1
|
Ozturk O, Koklu H, Akbal E, Aksoy EK, Altan E, Basar O, Yuksel O, Arslan S, Koklu S. Diverticular disease and posture during defecation : a prospective comparative study. Acta Gastroenterol Belg 2018; 81:490-495. [PMID: 30645917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND STUDY AIMS Although several factors are thought to be responsible for the development of colonic diverticulosis (CD), the underlying pathogenesis is still obscure and needs clarification. The aim of this study was to determine the prevalence, location and clinical features of CD and especially to detect whether there is an association between CD and postures during defecation. PATIENTS AND METHODS This prospective study enrolled 757 patients. The subjects were divided into two groups as a diverticulosis group (D group, n:95) and non-diverticulosis group (non-D group, n:662). RESULTS The median patient age was 54.9±13.2 years. CD frequency was 12.5% (n:95). The most commonly involved part of the colon was the sigmoid colon (56.8%). Diverticula location was on the left in 45.3% (n:43), on the right in 24.2% (n:23) and on both sides of the colon in 30.5% (n:29). Patients in the D group were older (p<0.001) and were predominantly female (p:0.04). The frequency of sitting during defecation (Western type toilet) was higher in the D group compared to the non-D group (72.2% vs 53.5%; p:0.007). The use-time of a Western-type toilet was longer in the D group compared to the non-D group (p:0.04). In multivariable logistic regression analysis, age and toilet type were independent risk factors for the development of diverticulosis. CONCLUSION Sitting during defecation seems to increase the risk of CD.
Collapse
Affiliation(s)
- O Ozturk
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - H Koklu
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - E Akbal
- Department of Gastroenterology, Çanakkale Onsekiz Mart University School of Medicine, Çanakkale, Turkey
| | - E K Aksoy
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - E Altan
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - O Basar
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - O Yuksel
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - S Arslan
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - S Koklu
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| |
Collapse
|
2
|
Koklu S, Basar O, Brugge WR. Endoscopic ultrasound guided tumor directed therapy and cyst ablation. Techniques in Gastrointestinal Endoscopy 2017. [DOI: 10.1016/j.tgie.2017.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
3
|
|
4
|
Sperl J, Horvath G, Halota W, Ruiz-Tapiador JA, Streinu-Cercel A, Jancoriene L, Werling K, Kileng H, Koklu S, Gerstoft J, Urbanek P, Flisiak R, Leiva R, Kazenaite E, Prinzing R, Patel S, Qiu J, Asante-Appiah E, Wahl J, Nguyen BY, Barr E, Platt HL. Efficacy and safety of elbasvir/grazoprevir and sofosbuvir/pegylated interferon/ribavirin: A phase III randomized controlled trial. J Hepatol 2016; 65:1112-1119. [PMID: 27542322 DOI: 10.1016/j.jhep.2016.07.050] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [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: 06/07/2016] [Revised: 07/27/2016] [Accepted: 07/30/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS Direct-acting antiviral agents have improved treatment outcomes for patients with hepatitis C virus (HCV) infection; however, head-to-head comparisons are limited. The C-EDGE Head-2-Head Study compared the safety and efficacy of elbasvir/grazoprevir (EBR/GZR) with sofosbuvir plus pegylated interferon/ribavirin (SOF/PR) in patients with HCV infection. METHODS This was a randomized, open-label, phase III trial. Two hundred fifty-seven patients with HCV genotype (GT)1 or 4 infection and baseline viral load >10,000IU/ml were randomized to receive 12weeks of EBR/GZR 50mg/100mg once daily (n=129) or sofosbuvir (400mg once daily) plus PR (n=128). Primary efficacy