Browsing by Subject "thyroxine"
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Item Serum angiotensin-converting enzyme and plasma atrial natriuretic peptide levels in hyperthyroid and hypothyroid rabbits(1997) Yeǧin E.; Yiǧitoǧlu M.R.; Ari Z.; Çelik I.; Akçay F.; Su̧zek H.Background. It is known that serum angiotensin-converting enzyme (ACE) and plasma atrial natriuretic peptide (p-ANP) levels increase in hyperthyroidism. However, the precise mechanism of the effects of thyroid hormone on ANP release remains to be clarified. No study investigating serum ACE together with p-ANP levels has been performed in experimental hyperthyroid and hypothyroid rabbits. The present study was designed in order to provide additional evidence of increased ANP production and secretion in hyperthyroidism and to investigate the relationships between ANP, ACE and thyroid hormones. Methods. Male New Zealand white rabbits (2.3-3.4 kg) were used throughout the study. Hyperthyroidism was induced by daily intraperitoneal administration of L-thyroxin (50 μg/100 g). Hypothyroidism was induced by daily intraperitoneal injection of propylthiouracil (2 mg/100 g body weight). Twelve days after the end of treatment, animals were sacrified under anesthesia and blood samples were obtained from the aorta for serum ACE and thyroid hormone and p-ANP determinations. Results. Serum ACE, plasma renin activity (PRA) and p-ANP were higher in hyperthyroid rabbits and lower in hypothyroid rabbits than in euthyroid rabbits. ANP concentration in atria was lower in hyperthyroid rabbits and higher in hypothyroid rabbits than in euthyroid rabbits. p-ANP, PRA and serum ACE levels were positively correlated with serum thyroxin levels. Inverse correlation was found between serum thyroxin and ANP concentration in atria (a-ANP), and between p-ANP and a-ANP. Conclusions. Our results indicate that not only p-ANP but also serum ACE activity was markedly increased in experimental hyperthyroid rabbits. It was thought that there were both direct and indirect effects of thyroxin on the release of ANP.Item Depression and anxiety in hyperthyroidism(2002) Demet M.M.; Özmen B.; Deveci A.; Boyvada S.; Adigüzel H.; Aydemir O.Background. Our objective was to determine symptomatology of depression and anxiety in patients with untreated hyperthyroidism and compare with euthyroid patients. Methods. Thirty-two patients with hyperthyroidism (high free T3 and free T4, and suppressed TSH) and 30 euthyroid (normal free T3, free T4, and TSH) controls attending the Endocrinology Out-Patient Department at Celal Bayar University Hospital in Manisa, Turkey were included in the study. Hormonal screening was performed by immunoassay and hemagglutination method. For psychiatric assessment, Hospital Anxiety and Depression Scale [HAD], Hamilton Depression Rating Scale [HAM-D], and Hamilton Anxiety Rating Scale [HAM-A] were used. There was no difference between the two groups in terms of demographic features. Results. Total scores obtained both from HAM-D and HAM-A were significantly greater in the hyperthyroidism group than that of the euthyroid group (p <0.05); there was no difference in terms of HAD. When compared in terms of symptomatology, early insomnia (HAM-D#6), work and activities (HAM-D#7), psychic anxiety (HAM-D#10), weight loss (HAM-D#16), insomnia (HAM-A#4), and cardiovascular symptoms (HAM-A#8) were significantly more frequent in the hyperthyroidism group. By Wilks lambda discriminant analysis, psychomotor agitation (HAM-D#9), weight loss (HAM-D#16), and insomnia (HAM-A#4) were found as the discriminating symptoms for the hyperthyroidism group, whereas somatic anxiety (HAM-A#11) and loss of interest (HAD#14) were distinguishing symptoms of the euthyroidism group. Conclusions. Hyperthyroidism and syndromal depression-anxiety have overlapping features that can cause misdiagnosis during acute phase. For differential diagnosis, one should follow-up patients with hyperthyroidism with specific hormonal treatment and evaluate persisting symptoms thereafter. In addition to specific symptoms of hyperthyroidism, psychomotor retardation, guilt, muscle pain, energy loss, and fatigue seem to appear more frequently in patients with comorbid depression and hyperthyroidism; thus, presence of these symptoms should be a warning sign to nonpsychiatric professionals for the need for psychiatric consultation. © 2002 IMSS. Published by Elsevier Science Inc.Item Coexisting acromegaly and primary empty sella syndrome(Maghira and Maas Publications, 2004) Hekimsoy Z.; Yünten N.; Sivrioglu S.The normal functions of the pituitary gland may be suppressed when the gland is compressed onto the sella floor by arachnoid tissue extending through an impaired sella diaphragm. Interestingly, pituitary hormone hypo- and hypersecretion, including