Browsing by Author "Cander, Soner"
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Item Ağrılı ve ağrısız tiroiditler(Uludağ Üniversitesi, 2014-12-05) Cander, Soner; Gül, Özen Öz; Ersoy, Canan; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı.Tiroidit, tiroidin çeşitli nedenlerle ortaya çıkan inflamasyonudur. Birçok neden, otoimmünite, enfeksiyonlar, radyasyon, ilaçlar tiroidit gelişimine neden olabilmektedir. Tiroiditlerin nedenleri gibi klinik tabloları da çok çeşitlidir. Bu nedenle ayrım ve sınıflama yapmak her zaman mümkün olamamaktadır. Hastalarda herhangi bir semptom olmaksızın tanı tesadüfen konulabildiği gibi, hastalar boyunda şiddetli ağrı, şişlik, guatr ile de başvurabilmektedirler. Hastalar ötiroidik olabilmekte, hipotiroidi veya tirotoksikoz da görülebilmektedir. Tedavi genellikle semptomları düzeltmeye yöneliktir. Tiroid disfonksiyonu saptanması halinde etyolojide göz önünde bulundurularak tedavi planlanmalıdırPublication Anthropometric outcomes in type 2 diabetic patients with new dapagliflozin treatment; actual clinical experience data of six months retrospective glycemic control from single center(Elsevier, 2019-01-01) Calapkulu, Murat; Cander, Soner; Gül, Özen Öz; Ersoy, Canan; CANDER, SONER; ÖZ GÜL, ÖZEN; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; CJH-1319-2022 ; AAH-8861-2021; AAI-1005-2021Introduction: Dapagliflozin is an antidiabetic drug that has been used as a member of the new antidiabetic drug group that acts by inhibiting SGLT-2 and increasing urinary glucose excretion. With numerous controlled experimental studies of dapagliflozin, evaluation of real-life data after entry into clinical practice is an important condition. In our study, the effects of dapagliflozin on glycemic control and anthropometric measurements were investigated retrospectively.Methods: A-total of thirty-one type 2 diabetics were enrolled in the study. Data of before dapagliflozin and three and six months of treatment were recorded.Results: Dapagliflozin reduced HbA1c levels by 0,9% at 3 months and 0,79% at 6 months. Fasting plasma glucose decreased 41,1 mg/dl in the 3rd and 42 mg/dl in the 6th, postprandiyal glucose decreased 86,3 mg/dl in the 3rd and 74,2 mg/dl in the 6th. In the 3rd and 6th, body weights decreased by 3,3 kg and 4,2 kg, BMI decreased by 1,3 kg/m(2) and 1,6 kg/m(2) respectively. Similarly, it was observed that the waist circumference decreased by 1,3 cmat the end of 6th.Conclusion: Our data show that SGLT-2 inhibitors provide glycemic control with reduce HbA1c levels by 0.8-0.9%, and reduce fasting and postprandial plasma glucose levels without increasing the risk of hypoglycemia and causing weight lose around 5% at the six mounths. SGLT-2 inhibitors were found to be more effective in reduce postprandiyal plasma glucose in patients who did not use insulin and fasting plasma glucose in patients with diabetes mellitus less than 10 years. (c) 2018 Published by Elsevier Ltd on behalf of Diabetes India.Item Assessing the impact of insulin glargine and detemir treatment to serum total IGF1 levels in the insulin-naive type 2 diabetic patients(Mary Ann Liebert, 2017-06) Dizdar, Oğuzhan Sıtkı; Koca, Nizameddin; Aydın, Taner; Cander, Soner; Gül, Özen Öz; Sarandöl, Emre; Ersoy, Canan; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0002-2593-7196; AAI-1005-2021; ABE-1716-2020; AAH-8861-2021; 25027068600; 26040787100; 55943324800; 6701485882Aim: The mitogenic potential of analog insulins due to their different insulin-like growth factor-1 (IGF1) receptor affinity is a situation that causes concern related to cancer risk. We aimed to examine the changes in the serum IGF1 levels formed by insulin glargine and detemir in the insulin-naive type 2 diabetic patients. Methods: The serum total IGF1 levels of the 62 insulin-naive type 2 diabetic patients were studied before and after 12 weeks of the started treatment with basal insulin analogs. Twenty-two and twenty patients (Group I and II) using the single-dose and double-dose insulin detemir and twenty patients (Group III) using insulin glargine were evaluated. Results: In Group I and Group II, the average 8.5% and 0.1% increases and in the Group III, 6.5% decreases were determined in the IGF1 values. The IGF1 changes were significant in the men but not in the women. Conclusion: In our study, it was determined that the insulin glargine depressed the serum IGF1 levels much more when compared to the insulin detemir. This result can be evaluated as the in vivo reflection of the in vitro findings related to the fact that the IGF1 receptor affinity of the glargine is higher.Item Assessment of factors