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Niedziółka SM, Datta S, Uśpieński T, Baran B, Skarżyńska W, Humke EW, Rohatgi R, Niewiadomski P. The exocyst complex and intracellular vesicles mediate soluble protein trafficking to the primary cilium. Commun Biol 2024; 7:213. [PMID: 38378792 PMCID: PMC10879184 DOI: 10.1038/s42003-024-05817-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 01/15/2024] [Indexed: 02/22/2024] Open
Abstract
The efficient transport of proteins into the primary cilium is a crucial step for many signaling pathways. Dysfunction of this process can lead to the disruption of signaling cascades or cilium assembly, resulting in developmental disorders and cancer. Previous studies on the protein delivery to the cilium were mostly focused on the membrane-embedded receptors. In contrast, how soluble proteins are delivered into the cilium is poorly understood. In our work, we identify the exocyst complex as a key player in the ciliary trafficking of soluble Gli transcription factors. In line with the known function of the exocyst in intracellular vesicle transport, we demonstrate that soluble proteins, including Gli2/3 and Lkb1, can use the endosome recycling machinery for their delivery to the primary cilium. Finally, we identify GTPases: Rab14, Rab18, Rab23, and Arf4 that are involved in vesicle-mediated Gli protein ciliary trafficking. Our data pave the way for a better understanding of ciliary transport and uncover transport mechanisms inside the cell.
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Affiliation(s)
- S M Niedziółka
- Centre of New Technologies, University of Warsaw, Warsaw, Poland
- Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - S Datta
- Centre of New Technologies, University of Warsaw, Warsaw, Poland
| | - T Uśpieński
- Centre of New Technologies, University of Warsaw, Warsaw, Poland
- Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - B Baran
- Centre of New Technologies, University of Warsaw, Warsaw, Poland
- Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - W Skarżyńska
- Centre of New Technologies, University of Warsaw, Warsaw, Poland
| | - E W Humke
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- IGM Biosciences, Inc, Mountain View, CA, USA
| | - R Rohatgi
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biochemistry, Stanford University School of Medicine, Stanford, CA, USA
| | - P Niewiadomski
- Centre of New Technologies, University of Warsaw, Warsaw, Poland.
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Evirgen S, Cavus B, Gokturk S, Iliaz R, Ozkan ZG, Baran B, Ormeci AC, Soyer OM, Karaca C, Demir K, Besisik SF, Poyanli A, Akyuz F, Kaymakoglu S. Is the Y90-radioembolization treatment effective on the intermediate-advanced stage of hepatocellular carcinoma and what is the albumin-bilirubin score's prediction factor for survival? Hepatol Forum 2023; 4:103-107. [PMID: 37822305 PMCID: PMC10564249 DOI: 10.14744/hf.2022.2022.0036] [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] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/13/2023] [Indexed: 10/13/2023]
Abstract
Background and Aim Radioembolization (RE) is a one of the palliative treatments that have been used to down stage and/or increase the survival time in intermediate-advanced stages of HCC. We aimed to evaluate the clinical impact of RE and the clinical use of the albumin-bilirubin (ALBI) score as a predictor for survival in HCC patients. Materials and Methods Fifty-nine unresectable hepatocellular carcinoma (HCC) patients were enrolled. RE was performed in 28 of them (group 1) and 31 patients were followed up in the natural course (NC) (group 2). Patients were classified according to the Child-Pugh score (only cirrhotic patients), Barcelona clinic liver cancer (BCLC) staging, and ALBI scores were also calculated. Results All patients in Group 1 were cirrhotic and their BCLC stages were as follows: 60.7% stage B and 39.3% stage C. In Group 2, 83.9% of patients were cirrhotic and their BCLC stages were as follows: 9.7% stage B, 51.6% stage C, and 38.7% stage D. Mortality rates were 82% and 100% in Groups 1 and 2, respectively. The median overall survival (OS) was 13.5 months (95% CI: 10.4-16.6 months) and 4.5 months (95% CI: 3.5-5.5 months) in Groups 1 and 2, respectively (p=0.000). When RE was applied to patients with ALBI Grade 1 and 2, the median OS was statistically higher than in the NC group, respectively (p<0.001, p<0.001). Conclusion RE is an effective treatment method at the advanced stages of HCC. The ALBI score is a more useful and practical than the other prognostic tools.
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Affiliation(s)
- Sami Evirgen
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Bilger Cavus
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Suut Gokturk
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Raim Iliaz
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Zeynep Gozde Ozkan
- Department of Nuclear Medicine, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Bulent Baran
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Asli Ciftcibası Ormeci
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Ozlem Mutluay Soyer
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Cetin Karaca
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Kadir Demir
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Selman Fatih Besisik
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Arzu Poyanli
- Department of Radiology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Filiz Akyuz
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Sabahattin Kaymakoglu
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
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Baran B, Kosieradzka K, Skarzynska W, Niewiadomski P. MRCKα/β positively regulates Gli protein activity. Cell Signal 2023; 107:110666. [PMID: 37019250 DOI: 10.1016/j.cellsig.2023.110666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023]
Abstract
Posttranslational modifications (PTMs) are key regulatory events for the majority of signaling pathways. Transcription factors are often phosphorylated on multiple residues, which regulates their trafficking, stability, or transcriptional activity. Gli proteins, transcription factors that respond to the Hedgehog pathway, are regulated by phosphorylation, but the sites and the kinases involved have been only partially described. We identified three novel kinases: MRCKα, MRCKβ, and MAP4K5 which physically interact with Gli proteins and directly phosphorylate Gli2 on multiple sites. We established that MRCKα/β kinases regulate Gli proteins, which impacts the transcriptional output of the Hedgehog pathway. We showed that double knockout of MRCKα/β affects Gli2 ciliary and nuclear localization and reduces Gli2 binding to the Gli1 promoter. Our research fills a critical gap in our understanding of the regulation of Gli proteins by describing their activation mechanisms through phosphorylation.
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Alavinejad P, Mousavi Ghanavati P, Alboraie M, Emara M, Baghaee S, Baran B, Ebrahimi Daryani N, Farsi F, Hajiani E, Hashemi SJ, Lak E, Taheri Y, Dangi A. Irritable Bowel Syndrome Demographics: A Middle Eastern Multinational Cross-sectional Study. Middle East J Dig Dis 2022; 14:222-228. [PMID: 36619142 PMCID: PMC9489318 DOI: 10.34172/mejdd.2022.276] [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] [Received: 08/28/2021] [Accepted: 02/02/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND: Irritable bowel syndrome (IBS) is the most frequent functional gastrointestinal (GI) disorder. In this study, we aimed to evaluate the different aspects of IBS among Middle Eastern residents. METHODS: During the study period, patients attending gastroenterology clinics of nine tertiary referral centers in four Middle Eastern couturiers (Iran, Egypt, Kuwait, and Turkey) were evaluated by Rome IV diagnostic criteria, and those who fulfilled the diagnostic criteria of IBS were asked to fill in a questionnaire covering different demographics and clinical aspects. RESULTS: Overall, during a 6-month period, 509 patients with IBS were included. 41.3% of the participants were male (210 patients), and 37.4% of them had academic education. 50% of the participants were Caucasian, and 34% were Arab, and originally, they were citizens of 18 countries. 77.4% of the participants were residents of subtropical areas, while 22.2% were living in temperate regions. The average age of the participants during the first presentation in subtropical and temperate areas were 38.4 ± 12.19 and 38.06 ± 12.18 years, respectively (P = 0.726). The most common subtypes of IBS in subtropical areas were unclassified (IBS-U, 44.4%), constipation dominant (IBS-C, 27.6%), mixed pattern (IBS-M, 21%), and diarrhea dominant (IBS-D, 6.8%) in descending order while in temperate areas the most common subtypes were IBS-U (43.3%), and IBS-D (22.1%), respectively (P < 0.001). Besides abdominal pain, the most common symptom of patients in each region was bloating (62.2% and 68.1%, respectively, P = 0.246). The rate of depression and anxiety were significantly higher among the residents of temperate areas in comparison with subtropical regions (41.6% vs. 16.5% and 80.5% vs. 58.4%, respectively, P < 0.001). CONCLUSION: Although the average age of IBS presentation is the same in subtropical and temperate areas, it seems that in temperate areas, the rate of IBS-D is more prevalent than in subtropical regions. The rate of anxiety and depression are significantly higher among those who searched social media and the internet to get information about their problems.
