A large number of patients with cardiovascular risk exhibit metabolic syndrome and are attended by several specialists. There is no information about possible differences in the clinical characteristics and management of these patients by... more
A large number of patients with cardiovascular risk exhibit metabolic syndrome and are attended by several specialists. There is no information about possible differences in the clinical characteristics and management of these patients by these specialists. The aim of the present study was to evaluate possible differences in clinical features, blood pressure control, therapeutic effort, and therapeutic inertia among medical specialities attending hypertensive patients with metabolic syndrome (MS). Cross-sectional study carried out in 17 autonomous communities in Spain, in hypertensive patients with MS consecutively recruited in ambulatory units from departments of cardiology, internal medicine, endocrinology and nephrology. Demographic and clinical data, as well as blood pressure control were assessed. Therapeutic effort was defined as the proportion of patients using 3 or more antihypertensive drugs. Therapeutic inertia was defined as the proportion of patients without any change i...
Research Interests: Endocrinology, Cardiology, Nephrology, Humanities, Medicine, and 15 moreCardiovascular Risk, Metabolic syndrome, Humans, Internal Medicine, Hypertension, Blood Pressure, Female, Male, Clinical Sciences, Aged, Middle Aged, Blood Pressure Control, Medicina Clinica, Cross Sectional Studies, and Abdominal Obesity
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Genel olarak, diabetes mellitus ve optik atrofi ilk dekadda, kraniyal diabetes insipidus ve sensorinöral sa ğırlık ikinci dekadda, üriner sistem patolojileri 3. dekadda ve multipl nörolojik anormallikler de 4. dekadda görülür. 2 Primer... more
Genel olarak, diabetes mellitus ve optik atrofi ilk dekadda, kraniyal diabetes insipidus ve sensorinöral sa ğırlık ikinci dekadda, üriner sistem patolojileri 3. dekadda ve multipl nörolojik anormallikler de 4. dekadda görülür. 2 Primer gonadal atrofi ise daha nadir olarak görülmektedir. Türkiye’den yayınlanan bir seride hipogonadizme rastlanmamı ştır. Biz primer hipogonadizmin e şlik ettiği WS’lu bir olguyu sunuyoruz.
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Hypertension is a common and important public health problem in Turkey and worldwide. Recommendations on the diagnosis and treatment of hypertension have been presented in many nationally and internationally agreed European and American... more
Hypertension is a common and important public health problem in Turkey and worldwide. Recommendations on the diagnosis and treatment of hypertension have been presented in many nationally and internationally agreed European and American guidelines. However, there are differences among these guidelines, and some of the recommendations are not consistent with clinical practice in our country. Consensus report preparation, with the participation of relevant associations, was considered necessary to merge recommendations by evaluating hypertension guidelines from the perspective of Turkey and to create a joint approach in the diagnosis and treatment of hypertension in adults. For this purpose, it was aimed to prepare a practical text in Turkey in which all physicians dealing with hypertensive patients, from family practitioners in primary care to specialists in tertiary care, could come to agreement on common concepts, and which would be used as a basic reference guideline. Considering ...
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The efficacy of low and high fixed dose radioactive iodine (RAI) therapy in patients with toxic nodular goiter was investigated. Ninety-three patients (25 males, 68 females) were included into the study (32 patients with toxic adenoma, 61... more
The efficacy of low and high fixed dose radioactive iodine (RAI) therapy in patients with toxic nodular goiter was investigated. Ninety-three patients (25 males, 68 females) were included into the study (32 patients with toxic adenoma, 61 patients with toxic multinodular goiter). Patients were treated with a fixed dose of 370 MBq (10 mCi) or 740 MBq (20 mCi) RAI. The average follow-up period was 17±10 months. The overall cure rate (eutyhroidism and hypothyroidism) was 81% in patients treated with 740 MBq RAI and 51% in patients treated with 370 MBq RAI (p<0.05). RAI therapy with a dose of 370 MBq and 740 MBq provided the cure in 73% and 91% of the patients with toxic adenoma and 42% and 76% of the patients with toxic multinodular goiter, respectively. No significant difference for gender was observed. Hypothyroidism developed in 4 and 15 patients with a dose of 370 MBq and 740 MBq RAI, respectively. A dose of 740 MBq RAI was found to be more effective for the treatment of toxic n...
