Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Relationship Between Thyroid Volume and Malignant Thyroid Disease(2014) Duran, Ayse Ocak; Anil, Cuneyd; Gursoy, Alptekin; Nar, Asli; Altundag, Ozden; Inanc, Mevlude; Bozkurt, Oktay; Tutuncu, Neslihan Bascil; https://orcid.org/0000-0003-3802-9733; https://orcid.org/0000-0003-0998-8388; https://orcid.org/0000-0003-0197-6622; https://orcid.org/0000-0002-1816-3903; 24338169; AAA-2743-2021; W-9219-2019; ABG-5027-2020The present retrospective study aimed to investigate the relationship between thyroid volume and prevalence of thyroid cancer. We investigated the data of 3,850 patients who underwent fine-needle aspiration biopsy (FNAB). Biopsy results were evaluated as diagnostic or nondiagnostic, and diagnostic results were classified as benign, malignant, and indeterminate. We included 2,672 patients who underwent FNAB firstly in our hospital and evaluated as diagnostic biopsy except subgroup of indeterminate. We obtained cytologic data, levels of serum thyroid-stimulating hormone (TSH), and thyroid volumes of those patients retrospectively. Among 2,672 patients with thyroid nodule, 2,562 (95.9 %) patients had benign cytology and 110 (%4,1) patients had malignant cytology. There was no correlation between the malignancy and gender (p = 0.935), and patients with malignant cytology were younger (52 vs 59, p < 0.001). Also, TSH levels were higher in patients with malignant than benign cytology (p = 0.017). Median volume of right part, left part, and total thyroid for patients who had malignant cytology was significantly lower than patients who had benign cytology (8.3, 7.1, 15.9 vs 10.8 ml, 9.0 mml, 20.6 ml, respectively, p <= 0.001 for all parameters). The results demonstrated that thyroid cancer prevalence was higher in patients with low thyroid volume. According to our results, thyroid volume should be considered as a risk factor for malignancy in the evaluation of thyroid nodules.Item Association of Body Mass Index with Depression and Alexithymia(2014) Karagol, Arda; Ozcurumez, Gamze; Taskintuna, Nilgun; Nar, Asli; https://orcid.org/0000-0002-3548-5517; https://orcid.org/0000-0003-0998-8388; ABE-8882-2020; AAK-3556-2021; AAA-2743-2021Objective: Association between body mass index (BMI) and mental disorders had long been investigated. Recent researches declare a relation between obesity and depressed mood as well as clinical depression. On the other hand mental disorders such as alexithymia are also found to be correlated with an increased risk of obesity. Therefore we aimed to evaluate depression and alexithymia together among normal, overweight and obese adults in order to assess what kind of an association is there between BMI, depression and alexithymia. Methods: We enrolled 100 adults, aged between 18 to 67 from department of endocrinology outpatient clinic whom had normal levels of TSH, fT3 and fT4 thyroid hormones and formed three groups according to their Body Mass Index (BMI). Individuals who had had BMI between 18.5 and 24.99 formed the normal, BMI between 25 and 29.99 formed the overweight and BMI 30 and above formed the obese groups. All three groups were evaluated by Composite International Diagnostic Interview for clinical diagnosis and also given Toronto Alexithymia Scale-26 item (TAS-26) as well as Beck Depression Inventory (BDI). Results: There was a positive relation between BMI and current depressive episode and this finding was stronger in women. There was no such relation with lifelong depression. TAS-26 total and subscale scores revealed no difference between three groups. As BDI total scores got higher TAS-26 scores were higher. Hence there was a strong positive relation between depression and alexithymia. Conclusion: Our findings indicate that higher BMI increases current depressive episode. No association is found between BMI and lifelong depression. Depression and depression severity are strongly associated with alexithymia. Contradictive with literature, alexithymia and its severity are not found to be related with BMI. Following overweight and obese individuals is important to offset the adverse outcomes of depression.Item Menstrual Changes After COVID-19 Infection and COVID-19 Vaccination(2022) Taskaldiran, Isilay; Vuraloglu, Emre; Bozkus, Yusuf; Iyidir, Ozlem Turhan; Nar, Asli; Tutuncu, Neslihan Bascil; https://orcid.org/0000-0001-5305-6807; https://orcid.org/0000-0002-1816-3903; 