related to the understanding of education and knowledge of self-care among patients with diabetes mellitus: A cross-sectional prospective study(Springer, 2016-09) Dizdar, Oğuzhan Sıtkı; Başpınar, Osman; Cander, Soner; Eker, Baki; Gül, Özen Öz; Şişman, Pınar; Ersoy, Canan; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı/İç Hastalıkları Bilim Dalı.; AAH-8861-2021; AAI-1005-2021; 26040787100; 57190169474; 6701485882The prevalence of diabetes mellitus is rapidly increasing particularly in developing countries. The aim of this study was to assess the knowledge and self-care practices of diabetes patients and to assess the contribution of the education to this knowledge level and glycemic control. We formed patient groups consisting of 15-30 diabetic patients. First, patients were surveyed using a diabetes self-care knowledge questionnaire (DSCKQ-30). Sunsequently, a standard PowerPoint presentation about diabetes self-management was made to the patients who were then surveyed again using DSCKQ-30. All patients were invited to hospital to measure their control glycated hemoglobin (HbA1c) level 3 months later. Of the total 364 participants, 62.9% were females. Significant increases in the percentage of correct responses were determined in all components between, before and after education. There was a significant decline of 1.1 in HbA1c levels after 3 months of education. Married or active working patients had a better understanding of the education about diabetes and had a greater knowledge of self-care management regardless of their level of education or income. Education about diabetes can significantly improve knowledge of self-care management and can help in achieving glycemic control. Continuing education about self-care management and complications is crucial and this should be accompanied by a regular assessment of pateients' diabetic knowledge.Publication Can diabetes insipidus be used as a marker for multisystemic and progressive disease in langerhans cell histiocytosis?(Kuwait Medical Assoc, 2021-12-01) Koca, Nizameddin; Cander, Soner; CANDER, SONER; Gul, Ozen Oz; ÖZ GÜL, ÖZEN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; 0000-0003-1457-4366; 0000-0002-1332-4165; V-9228-2017Langerhans cell histiocytosis (LCH) is a rare disease with an yearly incidence of nine cases per a million in children and 1-2 cases per a million adults. 68.6% of LCH presented with multisystem involvement. A 40-year-old woman who was admitted to endocrinology outpatient clinic with symptoms of polyuria, polydipsia and headache was diagnosed with diabetes insipidus (DI). Desmopressin treatment was initiated, but six months after therapy, re-evaluation revealed progression in hypophyseal mass. Thoracoscopic biopsy shows LCH with multisystemic involvement. She did not respond clinically to systemic chemotherapy and external radiotherapy and died due to pneumonia.LCH should be taken into consideration in patients diagnosed with DI. DI is almost always the hallmark of hypothalamic pituitary axis involvement and a sign of multisystemic involvement.Item Comparative genotoxic and cytotoxic effects of the oral antidiabetic drugs sitagliptin, rosiglitazone, and pioglitazone in patients with type-2 diabetes: A cross-sectional, observational pilot study(Elsevier, 2013-04-05) Gül, Özen Öz; Çinkılıç, Nilüfer; Gül, Cuma Bülent; Cander, Soner; Vatan, Özgür; Ersoy, Canan; Yılmaz, Dilek; Tuncel, Ercan; Uludağ Üniversitesi/Fen-Edebiyat Fakültesi/Biyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-7687-3284; 0000-0002-3595-6286; 0000-0003-2467-9356; AAH-8861-2021; O-7508-2015; AAH-5296-2021; AAI-1005-2021; A-7063-2018; 26040787100; 26533892300; 23988796000; 25027068600; 16235098100; 6701485882; 6701369462; 7006929833This cross-sectional, observational pilot. study was designed to investigate the frequency of different endpoints of genotoxicity (sister-chromatid exchange, total chromosome aberrations, and micronucleus formation) and cytotoxicity (mitotic index, replication index, and nuclear division index) in the peripheral lymphocytes of patients with type-2 diabetes treated with different oral anti-diabetic agents for 6 months. A total of 104 patients who met the American Diabetes Association criteria for type-2 diabetes were enrolled in the study. Of the 104 patients, 33 were being treated with sitagliptin (100 mg/day), 25 with pioglitazone (30 mg/day), 22 with rosiglitazone (4 mg/day), and 24 with medical nutrition therapy (control group). The results for all the genotoxicity endpoints were significantly different across the four study groups. Post hoc analysis revealed that the