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Amenore ile seyreden De Morsier Sendromu: Olgu sunumu
(2015) Kutlu, Orkide; Şahin, İbrahim; Sakin, Abdullah; Evren, Bahri
Öz: Septa Optik Displazi, De Morsier Sendromu olarak da bilinen nadir bir konjenital durumdur. Sendromun klasik triadındaki bulgular; beyin orta hat yapılarında anomaliler, optik sinir hipoplazisi ve hipofiz hormon disfonksiyonlarıdır. Triaddaki bulguların en az ikisinin bulunması ile tanı konulur. Burada primer amenore ile gelen ve de Morsier sendromu tanısı konulan bir olguyu sunduk. Optik sinir hipoplazisi, hipofizer yetmezlik veya beyin orta hat yapılarda anomali saptanması durumunda triada ait diğer bulguları araştırmalıdır ve gereğinde hormon replasman tedavileri başlanmalıdır.
ASSESSMENT OF PSYCHOLOGICAL RESPONSES AND RELATED FACTORS OF DISCHARGED PATIENTS WHO HAVE BEEN HOSPITALIZED WITH COVID-19
(Medicinska Naklada, 2021) Cansel, Neslihan; Tetik, Burcu Kayhan; Demi, Gulsu Hilal; Kurt, Osman; Evren, Bahri; Yucel, Aytac
Background: COVID-19 is the biggest pandemic of the last century. While a large number of cases and mortality rates direct the research to the clinic and prognosis of the disease, the mental health of these patients has recently become a matter of concern. This study aims to predict psychiatric morbidity and possible associated markers in COVID-19 survivors. Subjects and methods: A total of 102 survivors with COVID-19 infection participated in this study. A questionnaire was applied to the participants to evaluate demographic variables, history of comorbid diseases, smoking, loss of a relative due to COVID-19, and environmental attitudes after the discharge. Length of hospitalization, lung findings, intensive care history and treatments were recorded. Psychiatric morbidities were evaluated with General Anxiety Disorder-7, Patient Health Questionnaire-9 and The Results: Anxiety was found in 20.6%, depression in 13.7% based on moderate and above levels, 21.6% had significant PTSD. Female gender, history of psychiatric and comorbid diseases, smoking, perceived discrimination, and lack of long-lasting immunity posed a risk in terms of psychological response. There was a negative correlation between age and depression scores. No relation was found between the duration of hospitalization, presence of lung involvement, receiving intensive care treatment, losing a relative due to COVID-19 and psychological response. Conclusions: On patients treated for COVID-19 infection, psychological response continue after discharge. Mental health support and efforts to reduce stigma among infected subjects can reduce the psychological impact caused by the pandemic.
Bariatrik Cerrahi Adayı Morbid Obezite Hastalarının Yaşam Doyumunun Beden Algısı ve Benlik Saygısı ile İlişkisi
(2018) Karlıdağ, Rifat; Kayaalp, Cüneyt; Evren, Bahri; Şahin, İbrahim; Akyüz, Mahmut; Gönenir Erbay, Lale
Öz: Amaç: Obezitenin tıbbi sorunların yanı sıra psikososyal sorunlara da neden olduğu görülmektedir. Bu çalışmanın amacı bariatrik cerrahi adayı morbid obezite hastalarının yaşam doyumu, beden algısı ve benlik saygısı düzeylerini ve beden algısı ile benlik saygısının yaşam doyumu üzerine etkisini incelemektir. Gereç ve Yöntem: Çalışmaya Ocak-Aralık 2016 tarihleri arasında İnönü Üniversite Hastanesi Endokrinoloji Bilim Dalı’na başvuran ve vücut kitle indeksi (VKİ) en az 40 olan 136 morbid obezite hastası ve kontrol grubunu oluşturmak üzere VKİ 30’un altında olan 69 sağlıklı kişi dâhil edildi. Katılımcılar bir psikiyatri uzmanı tarafından değerlendirildi ve herhangi bir psikiyatrik hastalığı olanlar çalışma dışı bırakıldı. Hasta ve kontrol grubu-na sosyo-demografik veri formu, Coopersmith Benlik Saygısı Ölçeği, Beden Algısı Ölçeği ve Yaşam Doyumu Ölçeği uygulandı. Bulgular: Yapılan istatistiksel analizlerde morbid obezite hastalarında yaşam doyumu ve beden algısı ölçek puanları kontrol grubundan düşüktü. Benlik saygısı ölçek puanlarının ise hastalarda kontrol grubundan yüksek saptanması dikkat çekici idi. Yapılan korelasyon analizinde yaşam doyumu ve beden algısı arasında pozitif korelasyon saptandı. Sonuç: Çalışmanın bulgularına göre morbid obezite hastalarının kontrol grubuna göre yaşam doyumlarının daha düşük ve beden görünümlerinden memnuniyetsizliklerinin daha fazla olduğu, ancak benlik saygılarının yüksek olduğu görüldü. Ayrıca kişinin beden imajından memnuniyeti arttıkça yaşam doyumu da artmaktaydı. Beğeni kavramı ve güzellik anlayışı ve bunun kişi üzerinde etki derecesi toplumlar arasında farklılık göstermektedir. Benlik saygısının da kişiler arası ilişkilerden etkilendiği düşünülürse farklı toplumlarda yapılan diğer çalışmaların aksine çalışmamızda morbid obez hastalarda benlik saygısının yüksek oluşu toplumsal yapı ve/veya toplumsal kabul ve hasta sayısının değişkenliği ile ilişkili olabilir.
