Browsing by Author "Gül, Özen Öz"
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Publication A case of adrenal mass causing adrenal insufficiency: Tuberculosis(Aves, 2017-03-01) Şişman, Pınar; Peynirci, Hande; Saraydaroğlu, Özlem; Sahin, Ahmet Bilgehan; Gül, Özen Öz; Ersoy, Canan; Şişman, Pınar; Peynirci, Hande; SARAYDAROĞLU, ÖZLEM; ŞAHİN, AHMET BİLGEHAN; ÖZ GÜL, ÖZEN; ERSOY, CANAN; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0002-7846-0870; AAM-4927-2020; AAH-9701-2021; AAI-1005-2021; AAH-8861-2021; GRY-0605-2022; DUS-9872-2022Tuberculosis, the prevalence of which has continued to decline in developed countries, is still one of the reasons of adrenal insufficiency. In this report, we aimed to present a case of adrenal and miliary tuberculosis presenting with adrenal insufficiency. A 71-year-old woman with a history of unilateral adrenalectomy was admitted with the symptoms of adrenal insufficiency. In her further medical investigations, the diagnosis of primary adrenal insufficiency was established and a mass presenting as involvement of tuberculosis was detected in the adrenal gland. Bilateral pulmonary nodules compatible with miliary tuberculosis were observed. After anti-tuberculosis treatment, pulmonary nodules disappeared, but there was no significant decrease in the size of the adrenal mass. The patient, who underwent adrenalectomy, was followed with glucocorticoid and mineralocorticoid treatment. Tuberculosis of the adrenal glands is a common cause of adrenal insufficiency in developing countries. Tuberculosis can destroy the adrenal glands and the diagnosis of adrenal tuberculosis, especially presenting with enlargement of the adrenal glands, can be difficult.Publication A rare cause of hypopituitarism: Pituitary tuberculosis(Aves, 2012-01-01) Gül, Özen Öz; Ertürk, Erdinç; Cander, Soner; Ünal, Oğuz Kaan; Hakyemez, Bahattin; İmamoğlu, Şazi; ÖZ GÜL, ÖZEN; ERTÜRK, ERDİNÇ; CANDER, SONER; Ünal, Oğuz Kaan; HAKYEMEZ, BAHATTİN; İmamoğlu, Şazi; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; AAI-1005-2021; AAI-2318-2021; AAJ-6536-2021; HUR-0563-2023; GGN-5983-2022; FCO-4676-2022Pituitary tuberculosis is a rare condition that can present with hypopituitarism even without any evidence of systemic tuberculosis and is easily confused with pituitary adenomas. Headache and hypopituitarism are the most common presenting symptoms. We report the case of pituitary tuberculosis in a 39-year-old male patient who presented with panhypopituitarism. Although it is rare and difficult to diagnose, pituitary tuberculosis should be considered in every nonfunctional sellar masses, especially in fairly small ones with unexpected hypopituitarism.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 planlanmalıdırItem Akromegali hastalarında uyku apne sendromu sıklığının, uyku apne sendromu ile antropometrik ölçümler ve metabolik parametreler arasındaki ilişkinin değerlendirilmesi(Uludağ Üniversitesi, 2018) Biçer, Buket; Gül, Özen Öz; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.Akromegali uzun süre aşırı büyüme hormonu (GH) salınımı sonucu gelişen, somatik ve metabolik etkileri olan nadir bir hastalıktır. Ortalama görülme yaşı 40-45 arasında olup insidansı milyonda 4-6 yeni vaka olarak bildirilmektedir. Klinik olarak yüzde kabalaşma, diş aralıklarında açılma, ellerde ve ayaklarda büyüme görülürken, kardiyovasküler sistem, kas-iskelet sistemi ve respiratuvar sistem tutulumu da görülebilmektedir. Akromegalinin metabolik etkileri arasında hiperglisemi, hipertrigliseridemi ve hiperkalsiüri yer almaktadır. Akromegali hastalarında yaklaşık %40-50 oranında obstrüktif uyku apne sendromu (OSAS) görülmektedir. Akromegali hastalarında görülen OSAS'ın obezite, bel çevresi, kalça çevresi ve vücut kitle indeksi ile ilişkisi ve ayrıca OSAS'ı olan akromegali hastalarında diyabet ve kardiyovasküler bozuklukların daha fazla görüldüğü çok sayıda çalışmayla gösterilmiştir. Çalışmamıza akromegali tanılı 28 hasta dâhil edildi. Hastalar polisomnografi sonuçlarına göre OSAS'ı olanlar ve olmayanlar olarak değerlendirildi. Tüm hastaların tanı anında ve polisomnografi yapıldığında bakılan GH, insülin benzeri büyüme faktörü-1 (IGF-1) ve diğer hipofiz