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Tesfaye E, Getnet M, Anmut Bitew D, Adugna DG, Maru L. Brain functional connectivity in hyperthyroid patients: systematic review. Front Neurosci 2024; 18:1383355. [PMID: 38726033 PMCID: PMC11080614 DOI: 10.3389/fnins.2024.1383355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/05/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Functional connectivity (FC) is the correlation between brain regions' activities, studied through neuroimaging techniques like fMRI. It helps researchers understand brain function, organization, and dysfunction. Hyperthyroidism, characterized by high serum levels of free thyroxin and suppressed thyroid stimulating hormone, can lead to mood disturbance, cognitive impairment, and psychiatric symptoms. Excessive thyroid hormone exposure can enhance neuronal death and decrease brain volume, affecting memory, attention, emotion, vision, and motor planning. Methods We conducted thorough searches across Google Scholar, PubMed, Hinari, and Science Direct to locate pertinent articles containing original data investigating FC measures in individuals diagnosed with hyperthyroidism. Results The systematic review identified 762 articles, excluding duplicates and non-matching titles and abstracts. Four full-text articles were included in this review. In conclusion, a strong bilateral hippocampal connection in hyperthyroid individuals suggests a possible neurobiological influence on brain networks that may affect cognitive and emotional processing. Systematic Review Registration PROSPERO, CRD42024516216.
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Affiliation(s)
- Ephrem Tesfaye
- Department of Biomedical Sciences, Madda Walabu University Goba Referral Hospital, Bale-Robe, Ethiopia
| | - Mihret Getnet
- Department of Human Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Dagnew Getnet Adugna
- Department of Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Lemlemu Maru
- Department of Human Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Lou K, Liu S, Zhang F, Sun W, Su X, Bi W, Yin Q, Qiu Y, Zhang Z, Jing M, Ma S. The effect of hyperthyroidism on cognitive function, neuroinflammation, and necroptosis in APP/PS1 mice. J Transl Med 2023; 21:657. [PMID: 37740205 PMCID: PMC10517505 DOI: 10.1186/s12967-023-04511-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/06/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Increasing evidence has linked the thyroid dysfunction to the pathogenesis of dementia. Evidence from clinical studies has demonstrated that hypothyroidism is related to an increased risk of dementia. But the association of hyperthyroidism with dementia is largely unknown. METHODS We used the adenovirus containing thyrotropin receptor (TSHR) amino acid residues 1-289 (Ad-TSHR289)-induced Graves' disease (GD) phenotype in Alzheimer's disease (AD) model mice (APP/PS1 mice) to evaluate the effect of hyperthyroidism on the cognitive function and β-amyloid (Aβ) accumulation. RESULTS GD mice exhibited a stable long-term hyperthyroidism and cognitive deficits. Single Cell RNA-sequencing analysis indicated that microglia function played a critical role in the pathophysiological processes in GD mice. Neuroinflammation and polarization of microglia (M1/M2 phenotype) and activated receptor-interacting serine/threonine protein kinase 3 (RIPK3)/mixed lineage kinase domain-like pseudo-kinase (MLKL)-mediated necroptosis contributed to the pathological process, including Aβ deposition and neuronal loss. RIPK3 inhibitor could inhibit GD-mediated Aβ accumulation and neuronal loss. CONCLUSIONS Our findings reveal that GD hyperthyroidism aggravates cognitive deficits in AD mice and induces Aβ deposition and neuronal loss by inducing neuroinflammation and RIPK3/MLKL-mediated necroptosis.
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Affiliation(s)
- Kai Lou
- Department of Endocrinology, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, China
| | - Shudong Liu
- Department of Endocrinology, Shandong Rongjun General Hospital, Jinan, 250013, China
| | - Fengxia Zhang
- Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250011, China
| | - Wenxiu Sun
- Department of Nursing, Taishan Vocational College of Nursing, Taian, 271000, Shandong, China
| | - Xinhuan Su
- Department of Geriatrics Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Wenkai Bi
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, 250021, Shandong, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
| | - Qingqing Yin
- Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yaxin Qiu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, 250021, Shandong, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
| | - Zhenyuan Zhang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, 250021, Shandong, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
| | - Mengzhe Jing
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, 250021, Shandong, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
| | - Shizhan Ma
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, 250021, Shandong, China.