acromegaly, have been observed in patients with an 'empty sella'(1-4). This 'empty sella syndrome' has been classified into a primary form, in which no inciting factor (pituitary irradiation or surgery for a pituitary tumor) is present, and a secondary form, in which the empty sella occurs after pituitary procedures. In this report we describe a patient who presented with clinical and biochemical features of acromegaly and who had an empty sella on pituitary magnetic resonance imaging (MRI). Copyright © Neuroendocrinology Letters.Item Serum osteocalcin levels in hyperthyroidism before and after antithyroid therapy(2004) Barsal G.; Taneli F.; Atay A.; Hekimsoy Z.; Erciyas F.Hyperthyroidism is characterized by accelerated bone turnover, caused from direct stimulation of bone cells by increased thyroid hormones. In this study, we aimed to investigate serum osteocalcin levels as a bone formation marker, before antithyroid (propylthiouracil) therapy at hyperthyroid stage and after antithyroid therapy at euthyroid stage of the patients. Twenty four hyperthyroid patients (18 females, 6 males) and 20 (13 females, 7 males) healthy controls were included into this study. Blood and urine samples were taken before medical treatment at hyperthyroid state, and after the antithyroid therapy until the patients reached the euthyroid state. Serum alkaline phosphatase, osteocalcin, calcium, phosphorus, Free T3, Free T4, TSH and urine calcium/creatinine levels were assessed. We found a significant decrease in serum osteocalcin (p=0.006), urinary calcium/creatinine (p=0.004), and serum phosphorus (p=0.038) levels in euthyroid state in comparison to hyperthyroid state. The increases in serum bone formation marker osteocalcin and bone resorption marker urinary calcium/creatinine levels in hyperthyroid state compared to euthyroid state in our study confirmed that hyperthyroid patients have high bone turnover. We conclude that, hyperthyroid patients has high bone turnover of formation and resorption even after attainment of euthyroidism. Osteocalcin and urine calcium/creatinine are sensitive markers in documenting bone remodeling during treatment of hyperthyroidism. © 2004 Tohoku University Medical Press.Item A case of rhabdomyolysis induced acute renal failure secondary to statin-fibrate-derivative combination and occult hypothyroidism(Dustri-Verlag Dr. Karl Feistle, 2005) Kursat S.; Alici T.; Colak H.B.Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle contents into the systemic circulation. We hereby report a patient proved to be a case of unrecognized hypothyroidism presenting with rhabdomyolytic acute renal failure precipitated by the combined use of statin and fenofibrate. A 63-year-old woman was referred to our department because of fatigue, diffuse muscle pain and oliguria. On the basis of pathogenesis, clinical and laboratory examination the diagnoses of acute renal failure secondary to the statin-fibrate-derivative combination induced rhabdomyolysis and auto-immune thyroiditis induced hypothyroidism were made. Although saline, furosemide and sodium bicarbonate infusions enabled diuresis and have led to a rapid recovery of renal function and normalization of blood pressure in five days (creatinine level decreased from 4.5 mg/dl to 1.2 mg/dl), only thyroid replacement therapy (0,1 mg thyroxine) that begun after the exclusion of adrenal insufficiency resulted in complete resolution of rhabdomyolysis. This prompted the diagnosis of background, clinically silent rhabdomyolysis aggrevated by the statin-fibrate-derivative combination. To our knowledge this case illustrates the first example of rhabdomyolytic acute renal failure induced by a statin-fibrate-derivative combination with underlying hypothyroidism which was responsible for the basal clinically unobservable rhabdomyolysis. ©2005 Dustri-Verlag Dr. K. Feistle.Item Does thyroid replacement therapy affect pulmonary function tests in patients with subclinical hypothyroidism?(2006) Koral L.; Hekimsoy Z.; Yildirim C.; Ozmen B.; Yorgancioglu A.; Girgin A.Objective: Subclinical hypothyroidism is an elevation in serum thyroid-stimulating hormone (TSH) while having normal serum free thyroxine (FT4) and triiodothyronine (FT3) levels. The purpose of this prospective observational study was to evaluate the pulmonary function of patients diagnosed with subclinical hypothyroidism, both before and after treatment with thyroid hormone. Methods: This study took place at the Medical Faculty, Celal Bayar University, Manisa, Turkey between February 2003 and June 2004. Thirty-eight patients (37 females, one male) with subclinical hypothyroidism between 20 and 65 years of age were included in the study. Most were mildly obese. Arterial blood gases and pulmonary function tests were performed before treatment with thyroid hormone, and