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Pheochromocytoma (PHEO) occasionally associates with pathological lesions of the adrenal cortex. In most of them, ectopic adrenocorticotropic hormone (ACTH) produced by PHEO resulted in bilateral adrenocortical hyperplasia. The... more
Pheochromocytoma (PHEO) occasionally associates with pathological lesions of the adrenal cortex. In most of them, ectopic adrenocorticotropic hormone (ACTH) produced by PHEO resulted in bilateral adrenocortical hyperplasia. The coexistence of PHEO and pre-clinical Cushing&#39;s syndrome (PCS) of the same adrenal gland has rarely been reported. We report on a patient and discuss the peculiar diagnostic aspects of this entity. A 52-yr-old Turkish woman was hospitalized at Farabi Hospital for further examinations of a right adrenal mass that was incidentally discovered by abdominal ultrasonography during examinations for abdominal bloating and &quot;gas&quot; in other hospital. The patient had a history of palpitations, nervousness, sweating and heat intolerance. On admission, her blood pressure was 140/90 mmHg. A physical examination revealed no signs of an excessive production of adrenocortical steroids such as in CS. Tension Holter monitoring revealed paroximal hypertension attacks (183/105 mmHg). Urinary catecholamines were markedly increased. Her serum cortisol concentrations ranged from 5 to 17 microg/dl, whereas ACTH levels were undetectable. Cortisol was not suppressed on the overnight 1 mg oral dexamethasone suppression test (DST), 2-day low-dose dexamethasone suppression test (DST). Abdominal computed tomography and magnetic resonance imaging studies revealed a solid round tumor approximately 4 cm in diameter, located in the right adrenal gland. A 131 lodine-metaiodobenzylguanidine (131 I-MIBG) scan revealed uptake within tumor in the right adrenal gland. Right adrenalectomy was performed; the surgical specimen revealed PHEO and adrenocortical hyperplasia. To our knowledge, the present report is a rare case of PHEO combined with PCS in the same adrenal gland.
Research Interests: Magnetic Resonance Imaging, Medicine, Dexamethasone, Humans, Internal Medicine, and 14 moreFemale, Hyperplasia, Pheochromocytoma, Clinical Sciences, Middle Aged, Adrenal cortex, Adrenocorticotropic Hormone, Adrenal Gland, X ray Computed Tomography, Catecholamines, Adrenalectomy, Cushing Syndrome, Adrenal glands, and hydrocortisone
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Increased plasma atrial natriuretic peptide levels accompany the expansion of effective plasma volume in diabetic patients. Atrial natriuretic peptide has a deleterious effect on the pathogenesis of diabetic nephropathy by increasing... more
Increased plasma atrial natriuretic peptide levels accompany the expansion of effective plasma volume in diabetic patients. Atrial natriuretic peptide has a deleterious effect on the pathogenesis of diabetic nephropathy by increasing renal plasma flow and glomerular filtration rate. Angiotensin converting enzyme inhibitors decrease plasma atrial natriuretic peptide levels. We aimed to show the effect of losartan, a specific angiotensin II
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Insulin degludec/aspart (IDegAsp) and insulin glargine U300 (IGlarU300) have recently emerged as popular new‐generation insulin analogues. The aim of this real‐life study was to investigate the patient profiles in which IGlarU300 and... more
Insulin degludec/aspart (IDegAsp) and insulin glargine U300 (IGlarU300) have recently emerged as popular new‐generation insulin analogues. The aim of this real‐life study was to investigate the patient profiles in which IGlarU300 and IDegAsp were preferred and the insulin combinations after which each of them were mostly used and also to analyse the effect of these two insulin analogues on blood glucose regulation and hypoglycaemia.
