Browsing by Author "Aydin, K"
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Item Influence of the selective oestrogen receptor modulator (raloxifene hydrochloride) on IL-6, TNF-α, TGF-β1 and bone turnover markers in the treatment of postmenopausal osteoporosisÖzmen, B; Kirmaz, C; Aydin, K; Kafesciler, SO; Guclu, F; Hekimsoy, ZBackground. Osteoporosis that is encountered frequently in postmenopausal women, may cause an increased incidence of vertebral and iliac fractures that are associated with excess morbidity. Raloxifene hydrochloride, a selective oestrogen receptor modulator, has been shown to increase bone mineral density and decrease biochemical markers of bone turnover in postmenopausal women, without stimulatory effects on breast or uterus. Levels of proinflammatory cytokines, including IL-6, and TNF-alpha and TGF-beta 1 which are important cytokines involved in remodeling, have been evaluated previously in in vitro studies of osteoporosis. However, there seems to be a paucity of in vivo research concerned with changes in these cytokines in osteoporosis. Objective. In this study, we evaluated the effects of raloxifene (Evista (R); Lilly Pharmaceutical Co. USA, 60 mg/day) on biochemical bone turnover markers, serum parathyroid hormone, and 25-OH vitamin D, as well as the serum levels of IL-6, TNF-alpha and TGF-beta 1, in 22 postmenopausal, osteoporotic women before and after 12 weeks of raloxifene treatment. Methods. Well-matched, postmenopausal, non-osteoporotic control subjects were also enrolled in the study. Serum levels of all the parameters were measured in postmenopausal, osteoporotic women at baseline and end of the study. Results. It was found that serum osteocalcin and parathyroid hormone, and urine deoxypyridinoline levels decreased to normal levels with treatment. Serum 25-OH vitamin D levels after treatment in the patient group were higher than those in the control group. Serum IL-6, TNF-alpha and TGF-beta 1 levels did not change significantly with treatment. However, serum levels of IL-6 and TGF-beta 1 in the patient group after treatment, decreased to levels lower than those found in the control group. Serum TNF-alpha levels in the patient group before and after treatment, were lower than those in the control group. Conclusion. Raloxifene treatment reduces bone turnover biochemical markers, parathyroid hormone and induces 25-OH vitamin D in postmenopausal women. Moreover, it also affects some serum cytokine levels in the postmenopausal period.Item The effect of heat treatment on laser-welding performance of additive manufactured Ti6Al4V sheetsAydin, K; Karamolla, M; Karaagaç, I; Kaçal, A; Dogan, HIn this study, the laser weldability of Ti6Al4V materials produced by the selective laser melting (SLM) method, which is an additive manufacturing method, and the effects of heat treatment applied to the welded material on the welding performance were investigated experimentally. Stress relief and heat treatment were applied to the materials joined by laser welding at 800 degrees C (below the alpha phase transformation temperature), 950 degrees C (between alpha and beta phase transformation temperature), and 1080 degrees C (above the beta phase transformation temperature). In addition, transverse and longitudinal welded joining techniques were also investigated to determine anisotropy in the produced parts. The mechanical properties in the laser-welded region were examined by hardness and tensile tests, and an optical microscope, scanning electron microscope (SEM), and X-ray diffraction (XRD) examined the changes in the microstructure. Grain growth was observed in the microstructure due to the increase in heat treatment temperature, and the tensile strength increased from 631.2 to 754.2 MPa in transverse bonding, while it increased from 648.1 to 761.9 MPa in longitudinal bonding. High hardness values due to Widmanstatten morphology were determined in the hardness test, especially after heat treatments at 950 and 1080 degrees C. It has been observed that the heat treatment increases the welding performance of the laser-welded material, and the best welding performance is obtained with a welding efficiency of 83.5% in the heat treatment at 1080 degrees C.Item The Experimental Assessment of Deformation and Springback Behavior for Additive Manufactured Ti6Al4VAydin, K; Karamolla, M; Karaagac, I; Kabakci, MO; Dogan, HIn this study, heat treatment was applied to Ti6Al4V materials produced by the selective laser melting (SLM) method at 550 degrees C, 800 degrees C, 950 degrees C, and 1080 degrees C temperatures, and the effect of this process on microstructure and mechanical