Browsing by Author "Mousa, U."

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ABDOMINAL BIOELECTRIC IMPEDANCE FOR FOLLOW-UP OF DIETERS: A PROSPECTIVE STUDY
(2019) Bozkus, Y.; Mousa, U.; Demir, C. C.; Anil, C.; Kut, A.; Iyidir, O. Turhan; Kirnap, N. Gulsoy; Firat, S.; Nar, A.; Tutuncu, N. B.; 0000-0002-1816-3903; 31508169; ABG-5027-2020; K-7904-2019
Context. Visceral adipose tissue (VAT) is a strong predictor of carbohydrate metabolism disorders. Abdominal bioelectrical impedance analysis (A-BIA) is a simple method for the measurement of VAT and is a promising tool in screening and follow-up of abdominal obesity. However the role of A-BIA in dieting individuals has not been evaluated adequately in longitudinal follow-up studies. Objective. The aim of this study is to determine the role of A-BIA in identifying the changes in metabolic predictors after diet and/or exercise therapy. Design. All patients who sought weight loss treatment underwent baseline assessment and were prescribed a program of diet. After a mean follow-up of 3.2 months, data were analyzed. Subjects and Methods. Ultimately, 103 participants who reported adhering to the diet, enrolled to the study. We tested associations between changes in body composition measures and changes in laboratory measures using correlations and multivariate linear regression analysis. Results. Mean loss of body weight was 3.4 +/- 2.8 kg. All but waist-to-hip ratio, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels changed significantly (p<0.001). Decreases in body weight, body mass index (BMI), and VAT level significantly correlated with decreases in fasting blood glucose, fasting insulin level, and HOMA-IR score (r=0.230-0.371). In multiple linear regression analysis changes in BMI and VAT significantly correlated with change in HOMA-IR score (F(7.93)=2.283, p=0.034, R2=0.147). Conclusion. Decreases in BMI and VAT, as determined by A-BIA, were predictors of changes in metabolic laboratory measures. A-BIA is useful for follow-up of patients receiving diet therapy for weight loss.
Knowledge, Attitudes and Behaviors of Physicians Towards Thyroid Disorders and Iodine Requirements in Pregnancy
(2015) Kut, A.; Kalli, H.; Anil, C.; Mousa, U.; Gursoy, A.; 0000-0003-0776-8349; 0000-0002-8078-9376; 0000-0003-3802-9733; 25833359; A-2550-2015; I-1735-2018
Purpose Thyroid disorders including iodine deficiency during pregnancy are important health problems worldwide. However, considering real life, assessment of knowledge, attitudes, and practice of physicians is lacking. We aim to evaluate knowledge, attitudes and behaviors of physicians towards thyroid disorders and requirements of iodine during pregnancy on a nationwide basis. Methods Clinicians from different medical disciplines most likely to encounter pregnant women in daily practice (i.e., obstetricians, endocrinologists, and family physicians) were included. Family physicians were selected from primary care centers; endocrinologists and gynecologists were selected from state hospitals. Randomly selected 322 physicians from seven geographical regions of Turkey were included. Subjects filled a questionnaire which consisted of three sections about knowledge, attitudes and behaviors towards thyroid disorders and iodine requirements during pregnancy. Results Physicians had insufficient and/ or erroneous knowledge about thyroid disorders during pregnancy. 73.1 % of endocrinologists, 32.7 % of family physicians, and 17.8 % of obstetricians knew the correct level of TSH during pregnancy (p < 0.001). 67.1 % of physicians thought it is unnecessary to offer iodine supplementation to pregnant women. Endocrinologists achieved the highest scores in each section, and also had the highest total scores (p < 0.001). Family physicians achieved higher scores than obstetricians. Conclusions Physicians who encounter pregnant women in Turkey do not have sufficient information about management of thyroid disorders and providing iodine support during pregnancy and lactation.
Male sex and tumor diameter are independent risk factors for relapse or persistent disease in differentiated thyroid cancer
(2018) Yikilmaz, A.S.; Mousa, U.; Nar, A.
