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An İ, Kahraman FC, Bilgiç A, Aktürk AŞ, Albayrak H, Kartal D, Çınar SL, Solak SS, Uslu M, Şanlı HE, Yıldızhan İK, Şahin MT, Zindanci İ, Savaş S, Ayhan E, Cinel M, Ataş ENS, Aydemir M, Selek A, Elbüken G, Zuhur SS, Karaca Z, Bülbül BY, Ünübol M, Demir Ö, Hekimsoy Z, Tuna M, Asilsoy M, Çetin S. Cutaneous findings in patients with acromegaly and its relationship with concomitant endocrinopathies. Clin Endocrinol (Oxf) 2024. [PMID: 38712950 DOI: 10.1111/cen.15071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/22/2024] [Accepted: 04/27/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVES Skin changes in acromegaly are often the first sign of the disease. The aim of this study was to describe the cutaneous findings in patients with acromegaly. In addition, a secondary aim was to investigate the possible association of these findings with remission status and concomitant endocrinopathies. DESIGN, PATIENTS, AND MEASUREMENTS In this prospective multicenter study, 278 patients over the age of 18 years with acromegaly who were followed up in 14 different tertiary healthcare institutions were included. These patients, who were followed up by the Endocrinology Department, were then referred to a dermatologist for dermatological examination. The frequency of skin lesions was investigated by detailed dermatologic examination. Dermatological diagnosis is reached by clinical, dermatological and/or dermoscopic examination, and rarely skin punch biopsy examinations in suspicious cases. The possible association of the skin findings between remitted and nonremitted patients and with concomitant endocrinopathies were evaluated. RESULTS The most common skin findings in patients with acromegaly in our study were skin tags (52.5%), cherry angiomas (47.4%), seborrhoea (37%), varicose veins (33%), acneiform lesions (28.8%), hyperhidrosis (26.9%) and hypertrichosis (18.3%). Hypertrichosis was significantly more prevalent in patients nonremitted (p: .001), while xerosis cutis was significantly more prevalent in patients remitted (p: .001). The frequency of diabetes mellitus and hypothyroidism was significantly higher in patients with varicose veins and seborrhoeic keratosis than those without. Additionally, the coexistence of hypothyroidism, hyperthyroidism and galactorrhea was significantly higher in patients with Cherry angioma than in those without Cherry angioma (p-values: .024, .034 and .027, respectively). The frequency of hypogonadism in those with xerosis cutis was significantly higher than in those without (p: .035). CONCLUSIONS Cutaneous androgenization findings such as skin tag, seborrhoea, acne and acanthosis nigricans are common in patients with acromegaly. Clinicians should be aware that skin findings associated with insulin resistance may develop in these patients. It can be said that the remission state in acromegaly has no curative effect on cutaneous findings. Only patients in remission were less likely to have hypertrichosis. This may allow earlier review of the follow-up and treatment of acromegaly patients presenting with complaints of hypertrichosis. Additionally, it can be said that patients with skin findings such as cherry angioma may be predisposed to a second endocrinopathy, especially hypothyroidism. Including dermatology in a multidisciplinary perspective in acromegaly patient management would be beneficial to detect cutaneous findings earlier.
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Affiliation(s)
- İsa An
- Department of Dermatology, Şanlıurfa Training and Research Hospital, Sanlıurfa, Turkey
| | - Filiz Cebeci Kahraman
- Department of Dermatology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey
| | - Aslı Bilgiç
- Department of Dermatology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Aysun Şikar Aktürk
- Department of Dermatology, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Hülya Albayrak
- Department of Dermatology, Namık Kemal University Medical Faculty, Turkey
| | - Demet Kartal
- Department of Dermatology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Salih Levent Çınar
- Department of Dermatology, Erciyes University Medical Faculty, Kayseri, Turkey
| | | | - Meltem Uslu
- Department of Dermatology, Adnan Menderes University Medical Faculty, Turkey
| | - Hatice Erdi Şanlı
- Department of Dermatology, Ankara University Medical Faculty, Ankara, Turkey
| | | | - Mustafa Turhan Şahin
- Department of Dermatology, Celal Bayar University Medical Faculty, Manisa, Turkey
| | - İlkin Zindanci
- Department of Dermatology, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Sevil Savaş
- Department of Dermatology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Erhan Ayhan
- Department of Dermatology, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Murat Cinel
- Department of Endocrinology and Metabolism, Mehmet Akif Inan Education and Research Hospital, Şanlıurfa, Turkey
| | - Elif Nazlı Serin Ataş
- Department of Endocrinology and Metabolism, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Mustafa Aydemir
- Department of Endocrinology and Metabolism, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Alev Selek
- Department of Endocrinology and Metabolism, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Gülşah Elbüken
- Department of Endocrinology and Metabolism, Namık Kemal University Medical Faculty, Turkey
| | - Sayid Shafi Zuhur
- Department of Endocrinology and Metabolism, Namık Kemal University Medical Faculty, Turkey
| | - Züleyha Karaca
- Department of Endocrinology and Metabolism, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Buket Yılmaz Bülbül
- Department of Endocrinology and Metabolism, Trakya University Medical Faculty, Edirne, Turkey
| | - Mustafa Ünübol
- Department of Endocrinology and Metabolism, Adnan Menderes University Medical Faculty, Turkey
| | - Özgür Demir
- Department of Endocrinology and Metabolism, Ankara University Medical Faculty, Ankara, Turkey
| | - Zeliha Hekimsoy
- Department of Endocrinology and Metabolism, Celal Bayar University Medical Faculty, Manisa, Turkey
| | - Mazhar Tuna
- Department of Endocrinology and Metabolism, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Miray Asilsoy
- Department of Endocrinology and Metabolism, Sultan 2. Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Sedat Çetin
- Department of Endocrinology and Metabolism, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
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Akkuş E, Gökçay Canpolat A, Demir Ö, Çorapçıoğlu D, Şahin M. Asymptomatic pyuria and bacteriuria are not risk factors for urinary tract infection in women with type 2 diabetes mellitus initiated SGLT2 inhibitors. Int Urol Nephrol 2024; 56:1165-1172. [PMID: 37715859 DOI: 10.1007/s11255-023-03798-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/09/2023] [Indexed: 09/18/2023]
Abstract
PURPOSE Asymptomatic pyuria and bacteriuria are more prevalent in diabetic patients and may be associated with urinary tract infection (UTI). The aim of this study is to investigate the association between asymptomatic pyuria/bacteriuria at the initiation of SGLT2 inhibitor and UTI risk in female patients with type 2 diabetes. METHODS The study was designed as a practical, single-center, prospective, cohort study. The female outpatients with type 2 diabetes initiated SGLT2 inhibitor were included. Patients who were symptomatic or treated in the past 3 months for urinary or genital tract infection, had a high risk for UTI were excluded. Hospitalization/antibiotic use for indications other than UTI were exclusion criteria during follow-up. All patients were followed up for 3 months. Pyuria and bacteriuria were exposure and, UTI was the outcome. Cumulative incidence and relative risk of UTI were analyzed for pyuria and bacteriuria. RESULTS 143 female patients were included among 1132 female type 2 diabetic patients. 13 patients were excluded during follow-up. 41.5% of the patients (n = 54) had pyuria and 28.5% (n = 37) had bacteriuria. The cumulative incidence of UTI was 20% in the whole cohort, 25,9% (n = 14/54) in the pyuria group and 18.9% (n = 7/37) in the bacteriuria group. The relative risk of UTI was 1.64 (95% CI: 0.82-3.26, p = 0.15) for pyuria, 0.92 (95% CI: 0.42-2.01, p = 0.84) for bacteriuria, and 1.2 (95% CI: 0.47-3.08, p = 0.69) for pyuria plus bacteriuria. Adjusted odd ratios revealed similar results. CONCLUSIONS Asymptomatic pyuria/bacteriuria at the initiation of SGLT2 inhibitors are not risk factors for UTI in women with type 2 diabetes.
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Affiliation(s)
- Erman Akkuş
- Department of Internal Medicine, Trabzon Araklı Public Hospital, Trabzon, Turkey.
- Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey.
| | - Asena Gökçay Canpolat
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Özgür Demir
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Demet Çorapçıoğlu
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Şahin
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
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Korkmaz FN, Gökçay Canpolat A, Dalva K, Elhan AH, Şahin M, Çorapçıoğlu D, Demir Ö. Determination of the Relationship Between the Development and Recurrence of Subacute Thyroiditis and Human Leukocyte Antigen Subtypes. Genet Test Mol Biomarkers 2024; 28:2-9. [PMID: 38294356 DOI: 10.1089/gtmb.2023.0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Background: There are several studies investigating the role of human leukocyte antigens (HLA) in the development and recurrence of subacute thyroiditis (SAT). The HLA subtypes associated with SAT were usually determined in a population-based manner and HLA-B*35, HLA-B*18:01, HLA-C*04:01, and HLA-DRB1*01 were detected to play a role in the disease susceptibility and prognosis. The aim of this study was to determine HLA alleles associated with the tendency of recurrence and prevention of SAT within the Turkish population. Methods: This prospective study was conducted with 51 SAT patients and 720 healthy bone marrow donor volunteers. HLA-A, -B, -C, -DRB1, and -DQB1 were genotyped using next-generation sequencing. Results: The frequency of HLA-A*02:09, HLA-B*35:01/35:02/35:03, HLA-C*04:01, HLA-DRB1*12:01, and DRB1*13:03 were associated with an increased risk of SAT development (Odds Ratio: 22.4, 9.5, 10.3, 4.2, and 3.5, respectively). While HLA-A*02:09, HLA-B*35:01, HLA-B*44:02 HLA-C*07:18, and HLA-C*16:04 were associated with nonrelapsing SAT, HLA-DR*12:01was associated with relapsing SAT. HLA-B*35:02, HLA-B*35:03, and HLA-C*04:01 were more frequent both in relapsing and nonrelapsing groups according to control group. The frequency of HLA-B*18:01, reported as a risk factor previously, was similar in the SAT and control groups (p = 0.959). HLA-DRB1*11:01 was associated with a lower risk of SAT development. Conclusions: Along with -B*358 and -C*04, HLA-A*02:09 was detected as an important risk factor for SAT development in our population. HLA-DRB1*11:01 appears to be the protective HLA subtype against SAT. HLA-A*02:09, HLA-B*35:01, HLA-B*44:02, HLA-C*07:18, HLA-C*16:04, HLA-DQ*06:03, and HLA-DR*12:01 subtypes can establish a tendency to relapsing or nonrelapsing SAT.
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Affiliation(s)
- Fatma Nur Korkmaz
- Department of Internal Medicine, Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Türkiye
| | - Asena Gökçay Canpolat
- Department of Internal Medicine, Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Türkiye
| | - Klara Dalva
- Tissue Typing Laboratory, Department of Internal Medicine, Hematology, Faculty of Medicine, Ankara University, Ankara, Türkiye
| | - Atilla Halil Elhan
- Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara, Türkiye
| | - Mustafa Şahin
- Department of Internal Medicine, Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Türkiye
| | - Demet Çorapçıoğlu
- Department of Internal Medicine, Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Türkiye
| | - Özgür Demir
- Department of Internal Medicine, Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Türkiye
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Şah Ünal FT, Gökçay Canpolat A, Elhan AH, Sevim S, Sak SD, Emral R, Demir Ö, Güllü S, Erdoğan MF, Çorapçıoğlu D, Şahin M. Cancer rates and characteristics of thyroid nodules with macrocalcification. Endocrine 2023:10.1007/s12020-023-03650-x. [PMID: 38147262 DOI: 10.1007/s12020-023-03650-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 12/08/2023] [Indexed: 12/27/2023]
Abstract
AIMS The aim of this study was to determine the malignant potential of thyroid nodules with macrocalcifications and to evaluate the role of other sonographic findings in the diagnosis of malignancy in thyroid nodules besides macrocalcifications. METHODS The findings of 8250 patients who applied to our outpatient clinic and underwent thyroid ultrasonography(US) between 2008 and 2021 were retrospectively reviewed. We included a total of 296 patients with 296 macrocalcified nodules (macrocalcification group) and an age- and sex matched group of 300 patients (control group) with the cytopathologic and/or histopathologic data of fine-needle aspiration biopsy (FNAB) of thyroid nodules without calcification. Demographic characteristics of these patients, US characteristics of the nodules, and thyroid function tests were recorded. Cytopathological data of FNAB were classified according to BETHESDA. RESULTS The malignancy rate was 14.2% (42/296) in the macrocalcification group and 5.3% (16/300) in the control group (p < 0.001). There was no significant relationship between interrupted peripheral calcification and malignancy. Hypoechoic or markedly hypoechoic appearance, irregular border, solid structure, presence of accompanying pathological lymphadenopathy on sonographic examination and upper and middle zone localization were other sonographic features that increased the risk of malignancy of a nodule. The presence of autoimmunity was not found to be associated with the risk of malignancy. TSH and calcitonin levels of malignant nodules were higher than benign nodules. There was no significant difference between gender and malignancy. In the univariate analysis, it was found that the presence of macrocalcification increased the risk of malignancy 2.935 times. (OR:2.935, p < 0.001.95% CI for OR 1.611-5.349) In addition, being younger, being in the high TIRADS category, and being in the upper and middle zones were factors that increased the risk of malignancy. Gender, TSH level, nodule volume and structure were not associated with malignancy. However, after multivariate analysis, factors that significantly increased the risk of malignancy were younger age, higher TIRADS category, and nodule localization. CONCLUSION In our study, the malignancy rate was higher in the macrocalcification group than in the control group. However, no correlation was found after multivariate analysis. In the multivariate analysis, younger age, higher TIRADS category, and nodules located in the upper and middle zone were other factors associated with malignancy. There was no association between peripheral interrupted calcification and malignancy risk.
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Affiliation(s)
- Fatma Tuğçe Şah Ünal
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey.
| | - Asena Gökçay Canpolat
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Atilla Halil Elhan
- Ankara University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
| | - Selim Sevim
- Ankara University Faculty of Medicine, Department of Pathology, Ankara, Turkey
| | - Serpil Dizbay Sak
- Ankara University Faculty of Medicine, Department of Pathology, Ankara, Turkey
| | - Rıfat Emral
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Özgür Demir
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Sevim Güllü
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Murat Faik Erdoğan
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Demet Çorapçıoğlu
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Mustafa Şahin
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
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Köroğlu EY, Gökçay Canpolat A, Yılmaz S, Demir Ö. What Is the Role of Sensorineural Hearing Loss in Fabry Disease Screening? Turk Arch Otorhinolaryngol 2023; 61:52-57. [PMID: 37727814 PMCID: PMC10506525 DOI: 10.4274/tao.2023.2023-3-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/04/2023] [Indexed: 09/21/2023] Open
Abstract
Objective Fabry disease is a rare hereditary lysosomal storage disease caused by the deficiency of alpha-galactosidase A (α-GLA). Although sensorineural hearing loss is common in Fabry disease, there are no studies in the literature that have screened a population with sensorineural hearing loss for Fabry disease. In this study, we aimed to screen a group of patients who were diagnosed with sensorineural hearing loss and underwent a hearing test for Fabry disease. Methods One hundred sixty eight patients who were aged 18-75 years and diagnosed with idiopathic hearing loss between July 2019 and January 2020 were included. In male patients, α-GLA enzyme activity was analyzed. Patients with low enzyme activity were identified and genetic testing was performed for mutations in the GLA gene. In females, only genetic testing was performed. Results Eighty four women and 84 men were included in the study. α-GLA enzyme activity was low in 11 of the 84 male patients (13%). One out of these 11 patients had a gene mutation for Fabry disease. Moreover, four relatives of this index patient were diagnosed with Fabry disease in family screening. GLA gene mutation was also found in one of the 84 female patients. Consequently, two (1.2%) of our 168 patients were diagnosed with Fabry disease by screening with enzyme activity and genetic testing. Conclusion Our study showed that screening for Fabry disease in patients with idiopathic sensorineural hearing loss without other specific findings might be a useful strategy for detecting new cases.
