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Albayrak T, Torun Göktaş A, Eyüpoğlu S, Muhtaroğlu A, Dulger AC. Patient Anxiety in Endoscopy: A Comparative Analysis of Single vs. Dual Procedure Effects. Cureus 2024; 16:e57237. [PMID: 38686224 PMCID: PMC11056767 DOI: 10.7759/cureus.57237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2024] [Indexed: 05/02/2024] Open
Abstract
AIM This study aimed to investigate the difference in anxiety levels between patients undergoing gastroscopy only and those subjected to both gastroscopy and colonoscopy. Despite known preoperative anxiety impacts, no prior research has compared these specific patient groups. MATERIALS AND METHODS A total of 150 patients were divided equally into two groups: Group I, undergoing gastroscopy only, and Group II, undergoing gastroscopy and colonoscopy. Inclusion criteria were patients in the age range 18-70 years and having an ASA (American Society of Anesthesiologists) physical status classification of I-III. Exclusion criteria were patients outside the age range, and patients with hearing disorders, psychiatric disorders, dementia, or recent anxiolytic drug use. Anxiety was analysed using the Beck Anxiety Inventory Scale before procedures, without any premedication. RESULTS Patients in Group II had significantly higher anxiety levels, with particular increases noted in symptoms such as leg weakness and tremors, inability to relax, and fears of adverse events and death. These results highlighted a considerable elevation in anxiety among patients anticipating or undergoing combined endoscopic procedures. DISCUSSION The findings revealed that undergoing combined gastroscopy and colonoscopy procedures significantly elevated patient anxiety levels compared to gastroscopy alone. This suggests a critical need for healthcare providers to implement more strong preoperative counselling and anxiety reduction strategies for patients facing multiple procedures. Addressing this increased anxiety could lead to better patient experiences, reduced procedural complications, and improved satisfaction and outcomes.
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Affiliation(s)
- Tuna Albayrak
- Department of Anesthesiology and Reanimation, Giresun University Faculty of Medicine, Giresun, TUR
| | - Ayşegül Torun Göktaş
- Department of Anesthesiology and Reanimation, Giresun İlhan Özdemir State Hospital, Giresun, TUR
| | - Selin Eyüpoğlu
- Department of Anesthesiology and Critical Care, Giresun Training and Research Hospital, Giresun, TUR
| | - Ali Muhtaroğlu
- Department of General Surgery, Giresun University Faculty of Medicine, Giresun, TUR
| | - Ahmet Cumhur Dulger
- Department of Gastroenterology, Giresun University Faculty of Medicine, Giresun, TUR
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Issever K, Kuloglu E, Muhtaroglu A, Seker D, Kotur O, Dulger AC. The Effect of Direct Oral Anticoagulants on Gastric Mucosa and Helicobacter Pylori Prevalence in Dyspeptic Patients: A Retrospective Cross-Sectional Study. Cureus 2023; 15:e46477. [PMID: 37927617 PMCID: PMC10623502 DOI: 10.7759/cureus.46477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Background and aim Although direct oral anticoagulants (DOACs) are widely used and their side effects related to bleeding at various body sites have been well studied in the literature, less is known about their local impact on gastric mucosa. Some studies suggest that the higher risk of gastrointestinal (GI) bleeding associated with DOACs may be due to their direct local anticoagulant effects on the gastric mucosa. In this study, we aim to evaluate whether this potential local effect has a favorable outcome on the gastric mucosa and the prevalence of Helicobacter pylori (HP). Materials and methods A total of 125 patients with dyspepsia were included in the study. Sixty patients who had been using a DOAC for at least one month were classified as the "DOAC group," while 65 patients who had not used DOACs were designated as the "control group." Demographic, laboratory, and pathological findings for these patients were retrospectively analyzed from their medical files. Results Patients in the DOAC group were significantly less likely to have antral gastritis (AnG) (p = 0.028), while the frequencies of HP and atrophic gastritis (AtG) were similar between the two groups. Although not statistically significant, the DOAC group showed fewer instances of intestinal metaplasia (IM) and a higher number of upper GI ulcers. Patients who had been using DOACs for more than 12 months had increased incidences of IM, upper GI ulcers, AnG, and HP compared to those who had been using DOACs for 12 months or less. The Rivaroxaban subgroup showed significantly lower HP positivity compared to patients using other DOACs (p = 0.042). Among all subgroups, the Rivaroxaban group had the lowest frequency of AnG (p = 0.024). Conclusion While DOACs seem to prevent AnG, HP, and IM at their early use stages, unfavorable gastric mucosa manifestations might increase with prolonged use. Higher upper GI ulcer prevalence is another controversial result of this issue. Rivaroxaban shines amongst other DOACs with its lesser HP and AnG association. These exciting findings should be supported by randomized controlled trials with large patient populations.
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Affiliation(s)
- Kubilay Issever
- Internal Medicine, Giresun University Faculty of Medicine, Giresun, TUR
| | - Ersin Kuloglu
- Internal Medicine, Giresun University Faculty of Medicine, Giresun, TUR
| | - Ali Muhtaroglu
- General Surgery, Giresun University Faculty of Medicine, Giresun, TUR
| | | | - Osman Kotur
- Internal Medicine, Giresun University Faculty of Medicine, Giresun, TUR
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Issever K, Kuloglu E, Sengul D, Muhtaroglu A, Dulger AC. Helicobacter Pylori and Celiac Disease Antibody Positivity Have a Higher Prevalence in Patients With Distal Gastrectomy: A Cross-Sectional Retrospective Study. Cureus 2023; 15:e42976. [PMID: 37546692 PMCID: PMC10403781 DOI: 10.7759/cureus.42976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2023] [Indexed: 08/08/2023] Open
Abstract
Aims and objectives Distal gastrectomy was a widely used therapeutic option for peptic ulcer and gastroesophageal reflux disease until quite recently. The consequences of anatomical and physiological changes following surgery in the gastric mucosa have been the object of interest for the scientist. In this study, we aimed to determine whether Helicobacter pylori (HP) infection and celiac disease were more common in patients with a history of distal gastrectomy. Materials and methods This is an observational retrospective study conducted at Giresun University Faculty of Medicine. The medical files of 35 patients with dyspepsia who had a history of distal gastrectomy for benign etiologies (antrectomy group) and 50 patients with dyspepsia (control group) were retrospectively analyzed. Results There were more males and older patients in the antrectomy group. Concerning the lab parameters, platelets, lymphocyte, and albumin levels were significantly lower, and urea, creatinine, anti-Endomisium Ig A (anti-EMA), and anti-tissue transglutaminase IgA (anti-tTGA) antibody positivity were significantly higher in the antrectomy group. Gastric biopsy results revealed a higher positivity of HP, atrophy, neutrophil, and lymphocytes in the antrectomy group. Correlation analysis revealed an inverse correlation between albumin and anti-EMA/atrophy positivity whereas a positive correlation between anti-EMA and HP/atrophy positivity. Conclusions HP infection and coeliac disease (CD) could be the problems that distal gastrectomy patients with dyspepsia can face during their follow-up. Concerning the pre-malignant potential of HP, its screening and eradication should be performed to prevent the malignant transformation of the remnant gastric tissue.
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Affiliation(s)
- Kubilay Issever
- Internal Medicine, Giresun University Faculty of Medicine, Giresun, TUR
| | - Ersin Kuloglu
- Internal Medicine, Giresun University Faculty of Medicine, Giresun, TUR
| | - Demet Sengul
- Pathology, Giresun University Faculty of Medicine, Giresun, TUR
| | - Ali Muhtaroglu
- General Surgery, Giresun University Faculty of Medicine, Giresun, TUR
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Muhtaroglu A, Sengul I, Sengul D, Kesicioglu T, Seker D, Aydin M, Dulger AC. Does enteral nutrition through a percutaneous endoscopic gastrostomy, attenuate Helicobacter pylori colonization?: is it worth mentioning? Rev Assoc Med Bras (1992) 2023; 69:e20221733. [PMID: 37098934 PMCID: PMC10176647 DOI: 10.1590/1806-9282.20221733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 01/04/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVE In patients who experience difficulties in oral feeding, alimentary intake can be supported by creating direct access into the stomach through a percutaneous endoscopic gastrostomy. The present study purposed to compare naïve and exchanged percutaneous endoscopic gastrostomy tubes in terms of Helicobacter pylori infection and other clinical characteristics. METHODS A total of 96 cases who underwent naïve or exchanged percutaneous endoscopic gastrostomy procedures with various indications were incorporated into the study. The patients' demographic data, such as age and gender, etiology of percutaneous endoscopic gastrostomy, anti-HBs status, Helicobacter pylori status, the presence of atrophy and intestinal metaplasia, biochemical parameters, and lipid profiles, had been analyzed. In addition, the anti-HCV and anti-HIV statuses had also been evaluated. RESULTS The most common indication for percutaneous endoscopic gastrostomy placement was dementia in 26 (27.08%) cases (p=0.033). The presence of Helicobacter pylori positivity was significantly lower in the exchange group compared to the naïve group (p=0.022). Total protein, albumin, and lymphocyte levels were significantly higher in the exchange group compared to the naïve group (both p=0.001), and the mean calcium, hemoglobin, and hematocrit levels were statistically significantly higher in the exchange group (p<0.001). CONCLUSION Preliminary outcomes of the present study revealed that enteral nutrition attenuates the incidence of Helicobacter pylori infection. Considering the acute-phase reactant, the significantly lower ferritin values in the exchange group suggest that there is no active inflammatory process in the patients and that immunity is sufficient.