objective was sustained virologic response 12weeks after the end of therapy (SVR12, HCV RNA <15IU/ml). The primary safety objective was the proportion of patients experiencing a tier 1 safety event. RESULTS The majority of patients were non-cirrhotic (83.1%), treatment-naïve (74.9%) and had HCV GT1b infection (82.0%). SVR12 rates were 99.2% (128/129) and 90.5% (114/126) in the EBR/GZR and SOF/PR groups, respectively. The estimated adjusted difference in SVR12 was 8.8% (95% confidence interval [CI], 3.6-15.3%). Because the lower bound of the 1-sided 1-sample exact test was greater than -10% and greater than zero, both non-inferiority and superiority of EBR/GZR vs. SOF/PR were established. The frequency of tier 1 safety events was lower among patients receiving EBR/GZR than SOF/PR (0.8% vs. 27.8%, between group difference, 27.0% [95% CI, -35.5% to -19.6%; p<0.001]). CONCLUSIONS EBR/GZR has a superior efficacy and safety profile in patients with HCV GT1 or 4 infection compared with SOF/PR. LAY SUMMARY The combination of elbasvir/grazoprevir for 12weeks was highly effective in treating patients with chronic hepatitis C, genotypes 1 or 4 infection. This regimen was more effective than sofosbuvir/pegylated interferon/ribavirin for 12weeks, and was notably superior in patients regarded as difficult to treat, including those with previous treatment failure, cirrhosis, or a high baseline viral load. The combination of elbasvir/grazoprevir also demonstrated a superior safety and tolerability profile based on fewer serious adverse events, no serious drug-related adverse events, and no treatment discontinuations. CLINICAL TRIAL REGISTRATION Clinical trials.gov Identifier: NCT02358044.
Collapse
Affiliation(s)
- Jan Sperl
- Institut Klinické a Experimentální Medicíny (IKEM), Prague, Czech Republic.
| | | | - Waldemar Halota
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Anca Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Ligita Jancoriene
- Vilnius University, Department of Infectious and Chest Diseases, Dermatovenerology and Alergology, Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania
| | | | - Hege Kileng
- UNN Universitetssykehuset Nord Norge, Tromsø, Norway
| | | | - Jan Gerstoft
- Klinik for Infektionsmedicin, Rigshospitalet, University of Copenhagen, Denmark
| | - Petr Urbanek
- Department of Internal Medicine, 1st Medical Faculty Charles University and Central Military Hospital, Prague, Czech Republic
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland
| | | | - Edita Kazenaite
- Vilnius University, Faculty of Medicine, Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania
| | | | - Sushma Patel
- Merck & Co., Inc., Kenilworth, NJ, United States
| | - Jingjun Qiu
- Merck & Co., Inc., Kenilworth, NJ, United States
| | | | - Janice Wahl
- Merck & Co., Inc., Kenilworth, NJ, United States
| | | | - Eliav Barr
- Merck & Co., Inc., Kenilworth, NJ, United States
| | | |
Collapse
|
5
|
Tseveldorj N, Koklu S, Katipoglu K. An Unusual Cause of Gastric Linitis Plastica. Gastroenterology 2016; 151:e10-e11. [PMID: 27810370 DOI: 10.1053/j.gastro.2016.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 04/06/2016] [Revised: 07/12/2016] [Accepted: 07/15/2016] [Indexed: 12/02/2022]
Affiliation(s)
- Nomingerel Tseveldorj
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Seyfettin Koklu
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Kubra Katipoglu
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
| |
Collapse
|
6
|
Aksoy EK, Koklu S, Ozturk O, Koklu H, Karcaaltincaba M, Sezgin O. Hereditary angioedema: A rare cause of pancreatitis. Clin Res Hepatol Gastroenterol 2016; 40:e48-9. [PMID: 27576199 DOI: 10.1016/j.clinre.2016.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 09/27/2015] [Accepted: 02/04/2016] [Indexed: 02/04/2023]
Affiliation(s)
- Evrim K Aksoy
- Department of Gastroenterology, Hacettepe University School of Medicine, 06100 Sıhhıye, Ankara, Turkey.
