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    Does sufficient 25-hydroxyvitamin D mean lower metabolic risk for women?
    (Ios Press, 2020) Cetin, Zeynep; Baser, Ozden; Koseoglu, Derya; Catak, Merve
    OBJECTIVE: There are conflicting results regarding the relationship between metabolic diseases and vitamin D deficiency. We aimed to show the possible relationship between 25-hydroxy (OH) vitamin D levels and obesity, insulin resistance and hyperlipidemia in women. MATERIALS AND METHODS: Three hundred fifty seven female were included retrospectively. Body mass index (BMI) was determined with body weight (kg)/height (m(2)) formula. Fasting plasma glucose, insulin, lipid profile, calcium, phosphorus, parathormone, 25 hydroxy vitamin D, thyroid stimulating hormone were evaluated. Insulin resistance was calculated with homeostatic model values for insulin resistance (HOMA-IR). Patients were grouped according to 25 (OH) vitamin D levels and BMIs. RESULTS: 25 (OH) vitamin D was negative correlated with BMI, insulin and HOMA-IR, (respectively r = -0 .156, -0.128, -0.123 and p= 0.003, 0.015, 0.020). It is positive correlated with HDL and HDL/LDL ratio (respectively r= 0.183, 0.185 and p = 0.003, <0.001) HDL-C was higher in 25(OH) vitamin D sufficient group. After multivariate analysis, 25 (OH) vitamin D was still positively related with HDL and HDL/LDL ratio (respectively r= 0.127, 0.118 and p = <0.05). CONCLUSION: 25 (OH) Vitamin D is relationship with HDL, HDL/LDL ratio and invers relationship obesity. The normal 25 (OH) vitamin D supports the reduction of metabolik risk.
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    Malignancy outcomes and the impact of repeat fine needle aspiration of thyroid nodules with Bethesda category III cytology: A multicenter experience
    (Wiley, 2021) Koseoglu, Derya; Ozdemir Baser, Ozden; Cetin, Zeynep
    Background The clinical management of Bethesda III category thyroid nodules has some undefined points and differs among centers and conflicting malignancy rates are present in the literature. The aim of this study was to investigate the Bethesda category III thyroid nodule outcomes in our centers, to determine malignancy rates and also to evaluate clinical and sonographic features which may help to predict malignancy. Methods This retrospective study included 333 patients with thyroid nodules who had Bethesda category III on fine needle aspiration (FNA) in three tertiary medical centers of Turkey. Results Among 333 patients, 302 had appropriate follow up. Eighteen patients received thyroidectomy after the first FNA, with a malignancy rate of 38.89% (7/18) and 284 patients received a second FNA. After the second FNA, thyroidectomy was performed in 80 patients and 41 patients needed the third FNA. Thirteen thyroidectomies were performed after the third FNA. Totally 111 patients received thyroidectomy with a malignancy rate of 48.65% (54/111) among patients with surgery and the lower bound was detected as 17.88% (54/302). Of these patients the malignancy rates of patients receiving thyroidectomy with two and three FNAs were 47.50% (38/80) and 69.23% (9/13), respectively. Hypoechogenicity, microcalcification, and irregular margin were found as good predictors for malignancy. Conclusion We demonstrated that the malignancy rate was 48.65% in patients receiving thyroidectomy. We showed a higher malignancy rate than the traditionally rate of 5%-15%. This study showed that repeat FNAs decrease the rate of unnecessary surgery performed for benign lesions by increasing the rate of malignancy detection.
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    The role of therapeutic plasmapheresis in patients with hyperthyroidism
    (Pergamon-Elsevier Science Ltd, 2020) Baser, Ozden Ozdemir; Cetin, Zeynep; Catak, Merve; Koseoglu, Derya; Berker, Dilek
    Background: Hyperthyroidism is characterized by excess hormone secretion from the thyroid gland. Anti-thyroid drugs (ATDs), surgery, and radioactive iodine can be used in treatment. Plasmapheresis is a rapid and effective treatment option in cases where rapid euthyroidism is needed to be obtained due to complications of thyrotoxicosis and major adverse effects of ATDs. Material and method: We present patients receiving plasmapheresis to provide immediate euthyroidism due to severe hyperthyroidism, adverse effects of ATDs, or non-thyroid surgery from January 2012 to December 2016. Results: This study included 18 patients. The etiology of hyperthyroidism was TDG in seven patients, TDMNG in two, TA in two, TMNG in four, and one patient had AIT. Plasmapheresis was performed to achieve euthyroidism before surgery in two patients. The mean plasmapheresis session was 5.35. The mean number of sessions needed for patients with TDG and TDMNG was 4, whereas it was 6.5 for patients with TA and TMNG (p = 0.07). The decrease of mean free thyroxine and free triiodothyronine were 57 % and 73 %, respectively (p < 0.001). After plasmapheresis, total thyroidectomy was performed in 14 patients. Euthyroidism was achieved with RAI in one patient and with medical therapy in three patients. Conclusions: Plasmapheresis therapy is a reliable and effective treatment option for patients who cannot use ATDs because of their adverse events and those with hyperthyroidism that does not resolve with these drugs, or to achieve euthyroidism before total thyroidectomy, RAI or non-thyroid emergency surgery. However, it cannot be used widely because it is expensive and invasive.