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Affiliation(s)
- Ali Muhtaroglu
- Giresun University, Faculty of Medicine, Department of General Surgery - Giresun, Turkey
| | - Ilker Sengul
- Giresun University, Faculty of Medicine, Department of General Surgery - Giresun, Turkey
- Giresun University, Faculty of Medicine, Division of Endocrine Surgery - Giresun, Turkey
| | - Demet Sengul
- Giresun University, Faculty of Medicine, Department of Pathology - Giresun, Turkey
| | - Tugrul Kesicioglu
- Giresun University, Faculty of Medicine, Department of General Surgery - Giresun, Turkey
| | - Demet Seker
- Giresun University, Faculty of Medicine, Department of Neurology - Giresun, Turkey
| | - Muhammed Aydin
- Giresun University, Faculty of Medicine, Department of Internal Medicine - Giresun, Turkey
| | - Ahmet Cumhur Dulger
- Giresun University, Faculty of Medicine, Department of Gastroenterology - Giresun, Turkey
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Poyrazoglu OB, Dulger AC. Celiac disease is increased in esophageal squamous cell Carcinoma. Pak J Med Sci 2021; 37:1445-1450. [PMID: 34475928 PMCID: PMC8377909 DOI: 10.12669/pjms.37.5.2757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 04/05/2021] [Accepted: 04/29/2021] [Indexed: 11/20/2022] Open
Abstract
Background and Objective: The intercourse between Esophageal squamous cell carcinoma etc. (ESC) and Celiac disease (CD) is still a complicated subject. The purpose of this research was to define the relationship between CD and ESC, and the factors associated with CD in patients with ESC. Methods: This research was conducted by Van University Medical Center in Turkey from 2012 to 2016.CD was identified by analyzing duodenal biopsy materials from 63 ESC patients via histopathologic examinations. Serum samples from the patients were also serologically tested to identify CD. A control group was selected from among subjects who underwent gastroduodenoscopy due to dyspepsia. Distinctions between case characteristics were evaluated with chi-square tests and t-tests for categorical and continuous factors, respectively. Results: Of the 63 study cases, 6 (9.5%) were both histological and serological positive for CD. Of the 290 control group, 8 (2.8%) had histopathological CD and tested positive for celiac antibodies. The patients with ESC had a significantly higher prevalence of CD compared to the dyspeptic patients (p<0.001). In addition, the mean creatinine levels of ESC patients with histopathological-proven CD were higher than those without CD (p=0.026). Furthermore, ESC patients who tested positive for tTg IgA had significantly higher levels of glucose and AST than those who were negative for tTg IgA (p=0.032) and (p=0.008), respectively. Conclusion: The present study demonstrated a statistically significant positive correlation between ESC and CD. Most remarkably, higher creatinine, glucose, and AST levels may predict CD in patients with ESC. These evidences may lead novel approaches for preventing ESC in patients with CD.
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Affiliation(s)
- Omer Bilgehan Poyrazoglu
- Omer Bilgehan Poyrazoglu, MD Assistant Professor of General Surgery Nigde University Medical School, Omer Halisdemir State Hospital Department of General Surgery, Nigde, Turkey
| | - Ahmet Cumhur Dulger
- Ahmet Cumhur Dulger, MD Professor of Gastroenterology, Giresun University Medical School State Hospital, Department of Gastroenterology, Giresun, Turkey
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Akagun T, Ayraler A, Usta M, Baylan S, Dulger AC. MO392ACUTE KIDNEY INJURY IN HOSPITALIZED PATIENTS WITH COVID-19: A SINGLE-CENTER EXPERIENCE. Nephrol Dial Transplant 2021. [PMCID: PMC8194864 DOI: 10.1093/ndt/gfab082.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Preliminary reports indicate that AKI (acute kidney injury) seem to be associated with coronavirus disease 2019 (COVID-19) severity and outcomes. Although the reported incidence of AKI among hospitalized patients with COVID-19 varies widely, AKI among hospitalized patients is associated with poor prognosis. The aim of this study was to evaluate the clinical characteristics and outcomes in our COVID-19 patients who developed AKI during intensive care unit hospitalization.
Method
In our retrospective, observational study COVID-19 PCR positive 49 patients who were hospitalized with COVID-19 pnumoniae in intensive care unit and developed AKI were evaluated with demographics, laboratory data, treatment and outcome. The prognostic nutritional index (PNI), which is calculated using the serum albumin concentration and total lymphocytic count were also evaluated. All patients were treated with favipiravir+low molecular weight heparin; laboratory tests were recorded before and after favipiravir treatment.
Results
Of 49 patients; 28 were male. A total of 9/49 (18.4%) patients survived. All patients were treated with favipiravir; laboratory tests were recorded before and after favipiravir treatment. The clinical parameters of patients are shown in Table-1 and Table-2. Mean PNI of the patients who survived was higher than patients who were exitus.
Conclusion
AKI in hospitalized patients with COVID-19 was associated with high mortality. Of all patients with AKI, only 18.4% survived.
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Affiliation(s)
- Tulin Akagun
- Giresun University Faculty of Medicine, Nephrology, Giresun, Turkey
| | - Arzu Ayraler
- Giresun University Faculty of Medicine, Family Medicine, Turkey
| | - Murat Usta
- Giresun University Faculty of Medicine, Biochemistry, Turkey
| | - Süleyman Baylan
- Giresun University Faculty of Medicine, Internal Medicine, Turkey
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Tolunay HE, Aydın M, Cim N, Boza B, Dulger AC, Yıldızhan R. Maternal and Fetal Outcomes of Pregnant Women with Hepatic Cirrhosis. Gastroenterol Res Pract 2020; 2020:5819819. [PMID: 32190039 PMCID: PMC7064848 DOI: 10.1155/2020/5819819] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 12/10/2019] [Accepted: 12/23/2019] [Indexed: 01/05/2023] Open
Abstract
AIM The reproductive hormone levels and systemic physiology of women with hepatic cirrhosis are altered. Existing data have indicated the adverse effects of cirrhosis on both the mother and the fetus. Pregnancy is successful in most of the patients with chronic liver disease. But maternal and fetal complication rates are still high for decompensated hepatic cirrhosis. In this study, we aimed to evaluate the clinical features, etiological factors, medications, morbidity, mortality, and obstetric outcomes of pregnant women with hepatic cirrhosis. METHODS Pregnant women, who were diagnosed with maternal hepatic cirrhosis and followed up in our clinic between 2014 and 2017, were retrospectively evaluated. The pregnant women that had been followed up for hepatic cirrhosis were classified as compensated disease and decompensated disease. Eleven cases were included in this period. RESULTS The mean age of cases was 33.5 ± 5.5 years. The mean gravida number was 3.2 ± 1.1, and the mean parity number was 1.7 ± 1. Six cases were in the compensated cirrhosis stage, and 5 cases were in the decompensated cirrhosis stage. A pregnancy with decompensated cirrhosis was terminated after the fetal heart sound was negative in the 9th week of pregnancy. Spontaneous abortus occurred in one case (<20 weeks). The mean gestational week of the 9 cases was 33.3 ± 6.2. Two of the 9 cases delivered birth vaginally. Seven cases delivered by cesarean section. The mean first- and fifth-minute APGAR scores were 6.6 ± 1.41 and 8.2 ± 1.56, respectively. The mean birth weight was 2303 ± 981 g. Among 9 cases with live birth, 6 had compensated cirrhosis and 3 had decompensated cirrhosis. In the second trimester, upper gastrointestinal endoscopy was performed to all patients in terms of esophageal varices. Endoscopic band ligation was performed in 3 cases with upper gastrointestinal bleeding. The postpartum mortality did not occur. Discussion. Pregnancy is not recommended for patients with hepatic cirrhosis due to high maternal and fetal morbidity and mortality. The pregnancy course of cases with cirrhosis changes according to the stage of liver injury and severity of disease. Although the delivery method is controversial, delivery by cesarean section is recommended for patients with esophageal varices by the reason of bleeding from varices after pushing during labor. The bleeding risk must be kept in mind as coagulopathy is common in hepatic diseases. The maternal-fetal morbidity and mortality rates have been decreased by the current developments in hepatology, prevention of bleeding from varices with drugs and/or band ligation, improvement in liver transplantation, and increasing experience in this issue.
