Browsing by Author "ÖZ GÜL, ÖZEN"
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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 Adult nesidioblastosis, diagnostic value of the selective arterial calcium stimulation test and perfusion computed tomography. A case report(Editura Acad Romane, 2015-01-01) Cander, S.; Gül, Ö. Öz; Yıldırım-Eryılmaz, N.; Uğraş, N.; Ertürk, E.; Ersoy, C.; ÖZ GÜL, ÖZEN; ERYILMAZ, NERMİN YILDIRIM; UĞRAŞ, NESRİN; ERTÜRK, ERDİNÇ; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; AAI-1005-2021; AAH-8861-2021; AAJ-6536-2021; AAH-2716-2021; GKT-3420-2022Endogenous hyperinsulinemia was found in a 38-year-old female patient with recurrent neuroglycopenic symptoms he glucose level was 25 mg/dL, insulin 43.9 mu/mL, C-peptide,54 ng/mL). No lesion was found on imaging tests including ahanced computed tomography (CT) methods performed ith a preliminary diagnosis of insulinoma. A suspicious yperperfusion was present in the pancreatic tail on the erfusion CT examination performed after obtaining approval. he selective arterial calcium stimulation test (SACST) result as consistent with a diffuse disease in the body and tail. The atient underwent partial (75%) pancreatectomy and is now)llowed up as a diabetes patient on intensive insulin treatment the postoperative 38th month.The most common cause of endogenous yperglycemia in hypoglycemia patients is insulinoma. The oninsulinoma pancreatogenous hypoglycemia syndrome NIPHS) is rarely seen in the adult age group. Although invasive, ACST seems to be the most suitable test to differentiate diffuse r multiple disease from insulinoma and to guide the surgery hen advanced radiological imaging methods are inadequate " detect the presence of insulinoma. Regarding perfusion CT, would be more appropriate to wait for comparative data to put forward in a more consistent manner. When no response an be obtained to medical treatment in NIPHS, partial/total ancreatectomy is the most appropriate treatment option as enables recovery from the hypoglycemic episodes despite ading to a significant condition like diabetes.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.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.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.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.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.Publication Differences between atypical parathyroid tumors and parathyroid adenomas in patients with primary hyperparathyroidism(Springer India, 2023-09-29) Aydemir, Ensar; AYDOĞAN ÜNSAL, YASEMİN; ÖZ GÜL, ÖZEN; AYDEMİR, ENSAR; ATEŞ, COŞKUN; Ateş, Coşkun; CANDER, SONER; Cander, Soner; Saraydaroğlu, Özlem; SARAYDAROĞLU, ÖZLEM; Ersoy, Canan; ERSOY, CANAN; Ertürk, Erdinc; ERTÜRK, ERDİNÇ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0003-4300-2965; 0000-0003-4565-9848; 0000-0002-1332-4165; AAJ-6536-2021; AAB-6671-2022; AAA-7171-2022Atypical parathyroid tumor is a rare disease that can be challenging to distinguish from parathyroid adenoma. Atypical parathyroid tumor shows some laboratory and histopathological features with parathyroid cancer. This study attempts to compare clinical, laboratory, radiologic, and histopathological characteristics in atypical parathyroid tumor and parathyroid adenoma. This was a retrospective study based on the database of eighty-two subjects who underwent surgery for primary hyperparathyroidism at a tertiary referral center between 2010 and 2021. Forty-one patients with atypical parathyroid tumor were matched by age and gender to controls with parathyroid adenoma. Clinical, laboratory, radiologic, and characteristics were obtained from the hospital database. Forty-five (54.8%) of primary hyperparathyroidism patients were symptomatic, 36 (90%) had nephrolithiasis, 6 (15%) had fracture, and 3 (7.5%) had hypercalcemic crisis. Atypical parathyroid tumor patients present with significantly increased serum calcium, parathormone, and alkaline phosphatase levels (P < .001, all). No significant difference was observed in the results of bone mineral density, T-scores, and Z-scores. The size of adenoma was significantly greater in the atypical parathyroid tumor group (24 (8.8-70) mm vs. 12 (3.8-32) mm, P = 0.005). Our study revealed that increased preoperative serum calcium, parathormone, alkaline phosphatase concentrations, and parathyroid adenoma size on ultrasound may have predicted the atypical parathyroid tumor.Publication 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.