properties was also investigated. Moreover, the parts produced with the additive manufacturing technique can be exposed to many loads at the place of use. Therefore, to determine the resistance of the materials against bending, the V bending process was applied to the materials in 6-, 7.5-, and 9-degree dies. XRD and SEM investigated the microstructure and optical microscope changes, and the mechanical properties were examined by uniaxial tensile test and microhardness analysis. In the test samples, pore and unmelted powder particles due to production in the microstructure were observed, and it was observed that the grain sizes increased with the increase in the heat treatment temperature. It was observed that samples HT550, HT800, and HT950 were shaped without breaking in the bending process in the 6-degree die, and all the samples were broken in the experiments performed in the 7.5-and 9-degree die.Item Prevalence and predictors of gestational diabetes mellitus: a nationwide multicentre prospective studyAydin, H; Çelik, Ö; Yazici, D; Altunok, Ç; Tarçin, Ö; Deyneli, O; Sancak, S; Kiyici, S; Aydin, K; Yildiz, BO; Çakiroglu, AY; Özer, A; Tuzcu, AK; Kan, A; Çelik, A; Uysal, A; Atmaca, A; Evren, B; Taskiran, B; Bilir, BE; Duran, C; Arpaci, D; Tüzün, D; Kavak, EÇ; Aydeniz, E; Akbas, EM; Üstünyurt, E; Bil, E; Güney, E; Akbaba, E; Gürkan, E; Çagliyan, E; Karakiliç, E; Karakas, E; Kilinç, F; Söylemez, F; Küçükler, FK; Yorulmaz, G; Akbaba, G; Uysal, G; Kurt, G; Yaylali, GF; Selimoglu, H; Sari, H; Piskinpasa, H; Çelik, H; Peynirci, H; Bilal, I; Sahin, I; Gözükara, I; Anaforoglu, I; Senyuva, I; Ugur, K; Dogan, K; Keskin, L; Mert, M; Adas, M; Tonguç, M; Eroglu, M; Kulaksizoglu, M; Özcan, M; Çinar, N; Kutbay, NÖ; Dikbas, O; Bakiner, O; Turhan, ÖT; Tütüncüoglu, P; Sari, R; Melekoglu, R; Ayaz, R; Emral, R; Mumusoglu, S; Görar, S; Keskek, SÖ; Tosun, SA; Çetinkaya, SE; Temizkan, S; Ünsal, S; Demir, T; Yüce, T; Aksoy, Ü; Çinkir, Ü; Simsek, Y; Uyar, Y; Türk, Y; Pekkolay, Z; Hekimsoy, Z; Cantürk, Z; Üç, ZAAim Prevalence rates of gestational diabetes mellitus (GDM) show considerable variation among different countries and regions of the world. The primary aim of this study was to determine the nationwide prevalence and predictors of GDM in Turkey. Methods We conducted prospective nationwide screening among pregnant women. Between August 2016 and November 2017, a total of 2643 pregnant women from 51 centres in 12 different regions were enrolled. A two-step screening method and Carpenter and Coustan criteria were used in the diagnosis of GDM. Clinical and biochemical data were obtained using electronic database software. Results The national prevalence of GDM was found to be 16.2% [95% confidence intervals (CI) 15.0% to 17.4%] without a significant difference between urban and rural regions. Women with GDM were older (mean age: 32 +/- 5 vs. 28 +/- 5 years, P < 0.001) and heavier (mean BMI: 27.2 +/- 5.1 vs. 24.7 +/- 4.7 kg/m(2), P < 0.001) than their counterparts without GDM. The prevalence of GDM tended to increase with age (< 25 years, 6.9%; 26-35 years, 15.6%; and 36-45 years, 32.7%; P < 0.001). Maternal age, maternal BMI, history of previous GDM and family history of diabetes mellitus were independent predictors of developing GDM (P < 0.05 for all). Low-risk women (age < 25 years, BMI < 25 kg/m(2), no family history of diabetes) comprised 10.7% of the total population and the prevalence of GDM in these women was 4.5% (95% CI 2.4% to 7.8%). Conclusion The results of this nationwide study indicate that GDM is very common, affecting one in seven pregnancies in Turkey. Implementation of international guidelines on screening and management of this public health problem is required.Item The Importance of DHEA-S Levels in Cushing's Syndrome; Is There a Cut-off Value in the Differential Diagnosis?Ciftci, S; Soyluk, O; Selek, A; Erol, S; Hekimsoy, Z; Esen, A; Dursun, H; Sahin, S; Oruk, G; Mert, M; Soylu, H; Yurekli, BS; Ertorer, ME; Omma, T; Evran, M; Adas, M; Tanrikulu, S; Aydin, K; Pekkolay, Z; Can, B; Karakilic, E; Karaca, Z; Bilen, H; Canturk, Z; Cetinarslan, B; Kadioglu, P; Yarman, SThe purpose of this study was to determine possible cut-off levels of basal DHEA-S percentile rank in the differential diagnosis of patients with Cushing's syndrome (CS) with ACTH levels in the gray zone and normal DHEA-S levels. In this retrospective study including 623 pathologically confirmed CS, the DHEA-S percentile rank was calculated in 389 patients with DHEA-S levels within reference interval. The patients were classified as group 1 (n=265 Cushing's disease; CD), group 2 (n=104 adrenal CS) and group 3 (n=20 ectopic ACTH syndrome).ROC-curve