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  • Küçük Resim
    Öğe
    Evaluation of Respiratory Functions in Subclinical and Clinical Hypothyroidism
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2013) Yilmaz, Gulay; Adas, Mine; Helvaci, Aysen; Altintas, Nejat; Günaldi, Meral
    Aim: Subclinical hypothyroidism reflects the earliest stage of thyroid dysfunction with subjects having normal or decreased fT4, normal fT3 and decreased thyroid stimulating hormone levels. Thyroid hormones have effects on the respiratory system functions. It is well known that thyroid hormones have effects on the respiratory system functions however there are few studies concerning the effect of subclinical hypothyroidism on the respiratory system. We aimed to investigate the respiratory functions in patients diagnosed with subclinical and clinical hypothyroidism. Material and Methods: A total of 61 patients with clinical (n=31) or subclinical (n=30) hypothyroidism and 27 healthy subjects as a control group were included in the present study. Respiratory functions were evaluated by simple spirometry. All respiratory parameters including FVC, FVC%, FEV1, FEV1%, FEV1/FVC, FEF25-75, FEF25-75%, PEF, PEF% were assessed. Additionally, free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH) levels were measured in all subjects. Results: Patients in the clinical hypothyrodism, subclinical hypothyroidism and control groups were homogenous in terms of age and gender distribution. Body mass index (kg/m2) was determined to be significantly higher in patients with clinical hypothyroidism when compared to control subjects (p<0.05). Spirometric evaluation of the respiratory function revealed significantly lower values for FVC (L; p<0.05), FVC (%; p<0.05), FEV1 (L; p<0.05) and FEV1 (%; p<0.05) in all hypothyroid patients regardless of the clinical type when compared to control subjects. Conclusions: Respiratory function tests seem to be beneficial in the evaluation of respiratory functional state in hypothyroidism. We think that community screening with simple spirometry may be helpful for patients with risk of subclinical hypothyroidism.
  • Küçük Resim Yok
    Öğe
    Expert opinion on screening, diagnosis and management of diabetic peripheral neuropathy: a multidisciplinary approach
    (Frontiers Media Sa, 2024) Atmaca, Aysegul; Ketenci, Aysegul; Sahin, Ibrahim; Sengun, Ihsan Sukru; Oner, Ramazan Ilyas; Tilki, Hacer Erdem; Adas, Mine
    The proposed expert opinion aimed to address the current knowledge on conceptual, clinical, and therapeutic aspects of diabetic peripheral neuropathy (DPN) and to provide a guidance document to assist clinicians for the best practice in DPN care. The participating experts consider the suspicion of the disease by clinicians as a key factor in early recognition and diagnosis, emphasizing an improved awareness of the disease by the first-admission or referring physicians. The proposed screening and diagnostic algorithm involves the consideration of DPN in a patient with prediabetes or diabetes who presents with neuropathic symptoms and/or signs of neuropathy in the presence of DPN risk factors, with careful consideration of laboratory testing to rule out other causes of distal symmetric peripheral neuropathy and referral for a detailed neurological work-up for a confirmative test of either small or large nerve fiber dysfunction in atypical cases. Although, the first-line interventions for DPN are currently represented by optimized glycemic control (mainly for type 1 diabetes) and multifactorial intervention (mainly for type 2 diabetes), there is a need for individualized pathogenesis-directed treatment approaches for DPN. Alpha-lipoic acid (ALA) seems to be an important first-line pathogenesis-directed agent, given that it is a direct and indirect antioxidant that works with a strategy targeted directly against reactive oxygen species and indirectly in favor of endogenous antioxidant capacity for improving DPN conditions. There is still a gap in existing research in the field, necessitating well-designed, robust, multicenter clinical trials with sensitive endpoints and standardized protocols to facilitate the diagnosis of DPN via a simple and effective algorithm and to track progression of disease and treatment response. Identification of biomarkers/predictors that would allow an individualized approach from a potentially disease-modifying perspective may provide opportunities for novel treatments that would be efficacious in early stages of DPN, and may modify the natural course of the disease. This expert opinion document is expected to increase awareness among physicians about conceptual, clinical, and therapeutic aspects of DPN and to assist them in timely recognition of DPN and translating this information into their clinical practice for best practice in the management of patients with DPN.
  • Küçük Resim
    Öğe
    Klinik ve subklinik hipotiroidizimde solunum fonksiyonlarının değerlendirilmesi
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2013) Yılmaz, Gülay; Adas, Mine; Helvacı, Aysen; Altıntaş, Nejat; Günaldı, Meral
    Amaç: Subklinik hipotiroidizm tiroid disfonksiyonlarının erken evresidir ve hastaların ft4 düzeyleri normal veya düşük, ft3 düzeyleri normal ve tiroid stimulan hormonu düzeyleri azalmıştır. Tiroid hormonlarının solunum sistemi fonksiyonları üzerinde etkileri vardır. Titoid hormonlarının solunum sistemi fonksiyonları üzerine olan etkisi iyi bilinirken, Subklinik hipotiroidinin solunum sistemin üzerindeki etkilerini araştıran çok az çalışma vardır. Biz klinik ve subklinik hipotiroidi tanısı almış hastalarda solunum fonksiyonlarını araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmamıza, 31 klinik ve 30 subklinik hipotiroidili olmak üzere toplam 61 hasta ve 27 sağlıklı birey kontrol grubu olarak alındı. Solunum fonksiyonları basit spirometrik testler ile ile değerlendirildi. Tüm solunum parametreleri, FVC, FVC%, FEV1, FEV1%, FEV1/FVC, FEF25-75, FEF25-75%, PEF, PEF% değerlendirildi. Ayrıca, serbest triiodotironin (ST3) ve serbest tiroksin( ST4) ve tiroid stimule edici hormon (TSH) tüm bireylerde ölçüldü. Bulgular: Klinik hipotroidili, subklinik hipotiroidili hastalar ve kontrol grubu yaş ve cinsiyet dağılımı açısından homojendi. BMI (kg/m2) klinik hipotiroidili hastalarda kontrol grubu ile kıyaslandığında önemli düzeyde yüksekti (p<0.05). Solunum fonksiyonlarının değerlendirilmesinde FVC (L; p<0.05), FVC (%; p<0.05), FEV1 (L; p<0.05) and FEV1 (%; p<0.05) değerleri kontrol grubu ile karşılaştırıldığında, tüm hipotiroidili hastalarda klinik tipten bağımsız olarak önemli düzeyde düşüktü. Sonuç: Solunum fonksiyon testleri, hipotiroidizmli hastaların solunum fonksiyon durumunun değerlendirilmesinde faydalıdır. Basit spirometre ile toplum taramasının subklinik hipotroidi riski taşıyan hastaların tespiti açısından faydalı olacağını düşünüyoruz.