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Toruner M, Basaranoglu M, Atug O, Senturk O, Akyuz F, Cekic C, Over Hamzaoglu H, Tekin F, Sezgin O, Akpinar H, Celik AF, Tezel A, Gokturk HS, Kav T. Improvement of Work Productivity and Quality of Life with Anti-Tumor Necrosis Factor Treatment Used in Crohn's Disease in Routine Clinical Practice in Turkey. Turk J Gastroenterol 2022; 33:406-413. [PMID: 35678798 DOI: 10.5152/tjg.2022.21868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Patients with Crohn's disease experience major deterioration in work productivity and quality of life. We aimed to provide the long-term effects of anti-tumor necrosis factor agents on work productivity and activity impairment and quality of life in patients with Crohn's disease using the Inflammatory Bowel Disease Questionnaire and the Short-Form Health Survey-36. METHODS Patients with Crohn's disease and initiated an anti-tumor necrosis factor treatment were included and followed up for 12 months in this observational study. RESULTS A total of 106 patients were included in this study, and 64.2% of the patients were males. Mean [± standard deviation] age was 36.8 [± 10.9] years. At baseline, mostly perianal fistulas [65.7%] were observed [n = 23]. Intestinal stenosis was detected in 34.9% of the patients [n = 37], and most of the stenosis was located in the ileum [70.6%] followed by the colon [20.6%]. Extraintestinal symp- toms were observed in 24 patients [22.6%]. Most frequent extraintestinal symptom was arthritis with 71.4% [n = 15]. Mean time from first symptom to initiation of anti-tumor necrosis factor treatment was 6.3 [± 5.0] years. Improvements in work productivity and activ- ity impairment scores throughout 12 months were -24.1% [P = .003] for work time missed, -18.0% [P = .006] for impairment at work, -8.5% [P = .160] for overall work impairment, and -17.0% [P < .001] for daily activity impairment. Similarly, significant improvements [P < .001] were detected in all components of the Inflammatory Bowel Disease Questionnaire when compared to baseline. Statistically sig- nificant improvements [P < .05] were detected for all components of Short-Form Health Survey-36 except for mental health [P = .095]. CONCLUSION Our study indicates the significant improvement in work productivity and activity impairment and quality of life of patients with Crohn's disease who receive long-term anti-tumor necrosis factor treatment.
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Affiliation(s)
- Murat Toruner
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ibn-i Sina Hospital, Ankara, Turkey
| | - Metin Basaranoglu
- Department of Gastroenterology, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
| | - Ozlen Atug
- Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey
| | - Omer Senturk
- Department of Gastroenterology, Kocaeli University Faculty of Medicine, Izmit, Turkey
| | - Filiz Akyuz
- Department of Gastroenterology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Cem Cekic
- Department of Gastroenterology, Izmir Katip Celebi University, Izmir, Turkey
| | | | - Fatih Tekin
- Department of Gastroenterology, Ege University Medical School, Izmir, Turkey
| | - Orhan Sezgin
- Department of Gastroenterology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Hale Akpinar
- Department of Gastroenterology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Aykut Ferhat Celik
- Department of Gastroenterology, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey
| | - Ahmet Tezel
- Department of Gastroenterology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Huseyin Savas Gokturk
- Department of Gastroenterology, Baskent University Faculty of Medicine, Konya, Turkey
| | - Taylan Kav
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
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Abstract
We investigated the utility of noncontrast enhanced endosonography (EUS) in predicting the severity of acute pancreatitis (AP) during the first 72 to 96 h of admission.In total, 187 patients with acute biliary pancreatitis were included. The patients were classified into 2 groups as having severe and mild AP according to the Modified Glasgow scoring and computerized tomography severity index (SI). The 158 cases with mild and 29 cases with severe AP had a similar age and sex distribution.Although none of the cases with mild AP developed morbidity and death, of the cases with severe AP, 16 developed serious morbidities and 5 died. On EUS examination, we looked for parenchymal findings, peripancreatic inflammatory signs, free or loculated fluid collections, and abnormalities of the common bile duct and the pancreatic channel. Statistical analysis indicated a significant relationship between the severity of AP with diffuse parenchymal edema, periparenchymal plastering, and/or diffuse retroperitoneal free fluid accumulation, and peri-pancreatic edema. We also defined an EUSSI and found that the EUSSI had sensitivity of 89.7%, specificity of 84.2%, positive predictivity value (PPV) of 88.9%, negative predictivity value (NPV) of 91.2%, and an accuracy of 87.9% in the differentiation of mild and severe AP. We found that the EUSSI had an accuracy of 72.4%, sensitivity of 75.4%, specificity of 65.1%, PPV of 69.3%, and NPV of 73.1% for determining mortality.Our data suggest that EUS allowed us to accurately predict the severity and mortality in nearly 90% of cases with AP.
