Browsing by Author "Yavuz, Dilek Gogas"

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Assesment Of Attainment Of Recommended TSH Levels And Levothyroxine Compliance In Differentiated Thyroid Cancer Patients
(2022) Yavuz, Dilek Gogas; Yazan, Ceyda D.; Hekimsoy, Zeliha; Aydin, Kadriye; Gokkaya, Naile; Ersoy, Canan; Akalin, Aysen; Topaloglu, Omercan; Aydogan, Berna I.; Dilekci, Esra N. A.; Alphan Uc, Ziynet; Cansu, Guven B.; Ozsari, Levent; Iyidir, Ozlem T.; Olgun, Mehtap E.; Keskin, Lezzan; Mert, Meral; Can, Bulent; Gungor, Kaan; Galip, Tayfun; Canturk, Zeynep; Elbuken, Gulsah; Pekkolay, Zafer; Kutbay, Nilufer O.; Yorulmaz, Goknur; Kalkan, Ahmet T.; Unsal, Yasemin A.; Yay, Adnan; Karagun, Baris; Bozkur, Evin; 35639050
Objective Thyroid-stimulating hormone (TSH) suppression treatment can induce signs and symptoms of hyperthyroidism and hypothyroidism due to inappropriate treatment or poor compliance to the treatment. The current study aimed to investigate TSH levels, frequency of being on target TSH, adherence to levothyroxine (LT4) suppression treatment in differentiated thyroid cancer (DTC) patients after surgery in a multicentric setting. Design and Patients This multicentric cross-sectional study was conducted at 21 medical centres from 12 cities in Turkey. DTC patients followed at least one year in the same center included in the study. Clinical data, serum TSH, free thyroxine (FT4), thyroglobulin (Tg) and anti-Tg levels were recorded during the most recent visit. Body mass index, systolic and diastolic blood pressures, pulse rate were measured. LT4 doses were recorded and doses per kilogram of bodyweight were calculated. Pill ingestion habits recorded and adherence to the therapy were evaluated using the Morisky Medication Adherence Scale and categorized as good, moderate or poor compliant based on their scores. Risk stratification forpredicting the disease persistance and/or reccurence was assessed using the American Joint Committee on Cancer-7th edition thyroid cancer staging calculator. TSH serum concentrations were classified as severe suppression (TSH < 0.01 mU/L), moderate suppression (TSH: 0.01-0.1 mU/L), mild suppression (TSHL 0.1-0.5 mU/L), euthyroid (TSH: 0.5-4 mU/L) and hypothyroid (TSH > 4 mU/L). TSH levels can also be classified as on being on target, under the target, or beyond over the target, according to the American Thyroid Association recommendations. Results A group of 1125 patients (F/M: 941/184, 50.7 +/- 11.7 years) were included in the study. The mean LT4 daily dosage was 132.4 +/- 39.6 mcg/day. TSH levels showed severe suppression in 99 (%8.8) patients, moderate suppression in 277 (%24.6) patients and mild suppression in 315 (%28) patients and euthyroid range in 332 (%29.5) patients and hypothyroid range in 97 (8.6%). TSH levels were in target in 29.2% of the patients 20.4% of the patients were undertreated, 50.4% overtreated. The daily LT4 dose and LT4 dose/kg were significantly higher in the severe suppression group (p < .001, p < .001). According to the Morisky scale, 564 patients (50.1%) were good compliant, 368 patients (32.7%) were moderate compliant, and 193 patients (17.1%) were noncompliant. Patients with poor compliance need a higher dose of LT4 compared to the good compliance group (p < .001). TSH levels of patients with good compliance were 0.67 +/- 1.96 mU/L and TSH with poor compliance was 2.74 +/- 7.47 mU/L (p < .001). TSH levels were similar in patients on fixed and alternating dosages. Conclusion In 29.2% of the DTC patients, serum TSH levels were at target levels. Remaining of the study group have TSH levels under or over treatment range, exposing the patient to medication side effects. Majorty of the study group 82.8% have good or moderate adherence to LT4 therapy. Reaching TSH targets requires simplified and applicable guidelines and following the guideline recommendations.