genotoxicity observed in the sitagliptin group was significantly higher than that observed in the medical nutrition therapy group, but lower than that occurring in subjects who received thiazolidinediones. All of the three cytotoxicity endpoints were significantly lower in patients treated by oral anti-diabetic agents compared with those who received medical nutrition therapy. However, the three indexes did not differ significantly in the sitagliptin, rosiglitazone, and pioglitazone groups. Taken together, these pilot data indicate that sitagliptin and thiazolidinediones may exert genotoxic and cytotoxic effects in patients with type-2 diabetes. Further investigations are necessary to clarify the possible long-term differences between oral anti-diabetic drugs in terms of genotoxicity and cytotoxicity, and how these can modulate the risk of developing diabetic complications in general and cancer in particular.Item Comparison of efficacy and safety of once- versus twice-daily insulin detemir added on to oral antidiabetics in insulin-naive type 2 diabetes patients: 24-Week, crossover, treat to target trial in a single center(Elsevier, 2014-01-18) Cander, Soner; Dizdar, Oğuzhan Sıtkı; Öz Gül, Özen; Güçlü, Metin; Ünal, Oǧuz Kaan; Tuncel, Ercan; Ertürk, Erdinç; İmamoğlu, Şazi; Ersoy, Canan Özyardımcı; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0001-5082-9894; AAJ-6536-2021; AAH-8861-2021; AAI-1005-2021; ABI-4847-2020; 25027068600; 55202193000; 26040787100; 15073842600; 55042241400; 7006929833; 7005488796; 6602297533; 6701485882Aim: To compare once- versus twice-daily insulin detemir added on OADS therapy in insulin-naive type 2 diabetes patients in terms of efficacy and safety. Methods: An open-label study performed at a single center, comprised a randomized, crossover 24 week with insulin-naive type 2 diabetes patients. Insulin detemir was initiated with mean 0.12 U/kg in all patients (Group I once-daily, Group II twice-daily) and titrated for 24 week. Results: A total of 50 patients completed the study (Group I n:25, Group II n:25). With use of once- and twice-daily insulin, HbA1c values were decreased by 1.8% (+/- 2.0) and 1.5% (+/- 1.4) within the first 12 weeks (p<0.01), whereas increased by 0.21% (+/- 0.7) and 0.14% (+/- 0.8) in the second 12 weeks (p>0.05). The increases in the insulin doses were found as 0.22 U/kg and 0.35 U/kg with once- and twice-daily insulin use, respectively (p:0.04). Although minor hypoglycemic events were similar in both groups in the first 12 weeks, 2-fold increase was found in the patients shifting from once- to twice-daily dose. Within the first and second periods, the body weight of the patients was observed an increase of 0.4 and 1.6 kg with once-daily dose, whereas a decrease of 0.1 and 2.1 kg in the twice-daily dose, in the same period. Conclusion: Once-daily use of insulin detemir up to 0.4 U/kg was found to have similar efficacy and safety as twice-daily use. Twice dose use of insulin did not provide a prominent glycemic control advantage on 1.5-fold higher use of insulin.Publication Comparison of the effects of medical and surgical treatments in giant prolactinoma: A single-center experience(Springer, 2021-07-08) Hakyemez, Bahattin; Cander, Soner; CANDER, SONER; Oz Gul, Ozen; ÖZ GÜL, ÖZEN; Eylemer, Eda; Gunes, Elif; Hakyemez, Bahattin; HAKYEMEZ, BAHATTİN; Gullulu Boz, Elif; GÜLLÜLÜ BOZ, SAİDE ELİF; Yilmazlar, Selcuk; YILMAZLAR, SELÇUK; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; AAA-3274-2019Purpose Giant prolactinomas, which have extremely large sizes and high prolactin (PRL) values, are rarely seen. Although medical therapy is effective, surgical treatment is more frequently applied due to slightly lower response rates and compression symptoms. This study aimed to compare the medical and surgical treatment results in giant prolactinomas. Methods Thirty-nine patients who were followed up in our center for giant prolactinoma were included in the study, and the response rates of the patients were evaluated after the medical and surgical treatments. The treatment responses were compared in terms of tumor volume, PRL level, visual field, and pituitary function. Results The outcomes of the 66 treatment periods (medical n = 42; surgical n = 24) in 39 patients (mean age, 47.2 years; men, 89.7%) were evaluated. The most common presentations were hypogonadism and visual defects. The mean longest tumor diameter at diagnosis was 52.2 +/- 11.8 mm, and the median PRL levels were 5000 ng/mL. PRL level normalization was achieved in 69% with medical therapy, and a curative response was obtained in only two patients with surgery. Tumor