Person: YAVUZ, DİLEK
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YAVUZ
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DİLEK
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Publication Metadata only Comparison of staging and recurrence predictors in patients with differentiated thyroid cancer between the 7th and 8th editions of the American Joint Committee on Cancer staging systems(2023-02-09) YAVUZ, DİLEK; Elbasan O., Gogas Yavuz D.Background: The predictive value of American Joint Committee on Cancer (AJCC) 8 for recurrence in differentiated thyroid cancer (DTC) is not known. We aimed to compare AJCC 7 and 8 regarding the differences in staging and recurrence predictors in DTC. Methods: Demographic, clinical (duration of disease and follow-up, the extent of surgery), laboratory (TSH, fT4, thyroglobulin, and antithyroglobulin), pathological (type of thyroid cancer, localization, multifocality, diameter, extrathyroidal extension [ETE], and lymph node [LN] metastasis), and imaging findings (sonography, and whole-body scan), and follow-up features (metastases, recurrence and/or persistence, and RAI need) were retrospectively analyzed in adult patients with DTC followed-up for at least six months. Staging was determined in accordance with AJCC 7 and AJCC 8, prediction of recurrence and persistence by ATA risk stratification, and death risk by AMES systems. The alterations in staging and recurrence predictors were analyzed. Results: A majority of study patients (N.=524) were female (N.=424) and diagnosed with papillary cancer (N.=511), the median age at diagnosis was 44. 97.89% (N.=93) of stage 2-4 patients (N.=95) in AJCC 7 were down-staged in AJCC 8. We down-staged 41 patients of 45-55 years of age into stage 1 in AJCC 8 independent of LN status. A percentage of 26.71% of patients (N.=140) did have persistence, 9.54% (N.=50) persistence at the last follow-up, and 9.54% (N.=50) had recurrence. According to AJCC 8, T4 and AMES high risk were predictors for recurrence (hazard ratio: 3.053, P=0.023; hazard ratio:2.465, and P=0.005; respectively). Both AJCC 7 and 8 were associated with recurrence (P=0.008 and P<0.001, respectively). Stage 4 in AJCC 7, and stages 3 and 4 in AJCC 8 better predicted the probability of recurrence.Publication Metadata only Peripheral nervous system assessment in acromegaly patients under somatostatin analogue therapy(SPRINGER, 2017) YAVUZ, DİLEK; Alibas, H.; Yavuz, D. Gogas; Koytak, P. Kahraman; Uygur, M.; Tanridag, T.; Uluc, K.Purpose Acromegaly is known to affect peripheral nervous system (PNS) causing carpal tunnel syndrome (CTS) and polyneuropathy. The frequency of these disorders and the evaluation methods vary among studies. In the present study, we aimed to examine PNS of acromegaly patients under somatostatin analogue (SSA) therapy. Methods Forty-eight acromegaly patients (26 F/22 M, 45.58 +/- 11.6 years) under SSA treatment and 44 healthy controls (25 F/19 M, 47.46 +/- 8.7 years) were assessed by symptom questionnaires, neurologic examination and electrophysiological studies. Results 87.5 % of the acromegaly patients had at least one abnormal finding regarding PNS. With the incorporation of palm-wrist median nerve conduction velocity method, we detected CTS in 50 % of patients. Polyneuropathy was less frequent (29.2 %). Both conditions were independent from the coexisting diabetes mellitus (p = 0.22 for CTS, p = 0.71 for polyneuropathy). Polyneuropathy but not CTS was more common among biochemically uncontrolled acromegaly patients rather than those under control (p = 0.03; p = 0.68, respectively). Conculsion Our findings emphasize the high prevalence of peripheral nervous system involvement in acromegaly patients under SSA therapy and importance of neurological evaluation of these patients. Early diagnosis and treatment of the disease may reduce the PNS involvement.Publication Metadata only Estrogen receptor gene polymorphisms in a group of postmenopausal Turkish women: association with bone mineral density(TAYLOR & FRANCIS LTD, 2012) YOLDEMİR, AHMET TEVFİK; Yavuz, D. G.; Yoldemir, T.; Ozaltun, K.; Erenus, M.Objective To evaluate the frequency of the estrogen receptor (ER) gene