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BACKGROUND The majority of prediabetic people are overweight and weight loss is still the most effective treatment strategy. The aim of this study was to evaluate the effects of short-term exercise and/or diet on weight loss and clinical... more
BACKGROUND The majority of prediabetic people are overweight and weight loss is still the most effective treatment strategy. The aim of this study was to evaluate the effects of short-term exercise and/or diet on weight loss and clinical parameters in subjects with insulin resistance (IR). METHODS A total of 60 subjects (BMI ≥ 25.0 kg/m2) were included in the study. Subjects divided into two groups as follows: diet only (DI, n=27) and diet and exercise (DEI, n=27). DI group received an energy restricted diet program, while DEI group received a diet combined with an exercise program for four weeks. Anthropometric measurements and biochemical parameters were assessed at baseline and at the end. RESULTS Total body weight (BW) loss was 2.3 kg (2.5%) in DI group and 3.0 kg (3.2%) in DEI group at the end of four weeks. Fasting blood glucose (FBG) levels decreased significantly in DEI group (p=0.021). However, the reductions in FBG levels were mild and not statistically significant in DE group (p>0.05). Total cholesterol and LDL-c levels reduced in both groups, while triglyceride levels significantly decreased only in DI group (p<0.05). CONCLUSIONS Short-term lifestyle interventions have beneficial effects on weight loss and clinical parameters associated with glucose control and lipid profile in subjects with IR. Even small changes in BW (loss of <5% of initial BW) have a positive impact on clinical parameters.
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Research Interests: Medicine and Gynecomastia
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AIM The purpose of this study was to investigate the changes in serum irisin, fibroblast growth factor-21 (FGF21), visfatin, follistatin like protein-1 (FSTL1), and meteorin-like protein (Metrnl) levels in response to increased physical... more
AIM The purpose of this study was to investigate the changes in serum irisin, fibroblast growth factor-21 (FGF21), visfatin, follistatin like protein-1 (FSTL1), and meteorin-like protein (Metrnl) levels in response to increased physical activity and/or diet interventions in overweight subjects with impaired glucose metabolism (IGM). METHODS A total of 60 subjects (BMI > 25.0 kg/m2) with IGM were recruited in this single-centered interventional study. Twelve subjects dropped out during the study and the study was completed with 48 patients. Patients were divided into two groups as diet only (DI, n = 24) and diet and physical activity intervention (DPA, n = 24). Patients in DI group received a diet program while DPA group received a diet combined with a physical activity intervention for 12 weeks. Additional 24 healthy subjects were recruited to compare the baseline levels of proteins. Serum protein levels, anthropometric measurements, and biochemical parameters were assessed. RESULTS Irisin, FGF21, visfatin, and FSTL1 levels significantly decreased in both groups after 12-week intervention (p < 0.001). However, there were no differences in protein levels between DI and DPA groups (p > 0.05). Likewise, the total change in weight was similar in both DI (-4.35 kg) and DPA (-4.85 kg) groups (p > 0.05). A 5% reduction in initial body weight with DPA therapy resulted in a stronger correlation between the changes in irisin, visfatin, and FSTL1 levels and fasting glucose and HbA1c levels. CONCLUSIONS These results demonstrate that serum irisin, FGF21, visfatin, and FSTL1 levels decreased in response to weight loss interventions. Weight loss induced by DI or DPA therapies had similar lowering effects on these proteins in subjects with IGM, and these myokines might be related to glucose metabolism biomarkers.
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Background: Severe hyperlipidemia secondary to capecitabine, an oral fluoropyrimidine, is a very rare condition. There are no reported cases of hyperlipidemia associated with Uracil/tegafur (UFT). Objective: Report UFT-induced severe... more
Background: Severe hyperlipidemia secondary to capecitabine, an oral fluoropyrimidine, is a very rare condition. There are no reported cases of hyperlipidemia associated with Uracil/tegafur (UFT). Objective: Report UFT-induced severe hyperlipidemia. Method: A 71-year-old male patient with metastatic colorectal cancer receiving capecitabine treatment was hospitalized at the end of the eighth cycle with the complaint of fatigue. Capecitabine treatment was discontinued in the patient in whom severe hyperlipidemia was detected together with disease progression. Gemphibrozile 1200 mg/day was initiated; patient’s triglyceride level and serum cholesterol decreased from 1768 to 149 mg/dL and from 497 to 99 mg/dL, respectively, five weeks later. The patient started to receive UFT chemotherapy and after the second cycle, he presented to our hospital again with the complaints of fatigue, headache, and yellow vision. The investigations revealed a serum triglyceride level of 4115 mg/dL and a cho...
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Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. A nationwide, multicenter... more
Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c<7%, home arterial blood pressure (ABP) <135/85 mmHg, or LDL-C <100 mg/dL. Achieving all parameters indicated triple metabolic control. HbA1c levels of patients (n=5211) were 8.6±1.9% (71±22 mmol/mol) and 7.7±1.7% (61±19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, non-smoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. Few patients wi...