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Affiliation(s)
- Emrah Alper
- From the Department of Gastroenterology, Izmir Katip Çelebi University, İzmir, Turkey
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Ipek S, Cekic C, Alper E, Coban E, Eliacik E, Arabul M, Aslan F, Vatansever S, Yalcin H, Unsal B. Can red cell distribution width be a marker of disease activity in ulcerative colitis? Int J Clin Exp Med 2015; 8:13848-13853. [PMID: 26550336 PMCID: PMC4613021] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 07/21/2015] [Indexed: 06/05/2023]
Abstract
AIM The current study aimed to investigate the association between disease activity and red cell distribution width (RDW) levels in ulcerative colitis and to determine whether RDW can be used as a marker of disease activity in non-anemic ulcerative colitis. METHODS The RDW levels of 310 ulcerative colitis patients who underwent colonoscopy were analyzed retrospectively. The patients were divided into two groups (active disease and remission) according to the endoscopic activity index. In addition, the accuracy of RDW in determining disease activity in non-anemic patients was assessed. The efficacy of RDW in determining disease activity was compared to that of white blood cell count, platelet count, C-reactive protein, and erythrocyte sedimentation rate. RESULTS Two hundred and six (66.5%) patients had active disease, and 104 (33.5%) were in remission. The mean RDW levels in patients with active ulcerative colitis and in those in remission were 16.8±2.9 and 15.5±1.4, respectively (P<0.001). Ninety-six (46.6%) patients in the active disease group and 89 (85.6%) in the remission group were non-anemic, and their respective RDW levels were 15.4±1.2 and 15.3±1.1 (P=0.267). The sensitivity and specificity of RDW in determining inflammation were 41% and 91%, respectively (AUC 0.65, P<0.001). CONCLUSIONS This study demonstrated that RDW can be used as a marker for disease activity in ulcerative colitis, but it did not have the same efficacy in the non-anemic group.