PvuII and XbaI polymorphisms and their associations with bone mineral density (BMD) in a group of postmenopausal Turkish women. Design A total of 125 healthy postmenopausal women and 125 premenopausal healthy young women as controls were included in the study. The PvuII and XbaI polymorphisms in the ER gene were studied by the polymerase chain reaction-restriction fragment length polymorphism method. The BMD of the lumbar vertebrae and femoral neck were measured by dual-energy X-ray absorptiometry. Results The frequencies of the ER alpha PVuII genotypes PP, Pp and pp were 20%, 54.4% and 25.6% in premenopausal and 24.8%, 44.8% and 30.4% in postmenopausal women, respectively. The frequencies of the ER XbaI genotypes XX, Xx, xx were 16.8%, 48.8% and 34.4% in premenopausal and 16.8%, 48% and 35.2% in postmenopausal women, respectively. There was no difference in the frequencies of ER gene polymorphisms between premenopausal and postmenopausal women. BMD measurements were not different between ER PvuII and XbaI genotypes in premenopausal and postmenopausal women. Conclusions ER gene PvuII and XbaI polymorphisms have no major influence on bone mineral density in our group of postmenopausal women.Publication Metadata only Effect of low- and high-dose levothyroxine on thyroid nodule volume: a crossover placebo-controlled trial(BLACKWELL PUBLISHING LTD, 2002) YAVUZ, DİLEK; Koc, M; Ersoz, HO; Akpinar, I; Gogas-Yavuz, D; Deynell, O; Akalin, SOBJECTIVE The efficacy and the effective dose of levothyroxine suppressive therapy in the treatment of benign thyroid nodules are controversial. In this study, we aimed to determine the response of solitary thyroid nodules to low- or high-level TSH suppression in a placebo-controlled, randomized crossover trial. DESIGN Forty-nine patients with solitary thyroid nodules on palpation were randomized to high-level and low- level TSH suppression groups. In each group, patients were further randomized to placebo and active levothyroxine subgroups. Patients in each subgroup were crossed over to placebo or active levothyroxine at the end of the first year and were then followed up for an additional year. METHODS TSH levels were suppressed to 0.4-0.6 mIU/ml and less than or equal to0.01 mIU/ ml in the low-level and high-level TSH suppression groups, respectively. Nodule volumes were measured at baseline and every 6 months after the desired level of TSH was reached if the patients were in the active levothyroxine treatment group or every 6 months if they were in the placebo group. RESULTS In high-level TSH suppression groups, nodule volume decreased significantly at the end of the active treatment periods (4.99 +/- 2.02 ml vs. 3.20 +/- 1.50 ml, P < 0.01, in Group 1; and 3.72 &PLUSMN; 1.79 ml to 2.05 &PLUSMN; 0.64 ml, P < 0.001, in Group 2). In the low-level TSH suppression groups, nodule volume also decreased significantly at the end of the active treatment periods (4.43 +/- 1.76 ml vs. 3.04 +/- 1.32, P < 0.05, in Group 3; and 3.59 &PLUSMN; 0.89 ml to 2.22 &PLUSMN; 0.59 ml, P < 0.01, in Group 4). Nodule volumes regained their original volumes during the placebo treatment periods. The percentage decline in clinically relevant nodule volume reduction (greater than or equal to50%) was similar in the low- level and high-level TSH suppression groups. CONCLUSION Low- and high-level TSH suppression were equally effective in reducing nodule volume and thus, considering the complications of high-level TSH suppression, low- level TSH suppression should be used if one considers levothyroxine suppressive therapy to reduce thyroid nodule size.Publication Metadata only Vitamin D receptor gene BsmI, FokI, ApaI, TaqI polymorphisms and bone mineral density in a group of Turkish type 1 diabetic patients(SPRINGER-VERLAG ITALIA SRL, 2011) YAVUZ, DİLEK; Yavuz, Dilek Gogas; Keskin, Lezan; Kiyici, Sinem; Sert, Murat; Yazici, Dilek; Sahin, Ibrahim; Yuksel, Meral; Deyneli, Oguzhan; Aydin, Hasan; Tuncel, Ercan; Akalin, SemaPrevious studies have suggested an influence of vitamin D receptor alleles on bone metabolism and on susceptibility to type 1 diabetes mellitus in different ethnic populations. We aimed to investigate the distribution of