Elif Inanc’s research while affiliated with Kahramanmaraş Sütçü İmam University and other places

Objective: To investigate the effect of gonadotropin, sex hormone levels and insulin resistance (IR) on thyroid functions and thyroid volume (TV) in polycystic ovary syndrome (PCOS). Subjects and methods: 69 new diagnosed PCOS patients (age 24.82 ± 6.17) and 56 healthy control female (age 26.69 ± 5.25) were involved to the study. Fasting plasma glucose, lipid profile, insulin, thyroid stimulating hormone (TSH), free thyroxine (fT4), estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone levels and urine iodine were measured in all participants. Thyroid and pelvic ultrasound were performed in all participants. Results: Insulin, HOMA-IR, LH, E2 and TV were higher in PCOS group (p < 0.05). TV was significantly higher in PCOS patients with IR compared to non-IR PCOS patients (p < 0.001), while TSH, fT4, and urine iodine levels were similar between these groups (p > 0.05). There was a negative correlation between E2 and TSH (p < 0.05) and a positive correlation between TSH and TV (p < 0.05). There was a significant positive correlation between TV and LH, insulin, HOMA-IR (p < 0.05). Conclusion: This study showed that TV was increased in patients with insulin resistance but differences in TSH and LH levels may affect TV changes as well.

OBJECTIVE: Renal transplantation is the best treatment method of end-stage renal disease. Unfortunately, renal transplantation rates have not reached the desired level yet in our country. In this study, we aimed to evaluate the willingness, knowledge levels and expectation of hemodialysis patients about renal transplantation. MATERIAL and METHODS: Patients older than 18 years of age and treated with hemodialysis for at least 3 months were enrolled in the study. Twenty-three questions were asked and the answers evaluated. RESULTS: We determined that most patients have insufficient information about transplantation but are willing to undergo kidney transplantation and have expectations from physicians and the society about transplantation. CONCLUSION: Hemodialysis patients should be informed and encouraged regarding renal transplantation.

Posterior reversible encephalopathy syndrome (PRES) is characterised with neurological symptoms and typical radiological appearances. Hypertension is the most common cause of PRES. Systemic lupus erythematosus is a rare cause of PRES. Here, we present a 55-year-old case who presented with headache and convulsion and was diagnosed with concomitant lupus nephritis and PRES.

Tubulointerstitial nephritis and uveitis syndrome is characterized by a combination of acute tubulointerstitial nephritis and uveitis. It is thought to be an autoimmune disease. Currently, 200 cases have been described in the literature. Most patients with this syndrome are young women and adolescents although it may occur in adults and older patients. In this report, we describe two patients with the TINU syndrome who were followed-up at our hospital.

Fungal peritonitis is an important reason of catheter loss among peritoneal dialysis patients. The most frequently isolated agents are Candida species and some patients do not respond to the treatment and die. Two siblings who lived in the same house and followed-up at our center were admitted to the hospital for peritonitis and both were transferred to hemodialysis as fungal peritonitis was detected. The enabling factor was considered to be poor hygiene. Hygiene is important issue for peritoneal dialysis patients, especially those who live in the same house.

Hyperlipidemia is a component of the nephrotic syndrome and should be treated for increased risk of cardiovascular diseases. Statins are first choice in treatment. However, gastrointestinal side effects are commonly seen in patients with statin therapy. A 73-year-old man who used statin therapy for hyperlipidemia due to nephrotic syndrome presented to our clinic with muscle weakness and rhabdomyolysis and thrombocytopenia was detected. The patient's complaints improved after discontinuation of statin therapy. We report the case of thrombocytopenia and rhabdomyolysis associated with statin therapy in this patient, as it is a rare entity.

Central venous hemodialysis catheter applications are still the most common route for acute hemodialysis and some complications may be seen at the time of insertion or later and some of these may be fatal. Catheter malpositions and great vessel perforations have an important place among these complications. Vessel perforations may be fatal if not diagnosed in the early period and treated appropriately and may share the same symptomatology with other acute dialysis complications such as anaphylactic reactions, air embolism and acute coronary syndromes. We discuss chest pain occurring at the onset of dialysis in a patient with left brachiocephalic vein perforation and its similarities with the symptoms of other dialysis complications.