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Affiliation(s)
- Pezhman Alavinejad
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Imam Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,World Endoscopy Organization Star Group, Munich, Germany,Corresponding Author: Pezhman Alavinejad, MD, AGAF Associate professor of Gastroenterology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Telfax:+ 98 61332921839
| | - Parvin Mousavi Ghanavati
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Imam Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohamed Alboraie
- World Endoscopy Organization Star Group, Munich, Germany,Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Emara
- World Endoscopy Organization Star Group, Munich, Germany,Hepatology, Gastroenterology, and Infectious Diseases Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, P.O box 33516, Egypt
| | - Siamak Baghaee
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Imam Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bulent Baran
- World Endoscopy Organization Star Group, Munich, Germany,Department of Gastroenterology, KOC University Hospital, Istanbul, Turkey
| | | | - Farnaz Farsi
- Colorectal Research Center, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Eskandar Hajiani
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Imam Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Jalal Hashemi
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Imam Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elena Lak
- Imam Hosein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yasaman Taheri
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Imam Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abhijit Dangi
- Haya Al-Habeeb Gastroentrology Center, Mubarak Al-Kabeer Hospital, Hawally, Kuwait
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Glissen Brown JR, Perumpail RB, Duran JF, Bharadwaj S, Baran B, Becq A, Hurwitz M, McLaughlin M, Kaplan ID, Cohen J, Gabr M, Pleskow DK, Sawhney MS, Berzin TM. Preloaded 22-gauge fine-needle system facilitates placement of a higher number of fiducials for image-guided radiation therapy compared with traditional backloaded 19-gauge approach. Gastrointest Endosc 2021; 94:953-958. [PMID: 34081967 DOI: 10.1016/j.gie.2021.05.035] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/19/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Image-guided radiation therapy (IGRT) often relies on EUS-guided fiducial markers. Previously used manually backloaded fiducial needles have multiple potential limitations including safety and efficiency concerns. Our aim was to evaluate the efficacy, feasibility, and safety of EUS-guided placement of gold fiducials using a novel preloaded 22-gauge needle compared with a traditional, backloaded 19-gauge needle. METHODS This was a single-center comparative cohort study. Patients with pancreatic and hepatobiliary malignancy who underwent EUS-guided fiducial placement (EUS-FP) between October 2014 and February 2018 were included. The main outcome was the technical success of fiducial placement. Secondary outcomes were mean procedure time, fiducial visibility during IGRT, technical success of IGRT delivery, and adverse events. RESULTS One hundred fourteen patients underwent EUS-FP during the study period. Of these, 111 patients had successful placement of a minimum of 2 fiducials. Fifty-six patients underwent placement using a backloaded 19-gauge needle and 58 patients underwent placement using a 22-gauge preloaded needle. The mean number of fiducials placed successfully at the target site was significantly higher in the 22-gauge group compared with the 19-gauge group (3.53 ± .96 vs 3.11 ± .61, respectively; P = .006). In the 22-gauge group, the clinical goal of placing 4 fiducials was achieved in 78%, compared with 23% in the 19-gauge group (P < .001). In univariate analyses, gender, age, procedure time, tumor size, and location did not influence the number of successfully placed fiducials. Technical success of IGRT with fiducial tracking was high in both the 19-gauge (51/56, 91%) and the 22-gauge group (47/58, 81%; P = .12). CONCLUSIONS EUS-FP using a preloaded 22-gauge needle is feasible, effective, and safe and allows for a higher number of fiducials placed when compared with the traditional backloaded 19-gauge needle.
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Affiliation(s)
- Jeremy R Glissen Brown
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Ryan B Perumpail
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Jose F Duran
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Shishira Bharadwaj
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Bulent Baran
- Department of Gastroenterology, Koc University Hospital and Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Aymeric Becq
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Martina Hurwitz
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Matthew McLaughlin
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Irving D Kaplan
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Jonah Cohen
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Moamen Gabr
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Douglas K Pleskow
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Mandeep S Sawhney
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Tyler M Berzin
- Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
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6
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Baran B, Kale S, Patil P, Kannadath B, Ramireddy S, Badillo R, DaVee RT, Thosani N. Endoscopic ultrasound-guided parenchymal liver biopsy: a systematic review and meta-analysis. Surg Endosc 2020; 35:5546-5557. [PMID: 33052529 DOI: 10.1007/s00464-020-08053-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 09/29/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Endoscopic ultrasonography (EUS)-guided liver biopsy is a novel technique to obtain adequate liver samples for diagnosis of liver parenchymal diseases. There are studies that have evaluated the feasibility and safety of EUS-guided parenchymal liver biopsy (EUS-LB), however, factors that can influence specimen quality are yet to be determined. Our aim was to determine the diagnostic accuracy of EUS-LB and evaluate factors associated with specimen quality. METHODS We performed a detailed search of PubMed/MEDLINE and Web of Science™ databases to identify studies in which results of EUS-guided liver parenchymal biopsies were reported published up to July 2020. A random effects model was used to estimate pooled values (mean ± SE) for total specimen length (TSL) and complete portal tracts (CPT). Subgroup analyses were applied to find out the procedural factors associated with better specimen quality using Cochran's Q test. A total of 10 meta-analyses were done focusing on international studies. Total of 1326 patients who underwent EUS-LB. EUS-LBs performed for suspicion of parenchymal liver disease. Pooled mean values for TSL and CPT with subgroup analyses. RESULTS Twenty-three studies with a total of 1326 patients were included in our meta-analysis. Overall pooled mean TSL and CPT were 45.3 ± 4.6 mm and 15.8 ± 1.5, respectively. In subgroup analysis, core biopsy needles proved to better in terms of CPT than fine-needle aspiration needles (18.4 vs 10.99, p = 0.003). FNB with slow-pull or suction technique provided a similar TSL (44.3 vs 53.9 mm, p = 0.40), however, slow-pull technique was better in terms of CPT (30 vs 14.6, p < 0.001). Heterogeneity was present among the studies. Another limitation is the low number randomized control trials. CONCLUSION EUS-guided parenchymal liver biopsy is a good alternative to other methods of liver sampling. Using FNB needles with a slow-pull technique can provide better results.
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Affiliation(s)
- Bulent Baran
- Koc University School of Medicine, Istanbul, Turkey
| | - Santosh Kale
- Nassau University Medical Center, East Meadow, NY, USA
| | - Prithvi Patil
- UTHealth McGovern Medical School, Houston, TX, USA.,Center for Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX, 77030, USA
| | - Bijun Kannadath
- University of Arizona, Tucson, AZ, USA.,Center for Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX, 77030, USA
| | - Srinivas Ramireddy
- UTHealth McGovern Medical School, Houston, TX, USA.,Center for Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX, 77030, USA
| | - Ricardo Badillo
- UTHealth McGovern Medical School, Houston, TX, USA.,Center for Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX, 77030, USA
| | - Roy Tomas DaVee
- UTHealth McGovern Medical School, Houston, TX, USA.,Center for Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX, 77030, USA
| | - Nirav Thosani
- UTHealth McGovern Medical School, Houston, TX, USA. .,Center for Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX, 77030, USA.
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Özpolat HT, Baran B, Akyuz F. Skin lesions indicate cause of acute gastrointestinal bleeding: neurofibromatosis type 1. Lancet 2020; 396:e52. [PMID: 32979981 DOI: 10.1016/s0140-6736(20)31909-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/20/2020] [Accepted: 08/15/2020] [Indexed: 11/26/2022]
Affiliation(s)
| | - Bulent Baran
- Division of Gastroenterology, Koç University School of Medicine, Istanbul, Turkey
| | - Filiz Akyuz
- Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Kayar Y, Dertli R, Konur S, Agin M, Baran B, Ormeci AC, Akyuz F, Demir K, Besisik F, Kaymakoglu S. The development of extraintestinal manifestation and related risk factors in Crohn's patients. Ir J Med Sci 2020; 190:597-604. [PMID: 32748219 DOI: 10.1007/s11845-020-02326-z] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/23/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Crohn's disease (CD) primarily involves gastrointestinal tract; however, it can present with extraintestinal manifestations (EIMs), which leads to significant morbidity. Frequency of EIMs and associated risk factors vary due to genetic and environmental differences in studies. AIM To examine the frequency and risk factors associated with EIMs in CD. METHOD Patients with CD under follow-up from March 1986 to October 2011 were included in this study. Demographics, type of EIMs, autoimmune diseases, and clinical features of CD were recorded. Frequency of EIMs and associated risk factors were analyzed. RESULTS Three hundred thirty-six patients with CD were included in the study (mean follow-up duration 7.54 years). 55.4% (n: 186) were male and the mean age at diagnosis of CD was 30.6 years (range, 10.3-68.2 years). At least one EIM was detected in 47.3% and multiple EIMs in 22.9% of the cohort. Oral, joint, and skin involvements (32.4%, 24.7%, 9.2%, respectively) were the most common EIMs. Female gender (OR: 2.19, 95% CI: 1.34-3.58, p = 0.001), corticosteroid usage (OR: 2.32, 95% CI: 1.28-4.22, p = 0.007), and positive family history (OR: 5.61, 95% CI: 1.95-3.58, p = 0.001) were independent risk factors for EIM development. Colonic involvement (OR: 3.93, 95% CI: 1.59-9.68, p = 0.003), no surgical operation (OR: 2.31, 95% CI: 1.14-4.68, p = 0.020), and corticosteroid usage (OR: 2.85, 95% CI: 1.07-7.61, p = 0.037) were independent risk factors for multiple EIM development. CONCLUSION Although the immunological and clinical associations between EIMs and CD cannot be fully elucidated, identifying specific relationships of immune-mediated diseases will help to better understand CD pathogenesis.
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Affiliation(s)
- Yusuf Kayar
- Department of Internal Medicine, Division of Gastroenterology, Van Education and Research Hospital, Saglik Bilimleri University, 65100, Van, Turkey.
| | - Ramazan Dertli
- Department of Internal Medicine, Division of Gastroenterology, Van Education and Research Hospital, Saglik Bilimleri University, 65100, Van, Turkey
| | - Sevki Konur
- Department of Internal Medicine, Van Education and Research Hospital, Saglik Bilimleri University, Van, Turkey
| | - Mehmet Agin
- Department of Pediatry, Division of Gastroenterology, Van Education and Research Hospital, Saglik Bilimleri University, Van, Turkey
| | - Bulent Baran
- Department of Internal Medicine, Division of Gastroenterology, Koç University, Istanbul, Turkey
| | - Asli Ciftcibasi Ormeci
- Department of Internal Medicine, Division of Gastroenterology, Istanbul University, Istanbul, Turkey
| | - Filiz Akyuz
- Department of Internal Medicine, Division of Gastroenterology, Istanbul University, Istanbul, Turkey
| | - Kadir Demir
- Department of Internal Medicine, Division of Gastroenterology, Istanbul University, Istanbul, Turkey
| | - Fatih Besisik
- Department of Internal Medicine, Division of Gastroenterology, Istanbul University, Istanbul, Turkey
| | - Sabahattin Kaymakoglu
- Department of Internal Medicine, Division of Gastroenterology, Istanbul University, Istanbul, Turkey
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Attila T, Zeybel M, Yigit YE, Baran B, Ahishali E, Alper E, Aslan F, Ergonul O, Mungan Z. Upper socioeconomic status is associated with lower Helicobacter pylori infection rate among patients undergoing gastroscopy. J Infect Dev Ctries 2020; 14:298-303. [PMID: 32235091 DOI: 10.3855/jidc.11877] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 01/22/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Socioeconomic factors play an important role in the prevalence of Helicobacter pylori (HP) infection. The aim of this study is to investigate HP prevalence among symptomatic patients in the upper socioeconomic segment of the population undergoing gastroscopy in an endemic urban region. METHODOLOGY Over a 12-month period, data were collected from the first consecutive 1000 patients (500 from university hospital, 500 from community hospital) who had gastroscopy and HP evaluation. RESULTS Overall, 211/1000 patients (21.1 %) were found to have HP in gastric biopsies. The specificity, sensitivity, positive predictive value, negative predictive value and diagnostic accuracy of rapid urease test were 87.5%, 99.7%, 99%, 96.5%, and 96.9% respectively. Atrophic gastritis, gastric and duodenal ulcers were significantly more common in HP positive patients. Age based distribution of HP prevalence: > 6 decades (15.5%), 3rd-5th decades (26.1%), < 3rd decades (10.4%). CONCLUSION In an HP endemic country, the prevalence of HP infection among symptomatic patients belonging to the upper socioeconomic segment of the population appears to be markedly lower. The lowest prevalence in young patients is expected to result in future decrease in HP prevalence.