afterwards, the TSH value reached the normal range (indicating euthyroidism). Results: Oxygen saturation, but not partial oxygen pressure or partial carbon dioxide pressure, was statistically, but not clinically significantly higher after treatment with thyroid hormone (p=0.01). Pulmonary function tests were not significantly different before and after treatment with thyroid hormone. Conclusion: In our subclinical hy pothyroidism patients, pulmonary function tests were normal and did not significantly change with thyroid hormone replacement. The advantages of thyroid hormone replacement therapy, at least regarding respiratory function, seem to be clearly present in patients with overt, clinical hypothyroidism but not in patients with subclinical hypothyroidism.Item Dietary vitamin e (α-tocopherol acetate) and selenium supplementation from different sources: Performance, ascites-related variables and antioxidant status in broilers reared at low and optimum temperatures(2007) Özkan S.; Malayoǧlu H.B.; Yalçin S.; Karadaş F.; Koçtürk S.; Çabuk M.; Oktay G.; Özdemir S.; Özdemir E.; Ergül M.1. This study compared the effect of dietary supplementation with organic or inorganic selenium (Se) sources plus control amounts or large amounts of vitamin E (-tocopherol acetate) in broilers raised at control (20 to 24C) or low (145 to 168C) temperatures after 2 weeks of age. 2. The following dietary treatments were used from one day old. Diet 1, the control diet, comprised a commercial diet containing 015 mg/kg inorganic Se and 50 mg vitamin E/kg feed. Diet 2 was the same as diet 1, supplemented with 015 mg/kg inorganic Se. Diet 3 was the same as diet 2 but was supplemented with 200 mg/kg vitamin E. Diet 4 was the same as diet 1, but inorganic Se was replaced with 030 mg/kg organic Se. Diet 5 was the same as diet 4, supplemented with 200 mg/kg vitamin E. 3. Low temperature reduced the growth rate of broilers; however, at 6 weeks, there were no differences in the body weights of birds fed on organic Se supplemented diets housed at low or control temperature. The feed conversion ratio was significantly affected by low temperature but not by diet. The heterophil/lymphocyte ratio was higher in chicks after one week in the cold, indicating mild stress. Blood triiodothyronine levels were significantly higher in birds after 1 and 4 weeks in the cold but thyroxin was not affected. 4. Organic Se supplementation increased relative lung weight at the control temperature, which might lead to greater respiratory capacity. Relative spleen weight significantly decreased in broilers fed diets supplemented with inorganic Se under cold conditions, a possible indication of chronic oxidative stress. 5. At the low temperature, supplementation with organic Se alone, or with inorganic Se and vitamin E increased glutathione peroxidase (GSHPx) activity and glutathione (GSH) concentration in the liver of broilers, which may indicate increased activity of birds' antioxidant defence against suboptimal environments.Item Down-regulation of the auto-aggressive processes in patients with hypothyroid Hashimoto's thyroiditis following substitutive treatment with L-thyroxine(2009) Guclu F.; Ozmen B.; Kirmaz C.; Kafesciler S.O.; Degirmenci P.B.; Taneli F.; Hekimsoy Z.Background. Hashimoto's thyroiditis is a chronic, organ-specific autoimmune disease. It is the most common cause of primary hypothyroidism during the adolescent period, via autoimmune thyroid tissue destruction, affecting 2% of the population. The pathogenesis of Hashimoto's thyroiditis involves a complex interaction between predisposing genetic and environmental factors. Objective. In this study, we wanted to investigate the role of cytokines such as IL-2, IL-4, IL-12 and IFN-γ in the pathogenesis of the disease, and the changes to cytokine levels brought about by treatment with L-thyroxine. Methods. Sixty five female patients, aged 18-73 years with Hashimoto's thyroiditis, referred to the Celal Bayar University Medical Faculty Endocrinology out-patients clinic, were included in this study. After a 10-12 week period of L-thyroxine treatment, all patients were restored to the euthyroid state. At the beginning and end of the treatment period, serum-free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), autoantibodies against thyroid peroxidase (anti-TPO), autoantibodies against thyroglobulin (anti-Tg) levels were measured using a chemiluminecent, immunometric method, and cytokine levels were measured using ELISA. Results. There was a statistically significant decrease in the serum levels of TSH (p < 0.0001) and a concomitant increase in FT4 serum levels (p < 0.0001). Also, during the post-treatment period, serum levels of anti-Tg (p < 0.01) and anti-TPO (p < 0.001) were significantly lower than during the pre-treatment period. A