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Yayın Açık Erişim How the COVID-19 outbreak affected patients with diabetes mellitus?(Springer India, 2021-06-28) Şişman, Pınar; Polat, Irmak; Aydemir, Ensar; Karşı, Remzi; Gül, Özen Öz; Cander, Soner; Ersoy, Canan; Ertürk, Erdinç; AYDEMİR, ENSAR; ÖZ GÜL, ÖZEN; CANDER, SONER; ERSOY, CANAN; ERTÜRK, ERDİNÇ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; 0000-0003-4300-2965 ; AAA-7171-2022 ; GBT-4320-2022 ; CJH-1319-2022 ; AAH-8861-2021 ; AAJ-6536-2021Background Global COVID-19 outbreak has been such a stressful experience for most of the people. Using a web-based cross-sectional study, we aimed to evaluate the acute stress response, depression, and anxiety in patients with diabetes mellitus (DM) during the COVID-19 pandemic, and to examine the effect of these psychiatric problems on diet habits and glycemic controls of patients. Methods This web-based survey of COVID-19 was sent to the patients through the Whatsapp platform. All participants reported their demographic data, diabetes-related information, changes in self-monitoring blood glucose measurements, physical parameters, and eating habits after COVID-19, then completed Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale, Revised (IES-R) questionnaires which assessed acute stress sypmtoms, anxiety, and depression. Results Three hundred and four patients with DM [(141 type 1 DM (T1D) and 163 type 2 (T2D)] were included in the study. In our study, female gender, higher BMI and weight, decreased in financial income after outbreak, presence of diabetic complications and comorbid diseases (i.e., retinopathy, neuropathy, diabetic foot, hypertension, dyslipidemia), worsened glycemic levels, increased carbohydrate consumption, and snacking were associated with higher anxiety and depression scores. Depression was higher in patients with T2D and duration of illness was correlated with acute stress level. Conclusions It is important to be aware of the possibility of acute stress, depression, and anxiety after pandemic in patients with DM whose glycemic control is impaired. Psychological problems should not be ignored beyond physical inactivity and worsening eating habits.Yayın Açık Erişim 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.Yayın Açık Erişim Is laparoscopic adrenalectomy for pheochromocytoma safe and effective in geriatric patients?(Wiley, 2021-06-12) Günseren, Kadir Ömur; Çiçek, Mehmet Çağatay; Bolat, Deniz; Yeni, Sezgin; Vuruşkan, Hakan; Gül, Özen Öz; Yavaşcaoğlu, İsmet; GÜNSEREN, KADİR ÖMÜR; ÇİÇEK, MEHMET ÇAĞATAY; VURUŞKAN, HAKAN; ÖZ GÜL, ÖZEN; YAVAŞCAOĞLU, İSMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; 0000-0001-8673-3093; 0000-0002-0471-5404; 0000-0002-1332-4165; ABC-9924-2020; HGM-5995-2022 ; GFT-1275-2022; EFH-9523-2022; GBT-4320-2022; EIN-0828-2022Objectives The study aimed to assess the haemodynamic changes of laparoscopic adrenalectomy (LA) in geriatric patients with pheochromocytoma (PHEO). To the best of our knowledge, this is the first study to evaluate the haemodynamic outcomes of LA in this patient population.Methods Data of 350 patients who underwent single-side transperitoneal LA between 2000 and 2020 were reviewed retrospectively. Patients with a histopathological diagnosis of PHEO were included in the study and classified into two groups according to their ages at the date of surgery. Patients older than 65 years were accepted as elderly according to the World Health Organisation (WHO) recommendations.Results A total of 54 patients underwent LA for PHEO. Fifteen patients were enrolled in the elderly and 39 in the young groups. There were no significant differences in terms of the operation site (0.564), tumour size (0.878), perioperative results such as mean anaesthesia; operation times, blood loss and haemodynamic changes. There were no significant differences in mean hospitalisation and intensive care unit times. One patient in both groups had grade 1 complication according to Clavien Dindo classification (prolonged ileus, managed with medical treatment and transfusion during surgery, respectively).Conclusion Young and elderly patients had similar outcomes in terms of haemodynamic changes that occurred with LA. LA in elderly patients with PHEO is as safe and effective as in younger patients.Yayın Açık Erişim Effect of parathyroidectomy timing in kidney transplant recipients on graft function(Başkent Üniversitesi, 2021-04-01) Oruc, Aysegul; Ersoy, Alparslan; Yildiz, Abdulmecit; Gul, Ozen Oz; Ersoy, Canan; Oruc, Aysegul; ORUÇ, AYŞEGÜL; Ersoy, Alparslan; ERSOY, ALPARSLAN; Yildiz, Abdulmecit; YILDIZ, ABDULMECİT; Gul, Ozen Oz; ÖZ GÜL, ÖZEN; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-0342-9692; 0000-0002-1332-4165; AAH-8861-2021; AAH-4002-2021Objectives: Persistent hyperparathyroidism can have a deleterious effect on graft function in kidney transplant recipients, although serum calcium, phosphorus, and parathyroid hormone levels tend to normalize after successful transplant. Parathyroidectomy can result in sustained amelioration of persistent hyperparathyroidism despite graft failure risk and unfavorable graft outcomes. Data on this issue are limited and conflicting. Here, we evaluated the effects of parathyroidectomy on graft function in kidney transplant recipients.Materials and Methods: This retrospective study included 249 adult kidney transplant recipients (121 deceased-donor/128 living-donor; 142 males/107 females; mean age of 39.3 +/- 11.6 y; mean follow-up of 46.5 +/- 23.5 mo). Participants were grouped as those without (n = 222), those with pretransplant (n = 12), and those with posttransplant (n = 15) parathyroidectomy. Graft outcomes and serum calcium, phosphorus, and parathyroid hormone levels were studied.Results: Serum calcium levels at baseline and at 1, 3, 6, and 12 months and parathyroid hormone levels at baseline and at 6 and 12 months were higher and serum phosphorus levels at 3, 6, and 12 months were lower in the posttransplant parathyroidectomy group versus the other groups (P <.001). We observed no significant differences between groups regarding serum calcium, phosphorus, and parathyroid hormone levels at last visit. Estimated glomerular filtration rates at 3, 6, and 12 months and at last visit in the pretransplant parathyroidectomy group were higher than in those without parathyroidectomy (P <.05) and higher at 6 and 12 months than in the posttransplant parathyroidectomy group (P <.05). No significant differences regarding graft loss and patient mortality were observed among the 3 groups (P >.05).Conclusions: Parathyroidectomy resulted in sustained decreased levels of serum calcium and parathyroid hormone. We observed no graft failure risk associated with parathyroidectomy in our study. Parathyroidectomy before transplant is advantageous with better graft function.Yayın Sadece Metadata 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.Yayın Açık Erişim Retrospective analysis of vitamin D status on inflammatory markers and course of the disease in patients with COVID-19 infection(Springer, 2021-04-05) Ünsal, Yasemin Aydoğan; Gül, Özen Öz; Cander, Soner; Ersoy, Canan; Aydemir, Ensar; Ateş, Coşkun; Uzun, Ziya ; Armağan, Ersin; Ünsal, Oktay; Ertürk, Elif; AYDOĞAN ÜNSAL, YASEMİN; ÖZ GÜL, ÖZEN; CANDER, SONER; ERSOY, CANAN; AYDEMİR, ENSAR; ATEŞ, COŞKUN; ERTÜRK, ELİF; Armağan, Ersin; Uzun, Ziya; Bursa Uludağ Üniversitesi/Tıp Fakültesi; 0000-0002-1566-3099; 0000-0002-1332-4165; 0000-0001-6303-7896; 0000-0001-8519-784X; 0000-0003-4565-9848; 0000-0003-1363-2966; HSE-4469-2023; GBT-4320-2022; CJH-1319-2022; AAH-8861-2021; AAB-6671-2022; CDO-0747-2022; GQW-5454-2022; CBW-8706-2022; JQI-3400-2023Purpose The aim of the study was to investigate the association between serum 25-hydroxyvitamin D status within the last 6 months prior to COVID-19 infection and parameters of immune function and clinical outcomes. Methods Fifty-six patients, who were admitted to the emergency clinic and diagnosed with COVID-19 infection, were included in the study. Data on clinical characteristics, inflammatory parameters and vitamin D status were recorded for each patient. All the participants had data on 25-hydroxyvitamin D status within the last 6 months prior to COVID-19 infection. Results The patients were stratified as those with vitamin D status less than 20 ng/mL and higher than 20 ng/mL. A group with vitamin D status less than 20 ng/mL had lower lymphocyte counts and lower haemoglobin levels that was statistically significant (respectively; p = 0.021, p = 0.035). Higher C-reactive protein (CRP) levels were seen in the vitamin D-deficient group (p = 0.013). It was observed that vitamin D status of the patients who required oxygen therapy were lower than those who did not require oxygen therapy, not statistically significant (p = 0.05). Patients who did not use vitamin D supplementation within 6 months prior to COVID-19 infection had more likely to be diagnosed with pneumonia (p = 0.004). Conclusion Cases with lower vitamin D status had increased inflammatory markers and worse clinical outcomes than patients with higher vitamin D status. This study suggests that vitamin D status can be used as a prognostic factor in COVID-19 patients, and vitamin D supplementation can be recommended to improve the clinical outcomes in COVID-19 infection.