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Affiliation(s)
- Tan Attila
- Division of Gastroenterology and Hepatology, Koc University School of Medicine, Istanbul, Turkey.
| | - Mujdat Zeybel
- Division of Gastroenterology and Hepatology, Koc University School of Medicine, Istanbul, Turkey.
| | - Yesim Esen Yigit
- School of Medicine, Rumelifeneri, Koc University, Istanbul, Turkey.
| | - Bulent Baran
- Division of Gastroenterology and Hepatology, Koc University School of Medicine, Istanbul, Turkey.
| | - Emel Ahishali
- Division of Gastroenterology and Hepatology, Koc University School of Medicine, Istanbul, Turkey.
| | - Emrah Alper
- Division of Gastroenterology and Hepatology, Koc University School of Medicine, Istanbul, Turkey.
| | - Fatih Aslan
- Division of Gastroenterology and Hepatology, Koc University School of Medicine, Istanbul, Turkey.
| | - Onder Ergonul
- Division of Infectious Diseases, Koc University, Istanbul, Turkey.
| | - Zeynel Mungan
- Division of Gastroenterology and Hepatology, American Hospital, Istanbul, Turkey.
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Sahinturk H, Baran B, Sisman G, Altun R. Liver involvement is associated with blood culture positivity and high agglutination titre in patients with brucellosis in Turkey. J Med Microbiol 2018; 67:1078-1082. [PMID: 29972349 DOI: 10.1099/jmm.0.000791] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We investigated the incidence of and risk factors for liver involvement (LI) in patients with brucellosis in Turkey. Diagnosis was established by blood cultures (BCs) or compatible clinical presentation accompanied by serological evidence. Patients received either a combination of doxycycline plus rifampin for 6 weeks or doxycycline for 6 weeks plus streptomycin intramuscularly for the first 2 weeks. Liver function tests, including those for alanine (ALT) and aspartate aminotransferase (AST) levels, were monitored before and at the end of treatment. One hundred and ninety-five patients were included in the study. Seventy patients had elevated transaminases before treatment. Twenty-six patients had a positive BC for brucellosis. In multivariate analysis, BC positivity (OR=2.44, 95 % CI: 1.03-5.78, P=0.043) and serum agglutination titre (SAT) (OR=1.001, 95 % CI: 1.00-1.002, P=0.018) were found to be associated with LI. Serum aminotransferase levels were normalized in all patients with brucellosis. BC positivity and high SAT are independent factors that are associated with LI in patients with brucellosis.
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Affiliation(s)
- Huseyin Sahinturk
- 1Department of Infectious Diseases, Van Training and Research Hospital, Van, Turkey
| | - Bulent Baran
- 2Department of Gastroenterology, Koç University Hospital, Istanbul, Turkey
| | - Gurhan Sisman
- 3Department of Gastroenterology, Van Training and Research Hospital, Van, Turkey
| | - Reskan Altun
- 3Department of Gastroenterology, Van Training and Research Hospital, Van, Turkey
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Denis D, Sato E, Larson O, Kohnke EJ, Parr E, King J, Stewart K, Baran B, Keshavan M, Manoach D, Stickgold R. 0998 Sleep-dependent Memory Consolidation In Early Course Schizophrenia Patients And Familial High-risk Relatives. Sleep 2018. [DOI: 10.1093/sleep/zsy061.997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Denis
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
| | - E Sato
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
| | - O Larson
- Massachusetts General Hospital / Harvard Medical School, Boston, MA
| | - E J Kohnke
- Massachusetts General Hospital / Harvard Medical School, Boston, MA
| | - E Parr
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
| | - J King
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
| | - K Stewart
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
| | - B Baran
- Massachusetts General Hospital / Harvard Medical School, Boston, MA
| | - M Keshavan
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
| | - D Manoach
- Massachusetts General Hospital / Harvard Medical School, Boston, MA
| | - R Stickgold
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
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Coon WG, Mylonas D, Baran B, Demanuele C, Stickgold R, Manoach D. 0096 Sleep Spindle Coherence And Density Predict Sleep-enhanced Learning In Schizophrenia. Sleep 2018. [DOI: 10.1093/sleep/zsy061.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- W G Coon
- Harvard Medical School, Boston, MA
- Massachusetts General Hospital, Charlestown, MA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA
| | - D Mylonas
- Massachusetts General Hospital, Charlestown, MA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA
| | - B Baran
- Harvard Medical School, Boston, MA
- Massachusetts General Hospital, Charlestown, MA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA
| | - C Demanuele
- Harvard Medical School, Boston, MA
- Massachusetts General Hospital, Charlestown, MA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA
| | - R Stickgold
- Massachusetts General Hospital, Charlestown, MA
- Beth Israel Deconess Medical Center, Boston, MA
| | - D Manoach
- Harvard Medical School, Boston, MA
- Massachusetts General Hospital, Charlestown, MA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA
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Ekinci O, Baran B, Ormeci AC, Soyer OM, Gokturk S, Evirgen S, Poyanli A, Gulluoglu M, Akyuz F, Karaca C, Demir K, Besisik F, Kaymakoglu S. Current state and clinical outcome in Turkish patients with hepatocellular carcinoma. World J Hepatol 2018; 10:51-61. [PMID: 29399278 PMCID: PMC5787684 DOI: 10.4254/wjh.v10.i1.51] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 12/07/2017] [Accepted: 12/29/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate clinical, etiological, and prognostic features in patients with hepatocellular carcinoma.
METHODS Patients with hepatocellular carcinoma who were followed-up from 2001 to 2011 were included in the study. The diagnosis was established by histopathological and/or radiological criteria. We retrospectively reviewed clinical and laboratory data, etiology of primary liver disease, imaging characteristics and treatments. Child-Pugh and Barcelona Clinic Liver Cancer stage was determined at initial diagnosis. Kaplan-Meier survival analysis was done to find out treatment effect on survival. Risk factors for vascular invasion and overall survival were investigated by multivariate Cox regression analyses.
RESULTS Five hundred and forty-five patients with hepatocellular carcinoma were included in the study. Viral hepatitis was prevalent and 68 patients either had normal liver or were non-cirrhotic. Overall median survival was 16 (13-19) mo. Presence of extrahepatic metastasis was associated with larger tumor size (OR = 3.19, 95%CI: 1.14-10.6). Independent predictor variables of vascular invasion were AFP (OR = 2.95, 95%CI: 1.38-6.31), total tumor diameter (OR = 3.14, 95%CI: 1.01-9.77), and hepatitis B infection (OR = 5.37, 95%CI: 1.23-23.39). Liver functional reserve, tumor size/extension, AFP level and primary treatment modality were independent predictors of overall survival. Transarterial chemoembolization (HR = 0.38, 95%CI: 0.28-0.51) and radioembolization (HR = 0.36, 95%CI: 0.18-0.74) provided a comparable survival benefit in the real life setting. Surgical treatments as resection and transplantation were found to be associated with the best survival compared with loco-regional treatments (log-rank, P < 0.001).
CONCLUSION Baseline liver function, oncologic features including AFP level and primary treatment modality determines overall survival in patients with hepatocellular carcinoma.
