Aylia Yesilova

Anamnez Alma Şema ve Özellikler Başak OĞUZ İNAN Hasta Şikayeti ve Kimlik Bilgisi Muhammet KIZMAZ Anamnez Alma Gülru AVCI Özgeçmiş Tuğba Sevinç GAMSIZ Soy Geçmiş Yıldız İPEK Sosyal Durum ve Alışkanlıklar Vildan GÜRSOY Kullandığı İlaçlar Hilal HEYBELİ Beden Fonksiyonları Fatma AYKAŞ Genel Durum Sorgusu Alper Tuna GÜVEN Solunum Sistemiyle İlgili Sorgu Sonat Pınar KARA Kardiyovasküler Sistemle İlgili Sorgu Tolga Onur BADAK Gastrointestinal Sistemle İlgili Sorgu Gülden BİLİCAN Üroloji’de Anamnez Ersin GÖKMEN Lokomotor Sistemle İlgili Sorgulama Hatice AĞIR Sinir Sistemi İle İlgili Sorgu Ayşegül AKKAN SUZAN Fizik Muayene Usulleri–İnspeksiyon İsmail KIRLI Fizik Muayene Usulleri (Palpasyon) Ayşe Nilgün KUL Perküsyon Deniz TAZEOĞLU Oskültasyon Mehmet Emre AY Metabolik Nedenlere Bağlı Karın Ağrıları Özgür BAHADIR Beslenme Durumunun Değerlendirilmesi Büşra Betül ÇAĞIR Boy ve Önemli Gelişim Hastalıkları (I) Seçil ÖZIŞIK Boy ve Önemli Gelişim Hastalıkları (II) Mustafa CAN Postür Muayenesi Hatice AĞIR Anormal Hareket Bozuklukları-I Fatma Ebru ALGÜL Anormal Hareket Bozuklukları-II Fatma Ebru ALGÜL Yürüyüş Funda GÖKGÖZ DURMAZ Konuşmanın Değerlendirilmesi ve Konuşma Bozuklukları Tuba GÜLLÜ KOCA Koku Alma Ali YEŞİLTEPE Ateş Aslıhan METE YILDIRIM Ateş ve Tipleri Pınar ERGEN, Fatma YILMAZ KARADAĞ Terleme Nursel AKBAY Tırnaklar (I) Müge BİLGE Tırnaklar (II) Fatma KAPLAN EFE Epidermis, Dermis, Subkutan Doku Sümeyra Alan YALIM Primer Deri Lezyonları Nida ÖZTOP Sekonder Deri Lezyonları Şengül BEYAZ Derinin Muayenesi Gökçem YALIN KOCAMAZ Baş Muayenesi Aylia YEŞİLOVA Yüzün ve Saçın Muayenesi-Özel Hastalıklarda Müçteba CAN Göz Hastalıklarında Ön Segment Muayenesi Ayşe Yeşim ORAL, İbrahim Ethem AY Göz Hastalıklarında Arka Segment Muayenesi Müberra AKDOĞAN, İbrahim Ethem AY Burun Muayenesi Tuğba Sevinç GAMSIZ Dudakların Muayenesi Gülşah BOZ Kulaklar Zekiye Pınar İPEK EYVAZ Boyun Muayenesi, Boyun Damarlarının Muayenesi, Boyun Lenf Ganglionlarının Muayenesi, Trachea Muayenesi Selman GENCER Tiroid Muayenesi Ebru ÖZDEN YILMAZ, Arda Şakir YILMAZ

Introduction: We evaluated several biological indicators based on inflammation and/or nutritional status, such as systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized COVID-19 patients with and without malignancies for a prognostic significance. Methodology: This is a retrospective and observational study on 186 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 75 patients had various malignancies, and the rest (111), having a similar age and comorbidity profile based on propensity score matching, had no malignancy. Results: None of the measures as neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio, SII, PNI or ANDC was found to be significantly different between two groups. Odds ratio for the mortality, OR 2.39 (%95 CI 1.80–3.16) was found to be significantly higher for the malignancy group, even though the duration of hospitalization was statistically similar for both groups. PNI was found to be significantly lower for deceased patients compared with survivors in the malignancy group. Contrarily, ANDC was found to be significantly higher for deceased patients in the malignancy group. Conclusions: PNI and ANDC have independent predictive power on determining the in-hospital death in COVID-19 malignancy cases. It is suggested that ANDC seems to be a more sensitive score than SII in COVID-19 cases with malignancies.

