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OBJECTIVE: Laparoscopic sleeve gastrectomy (LSG) is the most preferred bariatric surgical procedure worldwide. LSG, a restrictive surgical method, has also proven to be a good metabolic surgery option. In this study, we examined weight loss and changes in metabolic parameters in our patients in the first year after LSG. PATIENTS AND METHODS: In this retrospective cohort study, preoperative and postoperative first-year body mass index (BMI) changes, biochemical and hormonal analysis results, and excess weight loss (EWL) rates of 1,137 patients who underwent LSG were evaluated. RESULTS: The median age of patients undergoing LSG was 39 years, and 943 (82.9%) of the patients were female while 194 (17.1%) were male. Preoperative BMI was 45.91 kg/m2 and postoperative first-year BMI was 28.98 kg/m2 (p<0.01). Fasting blood glucose, alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglycerides, insulin, free thyroxine, thyroid-stimulating hormone, and HbA1c percentage levels were significantly low in the postoperative first year (p<0.001). EWL was 81.0% (68.4-97.9%) and sufficient weight loss (SWL; ≥50% of EWL) was 92.2% in the postoperative first year. Median age, the prevalence of type 2 diabetes mellitus, preoperative fasting plasma glucose levels, and preoperative triglyceride levels were higher in the SWL group than they were in the group with insufficient weight loss (EWL of <50%). Factors such as male sex, body weight, and triglyceride levels were positively correlated with adequate weight loss, while BMI and total cholesterol levels were negatively correlated with adequate weight loss. Patients with BMI of >46.87 kg/m2 had a higher rate of adequate weight loss. CONCLUSIONS: LSG is a bariatric surgical procedure providing satisfactory weight loss and metabolic outcomes in the short term. Weight loss success in the first year after LSG was higher among patients with a baseline BMI of 46 kg/m2.

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OBJECTIVE: Obesity is a chronic metabolic disease declared as the 21st century pandemic by the World Health Organization. Obesity has become an alarming situation for society, and it has to be treated. If the appropriate criteria are met by patients, bariatric surgery is an effective treatment method that provides weight loss in a short time. There are no definitive criteria regarding which groups of patients and characteristics may benefit most from bariatric surgery. In this study, we evaluate whether serum basal cortisol levels can predict successful outcomes of bariatric surgery and whether there is any difference in outcome between diabetic and non-diabetic patients. PATIENTS AND METHODS: This observational study included 244 obese patients who had undergone laparoscopic sleeve gastrectomy (LSG). Preoperative and postoperative 6-month weight, body mass index (BMI), serum basal cortisol, fasting plasma glucose, 1-mg dexamethasone suppression test (DST) results, and Type 2 Diabetes Mellitus (T2D) history were recorded. We analyzed the patients first by dividing them into two groups as excessive weight loss (%EWL) ≥50% and %EWL< 50%, and then into two groups as diabetic and nondiabetic patients. RESULTS: The mean age of patients with %EWL≥ 50% was found to be statistically significantly lower than that of patients with %EWL< 50% [39 (19-60) vs. 47 (36-61) years; p=0.046]. While there was no significant difference in basal cortisol values (p=0.513), DST results were statistically significantly lower in patients with %EWL≥ 50% than patients with %EWL< 50% [0.6 (0.1-2.1) vs. 0.8 (0.7-1.1); p=0.040]. CONCLUSIONS: In obese patients undergoing LSG, serum basal cortisol level may not predict the success of operation. However, the result of 1 mg DST may predict the operation success.

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OBJECTIVE: We aimed at demonstrating the effect of thyroid function status on proprotein convertase subtilisin kexin type 9 (PCSK9) and determining the effect of thyroid hormones on lipid metabolism by comparing the PCSK9 levels of patients with subclinical hypothyroidism, overt hypothyroidism, and hyperthyroidism. PATIENTS AND METHODS: 124 patients with thyroid disorders, aged between 18 and 65 years, were included in this study. The participants were divided into 3 groups. Group 1 comprised 52 patients with subclinical hypothyroidism, Group 2 comprised 40 patients with overt hypothyroidism, and Group 3 comprised 32 patients with hyperthyroidism. In all of these groups, the thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, total cholesterol, fasting serum glucose, antithyroid peroxidase antibody, antithyroglobulin antibody, and PCSK9 levels were measured. RESULTS: No significant difference was found between the 3 groups in terms of age, gender, and body mass indices. Median PCSK9 measurements were 14.55 ng/mL in Group 1, 14.895 ng/mL in Group 2, and 9.775 ng/mL in Group 3. There was a significant difference in the PCSK9 levels between Group 1-Group 3 and Group 2-Group 3 (p <0.0001 and p <0.0001, respectively). A positive correlation between PCSK9 and the TSH levels (r = 0.211, p= 0.019), and a negative correlation (r = -0,239, p = 0.009 and r = -, 0.218, p = 0.015) between the fT3 and fT4 levels were found. CONCLUSIONS: The serum PCSK9 levels were shown to be associated with thyroid dysfunction. However, no relationship was observed between the serum PCSK9 level and thyroid autoantibody positivity, and obesity in this study.