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Affiliation(s)
- Omer Ekinci
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
| | - Bulent Baran
- Department of Gastroenterology, Koç University Hospital, Istanbul 34010, Turkey
| | - Asli Cifcibasi Ormeci
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
| | - Ozlem Mutluay Soyer
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
| | - Suut Gokturk
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
| | - Sami Evirgen
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
| | - Arzu Poyanli
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
| | - Mine Gulluoglu
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
| | - Filiz Akyuz
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
| | - Cetin Karaca
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
| | - Kadir Demir
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
| | - Fatih Besisik
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
| | - Sabahattin Kaymakoglu
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
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Mylonas DS, Demanuele C, Baran B, Kohnke EJ, Tocci C, Stickgold R, Hamalainen M, Manoach DS. 1126 SPINDLE ACTIVITY RELATED TO MOTOR PROCEDURAL LEARNING IN PATIENTS WITH SCHIZOPHRENIA. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1125] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Baran B, Demanuele C, Vuper TC, Seicol B, Fowler RA, Correll D, Parr E, Callahan CE, Morgan A, Stickgold R, Manoach DS. 1113 THE EFFECTS OF ESZOPICLONE ON SLEEP SPINDLES AND MEMORY CONSOLIDATION IN SCHIZOPHRENIA: A DOUBLE-BLIND RANDOMIZED TRIAL. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tocci C, Kohnke E, Mylonas D, Baran B, Parr E, Stickgold R, Manoach DS. 1125 COMPARISON OF SPINDLE DENSITY AND PROCEDURAL MEMORY RELIABILITY IN NAP AND OVERNIGHT SLEEP. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Soyer OM, Pehlivan A, Ormeci AC, Baran B, Sahin T. Rabbit syndrome developing during peginterferon alfa-2a use in chronic hepatitis C. Curr Med Res Opin 2017; 33:55-56. [PMID: 27595306 DOI: 10.1080/03007995.2016.1233100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ozlem Mutluay Soyer
- a Tekirdag State Hospital , Department of Gastroenterohepatology , Tekirdag , Turkey
| | - Aslihan Pehlivan
- b Tekirdag State Hospital , Department of Neurology , Tekirdag , Turkey
| | - Aslı Ciftcibasi Ormeci
- c Haseki Training and Research Hospital , Department of Gastroenterohepatology , Istanbul , Turkey
| | - Bulent Baran
- d Koç University Hospital , Department of Gastroenterohepatology , Istanbul , Turkey
| | - Tolga Sahin
- a Tekirdag State Hospital , Department of Gastroenterohepatology , Tekirdag , Turkey
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Soyer OM, Baran B, Ormeci AC, Sahin D, Gokturk S, Evirgen S, Basar R, Firat P, Akyuz F, Demir K, Besisik F, Kaymakoglu S, Karaca C. Role of biochemistry and cytological analysis of cyst fluid for the differential diagnosis of pancreatic cysts: A retrospective cohort study. Medicine (Baltimore) 2017; 96:e5513. [PMID: 28072692 PMCID: PMC5228652 DOI: 10.1097/md.0000000000005513] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Management of pancreatic cysts is based on neoplastic-nonneoplastic discrimination. Endoscopic ultrasound (EUS) enables to differentiate neoplastic-nonneoplastic lesions and also allows fine-needle aspiration (FNA). In this study, we aim to assess feasibility and clinical relevance of cytological and biochemical analysis in differential diagnosis of cystic pancreatic lesions in patients who had undergone endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) due to pancreatic cysts. METHODS Participants were 96 patients who had undergone EUS-FNA for differential diagnosis of pancreatic cysts. Pancreatic cysts were classified as benign-mucinous, nonmucinous, and malignant according to patient history, physical examination, EUS appearance, and cystic fluid assessment. Tumor markers (CEA, CA(cancer antigens) 72.4, CA 19-9) , amylase, lipase and cytological assesment were compared between 3 different groups. Receiver-operating characteristics (ROC) curves were constructed to identify appropriate cut-off values. RESULTS Fluid CEA and CA 72.4 levels for benign-mucinous and malignant cysts were significantly higher than for nonmucinous cysts (P ≤ 0.04). A cut-off CEA level of 207 ng/mL differentiated mucinous etiology with a sensitivity of 72.7%, specificity of 97.7%, and accuracy of 89.5%. The sensitivity, specificity, and accuracy of the CA 72.4 cut-off level of 3.32 ng/mL were 80%, 69.5%, and 73.6%, respectively. CONCLUSION Cyst fluid CEA and CA 72.4 levels have a high accuracy in discriminating mucinous from nonmucinous cysts. When combined with cytology their accuracy rate increases.
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Affiliation(s)
| | | | | | - Davut Sahin
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | | | | | - Pinar Firat
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Ormeci A, Aydın Y, Sumnu A, Baran B, Soyer OM, Pınarbasi B, Gokturk S, Gulluoglu M, Onel D, Badur S, Akyuz F, Karaca C, Demir K, Besisik F, Kaymakoglu S. Predictors of treatment requirement in HBeAg-negative chronic hepatitis B patients with persistently normal alanine aminotransferase and high serum HBV DNA levels. Int J Infect Dis 2016; 52:68-73. [PMID: 27619844 DOI: 10.1016/j.ijid.2016.09.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 09/03/2016] [Accepted: 09/05/2016] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Serum alanine aminotransferase (ALT) is a controversial marker for disease monitoring in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients. The aim of this study was to determine the fibrosis stage and histological activity index (HAI) in HBeAg-negative CHB patients with persistently normal ALT (PNALT) and high serum HBV DNA (≥2000 IU/ml) and to investigate clinical risk factors for the requirement of treatment through the examination of liver biopsy specimens. METHODS HBeAg-negative CHB patients with PNALT (≤40 IU/l) and high serum HBV DNA (≥2000 IU/ml) were included. HBV fibrosis stage and HAI were scored according to the Ishak system. Multivariate logistic regression analysis was used to estimate the independent risk factors for fibrosis stage ≥2 and/or HAI ≥6. Receiver operating characteristic curve analysis was used to determine an optimal age cut-off for liver biopsy. RESULTS A total 120 patients were enrolled. These patients had a mean HBV DNA level of 123680±494500 IU/ml; the HBV DNA load was 2000-20000 IU/ml in 68 patients (56.6%) and ≥20000 IU/ml in 52 (43.4%). Eighteen patients (15%) had moderate-to-severe histological activity (HAI ≥6). Forty-three patients (35.9%) had a fibrosis stage ≥2. Forty-eight patients (40%) had a fibrosis stage ≥2 and/or HAI ≥6. On multivariate logistic regression analysis, independent variables associated with fibrosis stage ≥2 and/or HAI ≥6 included age and HBV DNA viral load. Patients with HBV DNA 2000-20000 IU/ml were more likely to require treatment compared to those with a viral load ≥20000 IU/ml. The optimal age cut-off to predict fibrosis stage ≥2 and/or HAI ≥6 was 46 years. CONCLUSIONS Significant liver damage was detected in 40% of CHB patients with PNALT and high HBV DNA upon biopsy. Age and HBV DNA viral load were independent predictors of significant liver damage. A biopsy to determine the degree of liver damage is advisable for CHB patients older than 46 years.
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Affiliation(s)
- Aslı Ormeci
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Yucel Aydın
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Abdullah Sumnu
- Medipol University, Department of Nephrology, Istanbul, Turkey
| | - Bulent Baran
- Department of Gastroenterology, Koç University Hospital, Istanbul, Turkey
| | - Ozlem Mutluay Soyer
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Binnur Pınarbasi
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Suut Gokturk
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Mine Gulluoglu
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Derya Onel
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Selim Badur
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Filiz Akyuz
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Cetin Karaca
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Kadir Demir
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Fatih Besisik
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Sabahattin Kaymakoglu
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey.
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Windyga J, Stefanska-Windyga E, Odnoczko E, Baran B, Czubak G. Activated prothrombin complex concentrate in combination with tranexamic acid: a single centre experience for the treatment of mucosal bleeding and dental extraction in haemophilia patients with inhibitors. Haemophilia 2016; 22:e465-8. [DOI: 10.1111/hae.13035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2016] [Indexed: 11/29/2022]
Affiliation(s)
- J. Windyga
- Department of Disorders of Hemostasis and Internal Medicine; Institute of Hematology and Transfusion Medicine; Warsaw Poland
- Laboratory of Hemostasis and Metabolic Diseases; Institute of Hematology and Transfusion Medicine; Warsaw Poland
| | - E. Stefanska-Windyga
- Outpatient Clinic for Patients with Coagulation Disorders; Institute of Hematology and Transfusion Medicine; Warsaw Poland
| | - E. Odnoczko
- Laboratory of Hemostasis and Metabolic Diseases; Institute of Hematology and Transfusion Medicine; Warsaw Poland
| | - B. Baran
- Laboratory of Hemostasis and Metabolic Diseases; Institute of Hematology and Transfusion Medicine; Warsaw Poland
| | - G. Czubak
- Outpatient Clinic for Patients with Coagulation Disorders; Institute of Hematology and Transfusion Medicine; Warsaw Poland
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Ormeci AC, Akyuz F, Baran B, Gokturk S, Ormeci T, Pinarbasi B, Mutluay Soyer O, Evirgen S, Akyuz U, Karaca C, Demir K, Kaymakoglu S, Besisik F. Retention during capsule endoscopy: Is it a real problem in routine practice? J Int Med Res 2016; 44:968-75. [PMID: 27377071 PMCID: PMC5536635 DOI: 10.1177/0300060516645420] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 03/29/2016] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE This study evaluated the risks and outcomes of capsule retention during capsule endoscopy (CE) for investigating small bowel disease. Capsule retention is the most serious complication of CE. METHODS Before CE, the gastrointestinal tract was evaluated for blockages with computerized tomography. Analysis of CE was made retrospectively. RESULTS Capsule endoscopy was used to investigate obscure bleeding (90.2%; n = 324) or other symptoms (9.8%; n = 35). The capsule retention rate was 11/359 (3.1%); it was retained in a malignant lesion area (adenocarcinoma or melanoma) in two patients (18.2%), in the small bowel in an ulcerated area in five patients (45.5%), and in the oesophagus/stomach in four patients (36.4%) due to dysmotility. None of the patients had symptoms of obstruction. CONCLUSIONS Scanning patients before CE did not predict capsule retention. Retention is a complication of CE, but occurs as a result of the underlying disease. The risk of retention is increased in patients with motility disorders, suspected small bowel ulcers or malignancies.
