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Öğe 5-Alpha Reductase Deficiency: A Review of Five Cases Diagnosed with Ambiguous Genitalia(Galenos Yayincilik, 2017) Pekkolay, Zafer; Kilinc, Faruk; Tuzcu, Sadiye Altun; Soylu, Hikmet; Tuzcu, Alpaslan Kemal5-alpha reductase is an enzyme which is responsible for the conversion of testosterone to dihydrotestosterone (DHT) in the peripheral tissues. It plays a key role in the development of male external genitalia. The present study was carried to make a clinical presentation of five male patients diagnosed with 5-alpha reductase deficiency resulting in the developmental disorder of male sexuality as well as to draw attention to the patients' medical history, physical examination and laboratory features. A test group comprising of five male subjects previously diagnosed with 5-alpha reductase deciency after being hospitalized and a series of examinations between April 2007 and July 2014, were enrolled in the study. Physical examination, hormonal profiles, radiological findings and karyotype analyses of the patients were carried out and their previous medical history was recorded. All the patients with karyotype 46 XY were raised as a female. They had external genitalia similar to each other and expressed a lower level of DHT. The patients with a disorder of male sex development, who expressed lower levels of dihydrotestosterone, must be checked for 5-alpha reductase deficiency.cÖğe 68Ga-DOTATATE PET/CT Can Be an Alternative Imaging Method in Insulinoma Patients(Soc Nuclear Medicine Inc, 2017) Tuzcu, Sadiye Altun; Pekkolay, Zafer; Kilinc, Faruk; Tuzcu, Alpaslan KemalInsulinomas are the most common cause of hypoglycemia, resulting from endogenous hyperinsulinism. The diagnosis of insulinoma is established by demonstrating inappropriately high serum insulin concentrations during a spontaneous or induced episode of hypoglycemia. Most insulinomas are islet-cell tumors. They are often small (<2 cm), benign, and difficult to localize with current imaging techniques. Insulinomas can be detected using either noninvasive procedures (e.g., transabdominal ultrasonography, spiral CT, MRI, In-111-pentetreotide imaging, and F-18-L-dihydroxyphenylalanine PET) or invasive procedures (e.g., endoscopic ultrasonography) or a selective arterial calcium stimulation test with hepatic venous sampling. Methods: We performed Ga-68-DOTATATE PET/CT on 3 patients with insulinoma. Results: All patients' insulinomas were shown clearly with Ga-68-DOTATATE PET/CT. Conclusion: Ga-68-DOTATATE PET/CT imaging may be a useful noninvasive imaging technique to localize insulinomas preoperatively.Öğe Acoustic Radiation Force Impulse Imaging for Evaluation of Renal Parenchyma Elasticity in Diabetic Nephropathy(Amer Roentgen Ray Soc, 2015) Goya, Cemil; Kilinc, Faruk; Hamidi, Cihad; Yavuz, Alpaslan; Yildirim, Yasar; Cetincakmak, Mehmet Guli; Hattapoglu, SalihOBJECTIVE. The goal of this study is to evaluate the changes in the elasticity of the renal parenchyma in diabetic nephropathy using acoustic radiation force impulse imaging. SUBJECTS AND METHODS. The study included 281 healthy volunteers and 114 patients with diabetic nephropathy. In healthy volunteers, the kidney elasticity was assessed quantitatively by measuring the shear-wave velocity using acoustic radiation force impulse imaging based on age, body mass index, and sex. The changes in the renal elasticity were compared between the different stages of diabetic nephropathy and the healthy control group. RESULTS. In healthy volunteers, there was a statistically significant correlation between the shear-wave velocity values and age and sex. The shear-wave velocity values for the kidneys were 2.87, 3.14, 2.95, 2.68, and 2.55 m/s in patients with stage 1, 2, 3, 4, and 5 diabetic nephropathy, respectively, compared with 2.35 m/s for healthy control subjects. Acoustic radiation force impulse imaging was able to distinguish between the different diabetic nephropathy stages (except for stage 5) in the kidneys. The threshold value for predicting diabetic nephropathy was 2.43 m/s (sensitivity, 84.1%; specificity, 67.3%; positive predictive value, 93.1%; negative predictive value 50.8%; accuracy, 72.1%; positive likelihood ratio, 2.5; and negative likelihood ratio, 0.23). CONCLUSION. Acoustic radiation force impulse imaging could be used for the evaluation of the renal elasticity changes that are due to secondary structural and functional changes in diabetic nephropathy.Öğe Alternative treatment of resistant hypoparathyroidism by intermittent infusion of teriparatide using an insulin pump: A case report(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2019) Pekkolay, Zafer; Kilinc, Faruk; Soylu, Hikmet; Balsak, Belma; Guven, Mehmet; Tuzcu, Sadiye Altun; Kara, Ali VeyselHypoparathyroidism usually responds to oral active vitamin D and calcium, but, although rare, some patients do not respond to this treatment. A 47-year-old Caucasian female presented to our medical unit with classical oral treatment-resistant hypocalcemia after thyroidectomy. Teriparatide was infused through the insulin pump with dosage set to 1 unit which equals to 2.5 mu g of teriparatide. In conclusion, intermittent subcutaneous infusion of teriparatide using an insulin pump is a safe and effective treatment modality to ensure normocalcemic conditions in patients with classical treatment-resistant hypoparathyroidism.Öğe Association of clinical and laboratory parameters with ambulatory arterial stiffness index in acromegaly patients(Professional Medical Publications, 2018) Kilinc, Faruk; Pekkolay, Zafer; Demircan, Fatih; Gozel, Nevzat; Tuzcu, Alpaslan KemalObjective: In this study, we determined the relationship between the ambulatory arterial stiffness index (AASI) and clinical and laboratory parameters in patients with acromegaly. Methods: Sixty-five patients with acromegaly, who visited to Dicle University Medical Faculty Department of Endocrinology (33 females and 32 males), were included in this study. The study control group consisted of 65 subjects. Demographic and clinical data were recorded. Laboratory data (complete blood count, blood urea nitrogen, creatinine, electrolytes, albumin, lipid profile, growth hormone [GH], insulin-like growth factor-1, and the 75-g oral glucose tolerance test) performed over the last year were evaluated. The AASI was obtained from 24-hour ambulatory blood pressure monitoring records of all patients. This study was completed in 15 months from 2013 to 2015. Results: Twelve patients (18.4%) had diabetes and 21 patients (32%) had hypertension. The mean AASI value was 0.41 +/- 0.14. The mean AASI value in the control group was 0.25 +/- 0.09. Growth hormone (GH) levels were positively correlated with the AASI values. AASI values tended to be higher in hypertensive subjects than that in normotensive individuals. Conclusions: Our results show that the AASI value increased in patients with acromegaly, independent of the increase in blood pressure. The AASI was strongly dependent on the degree of the GH increase in patients with acromegaly and may have an important role predicting cardiovascular risk in patients with acromegaly.Öğe A case of mediastinitis accompanied with hyperosmolar nonketotic coma(Kare Publ, 2016) Tuna, Mazhar Muslum; Kilinc, Faruk; Pekkolay, Zafer; Soylu, Hikmet; Tuzcu, Alpaslan KemalMediastinitis is a serious infection involving mediastinal spaces after cervical infections spread along the facial planes. A late diagnosis of mediastinitis may result in death. Here we present a diabetic patient suffered from mediastinit accompanied with hyperosmolar nonketotic coma. A 61 years old male patient with type 2 diabetes was admitted to our hospital, with complaint of generalized worsening and fever. A diagnosis of nonketotic hyperosmolar coma was done and proper treatment started immediately. Neck tomography revealed abscess formation in the upper mediastinum. The needle aspirat culture failed to show bacterial growth. After five days of antibiotic treatment the patient's symptoms resolved. The abscess formation and pleural effusion almost disappeared on control tomography. No similar case presentation was seen in the current literature. Apart from this case, mediastinit should be keep in mind when a patient suffered from dysphagia, fever and cervical swelling. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner.Öğe Early detection of macular and peripapillary changes with spectralis optical coherence tomography in patients with prediabetes(Taylor & Francis Ltd, 2018) Sahin, Muhammed; Sahin, Alparslan; Kilinc, Faruk; Karaalp, Umit; Yuksel, Harun; Ozkurt, Zeynep Gursel; Turkcu, Fatih MehmetPurpose: To compare the retina ganglion cell complex (GCC) layer and peripapillary nerve fibre layer thickness (pRNFL) in patients with prediabetes and healthy subjects analysed by spectral domain optical coherence tomography (SD-OCT). Methods: This cross-sectional and comparative study included prediabetic patients and healthy subjects. All participants underwent SD-OCT measurement of pRNFL thickness, and GCC thickness. Results: A total of 30 eyes of the 30 patients with prediabetes and 30 eyes of 30 controls were included. The overall calculated pRNFL thicknesses were similar between the prediabetic and control subjects. The GCC thickness was significantly lower in all quadrants of the inner macula, and outer nasal quadrant in the prediabetes group when compared to the control group. Conclusion: Our study demonstrated that inner macular GCC thickness was significantly thinner in prediabetic subjects. As a result neurodegeneration may play role in the thinning of GCC.Öğe Elevated neutrophil-to-lymphocyte ratio in the diagnosis of subacute thyroiditis(Mattioli 1885, 2018) Kilinc, Faruk; Ergun, Yakup; Pekkolay, Zafer; Tuzcu, Sadiye Altun; Gozel, Nevzat; Tuna, Mazhar Muslum; Tuzcu, Alpaslan KemalSubacute thyroiditis (SAT) is a self-limiting inflammatory condition of the thyroid gland in which multinucleated giant cells constitute a key histological finding. The neutrophil-lymphocyte ratio (NLR), determined from peripheral blood, is accepted as an available and practical indicator of the systemic inflammation. The purpose of this study was to determine the neutrophil-to-lymphocyte ratio (NLR), a novel marker of inflammation, in patients with SAT and to compare these values with those from healthy subjects. A total of 150 participants were included in the study, 75 SAT patients and 75 healthy volunteers. Retrospectively, demographic and laboratory data of the subjects were obtained from our institution's database. Patients with active infection, diabetes mellitus, malignancy, other chronic inflammatory diseases and hematologic disorders were excluded from the study. Values for complete blood count (CBC) and serum laboratory parameters of SAT patients were the baseline values obtained at the time of SAT diagnosis. Control subjects consisted of healthy volunteers who visited our institution for a routine check-up. A total of 75 subacute thyroiditis patients 54 (72%) were female and 21 (28%) were males and 50 (66.6%) were female and 25 (33.3%) were male and 75 were healthy adults were included. The mean age was 39.95 +/- 14.2, years for patients with SAT and 37.53 +/- 13.45 years for the control group. There was no significant difference between the age for groups (P = 0.13). NLR levels were found to be 3,56 +/- 2,64 in patients with SAT; NLR levels were found to be 1.41 +/- 0.9 in the control group. NLR levels were significantly higher in patients with SAT compared to the control group. Our study showed that increased NLR may be useful as an indicator of the presence of SAT, especially in complicated cases. The assessment of neutrophil-lymphocyte ratio in conjunction with radiological and clinical findings will assist in the achievement of an accurate diagnosis. Larger, prospective studies are required to determine its usefulness in assessing diagnostic potential and treatment outcomes in SAT patients.Öğe Evaluation of Anthropometric and Metabolic Parameters in Obstructive Sleep Apnea(Hindawi Ltd, 2015) Yildirim, Yasar; Yilmaz, Sureyya; Guven, Mehmet; Kilinc, Faruk; Kara, Ali Veysel; Yilmaz, Zulfukar; Kirbas, GokhanAims. Sleep disorders have recently become a significant public health problem worldwide and have deleterious health consequences. Obstructive sleep apnea (OSA) is the most common type of sleep-related breathing disorders. We aimed to evaluate anthropometric measurements, glucose metabolism, and cortisol levels in patients with obstructive sleep apnea (OSA). Materials and Methods. A total of 50 patients with a body mass index >= 30 and major OSA symptoms were included in this study. Anthropometric measurements of the patients were recorded and blood samples were drawn for laboratory analysis. A 24-hour urine sample was also collected from each subject for measurement of 24-hour cortisol excretion. Patients were divided equally into 2 groups according to polysomnography results: control group with an apnea-hypopnea index (AHI) <5 (n = 25) and OSA group with an AHI = 5 (n = 25). Results. Neck and waist circumference, fasting plasma glucose, HbA1c, late-night serum cortisol, morning serum cortisol after 1 mg dexamethasone suppression test, and 24-hour urinary cortisol levels were significantly higher in OSA patients compared to control subjects. Newly diagnosed DM was more frequent in patients with OSA than control subjects (32% versus 8%, p = 0.034). There was a significant positive correlation between AHI and neck circumference, glucose, and latenight serum cortisol. Conclusions. Our study indicates that increased waist and neck circumferences constitute a risk for OSA regardless of obesity status. In addition, OSA has adverse effects on endocrine function and glucose metabolism.Öğe The Evaluation of Mean Platelet Volume in Hepatitis C Infection(Galenos Yayincilik, 2014) Demircan, Fatih; Kilinc, Faruk; Gozel, Nevzat; Erkalma Senates, Banu; Senates, EbubekirObjective: Mean platelet volume (MPV) is a simple test that can be detected by routine blood counts and is considered a risk factor for atherothrombosis. In our study, we aimed to compare platelet count and mean platelet volume of patients with diagnosis of hepatitis C with healthy patients groups. Materials and Methods: In this study, blood test results, age and gender of 107 HCV patients and 100 healthy individuals who admitted to our internal medicine polyclinic between January 2010 and August 2013 were evaluated retrospectively. Patient information was obtained from hospital records. Serum platelet counts, MPV, total cholesterol, triglycerides, LDL cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP) levels were recorded. Results: Of the 107 patients diagnosed with HCV, 55 (51.4%) were males and 52 (48.6%) were females and the mean age was 45.0 +/- 11.0 years (range 23-66). In the control group, 51 patients were males and 49 were females, the mean age was 43.9 +/- 12.0 years (range 17-67). The mean ALT and AST levels of the patients with HCV were 58.8 +/- 76.0 IU/L (12-401) and 79.7 +/- 124.6 IU/L (14-670), respectively; in the control group it was 31.6 +/- 12 IU/L (15-82) and 33.1 +/- 10 IU/L (15-78), respectively and the difference between the groups was significant (p<0.001). The mean triglyceride level was significantly higher in the HCV group (205.5 +/- 53.3 mg/dL) than that in the control group (185.5 +/- 34.4 mg/dL) (p<0.001). The mean platelet count was 152.2 +/- 53.8 x 10(3)/mm(3) in patients with HCV infection and it was 190.7 +/- 66.8 x 10(3)/mm(3) in the control group; the difference between the groups was significant (p<0.001). The mean MPV was 9.1 +/- 1.7 fL in HCV group and 7.4 +/- 1.0 fL in the healthy group, and the difference was statistically significant (p<0.001). Conclusion: In conclusion, according to our study; significant elevation in MPV level in patients with HCV infection may be responsible for the effect of the virus that leads to platelet dysfunction. This condition supports the relationship between the existence of HCV infection and the risk of atherothrombosis.Öğe Factors influencing insulin usage among type 2 diabetes mellitus patients: A study in Turkish primary care(Taylor & Francis Ltd, 2016) Yilmaz, Ahmet; Ak, Muharrem; Cim, Abdullah; Palanci, Yilmaz; Kilinc, FarukBackground: DM (diabetes mellitus) patients with poorly regulated blood glucose levels are at risk of increased morbidity and mortality. There are different factors that cause resistance to the initiation of insulin therapy such as beliefs and perceptions concerning diabetes and its treatment and the nature and consequences of insulin therapy. Objectives: We aimed to explore the reasons for this reluctance and how these obstacles could be overcome so that DM patients who require insulin could initiate therapy. Methods: This was a cross-sectional, descriptive study of diabetic patients with glycated haemoglobin A(1c) (HbA(1C)) levels above 7.0%, who were followed-up at a primary care and endocrinology outpatient clinic. Results: Ninety-four patients (57.4% females, 42.6% males) were recruited for this study. Most patients (57.4%) considered that insulin was a drug of last resort. Among all patients, 34.1% thought that insulin lowered blood glucose levels to an extreme degree and 14.9% disagreed. The patients thought that self-injection was hard (27.6%), required someone else to administer the injection (27.6%), insulin injection was painful (33.0%). 59.6% of all patients believed that their religion did not restrict the use of insulin, 52.1% stated that their family physicians had sufficiently informed them. Conclusion: Our most significant finding is that a lack of adequate information relating to insulin appears to be the major factor behind DM patients' refusal of insulin treatment. The fact that patients consider insulin treatment as a final solution to DM could be related to resistance to the initiation of insulin therapy.Öğe Gestational Severe, Nonfamilial Hypertriglyceridemia, Management with Insulin and Metformin, A Case Report(Omics Int Pvt Ltd, 2014) Tuna, Mazhar Mslm; Kilinc, Faruk; Pekkolay, Zafer; Soylu, Hikmet; Tuzcu, Alpaslan KemalSevere hypertriglyceridemia is a rare condition in pregnancy. We report a case of gestational, nonfamilial severe hypertriglyceridemia accompanied with gestational diabetes mellitus. Despite an intensive insulin regimen and dietary fat restriction plasma triglyceride levels were remained higher. After a plasmapheresis session, triglyceride levels were reduced nearly 40%. Since plasma glucose and triglyceride levels were higher, metformin therapy was administered. After two weeks of metformin therapy, plasma glucose levels were within target range and triglyceride level was reduced below 1000 mg/dl. She delivered at 38th week of pregnancy via elective cesarean section, a healthy female baby with normal birth weight. Serum triglyceride level decreased immediately to 280 mg/dl after delivery.Öğe The Impact of Red Blood Cell Distribution Width and Neutrophil/Lymphocyte Ratio on the Diagnosis of Major Depressive Disorder(Springer London Ltd, 2016) Demircan, Fatih; Gozel, Nevzat; Kilinc, Faruk; Ulu, Ramazan; Atmaca, MuratIntroduction: Major depressive disorder (MDD) is an important risk factor for cardiovascular mortality and morbidity. Red blood cell distribution width (RDW) and neutrophil/lymphocyte ratio (NLR) can be obtained with a basic hemogram test. These parameters have been found as a predictor of mortality in the general population and in several diseases such as cardiovascular disease. Methods: Our study included 100 patients with newly diagnosed MDD and 100 healthy control patients (who had no depressive symptoms and without heart disease) admitted to our outpatient clinics. Patients with MDD were started on selective serotonin reuptake inhibitor (SSRI) treatment and followed up for 3 months. Both MDD and control patients' laboratory tests and physical, neurological, and psychiatric examinations were performed both at diagnosis and after 3 months of treatment. Results: In total, 100 patients with MDD were evaluated and 80 were included in our study. The control group consisted of 91 healthy individuals. The mean age was 44 +/- 10.6 years for patients with MDD and 39.8 +/- 11.4 years for the control group. There was no significant difference between the age for groups (P = 0.13); 55% of patients with MDD and 33% of the control group was male. NLR levels were found to be 2.55 +/- 0.7 and RDW levels were found to be 14.3 +/- 2.6 in patients with MDD; NLR levels were found to be 1.41 +/- 0.8 and RDW levels were found to be 13.4 +/- 1.8 in the control group. RDW and NLR levels were significantly higher in patients with MDD compared to the control group. The significant difference between the levels of RDW and NLR in patients with MDD and the control group was dissolved after SSRI treatment (P < 0.001). RDW [ median 14.3, interquartile range (IQR) 2.8 vs. median 13.25, IQR 2.45; P < 0.001] and NLR (median 2.3, IQR 1.1 vs. median 2.0, IQR 1.15; P < 0.001) levels were significantly higher in patients with MDD compared to the control group. Conclusion: Our study showed that hematological inflammatory markers might be useful parameters that can be used in patients with MDD for coronary artery disease risk. Specifically, RDW and NLR seem to be more hopeful. Advanced, detailed, and larger studies are needed.