vitamin D receptor (VDR) alleles in relation to biochemical bone turnover parameters and bone densitometry measurements in a group of Turkish type 1 diabetic patients. One hundred and seventeen patients (M/F 57/60, 27.6 +/- A 7.3 y duration of diabetes 8.1 +/- A 6.3 y) and 134 healthy controls (M/F 61/73, 26.2 +/- A 5.3 y) were included in the study. Bone mineral density (BMD) was evaluated by dual-energy X-ray absorptiometry (DEXA). The vitamin D receptor gene (VDR) polymorphisms FokI, Bsm1, Apa1, and Taq1 were examined using a PCR-based restriction analysis. Serum levels of calcium, phosphor osteocalcin, intact parathyroid hormone, and C telopeptide were measured. Vitamin D receptor Bsm1 Fok1, Apa1, and Taq1 genotype distributions were not different between patient with diabetes and control groups. BMD was 0.77 +/- A 0.2 g/cm(2) vs. 0.97 +/- A 0.2 g/cm(2) (P = 0.0001) for the femur, 1.0 +/- A 0.1 g/cm(2) vs. 1.13 +/- A 0.1 g/cm(2) (P = 0.001) for type 1 diabetic patients and controls. Bone turnover markers were significantly lower in type 1 diabetic group. BMD measurements and bone metabolic markers were not different between the genotypes in either the patient with diabetes or the controls. The VDR gene polymorphisms, Bsm1, Fok 1, Apa1, and Taq1 showed no influence on bone metabolism in our group of type 1 diabetic patients.Publication Metadata only Epicardial Fat Tissue Thickness Correlates with Endothelial Dysfunction and Other Cardiovascular Risk Factors in Patients with Metabolic Syndrome(MARY ANN LIEBERT, INC, 2010) YAVUZ, DİLEK; Aydin, Hasan; Toprak, Ahmet; Deyneli, Oguzhan; Yazici, Dilek; Tarcin, Oezlem; Sancak, Seda; Yavuz, Dilek; Akalin, SemaBackground: Epicardial adipose tissue has shown to be related to cardiovascular risk. The aim of this study is to investigate the relationship between epicardial adiposity and endothelial function in metabolic syndrome. Methods: Fifty patients with metabolic syndrome were recruited. Anthropometric measurements, fasting blood glucose, insulin, lipid profile, high-sensitivity C-reactive protein (hsCRP), fibrinogen, apolipoprotein A (Apo A), Apo B1, and lipoprotein (a) [Lp(a)] were determined. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Epicardial fat thickness was measured via two-dimensional M-mode echocardiography. Endothelial function was assessed as flow-mediated dilatation at the brachial artery. Results: Epicardial fat tissue thickness was shown to be correlated negatively with FMD and positively with age, diastolic blood pressure, hsCRP, fibrinogen, HOMA-IR, and lipid parameters. Multiple regression analysis showed epicardial fat tissue thickness to be an independent factor influencing the endothelial function. Conclusions: Epicardial fat tissue may be a useful parameter in the assessment of patients with metabolic syndrome.Publication Metadata only Vitamin D receptor gene polymorphisms in a group of postmenopausal Turkish women: association with bone mineral density(INFORMA HEALTHCARE, 2011) YOLDEMİR, AHMET TEVFİK; Yoldemir, T.; Yavuz, D. G.; Anik, G.; Verimli, N.; Erenus, M.Objective To determine the frequency of the vitamin D receptor (VDR) gene polymorphisms BsmI, ApaI, TaqI and FokI and their associations with bone mineral density (BMD) in postmenopausal Turkish women. Design One hundred and thirty healthy postmenopausal women and 130 premenopausal healthy women acting as controls were included in the study. The BsmI, FokI, ApaI and TaqI polymorphisms in the VDR gene were studied by polymerase chain reaction-restriction fragment length polymorphism method. The BMD of the lumbar vertebrae and femur neck were measured by dual-energy X-ray absorptiometry. Comparisons between the groups were performed using the paired t-test and ANOVA. chi(2) or contingency tables were used to analyze qualitative results. Results Genotypes BB, Bb and bb occurred in premenopausal women with frequencies of 16.92%, 50% and 33.08% and in postmenopausal women with frequencies of 16.92%, 56.15% and 26.92%, respectively. Genotypes FF, Ff, ff occurred in premenopausal women with frequencies of 47.69%, 42.31% and 10% and in postmenopausal women with frequencies of 50.77%, 42.31% and 