| | - Seyfettin Koklu
- Department of Gastroenterology, Hacettepe University School of Medicine, 06100 Sıhhıye, Ankara, Turkey
| | - Omer Ozturk
- Department of Gastroenterology, Hacettepe University School of Medicine, 06100 Sıhhıye, Ankara, Turkey
| | - Hayretdin Koklu
- Department of Gastroenterology, Hacettepe University School of Medicine, 06100 Sıhhıye, Ankara, Turkey
| | - Musturay Karcaaltincaba
- Department of Radiology, Hacettepe University School of Medicine, 06100 Sıhhıye, Ankara, Turkey
| | - Orhan Sezgin
- Department of Gastroenterology, Mersin University School of Medicine, Mersin, Turkey
| |
Collapse
|
7
|
Koklu H, Koklu S, Ozturk O, Kahramanoglu Aksoy E, Karcaaltıncaba M, Sokmensuer C. Cirrhosis Related to Hepatic Sarcoidosis in Older Adults. J Am Geriatr Soc 2016; 64:1747-8. [PMID: 27448951 DOI: 10.1111/jgs.14277] [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] [Received: 12/08/2015] [Accepted: 12/15/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Hayretdin Koklu
- Division of Gastroenterology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Seyfettin Koklu
- Division of Gastroenterology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Omer Ozturk
- Division of Gastroenterology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Evrim Kahramanoglu Aksoy
- Division of Gastroenterology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | | | - Cenk Sokmensuer
- Department of Pathology, School of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
8
|
Koklu H, Koklu S, Ozturk O. Right- versus Conventional Left-Sided Starting Position for Colonoscopy: The Issues to Be Considered. Am J Gastroenterol 2016; 111:897. [PMID: 27249984 DOI: 10.1038/ajg.2016.62] [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: 12/11/2022]
Affiliation(s)
- Hayretdin Koklu
- Hacettepe University School of Medicine, Department of Internal Medicine, Division of Gastroenterology, Ankara, Turkey
| | - Seyfettin Koklu
- Hacettepe University School of Medicine, Department of Internal Medicine, Division of Gastroenterology, Ankara, Turkey
| | - Omer Ozturk
- Hacettepe University School of Medicine, Department of Internal Medicine, Division of Gastroenterology, Ankara, Turkey
| |
Collapse
|
9
|
Affiliation(s)
- Hayretdin Koklu
- Department of Internal Medicine, Division of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey.
| | | | | |
Collapse
|
10
|
Aksoy EK, Koklu S, Karcaaltıncaba M, Sahin TT. Image of the month: A Red Ball at the Base of the Cecum. Am J Gastroenterol 2015; 110:1652. [PMID: 26673488 DOI: 10.1038/ajg.2015.102] [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]
|
11
|
Yilmaz B, Koklu S, Buyukbayram H, Yalçin K, Korkmaz U, Posul E, Can G, Kurt M. Chronic hepatitis B associated with hepatic steatosis, insulin resistance, necroinflammation and fibrosis. Afr Health Sci 2015; 15:714-8. [PMID: 26957957 DOI: 10.4314/ahs.v15i3.3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The effect of hepatitis B virus (HBV) infection on fatty liver disease is unclear. OBJECTIVES The aim of this study was to investigate the viral and host causes of fatty liver in chronic hepatitis B (CHB) patients. This study included 88 CHB patients of which 17 were not treated. Liver biopsy was performed in each patient. Group 1 included those with hepatic steatosis (n=28) and group 2 those without hepatic steatosis. The groups were compared in terms of age, body mass index (BMI), Homeostasis Model Assessment- Insulin Resistance (HOMA-IR), viral load, biochemical parameters and histological findings. Patients in group 1 were subdivided according to the degree of steatosis as follows: grade 1 (15 patients, 53.6%), grade 2 (6 patients, 21.4%), and grade 3 (7 patients, 25%). RESULTS In group 1 (n=28), mean age, BMI, cholesterol, and HOMA-IR were found to be significantly higher than in group 2 (n=60). There were no significant differences in the positivity of viral load, HbeAg, treatment, fibrosis and other laboratory parameters between the two groups. HOMA-IR was the only independent predictive factor of liver steatosis in patients with CHB in logistic regression analysis. CONCLUSION Hepatic steatosis in CHB patients was associated with host metabolic factors.