volume reduction was 67% (no cure) in the medical and 75% (13% cure) in the surgical groups (p = 0.39). Improvement of visual field was 70.8% in the medical and 84.2% in the surgical group (p = 0.12). Conclusion In our study, it was observed that medical therapy was effective and safe in patients with giant prolactinomas. The use of surgical treatment should be limited to prolactinomas with compression or post-resistance to medical treatment in serious cases.Item Control of refractory hypercalcemia with denosumab in a case of metastatic parathyroid carcinoma(College of Physicians and Surgeons Pakistan, 2019-07-21) Çalapkulu, Murat; Gül, Özen Öz; Cander, Soner; Ersoy, Canan Özyardımcı; Ertürk, Erdinç; Sağıroğlu, Muhammed Fatih; Saraydaroğlu, Özlem; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; AAJ-6536-2021; AAH-8861-2021; AAH-9701-2021; AAI-1005-2021; CJH-1319-2022; DPC-0292-2022; 26040787100; 25027068600; 6701485882; 7005488796; 57218578082; 15074395500Parathyroid carcinoma is a rare cause of hyperparathyroidism and leads to severe hypercalcemia. The etiology is not fully known. Parathyroid cancer should be considered in the differential diagnosis, if serum calcium and parathyroid hormone levels increase, and parathyroid gland is palpable. Severe hypercalcemia is the most common cause of death in patients diagnosed with parathyroid carcinoma. Fluid replacement, diuretic therapy, bisphosphonates, and calcimimetic agents are the main treatment steps in the control of life-threatening hypercalcemia. Surgery is the primary treatment option, while denosumab is a treatment option for refractory hypercalcemia caused by parathyroid carcinoma, or for patients who are not eligible for surgery. There are few case reports in literature about denosumab treatment for parathyroid carcinoma. Herein, we report a case of a patient who presented with the complaint of leg pain and was diagnosed with parathyroid carcinoma. The elevated calcium level of the patient was controlled with denosumab.Item Correlates of visceral and subcutaneous fat thickness in non-diabetic obese and morbidly obese patients(Carbone Editore, 2017) Şeker, İsmail; Gül, Özen Öz; Pekgöz, Murat; Güllülü, Sümeyye; Cander, Soner; Tutuncu, Ahmet; Sağ, Saim; Açıkgöz, Ebru; Sarandol, Emre; Ersoy, Canan; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Fen-Edebiyat Fakültesi/Kardiyoloji Anabilim Dalı.; 0000-0002-2593-7196; 0000-0001-8404-8252; AAH-8861-2021; ABE-1716-2020; AAW-9185-2020; AAI-1005-2021; 26040787100; 36010142900; 57204660708; 25027068600; 7004229025; 12140008100; 56328183700; 55943324800; 6701485882Background: To determine the correlates of visceral and subcutaneous fat thickness in non-diabetic obese and morbidly obese patients Methods: A total of 31 obese female outpatients composed of morbidly obese (n=16, BMI of >= 40kg/m(2)) and obese (n=15, BMI of 30-39.9kg/m(2)) patients were included in the present study. Data on age, anthropometrics, blood biochemistry, HOMA-IR, carotid intima-media thickness (CIMT) were recorded in each subject as were plasma resistin (mu g/L) and visfatin (mu g/ml) levels, epicardial, subcutaneous and abdominal fat thickness (mm). Correlates of visceral and subcutaneous fat thickness were determined via linear regression models with inclusion of severity of obesity, insulin resistance, plasma resistin and visfatin levels and CIMT as variables. Results: Epicardial fat thickness (mm) was 3.1(1.0-10.20) and 8.8(2.60-13.0), CIMT (mm) was 5.8(4.7-8.9) and 5.9(4-8.6), abdominal fat thickness (mm) was 10.8(7.8-16.1) and 13.2(8.7-16.5), subcutaneous fat thickness(mm) was 43.8(28.4-62.9) and 57.4(39.5-72.7), plasma resistin levels (mu g/L) were 8.5(4.7-38.1) and 10.8(0.7-26.4) and plasma visfatin levels (mu g/ml) were 55.5(5.1-209.5) and 78.2(4.7-228) in obese and morbidly obese patients, respectively. Linear regression analysis revealed that being morbidly obese was likely to increase epicardial fat thickness by 4.33mm(p=0.004) compared with obesity, while for each 1 unit increase in HOMA levels, subcutaneous fat thickness was likely to decrease by 1.16mm(p=0.009). Conclusion: In conclusion, our findings revealed that neither plasma levels for resistin and visfatin nor CIMT correlated with visceral or subcutaneous fat thickness in non-diabetic obese females, while increase in subcutaneous and epicardial fat thickness values were noted with decrease in HOMA-IR and the presence of morbid obesity, respectively.Item Corrigendum to "Effect of cyclin D1 (CCND1) gene polymorphism on tumor formation and behavior in patients with prolactinoma" [Gene 509 (2012) 158-163](Elsevier, 