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Affiliation(s)
- Harun Egemen Tolunay
- Department of Obstetrics and Gynaecology, Van Yuzuncu Yil University, School of Medicine, Van, Turkey
| | - Mesut Aydın
- Department of Gastroenterology, Van Yuzuncu Yil University, School of Medicine, Van, Turkey
| | - Numan Cim
- Department of Obstetrics and Gynaecology, Van Yuzuncu Yil University, School of Medicine, Van, Turkey
| | - Barış Boza
- Department of Obstetrics and Gynaecology, Van Yuzuncu Yil University, School of Medicine, Van, Turkey
| | - Ahmet Cumhur Dulger
- Department of Gastroenterology, Van Yuzuncu Yil University, School of Medicine, Van, Turkey
| | - Recep Yıldızhan
- Department of Obstetrics and Gynaecology, Van Yuzuncu Yil University, School of Medicine, Van, Turkey
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Abstract
OBJECTIVE: Esophageal squamous cell carcinoma is one of the most common esophageal diseases in the developing world, but the relationship between esophageal squamous cell carcinoma and Helicobacter pylori infection remains a neglected topic. The primary objective of this study was to determine the association between Helicobacter pylori infection and esophageal squamous cell carcinoma. A second purpose was to determine the incidence and factors associated with Helicobacter pylori infection following esophagectomy. METHOD: The microorganism was identified by testing the gastric biopsy materials from 95 esophageal squamous cell carcinoma patients (66 females; 39 were esophagectomized) for urease activity in a medium containing urea and a power of hydrogen detection reagent and comparing the results with those from a healthy population. Differences in patient characteristics were assessed with chi-square tests and t-tests for categorical and continuous factors, respectively. RESULTS: The patients with esophageal squamous cell carcinoma had a significantly lower prevalence of Helicobacter pylori compared with the healthy population (p<0.001). The naive and esophagectomized patients, in contrast, showed no significant differences in Helicobacter pylori infection (p>0.005). Patients with esophageal squamous cell carcinoma showed a significant association between leukocytosis and hypoglobulinemia and the presence of Helicobacter pylori infection (p=0.023 and p=0.045, respectively). CONCLUSION: These results suggest that Helicobacter pylori is not an etiological factor in patients with esophageal squamous cell carcinoma. We found a statistically significant negative correlation between esophageal squamous cell cancer and Helicobacter pylori infection. These findings may guide new strategies for esophageal squamous cell carcinoma therapy.
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Affiliation(s)
| | - Ahmet Cumhur Dulger
- Yuzuncu Yil University, School of Medicine, Department of Gastroenterology, Van, Turkey
- *Corresponding author. E-mail:
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Suvak B, Dulger AC, Suvak O, Yesilyurt AÖ, Gultepe B, Guducuoglu H. The prevalence and impact of brucellosis in patients with hepatitis delta virus infection: inside the Brucella outbreak with cirrhosis. Arch Med Sci 2017; 13:377-382. [PMID: 28261291 PMCID: PMC5332459 DOI: 10.5114/aoms.2017.65317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 05/11/2015] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Hepatitis D virus (HDV) infection is a serious health problem leading to cirrhosis and hepatocellular carcinoma (HCC). Despite evidence that zoonotic infections are associated with end-stage liver disease, brucellosis in patients with delta hepatitis related to liver disease has not been well characterized. So, we examined this relationship using recent hospital-based data. MATERIAL AND METHODS We analyzed data from 96 delta hepatitis patients (mean age: 52.5 ±12.8 years; 50 male; 52 cirrhotics) and 117 (mean age: 50.4 ±7 years; 60 male) control subjects who were selected from patients with splenomegaly. The Brucella Wright test in connection with blood culture was used to detect active Brucella infection. Demographic features, laboratory data, results of ultrasonographic examination of the abdomen and Wright agglutination titers were compared between groups. RESULTS There were 9 (9%) patients with active brucellosis in delta hepatitis patients. Compared to the control group, there was a statistically significant difference between groups in terms of having active brucellosis (9 vs. 2 patients; p < 0.001). Higher MELD scores were also associated with active Brucella infection (p < 0.005). CONCLUSIONS Patients with chronic hepatitis D related cirrhosis (CHD-C) were at risk of developing brucellosis requiring hospitalization. Higher Wright titers among patients with more advanced liver disease may reflect a unique phenomenon that requires further investigation to determine underlying causative factors.
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Affiliation(s)
- Burak Suvak
- Gastroenterology Department, Medical School, Yuzuncu Yıl University, Van, Turkey
| | - Ahmet Cumhur Dulger
- Gastroenterology Department, Medical School, Yuzuncu Yıl University, Van, Turkey
| | - Ozlem Suvak
- Department of Family Medicine, Kecioren Family Medicine Center, Ankara, Turkey
| | - Aysun Özel Yesilyurt
- Internal Medicine Department, Medical School, Yuzuncu Yıl University, Van, Turkey
| | - Bilge Gultepe
- Microbiology Department, Vakıf Gureba Hospital, Istanbul, Turkey
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Tas Cengiz Z, Yilmaz H, Cicek M, Beyhan YE, Dulger AC. Cystoisospora sp. Infection Determined in Immunosuppressed and Immunocompetent Children: Three Cases Report. TurkiyeParazitolDerg 2016; 40:107-9. [DOI: 10.5152/tpd.2016.3980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Sayin R, Gokgul A, Ebinc S, Dulger AC, Tombul T. Clinical Overlap of Multiple Sclerosis and Autoimmune Hepatitis: Three Cases. J Coll Physicians Surg Pak 2016; 26:S45-S47. [PMID: 27376220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 12/29/2015] [Indexed: 06/06/2023]
Abstract
Multiple sclerosis (MS) is an autoimmune, inflammatory disease characterized by demyelination and axonal degeneration in the central nervous system. MS is the second major cause of disability following trauma, and is mostly seen between the ages of 20 - 40 years and in women. Autoimmune hepatitis (AH) is a chronic disease characterized by hypergammaglobulinemia, high levels of transaminases, presence of antibodies, and histologically by the necroinflammatory process with interface hepatitis. In AH, the etiological agent of the disease and the cause of liver injury remain unknown. MS may be associated with AH, autoimmune thyroiditis, and type 1 diabetes mellitus (DM). In literature, 8 cases with overlap of MS and AH have been reported. In this report, we present 3 cases which were detected with overlap of MS and AH, and are very rare condition in literature.