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; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim 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; Bursa Uludağ Üniversitesi/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.Publication 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.Publication Insulinoma case admitted with reactive hypoglycemia symptoms(Bentham Science Publ, 2020-01-01) Koca, Nizameddin; Ugraş, Nesrin; Cander, Soner; CANDER, SONER; Gül, Ozen Oz; ÖZ GÜL, ÖZEN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; AAI-1005-2021Aim: To present an insulinoma case with post-prandial hypoglycemic symptoms associated with glucose inducible endogenous hyperinsulinemia.Case: A 52-year-old female patient was evaluated for hypoglycemic symptoms especially those occuring within 3 hours after consuming sugary foods. These symptoms were persistent for a year and a half. She was diagnosed with reactive (post-prandial) syndrome and followed a recommended diet and was given acarbose but there was no improvement. The results suggested post-prandial endogenous hyperinsulinemia related hypoglycemia. Multiphasic computerized tomography revealed an 11x15x12 mm size mass lesion, anteriorly in the head and uncinate process of the pancreas and then the patients were treated surgically with pancreatic enucleation and cured.Conclusion: Distinguishing post-prandial syndrome by careful history and clinical evaluation in patients with postprandial symptoms is of great importance in terms of cost-effectivity. However, it should not be forgotten that although organic pathologies are mostly presented with fasting hypoglycemia, they may also cause post-prandial symptoms. Severity and progression of the symptoms that point to neuroglycopenia is important, and in this condition the most convenient clinical approach to the patient should be performed with careful and appropriate assessment steps.Publication 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.Publication Plasma neprilysin levels in patients with polycystic ovary syndrome(Editura Acad Romane, 2022-01-01) Şişman, P.; Gül, Öz Özen; ÖZ GÜL, ÖZEN; SARANDÖL, EMRE; Cander, Soner; CANDER, SONER; Sarandol, Emre; Ersoy, Canan; ERSOY, CANAN; Ertürk, Erdinç; ERTÜRK, ERDİNÇ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Biyokimya Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; 0000-0002-1332-4165; AAJ-6536-2021Context. Insulin resistance has been detected in a majority of patients with polycystic ovary syndrome (PCOS). Elevated neprilysin levels are associated with insulin resistance.Objective. The present study aims to investigate plasma neprilysin and its relationship with endocrine and metabolic characteristics in patients with PCOS.Subjects and Methods. Thirty-five premenopausal PCOS patients and 35 healthy volunteers of similar age were included in the study. Demographic characteristics, biochemical and hormonal findings and also plasma neprilysin levels were determined in these patients and healthy controls.Results. In our study, HOMA-IR values were significantly higher in PCOS patients (3.3 +/- 1.8) compared with the controls [(1.6 +/- 1), p<0.01]. Plasma neprilysin levels were significantly higher in the PCOS group compared to the control group (1502.1 +/- 1641.2 vs. 764.6 +/- 562.6 pg/mL). There was no difference in plasma neprilysin levels when PCOS patients were classified as overweight-obesity (BMI=25kg/m(2)) or non-obesity (BMI<25kg/m(2)).Conclusion. Our findings revealed significantly higher levels for plasma neprilysin and HOMA-IR values in PCOS