PubMed İndeksli Açık & Kapalı Erişimli Yayınlar
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Item The acromegaly registry of ten different centers in Turkey(2020) Keskin, Caglar; Demir, Ozgur; Karci, Alper Cagri; Berker, Dilek; Canturk, Zeynep; Yaylali, Guzin Fidan; Topsakal, Senay; Ersoy, Reyhan; Bayram, Fahri; Ertorer, Melek Eda; Bozkirli, Emre; Haydardedeoglu, Filiz; Dilekci, Esra Nur Ademoglu; Ay, Seyid Ahmet; Cansu, Guven Baris; Sahin, Mustafa; Emral, Rifat; Corapcioglu, Demet; 0000-0002-0179-9673; 0000-0001-7357-8709; 32417639; AAK-5003-2021; ABI-3705-2020; ABI-3393-2020Objectives: To describe biochemical and clinical features, and therapeutic outcomes of acromegaly patients in Turkey. Methods: Retrospective multicenter epidemiological study of 547 patients followed in 10 centers of the Turkish Acromegaly registry. Results: A total of 547 acromegaly patients (55% female) with a median age of 41 was included in this study. Majority of patients had a macroadenoma (78%). Transsphenoidal surgery was performed as primary treatment in 92% of the patients (n = 503). Surgical remission rate was 39% (197/503) in all operated patients. Overall disease control was achieved in 70% of patients. Remission group were significantly older than non-remission group (p = .002). Patients with microadenomas had significantly higher remission rates than patients with macroadenomas (p < .001). Patients with microadenomas were significantly older at the time of diagnosis when compared to patients with macroadenomas (p < .001). Preoperative growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels were significantly lower in the remission group (p < .001). Initial IGF-1 and GH levels were significantly higher in macroadenomas compared to microadenomas (p < .001). Medical treatment was administered as a second-line treatment (97%) in almost all patients without remission. Radiotherapy was preferred in 21% of the patients mostly as a third line treatment. Conclusions: This is one of the largest real life studies evaluating the epidemiological characteristics and treatment outcomes of patients with acromegaly who were followed in different centers in Turkey. Transsphenoidal surgery in the treatment of acromegaly still remains the most valid method. Medical treatment options may improve long-term disease outcomes in patients who cannot be controlled with surgical treatment (up to 70%).Item 2019 Turkish Hypertension Consensus Report(2019) Aydogdu, Sinan; Guler, Kerim; Bayram, Fahri; Altun, Bulent; Derici, Ulver; Abaci, Adnan; Tukek, Tufan; Sabuncu, Tevfik; Arici, Mustafa; Erdem, Yunus; Ozin, Bulent; Sahin, Ibrahim; Erturk, Sehsuvar; Bittigen, Atilla; Tokgozoglu, Lale; 31483311The Turkish Hypertension Consensus Report was prepared for the first time in 2015 to adapt the European and American international guidelines to our clinical practice and to create a practical report that could be a basic reference for all physicians dealing with hypertensive patients. This report, which was prepared by a committee with representation from 5 leading hypertension associations, has been accepted and is widely used. New clinical studies in hypertension literature and updated international guidelines since 2015 have demanded an update of the Turkish Hypertension Consensus Report as well. In this updated 2019 report, blood pressure levels were classified as Normal, Elevated, Stage 1, and Stage 2 hypertension. A new section was added for secondary hypertension. It was specified that drug treatment may be initiated with any 1 or a combination of 4 groups of drugs (diuretics, calcium channel blockers, angiotensin-converting enzyme [ACE] inhibitors, and angiotensin receptor blockers [ARBs]), except a combination of an ACE inhibitor and an ARB. It was emphasized that beta-blockers may be a first choice for hypertension treatment in diseases such as atrial fibrillation, heart failure, and coronary artery disease. The initial recommendation for hypertension treatment is a combination therapy in patients with a blood pressure level >= 150/90 mmHg. Target blood pressure values were redefined according to age and the presence of comorbidities. The hypertension treatment algorithm was renewed; it is proposed that drug therapy can also be initiated with a risk-based approach for the group with an elevated blood pressure (systolic blood pressure: 120-139 mmHg, diastolic blood pressure: 80-89 mmHg). The threshold clinic systolic blood pressure level was reduced from 160 mmHg to >= 150 mmHg for the initiation of drug therapy in individuals 80 years of age or more. The section on the treatment of special groups has now been expanded to include pregnancy and lactation. As in the previous report, in this update, practical recommendations for the most common cases seen in the clinic were the goal, rather than a comprehensive report that addresses all aspects of hypertension. This report has evidence-based recommendations for most patients; however, it should be kept in mind that there may be differences from 1 patient to another and that physicians should take an individualized approach according to a good clinical evaluation.