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Affiliation(s)
- Serkan Ipek
- Department of Gastroenterology, Izmir Katip Celebi University, Atatürk Training and Research HospitalIzmir, Turkey
| | - Cem Cekic
- Department of Gastroenterology, Izmir Katip Celebi University, Atatürk Training and Research HospitalIzmir, Turkey
| | - Emrah Alper
- Department of Gastroenterology, Izmir Katip Celebi University, Atatürk Training and Research HospitalIzmir, Turkey
| | - Eyup Coban
- Department of Gastroenterology, Izmir Katip Celebi University, Atatürk Training and Research HospitalIzmir, Turkey
| | - Eylem Eliacik
- Department of Hematology, Hacettepe UniversityAnkara, Turkey
| | - Mahmut Arabul
- Department of Gastroenterology, Izmir Katip Celebi University, Atatürk Training and Research HospitalIzmir, Turkey
| | - Fatih Aslan
- Department of Gastroenterology, Izmir Katip Celebi University, Atatürk Training and Research HospitalIzmir, Turkey
| | - Sezgin Vatansever
- Department of Gastroenterology, Izmir Katip Celebi University, Atatürk Training and Research HospitalIzmir, Turkey
| | - Hulya Yalcin
- Department of Biochemistry, Tepecik Training and Research HospitalIzmir, Turkey
| | - Belkis Unsal
- Department of Gastroenterology, Izmir Katip Celebi University, Atatürk Training and Research HospitalIzmir, Turkey
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Cekic C, Aslan F, Kirci A, Gümüs ZZ, Arabul M, Yüksel ES, Vatansever S, Yurtsever SG, Alper E, Ünsal B. Evaluation of factors associated with response to hepatitis B vaccination in patients with inflammatory bowel disease. Medicine (Baltimore) 2015; 94:e940. [PMID: 26039133 PMCID: PMC4616368 DOI: 10.1097/md.0000000000000940] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
It is recommended to investigate the serology of hepatitis B virus (HBV) and vaccinate seronegative patients at the time of diagnosis in inflammatory bowel diseases (IBD). This study aimed to investigate the efficacy of HBV vaccine and factors affecting the response.In this retrospective, observational study, HBV-seronegative IBD patients were administered 3 doses (at months 0, 1, and 6) recombinant 20 μg HbsAg. Patients' demographics, IBD attributes, and treatment methods were investigated as the factors with potential impacts on vaccination outcomes.One hundred twenty-five patients with IBD were evaluated. The number of patients with Anti-HBs >10 IU/L was 71 (56.8%), and the number of patients with anti-HBs >100 IU/L was 50 (40%). Age, disease activity, Crohn disease subtype, and immunosuppressive treatment (IST) were found to have significant effects on immune response (P = 0.011, P < 0.001, P = 0.003, and P < 0.001, respectively). With multivariate analysis, age < 45 years (OR 3.1, 95% CI 1.2-8.3, P = 0.020), vaccination during remission (OR 5.6, 95% CI 2.3-14, P < 0.001), and non-IST (OR 11.1, 95% CI 2.9-43.2, P = 0.001) had favorable effects on the occurrence of adequate vaccine response.The likelihood of achieving adequate immune response with standard HBV vaccination protocol in IBD is low. Selecting vaccination protocols with more potent immunogenicity is a better approach to achieve effective vaccine response in patients with multiple unfavorable factors.
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Affiliation(s)
- Cem Cekic
- From the Department of Gastroenterology, Katip Celebi University, Atatürk Training and Research Hospital (CC, FA, MA, ESY, SV, SG, EA, BÜ); Department of Gastroenterology, Şifa University, Faculty of Medicine (AK); Department of Internal Medicine (ZZG); and Department of Medical Microbiology, Katip Celebi University, Atatürk Training and Research Hospital, İzmir, Turkey (SGY)
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Aslan F, Akpinar Z, Alper E, Atay A, Aslan Yurtlu D, Cekic C, Bor S, Unsal B. The last innovation in achalasia treatment; per-oral endoscopic myotomy. Turk J Gastroenterol 2015; 26:218-23. [DOI: 10.5152/tjg.2015.0150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Aslan F, Akpinar Z, Cekic C, Alper E. En bloc resection of a 9 cm giant gastro-duodenal lipoma by endoscopic submucosal dissection. Dig Liver Dis 2015; 47:88-9. [PMID: 25304152 DOI: 10.1016/j.dld.2014.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 07/23/2014] [Revised: 08/19/2014] [Accepted: 09/10/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Fatih Aslan
- Gastroenterology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
| | - Zehra Akpinar
- Gastroenterology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
| | - Cem Cekic
- Gastroenterology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
| | - Emrah Alper
- Gastroenterology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
