Person: AYDEMİR, ENSAR
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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 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; Tıp Fakültesi; İç Hastalıkları Ana Bilim 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 Central venous sampling and magnetic resonance imaging in the diagnosis of acth-dependent cushing's syndrome(Sage Publications Inc, 2022-09-08) Ünsal, Yasemin Aydoğan; Gül, Zen Z.; Aydemir, Ensar; AYDEMİR, ENSAR; Ate, Co Kun; Ertürk, Erdinç; ERTÜRK, ERDİNÇ; Cander, Soner; CANDER, SONER; Ersoy, Canan; ERSOY, CANAN; Özpar, Rıfat; ÖZPAR, RİFAT; HAKYEMEZ, BAHATTİN; Tıp Fakültesi; Endokrinoloji ve Metabolizma Ana Bilim Dalı; 0000-0003-4300-2965; AAB-6671-2022; AAA-7171-2022; AAJ-6536-2021; HCI-4522-2022Objectives: Central venous sampling (CVS) with corticotropin-releasing hormone (CRH) stimulation is a crucial technique in evaluating adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS). We evaluated central venous sampling (CVS) and magnetic resonance imaging (MRI) findings in predicting the localization and lateralization of pituitary microadenomas.Methods: We analyzed 29 patients with CS who underwent CVS with CRH stimulation and examined with MRI retrospectively. Catheterization to central sinuses was successfully performed in 26 patients. Three patients with variant anatomy or inability to cannulate were diagnosed with CD after examination of pathology.Results: After CVS, among 26 patients, 23 patients were determined to have CD (88.4%) and 2 (7.7%) patients were diagnosed with ectopic ACTH syndrome. One patient was diagnosed with CD postoperatively. While the sensitivity of the CVS was 95.6%, sensitivity of the preoperative pituitary MRI was lower (69.5%). Also, the negative predictive value ratio was higher in CVS than in MRI (66% versus 22%). Diagnostic accuracy in the lateralization of the tumor was high as in CVS as in MRI (76.4% versus 73.9%).Conclusion: Central venous sampling with higher sensitivity in the localization of pituitary microadenoma, also has approximately similar diagnostic accuracy in lateralizing the tumor with MRI.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; Tıp Fakültesi; Endokrinoloji ve Metabolizma Ana Bilim 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 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; 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 Determining the body composition of patients with acromegaly as a cardiovascular risk(Erciyes Univ Sch Medicine, 2023-03-01) Ünsal, Yasemin Aydoğan; Gül, Özen Öz; ESENBUĞA, ŞEYMA; ÖZ GÜL, ÖZEN; ATEŞ, COŞKUN; Ateş, Coşkun; Aydemir, Ensar; AYDEMİR, ENSAR; CANDER, SONER; ERSOY, CANAN; Ertürk, Erdinç; ERTÜRK, ERDİNÇ; Tıp Fakültesi; Endokrinoloji ve Metabolizma Ana Bilim Dalı; HCI-4522-2022; AAB-6671-2022; AAA-7171-2022; AAJ-6536-2021Objective: This report aimed to examine changes in constituents of body composition that correlate to cardiovascular mor-bidity and mortality in patients with acromegaly using bioelectrical impedance analysis (BIA).Materials and Methods: This prospective study included 62 patients who were folowed up after their acromegaly diagnosis and 40 healthy volunteers. Alpatients' body compositions were evaluated using a body composition analyzer (TANITA MC-780-Black) with the BIA method. The laboratory and anthropometric measurements and body composition parameters were compared be-tween the patients with acromegaly and the controls. Moreover, these parameters were examined according to the disease activity.Results: This study showed that patients with acromegaly have higher plasma glucose levels than the control group (p=0.001). The homeostasis model assessment-insulin resistance index of patients with acromegaly was significantly higher than that of the controls (p=0.02). The compartments of intracellular water (ICW) and extracellular water (ECW) in the patients with acromegaly were larger than that in the controls (respectively; p=0.02 and p=0.001). The lean mass of the patients with acromegaly in the trunk and extremities was significantly higher than the controls (respectively; p=0.002 and p=0.001). The compartment of muscle was significantly larger than that in the controls (p=0.001). The basal metabolism in patients with acromegaly was significantly higher than that in the controls (p=0.002).Conclusion: Determining the body composition using the BIA method can provide important information about the car-diovascular risks in patients with acromegaly. With the BIA method, cardiovascular risk can be estimated and reduced with effective strategies.