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Affiliation(s)
- Refah Sayin
- Department of Neurology, Ufuk University, Faculty of Medicine, Ankara, Turkey
| | - Alper Gokgul
- Department of Neurology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Senar Ebinc
- Department of Internal Medicine, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Ahmet Cumhur Dulger
- Department of Internal Medicine, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Temel Tombul
- Department of Neurology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
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Dulger AC, Suvak B, Gonullu H, Gonullu E, Gultepe B, Aydın İ, Batur A, Karadas S, Olmez Ş. High prevalence of chronic hepatitis D virus infection in Eastern Turkey: urbanization of the disease. Arch Med Sci 2016; 12:415-20. [PMID: 27186189 PMCID: PMC4848352 DOI: 10.5114/aoms.2015.52030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 07/27/2014] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Both hepatitis B virus (HBV) and hepatitis D virus (HDV) infection play an increasingly important role in liver diseases. The main objective of this study was to investigate the socio-epidemiological, laboratory and radiological aspects of both HBV and HDV infection near the Iranian border of Turkey. MATERIAL AND METHODS The study included 3352 patients with HBV and HDV infection. Socioepidemiological, laboratory and radiological aspects of the study subjects were retrospectively examined. Comorbid metabolic diseases were not assessed due to the retrospective design of the study. RESULTS Most of the study subjects were HBe antigen negative. No significant difference in terms of HBV-DNA levels or HBe antigen seropositivity was detected between the city centre and rural areas (p > 0.005). The mean HBV-DNA level in the anti-HDV-positive group was significantly lower than in the anti-HDV-negative group (p < 0.001). The rate of HDV-RNA positivity in women was higher than in their male counterparts (p = 0.017). Anti-HDV-IgG was detected in 18.4% of tested subjects who came from an urban area. In contrast, 12.5% of subjects of the rural group had a positive result for anti-HDV-IgG. Among 134 ultrasonographically evaluated delta hepatitis patients, 37.3% had liver cirrhosis. On the other hand, in 1244 patients with hepatitis B monoinfection, there were 90 patients with liver cirrhosis. Radiologically, the rate of hepatic steatosis in delta hepatitis patients was lower than in those with HBV monoinfection. CONCLUSIONS Hepatitis D virus infection was particularly prevalent among the urban population as well as in female subjects. More broadly, the current observations are the first to suggest an inverse correlation between delta hepatitis and ultrasonography-proven hepatic steatosis.
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Affiliation(s)
- Ahmet Cumhur Dulger
- Department of Gastroenterology, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Burak Suvak
- Department of Gastroenterology, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Hayriye Gonullu
- Department of Emergency Medicine, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Edip Gonullu
- Department of Anesthesiology, Van Region Training and Research Hospital, Van, Turkey
| | - Bilge Gultepe
- Department of Microbiology, School of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - İbrahim Aydın
- Department of Gastroenterology, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Abdüssamet Batur
- Department of Radiology, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Sevdegul Karadas
- Department of Emergency Medicine, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Şehmus Olmez
- Department of Gastroenterology, School of Medicine, Yuzuncu Yil University, Van, Turkey
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Sevimli S, Karadas S, Dulger AC. Issues affecting health professionals during and after catastrophic earthquakes in Van-Turkey. J PAK MED ASSOC 2016; 66:129-134. [PMID: 26819153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To assess physical and psycho-social problems faced by health professionals, and to analyse the ethical, legal and triage dimensions of disaster medical services. METHODS The descriptive study was conducted from November 2011 to March 2012 and comprised health professionals from two hospitals of Van, Turkey A specific questionnaire was designed and interviews were conducted face to face. SPSS 13 was used for statistical analysis. RESULTS Of the 430 health professionals who had experienced one or more earthquakes and were part of the study, 225(52.3%) were nurses and 205(47.7%) were doctors. There were 224(52%) women and 206(48%) men. Besides, 206(48) were below 31 years of age. Overall, 193(44.9%) participants experienced chaos, 83(19.3%) panic and fear, and 129(30%) despair. Only 20(4.7%) of them lived at home, while others lived in tents, containers, hospitals or cars during the emergency and continued to provide services despite social, economic and psychological problems. Triage was preferred by 339(78.8%) of the respondents. CONCLUSIONS Problems of health professionals were multi-dimensional and addressing them would make service delivery more effective.
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Affiliation(s)
- Sukran Sevimli
- Department of Medical History and Ethics, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Sevdegul Karadas
- Department of Emergency Medicine, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Ahmet Cumhur Dulger
- Department of Gastroenterology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
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Suvak B, Dulger AC, Karadas S, Gonullu H, Bayram Y, Gonullu E, Batur A, Aykaç MC, Gunduz AM, Aytemiz E, Guducuoglu H. Brucellosis-related acute pancreatitis: A rare complication of a universal disease. J Int Med Res 2015; 44:131-5. [PMID: 26647073 PMCID: PMC5536568 DOI: 10.1177/0300060515583078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 03/24/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To determine the prevalence and determinants of acute pancreatitis in patients with acute brucellosis. METHODS Adult patients with brucellosis were retrospectively recruited. Brucellosis and acute pancreatitis were diagnosed according to standard criteria. Laboratory analyses included Wright agglutination titre, serum biochemical parameters and blood count. RESULTS Patients with acute pancreatitis (n = 21) had significantly higher Wright agglutination titres, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, γ-glutamyl transpeptidase, amylase, lipase and serum glucose concentrations, and significantly lower haemoglobin concentrations and haematocrit than patients with brucellosis alone (n = 326). CONCLUSIONS Hyperglycaemia, anaemia, and liver transaminase and cholestatic enzyme concentrations may represent new approaches for assessing disease severity in patients with brucellosis and acute pancreatitis.
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Affiliation(s)
- Burak Suvak
- Department of Gastroenterology, Yuzuncu Yil University, School of Medicine, Van, Turkey
| | - Ahmet Cumhur Dulger
- Department of Gastroenterology, Yuzuncu Yil University, School of Medicine, Van, Turkey
| | - Sevdegul Karadas
- Department of Emergency Medicine, Yuzuncu Yil University, School of Medicine, Van, Turkey
| | - Hayriye Gonullu
- Department of Emergency Medicine, Yuzuncu Yil University, School of Medicine, Van, Turkey
| | - Yasemin Bayram
- Department of Clinical Microbiology, Yuzuncu Yil University, School of Medicine, Van, Turkey
| | - Edip Gonullu
- Department of Anaesthesia, Van Region Training and Research Hospital, Van, Turkey
| | - Abdussamet Batur
- Department of Radiology, Yuzuncu Yil University, School of Medicine, Van, Turkey
| | - Mehmet Coşkun Aykaç
- Department of Emergency Medicine, Yuzuncu Yil University, School of Medicine, Van, Turkey
| | | | - Enver Aytemiz
- Department of Internal Medicine, Nizip State Hospital, Gaziantep, Turkey
| | - Huseyin Guducuoglu
- Department of Clinical Microbiology, Yuzuncu Yil University, School of Medicine, Van, Turkey
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Begenik H, Aslan M, Dulger AC, Emre H, Kemik A, Kemik O, Esen R. Serum leptin levels in gastric cancer patients and the relationship with insulin resistance. Arch Med Sci 2015; 11:346-52. [PMID: 25995751 PMCID: PMC4424252 DOI: 10.5114/aoms.2015.50967] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 04/02/2013] [Accepted: 04/12/2013] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Serum leptin levels have been examined in various cancers, with conflicting results. However, there is limited information regarding serum leptin levels and insulin resistance in gastric cancer patients. Therefore, we aimed to investigate serum leptin levels, performance status, insulin levels and insulin resistance in patients with gastric cancer. In addition, we examined the relationship between these measurements and leptin levels. MATERIAL AND METHODS Thirty-nine patients with gastric cancer and 30 control subjects were enrolled in the study. Serum leptin, total protein, albumin, growth hormone, insulin and glucose levels were measured. The homeostasis model assessment (HOMA) was used to assess insulin resistance. RESULTS Serum levels of insulin, glucose and growth hormone and insulin resistance were significantly lower in gastric cancer patients than controls (p < 0.05 for all). In the Pearson correlation analysis, insulin resistance was found to be significantly correlated with serum leptin levels in gastric cancer patients (r = 0.320, p = 0.047). We observed a significant negative correlation between performance status and insulin resistance in patients with cachexia (r = -0.512, p = 0.030), while no association was found in non-cachectic patients. CONCLUSIONS We concluded that serum leptin levels are significantly lower in gastric cancer patients. In addition, gastric cancer patients have decreases in insulin levels, insulin resistance and growth hormone levels. This study found a positive association between serum leptin levels and insulin resistance. Moreover, there is a negative association between serum leptin levels and growth hormone levels. Thus, low insulin and growth hormone levels may suppress the production of leptin in gastric cancer patients.
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Affiliation(s)
- Huseyin Begenik
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Mehmet Aslan
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Ahmet Cumhur Dulger
- Department of Gastroenterology, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Habib Emre
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Ahu Kemik
- Department of Biochemistry, Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Ozgur Kemik
- Department of General Surgery, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Ramazan Esen
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yil University, Van, Turkey
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Can A, Dogan E, Bayoglu IV, Tatli AM, Besiroglu M, Kocer M, Dulger AC, Uyeturk U, Kivrak D, Orakci Z, Bal O, Kacan T, Olmez S, Turan N, Ozbay MF, Alacacioglu A. Multicenter epidemiologic study on hepatocellular carcinoma in Turkey. Asian Pac J Cancer Prev 2015; 15:2923-7. [PMID: 24761926 DOI: 10.7314/apjcp.2014.15.6.2923] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hepatocellular cancer (HCC) is one of the important health problems in Turkey, being very common and highly lethal. The aim of this study was to determine clinical, demographic features and risk factors. MATERIALS AND METHODS Nine hundred and sixth-three patients with HCC from 13 cities in Turkey were included in this study. RESULTS Only 205 (21%) of the 963 patients were women, with a male:female predominance of 4.8:1 and a median age of 61 years. The etiologic risk factors for HCC were hepatitis B in 555 patients (57.6%), 453 (81%) in men, and 102 (19%) in women, again with male predominance, hepatitis C in 159 (16.5%), (14.9% and 22.4%, with a higher incidence in women), and chronic alcohol abuse (more than ten years) in 137 (14.2%) (16.8% and 4.9%, higher in males). The Child-Pugh score paralleled with advanced disease stage amd also a high level of AFP. CONCLUSIONS According to our findings the viral etiology (hepatitis B and hepatitis C infections) in the Turkish population was the most important factor in HCC development, with alcohol abuse as the third risk factor. The Child-Pugh classification and AFP levels were determined to be important prognostic factors in HCC patients.
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Affiliation(s)
- Alper Can
- Department of Medical Oncology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey E-mail :
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Suvak B, Dulger AC, Suvak O, Aytemiz E, Kemik O. The prevalence of helicobacter pylori among dyspeptic patients in an earthquake-stricken area. Clinics (Sao Paulo) 2015; 70:69-72. [PMID: 25672432 PMCID: PMC4311122 DOI: 10.6061/clinics/2015(01)12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 11/12/2014] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Helicobacter pylori is a gram-negative, spiral-shaped, urease-producing bacterium with multiple unipolar flagella. Humans are a major reservoir for H. pylori; however, there are no data on the prevalence of H. pylori among dyspeptic patients who have experienced natural disasters. Therefore, the aim of this study was to examine the prevalence of H. pylori in dyspeptic patients who survived a recent natural disaster and to compare the data between the pre-disaster and post-disaster periods. METHODS Between December 2011 and February 2012 (∼ one month following an earthquake), 209 dyspeptic patients who underwent gastroscopy were included in the study. For microorganism identification, gastric biopsy materials from the 209 disaster survivors with dyspeptic complaints were tested for urease activity in a medium containing urea and a pH indicator. The obtained results were compared with pre-disaster data from dyspeptic patients in the same city during the corresponding period of the previous year. Furthermore, the current H. pylori prevalence was evaluated among 139 dyspeptic patients between January 2014 and May 2014. RESULTS We found a significantly higher prevalence of H. pylori in disaster survivors with dyspepsia compared with dyspeptic patients in the pre-disaster period (p<0.005). Interestingly, the current H. pylori prevalence was found to be significantly higher than the prevalence in both the disaster and pre-disaster periods (p<0.005). CONCLUSION These results suggest that a recent earthquake could contribute to the development of H. pylori infection in subjects who live in the disaster-stricken area. These data also highlight the exceptionally high H. pylori prevalence in dyspeptic patients. Regional variations require further analyses.
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Affiliation(s)
- Burak Suvak
- Gastroenterology Department, Medical School, Yuzuncu Yil University, Van, Turkey
| | - Ahmet Cumhur Dulger
- Gastroenterology Department, Medical School, Yuzuncu Yil University, Van, Turkey
| | - Ozlem Suvak
- Kecioren Family Medicine Center, Ankara, Turkey
| | - Enver Aytemiz
- Internal Medicine Department, Medical School, Yuzuncu Yil University, Van, Turkey
| | - Ozgur Kemik
- Department of General Surgery, Medical School, Yuzuncu Yil University, Van, Turkey
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18
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Gonullu H, Karadas S, Dulger AC, Ebinc S. Hepatotoxicity associated with the ingestion of Papaver Rhoease. J PAK MED ASSOC 2014; 64:1189-1190. [PMID: 25823163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Liver injury appears to be associated with the use of herbal products and wild plants.This paper presents what is to our knowledge the first case report in the world of acute liver toxicity caused by Papaver Rhoease. A 17-year- old woman from eastern Turkey ingested Papaver Rhoease which is known as "poppy flower" among the local inhabitants. Her liver function tests were initially 10- 15 fold higher than normal. She was hospitalised in intensive care unit and on day 2 of hospitalisation, the results of her liver function tests showed about a hundred-fold increase compared to the normal level. Her general status deteriorated and she was transferred to another medical centre for liver transplantation.
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Karadas S, Dulger AC, Gonullu H, Bulut G, Beyazal M. Coexistence of hepatocelluler carcinoma and cyst hydatid disease of the liver. J PAK MED ASSOC 2014; 64:1075-1077. [PMID: 25823191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The evidence suggests that both delta hepatitis-related hepatocellular carcinoma (HCC) and cyst hydatid disease (CHD) are frequently seen separately in people who live in the rural areas of Asia. However, there are still a few case reports about coexistence of these different diseases in the same liver. The current case illustrates a number of clinical problems that physicians face in the diagnosis of patients with basically different liver masses.
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Dulger AC, Karadas S, Gonullu H, Beyazal M, Bulut G, Gultepe B. Can D-dimer levels predict the treatment outcome in a patient with tuberculosis? J PAK MED ASSOC 2014; 64:833-836. [PMID: 25255598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Tuberculous peritonitis is a leading cause of mortality and morbidity particularly in the developing world. Delay in initiation of treatment distinctively increases mortality. Treatment response to anti-tuberculosis drugs is usually observed by regression of symptoms and clearance of ascites. With initiation of treatment, laboratory values including CA-125 levels generally return to normal levels in 3 months. However, there is still no consensus about treatment response during the follow-up period. Serum D-dimer level is used as an inflammation marker in some cases. A case with Tuberculous peritonitis successfully monitorised by serum D-dimer levels is presented.
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Dulger AC, Aslan M, Ceylan MR, Olmez S, Karadas S, Akdeniz H. The Syndrome of Inappropriate Secretion of AntiDiuretic Hormone in Patients With Brucellosis. J Clin Lab Anal 2014; 29:366-9. [PMID: 24889373 DOI: 10.1002/jcla.21780] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 04/29/2014] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Various studies have shown that a number of infectious disease causes syndrome of inappropriate antidiuretic hormone (SIADH). However, the relationship between infectious disease and SIADH is not yet fully known. In this prospective study, we aimed to assess the presence of SIADH in patients with brucellosis. PATIENTS AND METHODS Thirty-five patients with acute brucellosis were retrospectively reviewed. The diagnosis of brucellosis was performed using the Wright test in connection with blood culture. SIADH was defined by euvolemic hyponatremia (serum sodium level lower than 135 mEq/l) with increased urinary sodium excretion (urinary sodium higher than 40 mmol/l). RESULTS Of the 35 patients, 19 (54%) had SIADH; 20 (57%) also had hypouricemia (uric acid level lower than 4 mg/dl). Additionally, all of the studied patients had a high mean urinary sodium excretion rate (mean 132 mmol/l; range 40-224). Most importantly, the hyponatremic patients were more likely to have a lower albumin level (P < 0.01). CONCLUSIONS SIADH is a major complication of brucellosis. The presence of SIADH could be a diagnostic tool for diagnosing brucellosis. Further larger randomized studies may confirm these findings.