Öğe Improvement of minimally invasive parathyroidectomy outcomes by real time ultrasonography performed by a surgeon and radiologist team(Soc Romana Ultrasonografe Medicina Biologie-Srumb, 2015) Uslukaya, Omer; Gumus, Metehan; Tasdemir, Bekir; Goya, Cemil; Kilinc, Faruk; Oguz, Abdullah; Turkoglu, AhmetAims: Minimally invasive parathyroidectomy (MIP) has become the first line of treatment for primary hyperparathyroidism caused by solitary parathyroid adenoma. In order to increase the sensitivity of high-resolution ultrasonography (hUS), surgeon performed ultrasonography (SUS) has been increasingly used preoperatively. However, a radiologist and surgeon performing ultrasonography (RSUS) has not been a usual practice. In this study, we aimed to evaluate the clinical contribution of RSUS on MIP. Material and methods: From 2012 to 2014, a total of 30 consecutive patients (4 male, 26 female, mean age 48.87 +/- 14.52 years) with solitary parathyroid adenoma, were included in the study. All patients underwent preoperative hUS and Technetium-99m sestamibi scintigraphy. In patients, demographic characteristics, diagnostic tools used, levels of biochemical parameters, duration of operation, and length of hospital stay were recorded. Results: Adenomas were successfully localized by US in all patients and the surgical approach was determined according to this localization. Parathyroidectomy with MIP was successfully performed under local anesthesia in all patients. Mean operation time was 19.87 +/- 3.35 min. Postoperative PTH and calcium values were significantly decreased. All patients were discharged from the hospital in the same day. None of the patients had complications such as recurrent laryngeal nerve injury, hematoma, or injury to nearby organs. None of the patients had drains placed. Conclusions: Adenoma is well localized by US and thus, MIP can be completed under local anesthesia. US provides a very important clinical contribution to the success of MIP. In addition to these, RSUS helps in determining the location of the incision and the shortest way to achieve the lesion; therefore, it provides a small incision and shortens duration of the operation with a minimal dissection.Öğe The incidence rate of hepatosteatose in virus carriers with inactive Hepatitis B(Science & Innovation, Ltd, 2014) Demircan, Fatih; Gozel, Nevzat; Denk, Affan; Kilinc, FarukObjective - The aim of this study is to examine the data retrospectively from patients with inactive HBV whose livers were evaluated by ultrasonography and to investigate hepatosteatosis as well as related parameters in this patient group. Material and Methods - In our study, the data of 134 patients, who have applied to the Internal Disease Polyclinic of Elazig cagn Private Medical Center between January 2010 and August 2013 being diagnosed as carriers for inactive HBV and then performed abdominal ultrasonography, were evaluated retrospectively. Information for each patient was accessed by means of both the internal disease polyclinic in our hospital and patient epicrisis reports. The observed levels of plasma trigliserides, LDL cholesterol, AST, ALT, GGT, and ALP were all recorded. Findings - Out of 134 subjects, 72 were male while 62 were female accounting for 54% and 46%, respectively. The mean age of the patients were found to be 44.8 +/- 10.6 years old. Hepatosteatosis was found in 92 patients accounting for 68.7 %. The mean of age in some patients diagnosed with steatosis was found 50.1 +/- 7.6 years, while the others without steatosis was 33.2 +/- 6.0 years suggesting a significant difference compared to the former (p = 0.001). Furthermore, a consistency in difference was also found between these two groups with and without hepatosteatosis in terms of average triglyceride levels (p = 0.001). The mean GGT levels were consistently higher in the group with hepotosteatosis (p = 0.004). No significant difference was found between these two groups regarding their mean cholesterol levels of AST, ALT, ALP, and LDL. Conclusion - In patients with asymptomatically HBV infection, an increased risk for hepatosteatosis comes along with an increased levels of plasma triglycerides and GGT in the course of aging.Öğe Increased Serum Sclerostin Levels in Patients With Active Acromegaly(Endocrine Soc, 2020) Pekkolay, Zafer; Kilinc, Faruk; Gozel, Nevzat; Onalan, Ebru; Tuzcu, Alpaslan KemalContext: Bone mineral density is normal in acromegalic patients and the cause of increased fracture risk that characterizes active acromegaly is unknown. Objective: This study compared serum sclerostin levels between patients with active acromegaly and healthy individuals. Design, Setting, and Participants: The serum sclerostin levels of patients with active acromegaly were compared with those of healthy volunteers in a cross-sectional study. The mean age of the 30 acromegaly patients (male/female: 14/16) was 47.26 +/- 12.52 years (range, 18-64 years) and that of the healthy volunteers (male/female: 17/13) was 44.56 +/- 10.74 years (range, 19-62 years). IGF-1 and GH levels were measured using an electrochemiluminescence method, and serum sclerostin levels using an ELISA. The Mann-Whitney U test was used to compare sclerostin levels between the 2 groups. The correlations of sclerostin level with IGF-1 and GH were determined using Spearman's test. Results: The 2 groups did not differ in age or sex (P > 0.05). The median GH and IGF-1 levels in the patient group were 2.49 ng/mL (range, 0.22-70.00 ng/mL) (interquartile range [IQR], 1.3-4.52) and 338.5 ng/mL (range, 147-911 ng/mL) (IQR, 250-426), respectively. The median GH and IGF-1 levels in the control group were 0.95 ng/mL (range, 0.3-2.3) and 144 ng/mL (range, 98-198), respectively. The median sclerostin level was 29.95 ng/mL (range, 7.5-78.1 ng/mL) (IQR, 14.37-37.47) in the acromegaly group and 22.44 ng/mL (range, 8.45-36.44 ng/mL) (IQR, 13.71-27.52) in the control group (P < 0.05). There was a moderate positive correlation between the sclerostin and IGF-1 levels (rho = 0.54; P < 0.01), and between the sclerostin and GH levels (rho = 0.41; P < 0.05). Conclusions: High sclerostin levels may contribute to the increased fracture risk seen in patients with acromegaly.Öğe Is diabetes mellitus a negative prognostic factor for the treatment of advanced non-small-cell lung cancer?(Elsevier Espana Slu, 2014) Inal, Ali; Kaplan, M. Ali; Kucukoner, Mehmet; Urakci, Zuhat; Kilinc, Faruk; Isikdogan, AbdurrahmanBackground: It has been demonstrated that there are a lot of different prognostic factors which Non-small cell lung are worthy of consideration whereas diabetes mellitus (DM) has not been clearly or consistently identified as a prognostic value in advanced non-small cell lung cancer (NSCLC). The aim Prognostic factors of this study was to investigate the prognostic significance of the characteristics of patients in advanced NSCLC. Specifically, we investigated the impact of DM for progression-free survival (PFS) and overall survival (OS) in patients receiving first-line platinum-based doublets chemotherapy. Methods: We retrospectively reviewed 442 patients with advanced NSCLC. DM and other potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. Result: The results of univariate analysis for OS were identified as having prognostic significance: performance status (p < 0.001), stage (p < 0.001), DM (p < 0.001), liver metastasis (p = 0.02) and brain metastasis (p < 0.001). Stage, diabetes mellitus, and liver metastasis were identified as having prognostic significance for PFS. Multivariate analysis showed that poor performance status, presence of DM and advanced stage were considered independent negative prognostic factors for OS (p 0.001, p < 0.001 and p < 0.001 respectively). Furthermore, DM and stage were considered independent negative prognostic factors for PFS (p 0.005 and p 0.001 respectively). Conclusion: In conclusion, DM at the time of diagnosis was associated with the negative prognostic importance for PFS and OS in the advanced stage patients who were receiving first-line platinum-based doublets chemotherapy. In addition poor performance status and advanced stage were identified as negative prognostic factors. (c) 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L. All rights reserved.Öğe Preoperative intravenous ibandronate for treating severe hypercalcemia associated with primary hyperparathyroidism: an effective and low cost(Mattioli 1885, 2018) Pekkolay, Zafer; Kilinc, Faruk; Soylu, Hikmet; Balsak, Belma; Guven, Mehmet; Tuzcu, Sadiye Altun; Tuzcu, Alpaslan KemalPrimary hyperparathyroidism (PHPT) is a prevalent mineral metabolism disorder usually caused by a single parathyroid adenoma. Although PHPT is the most frequent cause of hypercalcemia, severe hypercalcemia cases are rarely encountered. Severe hypercalcemia results in fatal complications unless immediately treated; moreover, it causes delays in surgery for PHPT, the primary treatment. Some patients admitted because of hypercalcemia require intravenous bisphosphonate treatment. Aimed to investigate the efficacy of intravenous ibandronate, which is a relatively cheap drug than other intravenous bisphosphonates, in the preoperative treatment of symptomatic hypercalcemia in patients with PHPT. Also, there are some difference in the total cost of treatment for patients treated with ibandronate and zolendronate. The