hormon düzeyleri incelendi. Ayrıca tüm hastaların polisomnografi yapıldığında bakılan boy, kilo, vücut kitle indeksi (VKİ), bel çevresi (BÇ), kalça çevresi (KÇ), bel-kalça oranı (BKO), kan basıncı (KB) değerlendirildi ve açlık glukozu, tokluk glukozu, lipid profili incelendi. Hastalarda diyabetes mellitus (DM), hipertansiyon (HT) ve koroner arter hastalığı (KAH) sıklığı değerlendirildi. Hastalar OSAS'ı olanlar ve olmayanlar olarak iki grupta incelendi. OSAS'ı olan hasta grubunda vücut kitle indeksi, bel çevresi, bel/kalça oranı anlamlı olarak daha fazla bulundu. Ayrıca OSAS'ı olan hasta grubunda diyabetes mellitus'un ve hipertrigliserideminin anlamlı olarak fazla olduğu gösterildi. Akromegali hastalarında OSAS önemli bir klinik antite olup hastaların kardiyovasküler hastalık riskinde dolayısıyla mortalitede belirgin olarak artışa neden olan bir durumdur. OSAS'ı olan akromegali hastalarında diyabetes mellitus ve hipertrigliseridemi sık görülmektedir. Ayrıca vücut kitle indeksi ve bel/kalça oranı fazla olan akromegali hastalarında OSAS görülme riskinde artış görğlmektedir. Akromegali hastalarında OSAS'ı erken tanımak mortalite ve morbiditeye önemli katkı sağlayacaktır.Publication An uncommon reason of osteoporosis: Spondyloepiphyseal dysplasia congenita(Galenos Yayıncılık, 2017-12-01) Elbasan, Onur; Şişman, Pınar; Gül, Özen Öz; Cander, Soner; Ersoy, Canan; Elbasan, Onur; ÖZ GÜL, ÖZEN; CANDER, SONER; ERSOY, CANAN; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı.; AAI-1005-2021; ABF-5216-2021; AAH-8861-2021; CJH-1319-2022Skeletal dysplasia is a complex and rare disease group that presents with clinical and radiological findings that differ from classical metabolic bone diseases in which bone and cartilage tissue are affected together. Spondyloepiphyseal dysplasia conjenita with involvement of the spine and long bone epiphyses is seen with short stature and short body from birth. Although bone deformities such as shortness of neck and vertebrae, kyphosis, scoliosis, pectus carinatum, genu varum or valgum are frequent, association with osteopenia/osteoporosis has been rarely reported. Although spondyloepiphyseal dysplasia tarda and osteopenia are coexisting in the literature, there is no evidence of the association of spondyloepiphyseal dysplasia tarda and conjunctiva with osteoporosis. In our case report, we presented a patient who was applied to our center with short stature, diagnosed with osteoporosis and spondyloepiphyseal dysplasia congenita by detecting femur head aplasia in radiological imaging.Publication An unusual case of adult-onset multi-systemic langerhans cell histiocytosis with perianal and incident thyroid involvement(Bioscientifica Ltd, 2017-02-01) Gül, Özen Öz; Şişman, Pınar; Cander, Soner; Gözden, Erdem; Kurt, Meral; Saraydaroğlu, Özlem; Kırdak, Turkay; Ersoy, Canan; Ertürk, Erdinç; ÖZ GÜL, ÖZEN; Şişman, Pınar; KURT, MERAL; CANDER, SONER; Gözden, Erdem; SARAYDAROĞLU, ÖZLEM; Kırdak, Turkay; ERSOY, CANAN; ERTÜRK, ERDİNÇ; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Anabilim Dalı.; AAI-1005-2021; DUS-9872-2022; HUR-0563-2023; EWL-5375-2022; AAA-3961-2020; AAH-9701-2021; CZX-7145-2022; AAH-8861-2021; AAJ-6536-2021Langerhans cell histiocytosis (LCH) is a rare sporadic disease characterized by histiocytic neoplastic infiltration of various organ systems and a wide spectrum of clinical manifestations, ranging from benign and self-limiting to lethal. Herein, we report a rare case of adult-onset multi-systemic LCH in a 36-year-old male patient with an initial perianal presentation and incidental finding of subsequent thyroid gland involvement in the follow-up period. The patient with a history of perianal LCH treated with surgical excision and local radiotherapy was referred to our Endocrinology Department upon detection of hypermetabolic nodular lesions in the left lateral lobe of thyroid gland on positron emission tomography-computed tomography (PET/CT)scan in the nineth month of follow-up. Current evaluation revealed euthyroid status, a hypoechoic solid lesion of 13 x 9 mm in size with irregular borders in the left thyroid lobe on thyroid USG and cytologic assessment of thyroid nodule. The patient was diagnosed with suspected, oncocytic lesion, Hashimoto thyroiditis or LCH. The patient underwent total thyroidectomy and pathological assessment confirmed the diagnosis of Langerhans cell histiocytosis. Assessments in the sixth month of postoperative follow-up revealed euthyroid status with no thyroid tissue remnants or pathological lymph node on thyroid USG. In view of the multifocal lesions indicating multi-system disease, a systemic chemotherapy protocol with combination of prednisone (PRED) and vinblastine (VBL) has been planned by the hematology department.Publication Anaplastik tiroid karsinomu tanısında morfolojik ve immünohistokimyasal bulguların yeri: 10 yıllık seri(Bursa Uludağ Üniversitesi, 2023-12-18) Saraydaroğlu, Özlem; Dölek, Rabia; Gül, Özen Öz; Gürlüler, Ercüment; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Endokrinoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; 0000-0002-4127-9656; 0000-0002-1751-7693; 0000-0002-1332-4165; 0000-0002-6008-5494Tüm tiroid kanserleri içinde en agresif ve mortal seyirli kanser türü olan anaplastik karsinom, andiferansiye follikül epitel hücrelerinden kaynaklanır. Genellikle ileri yaşta ortaya çıkar. Hızlı büyüyen boyun kitlesi, yutma güçlüğü, ses kısıklığı, solunum güçlüğü en sık görülen başvuru yakınmalarıdır. 2011-2022 yılları arasında merkezimizde anaplastik karsinom tanısı almış 18 olguda klinik, histopatolojik ve immünohistokimyasal bulguların tanıdaki yeri ve sağ kalım özellikleri literatür bilgileri ışığında tartışıldı. Klinik seyir ve görüntüleme yöntemleri anaplastik karsinom için kuşku uyandırır ancak kesin tanı patolojik olarak anaplastik morfolojinin görülmesi ve yardımcı bazı immünohistokimyasal ve/veya moleküler tetkiklerin yapılması ile konur. Farklı histopatolojik görünümlere sahip olabilen bu tümörlerde andiferansiye özellikler gösteren karsinomlar, sarkomlar ve lenfomalar ayırıcı tanı içine alınmalıdır.Publication 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 Association between p16(cdkn2a) c540g polymorphism and tumor behavior in prolactinoma: A single-center study(Spandidos Publ Ltd, 2014-07-01) Karkucak, Mutlu; Gül, Özen Öz; ÖZ GÜL, ÖZEN; Yakut, Tahsin; Sağ, Şebnem Özemri; ÖZEMRİ SAĞ, ŞEBNEM; Ersoy, Canan; ERSOY, CANAN; Tuncel, Ercan; Ertürk, Erdinç; ERTÜRK, ERDİNÇ; Cander, Soner; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Genetik Anabilim Dalı.; AAJ-6536-2021; AAH-8861-2021; AAI-1005-2021; ABI-5648-2022; AAH-8355-2021Pituitary tumors usually originate as benign sporadic adenomas and develop into invasive and aggressive tumors such as prolactinomas, which are common functioning pituitary adenomas. The aim of the present study was to examine the association between the tumor behavior in prolactinomas and the p16(CDKN2A) gene polymorphism occurring at the 3'-untranslated region of exon 3 (C540G). A total of 104 patients with prolactinoma were included and assigned to two groups based on invasive vs. non-invasive tumor behavior. Ki67 indices were recorded according to histopathology results. Genotypic analysis of the p16( CDKN2A) C540G polymorphism was carried out using a modified polymerase chain reaction-restriction fragment length polymorphism assay. The corresponding frequencies for CC, CG and GG genotypes in non-invasive vs. invasive tumors were 61.5, 30.8, 7.7 and 64.1, 28.2, 7.7%, respectively ( not significant). The observed CG genotype frequency was higher compared with previous studies. In addition, the patients with giant adenomas or a high Ki67 index had a higher frequency of the CG genotype as compared with the other subgroups, although the differences were not significant (46.2 and 42.9%, respectively). In conclusion, a higher frequency of the C540G CG genotype of the CDKN2A gene was found among patients with prolactinoma in comparison with previous studies. These frequencies were also higher in the subgroups with elevated Ki67 or giant adenomas. Further studies are required to improve the definition of the role of the CG genotype in the development and progression of tumors in prolactinomas.Publication Association between resistance to cinacalcet and parathyroid gland hyperplasia in kidney transplant recipients with persistent