analyses were used to calculate the optimal cut-off level of DHEA-S percentile rank in the reference interval in the differential diagnosis of CS, and the effectiveness of this cut-off level in the identification of the accurate etiology of CS was assessed in patients who were in gray zone according to their ACTH levels. The DHEA-S percentile rank in the reference interval were significantly lower in group 2 compared to the other two groups (p<0.001), while group 1 and group 3 had similar levels. The optimal cut-off level of DHEA-S percentile rank in the reference interval providing differential diagnosis between group 1 and group 2 was calculated as 19.5th percentile (80.8% sensitivity, 81.5% specificity) and the level demonstrated the accurate etiology in 100% of CD and 76% of adrenal CS patients who were in the gray zone. This study showed that the cut-off value of DHEA-S level less than 20% of the reference interval could be used for differential diagnosis of CD and adrenal CS with high sensitivity and specificity, and it should be taken into the initial evaluation.Item Assesment of attainment of recommended TSH levels and levothyroxine compliance in differentiated thyroid cancer patientsYavuz, DG; Yazan, CD; Hekimsoy, Z; Aydin, K; Gokkaya, N; Ersoy, C; Akalin, A; Topaloglu, O; Aydogan, BI; Dilekci, ENA; Uc, ZA; Cansu, GB; Ozsari, L; Iyidir, OT; Olgun, ME; Keskin, L; Mert, M; Can, B; Gungor, K; Galip, T; Cantürk, Z; Elbuken, G; Pekkolay, Z; Kutbay, NO; Yorulmaz, G; Kalkan, AT; Unsal, YA; Yay, A; Karagun, B; Bozkur, EObjective Thyroid-stimulating hormone (TSH) suppression treatment can induce signs and symptoms of hyperthyroidism and hypothyroidism due to inappropriate treatment or poor compliance to the treatment. The current study aimed to investigate TSH levels, frequency of being on target TSH, adherence to levothyroxine (LT4) suppression treatment in differentiated thyroid cancer (DTC) patients after surgery in a multicentric setting. Design and Patients This multicentric cross-sectional study was conducted at 21 medical centres from 12 cities in Turkey. DTC patients followed at least one year in the same center included in the study. Clinical data, serum TSH, free thyroxine (FT4), thyroglobulin (Tg) and anti-Tg levels were recorded during the most recent visit. Body mass index, systolic and diastolic blood pressures, pulse rate were measured. LT4 doses were recorded and doses per kilogram of bodyweight were calculated. Pill ingestion habits recorded and adherence to the therapy were evaluated using the Morisky Medication Adherence Scale and categorized as good, moderate or poor compliant based on their scores. Risk stratification forpredicting the disease persistance and/or reccurence was assessed using the American Joint Committee on Cancer-7th edition thyroid cancer staging calculator. TSH serum concentrations were classified as severe suppression (TSH < 0.01 mU/L), moderate suppression (TSH: 0.01-0.1 mU/L), mild suppression (TSHL 0.1-0.5 mU/L), euthyroid (TSH: 0.5-4 mU/L) and hypothyroid (TSH > 4 mU/L). TSH levels can also be classified as on being on target, under the target, or beyond over the target, according to the American Thyroid Association recommendations. Results A group of 1125 patients (F/M: 941/184, 50.7 +/- 11.7 years) were included in the study. The mean LT4 daily dosage was 132.4 +/- 39.6 mcg/day. TSH levels showed severe suppression in 99 (%8.8) patients, moderate suppression in 277 (%24.6) patients and mild suppression in 315 (%28) patients and euthyroid range in 332 (%29.5) patients and hypothyroid range in 97 (8.6%). TSH levels were in target in 29.2% of the patients 20.4% of the patients were undertreated, 50.4% overtreated. The daily LT4 dose and LT4 dose/kg were significantly higher in the severe suppression group (p < .001, p < .001). According to the Morisky scale, 564 patients (50.1%) were good compliant, 368 patients (32.7%) were moderate compliant, and 193 patients (17.1%) were noncompliant. Patients with poor compliance need a higher dose of LT4 compared to the good compliance group (p < .001). TSH levels of patients with good compliance were 0.67 +/- 1.96 mU/L and TSH with poor compliance was 2.74 +/- 7.47 mU/L (p < .001). TSH levels were similar in patients on fixed and alternating dosages. Conclusion In 29.2% of the DTC patients, serum TSH levels were at target levels. Remaining of the study group have TSH levels under or over treatment range, exposing the patient to medication side effects. Majorty of the study group 82.8% have good or moderate adherence to LT4 therapy. Reaching TSH targets requires simplified and applicable guidelines and