Can melatonin correct the negative effect of experimental diabetes created during the maternal period on fetal rat development and puppies cognitive functions?
(2021) Evren, Bahri; Koz, Sema Tulay; Ozkan, Yusuf; Guldogan, Emek
Aim: Chronic hyperglycemia can cause cognitive impairments such as learning and memory impairment. In our study, we aimed to investigate the levels of glial fibrillary acidic protein (GFAP), neural cell adhesion molecules (NCAM), lipid peroxidation (LPO), and glutathione (GSH) molecules and the protective effect of melatonin in the brain tissue of baby rats with diabetic mothers. Materials and Methods: Wistar-Albino rats used in the experiments were obtained from Firat University Experimental Research Center. Morris Water Maze Test is a learning and memory test commonly used in rats and mice. In the statistical analysis of the data; one-way analysis of variance (One-way ANOVA) was used to evaluate the significance of NCAM, GFAP, LPO, GSH levels between three groups, and repeated measures analysis of variance (Repeated measures one-way ANOVA) was used to evaluate the Morris Water Maze learning test. Results: Learning was worse in rats whose mothers were diabetic compared to diabetes + melatonin and control groups. With the administration of melatonin to diabetic mothers during their pregnancy, an improvement was observed in the learning ability of baby rats. NCAM 180, GFAP, GSH levels were significantly lower (p <0.05, p <0.001, p <0.05), and LPO level was higher (p <0.001) in baby rats with diabetic mothers compared to the control group. NCAM 180 and GFAP levels were significantly higher in the group that was administered melatonin during pregnancy (p <0.05, p <0.01), and LPO levels were lower (p <0.01). With the administration of melatonin during pregnancy, GSH levels were higher than the diabetes group, even though the difference was not statistically significant. Conclusion: Learning and memory functions are impaired in the offspring of diabetic mothers. The decrease in NCAM isoforms can inhibit brain development and the formation of synaptic plasticity. Decreased GFAP density may pose a problem in completing brain maturation in offspring of diabetic mothers. It has been observed that the administration of melatonin to diabetic mothers during their pregnancy is protective against the harmful effects of oxidative stress in their offspring due to its antioxidant effect.
A case of TSHoma mimicing Graves 'disease and makes GH cosecrete
(2022) Aydin, Emine Sener; Evren, Bahri; Şahin, İbrahim
Thyrotropinomas (TSHoma) are rare pituitary adenomas. TSHomas can synthesize other hormones simultaneously. Co-secretion of TSH and GH is rarely reported in the literature. In these patients, signs of hyperthyroidism and acromegaly can be observed together. Its clinic is heterogeneous and in some cases, symptoms of thyrotoxicosis may mask the acromegaly symptoms. Some TSHoma patients may also be mistakenly diagnosed with Graves and experience a delay in diagnosis. We aimed to present a unique case with a diagnosis of TSHoma, who was referred to our center when Euthyroidism was not achieved and was followed up with a pre-diagnosis of Graves and also had GH co-secretion.