Collapse
|
12
|
|
13
|
Yilmaz B, Roach EC, Koklu S. An Unusual Cause of a High Carbonhydrate Antigen 19-9 Level in an Elderly Individual: Polycystic Liver Disease. J Am Geriatr Soc 2015; 63:1487-8. [DOI: 10.1111/jgs.13541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Bulent Yilmaz
- Department of Gastroenterology; School of Medicine; Hacettepe University; Ankara Turkey
| | - Emir Charles Roach
- Department of Gastroenterology; School of Medicine; Hacettepe University; Ankara Turkey
| | - Seyfettin Koklu
- Department of Gastroenterology; School of Medicine; Hacettepe University; Ankara Turkey
| |
Collapse
|
14
|
Ozturk O, Koklu S, Peynircioglu B, Eldem G. An unusual cause of massive gastrointestinal bleeding. Dig Liver Dis 2015; 47:e11. [PMID: 25818252 DOI: 10.1016/j.dld.2015.03.008] [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] [Received: 01/10/2015] [Revised: 03/06/2015] [Accepted: 03/09/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Omer Ozturk
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Seyfettin Koklu
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Bora Peynircioglu
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Gonca Eldem
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| |
Collapse
|
15
|
Ozturk O, Koklu S, Aksoy EK. Hepatitis B resolution after autologous Bone Marrow Transplantation. Acta Gastroenterol Belg 2015; 78:255. [PMID: 26151702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
16
|
Ozturk O, Koklu S. An unusual foreign body in the ileum. Gastrointest Endosc 2015; 81:1302-3. [PMID: 25864905 DOI: 10.1016/j.gie.2014.12.060] [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] [Received: 12/08/2014] [Accepted: 12/30/2014] [Indexed: 02/08/2023]
Affiliation(s)
- Omer Ozturk
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Seyfettin Koklu
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| |
Collapse
|
17
|
Yilmaz B, Roach EC, Koklu S, Aydin O, Unlu O, Kilic YA. Air leak syndrome after endoscopic retrograde cholangiopancreatography: A rare and fatal complication. World J Gastroenterol 2015; 21:4770-4772. [PMID: 25914490 PMCID: PMC4402328 DOI: 10.3748/wjg.v21.i15.4770] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/28/2014] [Accepted: 02/12/2015] [Indexed: 02/06/2023] Open
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is a state of the art diagnostic and therapeutic procedure for various pancreatic and biliary problems. In spite of the well-established safety of the procedure, there is still a risk of complications such as pancreatitis, cholangitis, bleeding and perforation. Air leak syndrome has rarely been reported in association with ERCP and the optimal management of this serious condition can be difficult to establish. Our group successfully managed a case of air leak syndrome following ERCP which was caused by a 3cm Stapfer type I perforation in the posterolateral aspect of the second part of the duodenum and was repaired surgically. Hereby, we describe the presentation and subsequent therapeutic approach.