statistically significant decrease was shown for interleukin (IL)-12 serum levels during the post-treatment period (p < 0.001). However, the decrease in interferon (IFN)-γ serum levels was not statistically significant (p = 0.276). On the other hand, no change was demonstrated in serum IL-2 and IL-4 levels (p = 0.953 and p = 0.313, respectively) after treatment with L-thyroxine. Conclusion. Considering that our study involved a 10-12 week period of treatment, the statistically significant decrease in serum IL-12 levels, and the statistically non-significant decrease in IFN-γ levels, might indicate that a T helper type 1 inflammatory process had been halted or slowed down.Item Interactions of thyroid hormones; Insulin-like growth factor-1 (IGF-1), igf binding proteins, and nutritional anthropometric parameters in school children with goiter detected by palpation(2009) Ersoy B.; Gunes H.S.; Uyanik B.S.; Taneli F.; Gunay T.Aim: In the present study we evaluated anthropometric indices, serum thyroid hormones, insulin-like growth factor-1 (IGF-1) and IGF- binding proteins (IGFBPs) levels, in children who has palpable goiter at endemic population. We aimed to 1) compare children with palpable goiter with healthy peers, 2) detect interaction of anthropometric indices, serum thyroid hormones, IGF-1 and IGFBPs parameters in both groups 3) evaluate the effects of their nutritional status to these parameters. Subjects and Methods: We performed goiter palpation to 1018 child and found goiter at 81 child. Seventy-three pubertal children were included in this study. Seventy-five healthy children were defined as the control group. Weight and height of all children were measured. Thyroid hormone levels, IGF-1, IGFBP-3, and IGFBP-1 were assessed in both groups. Results: Height and weight SDS were significantly lower in children who had goiter by palpation than healthy peers (p<0.05). Free T4 (FT4) levels were significantly higher in control group than children with palpable goiter (p<0.05). IGF-1 level and IGF-1 SDS were significantly lower in children with palpable goiter (p<0.001), IGFBP3 and IGFBP1 levels were not significantly different between the two groups (p>0.05). Serum IGF-1 and IGFBP-3 levels were significantly lower (p<0.05) in underweight children with goiter than normal weight group. In the presence of goiter, IGF-1 levels were lower (B: 0.97, 95% CI: 0.960.98, p<0.001). Conclusion: In endemic areas, children with palpable goiter were shorter and thinner than the healthy peers. Thyroid hormones were between the reference ranges. In children with palpable goiter, IGF-1 levels were lower and IGFBP-3 and IGFBP-1 levels were not different from the healthy control group. However, at the presence of goiter IGF-1 levels decrease. This decrease can be the result of insufficient nutrition and result in short stature and weakness than their healthy peers. © Georg Thieme Verlag KG Stuttgart, New York.Item Acute phase reactants in patients with coronary slow flow phenomenon; [Koroner yavaş akım fenomeni olan hastalarda akut faz reaktanları](AVES, 2010) Madak N.; Nazli Y.; Mergen H.; Aysel S.; Kandaz M.; Yanik E.; Çekdemir D.; Tavli T.Objective: In this study, we sought to investigate the serum levels of high sensitivity C-reactive protein (Hs-CRP), N-terminal pro-brain natriuretic peptide (NT proBNP), erythrocyte sedimentation rate, leukocyte, thyroid hormone and fibrinogen levels in patients with coronary slow flow phenomenon (CSFP). Methods: A total of 82 patients with angiographically proven normal coronary arteries and slow coronary flow in all three coronary vessels (45 males and 37 females, mean age 59±11 years) and 34 patients with normal coronary arteries and normal coronary flow (19 males and 15 females, mean age 56±10 years) with similar risk profiles were included in this cross-sectional observational study. Coronary flow rates of all patients and control subjects were documented by Thrombolysis In Myocardial Infarction (TIMI) frame count, serum level of Hs-CRP, NT proBNP, sedimentation, leukocyte, free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH) and fibrinogen levels were measured. Statistical analysis was performed using t test for independent samples, Chi-square test and Pearson correlation analysis. Results: Hs-CRP (0.88±0.86 vs 0.36±0.35 mg/L, p<0.001) and NT proBNP (117.83±163.2 vs 47.33±30.6 ng/ml, p<0.01) were found to be significantly higher in patients with coronary slow flow compared with normal control group. There are no significant differences regarding thyroid hormones, fibrinogen, sedimentation and leukocyte between two groups. The mean TIMI frame counts were positively correlated (r=0.454, p=0.001 and r=0.554, p=0.001, respectively) with plasma Hs-CRP levels and NT-proBNP levels. Conclusion: Hs-CRP and NT proBNP are