A clinical decision support system based on machine learning for the prediction of diabetes mellitus
(2022) Evren, Bahri; Tunç, Zeynep
Aim: Early diagnosis of diabetes mellitus (DM), one of the most important health prob- lems worldwide, and taking necessary steps are very important. Therefore, it has become very important to develop models for the prediction of the disease. The aim of this study is to create a clinical decision support model with Stochastic Gradient Boosting, a machine learning model for DM prediction. Materials and Methods: In the study, modeling was done with the Stochastic Gradient Boosting method using an open access data set including the factors associated with DM. Model results were evaluated with accuracy, balanced accuracy, sensitivity, selectivity, positive predictive value, negative predictive value, and F1-score performance metrics. In addition, 5-fold cross-validation method was used in the modeling phase. Finally, variable importance values were obtained by modeling. Results: Accuracy, balanced accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F1 score from by Stochastic Gradient Boosting modeling were 93.6%, 92.8%, 91.7%, 93.9%, 73.3%, 98.4%, and 81.5%, respectively. According to the variable importance values obtained for the input variables in the data set examined in this study, the most important variables are glucose, age, systolic BP, cholesterol, chol/HDL, BMI, height, waist/hip, HDL, waist, weight, diastolic BP, hip, and gender: male. Conclusion: In the current study, it was seen that the ML model applied with the results obtained can predict diabetes. Addition, according to the results of the relevant model, the most important risk factors for DM were determined and given in degrees of importance of the risk factors. With these results, necessary precautions can be taken for the disease at early levels.
DNA repair proteins may differentiate papillary thyroid cancer from chronic lymphocytic thyroiditis and nodular colloidal goiter
(Nature Portfolio, 2021) Evren, Bahri; Yilmaz, Sami; Karadag, Nese; Sertkaya, Ayse Cikim; Topaloglu, Omercan; Kilinc, Faruk
Malignant thyroid lesions are the most common malignancy of the endocrine glands with increasing rates in the last two decades. Papillary thyroid cancer is the most common thyroid malignancy. In our study, we aimed to quantitatively evaluate the levels of DNA repair proteins MSH2, MLH1, MGMT, which are representative blocks of patients diagnosed with papillary carcinoma, chronic thyroiditis, or colloidal goiter. Total or subtotal thyroidectomy material of 90 patients diagnosed with papillary carcinoma, nodular colloidal goiter, or chronic thyroiditis between 2009 and 2012 were retrospectively evaluated. Tissue samples obtained from paraffin blocks were stained with MGMT, MSH2, MLH1 proteins and their immunohistochemistry was evaluated. Prepared sections were examined qualitatively by an impartial pathologist and a clinician, taking into account the staining method under the trinocular light microscope. Although there was no statistically significant difference in MGMT, MSH2, MLH1, follicular cell positivity, staining intensity, and immunoreactivity values, papillary carcinoma cases showed a higher rate of follicular cell positivity, and this difference was more pronounced between papillary carcinoma and colloidal goiter. In the MSH2 follicular cell positivity evaluation, the difference between chronic thyroiditis and colloidal goiter was significant (p=0.023). The difference between chronic thyroiditis and colloidal goiter was significant in the MSH2 staining intensity evaluation (p=0.001). The difference between chronic thyroiditis and colloidal goiter was significant in MLH1 immunoreactivity evaluation (p=0.012). Papillary carcinoma cases were demonstrated by nuclear staining only for MSH2 and MLH1 proteins as opposed to hyperplastic nodules. The higher levels of expression of DNA repair genes in malignant tumors compared to benign tumors are attributed to the functional activation of DNA repair genes. Further studies are needed for DNA repair proteins to be a potential test in the development and progression of thyroid cancer.
