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    Are Small Adrenal Incidentalomas Solely a Radiological Finding?
    (Johann Ambrosius Barth Verlag Medizinverlage Heidelberg Gmbh, 2015) Eroglu, M.; Erbag, G.; Turkon, H.; Binnetoglu, E.; Ozkul, F.; Gunes, F.; Sen, H.
    Objective: The criterium defining the threshold size of adrenal incidentaloma (AI) is a size greater than 1cm diameter. However, data concerning AI1cm in diameter is scant. The aim of this study was to evaluate the function of adrenal masses1cm and to compare them with adrenal masses>1cm. Materials and Methods: The study included 130 consecutive patients with AI (38 and 92 AI at 1cm and >1cm, respectively). The patients were evaluated according to demographic and hormonal characteristics. Results: The prevalence of SCS was 5.3 and 12% in AI1cm and >1cm diameter, respectively. Hyperaldosteronism was found only in patients with >1cm AI. Pheochromocytoma were not found in either group. Patients with >1cm AI had a higher prevalence of SCS and primary hyperaldosteronism than patients with 1cm AI, but the difference was not significant. The prevalence of diabetes and hypertension was high both in non-functional AI with 1cm and >1cm patients and showed no significant difference between the 2 groups. Conclusion: Our study is the first to focus on the clinical and hormonal characteristics of patients with 1cm AI. Those with AI1cm harboured SCS, as was the case for AI>1cm. Similar to AI>1cm, non-functional AI1cm also had a higher prevalence of diabetes and hypertension.
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    Mean Platelet Volume and Neutrophil Lymphocyte Ratio as Related to Inflammation Markers and Anti-CCP in Rheumatoid Arthritis
    (Georg Thieme Verlag Kg, 2016) Gokmen, F.; Akbal, A.; Resorlu, H.; Binnetoglu, E.; Cevizci, S.; Gokmen, E.; Kose, M. M.
    Background: Various thrombocyte markers and white blood cell levels and their subtypes have recently been investigated in association with infl ammation. The purpose of this study was to determine the correlation of mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) with disease activation and clinical parameters in rheumatoid arthritis (RA) patients. Methods: 84 RA patients and 60 healthy controls were included. Platelet, MPV, white cell, neutrophil and lymphocyte levels in full blood counts were investigated, and NLR was calculated. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), disease activation score (DAS 28) and a health assessment questionnaire (HAQ) were used in the evaluation of RA. Results: In the present study a total of 144 patients was enrolled, 84 with RA and 60 healthy individuals. 75.2 % (n = 108) were women and 24.8 % (n = 36) were men. The patients with RA had lower MPV than control individuals (MPV; 8.52 +/- 1.15 fL and 8.92 +/- 0.87 fL, respectively) and CRP (r: -0.234, p = 0.005). RA patients' mean NLR was signifi cantly higher than that of the control group (2.74 +/- 1.74 and 1.80 +/- 0.78, respectively; p < 0.001). Furthermore, anti-CCP positive patients had higher NLR than anti-CCP negative patients (NLR; 2.51 +/- 1.92 and 1.95 +/- 1.22, p = 0.019 respectively). NLR was positively correlated with ESR (r = 0.190, p = 0.023), CRP (r = 0.230, p = 0.035) and anti-CCP (r = 0.300, p = 0.005). Conclusion: In conclusion, MPV and NLR together with acute phase reactants can be a useful index for showing infl ammation in RA patients.
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    Relationship between betatrophin levels and metabolic parameters in patients with polycystic ovary syndrome
    (C M B Assoc, 2016) Erbag, G.; Eroglu, M.; Turkon, H.; Sen, H.; Binnetoglu, E.; Aylanc, N.; Asik, M.
    To evaluate the status of serum betatrophin levels and potential relations between metabolic parameters and betatrophin levels in patients with polycystic ovary syndrome. We included patients newly diagnosed with PCOS in our study. Fifty-seven female patients (30 patients with PCOS and 27 healthy control subjects) were enrolled in this study. Serum betatrophin levels were measured using a betatrophin enzyme-linked immunosorbent assay kit. Insulin resistance was calculated using the homeostasis model of the assessment-insulin resistance index formula. The betatrophin level was 1538,85 ng/L in the patient group and 2440,46 ng/L in the control group, and the difference was statistically significant (p=0.003). A significantly negative correlation was found between betatrophin level and insulin, HOMA-IR, and BMI. Betatrophin levels in patients with PCOS are lower than those without PCOS and inversely related to insulin resistance.
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    The Importance of Education in Diabetic Foot Care of Patients with Diabetic Neuropathy
    (Johann Ambrosius Barth Verlag Medizinverlage Heidelberg Gmbh, 2015) Sen, H. M.; Sen, H.; Asik, M.; Ozkan, A.; Binnetoglu, E.; Erbag, G.; Karaman, H. I. O.
    Objective: Our aim is to research the effect of the knowledge and routine gained from the diabetic foot (DF) care education program given to patients with Type 2 Diabetes Mellitus (DM) with diabetic neuropathy. Materials and Method: A total of 104 patients with Type 2 DM and diabetic neuropathy participated in a survey to evaluate standards of DF care, and knowledge of and behavior relating to personal care. The difference in knowledge and personal care between the group who had received education on diabetes and the group who had not was researched. Results: A total of 42.3 % of patients reported receiving education about diabetes. The education for Type 2 DM patients increased the frequency of attending yearly check-ups (p:0.028), and helped develop the habit of having doctors check their feet (p:0.004). When comparing the daily practice of those who had received education about DF care with those who had not, positive effects of education were seen in all questions evaluating foot care, nail care and choice of shoe. The statistical analysis proved that the educated group were significantly better in terms of foot care such as using moisturizer (p:0.002) and using insoles (p:0.042). Conclusion: Our study reveal that educating diabetic patients about foot care is an effective method to develop their knowledge. However we observed that this education is not provided to all diabetic patients. We believe that every diabetic patient should receive education from the moment of diagnosis and repeated education during check-ups by doctors will increase effectiveness.
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    Timing of Lidocaine Spray for Upper Gastrointestinal System Endoscopy and Effect on Quality for Patients
    (Georg Thieme Verlag Kg, 2014) Binnetoglu, E.; Akbal, E.; Kocak, E.; Koklu, S.; Gunes, F.
    Background: During the esophagogastroduodenoscopy the comfort of both the patient and the doctor performing the endoscopy topical anesthetic are used. However some discomfort from the use of topical anesthetics to suppress the gag reflex may be observed. We aimed to compare the effects of local spray given immediately with that given in the endoscopy waiting room in terms of oropharynx anesthesia, gag reflex, amount of secretion, endoscopy duration, and quality of the procedure. Methods: The patients were devided into two groups; Group 1 was anesthetized with lidocaine spray (Zylocaine spray 10 %) immediately before the procedure; while Group 2 was anesthetized in the preparation room. The patients did not use any other drugs, i.e., anti-anxiety medications, sedatives, etc. Results: The patients were randomly sorted into two groups, with 65 in the first group and 69 in the second. There was no significant difference between Group 1 and 2 in terms of age, gender, or educational level. The amount of secretion in Group 1 was significantly less compared to Group 2. There was no significant difference in terms of endoscopy duration, gag reflex, throat pain scores and the quality of the procedure. Conclusion: We showed that oropharynx anesthesia with lidocaine immediately before the procedure causes an important reduction in the amount of secretion. In this way the endoscopy practitioner can see the stomach mucosa more clearly. For this reason lidocaine administration immediately before the procedure may be safely given to patients.