36349056; K-7904-2019; ABG-5027-2020Background. Several factors such as stress, depression, infection, and vaccination influenced the menstrual cycle in women during the coronavirus disease 2019 (COVID-19) pandemic. We investigated whether there were changes in the menstrual cycle in women after COVID-19 vaccination or infection and, if so, the nature of the change. Methods. This study was designed as a descriptive, cross-sectional study. A face-to-face survey was conducted among menstruating women aged 18-50 years from May 31 to July 31, 2022. Women were inquired about their first three menstrual cycles that occurred after COVID-19 infection or vaccination. Results. Of 241 women with COVID-19 infection, 86 (35.7%) mentioned that they experienced various changes in their menstrual patterns in the first three cycles after infection. Of 537 participants who received various COVID-19 vaccines, 82 (15.1%) stated that they experienced changes in their menstrual patterns after vaccination. The incidence of postvaccination menstrual change was higher in women who received Pfizer-BioNTech and Sinovac (CoronaVac) vaccines. Only 10.9% of women who reported a change in their menstrual pattern after vaccination or infection consulted a physician. Conclusion. COVID-19 infection and vaccination can affect the menstrual cycle in women. It is important to be aware of the menstrual changes after COVID-19 infection and vaccination and to warn and inform women about this issue.Item Acoustic Radiation Force Impulse Elastography and Ultrasonographic Findings of Achilles Tendon in Patients With and Without Diabetic Peripheral Neuropathy: A Cross-Sectional Study(2021) Iyidir, Ozlem Turhan; Rahatli, Feride Kural; Bozkus, Yusuf; Ramazanova, Lala; Turnaoglu, Hale; Nar, Asli; Tutuncu, Neslihan Bascil; 0000-0001-5305-6807; 0000-0002-6976-6659; 0000-0003-0998-8388; 0000-0002-1816-3903; 30786314; K-7904-2019; AAA-5419-2021; AAA-2743-2021; ABG-5027-2020Aims We aimed to evaluate the elastographic features of Achilles tendon with Acoustic Radiation Force Impulse in patients with and without diabetic neuropathy. Methods According to the presence of peripheral neuropathy, 45 patients with type 2 diabetes were divided into 2 subgroups. Those with peripheral neuropathy were defined as group I (22 patients) and those without peripheral neuropathy were defined as group II (23 patients). A total of thirty age-, gender-, and body mass index-matched healthy individuals were selected as controls. All participants underwent both ultrasonographic and Acoustic Radiation Force Impulse elastographic examination in order to evaluate Achilles Tendon thickness and stiffness. Results Achilles tendon thicknesses were similar between groups (p = 0.991). Achilles tendon thicknesses of both patient groups were significantly higher than the control group (group I vs control p = 0.01; group II vs control p = 0.006). Stiffness values of Achilles tendons were similar between the control group and group II (p = 0.993). Shear Wave Velocity was significantly lower in group I than group II and control group (p < 0.001). Conclusion Diabetic patients with neuropathy have thicker and softer Achilles tendon while the elasticity of Achilles tendon in diabetic patients without neuropathy is similar to the healthy controls. Softening of the Achilles tendon may be an early sign of diabetic foot and reveal the patients with a risk of diabetic foot.Item Short-Term Effect of Hypergastrinemia Following Esomeprazole Treatment On Well-Controlled Type 2 Diabetes Mellitus: A Prospective Study(2020) Bozkus, Yusuf; Mousa, Umut; Iyidir, Ozlem T.; Kirnap, Nazli; Demir, Canan C.; Nar, Asli; Tutuncu, Neslihan B.; 0000-0002-1816-3903; 0000-0002-6976-6659; 0000-0002-8078-9376; 0000-0001-5305-6807; 0000-0003-0998-8388; 31995024; ABG-5027-2020; AAA-5419-2021; AAK-4857-2021; I-1735-2018; K-7904-2019; AAA-2743-2021Objective: Proton pump inhibitor (PPI) drugs reduce gastric acid secretion and lead to an increase in serum gastrin levels. Many preclinical and some clinical researches have established some positive effects of gastrin or PPI therapy on glucose regulation. The aim of this study was to prospectively investigate the short term effects of esomeprazole on glycaemic control in patients with type 2 diabetes mellitus. In addition, the presence of an association between this effect and gastrin levels