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Affiliation(s)
- Ahmet Cumhur Dulger
- Department of Gastroenterology, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Mehmet Aslan
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Mehmet Resat Ceylan
- Department of Infectious Disease and Clinical Microbiology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Sehmus Olmez
- Department of Gastroenterology, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Sevdegul Karadas
- Department of Emergency Medicine, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Hayrettin Akdeniz
- Department of Infectious Disease and Clinical Microbiology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
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22
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Aydin I, Karadas S, Gonullu H, Dulger AC. Epidemiological analysis of poisoning cases in Van, Turkey. J PAK MED ASSOC 2014; 64:560-562. [PMID: 25272544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To investigate the etiological and demographical characteristics of acute adult poisoning cases in eastern Turkey. METHODS The retrospective study was conducted at the Emergency Department of Yuzuncu Yil University, School of Medicine, and comprised data related to the period between 2007 and 2009. The data obtained included age, gender, referrals, manner of poisoning, manner of application, the department which followed up on the patients, duration of hospital stay. All data was noted on proforma. SPSS 15 was used for statistical analysis. RESULTS Of the total cases visiting the Emergency Department, 1207 (1.1%) related to poisoning. Of them, 880 (72.9%) had attempted suicide; 858 (71.1%) were female; 349 (29%) were male. The average age of the females was 25.4 +/- 8.5 years, and that of the males 28.3 +/- 14.3 years. Single-medicine was noted in poisoning 544 (45.1%) patients. Other poisoning types were multidrugs 373 (30.9%); rat poisoning, insecticide and pesticides, 145 (12%); corrosives 38 (3.1%); and weed, mushroomang; food 47 (3.8%). Oral poisoning was noted in 1141 (94.5%) cases. A total of 1019 (84.4%) patients received treatment and were followed up in the Emergency Department. Six (0.6%) patients died. CONCLUSION There is a need to generate more awareness about the hazards of domestic cleaning products and to keep it away at some distinct place to minimised chances of confusion.
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Kucukoglu ME, Dulger AC, Aslan M, Olmez S, Guler A, Aldemir MN, Ebinc S, Karadas S, Demirkıran D. Abnormal liver function test in hydatidiform moles: a retrospective study comparing the hyperthyroid state and the euthyroid state. Gynecol Endocrinol 2014; 30:287-9. [PMID: 24479884 DOI: 10.3109/09513590.2013.875993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The effect of a hyperthyroid or euthyroid state on liver function tests in patients with hydatidiform moles (HM) is not known. The aim of this study was to determine the effect of hyperthyroidism on liver transaminases in HM. PATIENTS AND METHODS We retrospectively reviewed aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in 80 patients with HM (23 complete moles and 57 partial moles). RESULTS Of the 80 HM patients, 52 (65%) were euthyroid and 28 (35%) were hyperthyroid. The number of gravida and the levels of serum β-human chorionic gonadotropin (β-HCG), AST, and ALT were significantly higher in the hyperthyroid state than in the euthyroid state (p = 0.033, p = 0.001, p = 0.001 and p = 0.001; respectively). Number of gravida, serum TSH and total T4 were significantly higher in complete HM than partial HM (p < 0.05, p < 0.001, p < 0.05; respectively). CONCLUSIONS Our results demonstrated that HM-related β-HCG may activate thyroid cells via TSH-related signalling, resulting in the release of high levels of FT4, FT3, TT3 and TT4, and a subsequent decrease in TSH.
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Olmez S, Aslan M, Yavuz A, Bulut G, Dulger AC. Diffuse nodular lymphoid hyperplasia of the small bowel associated with common variable immunodeficiency and giardiasis: a rare case report. Wien Klin Wochenschr 2014; 126:294-7. [PMID: 24647448 DOI: 10.1007/s00508-014-0525-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 02/08/2014] [Indexed: 12/16/2022]
Abstract
Diffuse nodular lymphoid hyperplasia (DNLH) of the intestine is an extremely rare lymphoproliferative disorder of uncertain etiology. Typically, numerous polypoid nodules composed of hyperplastic benign lymphoid tissue are present in the small and/or large intestinal mucosa. DNLH has been observed in association with common variable immunodeficiency (CVID). A 38-years-old man was admitted to our clinic due to dyspeptic complaints. An upper gastrointestinal system endoscopic examination revealed DNLH in the duodenum. A biopsy specimen showed the presence of nodular lymphoid hyperplasia and a Giardia lamblia infection in the duodenum. CVID was suspected, and the diagnosis was established by demonstrating a significant reduction in the serum gamma-globulin levels. DNLH is a rare benign condition with regards to diagnosis and treatment of unknown etiology. In patients with DNLH, screening for the immune deficiencies is being important in addition to histopathological examinations.
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Affiliation(s)
- Sehmus Olmez
- Department of Gastroenterology, Medical Faculty,Yuzuncu Yil Universitesi, 65000, Van, Turkey,
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Begenik H, Kemik AS, Emre H, Dulger AC, Demirkiran D, Ebinc S, Kemik O. The association between serum Dickkopf-1 levels and esophageal squamous cell carcinoma. Hum Exp Toxicol 2013; 33:785-8. [PMID: 24220876 DOI: 10.1177/0960327113510537] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Serum Dickkopf-1(DKK-1) is elevated in many malignancies and is an important indicator of malignant potential. However, its significance in esophageal squamous cell cancer (ESCC) has not yet been clarified. We hypothesized a role for DKK-1 in patients with ESCC. The study consisted of 90 ESCC patients and 85 healthy controls. After diagnosis, the level of DKK-1 was measured in the serum samples by enzyme-linked immunosorbent assay and the levels of DKK-1 were much higher in the ESCC patients than in the healthy control group (p < 0.0001). For serum DKK-1, the sensitivity and specificity of the assay were 70 and 80%, respectively. The preoperative serum DKK-1 level was elevated in the ESCC patients. Although serum DKK-1 is not a specific biomarker for ESCC, it might be a useful marker for the diagnosis and treatment of ESCC.
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Affiliation(s)
- H Begenik
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - A S Kemik
- Department of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - H Emre
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - A C Dulger
- Department of Gastroenterology, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - D Demirkiran
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - S Ebinc
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - O Kemik
- Department of General Surgery, Medical Faculty, Yuzuncu Yil University, Van, Turkey
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Abstract
Fixed drug eruption (FDE) is a rare form of drug allergies that recur at the same cutaneous or mucosal site in every usage of drug. Single or multiple round, sharply demarcated and dusky red plaques appear soon after drug exposure. Ursodeoxycholic acid (UDCA: 3α,7β-dihydroxy-5β-cholanic acid) is used for the treatment of cholestatic liver diseases. Some side effects may be observed, such as diarrhea, dyspepsia, pruritus and headaches. We encountered only three cases of lichenoid reaction regarding the use of UDCA among previous studies. In this article, we reported a generalized FDE case related to UDCA intake in a 59-year-old male patient with cholestasis for the first time in the literature.
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Esen R, Dulger AC, Begenik H, Demirtas L, Ebinc S, Aytemiz E, Sunnetcioglu M, Aslan M. Prevalence of Helicobacter pylori in patients with brucellosis. J Investig Med 2013; 60:895-7. [PMID: 22743737 DOI: 10.2310/jim.0b013e31825bccc2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Helicobacter pylori infection affects approximately 40 million individuals in Turkey. Our prefecture is an endemic area for H. pylori infection and brucellosis. However, there are no data on the H. pylori prevalence among patients with brucellosis. OBJECTIVES The primary aim of the current study was to investigate the link between H. pylori infection and brucellosis. The secondary aim was to determine the seroprevalence of H. pylori infection in healthy individuals. METHODS Between May 2010 and May 2011, serum was collected from patients with Brucella infection (n = 111) and healthy individuals (n = 120) and analyzed using an enzyme-linked immunosorbent assay kit. Brucella infection was defined as a positive Wright test or blood culture positivity for Brucella in conjunction with disease symptoms and findings. RESULTS Among the 111 patients with brucellosis, 69% (n = 77) had a seropositivity result for H. pylori IgG. The healthy control subjects had an 87% (n = 104) seropositivity for H. pylori IgG. The serum H. pylori IgG antibody seropositivity was significantly lower in the patients with Brucella infection compared with the control subjects (P < 0.001). CONCLUSION Our results show that the serum prevalence of H. pylori among the patients infected with brucellosis is significantly lower than that in the control population. A negative correlation between H. pylori infection and brucellosis infection might be hypothesized.
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Affiliation(s)
- Ramazan Esen
- Department of Internal Medicine, School of Medicine, Yuzuncu Yil University, Van, Turkey
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Abstract
We report a case of primary endodermal sinus tumor of the omentum which may be the fourth reported case in the English literature. A 19-year-old boy presented with ascites. Analysis of ascites revealed high levels of AFP and CA 125. Laparoscopic biopsy showed endodermal sinus tumour. He was treated with four courses of the BEP regimen (bleomycin, etoposide, cisplatin). The patient was died 2 months after the first appearance of the ascites. Endodermal sinus tumor (EST) is a rare neoplasm which usually arises in the testis or ovary. But extragonadal EST especially located in the abdomen is very rare condition. Clinicians should remain vigilant particularly, when there is a low gradient ascites and are high levels of tumor markers in ascites in young patients.