hypercalcemia(Avicenna Organ Transplant Center, 2020-01-01) ORUÇ, AYŞEGÜL; Ersoy, Alparslan; ERSOY, ALPARSLAN; Yıldız, Abdülmecid; Gül, Özen Öz; ÖZ GÜL, ÖZEN; Kocaeli, Ayşen Akkurt; Erturk, E.; ERTÜRK, ELİF; Ersoy, C.; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; 0000-0002-0342-9692; JQI-3400-2023; AAI-1005-2021; JFB-3910-2023; AAH-4002-2021; KFR-7347-2024Background: Persistent hypercalcemia and hyperparathyroidism after successful kidney transplantation can be detrimental in some recipients and should be ameliorated.Objective: To point out the concerns regarding resistance to cinacalcet in kidney transplant recipients with persistent hypercalcemia.Methods: 14 renal transplant recipients who received cinacalcet treatment because of persistent hypercalcemia were included in the study. Serum creatinine, estimated glomerular filtration rate (eGFR), calcium, phosphorus, and intact parathyroid hormone (PTH) levels at the baseline and throughout the treatment, and ultrasonography and parathyroid scintigraphy findings were recorded.Results: Cinacalcet treatment was initiated after a mean +/- SD of 20.7 +/- 19.7 months of transplantation and maintained for 16.9 +/- 7.9 months. Serum calcium levels were significantly decreased with the cinacalcet treatment. There were no significant changes in serum creatinine, eGFR, phosphorus, and PTH levels. In all participants, serum calcium levels were increased from 9.8 +/- 0.6 to 11.1 +/- 0.6 mg/dL (p<0.001) within 1 month of cessation of cinacalcet. 7 recipients with adenoma-like hyperplastic glands underwent parathyroidectomy (PTx) due to failure with cinacalcet.Conclusion: Cinacalcet may be an appropriate treatment for a group of recipients with hypercalcemia without adenoma-like hyperplastic glands or who had a contraindication for surgery. Recipients with enlarged parathyroid gland may resist to cinacalcet-induced decrease in serum PTH, although the concomitant hypercalcemia may be corrected.Item Changes in the management of type 2 diabetic patients in family medicine practices in the Bursa region(Elsevier, 2017-04) Göktaş, Olgun; Gül, Özen Öz; Ertürk, Erdinç; Uludağ Üniversitesi/Tıp Fakültesi/Aile Sağlığı Merkezi/Aile Hekimliği Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı/İç Hastalıkları Bölümü.; AAJ-6536-2021; AAI-1005-2021; 6603078279; 26040787100; 7005488796Aim: The aim of the study was to investigate the treatment and monitoring patterns of type 2 diabetes patients in the Bursa region over the last 5 years since the implementation of family practice in Turkey in 2010. Methods: A total of 216 volunteer family doctors working in family health centers took part in this study. The records of 44,819 diabetic patients who visited these doctors between January 1, 2010 and December 31, 2014 were inspected retrospectively. Apart from the identity of the patients, morphometric data, including the type of medication used for diabetes and the HbA1C, serum creatinine and LDL cholesterol values, were recorded. Results: A total of 38.9% (17,416 patients) of the patients in the study were male and 61.1% (27,403 patients) were female. The average age was 59.7 years with a range of 13.2 years. Although the patients' average body mass index (BMI) did not change over the 5 years monitoring, average blood pressure (BP), and serum creatinine and LDL cholesterol levels decreased significantly. The hemoglobin A1c levels were significantly lower after 2010 compared to the 2010 data. Upon examining the medication prescribed for the patients, we determined that the use of metformin and insulin increased, whereas the prescription of thiazolidinedione (glitazone) decreased. There was a significant increase in the amount of patient data recorded over the last 5 years. Conclusions: Despite the increased level of data entry in these patients with type 2 diabetes, the surveillance of diabetes parameters according to treatment guidelines remains suboptimal. There continues to be a need to engage family practitioners on ongoing education and practice enhancement programs.Item Clinical management, psychosocial characteristics, and quality of life in patients with homozygous familial hypercholesterolemia