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Affiliation(s)
- Asli Cifcibasi Ormeci
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Filiz Akyuz
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Bulent Baran
- Department of Gastroenterology, Koç University Hospital, Istanbul, Turkey
| | - Suut Gokturk
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tugrul Ormeci
- Department of Radiology, Medipol University, Istanbul, Turkey
| | - Binnur Pinarbasi
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ozlem Mutluay Soyer
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sami Evirgen
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Umit Akyuz
- Department of Gastroenterology, Yeditepe University, Istanbul, Turkey
| | - Cetin Karaca
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Kadir Demir
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sabahattin Kaymakoglu
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Fatih Besisik
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Ormeci A, Emrence Z, Baran B, Soyer OM, Gokturk S, Evirgen S, Akyuz F, Karaca C, Besisik F, Kaymakoglu S, Ustek D, Demir K. Can Helicobacter pylori be eradicated with high-dose proton pump inhibitor in extensive metabolizers with the CYP2C19 genotypic polymorphism? Eur Rev Med Pharmacol Sci 2016; 20:1795-1797. [PMID: 27212172] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Proton pump inhibitors (PPI) metabolism and pharmacokinetics are regulated by cytochrome P450 enzymes in the liver. Cytochrome P450 2C19 (CYP2C19) polymorphism plays an import role in the metabolism of PPIs. The three possible genotypes for CYP2C19 each has a distinct effect on the pharmacodynamics of PPIs. Homozygote extensive metabolizers (HomEM) are the most frequent genotype and have two wild-types (non-mutant) (*1/*1) alleles. HomEM is associated with increased enzyme activity, which increases the rate of PPI metabolism. Intragastric pH, which is required for eradication, is lowest in HomEM. In HomEMs, an insufficient increase in intragastric pH results in decreased anti-Helicobacter pylori (HP) efficacy of the antibiotics and, therefore, lower eradication rates. We determined whether the HP eradication rate would increase after high-dose PPI treatment of extensive PPI metabolizers who had been treated unsuccessfully with a standard PPI dose. In our report, increasing the PPI dosage in patients with genotype polymorphisms may be effective on eradication rates. Eradication rates are directly affected by CYP2C19 polymorphisms, and eradication treatments should be planned considering such genotypic polymorphisms. Hence, CYP2C19 genotyping prior to treatment may facilitate determination of the optimum PPI dose to improve the therapeutic outcome. However, further researches are required to confirm this hypothesis.
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Affiliation(s)
- A Ormeci
- Department of Internal Medicine, Division of Gastroenterology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
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Soyer OM, Baran B, Ormeci AC, Gokturk S, Aydın E, Onel D, Gulluoglu M, Karaca C, Akyuz F, Demir K, Besisik F, Kaymakoglu S. Comparison of the efficacy of 12 months and longer courses of interferon therapy for the treatment of chronic delta hepatitis: a retrospective cohort study. Postgrad Med 2016; 128:432-8. [DOI: 10.1080/00325481.2016.1175310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Ormeci A, Akyuz F, Baran B, Gokturk S, Ormeci T, Pinarbasi B, Soyer OM, Evirgen S, Akyuz U, Karaca C, Demir K, Kaymakoglu S, Besisik F. What is the impact of capsule endoscopy in the long term period? World J Gastrointest Endosc 2016; 8:344-348. [PMID: 27076873 PMCID: PMC4823673 DOI: 10.4253/wjge.v8.i7.344] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 06/19/2015] [Revised: 08/14/2015] [Accepted: 01/29/2016] [Indexed: 02/05/2023] Open
Abstract
AIM: To assess the clinical impact of capsule endoscopy (CE) in the long-term follow-up period in patients with obscure gastrointestinal bleeding (OGIB).
METHODS: One hundred and forty-one patients who applied CE for OGIB between 2009 and 2012 were retrospectively analyzed, and this cohort was then questioned prospectively. Demographic data of the patients were determined via the presence of comorbid diseases, use of non-steroidal anti-inflammatory drugs anticoagulant-antiaggregant agents, previous diagnostic tests for bleeding episodes, CE findings, laboratory tests and outcomes.
RESULTS: CE was performed on 141 patients because of OGIB. The capsule was retained in the upper gastrointestinal (GI) system in two of the patients, thus video monitoring was not achieved. There were 139 patients [62% male, median age: 72 years (range: 13-93 years) and a median follow-up duration: 32 mo (range: 6-82 mo)]. The overall diagnostic yield of CE was 84.9%. Rebleeding was determined in 40.3% (56/139) of the patients. The rebleeding rates of patients with positive and negative capsule results at the end of the follow-up were 46.6% (55/118) and 4.8% (1/21), respectively. In the multivariate analysis, usage of NSAIDs, anticoagulant-antiaggregant therapies (OR = 5.8; 95%CI: 1.86-18.27) and vascular ectasia (OR = 6.02; 95%CI: 2.568-14.146) in CE were detected as independent predictors of rebleeding. In the univariate analysis, advanced age, comorbidity, and overt bleeding were detected as predictors of rebleeding.
CONCLUSION: CE is a reliable method in the diagnosis of obscure GI bleeding. Negative CE correlated with a significantly lower rebleeding risk in the long-term follow-up period.
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Ormeci AC, Akyuz F, Baran B, Soyer OM, Gokturk S, Onel M, Onel D, Agacfidan A, Demirci M, Yegen G, Gulluoglu M, Karaca C, Demir K, Besisik F, Kaymakoglu S. Steroid-refractory inflammatory bowel disease is a risk factor for CMV infection. Eur Rev Med Pharmacol Sci 2016; 20:858-865. [PMID: 27010142] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Patients with inflammatory bowel disease (IBD) show increased the prevalence of cytomegalovirus (CMV) infection due to the severity of the disease and the immunosuppressive treatments they receive. The aim of this study was to determine the prevalence of CMV infection in IBD patients and identify the risk factors for CMV infection with different demographic characteristics in IBD patients. PATIENTS AND METHODS We enrolled 85 patients diagnosed with IBD (43 with ulcerative colitis (UC) and 42 with Crohn's disease (CD)) in this prospective study. The clinical disease activities of UC and CD were assessed using Truelove-Witts and Crohn's disease activity index (CDAI). CMV infection was assessed by detection of DNA using real-time polymerase chain reaction (PCR) in blood samples and quantitative PCR in colonic biopsy specimens and by detection of inclusion bodies using hematoxylin-eosin staining. RESULTS Thirteen patients with IBD exhibited concomitant CMV infection. CMV infection was not detected in any of the patients in remission. Viral loads measured in the colonic mucosa of infected patients ranged from 800-7000 genome copies/mL total extracted DNA. The mean serum CMV DNA level was 1694 ± 910 copies/mL (range: 800-3800). The rate of steroid resistance in CMV-positive cases was significantly higher than that in CMV-negative cases (p = 0.001). CD with acute exacerbation was a risk factor for CMV disease (p = 0.04). All of the CMV-positive patients received immunosuppressive treatments. CONCLUSIONS CMV infection should be suspected in steroid-resistant UC and CD. Antiviral treatment improved the clinical outcome in steroid-resistant IBD cases with serum CMV DNA levels above 1000 copies/mL.
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Affiliation(s)
- A C Ormeci
- Department of Internal Medicine, Division of Gastroenterology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
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Ormeci A, Emrence Z, Baran B, Gokturk S, Soyer OM, Evirgen S, Akyuz F, Karaca C, Besisik F, Kaymakoglu S, Ustek D, Demir K. Effect of cytochrome P450 2C19 polymorphisms on the Helicobacter pylori eradication rate following two-week triple therapy with pantoprazole or rabeprazole. Eur Rev Med Pharmacol Sci 2016; 20:879-885. [PMID: 27010145] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Cytochrome P450 2C19 (CYP2C19) polymorphisms play an important role in the metabolism of proton pump inhibitors. Rabeprazole is primarily metabolized via non-enzymatic pathways. In this study, we determined whether rabeprazole- and pantoprazole-based eradication treatments were influenced by CYP2C19 polymorphisms. PATIENTS AND METHODS A total of 200 patients infected with Helicobacter pylori were treated with either 40 mg of pantoprazole or 20 mg of rabeprazole plus 500 mg of clarithromycin, 1000 mg of amoxicillin twice daily for 2 weeks. CYP2C19 genotype status was determined by Polymerase Chain Reaction (PCR)-restriction-fragment-length polymorphism. The genotypes of cytochrome P450 2C19 were classified as homozigote extensive metabolizer (HomEM), heterozigote metabolizer (HetEM) and poor metabolizer (PM). The CYP2C19 genotype of all patients, the effectiveness of the treatment, the effect of the genotypic polymorphism on the treatment were assessed. RESULTS The frequencies of HotEM, HetEM, PM were 78%, 19.5% and 2.5%, respectively. 48% (n = 96) of the patients received treatment with rabeprazole and 52% (n = 104) with pantoprazole. The eradication rate was 64.7% for HomEM, 79.4% for HetEM, 100% for PM (p = 0.06). In HetEM, PM, are considered as a single group, the eradication rates were higher in patients with the HetEM and PM (HetEM+PM) genotypes than in those with the wild-type genotype (81.8 vs. 64.7% p = 0.031). Among the patients treated with rabeprazole, the eradication rates were significantly lower in those with the HomEM genotype than in those with the HetEM+PM genotypes (60% vs. 85.7% p = 0.023). CONCLUSIONS The genotypic polymorphism is effective on the rate of eradication. Eradication treatment rate with rabeprazole is influenced by CYP2C19 genotype.
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Affiliation(s)
- A Ormeci
- Department of Internal Medicine, Division of Gastroenterohepatology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
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Sisman G, Baran B. Placement of a Self-Expanding Metal Stent to Treat Esophagogastric Benign Anastomotic Stricture via Retroflexed Ultrathin Endoscopy: A Case Report with a Video. Clin Endosc 2015; 48:428-30. [PMID: 26473127 PMCID: PMC4604282 DOI: 10.5946/ce.2015.48.5.428] [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] [Received: 08/30/2014] [Revised: 12/16/2014] [Accepted: 12/16/2014] [Indexed: 11/14/2022] Open
Abstract
Previous studies reported that ultrathin endoscope (UE) provides endoscopic guidance during insertion of a self-expanding metal stent (SEMS) without fluoroscopic monitoring in patients with upper gastrointestinal stenosis (benign or malignant) or postoperative esophageal leakage. According to the type of SEMS and level of the stenosis, the technique of the procedure is variable. Herein, we report a patient who underwent placement of a distal release esophageal SEMS to treat an esophagogastric anastomotic stricture via retroflexed UE.