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Affiliation(s)
| | - Huseyin Begenik
- Yuzuncu Yil University, Medical faculty, Internal Medicine, Van, Turkey
| | - Ramazan Esen
- Yuzuncu Yil University, Medical faculty, Internal Medicine, Van, Turkey
| | - Mete Rafet
- Yuzuncu Yil University, Medical faculty, Gastroenterology, Van, Turkey
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Dulger AC, Esen R, Mete R, Begenik H, Aytemiz E, Tasdemir M, Ebinc S, Aslan M. The prevalence of hereditary hemochromatosis in some men from the Eastern part of Turkey and the effects of H63D mutations on iron studies. Clin Chem Lab Med 2012; 0:1-4. [PMID: 22718642 DOI: 10.1515/cclm-2012-0126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 05/04/2012] [Indexed: 11/15/2022]
Abstract
Abstract Background: Hereditary hemochromatosis (HH) is characterized by an increased intestinal absorption of iron due to mutations in iron-related genes. The C282Y and H63D mutations of the HFE gene are principally responsible for HFE-related hemochromatosis. The majority of HH cases are reported in Western countries where HFE-related mutations are common. The prevalence of HFE-related mutations is not yet clear in eastern Turkey. We aim to clarify the frequency of HFE gene mutations in men who live in eastern Turkey and also assess the biochemical effects of the H63D mutation. Methods: Using the reverse hybridization Hemochromatosis Strip Assay A (ViennaLab, Profiblot T-48, Tecan), DNA extracted from the blood samples of 159 healthy men was analyzed for different mutations in the HFE gene. Results: The H63D mutation was found with an overall carrier frequency of 5.6% (7% heterozygous and 2% homozygous). We also noted that the C282Y gene mutation was not detected in the study. In subjects with the H63D mutation, there were significantly elevated levels both of serum iron and transferrin saturation (p<0.05). Other hematologic and biochemical tests were in the normal ranges in H63D-positive subjects. Conclusions: A lack of C282Y mutations has been reported as a basic finding for non-Western countries and Turkey. H63D mutations in the HFE gene may cause higher levels of serum iron and transferrin saturation. Both may be useful as simple screening tools for HH.
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Dulger AC, Begenik H, Demirtas L, Esen R, Emre H. A Flare of Ulcerative Colitis Accompanied With Cerebral Sinus Venous Thrombosis And Bilateral Thalamic Infarctus: A Case Report. Gastroenterology Res 2012; 5:67-70. [PMID: 27785183 PMCID: PMC5051169 DOI: 10.4021/gr403w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2012] [Indexed: 01/06/2023] Open
Abstract
Ulcerative colitis (UC) is a chronic inflammatory and recurrent disorder that is characterized by bowel inflammation. Some patients with Inflammatory Bowel Disease (IBD) have acute, severe, and sometimes devastating intracranial complications that require immediate medical intervention. Cerebral sinus vein thrombosis is a rare but serious extraintestinal complication associated with ulcerative colitis. Herein we report a 30-year-old man with UC who presented with a flare of gastrointestinal symptoms with mental obtundation and apathy. Total colonoscopy revealed active colitis and cranial MRI showed extensive cerebral sinus venous thrombosis with thalamic infarcts. Because the patient was clinically unstable metilprednisolon with low molecular weight heparin were administered. Two days after treatment the patient was died despite all medical efforts.
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Affiliation(s)
| | - Huseyin Begenik
- Yuzuncu Yil University, Department of Internal Medicine, Van, Turkey
| | - Levent Demirtas
- Ipekyolu Public Hospital, Department of Internal Medicine, Van, Turkey
| | - Ramazan Esen
- Yuzuncu Yil University, Department of Internal Medicine, Van, Turkey
| | - Habib Emre
- Yuzuncu Yil University, Department of Internal Medicine, Van, Turkey
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Aslan M, Cosar N, Celik H, Aksoy N, Dulger AC, Begenik H, Soyoral YU, Kucukoglu ME, Selek S. Evaluation of oxidative status in patients with hyperthyroidism. Endocrine 2011; 40:285-9. [PMID: 21519910 DOI: 10.1007/s12020-011-9472-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Accepted: 04/07/2011] [Indexed: 11/29/2022]
Abstract
Data on the antioxidant levels enzyme in patients with hyperthyroidism are limited and conflicting. Therefore, the objective of this study was to evaluate the oxidative status using an automated method in patients with hyperthyroidism. Thirty-six subjects with hyperthyroidism and 30 healthy controls were enrolled in this study. Serum oxidative status was determined via measurement of total antioxidant capacity (TAC) and total oxidant status (TOS) and calculation of oxidative stress index (OSI). Serum TAC levels were significantly lower in patients with hyperthyroidism than controls (P=0.002), while serum TOS levels and OSI values were significantly higher (P=0.008, 0.004; respectively). Serum TAC levels were correlated with TSH levels (rho=0.223, P=0.032), FT3 levels (rho=-0.434, P=0.002) and FT4 levels (rho=-0.363, P=0.003) in patients. Further, TOS levels and OSI values were correlated with TSH levels (rho=-0.245, P=0.037; rho=-0.312, P=0.011, respectively), FT3 levels (rho=0.293, P=0.017, rho=0.505, P=0.002, respectively), and FT4 levels (rho=0.302, P=0.006, rho=0.321, P=0.008, respectively) in patients. Duration of disease was significantly correlated with OSI values in patients (rho=0.420, P=0.011), while no correlation with serum TAC levels and TOS levels (P>0.05). Oxidants are increased and antioxidants are decreased in patients with hyperthyroidism; as a result, the oxidative-antioxidative balance is shifted to the oxidative side. Increased oxidative stress may play a role in the pathogenesis of hyperthyroidism. It is believed that supplementation of antioxidant vitamins such as vitamins C and E may be helpful for these patients.
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Affiliation(s)
- Mehmet Aslan
- Medical Faculty, Department of Internal Medicine, Yuzuncu Yil University, Van, Turkey.
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Dulger AC, Kemik O, Selvi F, Begenik H, Emre H, Erdur FM. Hepatic Encephalopathy in Connection With Budd-Chiari Syndrome due to Infection With Echinococcus Multilocularis: A Case Report. Gastroenterology Res 2011; 4:127-130. [PMID: 27942328 PMCID: PMC5139819 DOI: 10.4021/gr306e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2011] [Indexed: 11/30/2022] Open
Abstract
Budd-Chiari syndrome (BCS) is a hepatic venous outflow block generally resulting from disorders affecting hepatic venous system. Elevated hepatic venous pressure results in portal hypertension. BCS may also cause hepatic encephalopathy. Echinococcus multilocularis is a tapeworm parasite and the natural course of the disease may affect liver parenchyma as well as hepatic venous tree. It is the most terrible parasitic disease of the liver and is easily confused with hepatic malignancies. Albendazole therapy may suppress disease progression. Alveolar echinococcosis of the liver rarely causes Budd-Chiari syndrome-related hepatic encephalopathy (HE). We report a rare case of alveolar echinococcosis-related BCS with HE, who was successfully managed by rifaximin and albendazole.
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Affiliation(s)
- Ahmet Cumhur Dulger
- Department of Gastroenterology, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Ozgur Kemik
- Department of General Surgery, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Fatih Selvi
- Department of Emergency Medicine, Medical Faculty, Yuzuncu Yil University,Van, Turkey
| | - Huseyin Begenik
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Habib Emre
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Fatih Mehmet Erdur
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yil University, Van, Turkey
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Kemik O, Kemik AS, Sümer A, Dulger AC, Adas M, Begenik H, Hasirci I, Yilmaz O, Purisa S, Kisli E, Tuzun S, Kotan C. Levels of matrix metalloproteinase-1 and tissue inhibitors of metalloproteinase-1 in gastric cancer. World J Gastroenterol 2011; 17:2109-12. [PMID: 21547130 PMCID: PMC3084396 DOI: 10.3748/wjg.v17.i16.2109] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 01/18/2011] [Accepted: 01/25/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the levels of preoperative serum matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in gastric cancer.
METHODS: One hundred gastric cancer patients who underwent gastrectomy were enrolled in this study. The serum concentrations of MMP-1 and TIMP-1 in these patients and in fifty healthy controls were determined using an enzyme-linked immunosorbent assay.