6.92%, respectively. Genotypes AA, Aa, aa occurred in premenopausal women with frequencies of 23.85%, 56.15% and 20% and in postmenopausal women with frequencies of 26.15%, 46.15% and 27.70%, respectively. Genotypes TT, Tt and tt occurred in premenopausal women with frequencies of 37.69%, 45.38% and 16.92% and in postmenopausal women with frequencies of 39.23%, 45% and 15.38%, respectively. There was no difference in the frequencies of VDR gene polymorphisms between premenopausal and postmenopausal women. BMD measurements were not different between genotypes in premenopausal and postmenopausal women. Conclusions The VDR gene BsmI, FokI, ApaI and TaqI polymorphisms have no major influence on bone mineral density in our group of postmenopausal women.Publication Metadata only Hipoparatiroidi: Etiyoloji, klinik ve tanıya gidiş(Akademisyen Yayınevi Kitabevi, 2023-01-01) YAVUZ, DİLEK; Yavuz D.Hipoparatiroidi (hipoPT) hipokalsemi ve eşlik eden düşük/ölçülemeyecek kadar düşük paratiro id hormon (PTH) düzeyleri ile karakterize ender bir hastalıktır (1). Hipoparatiroidi tanısı biyokimyasal olarak dü zeltilmiş kalsiyum veya iyonize kalsiyum düzeyi nin normalin altında olması ve eşlik eden uygun suz serum PTH düşüklüğü/ölçülemeyecek kadar düşük olması ile konur (1,2). Hipoparatiroidi prevalansı Kuzey Amerika’da 100,000 de 37, Avrupa’da 100,000 de 22 olarak rapor edilmiştir. Ülkemizdeki prevalansı bilinme mektedir. Hipoparatiroidi, renal yetmezlik, böbrek taşı, posterior subkapsüler katarakt, intraserebral kal sifikasyon riskini arttırmaktadır. Kardiyovasküler hastalık, kemik kırığı ve malinite riskini de art tırabileceği rapor edilmektedir. Kronik hipokal semi, hiperkalsiüri ve diğer komorbid sorunların mortaliteye etkisi açık değildir. Uzun dönemde hipoPT tedavisinde yetersizlik, akut ve kronik komplikasyonlar hastalığın morbiditesini etkile yen unsurlardır (1,2Publication Metadata only Effects of restoration of the euthyroid state on epicardial adipose tissue and carotid intima media thickness in subclinical hypothyroid patients(HUMANA PRESS INC, 2015) ÖZBEN SADIÇ, BESTE; Yazici, Dilek; Ozben, Beste; Toprak, Ahmet; Yavuz, Dilek; Aydin, Hasan; Tarcin, Ozlem; Deyneli, Oguzhan; Akalin, SemaEpicardial adipose tissue (EAT) thickness is a novel cardiovascular risk indicator, whereas carotid intima media thickness (CIMT) is a known marker of subclinical atherosclerosis. The aim of this study was to measure EAT thickness and CIMT in subclinical hypothyroid (SCH) patients and to determine the effect of restoration of the euthyroid state on these variables. The study included 43 patients with SCH (mean age: 35.2 +/- 10.7 years; F-M ratio: 42: 1) and 30 healthy controls (mean age: 34.5 +/- 8.2 years; F-M ratio: 25: 5). EAT thickness and CIMT were measured via conventional echocardiography and ultrasonography. Among the patients, 23 were followed up with L-thyroxine replacement until restoration of the euthyroid state and re-evaluated 6 months after baseline. Basal EAT thickness was higher in the SCH patients than in the controls (3.2 +/- 0.7 vs. 2.3 +/- 0.3 mm-p < 0.0001), whereas CIMT was similar in both groups (0.50 +/- 0.09 vs. 0.48 +/- 0.04 mm). EAT thickness was correlated with CIMT in the patient group (r = 0.39, p = 0.01), but this correlation was not evident based on multivariate analysis when corrected for age and body mass index (r(2) = 0.47 and p = 0.0001 for the model). In the follow-up patient subgroup, both EAT thickness and CIMT decreased significantly following L-thyroxine treatment, when normal TSH levels were attained (3.4 +/- 0.7 vs. 2.3 +/- 0.5 mm-p = 0.007 and 0.51 +/- 0.09 vs. 0.46 +/- 0.07 mm-p = 0.01, respectively). EAT thickness was greater in the SCH patients than in controls, whereas CIMT was similar in both groups. Restoration of the euthyroid state with L-thyroxine treatment was associated with significant decreases in EAT thickness and CIMT in the group of patients that received L-thyroxine treatment and, as such, might reduce the cardiovascular risk associated with SCH.Publication Metadata only Osteogenezis imperfekta tanılı 10 hasta: Klinik özellikler, sonuçlar ve tedavi yanıtı(2022-05-20) YAVUZ, DİLEK; Dashdemirova S., Yavuz D.