Objective Our aim was to investigate the thyroid function tests and thyroid volume differences among males with isolated hypogonadotropic hypogonadism (IHH) who take androgen replacement treatment (ART). Materials and methods Forty-four male with IHH with a mean age 33.2 (18-54), diagnosed in Endocrinology and Metabolism Department between September 2013 and September 2014 and 40 healthy male control with a mean age 27.77 (18-55) were involved to study. Patient group was divided to testosterone-treated patients (n = 19) and human chorionic gonadotropine (hCG)-treated patients (n = 25). Patient group was compared in terms of total testosterone, thyroid function tests [thyroid stimulating hormone (TSH), free thyroxine (fT4)] and thyroid volume, before and 6 months after treatment. Patient group was compared with control group as well. Results When we compared the patient group with the control group, there was no significant difference for age, Body mass index, TSH, fT4 and thyroid volume between two groups before treatment. There was no difference in terms of TSH, but fT4, testosterone levels and thyroid volume were significantly higher after treatment, when the patient group was compared before and after treatment (p < 0.05). When we compared testosterone-treated patients and hCG-treated patients; thyroid volume was higher among hCG-treated patients (p = 0.001) but there was no difference for thyroid volume before and after testosterone treatment (p > 0.05). There was no statistically significant correlation between testosterone levels with TSH, fT4 and thyroid volume (r = 0.09, p = 0.32; r = 0.14, p = 0.11; r = 0.15, p = 0.09, respectively). Conclusion Our study showed that ART increases the thyroid volume especially in hCG-treated patients. Therefore, we suggest that thyroid volume changes should be followed up in hCG-treated patients.

Aim: Hyperinsulinaemia is frequent finding in patients with hyperprolactinemia and has associations with thyroid volume. In this study, we evaluated the association between thrombotic markers, insulin resistance, CIMT, and thyroid volume in female patients with prolactinoma. Material and methods: 38 women with prolactinoma and 24 healthy women were included to the study. We evaluated anthropometric, biochemical, hematologic and hormonal parameters as well as thyroid volume (TV) and CIMT in prolactinoma patients (before treatment) and controls. Insulin resistance was calculated using the HOMA-IR. Results: Mean age, BMI, TSH, mean platelet volume (MPV) and platelet distribution width (PDW) levels were similar between groups (P>0.05). HOMA-IR, platelet counts, prolactin, insülin levels, CIMT and tiroid volume was were significantly higher in prolactinoma group (P<0.05). While there was positive correlation between prolactin levels and insulin levels, platelet counts, CIMT and triglyceride levels (P=0.04, r=0.23; P=0.01, r=0.32; P=0.02, r=0.28; P=0.01, r=0.31, respectively), there was no significant correlation between prolactin levels and TV, MPV, PDW, and HOMA-IR (P>0.05). There was statistically significant positive correlation between TV and HOMA-IR, insulin levels, platelet counts and CIMT (P=0.00, r=0.45; P=0.00, r=0.43, P=0.00, r=0.35, respectively). Conclusion: Hyperprolactinemia has been implicated in the pathogenesis of obesity and glucose intolerance and is reportedly associated with an impaired metabolic profile. Additionally, elevated PRL levels may increase the risk of developing atherothrombotic events via the activation of platelets. Thyroid volume has been found to be associated with age, anthropometry, smoking, iodine status and hyperinsulinaemia. Additonally, growth hormone and growth factors have been shown to affect TV. In our study, we determined relationship between TV and insulin resistance, platelet count, and CIMT in patients with prolactinoma. So we think that, insulin resistance and thrombotic factors may be responsible for change in thyroid volume in patients with prolactinomas.

Aim: Diabetes mellitus is a chronic metabolic condition characterised by persistent hyperglycaemia with resultant morbidity and mortality related primarily to its associated microvascular and macrovascular complications In this study our aim was to investigate the prevalence of the most frequently occurring hand complications in 1000 type 2 diabetes mellitus (T2DM) patients. Material and methods: 297 patients (mean age 52.13±9.37 years, 190 women and 107 men) who had T2DM were included as a preliminary in this study. The presence of cheiroarthropathy, Dupuytren’s contracture, tinnel sign, and tendinitis was assessed. All patients were evaluated also by the Rheumatology Division. Diabetic retinopathy was assessed by direct ophthalmoscopy. Urinary albumin excretion was determined in at least two 24 h urine samples. Results: The mean diabetic duration was 7.71±6.28 years. Dupuytren’s contracture was present in 7.7%, cheiroarthropathy in 11.1%, tinnel sign in 19.5%, and tendinitis in 4.4%. Retinopathy was present in 15.5% and nephropathy in 18.2%. Mean HbA1c was 8.58±2.03. Mean fasting glucose was 174.6±69.22 mg/dl. The relationship between these complications and patients’ age, sex, duration of diabetes, and glycaemic control was also analysed. There was positive correlation between age and cheiroarthropathy and dupuytren’s contracture (P=0.01, r=193 and P=0.000, r=248 respectively). There was positive correlation between diabetic duration and diabetic retinopathy (P=0.000, r=216). There was positive correlation between diabetic duration and cheiroarthropathy (P=0.044, r=117). There was positive correlation between diabetic nephropathy and tinnel sign (P=0.005, r=164). Conclusions: Some musculoskeletal disorders are more prevalent in T2DM patients and this may be associated with duration of diabetes. Also the hand abnormalities were associated with the diabetic complications. Long-term prospective randomised controlled trials on preventing musculoskeletal complications and disability in diabetics are needed.