Person: ÖZ GÜL, ÖZEN
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ÖZ GÜL
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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 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 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 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.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 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 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 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.