2014-04-15) Cander, Soner; Ertürk, Erdinç; Karkucak, Mutlu; Öz Gül, Özen; Görükmez, Orhan; Yakut, Tahsin; Ünal, Oǧuz Kaan; Ersoy, Canan Özyardımcı; Tuncel, Ercan; İmamoğlu, Şazi; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Genetik Anabilim Dalı.; AAI-1005-2021; AAJ-6536-2021; AAH-8861-2021; AFZ-0764-2022; ABI-5648-2022; 25027068600; 7005488796; 35388323500; 26040787100; 56681045900; 6602802424; 55042241400; 6701485882; 7006929833; 6602297533Item Cytokine signal suppressor (SOCS) 1-1478 CA/del gene polymorphism in Turkish patients with polycystic ovary syndrome(Taylor & Francis, 2017-10-03) Gül, Cuma Bülent; Gül, Özen Öz; Cander, Soner; Budak, Ferah; Oral, Barbaros; Ersoy, Canan; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Anabilim Dalı.; 0000-0001-7625-9148; 0000-0003-0463-6818; AAI-1005-2021; F-4657-2014; K-7285-2012; AAH-8861-2021; 26040787100; 25027068600; 6701913697; 7004498001; 6701485882Eighty-four subjects, premenopausal female patients (n=42, mean (SD) age: 26.4 (4.2) years) diagnosed with polycystic ovary syndrome (PCOS) and age-matched healthy volunteers (n=42, mean (SD) age: 27.6(3.4) years), were included in this study. Data on physical examination, anthropometric measurements and blood biochemistry analysis were recorded for each subject along with analysis for SOCS1-1478 CA/del polymorphism by polymerase chain reaction-restriction fragment length polymorphism. The relation of SOCS1-1478 CA/del polymorphism to PCOS status and insulin resistance was analysed via logistic regression analysis. Mean (SD) levels for BMI (28.5(6.5) vs.22.5 (4.9) kg/m(2), p<.001), HOMA-IR (3.1(1.8) vs.1.5 (1.0), p<.001), LDL-cholesterol (115.9(32.7) vs.100.7 (27.3)mg/dL, p=.03) and triglyceride (113.8(64.9) vs.83.3(36.3)mg/dL, p=.017) were significantly higher in patients. Groups were similar in terms of SOCS1-1478 CA/del polymorphism. No significant relation of this polymorphism was noted to PCOS and HOMA-IR. Our findings revealed no difference between groups in terms of the rate of SOCS1-1478 CA/del polymorphism, and no significant relation of this polymorphism to insulin resistance and PCOS status. IMPACT STATEMENT Polycystic ovary syndrome (PCOS), the most common cause of anovulation and the most commonly encountered form of female endocrine disease. SOCS proteins have been suggested to play a fundamental role in the negative feedback regulation of the JAK-STAT pathway, which is the major signalling pathway involved in a wide range of physiologic and pathologic processes, including inflammatory diseases, malignancies and immune disorders. Pathways involving the induction of suppression of SOCS proteins were also shown likely to be involved in mediating cytokine-induced insulin resistance. The present study was designed to determine the frequency of SOCS1-1478 CA/del gene polymorphism in patients with PCOS in relation to healthy controls and insulin resistance. Our findings revealed significantly higher rates of insulin resistance, obesity and dyslipidaemia in Turkish patients with PCOS compared with age-matched healthy controls, while no difference between study groups in terms of the rate of SOCS1-1478 CA/del polymorphism along with no significant relation of SOCS1-1478 CA/del polymorphism to insulin resistance and PCOS status. Future larger scale studies with the application of standardised diagnostic methods and criteria, and of state-of-the-art modern techniques including genomics, proteomics and pharmacogenetics would provide better understanding of the association between PCOS and genomic variants.Item Dapagliflozin kullanan diyabetik hastalarda antropometrik değerler, glisemik kontrol parametreleri ve lipid profilindeki değişimin retrospektif analizi(Uludağ Üniversitesi, 2018) Çalapkulu, Murat; Cander, Soner; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.Tip 2 Diabetes Mellitus (DM) tedavisinde amaç uzun dönemde ortaya çıkan komplikasyonları azaltmak, yaşam kalitesini iyileştirmek ve mortalite hızını azaltmaktır. Diyabet tedavisinde glisemik kontrolü sağlamak amacıyla, tıbbi beslenme tedavisi ve yaşam tarzı değişiklikleri ile birçok antidiyabetik ilaçla kombine olarak farmakolojik tedaviler uygulanmaktadır. Bunlara rağmen uygun tedavi oranları düşük olup yeni tedavilere ihtiyaç duyulabilmektedir. Dapagliflozin, SGLT-2 inhibisyonu ile üriner glukoz atılımını arttırarak etki gösteren yeni antidiyabetik ilaç grubunun bir üyesi olarak kullanıma girmiş bir antidiyabetik ilaçtır. Çalışmamızda dapagliflozinin glisemik kontrol, lipid profili ve antropometrik ölçümler üzerine etkilerinin gerçek yaşam verisi olarak retrospektif metodla incelenmesi amaçlanmıştır. Çalışmaya 45-80 yaş arası, vücut kile indeksi > 20 kg/m² olan, HgbA1c düzeyi %6,5 ile %13 arasında olan 31 tip 2 DM hastası dahil edildi. Hastaların tedavi öncesi ve tedavi başlandıktan sonra üçüncü ve altıncı ayda olmak üzere toplamda 3 retrospektif muayene verisi kaydedilerek değerlendirme yapıldı. Yaş ortalaması 57,39 ve ortalama diyabet süresi 11 yıl olan hastalarda dapagliflozin tedavisi ile HbA1c düzeyinde 3 ayda %0,9 ve 6 ayda %0,79 azalma, açlık kan şekerinde 3 ayda 41,1 mg/dl ve 6 ayda 42,1 mg/dl , tokluk kan şekerinde 3 ayda 86,3 mg/dl ve 6 ayda 74,2 mg/dl azalma saptandığı görüldü. Üç ve altıncı aylarda, hastaların vücut ağırlığında 3,3 kg ve 4,2 kg, vücut kitle endekslerinde 1,3 kg/m² ve 1.6 kg/m², bel çevresinde 1,3 cm azalma saptandı. Hastaların lipid profillerinde altıncı ay değerlerinde anlamlı derecede olumlu değişim mevcuttu. Dehidratasyona bağlı olarak hemoglobin konsantrasyonlarında hafif derecede artış mevcuttu. Buna karşın tromboembolik olay, hipoglisemi atağı ve üriner infeksiyon tespit edilmedi. Çalışma verilerimize göre dapagliflozin, diyabet tedavisinde glisemik kontrolde etkin olmasının yanı sıra kilo kaybı da sağlamakta ve lipid profiline olumlu katkı sağlamaktadır. Güvenlik profili açısından da altı aylık kullanımda ciddi olumsuz bir etkisinin olmadığı ve iyi tolere edildiği gözlenmektedir.Item Dapagliflozin kullanan diyabetik hastalarda serum elektrolit değerlerinin 6 aylık değişimini gösteren tek merkez gerçek klinik deneyim verileri(Uludağ Üniversitesi, 2018-10-25) Çalapkulu, Murat; Cander, Soner; Gül, Özen Öz; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı.Dapagliflozin, SGLT-2 inhibisyonu ile üriner glukoz atılımını arttırarak etki gösteren yeni bir grup antidiyabetik ilaçtır. Dapagliflozinin klinik uygulamaya girdikten sonra gerçek yaşam verilerinin değerlendirilmesi önemli bir durumdur. Çalışmamızda, tek merkezde takip edilen hastalarda dapagliflozinin elektrolit değerleri üzerine etkisinin değerlendirilmesi amaçlandı. Çalışmaya 45-80 yaş arası, vücut kitle indeksi > 20 kg/m², HbA1c düzeyi %6,5 ile %13 arasında olan 31 tip 2 diyabet hastası dahil edildi. Hastaların tedavi öncesi ve tedavi başlandıktan sonra üçüncü ve altıncı ayda olmak üzere toplamda 3 retrospektif muayene verisi kaydedilerek değerlendirme yapıldı. Dapagliflozin tedavisi ile sodyum düzeyinde, üçüncü ayın sonunda 0,29 mEq/L ve altıncı ayında 0,90 mEq/L azalma saptandı. Potasyum düzeyinde üçüncü ve altıncı aylarda sırasıyla 0,17 mEq/L ve 0,11 mEq/L azalma saptandı. Kalsiyum düzeyinde üçüncü ve altıncı aylarda sırasıyla 0,1 mg/dl ve 0,04 mg/dl azalma saptandı. Yapılan istatiksel analiz sonucunda sodyum, kalsiyum ve potasyum değerlerinde üçüncü ve altıncı ayda gözlenen azalmaların istatistiksel açıdan anlamlı olmadığı saptandı. Literatür tarandığı zaman da dapagliflozin tedavisi sırasında sodyum, potasyum ve kalsiyum düzeylerinde istatistiksel açıdan anlamlı olmayan değişiklikler izlenmiş olduğu görüldü. Bu da bizim çalışmamızla tutarlılık göstermektedir.Publication Demographic and clinical features of medullary thyroid carcinoma(Turkiye Klinikleri, 2020-12-01) Şişman, Pınar; Bicer, Buket; Öztop, Hikmet; ÖZTOP, HİKMET; Gül, Özen Öz; ÖZ GÜL, ÖZEN; Cander, Soner; CANDER, SONER; Ocakoglu, Gokhan; OCAKOĞLU, GÖKHAN; Ersoy, Canan; ERSOY, CANAN; Ertürk, Erdinç; ERTÜRK, ERDİNÇ; Bursa Uludağ Üniversitesi/Tıp Fakültesi; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; 0000-0002-1114-6051; AAH-5180-2021; AAJ-6536-2021; HTQ-8395-2023; AAH-8861-2021; HLG-6346-2023; AAI-1005-2021Objective: Medullary thyroid carcinoma (MTC) is an aggressive neuroendocrine tumor affecting the parafollicular C cells of the thyroid gland. This study aimedto analyze demographic and clinical factors that might affect the prognosis of MTC andevaluate the long-term outcomes of surgery in MTC patients at a single center. Material and Methods: A total of 36 patients with a confirmed MTC diagnosis based on histopathological examination and underwent surgery-during 2000-2015 were examined. Archived files of these patients were reviewed, and data on clinical, biochemical, and radiological test results were assessed. Factors affecting disease-free survival were also evaluated. Results: Theduration of the follow-up of the patients was 80.3 +/- 76.1 months. MEN2A was detected in three patients (8.3%). Twelve patients (33.3%) had metastasis at the time of diagnosis. During the follow-up period, local recurrence was observed in 13 (36.1%) patients. Nine patients (25%) presented metastasis at follow-up. The mean disease-free survival was high in sporadic MTC compared to hereditary