the case of a 22-year-old patient in the 11th week of pregnancy who was admitted to our hospital with Cushing&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome complicated by early pre-eclampsia. Severe pre-eclampsia has high maternal and perinatal morbidities, and therefore the possibility of this complication requires that Cushing&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome, although rare in pregnancy, be given a high clinical suspicion. Medical therapy and/or surgical therapy should be considered promptly to influence outcome favorably.

Research paper thumbnail of Serum Matrix Metalloproteinase-9 Levels in the Diagnosis of Functioning Adrenal Tumors

Serum Matrix Metalloproteinase-9 Levels in the Diagnosis of Functioning Adrenal Tumors

Endocrine Practice, 2010

To investigate whether serum matrix metalloproteinase-9 (MMP-9) levels can be used as a diagnosti... more To investigate whether serum matrix metalloproteinase-9 (MMP-9) levels can be used as a diagnostic tool in determining the functioning status of benign adrenal tumors. In this case-control study, medical records of patients with adrenal tumors who consecutively presented to an endocrinology clinic between August 2005 and October 2008 were evaluated. Operation was recommended when the incidentaloma was larger than 4 cm or when a hypersecreting tumor was suspected. A control group of healthy persons matched for age, body mass index, and sex was also enrolled. Patients underwent routine endocrinologic examinations. MMP-9 levels were compared preoperatively and postoperatively. Findings were compared among patients with functioning adrenal tumors, patients with nonfunctioning adrenal tumors, and control participants. Of 370 patients with adrenal tumors, 50 with adrenal incidentaloma met the inclusion criteria. Twenty-five healthy individuals were enrolled as controls. Group 1 included 20 patients with functioning adrenal tumors (14 with Cushing syndrome and 6 with pheochromocytoma), and Group 2 included 30 patients with nonfunctioning adrenal tumors. MMP-9 levels were higher in patients with nonfunctioning adrenal tumors and functioning adrenal tumors than in control participants (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001). MMP-9 levels in patients with functioning adrenal tumors were significantly higher than those in patients with nonfunctioning adrenal tumors (P = .002). After operation, MMP-9 levels decreased significantly in patients with Cushing syndrome and in those with pheochromocytoma; however, patients with Cushing syndrome and pheochromocytoma had similar MMP-9 levels preoperatively and postoperatively. No significant linear correlation existed between tumor volume and MMP-9 levels. A significant positive correlation was determined between preoperative MMP-9 concentrations and 24-hour urinary fractionated metanephrine and epinephrine (r = 0.938, P = .006; r = 0.965, P = .002, respectively), between MMP-9 levels and baseline cortisol levels (r = 0.402, P = .003), and between MMP-9 levels and cortisol levels obtained after dexamethasone suppression testing (r = 0.357, P = .006). Our data suggest that serum MMP-9 levels may be useful in differentiating benign subclinical functioning adrenal tumors from benign nonfunctioning adrenal tumors.

Research paper thumbnail of Serum transforming growth factor-beta levels in patients with vitamin D deficiency

European Journal of Internal Medicine

Research paper thumbnail of Severe hyperphosphatemia and symptomatic hypocalcemia after bowel cleansing with oral sodium phosphate solution in a patient with postoperative hypoparathyroidism

Central European Journal of Medicine, 2010

Oral sodium phosphate (NaP) is increasingly being used for bowel preparation. There are several r... more Oral sodium phosphate (NaP) is increasingly being used for bowel preparation. There are several reports of significant serum electrolyte changes after the administration of oral NaP solution in renal failure. We report a case of postoperative hypoparathyroidism who developed severe hyperphosphatemia and associated hypocalcemia after bowel preparation with oral NaP. A 39-year old woman was admitted to the hospital because of multiple bone fractures. The diagnosis of primary hyperparathyroidism was confirmed. Further assays suggested Cushing’s disease and MRI disclosed a pituitary microadenoma. Considering the diagnostic suspect of multiple endocrine neoplasia type 1, computed tomography of abdomen was performed, showing a mass in the right adrenal. The patient underwent transsphenoidal surgery and then total parathyroidectomy. Despite total removal of the microadenoma by transsphenoidal surgery, there was no suppression in serum cortisol levels. So, an operation was scheduled for the adrenal tumor. The patient was administered 45 mL oral NaP solution for bowel cleansing before the surgery. Although her calcium and phosphorus levels were normal before NaP administration, four hours later she developed respiratory distress and tetany. Laboratory studies revealed severe hyperphosphatemia and hypocalcemia. We conclude that the use of NaP for bowel preparation should be avoided in patients with hypoparathyroidism.