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Affiliation(s)
- Ekin Yiğit Köroğlu
- Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Asena Gökçay Canpolat
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Suna Yılmaz
- Department of Audiology, Ankara University Faculty of Health Sciences, Ankara, Turkey
| | - Özgür Demir
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
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Korkmaz FN, Yilmaz-Oral D, Asker H, Guven B, Turkcan D, Kirlangic OF, Oztekin CV, Çorapçıoğlu D, Demir Ö, Ates I, Gur S. Combined levothyroxine and testosterone treatment for restoring erectile dysfunction in propylthiouracil-induced hypothyroid rats. J Sex Med 2023; 20:732-741. [PMID: 37105943 DOI: 10.1093/jsxmed/qdad034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/10/2022] [Accepted: 02/28/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Sexual dysfunction may indicate severe endocrine diseases. Recent research has suggested a link between hypothyroidism, low testosterone (T) levels, and erectile dysfunction (ED); however, the exact cause is unknown. AIM We sought to investigate possible beneficial effects of levothyroxine and T alone or in combination on ED in propylthiouracil (PTU)-induced hypothyroid rats. METHODS Adult Wistar rats (n = 35) were divided into 5 groups: control, PTU-induced hypothyroidism, PTU + levothyroxine, PTU + Sustanon (a mixture of 4 types of T: propionate, phenylpropionate, isocaproate, and decanoate) and PTU + levothyroxine + Sustanon. PTU was given in drinking water for 6 weeks. Four weeks after PTU administration, levothyroxine (20 μg microgram kg/day, oral) and Sustanon (10 mg/kg/week, intramuscular) were given for 2 weeks. Serum levels of total T, triiodothyronine (T3), and thyroxine (T4) were determined. In vivo erectile response and in vitro relaxant responses were measured. Localization of neuronal nitric oxide synthase (nNOS), endothelial NOS (eNOS), and phosphodiesterase type 5 (PDE5) were determined using immunohistochemical analysis. The relative area of smooth muscle to collagen was measured using Masson trichrome staining. OUTCOMES Outcome variables included in vivo erectile function, in vitro relaxant and contractile responses of corpus cavernosum (CC) strips; protein localization of eNOS, nNOS, and PDE5; and smooth muscle content in penile tissue. RESULTS The rat model of hypothyroidism showed a significant decline in serum levels of total T, T3, and T4. Levothyroxine increased T3 and T4 levels, whereas Sustanon normalized only total T levels. Combined treatment enhanced all hormone levels. Rats with hypothyroidism displayed the lowest erectile response (P < 0.001 vs controls). Combined treatment returned reduced responses, while partial amelioration was observed after levothyroxine and Sustanon treatment alone. Acetylcholine (P < 0.01 vs controls), electrical field stimulation (P < 0.001 vs controls), and sildenafil-induced relaxant responses (P < 0.05 vs controls) were decreased in the CC strips from hypothyroid rats. The combined treatment increased the reduction in relaxation responses. Levothyroxine and Sustanon restored decreases in eNOS and nNOS expression in the hypothyroid group. There was no significant difference in PDE5 expression among groups. Monotreatment partially enhanced reduced smooth muscle mass, while combined therapy completely recovered. CLINICAL IMPLICATIONS The combination of thyroid hormones and T is likely to be a therapeutic approach for treatment of hypothyroidism-induced ED in men. STRENGTHS AND LIMITATIONS Beneficial effects of levothyroxine and Sustanon treatment were shown in vitro and in vivo in PTU-induced hypothyroid rats. The main limitation of the study was the lack of measurement of androgen-sensitive organ weights and luteinizing hormone, follicle-stimulating hormone, and prolactin levels. CONCLUSION These findings demonstrate that neurogenic and endothelium-dependent relaxation responses are reduced by hypothyroidism, which is detrimental to T levels and erectile responses. Levothyroxine and Sustanon combination medication was able to counteract this effect.
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Affiliation(s)
- Fatma Nur Korkmaz
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
- Department of Internal Medicine, Division of Endocrinology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Didem Yilmaz-Oral
- Department of Pharmacology, Faculty of Pharmacy, Cukurova University, Adana, Turkey
| | - Heba Asker
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
- Department of Medical Pharmacology, Faculty of Medicine, Lokman Hekim University, Ankara, Turkey
| | - Berna Guven
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - Damla Turkcan
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - Omer Faruk Kirlangic
- Department of Medical Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey
- Vocational School of Health Services, Ankara University, Ankara, Turkey
| | - Cetin Volkan Oztekin
- Department of Urology, Faculty of Medicine, University of Kyrenia, Kyrenia, TRNC, Turkey
| | - Demet Çorapçıoğlu
- Department of Internal Medicine, Division of Endocrinology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Özgür Demir
- Department of Internal Medicine, Division of Endocrinology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ilker Ates
- Department of Toxicology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - Serap Gur
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
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Araz M, Soydal Ç, Demir Ö, Gökcan MK, Küçük NÖ. The Role of 18F-FDOPA PET/CT in Recurrent Medullary Thyroid Cancer Patients with Elevated Serum Calcitonin Levels. Mol Imaging Radionucl Ther 2023; 32:1-7. [PMID: 36815513 PMCID: PMC9950688 DOI: 10.4274/mirt.galenos.2022.81904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Objectives To evaluate the diagnostic performance of 18F-dihydroxyphenylalanine (FDOPA) positron emission tomography/computed tomography (PET/CT) in the detection of medullary thyroid carcinoma (MTC) recurrence in patients with elevated calcitonin levels. Methods The patients who had undergone 18F-FDOPA PET/CT imaging for elevated calcitonin levels after primary surgery of MTC were included in the study. addition, if available 18F-fluorodeoxyglucose (FDG) PET/CT and Gallium-68 (68Ga)- DOTATATE PET/CT images of the patients were evaluated retrospectively. The sensitivity and diagnostic performance of 18F-DOPA PET/CT were investigated. Results A total of 14 patients (9 F and 5 M; median age: 45) were included in the analysis. Three patients had MEN IIA syndrome and 1 patient had MEN IIB syndrome, 10 patients had a diagnosis of sporadic MTC. Median calcitonin levels of the patients were calculated as 757.5 (min-max: 28.5-7911) pg/mL. Nine patients and 5 patients had undergone ultrasound and contrast-enhanced computed tomography (ceCT) of the neck, respectively, before 18F-FDOPA PET/CT imaging. 18F-FDOPA PET/CT revealed pathological uptake in the thyroid bed, lymph nodes, and distant organs in three, five and two patients, respectively. Median maximum standardized uptake value for the recurrent or metastatic lesions were calculated as 6.4 (min-max: 1.9-18.4). The sensitivity of 18F-FDOPA PET/CT in the detection of recurrent disease was calculated as 64%. Eight patients had 68Ga-DOTATATE PET/CT and 7 of them had 18F-FDG PET/CT within 3 months period before 18F-FDOPA PET/CT. 18F-FDOPA PET/CT revealed recurrent disease in 4 of 5 and 2 of the 5 patients who had negative 18F-FDG PET/CT and negative 68Ga- DOTATATE PET/CT, respectively. Conclusion 18F-FDOPA PET/CT can detect recurrence in about two- thirds of patients with elevated calcitonin levels after primary surgery for MTC. Due to variable differentiation degree, different receptor status, and clinical behavior of MTC, all three radiopharmaceuticals can be beneficial and are complementary to each other in patient management.
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Affiliation(s)
- Mine Araz
- Ankara University Faculty of Medicine, Department of Nuclear Medicine, Ankara, Turkey,* Address for Correspondence: Ankara University Faculty of Medicine, Department of Nuclear Medicine, Ankara, Turkey Phone: +90 532 666 73 13 E-mail:
| | - Çiğdem Soydal
- Ankara University Faculty of Medicine, Department of Nuclear Medicine, Ankara, Turkey
| | - Özgür Demir
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Mustafa Kürşat Gökcan
- Ankara University Faculty of Medicine, Department of Otorhinolaryngology and Head and Neck Surgery, Ankara, Turkey
| | - Nuriye Özlem Küçük
- Ankara University Faculty of Medicine, Department of Nuclear Medicine, Ankara, Turkey
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Tapar H, Demir Ö, Genç A, Balta MG, Kölükçü V, Karaman T, Dogru S, Karaman S, Suren M. Investigation of the analgesic efficacy of ultrasound-guided thoracolumbar interfacial plane block in vertebral surgery: A prospective randomized clinical study. Saudi Med J 2022; 43:1136-1141. [PMID: 36261200 PMCID: PMC9994504 DOI: 10.15537/smj.2022.43.10.20220467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES To investigate the effect of thoracolumbar interfacial plane block (TLIP) on analgesic consumption and pain score in vertebral surgery. METHODS All patients (64 patients undergoing vertebral surgery) were randomly allocated as Group T (patients with block, n=32) and Group C (patients without block, n=32). After surgery, patient-controlled analgesia using tramadol was administered to all patients. Pain intensity was evaluated with visual analogue scale (VAS; recovery room at 1, 2, 6, 12, and 24 hours postoperative), and as rescue analgesia, morphine was administered to patients with VAS scores of >4. In this study, total tramadol consumption, the number of patients requiring morphine, VAS score, and Quality of Recovery-40 of all patients questionnaire was evaluated. RESULTS There were important differences between the 2 groups according to mean postoperative tramadol consumption (Group T and Group C; 180 mg [100-260] vs. 210 mg [100-300]; p=0.001) and the number of patients requiring additional analgesia (n=4; 12.5% vs. n=24; 75%, p=0.000). There were important differences between the 2 groups according to the postoperative VAS pain score (p=0.000). CONCLUSION Ultrasound-TLIP reduces analgesic consumption and pain severity after vertebral surgery. Therefore, it is an important regional analgesia technique. CLINICALTRIALSGOV GRANT NO: NCT04548076.