significantly higher in patients with coronary slow flow compared with normal control group. Their increased levels are positively correlated with TIMI frame count. © 2010 by AVES Yayi{dotless}li{dotless}k Ltd.Item Oxidative DNA damage: The thyroid hormone-mediated effects of insulin on liver tissue(Humana Press Inc., 2010) Altan N.; Sepici-Dinçel A.; Şahin D.; Kocamanoǧlu N.; Kosova F.; Engin A.Thyroid hormone affects glucose homeostasis with its actions between the skeletal muscle and liver and the altered oxidative and non-oxidative glucose metabolism. In our study three chemicals are considered biomarkers associated with oxidative stress for protein modifications were measured; 8-hydroxy-2-deoxyyguanosine (8-OHdG), a major lesion that can be generated by reactive oxygen species for DNA damage, protein carbonyl content (PCO), products of protein oxidation and advanced oxidation protein products (AOPPs) a dithyrosine containing cross-linked protein products. The purpose of the recent study was to determine the effects of insulin and T4 or their combination in diabetic, thyroidectomized, or diabetic-thyroidectomized rats and possible relations with oxidative DNA and protein damages. For this purpose, rats were assigned to eight groups: Group 1; control, Group 2; diabetes, Group 3; diabetes + insulin, Group 4; surgically thyroidectomized control, Group 5; thyroidectomized + diabetes, Group 6; thyroidectomized + diabetes + insulin, Group 7; thyroidectomized + diabetes + insulin + thyroid hormone, levothyroxin sodium, 2.5 μg/kg and Group 8; thyroidectomized + diabetes + insulin + thyroid hormone, levothyroxin sodium, 5.0 μg/kg for 5 weeks. After the genomic DNA of liver tissues was extracted, the ratio of 8-OHdG to deoxyguanosine and liver tissue protein oxidation markers was determined. The main findings of our recent study were the increased 8-OHdG levels during the diabetes, hypothyroidism, and hypothyroidism with diabetes, which can be regulated in different percentages with the treatment of 2.5 and 5.0 μg/kg doses of thyroid hormone and the altered protein carbonyl and AOPP levels of liver tissue. Consequently, it was observed that the DNA and protein damage induced by oxidative stress in diabetes could be regulated by dose-dependent thyroid hormone-mediated effects to insulin treatment. © 2010 Springer Science+Business Media, LLC.Item The prevalence of hyperprolactinaemia in overt and subclinical hypothyroidism(2010) Hekimsoy Z.; Kafesçiler S.; Güçlü F.; Özmen B.The aims of this study were to: 1) determine the prevalence of hyperprolactinaemia in patients with newly diagnosed subclinical and overt hypothyroidism, and 2) investigate the change in PRL levels with treatment. In this observational study, patients with a new diagnosis of hypothyroidism in our endocrinology clinic were approached for participation, as were healthy controls. Patients with medical reasons for having elevated PRL levels, lactating and pregnant women were excluded from the study. No patient had kidney or liver disease. After examination to determine if clinical causes of PRL elevation were present, serum levels of thyrotropin (TSH), free thyroxine, free triiodothyronine and PRL were measured and correlation of PRL levels with the severity of hypothyroidism (overt or subclinical) was performed. Fifty-three patients (45 women, 8 men, mean age 45.3±12.2 years) had overt hypothyroidism. One hundred forty-seven patients (131 women, 16 men, mean age 42.9±12.6 years) had subclinical hypothyroidism. One hundred healthy persons (85 women, 15 men, mean age 43.9±11.4 years) participated as controls. The same blood tests were repeated in patients after normalization of TSH levels with L-thyroxine treatment. PRL elevation was found in 36% of patients with overt hypothyroidism, and in 22% of patients with subclinical hypothyroidism. PRL levels decreased to normal in all patients after thyroid functions normalized with L-thyroxine treatment. In the hypothyroid patients (overt and subclinical) a positive correlation was found between TSH and PRL levels (r=0.208, p=0.003). PRL regulation is altered in overt and subclinical hypothyroidism, and PRL levels normalize with appropriate L-thyroxine treatment.