The Effect of Body Mass Index on the Sexual Functions of Morbidly Obese Female Patients
(Yerkure tanıtım & yayıncılık hızmetlerı a s, cumhuryet cad 48-3b, harbıye, ıstanb, 34367, turkey, 2017) Erbay, Lale Gonenir; Ozlu, Mustafa; Sahin, Ibrahim; Evren, Bahri; Kayaalp, Cuneyt; Karlidag, Rifat
Objective: The aim of this study is to investigate whether morbidly obese female patients are suffering sexual dysfunction, in addition to analyzing the effect of body mass index (BMI) on sexual functions. Method: A total of 72 morbidly obese women admitted to the Endocrinology Department, whose BMI scores were 40 or over, and 28 healthy women age-matched with the morbidly obese group, whose BMI scores were under 30 were included in this study. Considering the effects on sexual functioning, the patients and the control group were evaluated by a psychiatric specialist. women with a psychiatric disorder according to DSM-5, taking medicines that could affect sexual functions, and those with a chronic physical or any neurological disease or being pregnant or breastfeeding were excluded from the study. A sociodemographic data form and the Arizona Sexual Experiences Scale (ASEX) were administered to both the treatment and control group. Results: Statistical analyses revealed that morbidly obese female patients more frequently suffered from sexual dysfunction compared to the control group. The Arizona Sexual Experiences Scale (ASEX) and all subscale scores except the sexual satisfaction rate were significantly higher in morbidly obese female patients than in the control group. There was no correlation found between the BMI and sexual function in the analyses conducted. Conclusion: In our study, morbidly obese female patients were found to show more impairments in all areas of sexual functions except sexual satisfaction rate when compared to the control group. Previous studies have suggested that obesity is the cause of sexual dysfunction in men; however, the same relationship could not be demonstrated in women. In a limited study of female patients, conflicting results were attributed to the inability to control variables. The fact that variables such as depression, anxiety, and chronic physical illness, which may affect sexual function, had been assessed in our study is important for accurately interpreting the findings. The data in our study reveals the importance of investigating sexual functions in morbidly obese female patients.
The estimating of hypothyroidism with the bagged CART model based on clinical dataset and identify of risk factors
(2022) Evren, Bahri; Yaşar, Şeyma
Aim: The purpose of this study is to use machine learning techniques, Bagged CART, to classify hypothyroidism, which typically results from insufficient thyroid hormone synthesis in the body or seldom affects target tissues, and to identify potential risk factors. Materials and Methods: In this study, the open source data set obtained from the UCI database was used. The 10-fold cross-validation technique was used in the creation of the Bagged CART model from the Decision Tree Ensembles class to classify hypothyroid, and the performance criteria of this model were accuracy, balanced accuracy, sensitiv- ity, specificity, positive predictive value, negative predictive value, F1-Score, G-mean and Matthews Correlation Coefficient ( MCC) was given. Then, the significance of the vari- able was calculated through the model created and possible risk factors for hypothyroidism were determined. Results: The accuracy, balanced accuracy, sensitivity, specificity, positive predictive value, negative predictive value, F1-Score, G-mean and Matthews Correlation Coefficient (MCC) performance criteria for the model created for the classification of hypothyroidism were 99.9%, 99.2%, 98.3%, 100.0%, 100.0%, 99.9%, 99.2%, 99.9%, and 99.1%, respectively. According to the created XGBoost model, the three most important factors that could be associated with hypothyroidism were determined as TBG, TSH, T4U, TT4, age, FTI, Query hypothroid, on thyroxine, on antithyroid medication, thyroid surgery, sex, TBG measured, sick, T3 mesured, Query hyperthyroid, goitre. Conclusion: In conclusion, considering the results of the machine learning model created in this study, the hypothyroidism classification performance was quite high and the signif- icance of the variables and possible risk factors for hypothyroidism were determined. In the light of the findings, it is predicted that these risk factors may be useful in the clinic.
Evaluation of Development of Nonalcoholic Fatty Pancreas Disease After Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis in Liver Transplant Patients: Computerized Tomography Versus Ultrasound
(Aves, 2023) Cengiz, Ayse Nuransoy; Bilgic, Yilmaz; Karatoprak, Sinan; Gokce, Ayse; Evren, Bahri; Akbulut, Sami; Yilmaz, Sezai
Background/Aims: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common serious adverse event in liver transplant patients The average incidence has been reported as 1.3%-15.1% in prospective series. In our study, we have prospectively evaluated the prevalence of nonalcoholic fatty pancreatic disease (NAFPD) after PEP via computerized tomography (CT) and determined the ratio of fatty pancreas by ultrasound imaging in liver transplant patients. Materials and Methods: We have retrospectively analyzed 2922 patient files, and 146 patients were indicated for ERCP. PEP was observed in 32 patients. After presenting the significant association between the NAFPD and PEP, we prospectively reached 32 patients included in the study. Ten out of those patients have been performed ultrasound with regard to NAFPD. Results: PEP was defined in 32 patients in whom CT was performed to investigate NAFPD. When the patients were contacted, it was observed that 12% were deceased, 71% were alive, but 15% of them were untraceable. Ultrasound has been performed on 10 of 32 patients to determine NAFPD. There was a significant reduction in post-PEP pancreas/spleen rate compared to pre-PEP pancreas/ spleen rate (P =.001). Both the pre-PEP and post-PEP pancreas-spleen difference dropped significantly (P =.002). Conclusion: Ultrasound imaging could be utilized as a scanning test and an alternative to evaluate and diagnose NAFPD, particularly in risky patients.
