The comparison of bone mineral density in primary hyperparathyroidim, vitamin D induced secondary hyperparathyroidism, and patients with both condition: a single center experience

Background: To compare bone mineral densities via dual energy X-ray absorptiometry method (DXA) between various hyperparathyroidism (HPT) types such as primary, vitamin D induced secondary, and both conditions.Methods: Participants who were aged between 18-45 years and had elevated parathyroid hormone levels were included. After initial evaluations, patients were divided into 3 groups according to diagnoses: primary HPT (pHPT), vitamin D induced secondary HPT (sHPT), and combined (primary+secondary) one. In addition to the bone mineral density (BMD), demographic and laboratory datas were recorded.Results: Of 166 patients, 147 of the patients were female, 19 were male, and average age was 38.10±7.24 years. Significant difference was found in terms of age (p=0.03) between pHPT and sHPT. Blood calcium, PTH, 25-OH vitamin D, and daily urine calcium excretion levels were significantly higher and phosphorus levels were lower in the pHPT group compared to the sHPT and combined disease group. Both T and Z scores of the pHPT group were significantly lower than the sHPT group especially in the lumbar region. However, no significant difference was noted between pHPT and combined disease group with respect to T and Z scores in all regions.Conclusions: The results of this study indicate that pHPT has a significantly worse impact on skeletal mineral density particularly in the lumbar region than sHPT. The addition of vitamin D deficiency to the clinical picture seems to have no significant influence on BMD in pHPT. To confirm and clarify these findings, prospective studies with larger number of participants are needed

Evaluation of urban landscape with green infrastructure approach: the case of Cankaya / Ankara

Yeşil altyapı peyzaj içinde birçok fonksiyonun sağlanabilmesi için stratejik olarak planlanan ve yönetilen sistem bütününü ifade etmektedir. Bu çalışmada Ankara ili Çankaya ilçesinin kent peyzajı yeşil altyapı yaklaşımı ile incelenerek 2012-2018 yılları arasında yeşil altyapıda meydana gelen değişimler analiz edilip planlama önerileri geliştirilmiştir. Çalışmada, öncelikle yeşil altyapı bileşenlerini oluşturan tüm kentsel açık ve yeşil alanlar parça ve koridor tipolojisine göre 2012 ve 2018 yıllarına ait Copernicus Kent Atlası (Urban Atlas-UA) verileri kullanılarak tanımlanmıştır. Daha sonra ise bu alanlarda yaşanan değişimler FRAGSTATS 4.2 yazılımında sınıf düzeyinde sekiz peyzaj metriği ile analiz edilmiştir. Sonuç olarak, yeşil altyapı bileşenlerinin konut, sanayi ve taş ocakları gibi kültürel alanlar tarafından baskılandığı ve tahribata uğradığı belirlenmiştir. Bu kapsamda yeşil altyapı bileşenleri üzerindeki tahribat ile birlikte meydana gelen parçalanmanın önüne geçilebilmek amacıyla yol ağaçlandırması ve refüj bitkilendirmesi gibi yeşil altyapı bileşenlerinin birbirleriyle bağlantıları sağlayabileceği ve mevcut açık ve yeşil alan miktarının arttırılmasına/iyileştirilmesine katkıda bulunabilecek önerilerde bulunulmuştur.Green infrastructure refers to the system that is strategically planned and managed to provide many functions within the landscape. In this study, the urban landscape of Çankaya district in Ankara province was examined within the scope of the green infrastructure approach, and the changes in the green infrastructure between the years 2012-2018 were analyzed and planning proposals were developed. Initially, all types of urban open and green areas that make up the green infrastructure components were defined according to the patch and corridor typology using the Copernicus Urban Atlas (UA) data of the years 2012 and 2018, and then the changes in these areas were defined and analyzed using 8 class level landscape metrics in FRAGSTATS 4.2 software. As a result, it has been determined that the green infrastructure components were suppressed and destroyed by building areas such as housing, industry and quarries. In this context, in order to prevent the fragmentation that occurs with the destruction on the green infrastructure components, suggestions have been made that the green infrastructure components such as roadside and refuge vegetation can provide connections with each other and contribute to the existing open and green space

Neogene Uplift and Magmatism of Anatolia: Insights from Drainage Analysis and Basaltic Geochemistry

It is generally agreed that mantle dynamics have played a significant role in generating and maintaining the elevated topography of Anatolia during Neogene times. However, there is much debate about the relative importance of subduction zone and asthenospheric processes. Key issues concern onset and cause of regional uplift, thickness of the lithospheric plate, and the presence or absence of temperature and/or compositional anomalies within the convecting mantle. Here, we tackle these interlinked issues by analyzing and modeling two disparate suites of observations. First, a drainage inventory of 1,844 longitudinal river profiles is assembled. This geomorphic database is inverted to calculate the variation of Neogene regional uplift through time and space by minimizing the misfit between observed and calculated river profiles subject to independent calibration. Our results suggest that regional uplift commenced in the east at 20 Ma and propagated westward. Secondly, we have assembled a database of geochemical analyses of basaltic rocks. Two different approaches have been used to quantitatively model this database with a view to determining the depth and degree of asthenospheric melting across Anatolia. Our results suggest that melting occurs at depths as shallow as 60 km in the presence of mantle potential temperatures as high as 1400°C. There is evidence that potential temperatures are higher in the east, consistent with the pattern of sub-plate shear wave velocity anomalies. Our combined results are consistent with isostatic and admittance analyses and suggest that elevated asthenospheric temperatures beneath thinned Anatolian lithosphere have played a first order role in generating and maintaining regional dynamic topography and basaltic magmatism

Nonclassical Congenital Adrenal Hyperplasia and Pregnancy

Objective. The most common form of congenital adrenal hyperplasia (CAH) is 21-hydroxylase (21-OH) deficiency due to mutation of the CYP21A2 gene. Patients with nonclassical CAH (NC-CAH) are usually asymptomatic at birth and typically present in late childhood, adolescence, or adulthood with symptoms of excessive androgen secretion. Subfertility is relative in NC-CAH, but the incidence of spontaneous miscarriage is higher. Here, we report a previously undiagnosed female who gave birth to a normal male child and is planning to become pregnant again. Case Report. A 32-year-old female was referred to our clinic for obesity. Her medical history revealed that she had had three pregnancies. She was planning to become pregnant again. Her laboratory results revealed that she had NC-CAH. Since her husband is the son of her aunt and she had miscarriages and intrauterin exitus in her history, their genetic analyses were performed. Conclusion. Since most patients with NC-CAH have a severe mutation, these patients may give birth to a child with the classical CAH (C-CAH) if their partner is also carrying a severe mutation. Females with NC-CAH who desire pregnancy must be aware of the risk of having an infant with C-CAH