MTC. Conclusion: The study observed asignificant contribution to the hereditary nature of the disease on prognosis. However,other prognostic factors such as gender, nodule characteristics, recurrence and metastasis, and treatment modalities did differsignificant. Patients with MTC should be evaluated to know if the disease is sporadic or hereditary. The small sample size in this study restricts the power of statistical analysis;therefore, further prospective studies are necessary to reveal the other contributory prognostic factors in MTC.Item Diabetes mellitusun tanı, tedavi ve izlemi(Bursa Uludağ Üniversitesi, 2022-12) Güçlü, Metin; Ünal, Oğuz Kaan; Şişman, Pınar; Peynirci, Hande; Kocaeli, Ayşen Akkurt; Çalapkulu, Murat; İmamoğlu, Şazi; Ersoy, Canan Özyardımcı; Tuncel, Ercan; Ertürk, Erdinç; Ersoy, Alparslan; Gül, Özen Öz; Cander, Soner; Bursa Uludağ Üniversitesi Tıp Fakültesi/İç Hastalıkları Ana Bilim Dalı/Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı.; Bursa Uludağ Üniversitesi Tıp Fakültesi/İç Hastalıkları Ana Bilim Dalı/Nefroloji Bilim Dalı.Diabetes mellitus toplumda çok yaygın görülen, akut ve kronik komplikasyonları ile toplum sağlığını yakından ilgilendiren kronik metabolik bir hastalıktır. Ülkemizde ve dünyada görülme sıklığının yıllar içinde giderek artıyor olması, farklı organ sistemlerini etkileyen komplikasyonlara yol açması, diabetes mellitusu tüm branşlardaki hekimleri ilgilendiren bir hastalık haline getirmektedir. Diabetes mellitus hastalığını erken tanımak, doğru şekilde tiplendirmesini yapmak ve gerekli tedavileri gecikmeden etkin şekilde uygulamak hastanın daha sağlıklı bir yaşam sürmesi için çok önemlidir. Diyabetin en iyi şekilde tedavi ve takibi için çalışmalar sürekli devam etmekte ve konu güncelliğini her zaman korumaktadır. Bu kitapta hekimlerin diabetes mellitusun tanı, tedavi ve izleminde yeterli ve güncel bilgi düzeyine sahip olmaları ve bu halk sağlığı sorununun çözümüne katkıda bulunmaları hedeflenmiştir.Item Effect of cycline D1 (CCND1) gene polymorphism on tumor formation and behavior in patients with prolactinoma(Elsevier, 2012-11-01) Cander, Soner; Ertürk, Erdinç; Karkucak, Mutlu; Gül, Özen Öz; Görükmez, Orhan; Yakut, Tahsin; Ünal, Oğuz Kaan; Ersoy, Canan; Tuncel, Ercan; İmamoğlu, Şazi; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Genetik Anabilim Dalı.; AAI-1005-2021; AAH-8861-2021; AAJ-6536-2021; 25027068600; 7005488796; 35388323500; 26040787100; 56681045900; 6602802424; 55042241400; 6701485882; 7006929833; 6602297533The objective of this study was to investigate the effect of G870A gene polymorphism of CCND1 on the formation and behavioral features of prolactinomas. One hundred and thirteen patients with prolactinoma and 108 age and gender matched control were included in the study. The patients were divided into two groups as noninvasive and invasive tumors. CCND1 G870A gene polymorphism was compared in patients/control and invasive/noninvasive groups. A and G allele frequencies were found as 41.7% and 58.3% in the controls, and 61.1% and 38.9% in the patients (p<0.01). Rates of G/G, G/A and A/A genotypes were found as 11.8%, 55.9% and 32.4% in the noninvasive group, and 15.6%, 44.4% and 40.0% in the invasive group, respectively. Differences between patient and control groups were significant but were not between invasive and noninvasive groups in terms of the allele frequencies and genotype distribution. Mean tumor size and serum levels of prolactin at the time of diagnosis and change in these values after the treatment were not found statistically significant in genotype subgroups. CCND1 G870A gene polymorphism may be an important factor in the early stages of the tumor formation. However, it did not affect the features of the tumor.Item Effect of sitagliptin monotherapy on serum total ghrelin levels in people with type 2 diabetes(Elsevier Ireland, 2011-11) Gül, Özen Öz; Kıyıcı, Sinem Kücçuüksaraç; Ersoy, Canan; Cander, Soner; Yorulmaz, Hakan; Gül, Cuma Bülent; Sarandöl, Emre; Kırhan, Emine; Sığırlı, Deniz; Ertürk, Erdinç; Tuncel, Ercan; İmamoğlu, Sazi; Ünal, Oğuz Kağan; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0003-2467-9356; 0000-0002-2593-7196; AAI-1005-2021; A-7063-2018; AAJ-6536-2021; AAA-7472-2021; ABE-1716-2020; AAH-8861-2021; 26040787100; 12753880400; 6701485882; 25027068600; 24438635700; 23988796000; 55943324800; 37104411100; 24482063400; 7005488796; 7006929833; 55042241400Aim: Sitagliptin is not associated with weight gain and has neutral effects on body weight. It is unclear whether sitagliptin treatment alters serum ghrelin levels in people with type 2 diabetes. Methods: Forty-four subjects