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Adrenal ganglioneuromas are rare tumors originating from the neural crest tissue of the sympathetic nervous system. The clinical presentation for most patients is asymptomatic, and most of these tumors are hormone silent. We report a case... more
Adrenal ganglioneuromas are rare tumors originating from the neural crest tissue of the sympathetic nervous system. The clinical presentation for most patients is asymptomatic, and most of these tumors are hormone silent. We report a case of dopamine-secreting adrenal ganglioneuroma associated with paroxysmal hypertensive attacks in an adult patient. A 46-year-old woman was admitted to our hospital with a 2-month history of right flank pain, and a 2-year history of paroxysmal hypertensive attacks associated with headaches, palpitations, nervousness, and sweating. Abdominal CT and MRI revealed a solid round tumor approximately 4 cm in diameter on the upper pole of the right kidney. Urinary levels of dopamine and homovanillic acid were slightly elevated, although urinary levels of metanephrine and normetanephrine were suppressed. The urinary levels of epinephrine, norepinephrine, and vanillylmandelic acid were within normal limits. Right adrenalectomy was performed for treatment purposes. Histological diagnosis of the tumor was a ganglioneuroma originating from the adrenal medulla. In conclusion, this is a case of dopamine-secreting adrenal ganglioneuroma associated with paroxysmal hypertensive attacks in an adult patient.
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The main purpose of this study was to evaluate the levels of ischemia-modified albumin (IMA) and malondialdehyde (MDA) in patients with OHyper and SHyper, to assess the effects of antithyroid drug (ATD) therapy on the oxidative stress... more
The main purpose of this study was to evaluate the levels of ischemia-modified albumin (IMA) and malondialdehyde (MDA) in patients with OHyper and SHyper, to assess the effects of antithyroid drug (ATD) therapy on the oxidative stress (OS) parameters. Forty-five untreated patients with overt hyperthyroidism (OHyper), 20 untreated patients with subclinical hyperthyroidism (SHyper) and 30 age-and sex-matched healthy controls were prospectively included in the study. Biochemical and hormonal parameters were evaluated in all patients before and after treatment. Compared with the control subjects, the levels of MDA, glucose and TG were significantly increased in patients with SHyper (p<0.05), whereas LDL-C levels were significantly decreased (p<0.01). Patients with OHyper showed significantly elevated MDA and glucose levels (p<0.001) and significantly decreased LDL-C and HDL-C levels compared with the controls (p<0.01). In patients with Graves' disease, serum TSH levels w...
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We investigated the effect of aminoguanidine (AG) administration on GBM thickness, glomerular heparan sulfate (HS) content, and urinary albumin and HS excretion in diabetic rats. After induction of diabetes, female Wistar rats were... more
We investigated the effect of aminoguanidine (AG) administration on GBM thickness, glomerular heparan sulfate (HS) content, and urinary albumin and HS excretion in diabetic rats. After induction of diabetes, female Wistar rats were divided into 2 groups: Group AGDM (n=11) received 1g/L aminoguanidine bicarbonate in drinking water, group DC (n=12) was given only tap water. Control rats received AG (group AGH, n=8) or tap water (group HC, n=8). At the end of a period of 8 weeks, urinary albumin and glycosaminoglycan (GAG) excretion was detected. GBM heparan sulfate distribution and count was determined under the electron microscope. The AGDM group had lower urinary albumin and GAG excretion than diabetic controls. GBM thickness was increased in diabetic rats compared to groups of AGDM and HC. In AGDM group alcian blue stained particle distribution and count in the GBM was similar to healthy controls. In conclusion AG prevents the decrease of anionic charged molecules in the GBM and GB...