Research paper thumbnail of Pericardial Tamponade in a Patient with Thalassemia Major due to Hypothyoridism

Pericardial Tamponade in a Patient with Thalassemia Major due to Hypothyoridism

Acta Haematologica, 2006

-Thalassemia major (BTM) still remains a disease that displays a surplus of clinical complication... more -Thalassemia major (BTM) still remains a disease that displays a surplus of clinical complications during its follow-up. Pericardial effusion has been mentioned to oc-cur in these patients whereby pericardial tamponade is quite rare. On the other hand, hypothyroidism secondary to iron ...

Research paper thumbnail of Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus Tip 1 diyabetes mellituslu hastalarda karotis intima-media kalinliği ve komplikasyonlarla ilişkisi

Objective: Atherosclerosis is the major cause of the morbidity and mortality in type 1 diabetes m... more Objective: Atherosclerosis is the major cause of the morbidity and mortality in type 1 diabetes mellitus (DM). Carotid intima-media thickness (CIMT) is the early sign of atherosclerosis and thereby, also the sign of macrovascular diseases. In this study, we aimed to evaluate the CIMT in patients with type 1 DM, and its association with diabetic microvascular complications (nephropathy-retinopathy). Methods: One hundred and thirteen consecutive patients with type 1 DM without macrovascular disease were enrolled into this cross-sectional study. Age, gender, and body mass index matched 59 healthy subjects, were taken as the control group. Microvascular complications in diabetic patients were scanned. Ultrasonographic analysis of the carotid artery was performed with a high-resolution ultrasound scanner. Student's t, Mann Whitney U, Chi-square and Kruskal-Wallis tests, as well as multiple linear regression analysis were used for the statistical analysis. Results: Patients with type 1 DM had significantly higher CIMT compared to control group (p<0001). The CIMT of the patients with microvascular complications (nephropathy and/or retinopathy) was significantly increased (0.70±0.11 mm) compared with the patients without complications (0.63 ± 0.09 mm) (p=0.001). The increase in CIMT in type 1 DM in multiple regression analysis was dependent on the presence of proliferative retinopathy (beta=0.037, 95%CI 0.010-0.065, p=0.008), macroalbuminuria (beta=0.043, 95%CI 0.019-0.068, p=0.001), increased urinary albumin excretion (beta=0.00003, 95%CI 0.00001-0.00005, p=0.005) and duration of diabetes (beta=0.002, 95%CI 0.001-0.003, p=0.009). Conclusions: Increment of CIMT in type 1 diabetic patients was associated with microvascular complications, suggesting that diabetic microangiopathy is related with macroangiopathy. Therefore, there is a need for prospective studies to show the effect of increased CIMT on prognosis of type 1 DM. (Anadolu Kardiyol Derg 2010; 10: 52-8)

Research paper thumbnail of Kalp hastaliklarinda diyabet yönetimi

Kalp hastaliklarinda diyabet yönetimi

ÖZET Tip 2 diyabetes mellitus (DM) dünyada en sik görülen hastaliklardan birisidir ve sikliği gid... more ÖZET Tip 2 diyabetes mellitus (DM) dünyada en sik görülen hastaliklardan birisidir ve sikliği giderek artmaktadir. Kardiyovasküler hastaliklar, tip 2 diyabetik hastalardaki mortalite ve morbiditenin en önemli nedenidir. Kardiyovasküler mortalite diyabetik olmayanlara göre diyabetli hastalarda belirgin olarak artmiştir. Diyabet ve bozulmuş glukoz toleransina genelde metabolik sendrom komponenti olarak veya olmadan siklikla eşlik eden hiperlipidemi, hipertansiyon ve obezite gibi diğer kardiyovasküler

Research paper thumbnail of Prevalence and recurrence rate of colonic lesions in acromegalic patients