Evaluation Of Morbid Obese Patients In Terms Of Sexual Dysfunctions: A Cross-Sectional Study
(2022) Yaprak, Bülent; Şahin, İbrahim; Evren, Bahri; Keskin, Lezzan; Erbay, Lale Gönenir
Aim: Obesity is a risk factor for sexual dysfunction. The aim of this study was to determine the frequency of sexual dysfunction in patients diagnosed with morbid obesity.Methods: The patient group included in the study consisted of 78 morbidly obese patients with BMI?40 kg/m2 and 68 healthy individuals with normal BMI. The data were obtained by using the sociodemographic information form filled by the participants, Beck anxiety scale, Beck depression scale and Golombok Rust Sexual Satisfaction Inventory.Results: Obese individuals were found to have sexual dysfunction compared to individuals with normal body BMI (p<0.05). When the Golombok Rust subscale scores of obese men were compared to those of normal-weight individuals, a significant deterioration was found in all subscale scores, including frequency, communication, satisfaction, avoidance, touch, impotence and premature ejaculation. In addition, the anxiety and depression scores of obese individuals were shown to be higher than those of normal-weight individuals (p<0.05).Conclusion: Morbidly obese individuals should be evaluated in terms of sexual functions. We believe that regulating obesity treatment, including possible treatment for sexual dysfunction, will increase the success rate and enhance the quality of life for patients.
Evaluation of novel ventricular repolarization parameters in patients with acromegaly
(2023) Eren, Hayati; Genc, Selin; Evren, Bahri; Şahin, İbrahim
Objectives: T wave’s peak and end interval (Tp-e), Tp-e/QT ratio and Tp-e/QTc ratio are novel markers of ventricular repolarization and are associated with ventricular arrhythmias. Increased ventricular arrhythmia incidence is reported in patients with acromegaly. The purpose of this study is to evaluate ventricular repolarization using the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio in patients with acromegaly. Methods: Thirty-five patients with acromegaly were included in the study. The control group was consisted of forty-one subjects without acromegaly that having similar age, sex ratio and comorbidities. The Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio, and other ventricular repolarization parameters of all patients were evaluated using electrocardiography. Results: Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio were significantly prolonged in patients with acromegaly compared to the control group. Furthermore, Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio showed a significant correlation with plasma GH levels and LVMI values. Conclusions: Our study revealed that Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio are prolonged in patients with acromegaly. We believe that the Tp-e interval, Tp-e/QT ratio, and Tpe/QTc ratio can be used in the evaluation of increased cardiovascular risk in patients with acromegaly.
Four-dimensional speckle tracking echocardiography and fragmented QRS in detection of early left ventricular systolic dysfunction in patients with subclinical hyperthyroidism
(Wiley, 2023) Karaca, Yucel; Karasu, Mehdi; Tasolar, Hakan; Evren, Bahri
Background: Thyroid disorders are associated with many cardiovascular risk factors. The importance of thyroid hormones in the pathophysiology of heart failure is underlined by the European guidelines of the European Society of Cardiology. However, the role of subclinical hyperthyroidism (SCH) in subclinical left ventricular (LV) systolic dysfunction is not entirely clear. Methods: This cross-sectional study included 56 SCH patients and 40 healthy volunteers. The 56 SCH group was divided into two subgroups depending on the presence of fragmented QRS (fQRS). In both groups, left ventricular global area strain (LV-GAS), global radial strain (GRS), global longitudinal strain (GLS), and global circumferential strain (GCS) were obtained with four-dimensional (4D) echocardiography. Results: GAS, GRS, GLS, and GCS values were significantly different in SCH patients and in healthy volunteers. GLS and GAS values were lower in the fQRS+ than in the fQRS- group (-17.06 +/- 1.00 vs. -19.08 +/- 1.71, p < .001, and -26.61 +/- 2.38 vs. -30.61 +/- 2.57, p < .001, respectively). ProBNP was positively correlated with LV-GLS (r = 0.278, p = .006) and LV-GAS (r = 0.357, p < .001). Multiple linear regression analysis showed that fQRS was an independent predictor of LV-GAS. Conclusions: 4D strain echocardiography may be helpful for the prediction of early cardiac dysfunction in patients with SCH. The presence of fQRS may be an indicator of subclinical LV dysfunction in SCH.