A Bibliometric Analysis of Turkey's Contribution to Bone Health Literature from an Endocrinologist Perspective
(2019) Degertekin, Ceyla Konca; İyidir, Ozlem Turhan; Yavuz, Dilek Gogas; 0000-0001-5305-6807; K-7904-2019
Objective: To analyze the trend of Turkish publications related to bone health with respect to global publications and to determine the relative contribution of endocrinologists to metabolic bone disease literature. Material and Methods: Publications related to bone health up to and including the year 2017 were retrieved from the "Web of Science" (WoS) and "TUrkiye Atif Dizini" (TAD) database using metabolic bone disease related MeSH terms. Excel (v15.30) and Endnote X8 were used to summarize the bibliometric features, including the number of publications, authors, their affiliations, and contributing countries. Keywords were divided, for a detailed analysis, into three clusters: osteoporosis, parathyroid, and vitamin D-related. Results: A total of 1.880.666 papers were retrieved from WoS globally and, of those, 21.165 (1.13%) were published from Turkey. Of the papers published from Turkey, 3.0% were primarily contributed by endocrinologists. The relative contribution of endocrinology to osteoporosis-related (4.6% vs. 1.5%), parathyroid-related (23.7% vs. 5.3%), and vitamin D-related (23.7% vs. 5.3%) publications was higher for articles originating from Turkey compared to the global data. Endocrinology was among the top five specialties contributing to Turkish metabolic bone disease literature indexed in WoS and TAD. Conclusion: Turkey has a less than expected rate of research output in terms of metabolic bone disease. The relatively higher contribution of endocrinology to that effort is promising. Supporting bone research might accelerate the efforts of Turkish researchers in the field of metabolic bone health.
Identifying Clinical Characteristics of Hypoparathyroidism in Turkey: HIPOPARATURK-NET Study
(2021) Degertekin, Ceyla Konca; Yavuz, Dilek Gogas; Pekkolay, Zafer; Saygili, Emre; Ugur, Kader; Koca, Arzu Or; Unubol, Mustafa; Topaloglu, Omercan; Aydogan, Berna Imge; Kutbay, Nilufer Ozdemir; Hekimsoy, Zeliha; Yilmaz, Nusret; Balci, Mustafa Kemal; Tanrikulu, Seher; Unsal, Yasemin Aydogan; Ersoy, Canan; Omma, Tulay; Keskin, Muge; Yalcin, Mehmet Muhittin; Yetkin, Ilhan; Soylu, Hikmet; Karakose, Melia; Yilmaz, Merve; Karakilic, Ersen; Piskinpasa, Hamide; Batman, Adnan; Akbaba, Gulhan; Elbuken, Gulsah; Bahadir, Cigdem Tura; Kilinc, Faruk; Bilginer, Muhammet Cuneyt; Iyidir, Ozlem Turhan; Canturk, Zeynep; Yilmaz, Banu Aktas; Sayiner, Zeynel Abidin; Eroglu, Mustafa; 34495356
Hypoparathyroidism is an orphan disease with ill-defined epidemiology that is subject to geographic variability. We conducted this study to assess the demographics, etiologic distribution, treatment patterns and complication frequency of patients with chronic hypoparathyroidism in Turkey. This is a retrospective, cross-sectional database study, with collaboration of 30 endocrinology centers located in 20 cities across seven geographical regions of Turkey. A total of 830 adults (mean age 49.6 +/- 13.5 years; female 81.2%) with hypoparathyroidism (mean duration 9.7 +/- 9.0 years) were included in the final analysis. Hypoparathyroidism was predominantly surgery-induced (n = 686, 82.6%). The insulting surgeries was carried out mostly due to benign causes in postsurgical group (SG) (n = 504, 73.5%) while patients in nonsurgical group (NSG) was most frequently classified as idiopathic (n = 103, 71.5%). The treatment was highly dependent on calcium salts (n = 771, 92.9%), calcitriol (n = 786, 94.7%) and to a lower extent cholecalciferol use (n = 635, 76.5%) while the rate of parathyroid hormone (n = 2, 0.2%) use was low. Serum calcium levels were most frequently kept in the normal range (sCa 8.5-10.5 mg/dL, n = 383, 46.1%) which might be higher than desired for this patient group. NSG had a lower mean plasma PTH concentration (6.42 +/- 5.53 vs. 9.09 +/- 7.08 ng/l, p < 0.0001), higher daily intake of elementary calcium (2038 +/- 1214 vs. 1846 +/- 1355 mg/day, p = 0.0193) and calcitriol (0.78 +/- 0.39 vs. 0.69 +/- 0.38 mcg/day, p = 0.0057), a higher rate of chronic renal disease (9.7% vs. 3.6%, p = 0.0017), epilepsy (6.3% vs. 1.6%, p = 0.0009), intracranial calcifications (11.8% vs. 7.3%, p < 0.0001) and cataracts (22.2% vs. 13.7%, p = 0.0096) compared to SG. In conclusion, postsurgical hypoparathyroidism is the dominant etiology of hypoparathyroidism in Turkey while the nonsurgical patients have a higher disease burden with greater need for medications and increased risk of complications than the postsurgical patients.