Prevalence and recurrence rate of colonic lesions in acromegalic patients

Central European Journal of Medicine, 2010

Acromegaly is associated with an increased prevalence of colonic polyps. The aim of this study wa... more Acromegaly is associated with an increased prevalence of colonic polyps. The aim of this study was to evaluate the prevalence and recurrence rate of colonic polyps in acromegalic patients. Ninety-six acromegalic patients and 100 irritable bowel syndrome patients (IBS) were enrolled in the study. Twenty patients who were cured exclusively by surgery, and 20 patients that could not be hormonally controlled were re-examined colonoscopically after 36 months. Twenty-nine of 96 acromegalic patients (30.2%) had colonic polyps. In the IBS group, 10 (10.0%) had colonic polyps. The prevalence of colonic polyps was significantly higher in acromegaly. The group of acromegalic patients with and without polyps did not differ significantly with regard to plasma GH, IGF-I, fasting insulin levels and glycemic status. The presence of colonic polyps was correlated with increased patient age and male gender. We did not observe a difference in terms of polyp recurrence frequencies in the patients cured by surgery compared to uncontrolled patients. Acromegalic patients have a higher prevalence of colonic polyps than that of control subjects. We could not identify any factors that could predict polyps within the acromegalic patients - but age and male sex.

Research paper thumbnail of A report of ten patients with thyroid hemiagenesis: ultrasound screening in patients with thyroid disease

Background: Thyroid hemiagenesis (TH) is a rare congenital abnormality of the thyroid gland, char... more Background: Thyroid hemiagenesis (TH) is a rare congenital abnormality of the thyroid gland, characterised by the absence of one lobe. The true prevalence of this congenital abnormality is not known because the absence of one thyroid lobe usually does not cause clinical symptoms by itself. This study aims to identify the frequency of TH and associated diseases in outpatients referred to our clinic for the first time.

Research paper thumbnail of Endocrinological Approach to the Asymptomatic Primary Hyperparathyroidism

Research paper thumbnail of Compatibility of different methods for the measurement of visceral fat in different body mass index strata

Diagnostic and Interventional Radiology, 2009

Research paper thumbnail of Thyrotropin secreting pituitary adenoma accompanying a silent somatotropinoma

Turkish Neurosurgery, 2010

Thyroid stimulating hormone (TSH) secreting pituitary adenomas are rare tumors manifested as hype... more Thyroid stimulating hormone (TSH) secreting pituitary adenomas are rare tumors manifested as hyperthyroidism with goiter in the presence of elevated TSH. We present a case with pituitary adenoma secreting both TSH and growth hormone (GH) with the prominent clinical findings of hyperthyroidism but without clinical findings of acromegaly. Pituitary magnetic resonance imaging revealed a macroadenoma. Transsphenoidal surgery was performed twice. The immunohistochemical staining showed that tumor cells were strongly reactive to GH and relatively mildly reactive to TSH. Control pituitary imaging revealed a residual macroadenoma, and long acting octreotide treatment was administered. After two years of the treatment, tumor size remained the same while thyroid function tests and insulin-like growth factor 1 (IGF-I) values returned to normal ranges. In conclusion, we always recommend hormonal examinations for all patients who have pituitary adenoma without signs and symptoms of acromegaly.

Research paper thumbnail of Comparison of antithyroid drugs efficacy on P wave changes in patients with Graves' disease Graves hastalarinda antitiroid ilaçlarin P dalga değişiklikleri üzerine etkilerinin karşilaştirilmasi