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BACKGROUND: There is a strong relationship between arterial stiffness and endothelial dysfunction and hypertension. How arterial stiffness is affected in elevated PRL conditions is uncertain. Biological action of prolactin contributing to the atherosclerotic process is a new research area. AIMS: We aimed at investigating cardiovascular risk predictability by conducting arterial stiffness measurement in patients with idiopathic hyperprolactinemia. SUBJECTS AND METHODS: The biochemical parameters and arterial stiffness analyses of 54 patients with idiopathic hyperprolactinemia, who had applied to our polyclinic in 2017 and 2018, and 55 healthy volunteers having similar characteristics with regard to age, sex and body mass index. RESULTS: The median prolactin level of the idiopathic hyperprolactinemia patients with a median age of 31 was found to be 45 ng/mL. The peripheral and central blood pressures and pulse wave velocities (PWV) of both the patient group and the control group were found to be similar. Any relations between prolactin levels and blood pressure and arterial stiffness could not be found. DISCUSSION: Our study showed that arterial stiffness did not increase in young patients with idiopathic mild hyperprolactinemia. However, the long-term effects of mildly elevated prolactin levels are unknown. Prospective randomized studies are required, that could reveal more clearly the prolactin-cardiovascular risk relation, and the clinical effects of extra-pituitary hyperprolactinemia.

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PURPOSE: Conventional treatment of chronic hypoparathyroidism consists of oral calcium supplements and active vitamin D analogs; however, some patients are unable to meet treatment goals despite the high dosage of oral calcium supplementation. We aimed to investigate the effectiveness of alternate-day oral calcium intake in patients with uncontrolled chronic hypoparathyroidism. METHODS: In this retrospective cohort study, we evaluated 66 patients with chronic hypoparathyroidism who were admitted to our hospital between January 2017 and January 2019. Fourteen patients receiving ≥ 2000 mg/day oral elemental calcium and who were admitted to emergency department or our outpatient clinic at least once in the last 3 months for hypocalcemia requiring intravenous calcium replacement were switched to the alternate-day dosing regimen in which patients took calcium orally every other day. We collected and analyzed patients' medical history information, serum and urinary parameters over a 3-month period prior to and following the treatment. RESULTS: Before alternate-day dosing regimen, median oral calcium intake was 3750 mg/day, oral calcitriol intake was 0.88 mcg/day, serum calcium levels were 7.71 mg/dL, serum phosphate levels were 5.35 mg/dL, and 24-h urine calcium levels were 165 mg/day. Following alternate-day dosing regimen, median oral calcium intake was 1500 mg/day, oral calcitriol intake was 0.88 mcg/day, serum calcium levels were 8.25 mg/dL, serum phosphate levels were 5 mg/dL, and 24-h urine calcium levels were 210.5 mg/day. After alternate-day dosing regimen, oral calcium intake decreased and serum calcium levels increased. The number of emergency visits dropped from 21 to 3 after alternate-day dosing regimen. CONCLUSION: Patients with uncontrolled chronic hypoparathyroidism could be controlled more effectively with alternate-day dosing regimen.