Research Interests: Endocrinology, Chemistry, Enzyme Inhibitors, Medicine, Internal Medicine, and 15 moreBasement Membrane, Albumin, Female, Animals, Rats, Nitric Oxide Synthase, Albuminuria, Guanidines, Bicarbonate, Diabetic Rat, Glomerular Basement Membrane, Heparan Sulfate, Experimental Diabetes, excretion, and Kidney glomerulus
Nonenzymatic glycation of tissue and plasma proteins may stimulate the production of oxidant and carbonyl stress in diabetes. The aim of this study was to evaluate the effects of aminoguanidine (AG) on lipid peroxidation, protein... more
Nonenzymatic glycation of tissue and plasma proteins may stimulate the production of oxidant and carbonyl stress in diabetes. The aim of this study was to evaluate the effects of aminoguanidine (AG) on lipid peroxidation, protein oxidation and nitric oxide (NO) release in diabetic rat kidneys. After induction of diabetes with streptozotocin, female Wistar rats were divided into 2 groups. Group DAG (n=9) rats were given AG hydrogen carbonate (1 g/L) in drinking water and group D (n=8) was diabetic control rats given only tap water. Group H (n=8) was followed as healthy controls. At the end of an 8 week period, NO release, lipid and protein oxidation were determined in kidney tissues. NO release was significantly lower in diabetic rats compared with healthy controls (p<0.05). Lipid peroxidation was significantly high in group D (3.9 ± 0.3 nmol MDA/g tissue) compared with the group DAG (2.6 ± 0.1 nmol MDA/g tissue, p<0.01) and group H (2.4 ± 0.2 nmol MDA/g tissue). Protein oxidat...
Research Interests: Endocrinology, Chemistry, Medicine, Glycation, Internal Medicine, and 15 moreKidney, Diabetes mellitus, Nitric oxide, Female, Animals, Lipid metabolism, Lipid Oxidation, Lipid peroxidation, Experimental, Albuminuria, Guanidines, Diabetic Rat, Experimental Diabetes, Kidney cortex, and Diabetic nephropathies
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Research Interests: Cardiology, Diabetes, Medicine, Humans, Internal Medicine, and 15 moreHypertension, Diabetes mellitus, Blood Pressure, Circadian Rhythm, Female, Male, Heart rate, Clinical Sciences, Middle Aged, Prognosis, Albuminuria, Type 2 Diabetes Mellitus, Cross Sectional Studies, Ambulatory Blood Pressure, and Diabetic Neuropathies
The efficacy and the effective dose of levothyroxine suppressive therapy in the treatment of benign thyroid nodules are controversial. In this study, we aimed to determine the response of solitary thyroid nodules to low- or high-level TSH... more
The efficacy and the effective dose of levothyroxine suppressive therapy in the treatment of benign thyroid nodules are controversial. In this study, we aimed to determine the response of solitary thyroid nodules to low- or high-level TSH suppression in a placebo-controlled, randomized crossover trial. Forty-nine patients with solitary thyroid nodules on palpation were randomized to high-level and low-level TSH suppression groups. In each group, patients were further randomized to placebo and active levothyroxine subgroups. Patients in each subgroup were crossed over to placebo or active levothyroxine at the end of the first year and were then followed up for an additional year. TSH levels were suppressed to 0.4-0.6 mIU/ml and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or = 0.01 mIU/ml in the low-level and high-level TSH suppression groups, respectively. Nodule volumes were measured at baseline and every 6 months after the desired level of TSH was reached if the patients were in the active levothyroxine treatment group or every 6 months if they were in the placebo group. In high-level TSH suppression groups, nodule volume decreased significantly at the end of the active treatment periods (4.99 +/- 2.02 ml vs. 3.20 +/- 1.50 ml, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01, in Group 1; and 3.72 +/- 1.79 ml to 2.05 +/- 0.64 ml, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001, in Group 2). In the low-level TSH suppression groups, nodule volume also decreased significantly at the end of the active treatment periods (4.43 +/- 1.76 ml vs. 3.04 +/- 1.32, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05, in Group 3; and 3.59 +/- 0.89 ml to 2.22 +/- 0.59 ml, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01, in Group 4). Nodule volumes regained their original volumes during the placebo treatment periods. The percentage decline in clinically relevant nodule volume reduction (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 50%) was similar in the low-level and high-level TSH suppression groups. Low- and high-level TSH suppression were equally effective in reducing nodule volume and thus, considering the complications of high-level TSH suppression, low-level TSH suppression should be used if one considers levothyroxine suppressive therapy to reduce thyroid nodule size.