Collapse
|
18
|
Aksoy E, Koklu S. An unusual endoscopic finding in an elderly. Eur Geriatr Med 2015. [DOI: 10.1016/j.eurger.2014.09.016] [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: 10/24/2022]
|
19
|
Ozturk O, Koklu S, Basar O, Haznedaroglu IC. Severe radiation esophagitis successfully treated with Ankaferd hemostat. Gastrointest Endosc 2015; 81:1048-9. [PMID: 25805479 DOI: 10.1016/j.gie.2014.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 09/22/2014] [Accepted: 10/08/2014] [Indexed: 02/08/2023]
Affiliation(s)
- Omer Ozturk
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Seyfettin Koklu
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Omer Basar
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | | |
Collapse
|
20
|
Affiliation(s)
- Omer Ozturk
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Omer Basar
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Seyfettin Koklu
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Osman Yuksel
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Tugrul Purnak
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Cenk Sokmensuer
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
| |
Collapse
|
21
|
Ozturk O, Koklu S, Kurtulan O. Multiple masses in the colon of a patient with ulcerative colitis. Gastroenterology 2015; 148:e7-8. [PMID: 25529806 DOI: 10.1053/j.gastro.2014.08.007] [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] [Received: 07/15/2014] [Revised: 08/05/2014] [Accepted: 08/11/2014] [Indexed: 12/02/2022]
Affiliation(s)
- Omer Ozturk
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Seyfettin Koklu
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Olcay Kurtulan
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
| |
Collapse
|
22
|
Koklu S, Gulsen MT, Tuna Y, Koklu H, Yuksel O, Demir M, Guner R, Dogan Z, Kucukazman M, Poyrazoglu OK, Biyik M, Ozturk NA, Aydogan T, Coban S, Kocaman O, Sapmaz F, Gokturk SH, Karaca C, Demirezer A, Tanoglu A, Yildirim B, Altinbas A, Atak BM, Cosar AM, Alkan E. Differences in nephrotoxicity risk and renal effects among anti-viral therapies against hepatitis B. Aliment Pharmacol Ther 2015; 41:310-9. [PMID: 25982037 DOI: 10.1111/apt.13036] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [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: 08/03/2014] [Revised: 09/03/2014] [Accepted: 11/06/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Results are conflicting with respect to the renal effects of anti-viral agents used for hepatitis B virus infection. AIM To compare short and long-term renal effects in real-life settings and to determine risk factors for renal impairment during treatment. METHODS 2221 treatment-naïve patients were enrolled. Among these, 895 (302 lamivudine, 27 telbivudine, 282 entecavir, 273 tenofovir and 11 adefovir initiated patients) had 'repeated measures' of creatinine (baseline, 1st, 6th, 12th and 24th month of treatment). Telbivudine and adefovir groups were excluded from further analysis because of the low number of patients. We calculated the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) formula at each time point. Hypophosphataemia was also recorded. Risk factors for renal impairment were analysed. RESULTS Tenofovir caused a decline in GFR at each time point when compared to baseline levels. However, lamivudine and entecavir did not change GFR. GFR-shifting from ≥90 to 60-89 mL/min/1.73 m(2) was comparable among groups. The proportion of patients whose baseline creatinine increased more than 25% was comparable among all anti-virals. GFR showed a decline in patients who switched from entecavir to tenofovir. One patient with compensated cirrhosis needed to change from tenofovir because of renal safety. Seven and three patients developed transient hypophosphataemia in the tenofovir and lamivudine groups, respectively. CONCLUSIONS Although tenofovir caused a decline in GFR, differences between the anti-viral agents do not appear to be so impressive. In patients with and without renal risk factors at baseline, there is no impact of anti-virals, including tenofovir.
