Objective: Endocan, also known as endothelial cell specific molecule-1, is a vascular endothelium-derived factor and plays a key role
in angiogenesis. The aim of this study is to assess serum endocan
level in papillary thyroid cancer (PTC) patients which has not been investigated before. Material and Methods: This study included 48
patients with PTC who underwent total thyroidectomy between November 2018 and May 2019. As the control group, 40 age- and sexmatched cases with benign thyroid nodules were included. Serum
samples were obtained from the patients before surgery. Serum endocan levels of the patients and controls were measured and the results were compared. The relationship between endocan levels and
clinicopathological factors was investigated. Cases with benign thyroid
nodules were included as the control group. Results: PTC patients had
higher mean serum endocan level than control subjects (45.1±9.6 vs.
37.7±8.3 pg/mL, p<0.001). In PTC patients, there was no relationship between serum endocan levels and histopathologic variant,
lymphatic or vascular invasion, surrounding thyroid tissue invasion,
lymph node metastasis, surgical margin status, tumor-node-metastasis stage and American Thyroid Association risk stratification group,
age and tumor size. Conclusion: This study suggests that, if supported by more comprehensive studies with a sufficiently large sample
size in the future, serum endocan level may be used as an adjunctive
test in the diagnosis of PTC in patients with thyroid nodules.
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The prevalence of diabetes mellitus is increasing at an alarming rate worldwide. With no cure available, effective disease management is the best way to control disease
progression. Studies have shown that diabetes technology
helps to improve health outcomes and the quality of life of
the patients. Diabetes technology can be defined as any solution encompassing hardware, devices, and software used
in the disease management of patients. This review serves
as an introduction to diabetes mellitus by discussing the different categories of well-established diabetes technology,
related ongoing research, and its challenges. This review is
divided into 3 main categories, insulin administration, glucose monitoring, and hybrid devices that combine the 2 categories into one. Digital health application is also discussed
as it is becoming a notable tool in the disease management
of diabetes. Widespread use of these devices in disease management has been increasing in recent years. However,
there are still barriers that prevent the utilization of the full
potential of these devices.
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Objective: Simultaneous teamwork is an advanced collaboration subtype that includes the patient’s evaluation by the
team members (including physician, nurse and dietician) together in the same session. Our study aimed to investigate
the effect of a simultaneous teamwork approach on metabolic and clinical outcomes of patients with Type 1 diabetes
using an insulin pump. Material and Methods: This retrospective study included 49 previous insulin pump users with
Type 1 diabetes who participated in a simultaneous teamwork protocol. Metabolic and clinical parameters were collected before and after the teamwork approach. A separate
analysis of 16 patients in whom insulin pump was initiated
with simultaneous teamwork and pregnancy data from 9 patients were also reported. Results: Simultaneous teamwork
resulted in a significant reduction in the frequency of
hypoglycemic episodes in previous insulin pump users with
Type 1 diabetes. Hemoglobin A1c decreased, but the difference was statistically insignificant. Simultaneous teamwork
was also efficient on patients initiated an insulin pump and
for pregnancy follow-up in 2 separate subsets of patients
with Type 1 diabetes. Conclusion: The simultaneous teamwork approach is a practical method to manage Type 1 diabetes in insulin pump users with the potential to reduce the
frequency of hypoglycemic episodes.
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Objective: Bariatric surgery is one of the most effective
treatments for morbid obesity. Postoperatively, patients
should be followed up regularly. The objective of the study
was to examine the effect of the COVID-19 pandemic in patients who have undergone bariatric surgery because of
morbid obesity. Material and Methods: For the telephone
survey, 157 patients aged 18–65 years who had bariatric
surgery due to morbid obesity from 2015–2019 were contacted. The impact of the COVID-19 pandemic on weight
gain in patients who underwent obesity surgery and the severity of the patients who had COVID-19 were investigated.
The patients were evaluated nine months after the COVID19 pandemic started. Results: During the pandemic, weight gain was recorded in 94 patients (59.9%). Eating
behavior was enhanced in 80 (51%) patients in total, from
which 69 (73.4%) patients were in the weight gain group
(p<0.001). COVID-19 was found in 21 (13.3%) patients;
no intensive care was needed, and no mortality due to
COVID-19 occurred. Conclusions: It was observed that patients who had bariatric surgery during the pandemic changed their diet and eating patterns, mostly resulting in
weight gain. The follow-up of operated patients due to morbid obesity should not be interrupted during a pandemic like
COVID-19.