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Affiliation(s)
- Hakan Tapar
- From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
| | - Özgür Demir
- From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
| | - Ali Genç
- From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
| | - Mehtap G. Balta
- From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
| | - Vildan Kölükçü
- From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
| | - Tugba Karaman
- From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
| | - Serkan Dogru
- From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
| | - Serkan Karaman
- From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
| | - Mustafa Suren
- From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
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Gökçay Canpolat A, Demir Ö, Şahin M, Emral R, Çorapçıoğlu D. The missing link between inflammation and arterial stiffness among different metabolic phenotypes. Int J Clin Pract 2021; 75:e14727. [PMID: 34383387 DOI: 10.1111/ijcp.14727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/27/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Although metabolically healthy obesity (MHO) has begun to be seen as a being benign phenomenon, this conclusion is still not completely certain. Obesity is also associated with low-grade systemic inflammation and endothelial dysfunction. Thus, we aimed to assess Pulse Wave Velocity (PWV) as a marker of arterial stiffness and CV risk among individuals with MHO, metabolically unhealthy obesity (MUO), and metabolically healthy normal-weight (MHN). METHODS 150 participants (n = 50 MHO, n = 50 MUO, n = 50 MHN) who had been admitted to our outpatient clinics were enrolled in this cross-sectional study. Demographic, anthropometric, clinical, and laboratory data, including hs-CRP and PWV, were recorded for all subjects. RESULTS hs-CRP and PWV were higher in MUO and MHO than MHN individuals (P < .05). hs-CRP showed a strong positive correlation with PWV (r = 0.85, P < .001). After adjusting for other risk factors, multivariate linear regression analysis showed that the PWV was independently associated with BMI (β = 0.08, P = .03), WC (β = 0.04, P = .04) and hs-CRP (β = 6.08, P < .001). CONCLUSIONS PWV, which is an important non-invasive marker of cardiovascular risk, is higher in MHO than in MHN as in MUO individuals. Moreover, PWV was positively correlated with the serum hs-CRP level as a conventional marker for systemic inflammation. Thus, MHO can be seen as a cardiometabolic risk marker.
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Affiliation(s)
- Asena Gökçay Canpolat
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Özgür Demir
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Şahin
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Rıfat Emral
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Demet Çorapçıoğlu
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
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Altun R, Canpolat AG, Demir Ö, Erdogan MF. The course of Autoimmune Thyroiditis in WOMEN. Acta Endocrinol (Buchar) 2021; 17:472-478. [PMID: 35747864 PMCID: PMC9206145 DOI: 10.4183/aeb.2021.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CONTEXT Although, many studies have been made on the clinical course of autoimmune thyroiditis, this study focused on women and the factors effecting the natural course such as Selenium. OBJECTIVE The study aimed to determine Hashimoto's thyroiditis (HT) clinical course in adults and the factors that could affect it. DESIGN The study was in a retrospective manner between 2010-2018. SUBJECTS AND METHODS 101 patients with HT were followed for 60.7±32.7 months. Biochemical and ultrasonographic data were collected. We investigated whether the age at diagnosis, family history, smoking habits, levothyroxine replacement therapy, and serum selenium (Se) levels influenced the disease course. RESULTS No relationship was observed between age and thyroid functions, thyroid volumes (TV), and autoantibody (Ab) levels at diagnosis. Ab levels were irrelevant with TV, echogenicity, and nodularity at diagnosis. However, initial TSH levels were significantly associated with anti-TPO levels (p=0.028, r=0.218). In the untreated group, thyroid functions seemed to be stable. TV decreased significantly in both treated and untreated patients (p<0.001). The decrease in TV was significantly higher in the treatment group (p=0.002). In euthyroid and subclinical hypothyroid patients, levothyroxine therapy did not affect the decrease in TV. Ab levels remained stable in untreated patients, but anti-TPO levels significantly decreased in treated patients (p<0.001). Smoking seemed to increase only anti-Tg levels (p=0.009). Family history was not associated with any of the studied parameters. Serum Se level was negatively correlated only with thyroid echostructure and only in treated patients. TV showed a "Gaussian distribution" in all patients at the diagnosis and at the end, independent of levothyroxine treatment. CONCLUSIONS Most euthyroid patients remained euthyroid during five years of follow-up. The decrease in TV was significantly prominent with LT4 treatment. Importantly, TV followed a normal distribution instead of the bimodal distribution that is classically described.
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Affiliation(s)
- R. Altun
- Liv Hospital Ankara, Ankara, Turkey
| | - A. Gokcay Canpolat
- University Faculty of Medicine, Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ö. Demir
- University Faculty of Medicine, Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - M. F. Erdogan
- University Faculty of Medicine, Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
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11
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Aydoğan Bİ, Mutlu ABB, Yüksel S, Güllü S, Emral R, Demir Ö, Şahin M, Gedik VT, Çorapçıoğlu D, Sak SD, Erdoğan MF. The Association of Histologically Proven Chronic Lymphocytic Thyroiditis with Clinicopathological Features, Lymph Node Metastasis, and Recurrence Rates of Differentiated Thyroid Cancer. Endocr Pathol 2021; 32:280-287. [PMID: 33188468 DOI: 10.1007/s12022-020-09653-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2020] [Indexed: 10/23/2022]
Abstract
The influence of chronic lymphocytic thyroiditis (CLT) on clinicopathological features and behavior of differentiated thyroid carcinoma (DTC) is still debated. In the present study, we aimed to evaluate the prognosis of DTC on the presence of CLT. A total of 649 total thyroidectomized patients (379 female, 270 male) with DTC, who had follow-up data for at least 36 months were included. Clinical, histopathological data, preoperative thyroid peroxidase antibody (TPO-ab), thyroglobulin antibody (Tg-ab), thyroid-stimulating hormone (TSH) levels, and presence of recurrent/persistent disease (R/PD) were evaluated retrospectively. Presence of CLT was defined by histopathology. Frequency of CLT was 32% (n = 208) among DTC patients. Mean tumor size (maximal diameter) was smaller in CLT group when compared to non-CLTs (p = 0.006). Capsular invasion, vascular invasion, tumor stage, risk groups, and R/PD were negatively associated with CLT (p < 0.01, p = 0.04, p = 0.03, p = 0.02, p < 0.01, respectively). Extrathyroidal extension was more frequent in non-CLT group when compared CLT (p = 0.052). Preoperative TSH level was positively associated with lymph node metastasis (LNM) and higher in patients with lateral LNM when compared to central LNM (p < 0.01). Central LNM, lateral LNM, stage 4 tumor, and intermediate- and high-risk tumor groups increased the risk of R/PH, 2.5-, 2.9-, 12.7-, 2.3-, and 4.2-fold, respectively. Presence of CLT was independently related with favorable outcomes, as the risk of R/PD was decreased by 0.49-fold. In conclusion, coexistence of CLT was negatively associated with tumor size, capsular invasion, vascular invasion, and tumor stage in DTC. Risk of R/PD was decreased by approximately half in patients with CLT.
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Affiliation(s)
- Berna İmge Aydoğan
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey.
| | | | - Seher Yüksel
- Department of Pathology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sevim Güllü
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Rıfat Emral
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Özgür Demir
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Şahin
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Vedia Tonyukuk Gedik
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Demet Çorapçıoğlu
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Serpil Dizbay Sak
- Department of Pathology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Murat Faik Erdoğan
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
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12
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Gökçay Canpolat A, Cinel M, Dizbay Sak S, Taşkaldıran I, Korkmaz H, Demir Ö, Ersoy R, Dağdelen S, Berker D, Dalva K, Bahçecioğlu Mutlu AB, Erdoğan MF. Long-Term Outcomes of Tamoxifen Citrate Therapy and Histo- and Immunopathological Properties in Riedel Thyroiditis. Eur Thyroid J 2021; 10:248-256. [PMID: 34178711 PMCID: PMC8216025 DOI: 10.1159/000512017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/04/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Riedel thyroiditis (RT) is a rare form of thyroiditis; thus, data about the disease course and treatment options are limited. Therefore, we aimed to assess the clinical, serological, radiological, and histopathological features, as well as short- and long-term follow-up of RT patients under glucocorticoid (GC) and tamoxifen citrate (TMX). Parameters related to IgG4-related diseases (IgG4-RD) were also investigated. METHODS Eight patients with RT diagnosed between 2000 and 2019 were enrolled. Data were collected in a retrospective and prospective manner. The diagnosis was confirmed with histopathological features in all patients. Results of the treatment with GCs on short- to mid-term, followed by TMX in the long term, were evaluated. RESULTS The mean age at diagnosis was 40.5 ± 6.8 years; female predominance was observed (F/M:7/1). Parameters related to IgG4-RD, like increase in IgG4 serum levels, total plasmablast counts, and IgG4+ plasmablasts, were negative in most of our patients in both active and inactive states of the disease. Likewise, an increased ratio of IgG4/IgG-positive plasma cells >40% could only be observed in 2 cases. GCs followed by TMX were given to the patients with an over-all median follow-up time of 67 (8-216) months. All the patients considerably improved clinically and had a reduction in the size of the mass lesion on GCs, followed by TMX therapy. None of the patients had a recurrence under TMX therapy for a median period of 18.5 (7-96) months. CONCLUSION Even though RT is suggested to be a member of IgG4-RD, serologic or histological evidence of IgG4 elevation or positivity is only useful for diagnosis and follow-up of RT. The diagnosis should be based on clinical and radiological evidence and confirmed by histopathology. GCs are effective for initial treatment, and TMX is a successful and safe therapeutic option for long-term maintenance therapy.
