Browsing by Author "Dokmetas H.S."

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    Etiology of hypopituitarism in tertiary care institutions in Turkish population: Analysis of 773 patients from pituitary study group database
    (Humana Press Inc., 2014) Tanriverdi F.; Dokmetas H.S.; Kebapci N.; Kilicli F.; Atmaca H.; Yarman S.; Ertorer M.E.; Erturk E.; Bayram F.; Tugrul A.; Culha C.; Cakir M.; Mert M.; Aydin H.; Taskale M.; Ersoz N.; Canturk Z.; Anaforoglu I.; Ozkaya M.; Oruk G.; Hekimsoy Z.; Kelestimur F.; Erbas T.
    Hypopituitarism in adult life is commonly acquired and the main causes are known as pituitary tumors and/or their treatments. Since there are new insights into the etiology of hypopituitarism and presence of differences in various populations, more studies regarding causes of hypopituitarism are needed to be done in different ethnic groups with sufficient number of patients. Therefore, we performed a multi-center database study in Turkish population investigating the etiology of hypopituitarism in 773 patients in tertiary care institutions. The study was designed and coordinated by the Pituitary Study Group of SEMT (The Society of Endocrinology and Metabolism of Turkey). Nineteen tertiary reference centers (14 university hospitals and 5 training hospitals) from the different regions of Turkey participated in the study. It is a cross-sectional database study, and the data were recorded for 18 months. We mainly classified the causes of hypopituitarism as pituitary tumors (due to direct effects of the pituitary tumors and/or their treatments), extra-pituitary tumors and non-tumoral causes. Mean age of 773 patients (49.8 % male, 50.2 % female) was 43.9 ± 16.1 years (range 16-84 years). The most common etiology of pituitary dysfunction was due to non-tumoral causes (49.2 %) among all patients. However, when we analyze the causes according to gender, the most common etiology in males was pituitary tumors, but the most common etiology in females was non-tumoral causes. According to the subgroup analysis of the causes of hypopituitarism in all patients, the most common four causes of hypopituitarism which have frequencies over 10 % were as follows: non-secretory pituitary adenomas, Sheehan's syndrome, lactotroph adenomas and idiopathic. With regard to the type of hormonal deficiencies; FSH/LH deficiency was the most common hormonal deficit (84.9 % of the patients). In 33.8 % of the patients, 4 anterior pituitary hormone deficiencies (FSH/LH, ACTH, TSH, and GH) were present. Among all patients, the most frequent cause of hypopituitarism was non-secretory pituitary adenomas. However, in female patients, present study clearly demonstrates that Sheehan's syndrome is still one of the most important causes of hypopituitarism in Turkish population. Further, population-based prospective studies need to be done to understand the prevalence and incidence of the causes of hypopituitarism in different countries. © 2013 Springer Science+Business Media.
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    Real-life safety and efficacy of vildagliptin as add-on to metformin in patients with type 2 diabetes in Turkey - GALATA study
    (Informa Healthcare, 2015) Ayvaz G.; Keskin L.; Akin T.F.; Dokmetas H.S.; Tasan E.; Ar I.B.; Uren E.; Akber T.; Akdeniz Y.; Bambul N.; Bayraktaroglu T.; Borlu F.; Boz M.; Bozoglu E.; Buyukbese M.A.; Canberk A.; Comlekci A.; Delibasi T.; Demir S.; Eskioglu E.; Guler S.; Gulkan S.; Hekimsoy Z.; Karaca Z.; Keskin M.; Koca N.; Korkmaz H.; Onder E.; Ozisik L.; Peru C.; Sahin M.; Saygili F.; Serin S.; Sezer H.; Sezgin G.; Tasci I.; Tasliyurt T.; Torun A.N.; Tura Bahadir C.; Gursoy Yener G.; Yigit Z.