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, 250021, Shandong, China.
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China.
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Muacevic A, Adler JR, Shukla S, Kumar S. Neuropsychiatric Manifestations of Thyroid Diseases. Cureus 2023; 15:e33987. [PMID: 36811059 PMCID: PMC9938951 DOI: 10.7759/cureus.33987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/20/2023] [Indexed: 01/21/2023] Open
Abstract
Thyroid disorders are known to cause neuropsychiatric manifestations. Various neuropsychiatric manifestations are depression, dementia, mania, and autoimmune Hashimoto encephalopathy. Numerous investigations carried out in the previous 50-60 years have been evaluated critically. The pathophysiology of neuropsychiatric symptoms of thyroid diseases is described in the current study and its link with autoimmune Hashimoto encephalopathy is also discussed. Furthermore, this paper also describes the association between thyroid-stimulating hormones and cognitive impairment. Hypothyroidism is associated with depression and mania, and hyperthyroidism is linked with dementia and mania. The association between Graves' disease and various mental disorders such as depressive and anxiety disorders is also discussed. The aim of this study is to review the relationship between various neuropsychiatric disorders and thyroid diseases. A literature search from the PubMed database to find various neuropsychiatric manifestations of thyroid disorders in the adult population was conducted. According to the review of the studies, cognitive impairment can result from thyroid disease. It has not been possible to demonstrate how hyperthyroidism can hasten the process of developing dementia. However, subclinical hyperthyroidism, thyroid-stimulating hormone (TSH) levels below the normal range, and high free thyroxine (T4) levels all raise the risk of dementia in the elderly. Additionally, the potential mechanisms underlying this association have been examined. A quick summary of the research on mania as a clinical symptom of hypothyroidism and its likely causes and pathogenesis is also reviewed. There is no dearth of evidence that describes various neuropsychiatric manifestation in thyroid disorders.
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Wieland DR, Wieland JR, Wang H, Chen YH, Lin CH, Wang JJ, Weng CH. Thyroid Disorders and Dementia Risk: A Nationwide Population-Based Case-Control Study. Neurology 2022; 99:e679-e687. [PMID: 35794019 DOI: 10.1212/wnl.0000000000200740] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 03/31/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Dementia has been gaining attention in aging societies and is estimated to affect 50 million adults globally in 2020, and 12% of the US population may develop a thyroid disorder in their lifetime. There have been limited studies investigating the correlation between thyroid disorder and dementia in the Asian population. METHODS Our large nationwide population-based case-control study utilized the Taiwanese National Health Insurance Research Database. 7,843 adults with newly diagnosed dementia without a previous history of dementia or neurodegenerative disease between 2006 and 2013 were identified and included in our study. 7,843 adults without dementia diagnosis prior to the index date were age and gender matched as controls. Diagnosis of hyperthyroidism or hypothyroidism prior to the diagnosis of dementia or the same index date was identified. Results were obtained from logistic regression models and adjusted for sex, age, history of hypertension, diabetes, coronary artery disease, depression, hyperlipidemia, alcohol dependence syndrome, tinnitus, hearing loss, and radioactive iodine treatment. RESULTS A total of 15,686 patients were included in the study. Both case and control groups were slightly predominantly female (4,066 [51.8%]). The mean (SD) age for those with dementia was 74.9 (11.3) years, and for those without dementia was 74.5 (11.3) years. Among patients aged 65 years or older, a history of hypothyroidism was associated with an increased risk of being diagnosed with dementia (aOR, 1.81; 95% Cl 1.14-2.87; p=0.011), which was an association not present in patients older than 50 years but younger than 65 years. We found that this association was most significant among patients aged 65 years or older with a history of hypothyroidism who received hypothyroidism medication (aOR, 3.17; 95% Cl 1.04-9.69; p=0.043). DISCUSSION Our large-scale case-control study found that among people ≥ 65 years old, those with a history of hypothyroidism were associated with an 81% increased risk of having dementia and among those, there was an over 3-fold increased dementia risk with thyroid conditions that required thyroid hormone replacement treatment. Future well-controlled prospective longitudinal studies should be conducted to elucidate these potential mechanisms and relationships. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that among patients aged 65 years or older, a history of hypothyroidism was associated with an increased risk of being diagnosed with dementia.