Frequency of lysosomal acid lipase deficiency in patients with primary hyperlipidemia
(2019) Evren, Bahri; Bilgic, Yılmaz; Atay, Feyza Firat; Nuransoy Cengiz , Ayse; Cagin, Yasir Furkan
Abstract: The aim of our study was to investigate the prevalence of LAL (lysosomal acid lipase) deficiency in patients with primary hyperlipidemia. Twenty-four patients with primary hyperlipidemia were included in the study. The gender, age, height, weight, body mass index and waist circumference of the patients were recorded. Lipid profiles, glucose, transaminases and LAL enzyme profiles were evaluated. LAL enzyme deficiency was not detected in patients with primary hyperlipidemia. In our study, when we investigated LAL deficiency in primary hyperlipidemic patients, we could not find a relationship between them. As a result of our study, LAL deficiency was not detected in patients with primary hyperlipidemia. However, in this context, there is a need to work with a large number of patients.
The Frequency of Vitamin D Deficiency in Obese Patients on Bariatric Surgery Wait List: Is there any Association with Co-existence of Prediabetes or Diabetes?
(2019) Topaloğlu, Ömercan; Evren, Bahri; Yoloğlu, Saim; Sahin, Selale; Şahin, İbrahim
Abstract: Objective: The impact of co-existence of prediabetes on 25 (OH)D3 deficiency is less known. We investigated the prevalence and predictors of 25(OH)D3 deficiency in obese adults on the bariatric surgery waitlist. Material and Methods: One hundred ninety-nine patients without known chronic diseases including diabetesmellitus (DM) and hypertension were included. Anthropometric, biochemical, and hormonal [fasting insulin, C-peptide, 25(OH)D3] parameters were analyzed. Insulin resistance (IR) was calculated using the homeostasis model assessment of IR (HOMA-IR). Patients having HOMA-IR of ?2.5 were considered insulin resistant. Patients were divided into subgroups according to body mass index (BMI), fasting blood glucose, HOMA-IR, glycated hemoglobin A1c (HbA1c), and 25(OH)D3 levels. Results: According to HbA1c levels, prediabetes and DM were diagnosed in 39.6% (n=79) and 27.1% (n=54) of patients. The 25(OH)D3 levels were severely deficient, deficient, and insufficient in 47.2%, 36.7%, and 10.6%of patients; however, the levels were sufficient (?30 ng/mL) only in 5.5%. The mean 25(OH)D3 level was 9.59, 9.76, and 12.08 ng/mL in nondiabetic, prediabetic, and diabetic patients (p>0.05). BMI and 25(OH)D3 levels were negatively correlated (p=0.045, r=-0.142). HOMA-IR was not correlated with 25(OH)D3 levels (p=0.98); it was similar in patients with different 25(OH)D3 levels. Age ?40 years andmale gender were significant predictors for severe 25(OH)D3 deficiency, but IR, prediabetes, and DM were not significant predictors. Conclusion: Increased BMI was associated with decreased 25(OH)D3 levels. The co-existence of prediabetes does not seem to affect 25(OH)D3 levels. Age ?40 years and male gender were significant predictors for severe 25(OH)D3 deficiency. Severe 25(OH)D3 deficiency was frequent in obese patients on the bariatric surgery waitlist. Vitamin D deficiency was also shown in other studies on obesity. 25(OH)D3 levels should be measured in all patients undergoing bariatric surgery and managed accordingly. The effect of preoperative vitamin D replacement on postoperative weight loss will clarify the association between vitamin D levels and obesity.
Increase in C-peptide levels after resolution of hyperglycemia in patients with type 2 diabetes mellitus: Myths or facts?
