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Öğe The Incidence of Demodex folliculorum in the Combination of Allergic Rhinitis and Diabetes Mellitus(Iranian Scientific Society Medical Entomology, 2019) Arli, Cengiz; Ozsan, Muge; Gurkan, Eren; Kaya, Ozlem Aycan; Kokacya, SumeyyaBackground: Demodex mites are permanent ectoparasites of human pilosebaceous unit. They mainly infect skin of the face and scalp. Many studies have shown hi er density of the ectoparasites in diseased inflammatory skin than in normal skin. The aim of this study was to determine the frequency of Demodexfolliculorum (DE) in treatment-resistant patients with the combination of allergic rhinitis (AR) and diabetes mellitus (DM). Method: This study was conducted in 2014-2017. It included 92 patients aged 18-70 years who presented at the Ear, Nose and Throat (ENT) and Endocrinology Polyclinics of Mustafa Kemal University Medical Faculty Hospital, Turkey. An age and gender matched control group was formed of 30 healthy individuals. To determine the presence of DF, a few eyelashes were taken from eyelids in both groups. Then samples were examined under a light microscope. Results: DF positivity was determined in 44 (47.8%) of the 92 patients and in 1 (3.3%) of the 30 control group subjects. In the patient group, DF positivity was evaluated as present in 14 (43.7%) of the DM patients, in 12 (40%) of the AR patients and in 18 (60%) of the AR+DM patients. Statistically significant DF incidence was found in all three patient groups compared to the control group (P=0.001). The incidence in AR + DM group was not different from other patient groups. Conclusion: DM, AR, advanced age and obesity had prepared the environment for Demodex infestations. This issue should be considered especially in treatment of patients with AR+DM.Öğe The incidence of Demodex folliculorum in the combination of allergic rhinitis and diabetes mellitus(Tehran University of Medical Sciences (TUMS), 2019) Arlı, Cengiz; Ozsan, Muge; Gurkan, Eren; Aycan Kaya, Ozlem; Ko-Kacya, SumeyyaBackground: Demodex mites are permanent ectoparasites of human pilosebaceous unit. They mainly infect skin of the face and scalp. Many studies have shown higher density of the ectoparasites in diseased inflammatory skin than in normal skin. The aim of this study was to determine the frequency of Demodex folliculorum (DF) in treatment-resistant patients with the combination of allergic rhinitis (AR) and diabetes mellitus (DM). Method: This study was conducted in 2014-2017. It included 92 patients aged 18-70 years who presented at the Ear, Nose and Throat (ENT) and Endocrinology Polyclinics of Mustafa Kemal University Medical Faculty Hospital, Turkey. An age and gender matched control group was formed of 30 healthy individuals. To determine the presence of DF, a few eyelashes were taken from eyelids in both groups. Then samples were examined under a light microscope. Results: DF positivity was determined in 44 (47.8%) of the 92 patients and in 1 (3.3%) of the 30 control group subjects. In the patient group, DF positivity was evaluated as present in 14 (43.7%) of the DM patients, in 12 (40%) of the AR patients and in 18 (60%) of the AR+DM patients. Statistically significant DF incidence was found in all three patient groups compared to the control group (P=0.001). The incidence in AR + DM group was not different from other patient groups. Conclusion: DM, AR, advanced age and obesity had prepared the environment for Demodex infestations. This issue should be considered especially in treatment of patients with AR+DM. © 2019, Tehran University of Medical Sciences (TUMS). All rights reserved.Öğe Increased Rates of Coronary Artery Calcium Score in Patients with Non- Functioning Adrenal Incidentaloma(Bentham Science Publ Ltd, 2021) Akkus, Oguz; Akkus, Gamze; Kaypakli, Onur; Ozturk, Fatma Keles; Gurkan, Eren; Bekler, Ozkan; Sen, FatihAim: We evaluated cardiovascular (CV) risk stratification for nonfunctioning adrenal in-cidentalomas (NFAIs) via the coronary-artery-calcium (CAC) score. Materials and Methods: The participants were patients with NFAI (n = 55). They were compared to patients with chest pain, a low-intermediate Framingham-risk score, and a non-diagnostic tread-mill-exercise test, which served as the control group (n = 49). Subsequently, the NFAI group was subdivided according to a CAC score of <100 Agatston units - mild coronary-artery calcification (n = 40) - and >100 Agatston units - moderate-to-severe calcification (n = 15). Results: Similar rates of traditional risk factors were observed between the NFAI and control groups, and lower low-density lipoprotein