Objective: Some precursor P wave changes on electrocardiogram (ECG) before the atrial fibrillatio... more Objective: Some precursor P wave changes on electrocardiogram (ECG) before the atrial fibrillation (AF) episodes occur in the hyperthyroidism. Our aim was to compare the effect of two antithyroid drugs (ATD) on P wave duration and dispersion (PWD) in patients with hyperthyroidism. Methods: Fifty patients (13 men, 37 women; mean age 39.2±13.2 years) with newly diagnosed overt hyperthyroid patients with Graves' disease (GD) were enrolled in the prospective, randomized study. The maximum P wave duration (Pmax) and the minimum P wave duration (Pmin) were measured in all 12-lead surface ECGs. The patients were consecutively randomized to propylthiouracil (PTU) (n=24) and methimazole (MMZ) (n=26) groups. Electrocardiogram was repeated within euthyroid state after the 18-month ATD treatment. Student t-test, Mann-Whitney U and Pearson Chi-square tests were used for comparisons of the data between groups. The differences between pre-and post-treatment measurements within groups were evaluated by Wilcoxon Sign Rank test. The correlation of data was tested by using Spearman correlation analysis. Results: The maximum P wave duration (Pmax) was 90 (80-110) and 90 (90-110) msec, (p=0.586), and PWD was 35 (22.5-48.7) and 40 (30-40) msec, respectively (p=0.952) in PTU and MMZ groups. After euthyroidism was achieved, Pmax was 80 (80-90) and 87.5 (80-90) msec (p=0.676), and PWD was 27.5 (20-35) and 27.5 (20-30) msec in PTU and MMZ groups, respectively (p=0.540). After ATD treatment PWD decreased (p=0.009 and p<0.001, respectively) in both of PTU and MMZ groups. However effects of ATD on PWD change were similar (p=0.486). Conclusion: P wave duration and PWD are found to be prolonged in hyperthyroid patients with GD. Both propylthiouracil and methimazole reduce the P wave duration and dispersion. Thus, we can conclude that improvements in atrial conduction properties are not associated with the type of ATD but with only achievement of euthyroidism. (Ana do lu Kar di yol Derg 2009; 9: 298-303) ÖZET Amaç: Atryial fibrilasyonun (AF) henüz ortaya çıkmadan önce hipertiroidinin yüzey elektrokardiyogramına (EKG), P dalga parametrelerinde bazı değişiklikler ile yansıdığı düşünülmektedir. Çalışmamızda hipertiroidli hastalarda iki antitiroid ilacın P dalga süresi ve dispersiyonu üzerindeki etkilerinin karşılaştırılması amaçlanmıştır. Yöntemler: Yeni tanı almış hipertiroidli 50 Graves hastası prospektif, randomize çalışmaya dâhil edildi (13 erkek, 37 kadın; ortalama yaş 39.2±13.2 yıl). On iki derivasyonlu yüzey EKG' den en uzun P (Pmax) ve en kısa P (Pmin) uzunluğu belirlendi. Hastalar sırayla propiltiyourasil (PTU) (n=24) ve metimazol (MMZ) (n=26) gruplarına randomize edildi. On sekiz aylık antitiroid tedavi sonrası, hastalar ötiroid halde iken EKG tekrarlandı. Gruplar arası verilerin karşılaştırması için Student t-testi, Mann-Whitney U ve Pearson Ki-kare testleri kullanıldı. Tedavi öncesi ve sonrası gruplar arası farklılıklar Wilcoxon Sign Rank testi ile değerlendirildi. Verilerin korelasyonu Spearman analizi yardımıyla test edildi. Bulgular: Tedavi öncesi PTU ve MMZ tedavi gruplarında Pmax (sırasıyla 90 (80-110) ve 90 (90-110) ms, p>0.05) ile P dalga dispersiyonu (PWD) değerleri (sırasıyla 35 (22.5-48.7) ve 40 (30-40) ms, p>0.05) benzerdi. Tedavi sonrası PTU ve MMZ gruplarındaki Pmax (sırasıyla 80 (80-90) ve 87.5 (80-90) ms, p=0.676) ve PWD değerleri (sırasıyla 27.5 (20-35) ve 27.5 (20-30) ms, p=0.540) idi. Ötiroidizmin sağlanması ile PWD değerlerinde hem PTU grubunda, hem de MMZ grubunda istatistiksel olarak anlamlı düşüş tespit edildi (sırasıyla p=0.009 ve p<0.001). Ancak antitiroid ilaç gruplarının PWD değişiklik oranları benzerdi (p=0.486). Sonuç: Hipertiroidili Graves hastalarında P dalga süresi ve PWD artmaktadır. Propiltiyourasil ve metimazol tedavileri P dalga süresi ve dispersiyonunu azaltmaktadırlar. İlaç tedavisi ile ötiroidizm sağlandığında, atriyal ileti parametrelerinde ilacın cinsinden bağımsız olarak düzelme görülmektedir. (Ana do lu Kar di yol Derg 2009; 9: 298-303) Anah tar ke li me ler: Graves hastalığı, atriyal fibrilasyon, P dalga dispersiyonu, antitiroid ilaçlar Original Investigation Özgün Araşt›rma 298

Research paper thumbnail of Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus

Central European Journal of Medicine, 2009

The aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-T... more The aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-TPO), anti-thyroglobulin (Anti-TG), and anti-glutamic acid decarboxylase (Anti-GAD) antibodies in Turkish patients with type 1 diabetes mellitus (DM), and to compare the frequency of anti-TPO and anti-TG titers in the presence or absence of anti-GAD. A total of 104 patients including 56 males and 48 females with type 1 DM and their age-, gender-, and body mass index-matched control group, including 31 males and 27 females, 58 cases in total with an age range of 15-50 years, were recruited into this study. In patients with type 1 DM, positive anti-GAD was detected in 30.8% (n=32). In patients with positive anti-GAD, rate of positive anti-TPO was 37.5%; however, in patients with negative anti-GAD, the rate of positive anti-TPO was 9.7% and the difference was statistically significant (p=0.001). In patients with positive anti-GAD, the rate of positive anti-TG was 18.8%. In patients with negative anti-GAD, the rate of positive anti-TG was 2.8%, and the difference between them was statistically significant (p=0.005). In patients with positive and negative anti-GAD, rates of both positive anti-TPO and anti-TG were 15.6% and 1.4%, respectively, with the difference showing statistical significance (p=0.004). Thyroid autoimmunity in type 1 DM patients with positive anti-GAD was apparently higher; therefore, these patients should be followed more frequently and carefully.

Research paper thumbnail of The Effect of Thyroxine-Suppressive Therapy in Patients With Euthyroid Nodular Disease: A Randomized Controlled Study

The Effect of Thyroxine-Suppressive Therapy in Patients With Euthyroid Nodular Disease: A Randomized Controlled Study

Endocrinologist, 2010

... Çakir Özkaya, Evrim MD*; Aydin, Yusuf MD†; Özkan, Betül MD‡; Karaahmetoğlu Özkan, Selma MD‡; ... more ... Çakir Özkaya, Evrim MD*; Aydin, Yusuf MD†; Özkan, Betül MD‡; Karaahmetoğlu Özkan, Selma MD‡; Eskioğlu, Erdal MD‡; Güler, Serdar MD†. Article Outline. Collapse Box ... REFERENCES. 1. Rojeski MT, Gharib H. Nodular thyroid disease: evaluation and management. ...

Research paper thumbnail of Tip 2 Diyabetli Bireylerde Mthfr C677T ve A1298C Gen Polimorfizmleri ile Diyabetik Retinopati Arasindaki İlişkinin İncelenmesi (Evaluation of the Association of Mthfr C677T and A1298C Gene Polymorphisms with Diabetic Retinopathy in Type 2 Diabetes Patients

ÖZET Amaç: Bu çalışma, tip 2 diabetes mellituslu hastalarda diyabetik retinopati ile metilen tetr... more ÖZET Amaç: Bu çalışma, tip 2 diabetes mellituslu hastalarda diyabetik retinopati ile metilen tetrahidrofolat redüktaz C677T ve A1298C gen polimorfizmleri arasındaki ilişkiyi incelemek amacıyla yapılmıştır. Gereç ve Yöntemler: Çalışmaya, tip 2 diabetes mellitus tanısı ile takip edilen toplam 35 hasta alınmıştır. Bu hastalardan 21'i diyabetik retinopatisi bulunan, 14'ü ise kontrol grubu olarak diyabetik retinopatisi bulunmayan hastalardan seçilmiştir. Metilen tetrahidrofolat redüktaz C677T ve A1298C mutasyonları gerçek-zamanlı polimeraz zincir reaksiyonu yöntemiyle araştırılmıştır. Homosistein düzeyleri yüksek performans likit kromatografi yöntemi ile çalışılmıştır. Bulgular: Metilen tetrahidrofolat redüktaz mutasyonu açısından diyabetik retinopatisi bulunan ve bulunmayan gruplar arasında anlamlı bir farklılık tespit edilememiştir (p>0.05). Diyabetik retinopati grubunda 1 (% 4.8) hastada, kontrol grubunda ise 2 (% 14.3) hastada metilen tetrahidrofolat redüktaz C677T homozigot mutasyonu bulunmuştur. Her iki grup arasında mutasyonun bulunup bulunmaması açısından istatistiksel olarak anlamlı bir fark tespit edilememiştir (χ 2 =0.555, p>0.05). Metilen tetrahidrofolat redüktaz A1298C homozigot mutasyonu diyabetik retinopati grubunda 4 (% 19.0) hastada saptanmıştır. Kontrol grubunda ise A1298C homozigot mutasyonu hiç görülmemiştir (χ 2 =0.180, p>0.05). Diyabetik retinopatisi bulunan ve bulunmayan gruplar arasında biyokimyasal parametreler içinden; homosistein düzeylerinde anlamlı bir fark bulunamamıştır (p>0.05), kreatinin (p=0.043), mikroalbuminüri (p=0.036) ve folik asit (p=0.015) düzeyleri arasında ise anlamlı bir farklılık olduğu gözlenmiştir (p<0.05). Sonuçlar: Tip 2 diyabet hastalarında, diyabetik retinopati gelişimi ile metilen tetrahidrofolat redüktaz C677T ve A1298C gen mutasyonları arasında anlamlı bir ilişki bulunamamıştır. Daha fazla sayıda vakanın katılımıyla oluşturulacak gruplarda çalışmanın genişletilmesi uygun bir yaklaşım olacaktır.

Research paper thumbnail of Effects of combined female sex hormone replacement therapy on body fat percentage and distribution

Effects of combined female sex hormone replacement therapy on body fat percentage and distribution

Advances in Therapy, 2006

The effectiveness of hormone replacement therapy for patients with cardiovascular disease and for... more The effectiveness of hormone replacement therapy for patients with cardiovascular disease and for postmenopausal women with associated cardiovascular risks is currently under wide investigation. Among the cardiovascular risks are those related to body fat percentage and distribution. The present study undertook to investigate the effects of combined hormone replacement therapy on body fat percentage and distribution in postmenopausal women. Data for the present study were collected via retrospective analyses of 287 healthy postmenopausal women (146 as a study group, 141 as controls). Participants in the study group received 0.625 mg conjugated equine estrogen combined with 2.5 mg medroxyproges-terone acetate per day for 18 months. Body fat percentage and fat distribution were evaluated through the electrical impedance method and measurements of skinfold thickness, respectively. Two indices of centripetal fat distribution were defined: ratio of trunk-to-extremity skinfold thickness (T/E index), and ratio of upper-to-lower body skinfold thickness (U/L index). Investigators found that a daily dose of 0.625 mg of conjugated equine estrogen combined with 2.5 mg of medroxyprogesterone acetate taken for 18 months increased body fat percentage by decreasing lean body mass and by affecting upper-to-lower body fat distribution, without producing significant changes in overall weight. A slight decrease in the trunk-to-extremity body fat ratio was noted at 18 months of treatment, but this decrease did not reach statistical significance. Data related to the effects of hormone replacement therapy on body fat percentage and distribution in postmenopausal women are scarce. Additional research is needed to clarify the possible health benefits of hormone replacement therapy.

Research paper thumbnail of Prevalence of incidental thyroid cancer and its ultrasonographic features in subcentimeter thyroid nodules of patients with hyperthyroidism

Prevalence of incidental thyroid cancer and its ultrasonographic features in subcentimeter thyroid nodules of patients with hyperthyroidism

Endocrine, 2011

In patients, who undergo surgery for hyperthyroidism, many cases of incidental thyroid cancer (IT... more In patients, who undergo surgery for hyperthyroidism, many cases of incidental thyroid cancer (ITC) have been detected. In the literature, there is no study about ITC in subcentimeter nodules in these patients. We performed this study to determine the frequency of ITC in subcentimeter nodules and ultrasonographic features that can predict malignancy in the patients with hyperthyroidism. We retrospectively reviewed our database about 3114 patients, who underwent thyroidectomy in our hospital. Among 869 patients (27.9%), who were operated because of hyperthyroidism, we enrolled 337 patients, who underwent total thyroidectomy and had subcentimeter nodule [59 Graves’ disease (GD) 98 subcentimeter nodule; 278 toxic multinodular goitre (TMNG), 359 subcentimeter nodule], in this study. Twenty-five nodules with ITC and 432 benign nodules have been detected and compared for ultrasonographic (US) features. Incidental thyroid cancer detection ratio was 5.4% [10.2% (10/98) in subcentimeter thyroid nodules in individuals with GD, and 4.1% (15/359) in individuals with TMNG, P = 0.018)]. Significant differences have been observed between the groups in terms of microcalcification in US examination of malign and benign subcentimeter thyroid nodules and the ratio of anterioposterior diameter to transverse diameter (A/T) ≥1 [(OR = 5.172; 95% CI: 1.495–17.886, P = 0.015), and (OR = 5.930; 95% CI: 1.531–22.971, P = 0.007), respectively]. We detected a higher incidence of ITC in subcentimeter thyroid nodules in GD compared to TMNG. US examination of subcentimeter nodules in hyperthyroid individuals has indicated that microcalcification and ratio of A/T ≥1 are the parameters that predict malignancy.