© The Japan Endocrine Society.Item Impact of nasal polyposis on erectile dysfunction(2011) Gunhan K.; Zeren F.; Uz U.; Gumus B.; Unlu H.Background: Our male patients with chronic rhinosinusitis with nasal polyposis (NP) declare a better sexual function after functional endoscopic sinus surgery (FESS) with polypectomy. This study was planned to conduct the first prospective, controlled trial evaluating the possible relation between erectile dysfunction (ED) and NP by subjective and objective parameters. Methods: Thirty-three male patients with NP and thirty randomly selected male control subjects were evaluated. All subjects underwent assessments of nasal endoscopy, rhinomanometry, body mass index (BMI), Epworth Sleepiness Scale, full in-laboratory polysomnograpy and serum levels of glucose, thyroid hormones, lipid profile, and testosterone. ED was evaluated by the erectile function domain of the International Index of Erectile Function (IIEF-EF) subjectively and nocturnal penile tumescence (NPT) objectively. The NP group was reassessed 6 months after FESS. Results: The mean age, BMI, and laboratory tests of the patients and the control subjects had no significant difference. The well-recognized risk factors for ED were eliminated. Preoperative evaluation of the patients revealed that ED was present in 34 and 24% of the patients by IIEF-EF and NPT, respectively, which was significantly higher than the control group (p = 0.009 and p = 0.018, respectively). There was a significant improvement of ED in the assessment of IIEF-EF and NPT postoperatively (p = 0.014 and p = 0.037, respectively). Conclusion: ED was determined in a high percentage of patients with NP and significantly ameliorated after FESS. NP might present a risk factor in the development of ED. Copyright © 2011, OceanSide Publications, Inc.Item Comparison of high-sensitivity C-reactive protein and fetuin-A levels before and after treatment for subjects with subclinical hyperthyroidism(Humana Press Inc., 2014) Bilgir O.; Bilgir F.; Topcuoglu T.; Calan M.; Calan O.This study was designed to show the effect of propylthiouracil treatment on sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels on subjects with subclinical hyperthyroidism. After checking sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels of 35 patients with subclinical hyperthyroidism, each was given 50 mg tablets of propylthiouracil three times daily. After 3 months, sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels were then compared to the levels before treatment. Although high-sensitivity C-reactive protein and sCD40L levels were normal in the subclinical hyperthyroidism patients compared to the healthy controls, fetuin-A levels were statistically significantly higher (*p = 0.022). After treatment, fetuin-A levels of subclinical hyperthyroidism patients decreased statistically significantly compared to the levels before treatment (**p = 0.026). sCD40L and high-sensitivity C-reactive protein levels did not have a statistically significant difference compared to the control group and post-propylthiouracil treatment. In subclinical hyperthyroidism patients, high fetuin-A levels before propylthiouracil treatment and decreases in these levels after treatment in cases with subclinical hyperthyroidism indicated the possibility of preventing long-term cardiac complications with propylthiouracil treatment. © 2013 Springer Science+Business Media New York.Item Subclinical hypothyroidism: Comparison of adhesion molecule levels before and after levothyroxine therapy(SAGE Publications Ltd, 2014) Bilgir F.; Bilgir O.; Calan M.; Calan O.; Isikyakar T.Objective: Adhesion molecules are involved in inflammation, atherosclerosis and malignancy. This study measured levels of adhesion molecules before and after levothyroxine therapy in patients with subclinical hypothyroidism (SHO). Methods: Levels of soluble (s) intracellular adhesion molecule (ICAM)-1, s vascular cell adhesion molecule (sVCAM) VCAM-1 and sE-selectin were analysed in patients diagnosed with SHO, prior to administration of 50 mg/day levothyroxine orally for 3 months. Subsequently, levels of sICAM-1, sVCAM-1 and sE-selectin were reanalysed then compared with the pretreatment levels. Results: In 30 patients with SHO, levels of sICAM-1 were found to be significantly higher than those in healthy controls, (P=0.001). Post-treatment sICAM-1 levels were significantly lower than pretreatment levels (P=0.001). No significant differences were found in sVCAM-1 or sE-selectin levels between healthy controls and patients with SHO before treatment, or between patients with SHO pre- and post-treatment. Conclusions: Patients with SHO had significantly higher levels of sICAM-1 compared with controls. Levels became normal after treatment with levothyroxine. These findings emphasize the need for levothyroxine therapy in cases of SHO to normalize sICAM-1 levels. Such treatment helps to prevent the future development of atherosclerosis or cancer. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.Item Allergic rhinitis and its relationship with autoimmune thyroid diseases(OceanSide Publications Inc., 2015) Degirmenci P.B.; Kirmaz C.; Oz D.; Bilgir F.; Ozmen B.; Degirmenci M.; Colak H.; Yilmaz H.; Ozyurt B.Background: Autoimmune thyroid diseases are the most common of all autoimmune diseases. In the literature, Hashimoto thyroiditis (HT) is considered to be a T-helper (Th) type 1 dominant condition, and Graves disease is considered a Th2-dominant condition. Objective: The aim of this study was to highlight a new aspect of the relationships among Th cell subgroups by determining the incidence of autoimmune thyroid disease in patients with allergic rhinitis (AR). Methods: Patients were diagnosed with AR based on their medical histories, physical examinations, and skin-prick test results in an outpatient clinic. The levels of free triiodothyronine, free thyroxine, thyroid-stimulating hormone, thyroid peroxidase antibodies, and thyroglobulin antibodies were measured in peripheral blood samples from all study subjects. Results: A total of 1239 patients with AR and 700 consecutive, age- and sex-matched healthy subjects were included in the study. Thyroid function tests showed that 1037 patients with AR (83.7%) had normal thyroid function, 171 (13.8%) had euthyroid HT, and 31 (2.5%) had hypothyroid HT. Among the control subjects, thyroid function test results showed that 688 subjects (98.2%) had normal thyroid function, 10 subjects (1.4%) had euthyroid HT, and 2 subjects(0.4%) had hypothyroid HT. Conclusion: The incidence of HT in the general population is 1.5%; in contrast, it was observed in 16.3% of our patients with AR, which represented a much higher rate than that in the overall population. Graves disease was not detected in our study subjects. A high incidence of HT in patients with AR, in which Th2 responses are dominant, indicates that further studies of the relationships among atopy, autoimmune diseases, and Th cell subgroups are needed. Copyright © 2015, OceanSide Publications, Inc., U.S.A.Item Effects of CPAP (Continous positive airway pressure) treatment on oxidative stress and pro-inflammatory process; [CPAP (Continous positive airway pressure) tedavisinin oksidatif stres ve proinflamatuar sürece olan etkisi](Ege University Press, 2016) Kisabay A.; Sari U.S.; Çakiroğlu Aldemir E.; Oktan B.; Korkmaz T.; Dinç Horasan G.; Yilmaz H.Introduction: Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for development of atherosclerotic processes because it leads to hypertension, impaired glucose metabolism, obesity and metabolic syndrome, cardiac diseases, elevated blood pressure, and increased level of cholesterol, triglycerides, homocysteine, and coagulation. Materials and Methods: Our aim was to evaluate presence of subclinical atherosclerosis prior to CPAP treatment in the patients with OSAS without any history of previous diseases and any pathological finding in their investigations. After obtaining approval from the Ethics Board, we planned to compare the results of investigations for risk factors for atherosclerosis (fasting blood glucose [FBG], total cholesterol, Triglycerides, HDL- and LDL-cholesterol, thyroid function test, homocysteine, fibrinogen, high sensitivity C-reactive protein [hsCRP]) before and after CPAP treatment and to examine the effect of CPAP treatment on these parameters between July 2013 and July 2015. Findings: Findings obtained before CPAP treatment (homocysteine, hsCRP, HbA1c, subclinical hypothyroidism) suggested subclinical atherosclerosis. In comparative evaluation between the findings before and after CPAP treatment, no statistically significant difference was found in levels of triglycerides, HDL-cholesterol and fT4 (P = 0.346, 0.540, 0.060, respectively) whereas significant differences were found in leukocyte and platelet counts, hemoglobin level, fasting blood glucose, LDL-cholesterol, homocysteine, fibrinogen, fT3, TSH, CRP, and HbA1c (P = 0,003,-0,010,-0,000,-0,001,-0,008-0,004-0,000-0,000-0,025-0,000-0,000-0,000, respectively). Subclinical hypothyroidism was present in 12 (20%) patients before CPAP and in 5 (7%) patients after CPAP treatment. Conclusions: Improvement has been seen even in early markers of atherosclerosis with effective CPAP. © 2016, Ege University Press. All Rights Reserved.Item Manifestation of hashimoto's encephalopathy with psychotic signs: A case presentation(Yerkure Tanitim ve Yayincilik, 2016) Kisabay A.; Balikci K.; Sari S.; Selcuki D.Hashimoto's encephalopathy (HE) is a rare autoimmune disease with unclear pathophysiology, developing on the basis of Hashimoto's thyroiditis (HT), associated with antithyroid antibodies, that presents with autoimmune, neuroendocrine, and neuropsychiatric findings. The disease is characterized by generalized or focal slowing in the EEG, elevated antithyroid antibody titration in the serum, elevated cerebrospinal fluid protein level, and the presence of antithyroid antibodies. HE is known as an autoimmune disorder of the central nervous system. With this feature, it is differentiated from cognitive alterations observed in hypothyroidism or hyperthyroidism. The response to treatment with corticosteroids in line