We described a rare case of RS3PE associated with DPP-4 inhibitor (saxagliptin) therapy in a diabetic patient with no evidence of another underlying pathology. To the best of our knowledge, this is the first case report of RS3PE associated with saxagliptin. The patient presented with acute onset of swelling and pain in multiple peripheral joints, swelling of the dorsum of the hands and feet occurred a month after the initiation of saxagliptin. Laboratory results were remarkable for elevated acute phase reactants. The diagnosis of RS3PE was made through exclusion and was based on acute onset of pitting edema, synovitis shown by ultrasound and magnetic resonance investigation, absence of joint erosions and negative rheumatoid factor. Patient showed a good response to low dose of steroids with a complete and sustained remission. The development of RS3PE following introduction of drug should suggest this drug as a possible trigger for the development of RS3PE.

Primary Sjögren's syndrome (pSS) is a chronic inflammatory autoimmune disease that can occur in a primary form or assosiated with other systemic diseases such as systemic lupus erythematosus (SLE). Here, we present a patient with diagnosis of pSS who developed lupus nephritis (LN) five years later and had no manifestations of SLE clinically. The urine analysis including proteinuria, leukocyturia and hematuria and hypocomplementemia alerts us of the presence of immunocomplex glomerulonephritis. The histopathological findings of renal biopsy of the patient revealed focal proliferative glomerulonephritis with

Background Hashimoto's thyroiditis (HT) is the most prevalent autoimmune thyroid disorder. Both neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are reported to be increased in various inflammation-related diseases, but their clinical significance in HT remains unclear. Objectives The aim of this study was to investigate the relationship between thyroid autommunity and NLR and PLR as markers of systemic inflammation in HT. Methods In this study, we evaluated 145 women with HT and 60 age-matched healthy controls. We compared the PLR and the NLR of HT patients with controls and the correlation between the NLR, PLR, and C-reactive protein (CRP), thyroid-stimulating hormone (TSH) and thyroid antibody titers in the patient group. Also we compared the PLR and the NLR of HT patients that received levothyroxine with those who did not receive levothyroxine Results There were no significant differences between patient and control groups in terms of overall leukocyte counts, neutrophil counts, and other laboratory tests. In the patient group lymphocyte counts were lower while the platelet counts, NLR (2.29±0.65 vs1.68±0.40), PLR (164.95±55.14 vs106.88±32.19) were higher than those of the control (p<0.001 for all comparisons). Conclusion In this study we found that NLR and PLR were higher in euthyroid Hashimoto patients than in a healthy control group. NLR and PLR are likely non-specific indicators of immune disorder and their implications for HT and other conditions remain to be elucidated.

Objective: Hashimoto’s thyroiditis is a common autoimmune disorder. A few studies have analyzed the association between serum vitamin D levels and Hashimoto’s thyroiditis and available data remains inconclusive. The aim of this study was to evaluate the association between serum 25-Hydroxy vitamin D levels in pre- and postmenopausal woman with Hashimoto’s thyroiditis. Methods: We evaluated 120 premenopausal women with euthyroid Hashimoto’s thyroiditis (Group 1), 51 postmenopausal women with Hashimoto’s thyroiditis (Group 2), and the control groups consisted of 102 (74 premenauposal and 28 postmenauposal) age matched healthy subjects; who applied to our outpatient clinic of the internal medicine and endocrinology department. Anti-thyroid peroxidase (TPOAb) and anti- thyroglobuline (TGAb) antibody were positive in all patients. Serum thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), 25-Hydroxy vitamin D and parathyroid hormone (PTH) levels were measured. Results: In the group 1 the mean vitamin D level was 12.46 μg/L (SD±12.34), compared to 19.467 μg/L (S.D.±8.19) in the control group for premenopausal women, P=0.02 (Table 1). In the group 2 the mean vitamin D level was 18.46 (S.D.±10.97) μg/L, compared to 23.12 μg/L (S.D.±8.60) in the control group for postmenopausal women (Table 2). Table 1 Comparison of premenopausal women with euthyroid Hashimoto’s thyroiditis and control group Group 1 (n=120) Control (n=74) P Age 36.41±7.8 36.59±7.86 NS TSH (μIU/ml) 2.86±1.45 1.90±0.92 Group 2 (n=51) Control (n=28) P Age 54.2±5.65 53.28±5.31 NS TSH (μIU/ml) 2.74±2.05 2.47±1.11 NS Free T4 (ng/dl) 1.14±0.25 1.13±0.15 NS Free T3 (ng/dl) 2.99±0.46 3.01±0.39 NS TPOAb (IU/ml) 329.81±326.51 7.89±2.83 <0.001 TGAb (IU/ml) 381.32±721.65 20.50±17.11 <0.01 Vitamin D (μg/l) 18.46±10.97 23.12±8.60 NS PTH (ng/l) 52.16±23.25 51.18±18.34 NS (NS; Not Significant). Keywords: Hashimoto’s thyroiditis, 25-Hydroxy vitamin D, pre- and postmenopausal woman

