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    The Relationship between Third-generation TSH Receptor Antibody Positivity and Cumulative Methimazole Dose Used until Remission in Graves' Disease
    (Coll Physicians & Surgeons Pakistan, 2021) Ozcelik, Serhat; Celik, Mehmet; Vural, Aski; Aydin, Bunyamin; Gozu, Hulya
    Objective: To determine the relationship between the positivity of third-generation TSH receptor antibody ( TRAb) at the time of diagnosis and the cumulative methimazole dose used until remission in patients with Graves' disease. Study Design: Cross-sectional, descriptive study. Place and Duration of Study: Department of Endocrinology and Metabolic Diseases, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, Turkey from 2016 to 2018. Methodology: Newly diagnosed Graves' patients were included in the study. The patients were divided into two groups according to whether they entered remission (n: 21) or not (n: 20), in the 18th month of methimazole treatment. In addition, the patients were further divided into two categories, according to TRAb status at the time of diagnosis as negative (n: 17) or positive (n: 24). The TRAb positivity and the cumulative methimazole dose they used until the month of remission were compared in these groups. Results: The mean time to reach remission in 41 patients was 20.5 +/- 3.1 months. TSH receptor antibody positivity rate was 58.5%. When the TRAb positivity of the groups was compared according to the state of having remission in the 18th month of the treatment, the positivity rate in the non-remission group was statistically significantly higher (p = 0.023).The time to go into remission was longer and the cumulative methimazole dose requirement was higher in the TRAb positive group (p <0.001). Conclusion: Graves' disease patients with positive third-generation TRAb were found to have a lower rate of remission in the 18month period compared to negative patients.
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    Role of testosterone to estradiol ratio in predicting the efficacy of recombinant human chorionic gonadotropin and testosterone treatment in male hypogonadism
    (Sbem-Soc Brasil Endocrinologia & Metabologia, 2021) Celik, Mehmet; Ozcelik, Serhat; Bas, Suleyman; Sariaydin, Mehmet; Ozcelik, Melike; Gozu, Hulya
    Objective: We aimed to investigate the role of testosterone to estradiol ratio in predicting the effectiveness of human chorionic gonadotropin and testosterone treatments in male hypogonadism. Materials and methods:Thirty-six male patients with hypogonadotropic hypogonadism were included in the study. Seventeen (47.2%) patients received weekly recombinant human choriogonadotropin alpha (hCG) treatment (group-1) and 19 (52.8%) received testosterone replacement therapy (T treatment) every 21 days (group-2). Under these treatments, adequate frequency of morning erection (0_3/week), testosterone to estradiol ratio (T/E), and testicular volume changes were analyzed. Results: The mean age of the patients was 28.5 +/- 8.7 years. When the frequency of morning erection (0_3/week) was specified as adequate, the cut-off value for effective T/E ratio was found to be 12.0 (sensitivity 93.8%, specificity 90.0%). There was no significant difference between the treatment groups in terms of total testosterone levels, T/E ratio, or frequency of morning erections (0_3/week) (p 0.05). However, there was a statistically significant difference between the groups in terms of median left-right testicular volume in favor of group-1 (p < 0,05). Conclusion: In patients with hypogonadism who are under treatment, elevated estradiol-induced erectile dysfunction symptoms may persist even if serum testosterone levels are normal. Testosterone to estradiol ratio can be used as a predictive value in the effective treatment of hypogonadotropic hypogonadism with hCG and T. Arch Endocrinol Metab. 2021;65(5):617-24