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Peripherally and non-peripherally terminal alkynyl substituted manganese phthalocyanines (MnPc) were synthesized and characterized and then used as functional materials in modified electrodes. MnPcs were substituted with alkynyl groups, which are reactive moieties in click electrochemistry (CEC) reactions. Mn(iii) cations were incorporated into the cavity of the Pc ring in order to increase the redox activity of the complexes. Electrochemical characterizations of the complexes were determined by voltammetric and in situ spectroelectrochemical measurements in order to determine their possible technological applications. MnPc complexes illustrated five redox couples and these redox couples were assigned as [Cl-MnIIIPc2-]/[Cl-MnIIPc2-]1-, [Cl-MnIIPc2-]1-/[Cl-MnIPc2-]2-, [Cl-MnIPc2-]2-/[ Cl-MnIPc3-]3-, and [Cl-MnIIIPc2-]/[Cl-MnIIIPc1-]1+ redox processes. The position of the substituents affected the mechanism of the redox reactions and influenced the tendency to react with the molecular oxygen. Moreover, changing the position of the substituents slightly influenced the peak potentials and reversibility of the redox processes. For the applications, modified electrodes (ITO/PANI-N3-MnPc and GCE/PANI-N3-MnPc) were constructed with CEC reaction between azido functionalized polyaniline (PANI-N3) and terminally alkynyl substituted MnPcs and these electrodes. Voltammetric characterizations of the modified electrodes illustrated suitable redox activity and conductivity for the practical applications. Finally, the GCE/PANI-N3-MnPc electrode was tested as a potential electrocatalyst for water splitting reaction. Although the GCE/PANI-N3-MnPc electrode did not catalyze the hydrogen evolution reaction (HER), it significantly catalyzed the oxygen evolution reaction (OER) in aqueous solution.

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Multiple eruptive dermatofibromas (MEDF) are rare and their aetiology is unknown. More than half of the patients with MEDF have underlying diseases, and more than 80% of the underlying diseases are immune mediated. Familial cases suggesting a genetic cause have also been reported. We report a case of familial eruptive dermatofibromas associated with atopic dermatitis, possibly caused by both hereditary factors and compromised immunity.

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PURPOSE: This study reports the feasibility of the symmetric fields for the usage of asymmetric fields, and checks the accuracy of treatment planning system (TPS). MATERIALS AND METHODS: A GE Saturne-42 linear accelerator, which produces dual photon energies of 6 and 15 MV, and an ISIS-3D TPS were used in this study. Percent depth doses (PDDs), dose profiles, and isodose distributions for symmetric and asymmetric fields were generated in a water phantom and these data were compared to those calculated by the TPS. RESULTS: When the results were compared it was seen that the PDDs decreased with increasing off-axis distance and depth. The PDDs comparison demonstrated that for 15 MV, asymmetric and symmetric field PDDs can differ by as much as 4%, and the differences between the calculated by the TPS and the measured PDDs for asymmetric fields were less than 2%. It was also seen that the penumbra of symmetric and asymmetric fields were very close to each other and the difference between the calculated and the measured ones were less than 2 mm. The comparison between the measured and calculated isodose distributions for 6 and 15 MV photon beams for asymmetric field showed that a good agreement has been achieved in general, and the differences between the field edges and near the centre of the fields were found within 2 mm. CONCLUSION: This study shows that the measured and calculated data using water phantom and TPS (ISIS-3D), respectively, were in good agreement. Therefore TPS can be used safely for asymmetric fields in routine practice.

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Carcinoid tumours of the gastrointestinal tract are most frequently located at the appendix. We report two cases: In the first case, we realized a simple appendicectomy. In the second case, two weeks after the appendicectomy was performed, according to the histological characteristics of the tumoral specimen, the patient underwent a laparoscopic right hemicolectomy with regional lymphadenectomy. In both cases, 5-HIAA (5 HydroxyIndolAceticAcid) is assayed regularly and remains normal.

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BACKGROUND: Itraconazole is an oral antifungal agent, which has been proved to be effective in pityriasis versicolor. Different regimens for the treatment of pityriasis versicolor have been studied and good results were obtained with short-term treatment regimens. OBJECTIVE: To compare the efficacy and tolerability of the classical regimen of 200 mg/day itraconazole for 5 days with the regimens of 400 mg/day for 1 and 3 days. METHODS: A total of 60 patients with pityriasis versicolor were recruited into a randomized study. The patients were divided into three groups, each composed of 20 people. Mycological and clinical assessments were done before and on the 7th and 28th days after the treatment. Results were evaluated with the chi-squared test. RESULTS: The regimen of 400 mg/day itraconazole for 3 days was found to be as effective as the classical regimen of 200 mg/day for 5 days in the treatment of pityriasis versicolor. The regimen of 400 mg/day itraconazole for 1 day was found to be ineffective. CONCLUSION: This study has shown that a short course of itraconazole, 400 mg/day for 3 days, appears to be an effective and alternative treatment for pityriasis versicolor.

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