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Aslan F, Akpinar Z, Seren AR, Alper E, Cekic C, Ekinci N, Vatansever S, Unsal B. Are endoscopic mucosal resection and endoscopic submucosal dissection risky for patients with cirrhosis? Endoscopy 2014; 46 Suppl 1 UCTN:E149-50. [PMID: 24756268 DOI: 10.1055/s-0034-1364946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 12/10/2022]
Affiliation(s)
- Fatih Aslan
- Department of Gastroenterology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Zehra Akpinar
- Department of Gastroenterology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Ali Riza Seren
- Department of Anesthesiology and Reanimation, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Emrah Alper
- Department of Gastroenterology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Cem Cekic
- Department of Gastroenterology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Nese Ekinci
- Department of Pathology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Sezgin Vatansever
- Department of Gastroenterology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Belkis Unsal
- Department of Gastroenterology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
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Cekic C, Arabul M, Alper E, Pakoz ZBK, Saritas E, Ünsal B. Evaluation of the relationship between serum ghrelin, C-reactive protein and interleukin-6 levels, and disease activity in inflammatory bowel diseases. Hepatogastroenterology 2014; 61:1196-1200. [PMID: 25436282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIMS Ghrelin is a 28 aminoasid peptide hormone, have generally focused upon this peptide’s role upon growth and energy metabolism. Recently, studies investigating ghrelin’s effect upon inflammation and immune response have gained importance. We aimed to compare the effectiveness of ghrelin levels, Creactive protein and interleukin-6 levels in establishing disease activity. METHODOLOGY 52 cases with ulcerative colitis and 33 with Crohn’s disease, total 85 patients, were included in this study. The serum ghrelin levels of the patients in remission and of those with active disease were compared. RESULTS The mean serum ghrelin level in active patients (1243 ± 648 pg/ml), was found to be higher than those in remission (466 ± 214 pg/ml) (p<0.001). In establishing the disease activity, CRP is a the most effective marker compared to the other two inflammatory markers. AUC values were established as; CRP: 0.947 (95% CI,0.903-0.992),ghrelin:0.934(95% CI, 0.884-0.984) and interleukin-6: 0.756 (95% CI, 0.648- 0.864). DISCUSSION Serum ghrelin level can be used with CRP as an important marker in establishing the mucosal damage in inflammatory bowel diseases.
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Gorur S, Candan Y, Helli A, Akcin S, Cekirge SD, Kaya YS, Cekic C, Kiper AN. Low body mass index might be a predisposing factor for varicocele recurrence: a prospective study. Andrologia 2014; 47:448-54. [PMID: 24811266 DOI: 10.1111/and.12287] [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] [Subscribe] [Scholar Register] [Accepted: 03/17/2014] [Indexed: 11/30/2022] Open
Abstract
We investigated the possible relationship between body mass index (BMI) score and varicocele recurrence in an infertile patient population. A total of 255 primary infertile male patients (138 with varicocele and 117 for control) were included in this study. Height and weight measurements, clinical examination for varicocele, determination of serum hormone levels and spermiogram were performed in all cases. The BMI score was calculated, and patients with varicocele were operated with subinguinal technique and re-examined for recurrences. The varicocele group had significantly lower weight and the BMI score than the control group (P < 0.001). Varicocele recurrences were found in 22 patients (16% of them) after the operations. The BMI score was significantly lower in the recurrent group than in the nonrecurrent and control groups (P < 0.001). 73% of the recurrent, 50% of the nonrecurrent and 25% of the control group patients' BMI scores were under 25 kg m(-2) (P < 0.001). In logistic regression analysis, the BMI score was found as a determinant for varicocele recurrence (P = 0.027; OR: 1.25). It is concluded that BMI score lower than 25 kg m(-2) significantly increases the recurrence rate after varicocele operation, and it can be used as an objective indicator for microsurgical varicocelectomy.
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Affiliation(s)
- S Gorur
- Department of Urology, Faculty of Medicine, Mustafa Kemal University, Antakya-Hatay, Turkey
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