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    Association Between Thyroid Antibodies and Ultrasonic Imaging in Patients with Hashimoto's Thyroiditis
    (Galenos Publ House, 2022) Unal, Mustafa; Duran, Iffet Dagdelen; Karakilic, Ersen; Basaran, Mehtap Navdar; Guler, Serdar
    Aim: The association between high levels of anti-thyroid antibodies and the extent of destruction of thyroid tissue is well documented. The aim of the present study was to analyze the relationship between anti-thyroid antibodies, thyroid hormones, and sonographic parenchymal changes. Methods: The study was designed as a case-control study. Four hundred and seventy-five patients with HT and 98 healthy subjects were included in the study. Serum levels of free thyroxine (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone, and anti-thyroid antibodies (anti-thyroid peroxidase antibodies and anti-thyroglobulin antibodies) were measured. The ultrasonographic results of the patients were also recorded. Results: Serum levels of anti-TPO and anti-Tg were significantly associated with hypoechogenicity, heterogeneity, and pseudonodulation (p<0.001). There was no significant difference between the two groups in terms of cyst and nodule formation, however, a significant difference was found in terms of thyroid volume (p<0.001). Thyroid volumes were higher in the HT group. As serum anti-TPO levels increased in the HT group, parenchymal hypoechogenicity increased (p<0.001). Conclusion: Ultrasonography is a non-invasive method that provides information about the inflammatory activity of the thyroid gland. Significantly reduced echogenicity, heterogeneity, and multifocal pseudonodular infiltration were indicators of inflammatory activity and were associated with higher anti-TPO levels. Anti-TPO and ultrasonographical changes may be useful in the follow-up of Hashimoto's thyroiditis.
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    Comment on: Vertebral Fractures Increase the Long-Term Mortality of Patients with Coronavirus Disease 2019
    (AVES, 2025) Karakilic, Ersen; Saygili, Emre Sedar
    [No abstract available]
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    Impact of COVID-19 Vaccination on Fatality and Intensive Care Unit Admission in Patients with Type 2 Diabetes Mellitus
    (Aves, 2024) Karakilic, Ersen; Saygili, Emre Sedar; Yildiz, Ozlem; Kuyucu, Asli
    Objective: This study aims to investigate the influence of coronavirus (COVID-19) vaccination on hospital outcomes among patients with type 2 diabetes mellitus (T2DM). Methods: A total of 324 patients hospitalized for COVID-19 were evaluated retrospectively. Type 2 diabetes mellitus patients were matched 1:1 by the propensity score matching method to individuals without diabetes for age and gender. After matching, we analyzed 70 patients with T2DM and 70 without diabetes. Results: Individuals with T2DM exhibited a slightly higher vaccination rate than those without diabetes (67.1% vs. 54.3%, P = .119). Regardless of diabetes status, vaccinated participants experienced significantly lower rates of intensive care unit (ICU) admission (T2DM: 14.9% vs. 60.9%, P = .001; non- diabetics: 5.3% vs. 37.5%, P = .001) and fatality (T2DM: 2.1% vs. 60.9%, P = .001; non-diabetics: 0% vs. 46.9%, P = .001) compared to the unvaccinated group. The length of hospitalization and ICU admission rate were insignificantly higher in vaccinated individuals with T2DM than those without diabetes (9.0 days vs. 7.0 days, P = .154; 14.9% vs. 5.3%, P = .179). Multivariate logistic regression in T2DM patients revealed that CoronaVac vaccination significantly reduced ICU admission (OR: 0.089, 95% CI 0.022-0.360, P = .001), while male gender increased the risk (OR: 6.59, 95% CI 1.545-28.11, P = .011). Conclusion: In vaccinated individuals with T2DM, the risk of severe COVID-19 and fatality significantly decreased, similar to individuals without diabetes. This protection is not affected by vaccine type, vaccination count, or age.
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    Permanent central diabetes insipidus after mild head injury
    (Bmj Publishing Group, 2019) Karakilic, Ersen; Ahci, Serhat
    We report a case of a patient with mild traumatic brain injury (TBI) who was diagnosed with permanent central diabetes insipidus (DI). A 21-year-old man was admitted to our outpatient clinic with polyuria and polydipsia 1week after a mild head injury. He was well, except for these complaints. The initial laboratory workup was consistent with DI. There was no abnormality with other laboratory and hormone values. MRI showed lack of neurohypophyseal hyperintensity with no other abnormal findings. The patient responded well to desmopressin therapy. At the first year of the diagnosis, the patient still needed to use desmopressin treatment as we concluded that DI is permanent. DI is not uncommon after TBI, but it is often seen after severe TBI. We present here an extraordinary case of developing permanent DI after mild TBI with the absence of neurohypophyseal bright spot on MRI with no other abnormal findings.