undergoing LDL-apheresis in Turkey: Results of a nationwide survey (A-HIT1 registry)(Elsevier, 2019-07) Sağ, Saim; Gül, Özen Öz; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri/İç Hastalıkları Bölümü.; 0000-0001-8404-8252; AAW-9185-2020; AAI-1005-2021; 26040787100; 12140008100BACKGROUND: Homozygous familial hypercholesterolemia (HoFH) is a rare, life-threatening inherited disease leading to early-onset atherosclerosis and associated morbidity. Because of its rarity, longitudinal data on the management of HoFH in the real world are lacking, particularly on the impact the condition has on quality of life (QoL), including the impact of the extracorporeal lipid removal procedure apheresis (LA). METHODS: The A-HIT1 study included 88 patients with HoFH aged >= 12 years receiving regular LA in 19 centers in Turkey. Demographic and disease characteristics data were obtained. For patients aged >= 18 years, additional data on psychosocial status were obtained via the SF-36 score, the Hospital Anxiety and Depression Scale, and a HoFH-specific questionnaire. RESULTS: There was no standardized approach to therapy between centers. Mean (+/-SD) frequency of LA sessions was every 19.9 (+/-14) days, with only 11.6% receiving LA weekly, and 85% of patients were not willing to increase LA frequency. The most common concerns of patients were disease prognosis (31%), and physical, aesthetic, and psychological problems (27.5%, 15.9%, and 11.6%, respectively). Lower age at diagnosis was associated with better QoL, lower anxiety, improved functioning, and greater emotional well-being compared to later diagnosis. CONCLUSIONS: These findings demonstrate that adult patients with HoFH undergoing LA, experience significant impairment of QoL with an increased risk of depression. From patients' point of view, LA is time-consuming, uncomfortable, and difficult to cope with. The speed of diagnosis and referral has a considerable impact on patient well-being. (C) 2019 National Lipid Association. All rights reserved.Item Comparative effects of pioglitazone and rosiglitazone on plasma levels of soluble receptor for advanced glycation end products in type 2 diabetes mellitus patients(W B Saunders Co-Elsevier, 2010-01) Yılmaz, Yusuf; Gül, Özen Öz; Tuncel, Ercan; Ulukaya, Engin; Gül, Cuma Bülent; Kıyıcı, Sinem Küçüksaraç; Oral, Arzu Yılmaztepe; Güçlü, Metin; Ersoy, Canan; İmamoğlu, Şazi; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0003-0463-6818; 0000-0003-2467-9356; A-5841-2017; AAI-1005-2021; ABI-4847-2020; AAH-8861-2021; K-5792-2018; A-7063-2018; 26040787100; 7006929833; 6602927353; 23988796000; 12753880400; 23091316500; 15073842600; 6701485882; 6602297533Low levels of soluble receptor for advanced glycation end products (sRAGE) have been associated with the occurrence of vascular complications in patients with type 2 diabetes mellitus. Preliminary evidence has suggested that thiazolidinediones have the ability to modulate circulating levels of this molecule in the hyperglycemic milieu. The aim of this pilot study was to assess the differential effect of 2 different thiazolidinediones pioglitazone and rosiglitazone on plasma levels of sRAGE in type 2 diabetes mellitus patients. Sixty type 2 diabetes mellitus subjects were randomly assigned to receive pioglitazone (30 mg/d, n = 19), rosiglitazone (4 mg/d, n = 20), or placebo (medical nutrition therapy, n = 21) for 12 weeks. Changes in plasma glucose, glycosylated hemoglobin, insulin resistance (homeostasis model assessment), total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and sRAGE were evaluated at baseline and after 12 weeks. At 12 weeks, the pioglitazone (P < .001) group had a significant increase from baseline in sRAGE values that was not seen in the medical nutrition therapy and rosiglitazone groups. We conclude that, in type 2 diabetes mellitus patients, pioglitazone but not rosiglitazone significantly raised sRAGE, which may contribute to its antiatherogenic effects.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 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 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 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.