following the guideline recommendations.Item Prognostic factors of patients who received chemotherapy after cranial irradiation for non-small cell lung cancer with brain metastases: A retrospective analysis of multicenter study (Anatolian Society of Medical Oncology)Inal, A; Kodaz, H; Odabas, H; Duran, AO; Seker, MM; Inanc, M; Elkiran, ET; Gunaydin, Y; Menekse, S; Topcu, TO; Urakci, Z; Tastekin, D; Bilici, M; Cihan, S; Geredeli, C; Sezer, E; Uncu, D; Arpaci, E; Ozturk, B; Bal, O; Uysal, M; Tanriverdi, O; Gumus, M; Ustaalioglu, BBO; Suner, A; Cokmert, S; Hacibekiroglu, I; Aydin, K; Isikdogan, APurpose: Almost half of all patients diagnosed with non-small cell lung cancer (NSCLC) have distant metastases at presentation. One-third of patients with NSCLC will have brain metastases. Without effective treatment, the median survival is only 1 month. However, it is difficult to treat brain metastases with systemic chemotherapy since the agents have difficulty crossing the blood-brain barrier. Therefore, it is important to estimate the patient's survival prognosis. The aim of this study was to analyze prognostic factors for survival in Turkish patients who received chemotherapy after cranial irradiation for NSCLC with brain metastases. Methods: We retrospectively reviewed 698 patients with brain metastases resulting from NSCLC. Ten potential prognostic variables were chosen for analysis. Univariate and multivariate analyses were conducted to identify prognostic factors associated with overall survival (OS). Results: Among the 10 variables for univariate analysis, six were identified to have prognostic significance; these included sex, smoking history, histology, number of brain metastases, extracranial metastases, and neurosurgical resection. Multivariate analysis by the Cox proportional hazard model showed that a smoking history, extracranial metastases, and neurosurgical resection were independent negative prognostic factors for OS. Conclusion: Smoking history, extracranial metastases, and neurosurgical resection were considered independent negative prognostic factors for OS. These findings may facilitate pretreatment prediction of survival and can be used for selecting patients for more appropriate treatment options.Item Shared Biological Pathways and Processes in Patients with Intellectual Disability: A Multicenter StudyGünay, C; Aykol, D; Özsoy, O; Sönmezler, E; Hanci, YS; Kara, B; Sünnetçi, DA; Cine, N; Deniz, A; Özer, T; Ölçülü, CB; Yilmaz, O; Kanmaz, S; Yilmaz, S; Tekgül, H; Yildiz, N; Arslan, EA; Cansu, A; Dündar, NO; Kusgoz, F; Didinmez, E; Gençpinar, P; Uzunhan, TA; Ertürk, B; Gezdirici, A; Ayaz, A; Ölmez, A; Ayanoglu, M; Tosun, A; Topçu, Y; Kiliç, B; Aydin, K; Çaglar, E; Kosvali, OE; Okuyaz, C; Besen, S; Orgun, LT; Erol, I; Yüksel, D; Sezer, A; Atasoy, E; Toprak, U; Güngör, S; Ozgor, B; Karadag, M; Dilber, C; Sahinoglu, B; Yalçin, EU; Hacifazlioglu, NE; Yaramis, A; Edem, P; Tekin, HG; Yilmaz, U; Ünalp, A; Turay, S; Biçer, D; Mert, GG; Çetin, ID; Kirik, S; Öztürk, G; Karal, Y; Sanri, A; Aksoy, A; Polat, M; Özgün, N; Soydemir, D; Uzan, GS; Üstebay, D; Gök, A; Yesilmen, MC; Yis, U; Karakülah, G; Bursali, A; Oktay, Y; Kurul, SHBackground Although the underlying genetic causes of intellectual disability (ID) continue to be rapidly identified, the biological pathways and processes that could be targets for a potential molecular therapy are not yet known. This study aimed to identify ID-related shared pathways and processes utilizing enrichment analyses. Method In this multicenter study, causative genes of patients with ID were used as input for Disease Ontology (DO), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes enrichment analysis. Results Genetic test results of 720 patients from 27 centers were obtained. Patients with chromosomal deletion/duplication, non-ID genes, novel genes, and results with changes in more than one gene were excluded. A total of 558 patients with 341 different causative genes were included in the study. Pathway-based enrichment analysis of the ID-related genes via ClusterProfiler revealed 18 shared pathways, with lysine degradation and nicotine addiction being the most common. The most common of the 25 overrepresented DO terms was ID. The most frequently overrepresented GO biological process, cellular component, and molecular function terms were regulation of membrane potential, ion channel complex, and voltage- gated ion channel activity/voltage-gated channel activity, respectively. Conclusion Lysine degradation, nicotine addiction, and thyroid hormone signaling pathways are well-suited to be research areas for the discovery of new targeted therapies in ID patients.