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Affiliation(s)
- Gurhan Sisman
- Department of Gastroenterology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Bulent Baran
- Department of Gastroenterology, Van Training and Research Hospital, Van, Turkey
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Baran B, Soyer OM, Ormeci AC, Gokturk S, Evirgen S, Akyuz F, Karaca C, Demir K, Besisik F, Onel D, Gulluoglu M, Badur S, Kaymakoglu S. Tenofovir disoproxil fumarate has a substantial efficacy against multidrug-resistant strains of hepatitis B virus. Liver Int 2015; 35:2265-74. [PMID: 25800974 DOI: 10.1111/liv.12831] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 03/16/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS To evaluate the efficacy of tenofovir in chronic hepatitis B (CHB) patients with adefovir resistance (ADF-R) and suboptimal response to adefovir (ADF-S). METHODS Nucleos(t)ide analogue (NA)-naïve patients and patients with previous adefovir failure receiving tenofovir therapy for at least 6 months were included in the study. Biochemical and virological tests were obtained at baseline and 3-month intervals in the first year and every 6 months thereafter. The primary outcome measure was complete virological response (CVR) (HBVDNA < 20 IU/ml). CVR rates were calculated by Kaplan-Meier analysis, and a multivariate Cox proportional hazard model was generated to find out factors independently associated with CVR. RESULTS A total of 165 patients (118 men, mean age 42 ± 12, 64 HBeAg(+) ) were included in the study. There were 105 patients in NA-naïve, 32 patients in ADF-S and 28 patients in ADF-R groups. All patients in the ADF-R group had multidrug resistance patterns. Mean duration of tenofovir treatment was 29 ± 14 months. CVR rates in NA-naïve, ADF-S and ADF-R groups were 65% vs. 75% vs. 58% at 12th month, 77% vs. 87% vs. 79% at 24th month and 83% vs. 94% vs. 79% at 36th month respectively. According to multivariate Cox regression model, HBeAg positivity (HR = 0.56, 95%CI 0.36-0.86, P = 0.008), high baseline HBVDNA level (HR = 0.64, 95%CI 0.55-0.74, P < 0.001) and ADF-R (HR = 0.47, 95%CI 0.28-0.81, P = 0.006) were independent predictors for CVR. Seven patients encountered mild renal dysfunction and were managed by dose adjustments. CONCLUSION CVR rates during the follow-up show that tenofovir has a decreased, yet still potent in vivo efficacy against multidrug-resistant strains of HBV.
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Affiliation(s)
- Bulent Baran
- Department of Gastroenterology, Koç University Hospital, Zeytinburnu, Istanbul, Turkey
| | - Ozlem Mutluay Soyer
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Asli Cifcibasi Ormeci
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Suut Gokturk
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Sami Evirgen
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Filiz Akyuz
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Cetin Karaca
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Kadir Demir
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Fatih Besisik
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Derya Onel
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Mine Gulluoglu
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Selim Badur
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Sabahattin Kaymakoglu
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
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Baran B. Nucleos(t)ide analogs in the prevention of hepatitis B virus related hepatocellular carcinoma. World J Hepatol 2015; 7:1742-1754. [PMID: 26167247 PMCID: PMC4491903 DOI: 10.4254/wjh.v7.i13.1742] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 01/29/2015] [Revised: 05/06/2015] [Accepted: 06/19/2015] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is among the most common cancer types and causes of cancer related mortality worldwide. Almost 50% of all HCC cases globally are attributable to chronic hepatitis B virus (HBV) infection. The incidence rates of HCC in untreated Asian subjects with HBV infection was estimated to be 0.2% in inactive carriers, 0.6% for those with chronic hepatitis without cirrhosis, and 3.7% for those with compensated cirrhosis. In Western populations, HCC incidences are reported to be 0.02% in inactive carriers, 0.3% in subjects with chronic hepatitis without cirrhosis, and 2.2% in subjects with compensated cirrhosis. Despite effective antiviral treatment options which are able to transform chronic hepatitis into an inactive carrier state, the risk of HCC cannot be fully ruled out to exclude those patients from surveillance. Newer nucleos(t)ide analogues (NAs) as entecavir and tenofovir are very potent in terms of sustained virological suppression which leads to improved liver histology. However, they do not have any influence on the cccDNA or integrated DNA of HBV in the liver. Nonetheless, viral replication is the only modifiable component among the established risk factors for HBV-related HCC with the current treatment options. In this review, it was aimed to summarize cumulative evidence behind the concept of prevention of HBV related HCC by NAs, and to discuss remaining obstacles to eliminate the risk of HCC.
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Affiliation(s)
- E Ozturk
- Department of Haematology, Koç University Hospital, Istanbul, Turkey
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Yilmaz E, Baran B, Soyer OM, Onel M, Onel D, Ormeci AC, Gokturk S, Evirgen S, Akyuz F, Demir K, Besisik F, Kaymakoglu S, Karaca C. Effects of polymorphisms in interferon λ 3 (interleukin 28B) on sustained virologic response to therapy in patients with chronic hepatitis D virus infection. Clin Gastroenterol Hepatol 2014; 12:1753-8. [PMID: 24582569 DOI: 10.1016/j.cgh.2014.01.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 01/13/2014] [Accepted: 01/29/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS We investigated the association between interferon λ 3 (IFNL3) genotype (also known as interleukin 28B) and response to IFNα therapy in patients with chronic hepatitis D virus (HDV) infection. METHODS We studied IFNL3 genotypes of 32 patients (19 men; median age, 42.5 y) with chronic HDV infection. Nineteen patients (59%) were treated with pegylated IFNα and 13 patients (41%) were treated with standard IFNα, for at least 12 months. Levels of HDV RNA were measured before the initiation of treatment and every 6 months thereafter; patients were followed up for a median time of 16 months (range, 6-164 mo) after treatment ended. We used real-time polymerase chain reaction to classify the IFNL3 polymorphism rs12979860 as CC, CT, or TT, and rs8099917 as TT, GT, or GG. A virologic response was defined as undetectable HDV RNA in serum, and a sustained virologic response (SVR) was defined as undetectable HDV RNA after cessation of treatment until the end of the follow-up period. We evaluated the association between IFNL3 polymorphism and treatment response using univariate and multivariate analyses. RESULTS After treatment, a response was achieved in 16 patients (50%) and an SVR was achieved in 9 (28%). The percentages of patients with CC, CT, and TT at rs12979860 were 47%, 47%, and 6%, respectively; the percentages of patients with TT, GT, and GG at rs8099917 were 69%, 28%, and 3%, respectively. Rates of SVR were 27%, 27%, and 50% in patients with CC, CT, TT at rs12979860 (P = .78 for CC vs CT vs TT) and 36%, 11%, and 0% in patients with TT, GT, and GG at rs8099917 (P = .30 for TT vs GT vs GG). CONCLUSIONS The IFNL3 polymorphisms rs12979860 and rs8099917 do not significantly affect responses of patients with chronic HDV infection to treatment with IFNα.
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Affiliation(s)
- Emre Yilmaz
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey; Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Bulent Baran
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Ozlem Mutluay Soyer
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Mustafa Onel
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Derya Onel
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Asli Cifcibasi Ormeci
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Suut Gokturk
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Sami Evirgen
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Filiz Akyuz
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Kadir Demir
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Fatih Besisik
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Sabahattin Kaymakoglu
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey
| | - Cetin Karaca
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey.
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Uyanikoglu A, Ermis F, Akyuz F, Pinarbasi B, Baran B, Aydogan T, Demir K, Besisik F, Kaymakoglu S. Infliximab in inflammatory bowel disease: attention to adverse events. Eur Rev Med Pharmacol Sci 2014; 18:2337-2342. [PMID: 25219835] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To assess the efficacy and adverse effects of infliximab in patients with Crohn's disease and ulcerative colitis who are resistant to conventional therapy or having fistulising type Crohn's disease. PATIENTS AND METHODS The patients with a diagnosis of inflammatory bowel disease received infliximab between 2007 and 2009 were followed-up prospectively. Infliximab 5 mg/kg was given at week 0, 2, 6, and every 8 weeks thereafter. Early and late adverse events occurring during the treatment were recorded for each patient. RESULTS There were 36 patients [mean age 35±12, 17 male] included in the study. Thirty-two (88%) patients were receiving concomitant long-term immunosuppressive therapy. Complete or partial response was obtained in 75% of all patients. At least one adverse event was observed in 10 (28%) patients. Anaphylaxis was seen in 2 (6%) patients, mild acute infusion reaction in 2 (6%) patients, hypotension in 2 (6%) patients, respiratory distress in 2 (6%) patients, skin rash and eruptions in 2 (6%) patients, one hypertension (3%) and one (3%) tightness in the chest. Treatment was continued in all except patients with anaphylaxis. No infection, tumour or cases of death were observed. CONCLUSIONS Several adverse events might be observed in patients who receive infliximab. Care should be given to patients whom treatment was restarted after a break in regard to anaphylaxis. No serious adverse event was observed during infliximab treatment except allergic events.
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Affiliation(s)
- A Uyanikoglu
- Department of Gastroenterology, Harran University, Medical Faculty, Sanliurfa, Turkey.
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Affiliation(s)
- Bulent Baran
- Department of Gastroenterology, Van Training and Research Hospital, Van 65300, Turkey.
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Kaymakoglu S, Baran B, Onel D, Badur S, Atamer T, Akyuz F. Acute hepatitis B due to immune-escape mutations in a naturally immune patient. Acta Gastroenterol Belg 2014; 77:262-265. [PMID: 25090827] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Incidence of hepatitis B virus infection (HBV) has been greatly reduced globally after the introduction of universal vaccination programs. However, another potential threat was noticed almost 2 decades ago, which is the selection of antibody escape HBV strains. Antibody or immune escape strains of HBV carry mutations in the S gene which encodes "a" determinant region located at amino acid positions 124 to 149. Certain mutations in this region, which promotes antibody response, might lead to an alteration in the antigenicity of hepatitis B surface antigen (HBsAg). Anti-HBs might fail to neutralize the mutant virus and transmission or reappearance of infection in previously immunized individuals can be possible. Herein, we report a patient with known HBV seropositivity (HBsAg negative, anti-HBs positive, anti-HBc IgG positive) for more than 10 years who developed a symptomatic acute hepatitis due to occurrence of immune escape mutants in the absence of any immunosuppression or cytotoxic chemotherapy. To the best of our knowledge, this is the first reported case of acute hepatitis B due to escape mutations in a naturally immune patient.