Background. Differentiated thyroid cancer (DTC) is one of the most frequently observed neoplasms today. Recurrence of DTC has been previously reported to be dependent on tumor characteristics, the tumor size, the presence of lymph node metastasis, the presence of extra thyroid invasion, the presence of distant metas‑ tasis, oncogenes such as B‑RAF proto‑oncogene, ad‑ vanced age and male sex. However, many studies have failed to associate many of these data with relapse. The objective of the study was to evaluate the re‑ lationship between some histopathological and mor‑ phological findings with thyroid cancer relapse or per‑ sistent disease in a cohort of 393 DTC patients. Methods. We retrospectively analyzed 393 subjects with DTC, diagnosed in our institution between January 2000 and December 2010. Results. Histopathological analysis indicated papil‑ lary carcinoma in 362 (92.1%) subjects and follicular carcinoma in 31 (7.9%) subjects. Eighty‑two (20.9%) of the subjects relapsed or had persistent disease. Male subjects had a higher trend for relapse (RR 1.739 %95 CI: 1.059‑2.856) p=0.029). 18.8% of female sub‑ jects relapsed or had persistent disease, whereas the relapse rate was 30.4% in male subjects. Every 1 cm increase in tumor size increased the risk of relapse by 25% (RR=1.25, 95% CI: 1.11‑1.41, p<0.001). Male sex, nodule diameter, and tumor diameter were detected to be independent parameters for relapse or persistent disease (p=0.002; p<0.0001, p<0.001 respectively). Conclusion. We demonstrated that tumor diameter and male sex were the only parameters affecting re‑ lapse or persistent disease in our cohort. A possible reason for different reports from different studies may be non‑standardization of study protocols and surgical cure rates. Copyright © 2018 Balkan Medical Union.
Stimulated Thyroglobulin Values Above 5.6 Ng/Ml Before Radioactive Iodine Ablation Treatment Following Levothyroxine Withdrawal Is Associated with A 2.38-Fold Risk of Relapse in Tg-Ab Negative Subjects with Differentiated Thyroid Cancer
(2017) Mousa, U.; Yikilmaz, A. S.; Nar, A.; 0000-0001-5281-5955; 0000-0001-5281-5955; 0000-0002-8078-9376; 0000-0003-0998-8388; 28258491; AAT-4853-2020; ABE-9958-2021; I-1735-2018; AAA-2743-2021
Serum thyroglobulin (Tg) is the key parameter used in the follow-up of subjects with differentiated thyroid cancer (DTC). Current guidelines advise its measurement to take place when Thyrotropin (TSH) levels are > 30 A mu U/ml (stimulated Tg) and when TSH < 0.1 A mu U/ml (suppressed Tg). Although stimulated Tg levels < 1 ng/ml have been shown to display excellent prognosis, relapses may occur despite low Tg levels. Recently, very low cut-off levels of stimulated Tg have been proposed for determining the recurrence risk in these subjects. In this study, we aimed to assess the association between ablative stimulated Tg obtained before radioactive iodine ablation therapy (RAI) (ASTg) and late stimulated Tg obtained 6-12 months after primary therapy (LSTg) in a group of subjects with DTC. We also aimed to establish a cut-off level of Tg for recurrence. We retrospectively analyzed 393 subjects with low or intermediate risk DTC diagnosed at our institution between January 2000 and December 2010 with a mean follow-up period of 64.4 months (range 14-192 months). All stimulated Tg levels were performed following levothyroxine withdrawal in this study. Histopathological analysis indicated papillary carcinoma in 362 (92.1%) subjects and follicular carcinoma in 31 (7.9%) subjects. Three hundred and twenty-four (82.4%) of our cases were females, and 69 (17.6%) were males. Recurrence occurred in 82 (20.9%) of the subjects. Relapse was significantly more frequently observed in subjects with ASTg ae 2 ng/ml; and LSTg ae 2 ng/ml. (p = 0.004 and p < 0.001, respectively). In subjects negative for thyroglobulin antibodies (Tg-ab), an ASTg value ae5.6 ng/ml was established to increase the risk of recurrence by 2.38-fold (p = 0.002), whereas an LSTg ae 0.285 ng/ml increased the risk of relapse by 3.087-fold (p < 0.001). As a result of this study, we determined that the optimum cut-off level for both ASTg and LSTg may be lower than those previously reported. Using such a lower cut-off may improve sensitivity for detecting relapse.