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Affiliation(s)
| | | | - Han Wang
- Department of Neurology, Mayo Clinic College of Medicine & Science, Rochester, Minnesota, USA.,Department of Neurology, Mayo Clinic Health System, Mankato, Minnesota, USA
| | - Yi-Huei Chen
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, TAIWAN
| | - Ching-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, TAIWAN
| | - Jing-Jie Wang
- Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, TAIWAN.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chien-Hsiang Weng
- Department of Family Medicine, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA .,Coastal Medical Hillside Family Medicine, Pawtucket, Rhode Island, USA
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Charoenngam N, Rittiphairoj T, Ponvilawan B, Prasongdee K. Thyroid Dysfunction and Risk of Parkinson's Disease: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2022; 13:863281. [PMID: 35600588 PMCID: PMC9114488 DOI: 10.3389/fendo.2022.863281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Studies have suggested that patients with thyroid dysfunction may have an increased risk of developing Parkinson's disease (PD). However, the results from existing studies are inconsistent. Therefore, we aimed to investigate the association of hypothyroidism and hyperthyroidism with risk of PD using the method of systematic review and meta-analysis. METHODS Potentially eligible studies were identified from Medline and EMBASE databases from inception to December 2021 using search strategy that comprised of terms for "Thyroid" and "Parkinson's Disease". Eligible cohort study must consist of one cohort of patients with hypothyroidism/hyperthyroidism and another cohort of individuals without hypothyroidism/hyperthyroidism. Then, the study must report effect estimates with 95% confidence intervals (95% CIs) comparing incident PD between the groups. Eligible case-control studies must include cases with PD and controls without PD. Then, the study must explore their history of hypothyroidism/hyperthyroidism. Odds ratio (OR) with 95% CIs of the association between presence of hypothyroidism/hyperthyroidism and PD must be reported. Point estimates with standard errors were retrieved from each study and were combined together using the generic inverse variance method. RESULTS A total of 3,147 articles were identified. After two rounds of independent review by three investigators, 3 cohort studies and 6 case-control studies met the eligibility criteria and were included into the meta-analysis. Pooled analysis showed an increased likelihood of PD in both patients with hypothyroidism (pooled OR 1.56; 95%CI, 1.38 - 1.77; with moderate heterogeneity, I2 66.9%) and patients with hyperthyroidism (pooled OR 1.57; 95%CI, 1.40 - 1.77; with insignificant heterogeneity, I2 0.0%). Funnel plots for both meta-analyses were fairly symmetric, which did not indicate presence of publication bias. CONCLUSION This systematic review and meta-analysis found a significant association of both hypothyroidism and hyperthyroidism with an increased risk of PD.
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Affiliation(s)
- Nipith Charoenngam
- Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, United States
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- *Correspondence: Nipith Charoenngam,
| | | | - Ben Ponvilawan
- Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Klaorat Prasongdee
- Department of Medicine, MetroWest Medical Center, Framingham, MA, United States
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Quertermous BP, Kavuri S, Walsh DW. An old disease with a new twist: CNS and thyroid sarcoidosis presenting as subacute dementia. Clin Case Rep 2021; 9:e04829. [PMID: 34631064 PMCID: PMC8493448 DOI: 10.1002/ccr3.4829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 12/03/2022] Open
Abstract
Dementia in the elderly is extremely common and is often irreversible. When a patient presents with rapid cognitive decline, uncommon reversible etiologies should be investigated with the goal of restoring cognitive function.