RESULTS: Higher serum MMP-1 and TIMP-1 levels were observed in patients than in controls (P < 0.001). Serum MMP-1 and TIMP-1 levels were positively associated with morphological appearance, tumor size, depth of wall invasion, lymph node metastasis, liver metastasis, perineural invasion, and pathological stage. They were not significantly associated with age, gender, tumor location, or histological type.
CONCLUSION: Increased MMP-1 and TIMP-1 were associated with gastric cancer. Although these markers are not good markers for diagnosis, these markers show in advanced gastric cancer.
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Dulger AC, Kemik O, Begenik H, Sumer A, Bulut D, Bulut G. Synchronous Esophageal Squamous Cell Carcinoma and Esophageal Variceal Bleeding due to Idiopathic Portal Hypertension: A Case Report. Gastroenterology Res 2011; 4:84-87. [PMID: 27942320 PMCID: PMC5139760 DOI: 10.4021/gr300e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2011] [Indexed: 11/03/2022] Open
Abstract
Squamous cell carcinomas of esophagus are responsible for more than 80% of esophageal malignancies in Turkey. Idiopathic portal hypertension is a rare underlying cause of esophageal variceal bleeding. In such cases, detection of concomitant esophageal squamous cell cancer is also a rare occurrence. We report an unusual case of bleeding esophageal varices secondary to idiopathic portal hypertension associated with esophageal squamous cell cancer. To our knowledge, until now, there have been no reported cases of esophageal variceal bleeding due to idiopathic portal hypertension associated with esophageal squamous cell cancer. This case report demonstrates the two different conditions which may cause esophageal bleeding and there may be an association between idiopathic portal hypertension and esophageal squamous cell cancer.
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Affiliation(s)
| | - Ozgur Kemik
- Yuzuncu Yil University School of Medicine, General Surgery, Van, Turkey
| | - Huseyin Begenik
- Yuzuncu Yil University School of Medicine, Internal Medicine, Van, Turkey
| | - Aziz Sumer
- Yuzuncu Yil University School of Medicine, General Surgery, Van, Turkey
| | - Deniz Bulut
- Yuzuncu Yil University School of Medicine, Radiology, Van, Turkey
| | - Gulay Bulut
- Yuzuncu Yil University School of Medicine, Pathology, Van, Turkey
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Nazligul Y, Aslan M, Horoz M, Celik Y, Dulger AC, Celik H, Erel O. The effect on serum myeloperoxidase activity and oxidative status of eradication treatment in patients Helicobacter pylori infected. Clin Biochem 2011; 44:647-9. [PMID: 21396358 DOI: 10.1016/j.clinbiochem.2011.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 02/20/2011] [Accepted: 03/01/2011] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Myeloperoxidase activity has been investigated after eradication of Helicobacter pylori (H. pylori) in infected patients in previous studies but the results are controversial. The aim of this study was to investigate effect on serum myeloperoxidase activity and oxidative status of eradication treatment in H. pylori-infected patients. DESIGN AND METHODS Gastric biopsy specimens were obtained from 30 H. pylori infected patients. Serum myeloperoxidase activity was measured by enzyme-linked immunoassay. Oxidative status was determined using total antioxidant capacity (TAC) and total oxidant status (TOS) measurement and calculation of oxidative stress index (OSI). RESULTS After 2 weeks of the eradication treatment, serum myeloperoxidase activity, TOS and OSI values were significantly lower (all; p<0.001), while TAC was significantly higher (p<0.001). CONCLUSIONS Our results indicate that eradication treatment in H. pylori-infected patients may affect both oxidative stress and myeloperoxidase activity which is an important biomarker in pathogenesis of atherosclerosis.
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Affiliation(s)
- Yaşar Nazligul
- Kecioren Research Hospital, Department of Gastroenterology, Ankara, Turkey
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Kemik O, Sumer A, Kemik AS, Hasirci I, Purisa S, Dulger AC, Demiriz B, Tuzun S. The relationship among acute-phase response proteins, cytokines and hormones in cachectic patients with colon cancer. World J Surg Oncol 2010; 8:85. [PMID: 20920199 PMCID: PMC2954853 DOI: 10.1186/1477-7819-8-85] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 09/28/2010] [Indexed: 12/27/2022] Open
Abstract
Backgraund Acute-phase response proteins (APRP), cytokines and hormones have been claimed to be an independent prognostic factor of malignancies, however the basis for their association with prognosis remains unexplained. We suggest that in colon malignancies, as similar to pancreatic and lung cancers, changes in APRP are associated with angiogenesis. Methods C-reactive protein (CRP), albumin, IL-1α, IL-1β, IL-6, IL-8, IL-10, TNF-α, midkine, VEGF-A, VEGF-C, leptin, adiponectin, and ghrelin serum levels are studied in 126 colon cancer patients and 36 healthy subjects. Results We found statistically significant difference and correlations between two groups. We found significantly higher serum CRP, IL-1α, IL-1β, IL-6, IL-8, IL-10, TNF-α, VEGF-A, VEGF-C and leptin concentrations in patients relative to controls (p < 0.001). We found lower levels of the serum albumin, midkine, adiponectin and ghrelin in patients compared to control subjects (p < 0.001). Conclusions Cachexia in patients with colon cancers is associated with changes in APRP, cytokines and hormone concentrations. These biomarkers and cachexia together have a direct relationship with accelerated angiogenesis. This may lead to a connection between the outcomes in malignancies and the biomarkers.
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Affiliation(s)
- Ozgur Kemik
- Department of General Surgery, Yuzuncu Yıl University Medical Faculty, Van, Turkey.
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Kemik O, Sümer A, Kemik AS, Itik V, Dulger AC, Purisa S, Tuzun S. Human vascular adhesion proteın-1 (VAP-1): serum levels for hepatocellular carcinoma in non-alcoholic and alcoholic fatty liver disease. World J Surg Oncol 2010; 8:83. [PMID: 20849600 PMCID: PMC2949615 DOI: 10.1186/1477-7819-8-83] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2010] [Accepted: 09/17/2010] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The incidence of hepatocellular cancer in complicated alcoholic and non-alcoholic fatty liver diseases is on the rise in western countries as well in our country. Vascular adhesion protein-1 (VAP-1) levels have been presented as new marker. In our study protocol, we assessed the value of this serum protein, as a newly postulant biomarker for hepatocellular cancer in patients with a history of alcoholic and non-alcoholic fatty liver diseases. METHODS Pre-operative serum samples from 55 patients with hepatocellular cancer with a history of alcoholic and non-alcoholic fatty liver diseases and patients with cirrhosis were assessed by a quantitative sandwich ELISA using anti-VAP-1 mAbs. This technique is used to determine the levels of soluble VAP-1 (sVAP-1) in the serum. RESULTS sVAP-1 levels were evaluated in patients with hepatocellular cancer and liver cirrhosis. There was a significant difference in mean VAP-1 levels between groups. Serum VAP-1 levels were found higher in patients with hepatocellular cancer. CONCLUSION These findings indicate that the serum level of sVAP-1 might be a beneficial marker of disease activity in chronic liver diseases.
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Affiliation(s)
- Ozgur Kemik
- Department of General Surgery, Yuzuncu Yil University Medical Faculty, Van, Turkey.
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Abstract
Human dicrocoeliosis is reported sporadically in various parts of the world. We report a case in a 21-year-old male, who had right upper abdominal pain, weight loss, and chronic relapsing watery diarrhea three to four times daily for four weeks. The patient had abdominal tenderness to palpation in the right upper quadrant. Alkaline phosphatase, alanine aminotransferase, and serum immunoglobulin E levels were slightly elevated; all other biochemical and hematological findings were in their normal ranges. The duodenal biopsy samples were normal and an abdominal ultrasonography showed no biliary or hepatic abnormality. Stool microscopy revealed numerous eggs of Dicrocoelium dendriticum. As pseudoparasitosis can result from eating raw, infected animal liver, the patient was given a liver-free diet for three days, to rule out that possibility. Subsequent stool examinations showed eggs in each of the samples indicating that the infection was genuine. The patient was treated with triclabendazole 10 mg/kg in a single dose. Four weeks later, no parasite eggs were detected in the microscopic examination of the stool samples. The patient got better gradually and the symptoms disappeared. Physicians should keep in mind parasitic diseases such as the rarely encountered dicrocoeliosis.
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Affiliation(s)
- Zeynep Tas Cengiz
- Department of Parasitology, Medical Faculty of Yüzüncü Yil University, Van, Turkey
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