cholesterol rates were observed in the NFAI group. The CAC score was significantly higher for the NFAI group than the control group. Glucose, potassi-um, adrenocorticotropic-hormone, and basal-cortisol levels were higher in those with a CAC score of >100. High-density-lipoprotein cholesterol estimated glomerular filtration rate and ejection frac-tion (EF) were higher in those with a CAC score of <100. Adenoma size and location were similar between the groups. Age, EF, and glucose were the most significant variables related to CAC score in patients with NFAI, at >100 Agatston units. Discussion: Patients with a low-intermediate CV risk profile and NFAI have a higher risk of atherosclerosis when compared to patients with a low-intermediate CV risk profile, but no NFAI. Conclusion: In patients with NFAI, CAC score evaluation may be used to predict increased atherosclerosis, especially in patients of an older age with higher glucose and decreased EF.Öğe Parathyroid adenoma in a patient with congenital hypothyroidism(Pakistan Medical Assoc, 2018) Gurkan, Eren; Canturk, Zeynep; Ipci, Ozlem; Sahin, Zeliha; Cumali, GokceThyroid dysgenesis, the most common cause of congenital hypothyroidism, includes hypoplasia, ectopia, and agenesis. Agenesis may present as hemiagenesis, bilobar agenesis, or isthmic agenesis. A small ectopic thyroid tissue may sometimes be detected on the embryonal migration pathway of suspected bilobar agenesis cases. Comorbidity of hyperparathyroidism and thyroid dysgenesis has been a topic of interest. The case presented here is a pioneer in medical literature with a comorbidity of parathyroidism and ectopic thyroid tissue.Öğe Perinatal effects of maternal FT3/FT4 ratio on gestational transient thyrotoxicosis(Sbem-Soc Brasil Endocrinologia & Metabologia, 2021) Gurkan, Eren; Dolapcioglu, Kenan; Dirican, EmreObjective: The effects of maternal thyroid hormone levels on the course of pregnancy and birth weight have attracted interest. The aim of the present study was to consider FT3 and FT3/FT4 ratio in the evaluation of the effects of maternal thyroid functions in gestational transient thyrotoxicosis (GTT). Materials and methods: This case-control study included 45 patients with GTT and 45 healthy pregnant women. Maternal history before pregnancy, thyroid function tests, thyroid autoantibodies, and thyroid ultrasonography results in 6th to 10th weeks of pregnancy were used in the differential diagnosis of GTT. In both groups, the effects of FT3, FT4 and FT3/FT4 ratios on gestational age and birth weight were evaluated. Results: There was no significant difference in the gestational age between the GTT and control groups (39,3 +/- 1,0 weeks and 39,2 +/- 1,2 weeks, respectively). Birth weights were similar in both groups (3205,2 +/- 4899 g and 3196,6 +/- 309,3 g, respectively). When maternal weight was adjusted, a positive correlation was observed between maternal FT3/FT4 ratio and birth weight (r=0,317, p=0,017). Additionally there was a positive correlation between the gestational age and the birth weight in the control group (rho = 0,726, p=0,001). Conclusion: GTT had no significant effect on the gestational age and the birth weight. On the other hand an increase in the maternal FT3/FT4 ratio had a positive effect on the birth weight in the patient with GTT. Maternal characteristics (age, weight, BMI) and FT3/FT4 ratio should be taken into consideration in future impact assessment studies on this issue.Öğe Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study)(Elsevier Ireland Ltd, 2018) Sonmez, Alper; Haymana, Cem; Bayram, Fahri; Salman, Serpil; Dizdar, Oguzhan Sitki; Gurkan, Eren; Carlioglu, Ayse KargiliAims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. Methods: A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c <7%, home arterial blood pressure (ABP) <135/85 mmHg, or LDL-C <100 mg/dL. Achieving all parameters indicated triple metabolic control. Results: HbA1c levels of patients (n = 5211) were 8.6 +/- 1.9% (71 +/- 22 mmol/mol) and 7.7 +/- 1.7% (61 +/- 19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, nonsmoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. Conclusions: Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease. (C) 2018 Elsevier B.V. All rights reserved.