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Affiliation(s)
- Asena Gökçay Canpolat
- Department of Endocrinology and Metabolism, School of Medicine, Ankara University, Ankara, Turkey
- *Asena Gökçay Canpolat, Department of Endocrinology and Metabolism, School of Medicine, İbni-Sina Hospital, Ankara University, Altındağ, Ankara 06100 (Turkey),
| | - Murat Cinel
- Department of Endocrinology and Metabolism, School of Medicine, Ankara University, Ankara, Turkey
| | - Serpil Dizbay Sak
- Department of Pathology, School of Medicine, Ankara University, Ankara, Turkey
| | - Işılay Taşkaldıran
- Department of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey
| | - Hakan Korkmaz
- Department of Endocrinology and Metabolism, School of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Özgür Demir
- Department of Endocrinology and Metabolism, School of Medicine, Ankara University, Ankara, Turkey
| | - Reyhan Ersoy
- Department of Endocrinology and Metabolism, School of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Selçuk Dağdelen
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Dilek Berker
- Department of Endocrinology and Metabolism, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Klara Dalva
- Department of Haematology, School of Medicine, Ankara University, Ankara, Turkey
| | | | - Murat Faik Erdoğan
- Department of Endocrinology and Metabolism, School of Medicine, Ankara University, Ankara, Turkey
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Atmis V, Bülbül B, Bahşi R, Gümüşsoy M, Yalçin A, Doğan Z, Demir Ö, Erdoğan M, Atli T. Iodine concentration and prevalence of thyroid disease in older people after salt iodization in Turkey. East Mediterr Health J 2021; 27:151-158. [PMID: 33665799 DOI: 10.26719/2021.27.2.151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/22/2020] [Indexed: 11/09/2022]
Abstract
Background Iodine uptake is a main factor affecting thyroid disease. In Turkey, mandatory salt iodization began in 1999-2000. Aims This study in 2009 determined the prevalence of thyroid diseases in older people in Mamak district, Ankara after iodization to ascertain if salt iodization alone is sufficient to reach adequate iodine levels in the older population. Methods All Mamak residents ≥ 65 years were eligible for inclusion in the study. Demographic data and medical history were recorded. All participants had a thyroid ultrasound. Blood samples were taken to assess thyroid function and autoantibodies, and urine samples to assess iodine concentration. Participants with low levels of thyroid stimulating hormone underwent scintigraphy to assess thyroid uptake. Fine-needle aspiration biopsy was done of nodules ≥ 1.5 cm where thyroid stimulating hormone was not suppressed. Results Of 1200 eligible residents, 979 were included. Their mean age was 70.9 (standard deviation (SD) 5.7) years; 49.7% were women. Mean urinary iodine concentration was 98 (SD 81.29) μg/L. Goitre was found in 18.2% (89/487) of women and 6.7% (33/492) of men (P < 0.001) and 43.8% (428/979) had nodules. Subclinical hypothyroidism was found in 5.8% (57/979) of the participants, overt hyperthyroidism in 0.8% (8/979), subclinical hyperthyroidism in 2.2% (22/979) and T3 thyrotoxicosis in 0.3% (3/979). Toxic multinodular goitre and toxic adenoma caused 80% of hyperthyroidism cases. Biopsy detected no malignant pathology. Conclusion After salt iodization, iodine levels have not yet reached favourable levels in older people. Iodization of salt seems insufficient to achieve these levels in older people; alternative iodine supplementation should be considered.
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Affiliation(s)
- Volkan Atmis
- Department of Geriatrics, Ankara University, Ankara, Turkey
| | - Buket Bülbül
- Department of Endocrinology and Metabolism, Batman State Hospital, Batman, Turkey
| | - Remzi Bahşi
- Department of Geriatrics, Ankara University, Ankara, Turkey
| | - Mesut Gümüşsoy
- Department of Gastroenterology, Ankara University, Ankara, Turkey
| | - Ahmet Yalçin
- Department of Geriatrics, Ankara University, Ankara, Turkey
| | - Zeynal Doğan
- Department of Gastroenterology, Elazığ Medical Park Hospital, Elazığ, Turkey
| | - Özgür Demir
- Department of Endocrinology and Metabolism, Ankara University, Ankara, Turkey
| | - Murat Erdoğan
- Department of Endocrinology and Metabolism, Ankara University, Ankara, Turkey
| | - Teslime Atli
- Department of Geriatrics, Near East University, Lefkoşa, Cyprus
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Keskin Ç, Demir Ö, Karcı AÇ, Berker D, Cantürk Z, Yaylali GF, Topsakal Ş, Ersoy R, Bayram F, Ertörer ME, Bozkırlı E, Haydardedeoğlu F, Dilekçi ENA, Ay SA, Cansu GB, Şahin M, Emral R, Çorapçıoğlu D. The acromegaly registry of ten different centers in Turkey. Growth Horm IGF Res 2020; 53-54:101322. [PMID: 32417639 DOI: 10.1016/j.ghir.2020.101322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/15/2020] [Accepted: 04/24/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To describe biochemical and clinical features, and therapeutic outcomes of acromegaly patients in Turkey. METHODS Retrospective multicenter epidemiological study of 547 patients followed in 10 centers of the Turkish Acromegaly registry. RESULTS A total of 547 acromegaly patients (55% female) with a median age of 41 was included in this study. Majority of patients had a macroadenoma (78%). Transsphenoidal surgery was performed as primary treatment in 92% of the patients (n = 503). Surgical remission rate was 39% (197/503) in all operated patients. Overall disease control was achieved in 70% of patients. Remission group were significantly older than non-remission group (p = .002). Patients with microadenomas had significantly higher remission rates than patients with macroadenomas (p < .001). Patients with microadenomas were significantly older at the time of diagnosis when compared to patients with macroadenomas (p < .001). Preoperative growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels were significantly lower in the remission group (p < .001). Initial IGF-1 and GH levels were significantly higher in macroadenomas compared to microadenomas (p < .001). Medical treatment was administered as a second-line treatment (97%) in almost all patients without remission. Radiotherapy was preferred in 21% of the patients mostly as a third line treatment. CONCLUSIONS This is one of the largest real life studies evaluating the epidemiological characteristics and treatment outcomes of patients with acromegaly who were followed in different centers in Turkey. Transsphenoidal surgery in the treatment of acromegaly still remains the most valid method. Medical treatment options may improve long-term disease outcomes in patients who cannot be controlled with surgical treatment (up to 70%).
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Affiliation(s)
- Çağlar Keskin
- Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey.
| | - Özgür Demir
- Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey
| | - Alper Çağrı Karcı
- Ankara Numune Training and Research Hospital, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey
| | - Dilek Berker
- Ankara Numune Training and Research Hospital, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey
| | - Zeynep Cantürk
- Kocaeli University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Kocaeli, Turkey
| | - Güzin Fidan Yaylali
- Pamukkale University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Denizli, Turkey
| | - Şenay Topsakal
- Pamukkale University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Denizli, Turkey
| | - Reyhan Ersoy
- Yıldırım Beyazıt University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey
| | - Fahri Bayram
- Erciyes University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Kayseri, Turkey
| | - Melek Eda Ertörer
- Başkent University, Adana Dr. Turgut Noyan Training and Research Hospital, Department of Endocrinology and Metabolic Diseases, Adana, Turkey
| | - Emre Bozkırlı
- Başkent University, Adana Dr. Turgut Noyan Training and Research Hospital, Department of Endocrinology and Metabolic Diseases, Adana, Turkey
| | - Filiz Haydardedeoğlu
- Başkent University, Adana Dr. Turgut Noyan Training and Research Hospital, Department of Endocrinology and Metabolic Diseases, Adana, Turkey
| | - Esra Nur Ademoğlu Dilekçi
- Abant İzzet Baysal University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Bolu, Turkey
| | - Seyid Ahmet Ay
- GATA Haydarpaşa Training Hospital, Department of Endocrinology and Metabolic Diseases, İstanbul, Turkey
| | - Güven Barış Cansu
- Eskişehir Yunus Emre Hospital, Department of Endocrinology and Metabolic Diseases, Eskişehir, Turkey
| | - Mustafa Şahin
- Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey
| | - Rıfat Emral
- Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey
| | - Demet Çorapçıoğlu
- Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey
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15
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Kara M, Demir Ö, Doğru M. Bond Strength of Metal and Ceramic Brackets on Resin Nanoceramic Material With Different Surface Treatments. Turk J Orthod 2020; 33:115-122. [PMID: 32637193 DOI: 10.5152/turkjorthod.2020.19103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/07/2020] [Indexed: 11/22/2022]
Abstract
Objective This study aimed to evaluate the effects of different surface conditoning methods on surface texture and shear bond strength (SBS) of brackets bonded to resin nanoceramic material. Methods Ceramic specimens were divided into two groups as metal brackets and ceramic brackets. In each group, the following five subgroups were conditoned with orthophosphoric acid (OPA), hydrofluoric acid (HFA), silica coating with Cojet, Nd: Yag laser, and Femtosecond (Fs) laser. Extra samples were used for scanning electron microscopy and 3D profilometer evaluation. Results All surface conditioning methods caused optimum or higher SBS. Metal brackets had higher SBS than porcelain brackets, but this difference reached statistical significance only in Fs laser group. OPA caused surface modification comparable to HFA because of polymer content of resin nanoceramic. Although Fs laser and Cojet conditioning caused optimum or higher SBS, surface damage of these methods to the resin nanoceramic specimens clearly seen on 3D profilometer. Conclusion HFA and Nd: Yag laser are effective surface conditioning methods for resin nanoceramics. OPA combined with silane application caused optimum SBS and can be used as an alternative to HFA. Surface texture changes should be considered to determine surface damage while deciding the optimum surface conditioning method for ceramics other than SBS.