Objective: Hashimoto’s thyroiditis (HT) is extremely common, particularly among women. Mean platelet volume (MPV) and platelet distribution width (PDW) are the measure of platelet size. We aimed to investigate MPV and PDW levels in euthyroid woman with HT. Methods: This was a retrospective study in which the data were obtained from a computerized patient registry database. We evaluated 145 women with HT and 60 matched healty controls, who applied to our outpatient clinic of the internal medicine and endocrinology department. Anti-thyroid peroxidase (anti-TPO) and anti-tiroglobulin (anti-TG) antibody were positive in all patients. Serum thyroid-stimulating hormone (TSH),free thyroxine, free triiodothyronine, platelet count (PC),platelet mass (PM), MPV, and PDW were measured. PM was calculated by multiplying MPV and PLT. All subjects iron, total iron binding capacity, ferritin, vitamin B12 and folic acid were evaluated. Results: There were no significant differences in age between the study and the control groups. Anti-TPO and anti-TG levels were significantly higher in the study group (PPPr=0.217, P=0.01). MPV was positive correlated with anti-TPO and anti-TG levels (r=0.175, P=0.03; r=0.407, Pr=0.168, P=0.04; r=0.250, P=0.006, respectively). Our results suggest that even if in euthyroid state, patients with HT have higher MPV, PDW,PC, and PM levels than the healthy controls. Even if in euthyroid state, HT patients with levothroxine replacement show higher MPV and PDW levels than those with no levothroxine replacement. MPV and PDW parameters are also positively correlated with serum TSH levels. Conclusions: Because of have a higher risk of thyroid malignancies in HT patients,higher MPV and PDW levels may be associated with inflammation and thyroid malignancies.

Objective: It is recognized that autoimmun thyroid dysfunction is associated with weight and metabolic changes, insulin resistance and type 1 diabetes. In this study, we aimed to investigate whether thyroid autoimmunity had an effect on insulin sensitivity in euthyroid woman with Hashimoto’s thyroiditis. Methods: Forty-seven newly diagnosed euthyroid woman with Hashimoto’ thyroiditis with a mean age of 43 years were included in the study. The control group consisted of 39 age and BMI matched healthy subjects. Thyroid hormones and antibodies, thyroid peroxidase antibody (TPOAb) and thyroglobuline antibody (TGAb), insulin, glucose, c-peptid, HbA1c and uric acid levels, and Homeostasis Model Assessment İnsulin Resistance (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI) parameters were measured in all the subjects. Results: No significant correlation was observed between thyroid autoimmunity and HOMA-IR and between thyroid autoimmunity and QUICKI in both groups (Table 1). Table 1 Patient Control P Age 43.62±8.64 41.68±7.43 NS TSH (μIU/ml) 2.1±1.61 2.0±1.01 <0.001 Free T4 (ng/dl) 1.15±0.32 1.13±0.13 NS Free T3 (ng/dl) 2.97±0.49 3.0±0.39 NS TPOAb (IU/ml) 288.43±291.17 8.81±5.20 <0.001 TGAb (IU/ml) 323.17±651.96 16.98±12.36 <0.001 Uric acid (mg/dl) 4.09±1.09 3.94±0.93 NS Fasting glucose (mg/dl) 86.95±10.83 88.64±9.61 NS Fasting insülin (μg/dl) 11.28±6.68 11.31±13.30 NS C peptid (ng/ml) 2.38±1.05 2.44±1.36 NS HbA1c (%) 5.5±0.37 5.42±0.50 NS BMI 28.37±6.06 28.80±9.28 NS HOMA-IR 2.41±1.66 2.44±2.90 NS QUICKI index 0.34±0.03 0.35±0.03 NS NS: Not significant. Conclusion: Thyroid autoimmunity seem to not have a potential effect on insulin sensitivity in patients with newly diagnosed euthyroid Hashimoto’s.