was evaluated. Methods: Thirty-two subjects with type 2 diabetes mellitus were enrolled and grouped as intervention (n=16) and control (n=16). The participants in the intervention group were prescribed 40 mg of esomeprazole treatment for three months. At the beginning of the study and at the 3rd month, HbA1c level (%) and gastrin levels (pmol/L) of participants were assessed. Then, the groups were compared in terms of their baseline and 3rd month values. Results: In the intervention group, the mean gastrin level increased significantly from 34.3 +/- 14.4 pmol/L to 87.4 +/- 43.6 pmol/L (p<0.001). The mean HbA1c level was similar to the pre-treatment level (6.3 +/- 0.7% vs. 6.4 +/- 0.9%, p=0.441). There were no statistically significant differences in all parameters of the control group. The majority of individuals were on metformin monotherapy (65.6 %). The subgroup analysis of metformin monotherapy revealed that, in intervention group, there was a significant increase in gastrin levels (39.9 +/- 12.6 vs. 95.5 +/- 52.5, p=0.026), but the HbA1c levels did not change (6.0 +/- 0.4 % vs. 5.9 +/- 0.6 %, p=0.288); and in control group, gastrin levels did not change (37.5 +/- 26.7 vs. 36.1 +/- 23.3, p=0.367), but there was an increase in HbA1c levels (6.1 +/- 0.50 vs. 6.4 +/- 0.60, p=0.01). Conclusion: Our study demonstrates that esomeprazole has no extra benefit for the controlled diabetic patient in three months. However, in only the metformin-treated subgroup, esomeprazole may prevent the rise in HbA1c level.Item The effect of iatrogenic subclinical hyperthyroidism on anxiety, depression and quality of life in differentiated thyroid carcinoma(2020) Gulsoy Kirnap, Nazli; Turhan Iyidir, Ozlem; Bozkus, Yusuf; Isildak, Serife Mehlika; Anil, Cuneyd; Firat, Sevde Nur; Demir, Canan; Nar, Asli; Bascil, Tutuncu Neslihan; 0000-0003-0998-8388; 0000-0001-5305-6807; 0000-0003-3802-9733; 0000-0002-1816-3903; 32490648; K-7904-2019Background/aim: Overt thyroidism is known to cause neuropsychiatric disorders but studies on subclinical hyperthyroidism (SCH) are limited. Subclinical hyperthyroidism induction by administering L-Thyroxine (LT4) is the standard treatment method in differentiated thyroid carcinoma (DTC) follow-up. Our aim was to investigate whether anxiety, depression and quality of life are affected in DTC patients followed-up with exogenous SCH. Materials and methods: The patients were divided into exogenous SCH by LT4-DTC (n = 127), euthyroid-DTC (n = 66) and exogenous euthyroid-benign thyroid nodutile (BTN) who underwent thyroidectomy for benign thyroid pathology (n = 85) groups. Results: The rate of moderate/severe anxiety was significantly higher in SCH-DTC than euthyroid-BTN group (27.5%, n = 35 vs. 9.4%, n = 8) (P = 0.001). TSH levels and Beck anxiety inventory (BAI) scores were significantly negatively correlated(P = 0.009 r = -0.16). Free T4 and BAI were significantly positively correlated (P = 0.04 r = 0.4). The groups were similar in terms of depression severity (P = 0.15). Subclinical hyperthyroid-DTC group scored significantly lowerthan euthyroid-BTN group in all scales of SF-36 quality of life survey. Conclusion: LT4-induced SCH, which is a part of traditional DTC treatment, can exacerbate the anxiety symptoms in patients and disrupt their quality of life, depending on the level of fT4.Item Thyroid volume in patients with glucose metabolism disorders(2014) Duran, Ayse Ocak; Anil, Cuneyd; Gursoy, Alptekin; Nar, Asli; Inanc, Mevlude; Bozkurt, Oktay; Tutuncu, Neslihan Bascil; 25465604Objective: Thyroid volume and the prevalence of thyroid nodules are higher in patients with insulin resistance. A relationship between thyroid volume and glucose metabolism disorders (GMD) has not as yet been clarified. The present retrospective study aimed to investigate the association between GMD and thyroid volume. Subjects and methods: We investigated the data of 2,630 patients who were evaluated for thyroid biopsy in our hospital. The study population included 602 patients with GMD, 554 patients with diabetes mellitus (DM) and 1,474 patients with normal glucose metabolism as a control group. We obtained the levels of serum thyroid stimulating hormone (TSH) and the thyroid volumes of those patients retrospectively. Results: The median ages for the control group, GMD group and DM group were 55 (15-91) years, 60 (27-97) years, and 65 (27-91) years