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Affiliation(s)
- Mehmet Kara
- Department of Orthodontics, Inonu University School of Dentistry, Malatya, Turkey
| | | | - Mehmet Doğru
- Department of Orthodontics, Dicle University School of Dentistry, Diyarbakır, Turkey
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Emral R, Aydoğan Bİ, Köse AD, Demir Ö, Çorapçıoğlu D. Could a nonfunctional adrenal incidentaloma be a risk factor for increased carotid intima-media thickness and metabolic syndrome. ACTA ACUST UNITED AC 2019; 66:402-409. [PMID: 30898604 DOI: 10.1016/j.endinu.2019.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/10/2019] [Accepted: 01/13/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study was designed to detect the potential association of a nonfunctional adrenal incidentaloma (NFAI) with insulin resistance and associated metabolic disturbances, with a subsequent increase in cardiovascular risk factors. METHODS Eighty-three NFAI patients and 56 volunteers (controls) without any adrenal abnormalities on computed tomography (CT) were included. Fasting blood glucose (FBG), fasting insulin, lipid profiles, uric acid, homocysteine, fibrinogen, high sensitivity C-reactive protein (hs-CRP), and adiponectin levels were measured in both groups. Blood pressure (BP), waist circumference, body mass index (BMI), and carotid intima media thickness (CIMT) were evaluated in both the patients and volunteers. RESULTS There were no significant difference between the NFAI and control groups with respect to age, sex, BMI, waist circumference, systolic and diastolic BP, smoking, concomitant disease, and medications. Fasting insulin and glucose levels and homeostasis model of assessment-insulin resistance (HOMA-IR) scores were significantly higher in the NFAI group as compared with those in the control group (p<0.01). The frequency of metabolic syndrome in the NFAI group was higher than that in the control group (p<0.01). All the lipid fractions, except triglyceride (TG), (p<0.05), homocysteine (p=0.01), and fibrinogen levels (p<0.001), were significantly higher in the NFAI group as compared with the levels in the control group. There were no significant differences between the NFAI and control groups in terms of uric acid, hs-CRP, and adiponectin levels. The CIMT values in the NFAI group were significantly higher than those in the control group (0.74±0.14 vs. 0.53±0.09, p<0.001). The mean CIMT value showed a statistically positive correlation with age (r=0.245, p=0.004); the HOMA-IR score (r=0.490, p<0.001); and FBG (r=0.521, p<0.001), fasting insulin (r=0.432, p<0.001), total cholesterol (TC) (r=0.267, p=0.002), and fibrinogen (r=0.398, p<0.001) levels in the NFAI group. CONCLUSIONS The results indicated that the NFAI patients had an elevated risk of insulin resistance, with metabolic syndrome and increased CIMT values. Long-term follow-up studies should be designed to evaluate postsurgical alterations in metabolic parameters and cardiovascular risk factors in NFAI patients.
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Affiliation(s)
- Rıfat Emral
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey
| | - Berna İmge Aydoğan
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey.
| | - Ayla Demir Köse
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey
| | - Özgür Demir
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey
| | - Demet Çorapçıoğlu
- Ankara University Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey
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Aydoğan Bİ, Şahin M, Ceyhan K, Deniz O, Demir Ö, Emral R, Tonyukuk Gedik V, Uysal AR, Çorapçıoğlu D. The influence of thyroid nodule size on the diagnostic efficacy and accuracy of ultrasound guided fine-needle aspiration cytology. Diagn Cytopathol 2019; 47:682-687. [PMID: 30861335 DOI: 10.1002/dc.24170] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/12/2019] [Accepted: 02/26/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Diagnostic accuracy of fine-needle aspiration cytology (FNAC) in large and subcentimeter nodules is still debated. We aimed to evaluate the impact of nodule size on efficacy of the ultrasound-guided FNAC. METHODS B-mode grayscale ultrasound (US), US-guided FNAC according to Bethesda system and histopathological data of 514 nodules from 371 patients, who underwent thyroidectomy were examined retrospectively. Nodules were grouped by maximal diameter; group A nodules were smaller than 10 mm (n = 59), group B nodules were between 10 and 29 mm (n = 218), and group C nodules were 30 mm or greater (n = 130). RESULTS Sensitivity, specificity, and accuracy of FNAC was 92.0%, 100%, and 95.1% in group A, 80.7%, 99.1%, and %92.9 in group B, 70.0%, 98.9%, and 95.8% in group C nodules, respectively. The prevalence of papillary thyroid cancer (PTC) and incidental PTC were 44.2% (n = 164) and 6.4% (n = 24), respectively. Malignancy rate was more frequent in group A when compared to groups B and C (P < 0.01). Nodule size was positively associated with follicular cancer risk (P = 0.009). The thyroid stimulating hormone level was positively associated with malignancy (P = 0.02) and optimal cut-off value was 0.96 mIU/L. False-negative rate was 8.0%, 19.3%, and 30.0% in groups A, B, and C nodules, respectively. CONCLUSIONS Although the malignancy rate was low in nodules ≥30 mm, diagnostic surgery for large nodules should be considered because of decreased reliability of FNAC, ineffectiveness of clinical and sonographic criteria. False-negative rate was relatively low and malignancy rate was high in subcentimeter nodules, supporting the accuracy of FNAC.
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Affiliation(s)
- Berna İmge Aydoğan
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Şahin
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Koray Ceyhan
- Department of Cytology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Olgun Deniz
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Özgür Demir
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Rifat Emral
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Vedia Tonyukuk Gedik
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ali Rıza Uysal
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Demet Çorapçıoğlu
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
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Gökçay Canpolat A, Şahin M, Ediboğlu E, Erdoğan MF, Güllü S, Demir Ö, Emral R, Çorapçıoğlu D. Diagnostic accuracy of parathyroid hormone levels in washout samples of suspicious parathyroid adenomas: A single-centre retrospective cohort study. Clin Endocrinol (Oxf) 2018; 89:489-495. [PMID: 30004132 DOI: 10.1111/cen.13812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 06/18/2018] [Accepted: 07/11/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Minimally invasive surgery is an alternative surgical approach for primary hyperparathyroidism with less surgical trauma and anaesthesia complications. When combined with intraoperative measurement of parathyroid hormone (PTH), cure rates are exceeding 97%. Preoperative intact PTH determination in washout samples is really very useful when parathyroid lesions cannot be easily distinguished from thyroid lesions or sometimes lymph nodes. Herein, we aimed to report our institutional experience about parathyroid fine-needle aspiration (FNA) method and suggest a cut-off ratio for this purpose. METHODS In our clinic, we performed ultrasonography (USG)-guided parathyroid FNA procedure for 131 patients diagnosed with primary hyperparathyroidism between January 2005 and January 2016. Both cytologic evaluation and intact PTH determination were performed in washout samples. Eighty-seven of the study group also had a parathyroid scintigraphy. Both demographic features and laboratory results were all recorded. RESULTS Median serum PTH level was 142 (113-197), while mean PTH washout level was 1824 (0-3953). When three of the localization techniques are compared with each other, FNA-PTH washout group had a better diagnostic accuracy (90.8%) when compared to cytology (7.92%) and MIBI (67.8%) groups. Both MIBI and FNA-PTH washout group had 100% positive predictive value (PPV) and 100% specificity. We found values greater than 436.5 pg/mL for FNA-PTH washout with a sensitivity of 90.3% and specificity of 88.9% (P < 0.01 and AUC 94.3 (87.8-100)) and a cut-off for FNA/serum PTH greater than 3.05 with a sensitivity of 91.2% and specificity of 89% (P = 0.02 and AUC 94.5 (88.8-100)) which implicate parathyroid lesions. CONCLUSION According to the literature, PTH determination in washout samples has a specificity of 75%-100% and sensitivity of 70%-100%. This approach has better results than both cytology and scintigraphy in case of concomitant multinodular thyroid disease in experienced hands. Although there is not a definite cut-off for PTH levels in washout samples, we agree with the need of ratios rather than cut-offs in this issue.