with type 2 diabetes were randomly assigned to receive sitagliptin or medical nutrition therapy (MNT) for 12 weeks. Changes in anthropometric variables, glycemic control, insulin resistance, lipid parameters, and total ghrelin levels were evaluated at baseline and following 12 weeks of treatment. Results: Significant decreases in body weight and body mass index were observed over the entire study period in both treatment groups. Glycosylated hemoglobin and postprandial plasma glucose levels were statistically significant decreased in the groups receiving sitagliptin compared with baseline values (p = 0.021 and p = 0.021, respectively), while they were unchanged in the groups receiving MNT. There was a significant decrease in total ghrelin in the groups receiving sitagliptin (p = 0.04) compared with baseline values but not in the groups receiving MNT (p = 0.46) at the end of the 12 weeks. Conclusions: In this study of patients with type 2 diabetes, treatment with sitagliptin was associated with a significant decrease in serum ghrelin levels. These results suggest that the neutral effect of sitagliptin on weight might be associated with the suppression of fasting serum ghrelin levels.Item Endokrinoloji polikliniğine başvuran hastalarda tiroid fonksiyonlarının yaş ile olan ilişkisinin incelenmesi(Uludağ Üniversitesi, 2011-05-31) Gül, Özen Öz; Şahin, Serkan; Cander, Soner; Gül, Bülent; Ünal, Oğuz Kaan; Akçalı, Ünsal; Cangür, Şengül; Aikış, Nihan; Bayındır, Ayşenur; Ersoy, Canan; İmamoğlu, Şazi; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.Tiroid fonksiyon bozuklukları yaşlı hastalarda oldukça sık görülmektedir. Çalışmamızda Endokrinoloji Polikliniğine yönlendirilmiş 65 yaş altındaki ve 65 yaş ve üzerindeki hastaların tiroid fonksiyonlarını ve epidemiyolojik özelliklerini karşılaştırılmalı olarak değerlendirmeyi amaçladık. Çalışmamıza yaşları 18 ile 78 arasında değişen, Endokrinoloji bölümüne tiroid hastalığı şüphesi ile yönlendirilmiş, toplam 116 hasta alındı. Hastaların antropometrik ölçümleri, doğum yeri, yaşadığı yer, tiroid hastalığı açısından aile anamnezi sorgulandı. Her iki gurupta hastaların başvuru anındaki tiroid fonksiyon testleri incelendi. Hastalarımızın 66’sı 65 yaş altında (grup 1) ve 50’si ise 65 yaş ve üzerindeydi (grup 2). Grup 1’de hipotiroidi (subklinik) %16.67 oranında, hipertiroidi (subklinik ve aşikar) %37.88 oranında görülürken, grup 2’de hipotiroidi (subklinik) %4 oranında, hipertiroidi (subklinik ve aşikar) %46 oranında görüldü. Çalışmamızda Endokrinoloji Polikliniğine yönlendirilmiş 65 yaş ve üstündeki hastalarda tiroid fonksiyonları açısından 65 yaş altı hastalara göre fark saptanmadı. Çalışmamızda tiroid disfonksiyonu oranlarının yüksek saptanması hastaların tiroid hastalığı ön tanısıyla bölümümüze yönlendirilmiş olması ile ilişkilendirildi.Item Evaluation of insulin resistance and plasma levels for visfatin and resistin in obese and non-obese patients with polycystic ovary syndrome(John Libbey Eurotext, 2015-10-01) Cander, Soner; Gül, Bülent; Gül, Özen Öz; Açıkgöz, Ebru; Sarandöl, Emre; Ersoy, Canan; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Biyokimya Anabilim Dalı.; 0000-0002-2593-7196; AAI-1005-2021; JLB-9964-2023; ABE-1716-2020; AAH-8861-2021; 26040787100; 56328183700; 55943324800; 6701485882This study was designed to evaluate insulin resistance and plasma levels of visfatin and resistin in obese and non-obese patients with polycystic ovary syndrome (PCOS). A total of 37 premenopausal PCOS patients with (n = 18, mean (SD) age: 27.5 (5.7 years) or without obesity (n = 19, mean (SD) age: 23.7 (3.1) years) and healthy volunteers (n = 18, mean (SD) age: 29.8 (4.1) years) were included in this study. Data on clinical characteristics, glycemic parameters and lipid parameters were recorded for each subject as were plasma visfatin and resistin levels. Mean (SD) HOMA-IR values were significantly higher in obese PCOS patients (3.4 (1.7)) compared with non-obese PCOS patients (2.0 (1.2), p<0.01) and controls (1.6 (0.8), p<0.01). No significant difference was noted between study groups in terms of plasma resistin (ng/mL) or visfatin (ng/mL) levels. There was no correlation between serum plasma visfatin (r = 0.127, p = 0.407) and resistin (r = -0.096, p = 0.544) levels and HOMA-IR. In conclusion, our findings revealed increased likelihood of metabolic and dyslipidemic manifestations in obese compared to non-obese PCOS patients, while no significant difference was noted in visfatin and resistin levels among PCOS patients in terms of co-morbid obesity and in comparison to controls.
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