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Affiliation(s)
| | - Sravan Kavuri
- Medical College of Georgia Augusta University Augusta GA USA
| | - David W Walsh
- Medical College of Georgia Augusta University Augusta GA USA
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Lai F, Mercaldo N, Wang CM, Hersch GG, Rosas HD. Association between Inflammatory Conditions and Alzheimer's Disease Age of Onset in Down Syndrome. J Clin Med 2021; 10:3116. [PMID: 34300282 PMCID: PMC8307987 DOI: 10.3390/jcm10143116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 02/01/2023] Open
Abstract
Adults with Down syndrome (DS) have an exceptionally high prevalence of Alzheimer disease (AD), with an earlier age of onset compared with the neurotypical population. In addition to beta amyloid, immunological processes involved in neuroinflammation and in peripheral inflammatory/autoimmune conditions are thought to play important roles in the pathophysiology of AD. Individuals with DS also have a high prevalence of autoimmune/inflammatory conditions which may contribute to an increased risk of early AD onset, but this has not been studied. Given the wide range in the age of AD onset in those with DS, we sought to evaluate the relationship between the presence of inflammatory conditions and the age of AD onset. We performed a retrospective study on 339 adults with DS, 125 who were cognitively stable (CS) and 214 with a diagnosis of AD. Data were available for six autoimmune conditions (alopecia, celiac disease, hypothyroidism, psoriasis, diabetes and vitamin B12 deficiency) and for one inflammatory condition, gout. Gout was associated with a significant delay in the age of AD onset by more than 2.5 years. Our data suggests that inflammatory conditions may play a role in the age of AD onset in DS. Further studies are warranted.
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Affiliation(s)
- Florence Lai
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA;
| | - Nathaniel Mercaldo
- Department of Radiology, Center for Neuroimaging of Aging and Neurodegenerative Diseases, Athinoula A. Martinos Center for Biomedical Imaging, 149 13th Street, Charlestown, MA 02129, USA;
| | | | - Giovi G. Hersch
- College of Arts and Sciences, Boston University, Boston, MA 02215, USA;
| | - Herminia Diana Rosas
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA;
- Department of Radiology, Center for Neuroimaging of Aging and Neurodegenerative Diseases, Athinoula A. Martinos Center for Biomedical Imaging, 149 13th Street, Charlestown, MA 02129, USA;
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Ekinci İ, Ekinci E, Buyukkaba M, Cinar A, Kirac Utku İ, Ozkan H, Tunc M, Kumbasar A, Tabak O. Selective Attention and Information Processing Speed in Graves' Disease: Stroop Interference Effect. Cureus 2021; 13:e14072. [PMID: 33903835 PMCID: PMC8062313 DOI: 10.7759/cureus.14072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Cognitive functions are affected by thyroid hormones. In this study, we aimed to investigate the selective attention and information processing speed in thyrotoxic Graves’ disease. Methodology This study was conducted among 40 patients with thyrotoxic Graves’ disease and age and gender-matched 40 healthy controls. Stroop Color and Word test were applied to healthy controls once and to patients with Graves’ disease during thyrotoxic and euthyroid periods. Stroop interference effect was calculated. Results The mean age was 34.67 ± 11 in the Graves’ group and 34.72 ± 9.16 in the control group (p > 0.05). The number of errors and self-corrections in Stroop Color and Word test was higher in patients with thyrotoxic Graves’ disease than both patients with euthyroid Graves’ disease and healthy controls (p < 0.05). Stroop interference effect was significantly longer in patients with thyrotoxic Graves’ disease than both patients with euthyroid Graves’ disease and healthy controls (p < 0.05). All parameters obtained from the Stroop Color and Word test including errors, self-corrections, and Stroop interference effect were similar in patients with euthyroid Graves’ disease and healthy controls. Conclusions Selective attention was impaired and information processing speed was slow in patients with thyrotoxic Graves’ disease, and these findings were associated with age and educational level. After becoming euthyroid through antithyroid medication, these pathological findings returned to normal levels. Additionally, Stroop interference effect was significantly decreased when patients with Graves’ disease became euthyroid.
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Affiliation(s)
- İskender Ekinci
- Internal Medicine, Health Sciences University, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR
| | - Esra Ekinci
- Social Services Department, Directorate of Woman and Family Services, Istanbul Metropolitan Municipality, Istanbul, TUR
| | - Mitat Buyukkaba
- Internal Medicine, Health Sciences University, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR
| | - Ahmet Cinar
- Internal Medicine, Arnavutkoy State Hospital, Istanbul, TUR
| | - İrem Kirac Utku
- Internal Medicine, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR
| | - Hanise Ozkan
- Internal Medicine, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR
| | - Muhammed Tunc
- Internal Medicine, Bezmialem Vakif University, Istanbul, TUR
| | - Abdulbaki Kumbasar
- Internal Medicine, Health Sciences University, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR
| | - Omur Tabak
- Internal Medicine, Health Sciences University, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR
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