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Affiliation(s)
- Asena Gökçay Canpolat
- Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey
| | - Mustafa Şahin
- Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey
| | - Elif Ediboğlu
- Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Murat Faik Erdoğan
- Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey
| | - Sevim Güllü
- Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey
| | - Özgür Demir
- Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey
| | - Rıfat Emral
- Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey
| | - Demet Çorapçıoğlu
- Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey
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Demir Ö, Öksüz E, Deniz FE, Demir O. Assessing the effects of lumbar posterior stabilization and fusion to vertebral bone density in stabilized and adjacent segments by using Hounsfield unit. J Spine Surg 2017; 3:548-553. [PMID: 29354730 DOI: 10.21037/jss.2017.09.05] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Computed tomography (CT) with Hounsfield unit (HU) is being used with increasing frequency for determining bone density. Established correlations between HU and bone density have been shown in the literature. The aim of this retrospective study was to determine the bone density changes of the stabilized and adjacent segment vertebral bodies by comparing HU values before and after lumbar posterior stabilization. Methods Sixteen patients who had similar diagnosis of lumbar spondylosis and stenosis were evaluated in this study. Same surgical procedures were performed to all of the patients with L2-3-4-5 transpedicular screw fixation, fusion and L3-4 total laminectomy. Bone mineral density measurements were obtained with clinical CT. Measurements were obtained from stabilized and adjacent segment vertebral bodies. Densities of vertebral bodies were evaluated with HU before the surgeries and approximately one year after the surgeries. The preoperative HU value of each vertebra was compared with postoperative HU value of the same vertebrae by using statistical analysis. Results The HU values of vertebra in the stabilized and adjacent segments consistently decreased after the operations. There were significant differences between the preoperative HU values and the postoperative HU values of the all evaluated vertebral bodies in the stabilized and adjacent segments. Additionally first sacral vertebra HU values were found to be significantly higher than lumbar vertebra HU values in the preoperative group and postoperative group. Conclusions Decrease in the bone density of the adjacent segment vertebral bodies may be one of the major predisposing factors for adjacent segment disease (ASD).
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Affiliation(s)
- Özgür Demir
- Department of Neurosurgery, Gaziosmanpaşa University, Tokat, Turkey
| | - Erol Öksüz
- Department of Neurosurgery, Gaziosmanpaşa University, Tokat, Turkey
| | | | - Osman Demir
- Department of Biostatistics, Gaziosmanpaşa University, Tokat, Turkey
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Demir Ö, Tonga F. Post-travmatik akut subdural hematomun spontan ve hızlı rezolüsyonu. Ege Tıp Dergisi 2016. [DOI: 10.19161/etd.344230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Cerit ET, Ağbaht K, Demir Ö, Şahin M, Gedik VT, Özcan C, Çorapçıoğlu D. DISCORDANCE BETWEEN GH AND IGF-1 LEVELS IN TURKISH ACROMEGALIC PATIENTS. Endocr Pract 2016; 22:1422-1428. [PMID: 27631850 DOI: 10.4158/ep161295.or] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Discordance between insulin-like growth factor-1 (IGF-1) and growth hormone (GH) levels is an important problem in the follow-up of patients diagnosed with acromegaly. Our aims were to evaluate the discordance between IGF-1 and GH levels and compare the performance of different cut-off levels for the nadir in GH (GHn) in acromegalic patients. METHODS The study included 63 acromegalic patients in a follow-up at a tertiary care university hospital facility. Levels of IGF-1, IGF binding protein-3 (IGFBP-3), and GH were investigated. The baseline GH and GHn levels were evaluated after an oral glucose tolerance test (cut-offs of 0.4 and 1 ng/mL, respectively). The discordance rates between GHn and IGF-1 levels, and IGF-1/IGFBP-3 ratios were determined. RESULTS We first adopted a GHn cut-off value of 1 ng/mL and found that 27 patients (42.9%) exhibited biochemical remission (BR) (IGF-1 <95th percentile, GH <1), and 25 patients (39.7%) had no BR (NBR) (IGF-1 ≥95th percentile, GH >1). Discordance in the presence of normal IGF-1 and nonsuppressed GH (DC1) occurred in 2 of 63 (3.2%) patients; discordance in the presence of high IGF-1 and suppressed GH (DC2) occurred in 9 of 63 (14.3%) patients. If the GHn cut-off value adopted was 0.4 ng/mL, the distributions were 17 of 63 (27.0%) patients in BR, 29 of 63 (46.0%) patients in NBR, 12 of 63 (19.0%) in DC1, and 5 of 63 (7.9%) patients in DC2. If only the baseline GH values were considered, the distributions were very similar to those with a GHn cut-off value of 0.4 ng/mL. The IGF-1/IGFBP-3 ratio was lowest in the BR group. CONCLUSION Adopting a GHn cut-off value of 0.4 ng/mL did not increase the test performance compared with baseline GH only. In contrast, in the follow-up of acromegalic patients, the IGF-1/IGFBP-3 ratio might be a useful measurement when discordance between IGF-1 and GH levels occurs. We propose that these values be considered in clinical practice. ABBREVIATIONS BR = biochemical remission DC1 = discordance group 1 DC2 = discordance group 2 DM = diabetes mellitus GH = growth hormone GHn = nadir in GH IGF-1 = insulin-like growth factor-1 IGFBP-3 = IGF binding protein-3 LAR = long-acting release NBR = not in biochemical remission OGTT = oral glucose tolerance test.
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Baykal C, Polat Ekinci A, Öztürk Sarı Ş, Topkarcı Z, Demir Ö, Büyükbabani N. Annular Erythematous Patches as the Presenting Sign of Extranodal Natural Killer/T-Cell Lymphoma. Turk J Haematol 2016; 33:360-361. [PMID: 27476759 PMCID: PMC5204199 DOI: 10.4274/tjh.2016.0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
| | - Algün Polat Ekinci
- İstanbul University İstanbul Faculty of Medicine, Department of Dermatology and Venereology, İstanbul, Turkey, Phone: +90 212 635 29 39, E-mail:
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Erdoğan MF, Demir Ö, Ersoy RÜ, Gül K, Aydoğan Bİ, Üç ZA, Mete T, Ertek S, Ünlütürk U, Çakır B, Aral Y, Güler S, Güllü S, Çorapçıoğlu D, Dağdelen S, Erdoğan G. Comparison of Early Total Thyroidectomy with Antithyroid Treatment in Patients with Moderate-Severe Graves' Orbitopathy: A Randomized Prospective Trial. Eur Thyroid J 2016; 5:106-11. [PMID: 27493884 PMCID: PMC4949371 DOI: 10.1159/000444796] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/16/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The optimal therapeutic choice for Graves' hyperthyroidism in the presence of moderate-severe Graves' orbitopathy (GO) remains controversial. OBJECTIVES We aimed to compare GO course in patients with moderate-severe GO treated with early total thyroidectomy (TTx) versus antithyroid drug (ATD) regimens, in a prospective, randomized manner. METHODS Forty-two patients with moderate-severe GO were enrolled. A total of 4.5 g of pulse corticosteroids were given intravenously to all patients before randomization. Patients in the first group were given TTx, whereas patients in the second group were treated with ATDs. TSH was kept between 0.4 and 1 mIU/l. The clinical course of GO was evaluated with proptosis, lid aperture, clinical activity score (CAS), and diplopia. RESULTS Eighteen and 24 patients were randomized to the TTx and ATD groups, respectively. Thyroid autoantibodies decreased significantly, and there were significant improvements in proptosis, lid aperture, and CAS in the TTx group. While in the ATD group the decrement in thyroid autoantibodies was not significant, there were significant improvements in proptosis and CAS. When the TTx group was compared with the ATD group, anti-TPO, anti-Tg, and TSH-receptor antibodies were significantly decreased in the TTx group (p < 0.01), but there was no significant difference with respect to proptosis, lid aperture, CAS, and diplopia between the two groups during a median (min.-max.) follow-up period of 60 months (36-72). CONCLUSION Although no definitive conclusions could be drawn from the study, mainly due to limited power, early TTx and the ATD treatment regimens, followed by intravenous pulse corticosteroid therapy, seemed to be equally effective on the course of GO in this relatively small group of patients with moderate-severe GO during a median (min.-max.) follow-up period of 60 months (36-72).