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Objective: The primary objective of the CAPTURE study was to estimate
the prevalence of cardiovascular disease (CVD) in adults with Type 2 diabetes mellitus (T2DM) across 13 countries from 5 continents. Here, we present
the findings from Türkiye. Material and Methods: The non-interventional,
cross-sectional CAPTURE study (NCT03811288; NCT03786406) was conducted across 15 centers in Türkiye. Standardized demographic and clinical
data were collected from adults with T2DM who were treated by primary or
specialist care physicians. The prevalences of CVD and its 7 subtypes were
estimated. Descriptive statistics were used for data analysis. Results:
Amongst the 801 participants (n=200 from primary care, n=601 from specialist care) with T2DM enrolled, 250 had established CVD, an estimated weighted prevalence of 31.2% (28.0-34.4) 95% confidence interval.
Atherosclerotic CVD contributed to the majority (85.6%) of the CVD cases.
An estimated 24.0% of the Türkiye sample had coronary heart disease
(CHD). Heart failure was the second most predominant CVD subtype in Türkiye is correct sample (5.4%), followed by cardiac arrhythmia and conduction abnormalities (4.7%). Sodium-glucose co-transporter 2 inhibitors and
glucagon-like peptide-1 receptor agonists with cardiovascular (CV) benefits
were prescribed to 17.5% and 0.1% of the patients, respectively. Conclusion: Approximately 30% of participants with T2DM had established CVD in
the CAPTURE Türkiye population, comparable to the global pooled prevalence. CHD was the major contributor and encompassed approximately 75%
of the CVD cases. The use of glucose-lowering medication with CV benefits
was low compared to the global pooled population, which may be due to the
lack of reimbursement of these medications in Türkiye.
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Subacute thyroiditis (SAT) has been recently associated
with severe acute respiratory syndrome-coronavirus-2 infection or vaccines against it. We report a case of a 41-yearold male patient who developed persistent SAT after the
coronavirus disease-2019 (COVID-19) vaccination. He presented with sore throat and neck pain after the first dose of
the COVID-19 vaccine (CoronaVac®). There was no history
of a recent viral infection. Erythrocyte sedimentation rate
(ESR) and C-reactive protein (CRP) were elevated, thyroidstimulating hormone (TSH) and free thyroxine (fT4) were
normal, COVID-19 polymerase chain reaction test was negative, and sonography showed thyroiditis in the right lobe.
The symptoms resolved after treatment with methylprednisolone. However, 2 weeks after the second dose of the vaccine, the patient suffered from neck pain and hoarseness.
TSH and fT4 were normal, but anti-thyroid peroxidase (antiTPO), anti-thyroglobulin (anti-Tg), ESR, and CRP were elevated. Sonography revealed thyroiditis in the left lobe. The
patient was treated with ibuprofen. On follow-up, hypothyroidism was diagnosed, and levothyroxine started. Hence,
the clinicians should suspect the possibility of SAT in the
vaccinated subjects.
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Lymphomas are the rare causes in the differential diagnosis
of pituitary masses. While pituitary infiltration by lymphomas is relatively more frequent, isolated lymphoma associated with the pituitary gland is much rarer. We presented
a case of a 64-year-old female patient who was admitted to
the hospital due to headache, diplopia and decreased visual
acuity. Although the stated preoperative diagnosis was parasellar meningioma, the pathological diagnosis was given
as isolated primary pituitary lymphoma after ruling out any
other foci. After the definitive diagnosis, the patient underwent chemoradiotherapy. However, despite treatment, the
patient died due to pulmonary sepsis. Primary pituitary
lymphoma is an extremely rare condition generally seen in
elderly and/or immunosuppressive patients. In order to establish an effective therapeutic strategy, it is extremely crucial to distinguish between primary and secondary
lymphomas. However, the recent evidence for a standardized treatment protocol is still limited due to the small number of cases reported to date.
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46XX testicular disorder of sex development (DSD) is a rare condition characterized by sexual differentiation disorder with testicular insufficiency. Normal sex development often complicates the diagnosis of this ailment in adults. Patients are usually diagnosed incidentally during infertility research. In this article, we aimed to highlight the hormonal, molecular, and cytogenetic results of an adult male patient diagnosed with 46XX testicular DSD suffering from hypergonadotropic hypogonadism.