patients when compared to controls. No significant differences were noted between obese PCOS patients and non-obese PCOS patients in terms of plasma neprilysin levels.Publication 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.Publication Serum uric acid is not associated with diabetic nephropathy in patients with type 2 diabetes(Carbone Editore, 2015-03-30) Gül, Cuma Bülent; Yıldız, Abdülmecit; Gül, Özen Öz; Hartavi, Mustafa; Cander, Soner; Eroğlu, Ayça; Keni, Nermin; Bayındir, Ayşenur; Ersoy, Alparslan; Ersoy, Canan; YILDIZ, ABDULMECİT; ÖZ GÜL, ÖZEN; Hartavi, Mustafa; CANDER, SONER; Eroğlu, Ayça; Keni, Nermin; Bayındır, Ayşenur; ERSOY, ALPARSLAN; ERSOY, CANAN; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-0710-0923; AAI-1005-2021; AAH-5054-2021; AAH-8861-2021; HIG-9032-2022; CUI-5353-2022; HUR-0563-2023; COU-0270-2022; FEA-3241-2022; CFL-1808-2022Introduction: Although epidemiologic studies suggest a link between serum uric acid (SUA) and vascular complications in diabetes, the relationship of uric acid with diabetic nephropathy remains unclear. We aimed to investigate the relationship between SUA and the degree of albuminuria in patients with type 2 diabetes (T2D).Materials and methods: The cross-sectional study included 223 T2D patients. Nephropathy was graded as follows: nor-moalbuminuria, urinary albumin excretion (UAE) less than 30 mg per gram of creatinine (mg/g Cr); microalbuminuria, 30 to 300 mg/g Cr; or macroalbuminuria, more than 300 mg/g Cr. SUA was measured using a uricase-peroxidase enzymatic method.Results: The degree of nephropathy was as follows: normoalbuminuria in 163 subjects, microalbuminuria in 45 subjects, and macroalbuminuria in 15 patients. SUA did not differ significantly according to the degree of albuminuria. In addition, multivariable analysis demonstrated that hyperuricemia was not an independent predictor of neither microalbuminuria nor macroalbuminuria in T2D patients.Conclusion: Hyperuricemia does not reflect the severity of nephropathy in T2D patients.Publication Short term effect of laparoscopic sleeve gastrectomy on clinical, renal parameters and urinary ngal levels in diabetic and non diabetic obesity(Editura Acad Romane, 2019-07-01) Elbasan, Onur; Şişman, P.; Peynirci, Hande; Yabacı, Ayşegül; Dirican, Melehat; DİRİCAN, MELEHAT; Gül, Özen Öz; ÖZ GÜL, ÖZEN; Cander, Soner; CANDER, SONER; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0001-8580-9471; AAH-8861-2021; AAG-6985-2021; AAI-1005-2021Background. Although diseases such as diabetes, hypertension, obstructive sleep apnea and hyperlipidemia are clearly documented as obesity associated diseases, it is not well-known whether obesity causes renal pathologies. The aim of the present study was to evaluate the effect of weight loss following laparoscopic sleeve gastrectomy on clinical, renal parameters and urinary Neutrophil gelatinase-associated lipocalin (NGAL) levels in diabetic and non-diabetic obese patients.Methods. Nineteen morbidly obese patients (10 diabetic and 9 non diabetic) who underwent laparoscopic sleeve gastrectomy were evaluated clinically (anthropometric measurements) and biochemically before surgery and at 6 months from surgery.Results. Significant decreases in weight, BMI, FPG, PPG and HbA1c levels were observed in the diabetic group when the baseline and 6th month parameters of the patients were compared. There was also a significant decrease in SBP and DBP. At 6th month following laparoscopic sleeve gastrectomy, renal parameters such as creatinine, mAlb/creatinine, NGAL/creatinine did not differ in the diabetic group. In the nondiabetic group, serum creatinine levels were significantly decreased, but other renal parameters such as mAlb/creatinine and NGAL/creatinine were not significantly different.Conclusions. Our findings revealed significant decreases in weight, body mass index and glycemic parameters after sleeve gastrectomy in diabetic and non-diabetic patients, while no significant alteration was noted in renal functions, urinary NGAL and microalbumin levels.