medical records of patients operated at Dicle University Department of General Surgery between 2010 and 2017 due to PHPT were retrospectively evaluated. Patients who were admitted because of hypercalcemia associated with parathyroid adenoma and underwent minimally invasive surgery subsequent to the lowering of calcium levels via preoperative intravenous ibandronate and zolendronate were included. Totally, 20 of 167 patients received a preoperative bisphosphonate due to hypercalcemia associated with PHPT. Seven patients treated with zoledronate only. Thirteen were treated with ibandronate only. There was no difference in hypercalcemia correction between the groups. Percentage of patients with hypocalcemia was less in the ibandronate group. The hypocalcaemic period was shorter in patients receiving ibandronate. Cost of hospital stay in patients receiving ibandronate is cheaper than zolendronate (780 +/- 462 USD versus 1765 +/- 1537 USD). Ibandronate use reduces the cost of hypercalcemia treatment by 55% in comparison with zolendronic acid. Intravenous ibandronate for treating severe hypercalcemia associated with PHPT is an effective and relatively cheap drug.Öğe Protective Effect of Caffeic Acid Phenethyl Ester on Oxidative Stress in Diabetic Rat Sciatic Nerve(Asian Network Scientific Information-Ansinet, 2012) Yucel, Yavuz; Celepkolu, Tahsin; Kibrisli, Erkan; Kilinc, Faruk; Beyaz, Coskun; Aluclu, Mehmet Ufuk; Basarili, Mustafa KemalThere has been no report which investigates the effects of Caffeic Acid Phenethyl Ester (CAPE) on elevated levels of oxidative stress in sciatic nerve tissues of diabetic rats. Therefore, this study was undertaken to determine whether CAPE, by virtue of its antioxidant properties, could affect lipid peroxidation, nitric oxide (NO), Paraoxonase (PON-1) and the oxidant/antioxidant balance in the sciatic nerve of Streptozotocin (STZ)-induced diabetic rats. The rats were treated as follows: control; this group of rats (n = 9) received isotonic solution. Diabetic (STZ, untreated diabetic): STZ 50 mg kg(-1) b.wt. was given intraperitoneally for the induction to this group (n = 8). Diabetic+CAPE treatment (STZ+CAPE, CAPE-treated diabetic): diabetic rats (n = 8) received CAPE (10 mu mol/kg/day) for a period of 21 days beginning one week after the STZ administration. Biomarkers; Malondialdehyde (MDA), Total Oxidant Status (TOS), total antioxidant status (TAS), PON-1 and NO levels for oxidative stress in sciatic nerve of the rats were measured. We found a significant increase in MDA, NO and TOS levels along with a reduction in TAS levels and PON-1 activity in the sciatic nerves of the STZ-induced diabetic rats (at p<0.001). The MDA, TOS and NO levels in sciatic nerve were significantly reduced in the CAPE-treated diabetic group compared to the untreated diabetic group (at p<0.05). In conclusion, the results of this study demonstrated that CAPE exhibits protective effects against oxidative damage in the sciatic nerve tissues of diabetic rats.Öğe Relationship between increased mean platelet volume and glycosylated hemoglobin (HbA1c) in type 2 diabetes mellitus(Cukurova Univ, Fac Medicine, 2016) Sahpaz, Fatih; Kilinc, FarukPurpose: The purpose of the study was to research relationship between mean platelet volume elevation and glycosylated hemoglobin A1c (HbA1c) in Type 2 diabetes mellitus (DM). Material and Methods: The study carried out in 70 patients with type 2 DM and 50 non-diabetic subjects. Diabetic patients were divided into two groups according to their HbA1c levels: DM group1 consisted of patients with HbA1c levels <7% and DM group 2 consisted of patients with HbA1c levels >= 7%. Results: The mean HbA1c levels were as 5.5+/-0.8, 6.7+/-0.2 and 9.7+/-1.9 in the non-diabetic, DM Group 1 and DM Group 2, respectively. MPV was significantly higher in DM Group2 as compared to both non-diabetics and DM Group 1. MPV had a high positive Correlation with HbA1c. MPV was significantly higher in DM Group 2 as compared to both non-diabetics and DM Group 1. MPV had a high positive correlation with HbA1c. It is found that MPV was increased in type 2 DM. Conclusion: This study showed that in diabetes mellitus, MPV is increased and it is indicative of worsening glycemic control. The increased platelet size may be one of the factors in the increased risk of atherosclerosis associated with DM and associated micro and macro vascular complications.