(2020) Topaloğlu, Ömercan; Evren, Bahri; Yoloğlu, Saim; Şahin, Şelale; Şahin, İbrahim
Abstract: Aim: Long term control of glucotoxicity was shown to increase the secretion of insulin and C-peptide (Cp). We aimed to investigate the change in Cp levels after short term glycemic control in patients with uncontrolled type 2 diabetes mellitus (DM). Material and Methods: Patients with type 2 DM with uncontrolled hyperglycemia were included. Basal fasting Cp levels were measured both at admission (Cp-admission) and after control of hyperglycemia prior to discharge (Cp-discharge). Cp-difference was calculated as (Cp-discharge)-(Cp-admission). The patients were divided as group 1 (positive Cp-difference) and group 2 (negative Cp-difference), and group A (Cp-difference ?+0.5) and group B (Cp-difference ?-0.5). Results: Of the patients (n=123), 61.8% had positive Cp-difference, and mean Cp-differences were 0.16 (±1.59), 0.96 (±1.03), and -1.11 (±1.51) in all patients, group1 and 2; respectively (p=0.001). Mean body weight, creatinine and Cp-discharge were higher in group 1(p=0.045, p=0.013, p=0.001; respectively). Mean age, body mass index(BMI), diabetes duration, hospitalization, proteinuria, fasting and postprandial glucose, glucose-discharge, HbA1c, lipids, TSH, free T4, Cp-admission were similar in group 1 and 2.Cpdifference was correlated positively with Cp-discharge(p=0.001), negatively with Cp-admission (p=0.001). There were no significant differences between subgroups (age, BMI, diabetes duration, use of secretagogue, diabetic ketaoacidosis history, HbA1c (<10 or ?10%), hyperlipidemia, microvascular complication) regarding to Cp-difference. Positive predictors of positive Cp-difference were cardiovascular disease (p=0.004; Odds Ratio(OR)=3.006) and higher Cp-discharge(p=0.001; OR=6.420);positive predictors of Cpdifference ?+0.5 were male, lower Cp-admission and higher Cp-discharge. Conclusion: Our results indicate that short-term glycemic control has little but significant positive effect on basal Cp. Having cardiovascular disease was positive predictor for positive Cp-difference.
Increase in C-peptide levels after resolution of hyperglycemia in patients with type 2 diabetes mellitus: Myths or facts?
(2020) Topaloglu, Omercan; Evren, Bahri; Yologlu, Saim; Sahin, Selale; Sahin, Ibrahim
Aim: Long term control of glucotoxicity was shown to increase the secretion of insulin and C-peptide (Cp). We aimed to investigate the change in Cp levels after short term glycemic control in patients with uncontrolled type 2 diabetes mellitus (DM).Material and Methods: Patients with type 2 DM with uncontrolled hyperglycemia were included. Basal fasting Cp levels were measured both at admission (Cp-admission) and after control of hyperglycemia prior to discharge (Cp-discharge). Cp-difference was calculated as (Cp-discharge)-(Cp-admission). The patients were divided as group 1 (positive Cp-difference) and group 2 (negative Cp-difference), and group A (Cp-difference ≥+0.5) and group B (Cp-difference ≤-0.5).Results: Of the patients (n=123), 61.8% had positive Cp-difference, and mean Cp-differences were 0.16 (±1.59), 0.96 (±1.03), and -1.11 (±1.51) in all patients, group1 and 2; respectively (p=0.001). Mean body weight, creatinine and Cp-discharge were higher in group 1(p=0.045, p=0.013, p=0.001; respectively). Mean age, body mass index(BMI), diabetes duration, hospitalization, proteinuria, fasting and postprandial glucose, glucose-discharge, HbA1c, lipids, TSH, free T4, Cp-admission were similar in group 1 and 2.Cp-difference was correlated positively with Cp-discharge(p=0.001), negatively with Cp-admission (p=0.001). There were no significant differences between subgroups (age, BMI, diabetes duration, use of secretagogue, diabetic ketaoacidosis history, HbA1c (10 or ≥10%), hyperlipidemia, microvascular complication) regarding to Cp-difference. Positive predictors of positive Cp-difference were cardiovascular disease (p=0.004; Odds Ratio(OR)=3.006) and higher Cp-discharge(p=0.001; OR=6.420);positive predictors of Cp-difference ≥+0.5 were male, lower Cp-admission and higher Cp-discharge.Conclusion: Our results indicate that short-term glycemic control has little but significant positive effect on basal Cp. Having cardiovascular disease was positive predictor for positive Cp-difference.
Investigation of DMFT Index and Saliva Values in Morbidly Obese and Obese Patients
(Duzce Univ, Fac Medicine, 2023) Ayan, Gizem; Dayi, Burak; Sahin, Selale; Evren, Bahri
Objective: Obesity is a global chronic disease that affects both developed and developing countries. The purpose of this study was to examine the effect of morbid obesity and obesity on the decayed, missing, and filled teeth (DMFT) index and saliva values. Method: This study included 50 morbidly obese, 50 obese, and 50 control group patients aged 18-68 years. The DMFT index of the patients was determined through a clinical examination. The saliva kit was used to determine the saliva values [unstimulated saliva flow rate (USFR), stimulated saliva flow rate (SSFR), saliva viscosity (SV), saliva pH (SpH), and saliva buffering capacity (SBC)]. The patients were surveyed to learn about their oral health habits, nutritional habits, and socioeconomic status. Results: No significant difference was found in the number of decayed teeth, filled teeth, USFR, or SV between the groups (p > 0.05). The DMFT index, number of missing teeth, SSFR, SpH, and SBC all showed significant differences between the groups (p < 0.05). The significant variables associated with DMFT, according to the multiple linear regression model, were the frequency of dental visits (f3 = 0.365), age (f3 = 0.322), and SSFR (f3 = -0.256). Conclusion: Obese patients have a low saliva rate, low saliva pH, low buffering capacity, high DMFT index, and a high number of missing teeth.
Investigation of the Relationship between Social Support and the Level of Hopelessness in Diabetic Patients: Descriptive Research
(2023) Karakaş, Neşe; Aktura, Seher Çevik; Büyükbayram, Zeliha; Evren, Bahri; Sarıtaş, Seyhan Çıtlık
Study aimed to investigate the relationship between social support and the level of hopelessness in diabetic patients. The study was carried out as descriptive research in the internal medicine clinic and polyclinics of a state hospital located in the southeast of Turkey. The population of the research consisted of adult patients diagnosed with Diabetes Mellitus who were followed up in the internal medicine clinics of the said hospital. The sample of the research was composed of 252 patients through power analysis with 0.05 error, 0.95 confidence interval and 0.95 representative power of the universe. In the collection of the data, Personal Information Form developed by the researchers, Multidimensional Scale of Perceived Social Support, and Beck Hopelessness Scale were employed. In the analysis of the data, descriptive statistics, t-test in independent groups, One-Way ANOVA, Mann-Whitney U test, correlation and Cronbach’s alpha reliability analysis were used. In the study, the patients’ mean scores obtained from Multidimensional Scale of Perceived Social Support and Beck Hopelessness Scale were found to be 65.2±15 and 11.2±1.8, respectively. It was determined that the patients had high levels of perceived social support and moderate levels of hopelessness. In the study, a negative and significant relationship was found between the mean scores obtained from Multidimensional Scale of Perceived Social Support and Beck Hopelessness Scale. It was also determined that as the patients’ perceived social support levels increase, their levels of hopelessness decrease.
Is urotensin 2 levels related to disease progression in acromegaly
(2021) Kilinc, Faruk; Gozel, Nevzat; Evren, Bahri; Pekkolay, Zafer; Cakmak, Erkan; Ozdemir, Fethi Ahmet
The study aimed to compare serum Urotensin-2 stages in the patients having active acromegaly with healthy individuals and to reveal and discuss the possible effects of UII on vascular changes in acromegaly patients. In this prospective, serum urotensin stages of 30 active acromegalic patients who are followed up in the experienced adult endocrinology center were compared with the serum urotensin stages of 30 healthy volunteers. Patients' IGF-1 along with GH were carefully measured by ECLIA method, and serum urotensin stages, by ELISA method. There was no variation between two groups comparing there age (p = 0.43). Patient group, mean GH was 6.60 ng / mL with mean IGF-1 stage of 355.2 ng / mL. The mean urotensin stage was 3.62±2.27 pmol / L in the acromegaly group, 4.82±2.87 pmol / L in the healthy control group. There was no significant positive correlation of urotensin with IGF-1 stages (r = 0.11, p>0.05). Similarly, the results did not display significant positive correlation urotensin stage with GH (r = 0.13, p>0.05). Serum urotensin-2 stage was lower in acromegaly patients compared to the healthy group (control) and this variation was not statistically significant.

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