Research Interests: Medicine, Thyroid, Software Design, Humans, Internal Medicine, and 15 morePlacebo, Thyroid gland, Female, Clinical, Male, Randomised Controlled Trial, Clinical Sciences, Adult, Analysis of Variance, Randomized Controlled Trial, Clinical Endocrinology, Thyroid nodule, Thyroglobulin, Levothyroxine, and Paediatrics and reproductive medicine
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Research Interests: Andrology, Anthropometry, Medicine, Humans, Prolactin, and 14 moreTestosterone, Male, Young Adult, Body Mass Index, Gynecomastia, Clinical Sciences, Adult, Anamnesis, Luteinizing Hormone, Estradiol, Follicle stimulating hormone, Case Control Studies, Paediatrics and reproductive medicine, and dehydroepiandrosterone sulfate
OBJECTIVE: Sibutramine is an effective appetite suppresser agent, but treatment is often complicated with side effects, including palpitations and hypertension. In this study, we aimed to assess the effect of low-dose cardio-selective... more
OBJECTIVE: Sibutramine is an effective appetite suppresser agent, but treatment is often complicated with side effects, including palpitations and hypertension. In this study, we aimed to assess the effect of low-dose cardio-selective beta blocker combination with sibutramine treatment.METHODS: In total, 57 obese subjects were enrolled in the study and separated into two groups in order to receive sibutramine 10 mg/day
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Research Interests: Growth Hormone, Humans, Diabetes mellitus, Retinitis pigmentosa, Blood Pressure, and 15 moreWeight Loss, Male, Facial Features, Endocrine, Clinical Sciences, Adult, Pituitary Adenoma, Physical examination, Acromegaly, Pulse Rate, Diabetic ketoacidosis, Adenoma, Loss of Consciousness, Medical Treatment, and Bradycardia
The aim of this study is to evaluate the effects of losartan on blood pressure (BP), creatinine clearance (Ccr) and urinary albumin excretion (UAE), and to assess metabolic parameters in comparison with ACEI. Thirty-three type 2 diabetic... more
The aim of this study is to evaluate the effects of losartan on blood pressure (BP), creatinine clearance (Ccr) and urinary albumin excretion (UAE), and to assess metabolic parameters in comparison with ACEI. Thirty-three type 2 diabetic hypertensive patients were enrolled in the study. Twenty patients were randomized to receive 50 mg/day losartan and 13 patients to 10 mg/day fosinopril.
Research Interests: Diabetes, Lipids, Humans, Blood Glucose, Hypertension, and 17 moreInsulin, Blood Pressure, Female, Male, Diabetic Nephropathy, Clinical Sciences, Middle Aged, Electrolytes, Adult, Time Factors, Oral Hypoglycemic Agents, Losartan, Type 2 Diabetes Mellitus, Angiotensin Converting Enzyme Inhibitors, Aspartate Aminotransferases, Alanine Transaminase, and Diabetic Diet
Research Interests: Computed Tomography, Magnetic Resonance Imaging, Treatment Outcome, Cortisol, Humans, and 14 moreHypertension, Diabetes mellitus, Low Dose, Male, Endocrine, Clinical Sciences, Adult, Adrenal cortex, Sjogren´s Syndrome, Physical examination, Adrenocorticotropic Hormone, Adrenal Gland, X ray Computed Tomography, and Cushing Syndrome
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To investigate the markers of endogenous coagulation/fibrinolysis and vascular endothelial cell function, and to assess the relationships between hemostatic parameters and diabetic vascular complications in type 2 diabetic patients.... more
To investigate the markers of endogenous coagulation/fibrinolysis and vascular endothelial cell function, and to assess the relationships between hemostatic parameters and diabetic vascular complications in type 2 diabetic patients. Coagulation and fibrinolysis parameters were measured in 92 type 2 diabetic patients (43 male, 49 female, mean age 50.1 +/- 13.4 years) with (n = 44) and without (n = 48) vascular diabetic complications, and in 40 nondiabetic healthy subjects (20 male, 20 female, mean age 49.8 +/- 15.1 years). Common lipid parameters were also measured. The plasma levels of fibrinogen, antithrombin III (AT III), plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (vWF) activity and prothrombin time were found to be significantly increased in the type 2 diabetic patients compared with the healthy subjects. Glycosylated hemoglobin lc was inversely correlated with plasma protein S and activated prothrombin time. Protein C and S activities were positively correlated with plasma vWF activity, and were negatively correlated with plasma t-PA levels. vWF activity was negatively correlated with plasma t-PA levels. AT III levels were positively correlated with plasma total cholesterol levels, plasma low density lipoprotein cholesterol levels, plasma triglycerides and D-dimer levels. Plasma PAI-1 levels and factor V activity in diabetic patients with microvascular complications were significantly higher than those of the diabetic patients without microvascular complications. The plasma PAI-1 and platelet count were increased in patients with diabetic retinopathy compared with the diabetic patients without retinopathy. Plasma PAI-1 levels and factor VII activity were significantly higher in the diabetic patients with nephropathy than in diabetic patients without nephropathy. Plasma concentrations of fibrinogen and PAI-1 were significantly higher in the diabetic patients with neuropathy than the diabetic patients without neuropathy. The data demonstrated that patients with type 2 diabetes mellitus had a hypercoagulable state and hypofibrinolysis, thereby indicating that activation of coagulation with a reduced fibrinolytic activity may contribute to the increased risk of vascular disease in type 2 diabetic patients.
Research Interests: Humans, Endothelial Cells, von Willebrand factor, Blood Coagulation Factors, Diabetic Retinopathy, and 15 moreFemale, Male, Aged, Middle Aged, Peripheral Vascular Disease, Adult, Public health systems and services research, Biological markers, Lipid Profile, Type 2 Diabetes Mellitus, Healthy Subjects, Fibrinolysis, Total Cholesterol, Plasminogen Activator Inhibitor, and Case Control Studies
This is a report of 2 hypertensive siblings with a history of carotid body tumors and subsequent benign adrenal pheochromocytomas (pheos) in a family where the mother had died of possible adrenal carcinoma. The first case was a... more
This is a report of 2 hypertensive siblings with a history of carotid body tumors and subsequent benign adrenal pheochromocytomas (pheos) in a family where the mother had died of possible adrenal carcinoma. The first case was a 35-year-old woman with paroxysmal hypertensive attacks and a right adrenal mass. She had earlier undergone surgery to remove bilateral carotid body tumors. Investigation revealed excessive excretion of catecholamines and their metabolites in the urine. Abdominal MRI and (131)I-MIBG scintigraphy revealed a right adrenal tumor. Right adrenalectomy was performed. The second case, the 45-year-old brother of the first case, was found to have a left adrenal mass on abdominal MRI. Catecholamines and their metabolites in the urine were found to be increased. He had also had surgery to remove bilateral carotid body tumors of the neck. Left adrenalectomy was performed. Both siblings showed no evidence of other familial syndromes, such as multiple neoplasia type 2, von Hippel-Lindau disease or neurofibromatosis type 1. Although the combination of familial carotid body tumors and pheo is rare, a patient who remains hypertensive after removal of a carotid body tumor deserves a careful evaluation to exclude pheo. Such tumors may be extra-adrenal or multifocal.
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In this prospective, randomised, open trial, we wanted to evaluate the efficacy and safety of hourly subcutaneous (SC) insulin lispro administration in the treatment of diabetic ketoacidosis (DKA) in comparison with intravenous (IV)... more
In this prospective, randomised, open trial, we wanted to evaluate the efficacy and safety of hourly subcutaneous (SC) insulin lispro administration in the treatment of diabetic ketoacidosis (DKA) in comparison with intravenous (IV) regular insulin treatment. Twenty patients were enrolled in the study. The patients were randomly assigned into two groups. Following a bolus injection of 0.15 U/kg IV regular insulin, group L received half of this dose as hourly SC insulin lispro while group R was treated conventionally with IV regular insulin infusion. At the end of treatment period, time that needed for normalisation of serum glucose, beta-hydroxybutyrate, blood pH and urine ketone levels were not different in groups L and R. There was no mortality or serious side effects in both groups. In this study, we revealed that treatment of mild and moderate DKA with SC insulin lispro is equally effective and safe in comparison with IV regular insulin.