Öğe Use of automated quantitative pupillometric evaluation for monitoring the severity of diabetic retinopathy(Consel Brasil Oftalmologia, 2021) Cankurtaran, Veysel; Ilhan, Cagri; Tekin, Kemal; Citirik, Mehmet; Dirican, Emre; Gurkan, ErenPurpose: We aimed to evaluate the use of automated quantitative static and dynamic pupillometry in screening patients with type 2 diabetes mellitus and different stages of diabetic retinopathy. Method: 155 patients with type 2 diabetes mellitus (diabetes mellitus group) were included in this study and another 145 age- and sex-matched healthy individuals to serve as the control group. The diabetes mellitus group was divided into three subgroups: diabetes mellitus without diabetic retinopathy (No-diabetic retinopathy), nonproliferative diabetic retinopathy, and proliferative diabetic retinopathy. Static and dynamic pupillometry were performed using a rotating Scheimpflug camera with a topography-based system. Results: In terms of pupil diameter in both static and dynamic pupillometry (p <0.05), statistically significant differences were observed between the diabetes mellitus and control groups and also between the subgroups No-diabetic retinopathy, nonproliferative diabetic retinopathy, and proliferative diabetic retinopathy subgroups. But it was noted that No-diabetic retinopathy and nonproliferative diabetic retinopathy groups have showed similarities in the findings derived from static pupillometry under mesopic and photopic conditions. The two groups also appeared similar at all points during the dynamic pupillometry (p>0.05). However, it could be concluded that the proliferative diabetic retinopathy group was significantly different from the rest of the subgroups, No-diabetic retinopathy and nonproliferative diabetic retinopathy groups, in terms of all the static pupillometry measurements (p<0.05). The average speed of dilation was also significantly different between the diabetes mellitus and control groups and among the diabetes mellitus subgroups (p<0.001). While weak to moderate significant correlations were found between all pupil diameters in static and dynamic pupillometry with the duration of diabetes mellitus (p<0.05 for all), the HbAlc values showed no statistically significant correlations with any of the investigated static and dynamic pupil diameters (p>0.05 for all). Conclusion: This study revealed that the measurements derived from automated pupillometry are altered in patients with type 2 diabetes mellitus. The presence of nonproliferative diabetic retinopathy does not have a negative effect on pupillometry findings, but with proliferative diabetic retinopathy, significant alterations were observed. These results suggest that using automated quantitative pupillometry may be useful in verifying the severity of diabetic retinopathy.Öğe Utilization of statins and LDL-cholesterol target attainment in Turkish patients with type 2 diabetes-a nationwide cross-sectional study (TEMD dyslipidemia study)(Bmc, 2020) Bayram, Fahri; Sonmez, Alper; Haymana, Cem; Sabuncu, Tevfik; Dizdar, Oguzhan Sitki; Gurkan, Eren; Carlioglu, Ayse KargiliBackground Attaining acceptable levels of LDL Cholesterol (LDL-C) significantly improves cardiovascular (CV) outcomes in patients with type 2 diabetes mellitus (T2DM). The LDL-C target attainment and the characteristics of patients attaining these targets were investigated in this study. Furthermore, the reasons for not choosing statins and the physicians' attitudes on the treatment of diabetic dyslipidemia were also examined. Methods A nationwide, cross-sectional survey was conducted in tertiary centers for diabetes management. Adult patients with T2DM, who were under follow-up for at least a year in outpatient clinics, were consecutively enrolled for the study. LDL-C goals were defined as below 70 mg/dL for patients with macrovascular complications or diabetic nephropathy, and below 100 mg/dL for other patients. Data about lipid-lowering medications were self-reported. Results A total of 4504 patients (female: 58.6%) were enrolled for the study. The mean HbA1c and diabetes duration was 7.73 +/- 1.74% and 10.9 +/- 7.5 years, respectively. The need for statin treatment was 94.9% (n = 4262); however, only 42.4% (n = 1807) of these patients were under treatment, and only 24.8% (n = 448) of these patients achieved LDL-C targets. The main reason for statin discontinuation was negative media coverage (87.5%), while only a minority of patients (12.5%) mentioned side effects. Physicians initiated lipid-lowering therapy in only 20.3% of patients with high LDL-C levels. It was observed that the female gender was a significant independent predictor of not attaining LDL-C goals (OR: 0.70, 95% CI: 0.59-0.83). Conclusions Less than 50 % of patients with T2DM who need statins were under treatment, and only a quarter of them attained their LDL-C targets. There exists a significant gap between the guideline recommendations and the real-world evidence in the treatment of dyslipidemia in T2DM.