respectively and there was a statistically significant difference between the groups with regard to age and gender (p < 0.001). Levels of TSH were similar in all groups. The median total thyroid volumes for patients with DM and GMD were significantly higher than that of the control group [22.5 (3-202) mL, 20.2 (4-190) mL, and 19.2 (3-168) mL respectively, p <= 0.001 for all parameters]. Also the median total thyroid volume for patients with DM was significantly higher than that of the GMD group (p < 0.001). According to the correlation analysis, thyroid volume was significantly correlated with age (r = 0.92, p < 0.001) and TSH (r = 0.435, p < 0.001). Age, gender, TSH levels, GMD and DM diagnosis were independently correlated with thyroid volume. Conclusion: The thyroid gland is one of the target tissues of metabolic disorders. We reported a positive correlation between GMD/type 2 DM and thyroid volume. Further controlled, prospective, randomized studies on this subject are required to gain more information.Item Metformin Decreases Thyroid Volume and Nodule Size in Subjects with Insulin Resistance: A Preliminary Study(2016) Anil, Cuneyd; Kut, Altug; Atesagaoglu, Berna; Nar, Asli; Tutuncu, Neslihan Bascil; Gursoy, Alptekin; 26618447Objective: The aim of this study was to investigate the effects of metformin on thyroid volume and nodule size. Subjects and Methods: Prospective data were gathered on 100 newly diagnosed subjects with insulin resistance (68 female, 32 male) between August 2008 and May 2010. Each subject followed a standard diet and exercise program, and received 1,700 mg/day of metformin therapy for 6 months. The height, weight, waist circumference (WC) and thyroid hormone levels of each subject were measured. Additionally, the dimensions of the thyroid lobes and maximum diameter of each thyroid nodule were determined by ultrasonography. BMI and thyroid volumes were also calculated. Insulin resistance was estimated by homeostasis model assessment. All these parameters were measured at the beginning and at the end of the treatment period. Results: BMI and WC decreased significantly after metformin therapy (34.5 +/- 5.1 vs. 32.7 +/- 4.8, p < 0.0001, and 106.3 +/- 11.8 vs. 101.8 +/- 19.0 cm, p = 0.008, respectively). Insulin resistance also decreased after metformin therapy (4.5 +/- 1.9 vs. 2.9 +/- 1.7, p < 0.0001). The mean thyroid volume (22.5 +/- 11.2 vs. 20.3 +/- 10.4 ml, p < 0.0001) and mean thyroid nodule size (12.9 +/- 7.6 vs. 11.7 +/- 7.2 mm, p < 0.0001) also decreased after treatment. Conclusion: In subjects with insulin resistance, metformin therapy significantly decreased thyroid volume and nodule size. (C) 2015 S. Karger AG, BaselItem Comment on "Metformin Decreases Thyroid Volume and Nodule Size in Subjects with Insulin Resistance: A Preliminary Study"(2017) Nar, Asli; Anil, Cuneyd; Kut, Altug; Atesagaoglu, Berna; Tutuncu, Neslihan Bascil; Gursoy, Alptekin; 0000-0002-1816-3903; 0000-0003-0998-8388; 0000-0003-3534-2628; 0000-0003-2730-7144; 0000-0003-3802-9733; 27802445; ABG-5027-2020; AAA-2743-2021; W-2366-2017Item Metformin: Hype or Hope for Cancer(2017) Nar, Asli; 0000-0003-0998-8388; AAA-2743-2021Current studies show that especially pancreatic, liver, endometrial, colorectal, bladder and breast cancer incidences are increased by the presence of type 2 diabetes mellitus (T2DM). Possible links between T2DM and cancer include hyperinsulinemia, dysregulation of adipocytokines and hyperglycemia as well as shared confounding risk factors. There is evidence emerging from experimental and clinical studies that metformin can play a crucial anti-cancereous role. Since 2005, multiple studies showed the association between metformin and the reduction of risk in cancers of pancreas, colorectal, stomach, liver, breast and esophagus in diabetes cases. It was also claimed to improve survival in some cancers. Metformin is an insulin sensitizer and mainly acts through inhibiting hepatic gluconeogenesis by activating LKB1/AMP-activated protein kinase (AMPK). Metformin was found to have anti-cancerous and anti-metastatic effects mainly through activating AMPK dependent and independent signaling; inhibiting mTOR, MAPK, HER2, NF-kappa B, IGF signaling pathways and with its possible immuno-modulatory effects. Further studies are needed to evaluate the potential of metformin as adjuvant therapy for cancer especially in non-diabetic patients.