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Baran B, Gulluoglu M, Soyer OM, Ormeci AC, Gokturk S, Evirgen S, Yesil S, Akyuz F, Karaca C, Demir K, Kaymakoglu S, Besisik F. Treatment failure may lead to accelerated fibrosis progression in patients with chronic hepatitis C. J Viral Hepat 2014; 21:111-20. [PMID: 24383924 DOI: 10.1111/jvh.12127] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 05/01/2013] [Indexed: 01/16/2023]
Abstract
Chronic hepatitis C (CHC) patients with treatment failure (TF) remain at risk of continuing fibrosis progression. However, it has not been investigated whether there is an increased risk of accelerated fibrosis progression after failed interferon-based therapy. We aimed to investigate long-term influence of TF on fibrosis progression compared with untreated patients with CHC. We studied 125 patients with CHC who underwent paired liver biopsies from 1994 to 2012. Patients with advanced fibrosis were excluded from the analysis. Sixty-three patients had TF, and 62 patients were treatment-naïve (TN). Annual fibrosis progression rate (FPR) was calculated, and significant fibrosis progression (SFP) was defined as ≥ 2 stage increase in fibrosis during follow-up. Multiple regression analyses were performed to find out independent predictors of FPR and SFP. Demographic characteristics and duration between paired liver biopsies were similar in TF and TN groups. Baseline alanine aminotransferase and gamma-glutamyl transferase (GGT) levels (71 ± 31 vs 47 ± 22, P < 0.001 and 49 ± 39 vs 36 ± 28, P = 0.027, respectively), baseline mean fibrosis stage (2.2 ± 0.7 vs 1.9 ± 0.7, P = 0.018) and histologic activity index (6.3 ± 1.9 vs 4.3 ± 1.6, P < 0.001) were higher in the TF group compared with the TN group. In regression analyses, the strongest independent predictor of fibrosis progression was the GGT level (OR: 1.03, 95%CI 1.01-1.5, P < 0.001). Treatment experience (OR: 5.97, 95%CI 1.81-19.7, P = 0.003) also appeared as an independent predictor of both FPR and SFP. Failed interferon-based CHC treatment may lead to accelerated FPR in the long-term compared with the natural course.
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Affiliation(s)
- B Baran
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Uyanikoglu A, Akyuz F, Baran B, Simsek BP, Ermis F, Demir K, Gulluoglu M, Badur S, Kaymakoglu S. Co-infection with hepatitis B does not alter treatment response in chronic hepatitis C. Clin Res Hepatol Gastroenterol 2013; 37:485-90. [PMID: 23665172 DOI: 10.1016/j.clinre.2013.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 01/05/2013] [Accepted: 03/12/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIM To investigate the clinical features and treatment response in patients with hepatitis B (HBV) and hepatitis C virus (HCV) co-infection receiving anti-HCV therapy. PATIENTS AND METHOD Patients with HBV/HCV co-infection, who were eligible for anti-HCV therapy, were included in the study. Patients had detectable HBsAg for at least 6 months and detectable HCV-RNA before the initiation of therapy. Primary end-point was the proportion of patients achieving sustained virological response (SVR). HBV serology and HBV-DNA results obtained during the follow-up were assessed to determine HBV clearance or reactivation after anti-HCV therapy. RESULTS There were 612 patients in the HCV cohort and 52 (8.5%) of them were HBV/HCV co-infected. Twenty-eight patients (20 male, mean age: 47 ± 12) received anti-HCV treatment and followed-up for a mean duration of 53 months (12-156). Fifteen patients received peginterferon/ribavirin combination while the remaining patients received standard interferon/ribavirin combination (n=6) or standard interferon monotherapy (n=7). Patients receiving interferon monotherapy were under chronic hemodialysis therapy. SVR was achieved in 14 (50%) patients at the end of follow-up. The proportion of patients with SVR in three treatment arms were not significantly different (P=0.78). Eight of 11 patients with detectable HBV-DNA cleared HBV-DNA during treatment. Seven (25%) patients experienced a rebound in HBV-DNA, and one patient experienced an acute hepatitis flare which was controlled by tenofovir therapy. Two (7%) patients cleared HBsAg and one of them was seroconverted to anti-HBs. CONCLUSION Co-infection with HBV does not have a negative impact on the efficacy of anti-HCV treatment, but HBV-DNA should be monitored to overcome the risk of HBV exacerbation.
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Affiliation(s)
- Ahmet Uyanikoglu
- Harran University, Faculty of Medicine, Department of Gastroenterology, Sanliurfa, Turkey.
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Baran B, Gulluoglu M, Akyuz F. Nodular lymphoid hyperplasia of duodenum caused by giardiasis. Clin Gastroenterol Hepatol 2013; 11:A22. [PMID: 23333704 DOI: 10.1016/j.cgh.2012.12.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 12/17/2012] [Indexed: 02/07/2023]
Affiliation(s)
- Bulent Baran
- Department of Gastroenterohepatology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Karaca C, Baran B, Soyer OM. Unusual location of polypectomy with an ultra-slim gastroscope: biliary polyp (with video). Dig Endosc 2012; 24:477. [PMID: 23078446 DOI: 10.1111/j.1443-1661.2012.01323.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Cetin Karaca
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Karaca C, Soyer OM, Baran B, Ormeci AC, Gokturk S, Aydin E, Evirgen S, Akyuz F, Demir K, Besisik F, Kaymakoglu S. Efficacy of pegylated interferon-α treatment for 24 months in chronic delta hepatitis and predictors of response. Antivir Ther 2012; 18:561-6. [PMID: 22976528 DOI: 10.3851/imp2381] [Citation(s) in RCA: 20] [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] [Accepted: 08/20/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND To determine the efficacy of pegylated interferon-α (PEG-IFN-α) therapy for 24 months in chronic delta hepatitis (CDH). METHODS Patients with CDH who were treated by PEG-IFN-α2a or -2b for 24 months were included in the study. Demographic, biochemical and virological parameters were recorded at baseline and during follow-up. All included patients completed a treatment period of 24 months and at least a 6 month (range 6-60) follow-up period. Biochemical and virological response rates at end of treatment and end of follow-up were calculated, and predictors of sustained virological response (SVR) were analysed. RESULTS In total, 32 patients (22 males; mean age ± SD 42.7 ± 12 years) with CDH who were treated with PEG-IFN-α2a (180 µg) or -2b (1.5 µg/kg) once a week subcutaneously for 24 months were included in the study. All patients had compensated liver disease (25 [78%] were non-cirrhotic), increased transaminase levels and HDV RNA positivity at baseline. Genotypic analyses of HDV showed genotype I in all. Mean duration of follow-up was 19.5 months. At the end of treatment, virological response was achieved in 16 (50%) patients. SVR at the end of follow-up was achieved in 15 (47%) patients. A negative HDV RNA at 6 months of treatment was the only predictor of SVR (OR = 20; 95% CI 2, 195; P = 0.01). CONCLUSIONS PEG-IFN-α treatment achieved SVR in approximately half of the patients with CDH, and relapse rate was very low during the follow-up. Negativity of HDV RNA at 6 months may predict SVR in CDH.
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Affiliation(s)
- Cetin Karaca
- Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Baran B, Akyuz F, Khishigsuren B. Questions about calculating the effects of albumin therapy for spontaneous bacterial peritonitis. Clin Gastroenterol Hepatol 2012; 10:950; author reply 950. [PMID: 22504001 DOI: 10.1016/j.cgh.2012.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 03/21/2012] [Indexed: 02/07/2023]
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Baran B, Karaca C, Soyer OM, Lacin S, Demir K, Besisik F, Boztas G. Acute pancreatitis associated with H1N1 influenza during 2009 pandemic: a case report. Clin Res Hepatol Gastroenterol 2012; 36:e69-70. [PMID: 22361440 DOI: 10.1016/j.clinre.2012.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [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: 01/08/2012] [Accepted: 01/10/2012] [Indexed: 02/04/2023]
Abstract
The relationship between viral infections and acute pancreatitis (AP) is not well-defined and universally accepted. Although an association is debated due to lack of solid evidence, a vast number of case reports suggest a possible interrelation. Influenza A virus is one of the most common infectious pathogens in humans but the incidence of subclinical or overt AP during the course of flu is unknown. We report a case of AP, which occurs shortly after a H1N1 infection during the pandemic in 2009.
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Affiliation(s)
- Bulent Baran
- Istanbul University, Istanbul Faculty of Medicine, Department of Gastroenterohepatology, Capa, Istanbul, 34390, Turkey.