with the autoimmune nature of HE supports this diagnosis. This report shows a case presenting with neuropsychiatric symptoms, elevated antithyroid antibody titration in the serum, and complete response to steroid therapy. A clear indicator for the diagnosis of HE has not yet been found. Therefore, other potential causes need to be considered in the differential diagnosis of this clinical picture until they can be excluded after investigations. With this case report, we want to emphasize that in differential diagnosis of patients presenting with a variety of neuropsychiatric symptoms, Hashimoto's encephalopathy-though being seen quite rarely-should not be disregarded, given the dramatic improvement of patients receiving a correct diagnosis and appropriate treatment.Item Sexual function and hormone profile in young adult men with idiopathic gynecomastia: Comparison with healthy controls(IOS Press, 2016) Sir E.; Üçer O.; Aksoy A.; Güngör M.; Ceylan Y.Objectives: To compare sexual function and hormone profile in male patients with gynecomastia with matched controls. MATERIALS-METHODS: Forty-seven male subjects with gynecomastia and thirty healthy controls were enrolled in this study. Serum free T3, free T4, TSH, FSH, prolactin, estradiol, total testosterone, free testosterone, DHEA-SO4, LH and total PSA were measured in the patients and controls. Sexual function of the patients and controls were evaluated using International Index of Erectile Function (IIEF). The hormone values and IIEF scores of the patients were statistically compared with the controls'. RESULTS: The mean of age, body mass index, right and left testicular volume in the patient and control group were similar. The mean FSH and free T3 values of the patients were significantly lower than the controls (p = 0:007 and p = 0:03, respectively). The mean of the other hormone values in the both groups were found to be statistically similar (p > 0:05). The mean ±SD of total IIEF scores in the patient and control group were 60:14 ± 8:78 and 65:24 ± 5:52, respectively (p = 0:007). Although the mean IIEF-erectile function, orgasmic function and intercourse satisfaction scores in the patient group were significantly lower than the control group (p < 0:001, p = 0:004 and p = 0:001, respectively), the mean IIEF-desire score of the patients was significantly higher than the controls (p = 0:002). CONCLUSION: We found that the hormone profiles (except FSH and free T3) of the patients with gynecomastia were similar with the controls. However, gynecomastia adversely affected male sexual function. © 2016-IOS Press and the authors. All rights reserved.Item Out-of-reference range thyroid-stimulating hormone levels in levothyroxine-treated primary hypothyroid patients: A multicenter observational study(Frontiers Media S.A., 2017) Yavuz D.G.; Yazici D.; Keskin L.; Atmaca A.; Sancak S.; Saraç F.; Şahin I.; Dikbaş O.; Hekimsoy Z.; Yalin S.; Uygur M.; Yilmaz M.; Yirmibeşcik S.; Asmaz Ö.Objective: Although levothyroxine (LT4) replacement therapy for hypothyroidism has been established as safe, inexpensive and effective, many studies from different countries reported out-of-reference range thyroid-stimulating hormone (TSH) values for the hypothyroid patients under LT4 treatment. The aim of this study was to determine TSH levels of primary hypothyroid patients under LT4 treatment and to assess self-reported compliance with daily LT4 intake in tertiary care centers in Turkey. Design: In this cross-sectional, observational study, adult patients with primary hypothyroidism, receiving LT4 treatment for at least 6 months, were included. The patients were from 12 tertiary care centers in 9 cities of Turkey. TSH and free T4 levels were recorded from patient files and self-reported compliance with daily LT4 intake was assessed by interviewing the subjects at the last visit. Results: A total of 1,755 subjects (46 ± 13 years; F/M: 89.9/10.1%) with primary hypothyroidism were enrolled. Of the hypothyroid subjects, 44.8% had out-of-reference range serum TSH levels. TSH values were over the reference range (TSH > 4 mIU/L) in 26.2% and were under the reference range (TSH < 0.5 mIU/L) in 18.6% of the patients. Total duration of LT4 treatment was 5.9 ± 4.7 years and mean dose was 1.2 ± 0.6 μg/kg/day. Non-compliant patients (31.1%) had higher TSH levels (6.9 ± 16 vs 3.8 ± 0.9 mIU/L, P = 0.01) compared to compliant patients. Conclusion: The results of this study revealed that nearly half of the hypothyroid patients had out-of-reference range serum TSH values, despite under LT4 treatment. Compliance with LT4 treatment seems to be one of the major determinants to reach the target TSH levels in hypothyroid patients. © 2017 Yavuz, Yazici, Keskin, Atmaca, Sancak, Saraç, Şahin, Dikbaş, Hekimsoy, Yalin, Uygur, Yilmaz, Yirmibeşcik and Asmaz.