    Objective: To evaluate tolerability/safety and the efficacy of the combination of vildagliptin plus metformin in a real-life population of patients with type 2 diabetes mellitus (T2DM). Research design and methods: This multicenter, single-arm, 6 month, observational, prospective cohort study was conducted at 39 centers across Turkey. T2DM patients on vildagliptin and metformin for ≤4 weeks were enrolled regardless of their previous antidiabetic therapy. Main outcome measures: Efficacy was evaluated by measuring hemoglobin A1c (HbA1c) levels. Tolerability/safety parameters evaluated included hypoglycemic events, gastrointestinal events, peripheral edema and weight gain. Results: This study enrolled 665 patients with a mean±standard deviation (SD) age of 55.1±10.2 years and female predominance (n=394, 59.2%). Safety was assessed in all enrolled patients. Hypoglycemia was reported in 10 (1.5%) patients (95% confidence interval = 0.8-2.7%). Efficacy was assessed in 289 (43.5%) patients treated for 6±1 months; these patients showed a mean decrease in HbA1c of 0.8% from baseline value of 7.8% (p<0.001). The percentages of patients who achieved HbA1c targets of ≤6.5% and ≤7.0% were significantly increased, from 10.7% to 33.6% and from 22.1% to 52.6%, respectively (p<0.001 each). The decrease in HbA1c was independent of baseline HbA1c (≤8% vs. 8-10% vs. ≥10%), age (≤65 vs. >65 years) and body mass index (<30 vs. ≥30 kg/m2) (p<0.001 each). In total, 136 adverse events (AEs) were observed in 71 (10.7%) patients; 10 (1.5%) patients experienced hypoglycemia and gastrointestinal AEs were most commonly reported (n=29, 4.4%). Conclusions: In a 'real-life' setting, the vildagliptin and metformin combination was associated with significant improvements in reaching target HbA1c levels, even in elderly and obese patients with T2DM. Moreover, vildagliptin and metformin demonstrated a good overall tolerability/safety profile. © 2015 All rights reserved: reproduction in whole or part not permitted.
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    Evaluation and follow-up of patients diagnosed with hypophysitis: A cohort study
    (Oxford University Press, 2024) Hacioglu A.; Karaca Z.; Uysal S.; Ozkaya H.M.; Kadioglu P.; Selcukbiricik O.S.; Gul N.; Yarman S.; Koksalan D.; Selek A.; Canturk Z.; Cetinarslan B.; Corapcioglu D.; Sahin M.; Sah Unal F.T.; Babayeva A.; Akturk M.; Ciftci S.; Piskinpasa H.; Dokmetas H.S.; Dokmetas M.; Sahin O.; Eraydln A.; Fenkci S.; Ozturk S.; Akarsu E.; Omma T.; Erkan B.; Burhan S.; Pehlivan Koroglu E.; Saygili F.; Kilic Kan E.; Atmaca A.; Elbuken G.; Alphan Uc Z.; Gorar S.; Hekimsoy Z.; Pekkolay Z.; Bostan H.; Bayram F.; Yorulmaz G.; Sener S.Y.; Turan K.; Celik O.; Dogruel H.; Ertorer E.; Turhan Iyidir O.; Topaloglu O.; Cansu G.B.; Unluhizarci K.; Kelestimur F.
    Objective: Primary hypophysitis might be challenging to diagnose, and there is a lack of evidence regarding optimal treatment strategies due to rarity of the disease. We aim to investigate the clinical features and compare the outcomes of different management strategies of primary hypophysitis in a large group of patients recruited on a nationwide basis. Design: A retrospective observational study. Methods: The demographic, clinical, and radiologic features and follow-up data were collected in study protocol templates and analyzed. Results: One hundred and thirteen patients (78.8% female, median age: 36 years) were included. Lymphocytic (46.7%) and granulomatous hypophysitis (35.6%) were the prevailing subtypes out of 45 patients diagnosed after pathologic investigations. Headache (75.8%) was the most common symptom, and central hypogonadism (49.5%) was the most common hormone insufficiency. Of the patients, 52.2% were clinically observed without interventions, 18.6% were started on glucocorticoid therapy, and 29.2% underwent surgery at presentation. Headache, suprasellar extension, and chiasmal compression were more common among glucocorticoid-treated patients than who were observed. Cox regression analysis revealed higher hormonal and radiologic improvement rates in the glucocorticoid-treated group than observation group (hazard ratio, 4.60; 95% CI, 1.62-12.84 and HR, 3.1; 95% CI, 1.40-6.68, respectively). The main indication for surgery was the inability to exclude a pituitary adenoma in the presence of compression symptoms, with a recurrence rate of 9%. Conclusion: The rate of spontaneous improvement might justify observation in mild cases. Glucocorticoids proved superior to observation in terms of hormonal and radiologic improvements. Surgery may not be curative and might be considered in indeterminate, treatment-resistant, or severe cases. © 2024 The Author(s). Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved.