Person: ÖZ GÜL, ÖZEN
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ÖZ GÜL
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ÖZEN
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Publication Risk factors and outcomes of the post-liver transplantation diabetes mellitus(Aves, 2022-09-01) Ünsal, Yasemin Aydoğan; Gül, Özen Öz; Göktuğ, Mehmet Refik; Cander, Soner; Ersoy, Canan Özyardımcı; Aydemir, Ensar; Ateş, Coşkun; Ünsal, Oktay; Kıyıcı, Murat; Ertürk, Erdinç; ÖZ GÜL, ÖZEN; GÖKTUĞ, MEHMET REFİK; CANDER, SONER; Ersoy, Canan Özyardımcı; AYDEMİR, ENSAR; ATEŞ, COŞKUN; KIYICI, MURAT; ERTÜRK, ERDİNÇ; Tıp Fakültesi; Dahiliye Ana Bilim Dalı; 0000-0001-8519-784X ; GBT-4320-2022; CSJ-5407-2022; CJH-1319-2022; JMT-8992-2023; AAB-6671-2022; CDO-0747-2022; FHW-0015-2022; AAJ-6536-2021Objective: We aimed to identify the risk factors for the development of diabetes mellitus after transplantation in liver recipients.Methods: Two hundred twenty-seven patients with a follow-up period >8 months after liver transplantation were included in the study. The clinical and laboratory data of patients with post-liver transplantation diabetes mellitus and without post-liver transplantation diabetes mellitus were compared.Results: Of the 227 patients, 61 patients were diagnosed with diabetes mellitus in the pretransplantation period. Twelve percent of the patients (20 patients) were diagnosed with post-liver transplantation diabetes mellitus and 146 patients were not diagnosed with diabetes mellitus. We found that post-liver transplantation diabetes mellitus was associated with advanced age (95% CI: 1.002-1.142). Male liver recipients were diagnosed with a higher rate of post-liver transplantation diabetes mellitus than female recipients (15.5% and 5.4%, respectively; P =.045). Pretransplantation fasting plasma glucose levels were higher in patients with post-liver transplantation diabetes mellitus than without post-liver transplantation diabetes mellitus, which was not statistically significant (P =.097). While 22.2% of patients with post-liver transplantation diabetes mellitus had complications after transplantation, 14.2% of the patients without post-liver transplantation diabetes mellitus had complications after transplantation (P =.370).Conclusion: As post-liver transplantation diabetes mellitus is associated with graft failure and increased mortality and morbididy, candidates for liver transplantation should be screened for risk factors of diabetes, and blood work for diabetes mellitus should be done regularly in these patients. Since patients with advanced age, male gender, and higher fasting plasma glucose levels in the pretransplantation period have higher risk for the development of post-liver transplantation diabetes mellitus, these cases should be screened more carefully.Publication Answer regarding comment on: Risk factors and outcomes of the post-liver transplantation diabetes mellitus(Aves, 2023-01-01) Ünsal, Yasemin Aydoğan; Gül, Özen Öz; Göktuğ, Mehmet Refik; Cander, Soner; Ersoy, Canan Özyardımcı; Aydemir, Ensar; Ateş, Coşkun; Ünsal, Oktay; Kıyıcı, Murat; Ertürk, Erdinç; ÖZ GÜL, ÖZEN; GÖKTUĞ, MEHMET REFİK; CANDER, SONER; ERSOY, CANAN; AYDEMİR, ENSAR; ATEŞ, COŞKUN; KIYICI, MURAT; ERTÜRK, ERDİNÇ; Tıp Fakültesi; Endokrinoloji ve Metabolizma Hastalıklar Ana Bilim Dalı; 0000-0001-8519-784X ; GBT-4320-2022; CSJ-5407-2022; CJH-1319-2022; JMT-8992-2023; AAB-6671-2022; CDO-0747-2022; FHW-0015-2022; AAJ-6536-2021Publication 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; Tıp Fakültesi; Endokrinoloji Ana Bilim 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.Publication Co-existence of papillary and medullary thyroid carcinoma: Reports of three cases(Coll Physicians & Surgeons Pakistan, 2022-08-01) Calapkulu, Murat; Sagiroglu, Muhammed Fatih; Gul, Ozen Oz; ERTÜRK, ERDİNÇ; ÖZ GÜL, ÖZEN; CANDER, SONER; Cander, Soner; Saraydaroglu, Ozlem; SARAYDAROĞLU, ÖZLEM; Erturk, Erdinc; Ersoy, Canan; ERSOY, CANAN; 0000-0002-7445-2275; 0000-0002-1332-4165; ABF-6267-2020; AAJ-6536-2021Medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) are two different types of thyroid carcinoma. They have different features in terms of cellular origin, histopathology, clinical features, prevalence, and prognosis. PTC originates from follicular cells, while MTC from parafollicular cells. MTC and PTC co-existence is a rare phenomenon and occurs in less than 1% of all thyroid tumors. We report three cases with coexistent MTC and PTC in the same thyroid. The papillary component was dominant in two cases and the medullary in one case. While the first case was given radioactive iodine therapy, the third was treated with vandetanib. The second case was followed up postoperatively and did not receive treatment other than levothyroxine replacement. The co-existence of these tumors requires a different clinical approach in treatment and follow-up, depending on which type is dominant.Publication Adrenocortical carcinoma: Single center experience(Aves, 2017-12-01) Şişman, Pınar; Şahin, Ahmet Bilgehan; Peynirci, Hande; Cander, Soner; Gül, Özen Öz; Ertürk, Erdinç; Ersoy, Canan; ŞAHİN, AHMET BİLGEHAN; CANDER, SONER; ÖZ GÜL, ÖZEN; ERTÜRK, ERDİNÇ; ERSOY, CANAN; Tıp Fakültesi; Endokrinoloji ve Metabolizma Ana Bilim Dalı; 0000-0002-7846-0870; AAI-1005-2021; AAH-8861-2021; AAJ-6536-2021; HUR-0563-2023; AAM-4927-2020Objective: Adrenocortical carcinoma is an aggressive endocrine malignancy with an annual incidence of 0.5-2 cases per million. The most important factors that determine prognosis are tumor stage at the time of diagnosis and the success of surgery. However, advanced age, large tumor size, hormone secretion, high Ki-67 index (>10%), tumor necrosis and high mitotic activity are other factors associated with poor prognosis. In the present study, we aimed to evaluate the contribution of the patient and treatment-related factors to the prognosis in adrenocortical carcinoma.Material and methods: We included 15 adrenocortical carcinoma patients who were followed in our center between 2005 and 2015. The effects of age, gender, tumor size, type of operation, postoperative resection status and adjuvant treatment on disease-free survival and overall survival were analyzed.Results: Disease-free survival was 23.32+/-3.69 months and overall survival was 36.60+/-10.78 months. Gender, tumor size, tumor stage, type of operation, hormonal activity, presence of necrosis, recurrence and development of metastasis were not found to be associated with disease-free survival and overall survival (p>0.05). Postoperatively applied adjuvant treatments including mitotane, chemotherapy and radiotherapy did not significantly affect disease-free survival in our study, but statistically significant increase in overall survival was observed in patients getting adjuvant treatments (p=0.006).Conclusion: Adrenocortical carcinoma has poor prognosis and short overall survival, and in its clinical course, recurrence and development of metastasis can be commonly observed even after complete resection of the tumor. Therefore, the patients should be evaluated carefully while determining the surgical procedure during the preoperative period, and the operation and post-operative follow-up should be performed in experienced centers. However, due to the positive effects of adjuvant treatments on survival, all patients should be evaluated postoperatively for the necessity of adjuvant treatments, especially mitotane.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; 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.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; Tıp Fakültesi; Radyoloji Ana Bilim 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.Publication Re-training of type 2 diabetic patients for better adherence to diabetes care plan in oral anti-diabetics and plus insulin treatment groups(Aves, 2015-06-01) Cander, Soner; Gül, Özen Öz; Gül, Cuma Bülent; Yavaş, Sibel; Ersoy, Canan; ÖZ GÜL, ÖZEN; ERSOY, CANAN; Tıp Fakültesi; Endokrinoloji ve Metabolizma Ana Bilim Dalı; AAI-1005-2021; AAH-8861-2021Purpose: This prospective observational single-centre study was designed to evaluate the effect of patient re-training for better adherence to regular self-monitoring of blood glucose (SMBG), standard diabetic diet and exercise program in ambulatory patients with type 2 diabetes mellitus (T2DM) receiving oral anti-diabetic (OAD) and OAD plus insulin treatments.Material and Method: In this study, we enrolled a total of 61 patients with T2DM in whom ongoing therapy with OAD (n=34) and OAD+insulin (n=27) failed to achieve adequate glycemic control. The patients were educated for lifestyle behavior, adherence to diet and exercise therapy, close monitoring with SMBG without change in their ongoing drugs and dosing. Changes in glycemic parameters, serum lipids and anthropometrics at the end of 3rd month were compared between the treatment groups.Results: During the course of the study, a significant decrease in the body weight and fat were observed in OAD (p<0.001 and p=0.002) and OAD+insulin groups (p=0.044 and p=0.008, respectively). A significant decrease in the HbA1c % (6.1%; 8.2% to 7.6%) was observed in the overall population (p<0.001) as well as in OAD (p=0.011) and OAD+ insulin (p=0.001) groups. A significant decrease was noted in the post-prandial capillary blood glucose levels in only OAD+insulin group.Discussion: Re-training approach with close follow-up and frequent SMBG seems to be important factors for the maintenance of achieved glycemic control. In our study, the effect of diabetes education on postprandial capillary blood glucose levels was more pronounced in OAD+ insulin group.Publication Effect of rosiglitazone and insulin combination therapy on inflammation parameters and adipocytokine levels in patients with Type 1 DM(Hindawi, 2015-03-17) Güçlü, Metin; Gül, Özen Öz; Cander, Soner; Ünal, Oğuzkaan; Özkaya, Güven; Sarandöl, Emre; Ersoy, Canan; Güçlü, Metin; ÖZ GÜL, ÖZEN; CANDER, SONER; Ünal, Oğuzkaan; ÖZKAYA, GÜVEN; SARANDÖL, EMRE; ERSOY, CANAN; Tıp Fakültesi; Endokrinoloji ve Metabolizma Ana Bilim Dalı; 0000-0001-5082-9894; 0000-0003-0297-846X; A-4421-2016; ABE-1716-2020; AAI-1005-2021; ABI-4847-2020; AAH-8861-2021; HUR-0563-2023; IPU-7626-2023Aim. To investigate the efficacy of combined therapy of insulin and rosiglitazone on metabolic and inflammatory parameters, insulin sensitivity, and adipocytokine levels in patients with type 1 diabetes mellitus (type 1 DM). Material and Methods. A total of 61 adults with type 1 DM were randomly and prospectively assigned in open-label fashion to take insulin and rosiglitazone 4mg/day (n - 30) or insulin alone (n = 31) for a period of 18 weeks while undergoing insulin therapy without acute metabolic complications. Results. Combination therapy did not significantly improve metabolic and inflammatory parameters, insulin sensitivity, and adiponectin levels. While leptin and resistin levels decreased in both groups (group 1: resistin 6.96 +/- 3.06 to 4.99 +/- 2.64, P = 0.006; leptin 25.8 +/- 17.6 to 20.1 +/- 12.55, P = 0.006; group 2: resistin 7.16 +/- 2.30 to 5.57 +/- 2.48, P = 0.031; leptin 16.72 +/- 16.1 to 14.0 +/- 13.4, P = 0.007) Hgb and fibrinogen levels decreased only in group 1 (Hgb 13.72 +/- 1.98 to 13.16 +/- 1.98, P = 0.015, and fibrinogen 4.00 +/- 1.08 to 3.46 +/- 0.90, P = 0.002). Patients in both groups showed weight gain and the incidence of hypoglycemia was not lower. Discussion. The diverse favorable effects of TZDs were not fully experienced in patients with type 1 DM. These results are suggesting that insulin sensitizing and anti-inflammatory characteristics of TZDs were likely to be more pronounced in patients who were not totally devoid of endogenous insulin secretion.Publication Evaluation of upper gastrointestinal system in acromegaly(Masson Editeur, 2019-09-01) Şişman, Pınar; Pekgöz, Murat; Bayrakçı, Ismail; Şişman, Mete; Cander, Soner; CANDER, SONER; Gül, Özen Öz; ÖZ GÜL, ÖZEN; Ertürk, Erdinç; ERTÜRK, ERDİNÇ; Ersoy, Canan; ERSOY, CANAN; Tıp Fakültesi; AAH-8861-2021; AAI-1005-2021; AAJ-6536-2021Purpose. - Acromegaly causes multiple comorbidities, including gastrointestinal disorders. The present study evaluated the frequency of hiatal hernia and other upper gastrointestinal pathologies in patients with acromegaly, given that visceromegaly and reduced nitric oxide levels in acromegaly may impact diaphragm and lower esophageal sphincter function and thus possibly the development of hiatal hernia.Methods. - Thirty-nine acromegaly patients followed our center for the previous 6 months were recruited. Upper gastrointestinal endoscopy was performed once in all patients to evaluate hiatal hernia, esophagitis, gastroduodenitis and ulcer.Results. - Twenty-three patients were male and 16 female. Upper gastrointestinal endoscopy found hiatal hernia, esophagitis and gastroduodenitis or gastric ulcer in 3 (7.6%), 2 (1.7%) and 31 (79.4%) patients, respectively. Pathologic examination of gastric antrum biopsy found intestinal metaplasia in 12 (30.7%) patients, and Helicobacter pylori was positive in 13 (33.3%). There were no significant correlations between age, gender, disease duration or preoperative adenoma size on the one hand and hiatal hernia or other endoscopic findings on the other. Similarly, neither surgical success nor recurrence was associated with endoscopic findings.Conclusions. - The study showed that prevalence of gastritis, duodenitis, peptic ulcer and intestinal metaplasia is higher and prevalence of hiatal hernia lower in acromegaly patients than in the healthy population. Various unknown disease-related pathophysiological conditions may play a role; there is a need for further studies.