Role of cytological characteristics of benign thyroid nodules on effectiveness of their treatment with levothyroxine

Introduction: Levothyroxine (LT4) therapy has been used for the treatment of euthyroid nodular goiter, but there are controversial results about its usefulness. We aimed to evaluate the possible role of benign nodules’ cytological characteristics in response to LT4 therapy. Material and methods: In total, 93 patients with 128 nodules were included in the study; 74 of the nodules were treated with LT4 (group 1), and 54 of them had no medication (group 2). The subgroups consisted of adenomatous nodules, colloid nodules and cystic nodules. Results: In group 1, mean thyroid volume and mean nodule volume were reduced significantly (p = 0.002 and p = 0.022, respectively) with low-normal level thyrotropin (TSH) suppression (between 0.3 mIU/ml and 1.0 mIU/ml), while there were no significant changes in group 2. When we evaluated changes of the initial and last nodule volumes in cytological subgroups, only colloid nodules in group 1 had significant reduction (p = 0.040) and the others had no significant changes. By omitting the colloid nodules, when the other nodules were revaluated, there were no significant changes in either group. Conclusions: On the basis of these results, obtained from a large sample of Anatolian patients, it is possible that LT4 therapy leads to significant reductions of both thyroid volume and nodule size in colloid nodules, but not in other kinds of benign nodules

Ailevi bir vaka çalışması ile androjen duyarlılığı sendromu

To objective of this study was to present androgen insensitivity syndrome is seldom seen, in a family with three affected individuals. A 16-year-old,a 17-year-old, and a 18-year-old phenotypic female three individuals with primary amenorrhea were evaluated through a diagnostic protocol that included clinical, cytogenetic, and hormonal examinations. After the patients were diagnosed as androgen insensitivity syndrome, they were were operated on for gonadectomy and vaginoplasty with pudental thigh flep and postoperative long-term exogenous estrogen replacement therapy was started. The patients have succesfully been followed with exogenous estrogen replacement therapy for six years, which gives them comfortable social and phsychosexual life as women in accordance with their desire.Bu çalışmanın amacı, etkilenen üç kişiyle bir ailede nadiren androjen duyarsızlık sendromu sunmaktı. 16 yaşında, 17 yaşında ve 18 yaşında fenotipik bir kadın hastayı primer amenore ile üç kişi klinik, sitogenetik ve hormonal muayeneleri içeren bir tanı protokolü ile değerlendirildi. Hastalara androjen duyarsızlık sendromu tanısı konduktan sonra pudental uyluk flep ile gonadektomi ve vajinoplasti ameliyatları yapıldı ve postoperatif uzun süreli eksojen östrojen replasman tedavisi başlandı. Hastalar, altı yıl boyunca eksojen östrojen replasman tedavisi ile başarılı bir şekilde takip edildiler; bu da arzu ettikleri gibi kadınlar olarak rahat bir sosyal ve psikoseksüel yaşam sağlıyor

Türkiye’de insülin-naiv tıp 2 diyabet hastalarında insülin glarjin ile intensif insülin titrasyonu: Lantit çalışması

WOS: 000362601700003Purpose: This open-label, single-arm, phase 4 study was designed to evaluate the efficacy of intensive insulin glargine titration in type 2 diabetes mellitus (T2DM) patients for 6 months to reach good glycaemic control. Material and Method: Two hundred-forty one insulin-naive T2DM patients were included. The primary efficacy variable was the glycaemic control (HbA1c level of <= 7%). The secondary variables were a fasting blood glucose (FBG) level of <100 mg/dL, the final dose of basal insulin, number of dose adjustments, time to dose titration in reaching target HbA1c level of <= 7%, weight gain and treatment satisfaction using the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Hypoglycemia, severe hypoglycemia and adverse events were also assessed. Results: The mean (+/-SD) HbA1c level of 8.8+/-0.6% at baseline decreased to 7.4+/-0.9% on day-90 (p<0.001) and to 7.3+/-0.9% on day-180 (p<0.001). The percentage of patients with HbA1c <=%7 was 36.9% on day-90 and 40% on day-180. The mean FBG of 186.3+/-52.5 mg/dL at baseline decreased to 111.5+/-36.6 mg/dL on day-90 (p<0.001) and to 114.1+/-34.8 mg/dL on day-180 (p<0.001). The mean insulin glargine dose on the last day of FBG measurement (day-89) was 32.7+/-15.5 IU and the mean number of titrations was 12.7+/-6.6. These values on day-179 were 36.8+/-19.4 IU and 5.8+/-5.7, respectively. The total DTSQ score (20.3+/-7.7) and scores for each item at baseline showed improvement on day-180 (p<0.001). The most frequently reported adverse reactions were hypoglycaemia (49.7%) and weight gain (9.5%). Serious hypoglycaemia cases reported during the first and the second 3-month periods were 11.2% and 13.3%, respectively. Discussion: In conclusion, the use of insulin glargine with intensive dose titration is effective and safe in T2DM patients.Amaç: Bu açık-etiketli, tek-kollu faz 4 çalışma, insulin glarjin ile tedavi edilen tip 2 diabetus mellitus (T2DM) hastalarında iyi glisemik kontrol için etkili dozlara ulaşmada yoğunlaştırılmış insülin titrasyonunu değerlendirmek amacıyla tasarlanmıştır. Gereç ve Yöntem: Önceden insülin kullanmamış 241 T2DM hastası çalışmaya alınmıştır. Birincil değerlendirme kriteri glisemik kontrol (HbA1c seviyesi ≤%7), ikincil kriterler ise açlık kan şekeri (AKŞ) <100 mg/dL, son bazal insülin dozu, doz ayarlama sayısı, hedef HbA1c seviyesine ulaşıldığı an doz titrasyonuna kadar geçen zaman, kilo alımı ve tedavi memnuniyetinin Diyabet Tedavi Memnuniyet Anketi (DTSQ) ile değerlendirilmesi olmuş, ayrıca hipoglisemi, ciddi hipoglisemi ve advers olaylar da değerlendirilmiştir. Bulgular: Başlangıçtaki ortalama ± SD HbA1c seviyesi %8,8±0,6, 90. günde %7,4±0,9 seviyesine (p<0,001), 180. günde ise %7,3±0,9 seviyesine (p<0,001) düşmüştür. HbA1c seviyesi ≤%7 olan hastaların oranı 90. günde %36,9 iken 180. günde %40 olmuştur. Ortalama AKŞ başlangıçta 186,3±52,5 mg/dL iken 90. günde 111,5±36,6 mg/dL’ye (p<0,001), 180. günde ise 114,1± 34,8 mg/dL’ye düşmüştür (p<0,001). Son AKŞ ölçümü sırasında (89. gün) ortalama insülin glarjin dozu 32,7±15,5 IU ve ortalama titrasyon sayısı ise 12,7±6,6 idi. Bu değerler 169. gün 36,8±19,4 IU ve 5,8±5,7 idi. Total DTSQ skoru (20,3±7,7) ve her bir madde için 180. günde başlangıç vizitine göre bir iyileşme izlendi (p<0,001). En sık bildirilen advers olay hipoglisemi (%49,7) ve kilo alımı (%9,5) idi. İlk ve ikinci 3 aylık dönemlerde bildirilen ciddi hipoglisemi olayları sırasıyla %11,2 ve %13,3 idi. Tartışma: Sonuç olarak yoğunlaştırılmış doz titrasyonu ile insülin glarjin kullanımı T2DM hastalarında etkili ve güvenli bir tedavi seçeneğidir

