Clinical Utility of Hepassocin and TXNDC5 in Patients with Non-alcoholic Fatty Liver Disease and/or Type 2 Diabetes

Objective: The prevalence of non-alcoholic fatty liver disease (NAFLD) is high both in the general population and in people with type 2 diabetes mellitus (T2DM), while studies on its etiopathogenesis are still ongoing. The aim of this study is to investigate the association between the ultrasound grade of liver steatosis and serum levels of hepassocin (HPS) and thioredoxin domain-containing protein 5 (TXNDC5) in patients with T2DM. Method: The cross-sectional study included 156 participants who were divided into four groups: isolated NAFLD, isolated T2DM, both NAFLD and T2DM, and healthy controls. The demographic data as well as the physical characteristics, laboratory findings, and ultrasonographic grades of liver steatosis of the participants were evaluated between all groups. Results: According to ultrasound examinations, HPS values were significantly higher in patients with grade 1 and 2 liver steatosis than in patients without liver steatosis. HPS levels were significantly higher in the vast majority of participants, including healthy controls than in those with isolated T2DM. No significant differences were found between HPS and diabetes. There was no significant correlation between TXNDC5 serum levels and ultrasound results in all groups. Conclusion: In the present study, our results show that serum HPS levels were higher in individuals with liver steatosis than in individuals without liver steatosis. These results provide further evidence for the association of HPS with NAFLD and expand our understanding of its potential role in the pathogenesis of NAFLD. In addition, our study can be considered one of the first studies in the literature to investigate the association between ultrasonographic hepatic steatosis and serum HPS levels

Transphobic Attitudes of Physicians Who Play an Active Role in the Gender-Affirming Treatment in Turkey

Introduction Transgender people are exposed to many health inequality practices while receiving healthcare. In this study, we aimed to investigate the levels of transphobia among physicians who play an active role in the gender-affirming treatment (GAT) in Turkey. Methods In this cross-sectional study, 530 physicians from the disciplines of psychiatry, endocrinology, gynecology, urology, and plastic surgery were assessed. Respondents completed a web-based survey consisting of sociodemographic data form and Genderism and Transphobia Scale (GTS) from May to June 2020. Results Among the 530 physicians, 126 were psychiatrists, 107 were endocrinologists, 119 were gynecologists, 111 were urologists, and 67 were plastic surgeons. We concluded that the transphobic attitude was the lowest in psychiatrists and the highest in urologists. In addition, we found that males were more transphobic than females (for GTS, p < .001; morality/shame and teasing, p < .001; for violence, p = .003), married individuals than single ones (for GTS, p = .012; morality/shame, p = .006), and residents than other academic status (for teasing, p = .024). Finally, we showed that transphobic attitudes are higher among the religious and those belonging to a religion people, respectively, and lower among the atheists and the deists. Conclusions Our findings indicate that transphobia is quite common among physicians in Turkey other than psychiatrists who are more in contact with transgender people. Policy Implications It can be said that it may be important to establish more relationships with transgender individuals and develop policies regarding this situation in order to reduce the common transphobia among physicians

The effect of direct antiviral treatment on the depression, anxiety, fatigue and quality-of-life in chronic hepatitis C patients

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Can "VAI" Better Indicate Metabolic Syndrome Compared with Other Metabolic Syndrome-Related Parameters in Patients with Thyroid Nodules? A Study from Turkey

Background: To investigate the relationship between visceral adiposity index (VAI) and other metabolic syndrome (MetS)-related parameters, and thyroid nodules

Pasireotide treatment in Cushing?s disease: A single tertiary center?s experience