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Windyga J, Zbikowski P, Ambroziak P, Baran B, Kotela I, Stefanska-Windyga E. Management of factor VII-deficient patients undergoing joint surgeries - preliminary results of locally developed treatment regimen. Haemophilia 2012; 19:89-93. [DOI: 10.1111/j.1365-2516.2012.02921.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2012] [Indexed: 01/22/2023]
Affiliation(s)
- J. Windyga
- Institute of Hematology and Transfusion Medicine; Warsaw; Poland
| | - P. Zbikowski
- Central Clinical Hospital of the Ministry of Internal Affairs; Warsaw; Poland
| | - P. Ambroziak
- Central Clinical Hospital of the Ministry of Internal Affairs; Warsaw; Poland
| | - B. Baran
- Institute of Hematology and Transfusion Medicine; Warsaw; Poland
| | - I. Kotela
- Central Clinical Hospital of the Ministry of Internal Affairs; Warsaw; Poland
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Uyanikoglu A, Akyuz F, Ermis F, Arici S, Bas G, Cakirca M, Baran B, Mungan Z. Does Cholecystectomy Increase the Esophageal Alkaline Reflux? Evaluation by Impedance-pH Technique. J Neurogastroenterol Motil 2012; 18:187-93. [PMID: 22523728 PMCID: PMC3325304 DOI: 10.5056/jnm.2012.18.2.187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 10/03/2011] [Revised: 01/24/2012] [Accepted: 02/01/2012] [Indexed: 11/23/2022] Open
Abstract
Background/Aims The aim of this study is to investigate the reflux patterns in patients with galbladder stone and the change of reflux patterns after cholecystectomy in such patients. Methods Fourteen patients with cholecystolithiasis and a control group including 10 healthy control subjects were enrolled in this prospective study. Demographical findings, reflux symptom score scale and 24-hour impedance pH values of the 14 cholecystolithiasis cases and the control group were evaluated. The impedance pH study was repeated 3 months after cholecystectomy. Results Age, gender, and BMI were not different between the two groups. Total and supine weakly alkaline reflux time (%) (1.0 vs 22.5, P = 0.028; 201.85 vs 9.65, P = 0.012), the longest episodes of total, upright and supine weakly alkaline reflux mediums (11 vs 2, P = 0.025; 8.5 vs 1.0, P = 0.035; 3 vs 0, P = 0.027), total and supine weakly alkaline reflux time in minutes (287.35 vs 75.10, P = 0.022; 62.5 vs 1.4, P = 0.017), the number of alkaline reflux episodes (162.5 vs 72.5, P = 0.022) were decreased with statistical significance. No statistically significant difference was found in the comparison of symptoms between the subjects in the control group and the patients with cholecystolithiasis, in preoperative, postoperative and postcholecystectomy status. Conclusions Significant reflux symptoms did not occur after cholecystectomy. Post cholecystectomy weakly alkaline reflux was decreased, but it was determined that acid reflux increased after cholecystectomy by impedance pH-metry in the study group.
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Affiliation(s)
- Ahmet Uyanikoglu
- Department of Gastroenterology, Harran University Faculty of Medicine, Sanliurfa, Turkey
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Ready RE, Baran B, Chaudhry M, Schatz K, Gordon J, Spencer RMC. Apolipoprotein E-e4, processing speed, and white matter volume in a genetically enriched sample of midlife adults. Am J Alzheimers Dis Other Demen 2011; 26:463-8. [PMID: 21937476 PMCID: PMC10845549 DOI: 10.1177/1533317511421921] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Healthy midlife children of a parent with Alzheimer's disease ([AD] N = 23; 9 male) participated in neuropsychological testing, and magnetic resonance imaging (MRI) of brain volumetrics were obtained. In all, 35% of the sample were apolipoprotein E (ApoE)-e4 positive (n = 8; 5 male). The ApoE-e4 group exhibited significantly slower performances on an executive function and processing speed measure and had less white matter volume than the non-ApoE-e4 group. Lesser white matter volume was significantly correlated with slower processing speed. Processing speed and changes in white matter volume might be indicators of preclinical decline in AD.
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Affiliation(s)
- Rebecca E Ready
- Department of Psychology, University of Massachusetts, Amherst, 01003, USA.
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Gokturk S, Atay K, Ormeci A, Baran B, Soyer OM, Akyuz F, Karaca C, Kaymakoglu S. A rare complication of interferon treatment: optic neuropathy. Ann Gastroenterol 2011; 24:335. [PMID: 24713785 PMCID: PMC3959331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Accepted: 08/29/2011] [Indexed: 11/02/2022] Open
Affiliation(s)
- Suut Gokturk
- Gastroenterology Department, Istanbul University, Medical of Faculty, Turkey,
Correspondence to: Suut Gokturk, Gastroenterology Department, Istanbul University, Medical of Faculty, Turkey, e-mail:
| | - Kadri Atay
- Gastroenterology Department, Istanbul University, Medical of Faculty, Turkey
| | - Asli Ormeci
- Gastroenterology Department, Istanbul University, Medical of Faculty, Turkey
| | - Bulent Baran
- Gastroenterology Department, Istanbul University, Medical of Faculty, Turkey
| | - Ozlem Mutluay Soyer
- Gastroenterology Department, Istanbul University, Medical of Faculty, Turkey
| | - Filiz Akyuz
- Gastroenterology Department, Istanbul University, Medical of Faculty, Turkey
| | - Cetin Karaca
- Gastroenterology Department, Istanbul University, Medical of Faculty, Turkey
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Arabul M, Gullulu M, Yilmaz Y, Eren MA, Baran B, Gul CB, Kocamaz G, Dilek K. Influence of erythropoietin therapy on serum prohepcidin levels in dialysis patients. Med Sci Monit 2009; 15:CR583-CR587. [PMID: 19865058] [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] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Anemia is a common finding in dialysis patients. Recent evidence has accrued that hepcidin, an iron regulatory peptide, may play a crucial role in the pathophysiology of this condition. This study investigated the effect of erythropoietin (EPO) therapy on serum levels of prohepcidin, the pro-hormone of hepcidin, in patients with end-stage renal disease (ESRD) undergoing chronic dialysis treatment. MATERIAL/METHODS A total of 40 ESRD patients with renal anemia receiving either hemodialysis or peritoneal dialysis were included in this study. The patients were randomly allocated to EPO (subcutaneous 2000 microg three times weekly) plus parenteral iron (n=23) or parental iron only (n=17). Serum prohepcidin levels were measured before and at the end of the study. RESULTS The two groups were comparable in their demographic and laboratory characteristics. No significant differences were found in hemoglobin, hematocrit, iron store indices, or serum levels of prohepcidin at study entry. Significant increases in both hemoglobin and hematocrit as well as a decrease in serum prohepcidin level were evident in the EPO group at the end of the 6-month follow-up in comparison with their values at study entry compared with the control group (P<0.01). CONCLUSIONS It is concluded that EPO therapy, besides enhancing erythropoiesis, modulates serum prohepcidin levels in dialysis patients.
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Affiliation(s)
- Mahmut Arabul
- Department of Internal Medicine, Uludag University Medical School, Bursa, Turkey
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Algin O, Gokalp G, Baran B, Ocakoglu G, Yazici Z. Evaluation of sacroiliitis: contrast-enhanced MRI with subtraction technique. Skeletal Radiol 2009; 38:983-8. [PMID: 19506864 DOI: 10.1007/s00256-009-0723-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [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] [Received: 08/20/2008] [Revised: 04/25/2009] [Accepted: 05/18/2009] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of the study was to investigate the diagnostic value of contrast-enhanced MRI using the subtraction technique in the detection of active sacroiliitis. MATERIALS AND METHODS Magnetic resonance imaging was performed in 8 asymptomatic volunteers and 50 patients with clinically suspected active sacroiliitis. On precontrast MR images, T1-weighted spin-echo images with and without fat saturation (T1WFS and T1W), STIR and 3D-FLASH images with fat saturation were obtained in the semicoronal plane using a 1.5 Tesla imager. Postcontrast MRI was performed using the same T1WFS sequence as before contrast injection for all volunteers and patients. Postcontrast images were subtracted from fat-suppressed precontrast images. Enhancement within the joint space and bone marrow was considered to demonstrate active sacroiliitis. RESULTS In 50 patients (100 sacroiliac joints [SIJs]), 40 (76 SIJs) were considered to have active sacroiliitis based on MR images. Bone marrow edema was present in 33 patients (62 SIJs) on STIR images. Routine MRI allowed identification of contrast enhancement in SIJs on postcontrast T1WFS images in 31 patients (49 SIJs). Contrast enhancement was observed in 40 patients (76 SIJs) who were examined by MRI using the subtraction technique. Contrast enhancement was significantly more conspicuous on subtraction images than on non-subtracted postcontrast T1WFS images (Mann-Whitney U test, p<0.001). CONCLUSION Contrast-enhanced MRI with subtraction technique may be useful for early detection of active sacroiliitis.
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Affiliation(s)
- Oktay Algin
- Medical Faculty, Department of Radiology, Uludag University, Bursa, Turkey.
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Yilmaz Y, Baran B, Seniz NB, Dolar E. Familial Mediterranean Fever coexisting with celiac disease: is there a link with long-term colchicine treatment? J Gastrointestin Liver Dis 2009; 18:119-120. [PMID: 19337649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Abstract
AIM Excessive weight gain that leads to obesity is quite common after kidney transplantation. This is often attributed to immunosuppression. The aim of this retrospective study was to assess the effect of calcineurin inhibitors on post-transplant weight gain. METHODS A total of 99 patients were studied. The patients were divided into cyclosporine A (CyA) and tacrolimus (Tac) groups and were evaluated for weight changes and risk factors related to weight gain. RESULTS The weights of patients in both groups significantly increased after the sixth month. The median weight gain at 12 months was 3.5 and 8.0 kg compared with pretransplant dry weight in the Tac and CyA groups, respectively. The increases in the CyA group were significant compared with those of the Tac group. The prevalences of obese and overweight patients in both groups did not differ during a 12-month follow-up. The frequencies of diabetes mellitus, hypertension and dyslipidemia were comparable in both groups. The decrease in systolic blood pressure (BP) of the Tac group was significant compared with the decrease in the CyA group at the 12th month. In the 12-month follow-up period, the increases in triglyceride, total- and low-density lipoprotein-cholesterol values of the CyA group were significantly higher than those of the Tac group. The weight change between 0 and 12 months was negatively correlated with pretransplant body mass index (BMI) and positively with cumulative corticosteroid doses, total-cholesterol and BP changes. CONCLUSION Only pretransplant BMI, creatinine clearance, CyA usage, being hypertensive and dyslipidemic were independent predictors of weight gain at the 12th month. Our results suggested that the type of immunosuppression may affect post-transplant weight gain.
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Affiliation(s)
- Alpaslan Ersoy
- Department of Nephrology, Uludag University Medical School, Bursa, Turkey.
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