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    Predictors of Hypothyroidism Following Empirical Dose Radioiodine in Toxic Thyroid Nodules: Real-Life Experience
    (Elsevier Inc, 2022) Demir, Busra Kuyumcu; Karakilic, Ersen; Saygili, Emre Sedar; Araci, Nilgun; Ozdemir, Semra
    Objective: We aimed to determine the factors predicting hypothyroidism after radioactive iodine (RAI) treatment in patients with toxic adenoma and toxic multinodular goiter.Methods: We retrospectively collected the data of 237 patients with toxic multinodular goiter or toxic adenoma who had consecutively received RAI treatment between 2014 and 2020 at 2 medical centers. Patients who received the second RAI treatment and whose medical records could not be accessed were excluded from the study. Finally, 133 patients were included in the study. RAI was administered at an empirical dose of 15 or 20 mCi.Results: The median age of the 133 participants was 69 years (interquartile range, 62-75 years), and 64.7% of the participants were women. A total of 42.1% of the patients had toxic adenoma, whereas 57.9% of patients had toxic multinodular goiter. The median follow-up was 24 months (interquartile range, 11-38 months). During the follow-up, 61.7% of patients became euthyroid, 30.8% developed hypothy-roidism, and 7.5% remained hyperthyroid. The median month of hypothyroidism onset was 4 months (interquartile range, 2-9 months). Regression analysis revealed 2 factors that could predict hypothy-roidism: thyroid-stimulating hormone (odds ratio, 2.548; 95% CI, 1.042-6.231; P = .04) and thyroid volume (odds ratio, 0.930; 95% CI, 0.885-0.978; P = .005).Conclusion: Overall, 30.8% of the cases developed hypothyroidism after the RAI treatment. Approxi-mately 78% of hypothyroidism developed within the first 10 months. The risk of hypothyroidism was higher in patients with higher thyroid-stimulating hormone and smaller thyroid volume.(c) 2022 AACE. Published by Elsevier Inc. All rights reserved.
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    Tamoxifen Treatment for Riedel's Thyroiditis: A Case Report
    (Aves, 2023) Karakilic, Ersen; Saygili, Emre Sedar; Yildiz, Oezlem; Kuyucu, Asli
    Riedel's thyroiditis is a rare variant of thyroiditis, and treatment recommendations are based on case reports. This thyroiditis form is considered among immunoglobulin G4-related diseases. Intense fibrosis of the thyroid gland can cause compression of the surrounding tissues and hypothyroidism. Glucocorticoids are recommended as first-line therapy, and tamoxifen is second-line therapy. Other immunosuppressive agents have also been used in some resistant cases. Our case was presented with a palpable firm mass in the neck, shortness of breath, and hypothyroidism. The exact diagnosis of Riedel's thyroiditis was made after a pathological examination of a true-cut biopsy. We present the successful management of this case with glucocorticoid and tamoxifen combination treatment.
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    The Relationship Between the Admission Blood Glucose Level and 90-Day Mortality in Non-Diabetic Patients with Coronavirus Disease-2019
    (Galenos Publ House, 2022) Saygili, Emre Sedar; Karakilic, Ersen
    Introduction: The admission blood glucose (ABG) level is associated with increased mortality in non-diabetics patients with Coronavirus disease-2019 (COVID-19) in short-term follow-up studies. However, post-discharge mortality has also increased in COVID-19. Thus, this study aimed to examine the relationship between ABG and 90-day mortality including the post-discharge period. Methods: Non-diabetic patients who are hospitalized due to COVID-19 in 2020 were evaluated. Patients were divided into groups according to the ABG level. Groups 1, 2, and 3 have ABG level of <100 mg/dL, 100-139 mg/dL, and 140-199 mg/dL, respectively. Intensive care unit admission, in-hospital mortality, and 30- and 90-day mortality rates were evaluated as outcomes. COX regression analyzes were used to assess mortality risk factors. Results: A total of 1207 non-diabetic patients, of whom 49.2% were females, with a mean age of 65.2 +/- 13.4 years, were included in the study. The patients were followed up for a median of 153 (inter quartile range: 107.5-251, maximum: 369) days. The in-hospital and 30-day mortality of group 2 was higher than group 1 in the univariate analysis but without statistical significance in multivariate analysis. Group 3 had worse outcomes than group 1 in both univariate and multivariate analysis at all endpoints. Group 3 had 2.533 adjusted hazard ratios (95% confidence interval: 1.628-3.941, p<0.001) 90-day mortality compared with group 1. Conclusion: Non-diabetic patients with COVID-19 with an admission glucose level of >= 140 mg/dl had 2.5-fold increased all-cause mortality at 90 days. Therefore, being more careful in treating and following non-diabetic patients with COVID-19, especially those with hyperglycemia at admission, was recommended.