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Affiliation(s)
- Murat Faik Erdoğan
- Department of Endocrinology and Metabolic Diseases, Ankara University Medical Faculty, Ankara, Turkey
- *Murat Faik Erdoğan, Department of Endocrinology and Metabolic Diseases, School of Medicine, Ankara University, Adnan Saygun St., TR–06100 Samanpazarı/Ankara (Turkey), E-Mail
| | - Özgür Demir
- Department of Endocrinology and Metabolic Diseases, Ankara University Medical Faculty, Ankara, Turkey
| | - Reyhan Ünlü Ersoy
- Department of Endocrinology and Metabolic Diseases, Yıldırım Beyazıt University Medical Faculty, Ankara, Turkey
| | - Kamile Gül
- Department of Endocrinology and Metabolic Diseases, Yıldırım Beyazıt University Medical Faculty, Ankara, Turkey
| | - Berna İmge Aydoğan
- Department of Endocrinology and Metabolic Diseases, Ankara University Medical Faculty, Ankara, Turkey
| | - Ziynet Alphan Üç
- Department of Endocrinology and Metabolic Diseases, Ankara Training and Research Hospital, Ankara, Turkey
| | - Türkan Mete
- Endocrinology and Metabolic Diseases, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Sibel Ertek
- Department of Endocrinology and Metabolic Diseases, Ufuk University Medical Faculty, Ankara, Turkey
| | - Uğur Ünlütürk
- Department of Endocrinology and Metabolic Diseases, Ankara University Medical Faculty, Ankara, Turkey
| | - Bekir Çakır
- Department of Endocrinology and Metabolic Diseases, Yıldırım Beyazıt University Medical Faculty, Ankara, Turkey
| | - Yalçın Aral
- Department of Endocrinology and Metabolic Diseases, Ankara Training and Research Hospital, Ankara, Turkey
| | - Serdar Güler
- Endocrinology and Metabolic Diseases, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Sevim Güllü
- Department of Endocrinology and Metabolic Diseases, Ankara University Medical Faculty, Ankara, Turkey
| | - Demet Çorapçıoğlu
- Department of Endocrinology and Metabolic Diseases, Ankara University Medical Faculty, Ankara, Turkey
| | - Selçuk Dağdelen
- Department of Endocrinology and Metabolic Diseases, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Gürbüz Erdoğan
- Department of Endocrinology and Metabolic Diseases, Ufuk University Medical Faculty, Ankara, Turkey
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Aydoğan Bİ, Ünlütürk U, Demir Ö, Şahin M, Başkal N, Uysal AR. Early Onset Werner Syndrome. tjem 2015. [DOI: 10.4274/tjem.2722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Arslan M, Kıymaz N, Demir Ö, Yılmaz C, Yılmaz N. Bilateral abducens paralysis following head injury: a case report. J Pediatr Neurol 2015. [DOI: 10.1055/s-0035-1557180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mehmet Arslan
- Departments of Neurosurgery, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
| | - Nejmi Kıymaz
- Departments of Neurosurgery, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
| | - Özgür Demir
- Departments of Neurosurgery, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
| | - Cahide Yılmaz
- Departments of Pediatrics, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
| | - Nebi Yılmaz
- Departments of Neurosurgery, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
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Tanrıverdi H, Altuntaş M, Demir Ö, Afşar BB, Çelikiz M. Success Rates of Pharmacological Therapies Used for Smoking Cessation and Factors that Affect Smoking Cessation Rates. Electron J Gen Med 2015. [DOI: 10.15197/sabad.1.12.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Agbaht K, Demir Ö, Ünlütürk U, Doğan H, Arslan Ö, Çorapcıoğlu D. A Rare Presentation of Adrenal Insufficiency: Isolated Adrenocorticotropic Hormone Deficiency and Miyelofibrosis. tjem 2014. [DOI: 10.4274/tjem.2188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Demir Ö, Arslantaş H. The Effects of Progressive Relaxation Exercises Applied with Music Before Coronary Angiography and Percutaneous Transluminal Coronary Angioplasty on the State and Trait Anxiety of People. Psi Hem Derg 2014. [DOI: 10.5505/phd.2014.78942] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ertek S, Ersoy RÜ, Anıl C, Demir Ö, Erdoğan MF, Güllü S, Berker D, Gül K, Ünlütürk U, Erdoğan G. Hypothyroidism, new nodule formation and increase in nodule size in patients who have undergone hemithyroidectomy. Arch Med Sci 2012; 8:263-9. [PMID: 22661999 PMCID: PMC3361026 DOI: 10.5114/aoms.2012.28222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Revised: 11/04/2011] [Accepted: 11/14/2011] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION The current medical literature has conflicting results about factors related to hypothyroidism and nodular recurrences during follow-up of hemithyroidectomized patients. We aimed to evaluate factors that may have a role in new nodule formation, hypothyroidism, increase in thyroid lobe and increase in nodule volumes in these patients with and without Hashimoto's thyroiditis (HT), and with and without levothyroxine (LT4) use. MATERIAL AND METHODS We enrolled 140 patients from five different hospitals in Ankara and evaluated their thyroid tests, autoantibody titre results and ultrasonographic findings longitudinally between two visits with a minimum 6-month interval. RESULTS In patients with HT there was no significant difference between the two visits but in patients without HT, thyroid stimulating hormone (TSH) levels and nodule volume were higher, and free T4 levels were lower in the second visit. Similarly, in patients with LT4 treatment there was no difference in TSH, free T4 levels, or lobe or nodule size between the two visits, but the patients without LT4 had free T4 levels lower in the second visit. Regression analysis revealed a relationship between first visit TSH levels and hypothyroidism during follow-up. CONCLUSIONS Patients who have undergone hemithyroidectomy without LT4 treatment and without HT diagnosis should be followed up more carefully for thyroid tests, new nodule formation and increase in nodule size. The TSH levels at the beginning of the follow-up may be helpful to estimate hypothyroidism in hemithyroidectomized patients.
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Affiliation(s)
- Sibel Ertek
- Department of Endocrinology and Metabolic Diseases, Dr. R. Ege Hospital, Ufuk University Medical Faculty, Ankara, Turkey
| | - Reyhan Ünlü Ersoy
- Department of Endocrinology and Metabolic Diseases, Ataturk Hospital, Ankara, Turkey
| | - Cüneyd Anıl
- Department of Endocrinology and Metabolic Diseases, Baskent University Hospital, Ankara, Turkey
| | - Özgür Demir
- Department of Endocrinology and Metabolic Diseases, Ibni Sina Hospital, Ankara University Medical Faculty, Ankara, Turkey
| | - Murat Faik Erdoğan
- Department of Endocrinology and Metabolic Diseases, Ibni Sina Hospital, Ankara University Medical Faculty, Ankara, Turkey
| | - Sevim Güllü
- Department of Endocrinology and Metabolic Diseases, Ibni Sina Hospital, Ankara University Medical Faculty, Ankara, Turkey
| | - Dilek Berker
- Department of Endocrinology and Metabolic Diseases, Numune Hospital, Ankara, Turkey
| | - Kamile Gül
- Department of Endocrinology and Metabolic Diseases, Ataturk Hospital, Ankara, Turkey
| | - Uğur Ünlütürk
- Department of Endocrinology and Metabolic Diseases, Ibni Sina Hospital, Ankara University Medical Faculty, Ankara, Turkey
| | - Gürbüz Erdoğan
- Department of Endocrinology and Metabolic Diseases, Dr. R. Ege Hospital, Ufuk University Medical Faculty, Ankara, Turkey
| | - Ankara Thyroid Study Group
- Department of Endocrinology and Metabolic Diseases, Dr. R. Ege Hospital, Ufuk University Medical Faculty, Ankara, Turkey
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Bayram F, Gedik VT, Demir Ö, Kaya A, Gündoğan K, Emral R, Öztürk A, Uysal AR, Çorapçıoğlu D. Epidemiologic survey: reference ranges of serum insulin-like growth factor 1 levels in Caucasian adult population with immunoradiometric assay. Endocrine 2011; 40:304-9. [PMID: 21538205 DOI: 10.1007/s12020-011-9476-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2010] [Accepted: 04/18/2011] [Indexed: 10/18/2022]
Abstract
Gender, age adjusted, population based reference ranges are necessary to use insulin-like growth factor 1 (IGF-1) as a diagnostic marker or for therapeutic monitoring in growth hormone (GH) related diseases. The aim of the present study was to describe the serum IGF-1 distribution and to calculate age and gender specific reference values for Caucasian adult population. A representative sample of 1002 male and 1039 female, totally 2041 participants aged above 18 years old was examined. The subjects suffering from diabetes mellitus, renal diseases, liver diseases, cancer, or diseases of pituitary gland were excluded by medical history, physical examination, and laboratory tests. The subjects were not using any drug that could affect IGF-1 levels. Body mass index (BMI)>30 or<18 kg/m2 were excluded. Serum IGF-1 concentrations were determined by immunoradiometric assay (IRMA). Serum IGF-1 concentrations were declined with age in both males and females after the age of 18. Males had significantly higher serum IGF-1 levels than females in the age groups 18-24, 50-69 (P<0.05), but not in others (P>0.05). The present study established age and gender specific reference ranges for serum IGF-1 levels calculated for Caucasian adult population with IRMA that could be used in medical practice.
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Affiliation(s)
- Fahri Bayram
- Department of Endocrinology and Metabolic Diseases, School of Medicine, Erciyes University, Kayseri, Turkey
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Yesilkaya A, Memikoglu K, Azap A, Demir Ö, Balik I. P1222 Hypercalcaemia associated with chronic viral hepatitis C. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71062-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Saydam N, Kirb A, Demir Ö, Hazan E, Oto Ö, Saydam O, Güner G. Determination of glutathione, glutathione reductase, glutathione peroxidase and glutathione S-transferase levels in human lung cancer tissues. Cancer Lett 1997; 119:13-9. [DOI: 10.1016/s0304-3835(97)00245-0] [Citation(s) in RCA: 94] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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