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Research Interests:
Research Interests: Ultrasound, Prospective studies, Humans, Diabetes mellitus, Female, and 14 moreMale, Endothelial dysfunction, Parathyroid Hormone, Middle Aged, Endothelial Function, Cardiovascular Imaging, Endothelial cell, Chi Square Distribution, Primary hyperparathyroidism, Vasodilation, Blood Flow Velocity, Case Control Studies, Peripheral artery disease, and Brachial artery
Diagnosis of polycystic ovary syndrome (PCOS) is very difficult in women with ovulatory cycles. We assessed the diagnostic value of prostate-specific antigen (PSA) and free prostate-specific antigen (fPSA) in women with ovulatory or... more
Diagnosis of polycystic ovary syndrome (PCOS) is very difficult in women with ovulatory cycles. We assessed the diagnostic value of prostate-specific antigen (PSA) and free prostate-specific antigen (fPSA) in women with ovulatory or anovulatory PCOS. Study group consisted of 62 women with PCOS and 35 healthy female controls. PCOS group was divided into two subgroups as anovulatory (n = 42; 68%, Group A) and ovulatory group (n = 20; 32%, Group B). A cut-off level of PSA and fPSA was established for the sensitivity, specificity, positive likelihood ratio, area under curve, diagnostic accuracy, and positive and negative predictive values of diagnosis of PCOS. In group A, a PSA level of greater than 10 pg/ml yielded a sensitivity of 73.2%, a specificity of 80%, and a diagnostic accuracy of 73%, with a positive predictive value of 88.2% and a negative predictive value of 59.3%. An fPSA level of greater than 2.1 pg/ml yielded a sensitivity of 71.2%, a specificity of 80.4%, and a diagnostic accuracy of 87%, with a positive predictive value of 87.2% and a negative predictive value of 58.4%. In group B, a PSA level of greater than 10 pg/ml yielded a sensitivity of 65%, a specificity of 80%, and a diagnostic accuracy of 73%, with a positive predictive value of 76.5% and a negative predictive value of 69.6%. An fPSA level of greater than 2.1 pg/ml yielded a sensitivity of 65.4%, a specificity of 80.4%, and a diagnostic accuracy of 87%, with a positive predictive value of 75.5% and a negative predictive value of 68.4%. Circulating androgens and hirsutism are independently associated with the degrees of PSA and fPSA in PCOS women. Increased plasma levels of PSA (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;10 pg/ml) and fPSA (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;2.1 pg/ml) could be helpful as a diagnostic tool for women with ovulatory or anovulatory PCOS.
Research Interests: Adolescent, Humans, Female, Ovulation, Endocrine, and 13 moreYoung Adult, Anovulation, Clinical Sciences, Polycystic Ovary Syndrome, IRT-likelihood Ratio, Adult, Diagnostic Accuracy, Sensitivity and Specificity, Prostate Specific Antigen, Area Under Curve, Predictive value of tests, Positive predictive value, and Case Control Studies
Ischemia-modified albumin (IMA) is a novel marker of tissue ischemia. Nowadays, IMA is accepted as a marker of oxidative stress. In this study, we aimed at establishing an association between IMA and hyperglycemia, blood pressure, lipid... more
Ischemia-modified albumin (IMA) is a novel marker of tissue ischemia. Nowadays, IMA is accepted as a marker of oxidative stress. In this study, we aimed at establishing an association between IMA and hyperglycemia, blood pressure, lipid parameters, microvascular complications, hsCRP, and microalbuminuria in type 2 diabetes patients without overt macrovascular disease and acute ischemia. Fifty type 2 diabetes mellitus patients without a history of macrovascular disease or end-stage renal disease were enrolled into the study. Age-matched 30 healthy individuals were also included in the study as a control group. Plasma IMA (0.329 ± 0.046 and 0.265 ± 0.045 AbsU; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and hsCRP levels (0.51 ± 0.36 and 0.32 ± 0.17 mg/dl; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) were significantly higher in the diabetic group compared to healthy controls. IMA level was significantly correlated with hsCRP (r = 0.76; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001), HbA1c (r = 0.72; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001), microalbuminuria (r = 0.40; P = 0.004), systolic blood pressure (r = 0.28; P = 0.049), diastolic blood pressure (r = 0.44; P = 0.005), and HOMA-IR (r = 0.42; P = 0.005) levels in the entire diabetic subjects. In the diabetic patients group, presence of microalbuminuria was associated with a higher plasma IMA level (0.355 ± 0.035 and 0.265 ± 0.0045 AbsU; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001, patients with microalbuminuria and control subjects, respectively). In the type 2 diabetes patients with nephropathy, IMA level (0.355 ± 0.035 and 0.311 ± 0.046 AbsU; P = 0.002) was determined higher compared to the diabetes patients without nephropathy. Diabetic patients without an overt cardiovascular disease still have a higher serum IMA level compared to healthy controls. The correlation of high plasma IMA levels with high hsCRP and microalbuminuria levels in diabetic subjects indicates the presence of a chronic ischemic process. Therefore, elevated IMA levels may indicate an underlying subclinical vascular disease in type 2 diabetes mellitus patients.