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Mehtap EVRAN, Murat SERT, Gamze AKKUŞ, Ömer Sunkar BİÇER, Erol KESİKTAŞ, Behice KURTARA, Erol AKSUNGU, Tamer TETİKER
Mehtap EVRAN, Murat SERT, Gamze AKKUŞ, Ömer Sunkar BİÇER, Erol KESİKTAŞ, Behice KURTARA,
... Devamını oku
Objective: To identify the clinical predictors of amputation outcomes in patients with diabetic foot ulcers (DFUs) and the management of such pa- tients. Material and Methods: Four hundred (273 men; 127 women) pa- tients with DFUs, who were followed at our clinic between 2008-2014, were included. Patients' demographic characteristics, glycemic parameters, and diabetic complications were evaluated. The amputations were classified as minor (distal to metatarsus) and major (Chopart, and below or upper knee) amputations. Results: The mean age of the patients was 62.4±10.5 years. Three hundred and ninety-five patients had type 2 diabetes mellitus. The mean diabetes duration was 17±8 years. The rate of chronic diabetic com- plications consisting of neuropathy, nephropathy, and retinopathy were 97.5%, 81.3%, and 94.8%, respectively. Osteomyelitis and peripheral ar- terial disease rates were 327 (81.8%) and 265 (66%), respectively. The majority of the foot ulcers were of Wagner grade 3 (53.2%) and 4 (27.5%). According to the initial clinical considerations, 60% of the patients were administered empirical antibiotic therapy for infection. The minor and major amputation rates were 110 (25.5%) and 146 (36.3%), respectively. The average glycosylated hemoglobin value was 8.9±2.3%. Peripheral ar- terial disease [odds ratio (OR): 2.183, 95% confidence interval (CI): 1.242-3.837, p<0.001), osteomyelitis [OR: 5.062, 95% CI: 2.296-11.161, p<0.001) and Wagner grade (OR: 62.352, %95 CI: 7854-495.021, p<0.001) were found to increase the amputation risk. Conclusion: Dia- betic neuropathy is still an underlying major risk factor for the develop- ment of DFUs. The presence of peripheral arterial disease, osteomyelitis, and high Wagner degree are negative prognostic factors for the need for amputation.
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A. Serap YALI, Mehmet YAŞAR, Meliha Melin UYGUR, Sait KARAKURT, Dilek GOGAS YAVUZ
A. Serap YALI, Mehmet YAŞAR, Meliha Melin UYGUR, Sait KARAKURT, Dilek GOGAS YAVUZ
Objective: We aimed to evaluate the pulmonary function tests (PFTs) and serum carboxymethyl-lysine (CML) level and their asso- ciation with the disease activity in patients with acromegaly. Mate- rial and Methods: This cross-sectional study included 65 acromegalic patients (F/M:28/37) and 52 controls ( F/M:23/29). PFTs such as spirometry and diffusing capacity of the lungs for carbon mo- noxide (DLCO) were performed to determine the lungs’ ability to exc- hange gases. Serum CML levels were measured with the enzyme-linked immunosorbent assay. Basal and nadir growth hor- mone (GH), hemoglobin A1c (HbA1c), and insulin-like growth factor- 1 (IGF-1) were also assessed. Results: Serum CML levels were significantly higher in acromegalic patients (208.1±80 ng/mL) than in controls (174.2±11 ng/mL), (p=0.02). The evaluated PFTs were expressed as predicted values [forced expiratory volume in the 1st second % (p=0.01), forced vital capacity % (p=0.007), functional residual capacity % (p=0.03), residual volume % (p=0.03), vital ca- pacity % (p=0.007), total lung capacity % (p=0.01), and DLCO% (p=0.02)] that were found to be elevated in acromegalic patients than in controls. CML levels positively correlated with HbA1c (r=0.53, p=0.02) but did not correlate with basal GH levels (r=0.35, p=0.06). GH and IGF-1 levels positively correlated with lung volume in acro- megalic patients. Conclusion: Serum CML levels increased in acro- megaly patients but had no association with the PFTs results. Increased lung volume was the most prominent lung function altera- tion in acromegalic patients; relevantly, we found elevated GH and IGF-1 levels to be associated with the increased lung volumes. Future studies need to evaluate the association between the advanced glycation end-products and complications of acromega
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