Ailevi bir vaka çalışması ile androjen duyarlılığı sendromu

To objective of this study was to present androgen insensitivity syndrome is seldom seen, in a family with three affected individuals. A 16-year-old,a 17-year-old, and a 18-year-old phenotypic female three individuals with primary amenorrhea were evaluated through a diagnostic protocol that included clinical, cytogenetic, and hormonal examinations. After the patients were diagnosed as androgen insensitivity syndrome, they were were operated on for gonadectomy and vaginoplasty with pudental thigh flep and postoperative long-term exogenous estrogen replacement therapy was started. The patients have succesfully been followed with exogenous estrogen replacement therapy for six years, which gives them comfortable social and phsychosexual life as women in accordance with their desire.Bu çalışmanın amacı, etkilenen üç kişiyle bir ailede nadiren androjen duyarsızlık sendromu sunmaktı. 16 yaşında, 17 yaşında ve 18 yaşında fenotipik bir kadın hastayı primer amenore ile üç kişi klinik, sitogenetik ve hormonal muayeneleri içeren bir tanı protokolü ile değerlendirildi. Hastalara androjen duyarsızlık sendromu tanısı konduktan sonra pudental uyluk flep ile gonadektomi ve vajinoplasti ameliyatları yapıldı ve postoperatif uzun süreli eksojen östrojen replasman tedavisi başlandı. Hastalar, altı yıl boyunca eksojen östrojen replasman tedavisi ile başarılı bir şekilde takip edildiler; bu da arzu ettikleri gibi kadınlar olarak rahat bir sosyal ve psikoseksüel yaşam sağlıyor

Additional file 2: of An international survey on hypoglycemia among insulin-treated type I and type II diabetes patients: Turkey cohort of the non-interventional IO HAT study

Estimated rate of any hypoglycemic event by duration of insulin therapy in T1DM and T2DM patients. Percentages represent percent of patients with hypoglycemia in each quartile. PPY = per patient-year; T1DM = type 1 diabetes mellitus; T2DM = type 2 diabetes mellitus. (PPTX 362 kb

An international survey on hypoglycemia among insulin-treated type I and type II diabetes patients: Turkey cohort of the non-interventional IO HAT study

Background: Limited real-world data are currently available on hypoglycemia in diabetes patients. The International Operations Hypoglycemia Assessment Tool (IO HAT) study was designed to estimate hypoglycemia in insulin-treated type I (T1DM) and type II (T2DM) diabetes mellitus patients from 9 countries. The data from Turkey cohort are presented here. Methods: A non-interventional study to determine the hypoglycemia incidence, retrospectively and prospectively, in Turkish T1DM and T2DM patients using a 2-part self-assessment questionnaire. Results: Overall, 2348 patients were enrolled in the Turkey cohort (T1DM = 306 patients, T2DM = 2042 patients). In T1DM patients, 96.8% patients reported hypoglycemic events (Incidence rate [IR]: 68.6 events per patient-year [ppy]), prospectively, while 74.0% patients reported hypoglycemic events (IR: 51.7 events ppy), retrospectively. In T2DM patients, 95.9% patients (IR: 28.3 events ppy) reported hypoglycemic events, prospectively, while 53.6% patients (IR: 23.0 events ppy) reported hypoglycemic events, retrospectively. Nearly all patients reported hypoglycemia during the prospective period. Conclusions: This is a first patient-reported dataset on hypoglycemia in Turkish, insulin-treated diabetes patients. A high incidence of patient-reported hypoglycemia confirms that hypoglycemia remains under-estimated. Hypoglycemia increased healthcare utilization impacting patients' quality of life. Hypoglycemia remains a common side effect with insulin-treatment and strategies to optimize therapy and reduce hypoglycemia occurrence in diabetes patients are required