Background/aim: Cushing's disease (CD), which cannot be controlled by surgery, requires medical treatment. In this situation, treatments with long-term effectiveness and safety profiles are needed. We aimed to evaluate the effects and adverse effects of pasireotide treatment in CD. Materials and methods: Patients who were followed up for CD and treated with pasireotide between 2014-2020 at Cerrahpa,sa Medical Faculty, were evaluated retrospectively. The efficacy and adverse effects of pasireotide were evaluated in this study. Results: Thirty-two patients were evaluated. The mean duration of treatment was 26.5 [range, 12.0-37.0] months. The 24-h urinary free cortisol (UFC) decreased 46% during the treatment and normalized in 37.5% of patients. A significant decrement was found between pretreatment and last follow-up UFC (p = 0.001). Plasma ACTH decreased by 21%. A significant decrement was found between pre-treatment and the 3rd month, 6th month, and last follow-up ACTH levels (p = 0.014, p = 0.017, and p = 0.017, respectively). Serum cortisol levels decreased by 18% and a significant decrement was found between pretreatment and the 3rd month, and between pretreatment and the last follow-up (p = 0.034 and p = 0.013, respectively). While fasting blood glucose at the 3rd month was significantly higher than pretreatment fasting blood glucose, no significant difference was found between pretreatment fasting blood glucose and 6th month and last follow-up fasting blood glucose. Although there was a significant difference between pretreatment HbA1c levels and the HbA1c levels at the 3rd month (5.9% vs. 6.6% p = 0.007), 6th month (5.9% vs. 6.7% p = 0.003), and the last follow-up (5.9% vs. 7.1% p = 0.001), in the last follow-up, the majority (77%) of patients had adequate glycemic control (HbA1c <= 7.0 %). Conclusion: Pasireotide treatment is an alternative treatment in CD, remission is obtained in the first months of treatment, and continues for an extended period. Although hyperglycemia is the most common adverse effect, it can be successfully controlled

Sexual Functions of Transgender Individuals Before Gender Transition

Objective: It is important to evaluate sexual function during the follow-up of transgender individuals in the gender pre-transition period. However, there exists inadequate literature evaluating the sexual functions of transgender individuals who have not received hormone therapy and/or undergone gender-affirming surgery. The aim of this study was to evaluate sexual function in transgender individuals in the gender pre-transition period. Material and Methods: Transgender individuals who were admitted consecutively to the tertiary care hospital between February and December 2019 were evaluated. Those who agreed to fill the questionnaires were included. Sexual functions of participants were evaluated using the Golombok-Rust Inventory of Sexual Satisfaction developed for cisgender and heterosexual individuals. In addition, the Arizona Sexual Experiences Scale was used for a psychometric test. Results: Sixty-five participants who did not receive hormone therapy and/or undergone gender-affirming surgery were included. Of these, 45 individuals were trans men (TM), and 20 were trans women (TW). The mean ages of TW and TM were 25.05 +/- 6.73 and 24.23 +/- 5.58 years, respectively. The percentages of sexual dysfunction were found to be 87.8 degrees/o in TM and 92.3% in TW, according to the Arizona Sexual Experiences Scale. According to the common subscales of the Golombok-Rust Inventory of Sexual Satisfaction, the most common problem in both groups was low sexual frequency. Conclusion: Owing to the importance of evaluating the sexual function in transgender individuals during the gender pre-transition period or in those who do not intend to undergo gender-affirming treatment, a scale should be developed for this period

Hypothalamic-Pituitary Axis Function and Adrenal Insufficiency in COVID-19 Patients.

The outbreak of COVID-19 has affected more than half a billion people worldwide and caused more than 6 million deaths since 2019. The responsible virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), primarily affects the lungs, but it has multisystemic effects. It is well known that dysfunction of multiple endocrine organs may occur during or after COVID-19. Impairment of hypothalamic-pituitary-adrenal (HPA) axis is of utmost importance as it may lead to death if went undiagnosed. SARS-CoV-2 may cause both primary and secondary adrenal insufficiencies (AI). The clinical manifestations of AI are generally non-specific and might be attributed to the complications caused by the infection itself. The underlying pathogenetic mechanisms were explained by the immunogenic, vascular effects of the infection or the direct effects of the virus. The diagnosis of AI in critically ill patients with COVID-19 is not straightforward. There is lack of consensus on the cut-off values of basal serum cortisol levels and stimulation tests during the disease. Here we review the literature with a special regard on the evaluation of HPA axis in patients with COVID-19. We conclude that the possibility of AI should always be kept in mind when dealing with patients with COVID-19, and repeated basal cortisol measurements and the ACTH stimulation test results could guide the clinician during the diagnostic process

Effectiveness of Cabergoline Treatment in Patients with Acromegaly Uncontrolled with SSAs: Experience of a Single Tertiary Center

Purpose To evaluate the effectiveness of cabergoline and the parameters affecting cabergoline response as add-on treatment to somatostatin analaogues (SSA) in patients with acromegaly uncontrolled with SSAs