Collapse
Affiliation(s)
- S Koklu
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Buldukoglu OC, Koklu S, Koklu H, Uluoglu O, Kulduk G. Intestinal perforation as the initial presentation of polyarteritis nodosa in an older adult. Geriatr Gerontol Int 2015; 15:121-2. [PMID: 25583391 DOI: 10.1111/ggi.12266] [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] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Osman Cagin Buldukoglu
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
24
|
Ozturk O, Koklu S, Veisalov M. An unusual cause of giant gastric ulcer. Acta Gastroenterol Belg 2014; 77:437. [PMID: 25682636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
25
|
Yıldız P, Yilmaz B, Yıldız M, Dizen H, Koklu S, Şimşek G. Giant gastric tubulovillous adenoma: a rare upper gastrointestinal bleeding. Acta Gastroenterol Belg 2014; 77:435-436. [PMID: 25682635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
26
|
|
27
|
Koklu S, Gulsen MT, Tuna Y, Koklu H, Yuksel O, Yilmaz B, Karaca C, Ataseven H, Guner R, Kucukazman M, Kockar C, Demir M, Poyrazoglu OK, Ibis M, Purnak T, Etgul S, Alkan E, Coban S, Gokturk S, Biyik M, Baykal O, Basar O, Koklu N, Tatar G, Simsek H. Lamivudine treatment failure risks in chronic hepatitis B patients with low viral load. Digestion 2014; 88:266-71. [PMID: 24356645 DOI: 10.1159/000356312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 09/30/2013] [Indexed: 02/04/2023]
Abstract
AIM To analyze the risk factors of lamivudine treatment failure (LTF) for the long-term use in patients with low viral load (LVL). MATERIAL AND METHODS In this multicenter study, 548 antiviral naïve noncirrhotic adult patients with LVL (for HBeAg+ patients HBV DNA <10 9 copies/ml and for HBeAg–patients HBV DNA <10 7 copies/ml) were enrolled. As a control group, 46 lamivudine-initiated patients with high viral load (HVL) were included. Primary outcome was switching to or adding on another antiviral drug as a consequence of primary nonresponse, partial response, viral breakthrough or adverse events. Secondary outcomes included LTF rates at 1, 2, 3, 4 and 5 years and LTF-related viral and host factors. RESULTS Among 594 patients, 294 had to change lamivudine at the follow-up. Primary nonresponse, partial response, viral breakthrough or adverse events frequencies were 6.8, 1.6, 64.5 and 0.1%, respectively. Five-year LTF rates were 61.3 and 84.2% in patients with LVL and HVL, respectively. Among patients with LVL, patients with <100,000 copies/ml and ≥ 100,000 copies/ ml had 54.8 and 67.3% LTF rates at the end of the 5th year, respectively. Logistic regression analysis of risk factors showed HBeAg+, hepatic activity index, HBV DNA, virological response at 6 months and duration of follow-up were independent predictors for LTF (p values were 0.001, 0.008, 0.003, 0.020 and 0.003, respectively). CONCLUSION Similar to patients with HVL, first-line lamivudine therapy is not efficient for long-term use in patients with LVL. LTF risk is so high even in the absence of worse predictive factors.
Collapse
|
28
|
Bulus H, Basar O, Tas A, Yavuz A, Akkoca M, Coskun A, Coban S, Tuna Y, Erbis H, Koklu S. Evaluation of three instruments for laparoscopic cholecystectomy: harmonic scalpel, bipolar vessel sealer, and conventional technique. MINERVA CHIR 2013; 68:537-542. [PMID: 24193285] [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: 06/02/2023]
Abstract
AIM Laparoscopy is the gold standard procedure in the surgery of gall bladder. Harmonic scalpel and bipolar vessel sealer are the other instruments for laparoscopic cholecystectomy. The aim of this study is to compare the effectiveness and safety of the three instruments for laparoscopic cholecystectomy. METHODS A total of 60 patients were included into the study. Patients were divided into three groups. In Group A, cystic duct and artery were sealed using laparoscopic clips and gall bladder was dissected from the hepatic bed using electrocautery. In Group B, cystic duct and artery were sealed using Harmonic scalpel and gall bladder was dissected from the hepatic bed using Harmonic scalpel. In Group C, cystic duct and artery were sealed using Bipolar vessel sealer and gall bladder was dissected from the hepatic bed using Bipolar vessel sealer. Groups were compared for the following parameters: duration of surgery, amount of drainage, cystic duct opening pressure and cost. RESULTS The duration of surgery was 31.5 ± 11.1 minutes in Group B, 33.1 ± 10 minutes in Group A, and 36.5 ± 9.9 in Group C; and the difference between Group B and Group C was statistically significant (P<0.04). Cystic duct opening pressure was highest in Group A which was 324.0 ± 23.4 mmHg. For all of these 3 groups total cost was found to be 900$, 2900$, 1800$ for groups A, B, and C; respectively. CONCLUSION In laparoscopic cholecystectomy different energy source instruments may be safe to use with a cautious dissection and sealing of the cystic duct.
Collapse
Affiliation(s)
- H Bulus
- Department of General Surgery Kecioren Training and Research Hospital, Ankara, Turkey -
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Bulus H, Tas A, Morkavuk B, Koklu S, Soy D, Coskun A. Can the efficiency of modified Alvarado scoring system in the diagnosis acute appendicitis be increased with tenesmus? Wien Klin Wochenschr 2013; 125:16-20. [PMID: 23292641 DOI: 10.1007/s00508-012-0308-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Accepted: 11/29/2012] [Indexed: 01/25/2023]
Abstract
BACKGROUND Acute appendicitis is one of the main pathological conditions requiring emergency surgical intervention. The most widely accepted scoring system is modified Alvarado scoring system (MASS). In this study we aimed to improve the efficiency of MASS by adding a new parameter and to evaluate its efficiency in the diagnosis of acute appendicitis. METHODS This study included 158 patients who underwent acute appendectomy in Keçiören Training and Research Hospital General Surgery Department. In addition to criteria of MASS, all patients were questioned about the presence of tenesmus. The validity of MASS and MASS with additional parameter was evaluated with respect to sensitivity, specificity and positive and negative predictive values. RESULTS Accuracy rates of MASS, clinical findings, ultrasonography and MASS with additional parameter in the diagnosis of acute appendicitis were 64, 76, 85 and 80 %. False positivity rates for clinical findings, MASS and MASS with additional parameter in the diagnosis of acute appendicitis were 17, 26 and 10 %, respectively. Sensitivity and specificity of clinical findings in the diagnosis of acute appendicitis were 83 and 66 %, respectively. Sensitivity and specificity of MASS in the diagnosis of acute appendicitis were 74 and 39 %, respectively, and those of MASS with additional parameter were appendicitis increased to 83 and 66 %, respectively. CONCLUSIONS MASS is a simple, cheap and objective scoring system and does not require expertise. When tenesmus is added to standard MASS, rates of accuracy, sensitivity and specificity become better than those in MASS in the diagnosis of acute appendicitis.
Collapse
Affiliation(s)
- Hakan Bulus
- Kecioren Training and Research Hospital, General Surgery Clinic, Kecioren, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
30
|
Purnak T, Beyazit Y, Ibis M, Koklu S, Efe C, Ozaslan E, Ciftci A, Tenlik I. The involvement of nitric oxide in the physiopathology of hepatoportal sclerosis. Clin Biochem 2012; 45:1450-4. [PMID: 22820432 DOI: 10.1016/j.clinbiochem.2012.07.091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 07/03/2012] [Accepted: 07/08/2012] [Indexed: 12/16/2022]
|
31
|
Tas A, Koklu S. Unusual cause of common bile duct dilatation in asymptomatic elderly patient: right hepatic artery syndrome. Ann Hepatol 2012; 11:150-1. [PMID: 22166578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Adnan Tas
- Research Fellow, Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey;Erzurum mahallesi, Dumlupýnar caddesi, Eceabant sokak, No:14/4 Cebeci/ Çankaya/Ankara, Turkey 05305405079 E-mail:
| | | |
Collapse
|
32
|
Tas A, Koklu S, Cakal B, Yildiz F, Aktas S. Psoriatic colitis mimicking ulcerative proctitis in an elderly patient. Chin Med J (Engl) 2012; 125:2080. [PMID: 22884084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
|
33
|
Simsek G, Bulus H, Tas A, Koklu S, Yilmaz SB, Coskun A. An unusual cause of inguinal hernia in a male patient: endometriosis. Gut Liver 2012; 6:284-5. [PMID: 22570762 PMCID: PMC3343171 DOI: 10.5009/gnl.2012.6.2.284] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 10/10/2011] [Indexed: 11/04/2022] Open
Affiliation(s)
- Gulcin Simsek
- Department of Pathology, Kecioren Training and Research Hospital, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
34
|
Beyazit Y, Koklu S, Tas A, Purnak T, Sayilir A, Kurt M, Turhan T, Celik T, Suvak B, Torun S, Akbal E. Serum adenosine deaminase activity as a predictor of disease severity in ulcerative colitis. J Crohns Colitis 2012; 6:102-7. [PMID: 22261534 DOI: 10.1016/j.crohns.2011.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [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: 05/31/2011] [Revised: 07/01/2011] [Accepted: 07/15/2011] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM Ulcerative colitis (UC) is a chronic inflammatory disease characterized by recurrent inflammation and ulcerations of colonic mucosa and an inappropriate and delayed healing. Adenosine deaminase (ADA) is a cytoplasmic enzyme involved in the catabolism of purine bases, capable of catalyzing the deamination of adenosine, forming inosine in the result process. Although ADA has been shown to increase in several inflammatory conditions, there are no literature data indicating an alteration in UC. METHODS This study evaluated the activity of total ADA in serum of 43 patients with UC and 18 healthy controls. Patients' age, disease duration, drug intake, and other medical history were all noted for each subject. Complete blood count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were determined for both patients and controls. Correlation analysis was also performed between ADA and other inflammation markers of UC. RESULTS Serum mean ADA levels were 11.12 ± 2.03 and 7.99 ± 2.04 U/l for patients with UC in active state and in remission and 8.55 ± 2.26 U/l in the healthy control group. Mean serum ADA levels were significantly elevated in active UC patients compared with patients with UC in remission and control groups. Overall accuracy of ADA in determination of active UC was 83.7 with sensitivity 83.3%, specificity 84.2%. CONCLUSIONS Serum ADA levels were found to be elevated in UC patients in active state suggesting a partial role of activated T-cell response in the disease pathophysiology. Further randomized controlled studies are warranted to demonstrate the role of ADA in UC patients, with a special interest in specifically targeted therapies against ADA for achieving disease remission.
Collapse
Affiliation(s)
- Yavuz Beyazit
- Department of Gastroenterology, Turkiye Yuksek İhtisas Training and Research Hospital, Ankara, Turkey.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Taş A, Koklu S, Beyazit Y, Akbal E, Kocak E, Celik H, Bıyıkoğlu I. The endoscopic course of scattered white spots in the descending duodenum: a prospective study. Gastroenterol Hepatol 2012; 35:57-64. [PMID: 22260755 DOI: 10.1016/j.gastrohep.2011.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 10/18/2011] [Accepted: 11/18/2011] [Indexed: 10/14/2022]
Abstract
AIM Scattered white spots (SWSs) in the descending duodenum are an uncommon finding of upper gastrointestinal system endoscopy (UGSE). Intestinal lymphangiectasia, chronic nonspecific duodenitis and giardiasis are associated with a SWS appearance. The aim of this study was to determine the frequency of SWS during routine endoscopy, as well as to evaluate the effect of treatment on this finding. MATERIALS AND METHODS Patients undergoing UGSE with a SWS appearance in the descending duodenum were included prospectively. Appearance of SWSs was graded endoscopically based on density, after which patients were divided into two groups; group 1 (treated group) and group 2 (untreated group). Patients with Helicobacter pylori infection were given eradication therapy, whereas a diet was recommended to patients with intestinal lymphangiectasia. Proton pump inhibitors were initiated for patients with H. pylori negative gastritis. All patients were re-evaluated three months after therapy for the presence of any changes in the SWS appearance. RESULTS SWSs were observed in 97 (3.2%) out of 3010 patients. This appearance was most commonly associated with chronic non-specific duodenitis followed by intestinal lymphangiectasia. While in the untreated group no statistically significant change in SWS appearance was observed, the decrease in endoscopic grade seen in the treated group was statistically significant (p<0.001). CONCLUSION The prevalence of SWSs during routine UGSE was 3.2%, with this finding being more commonly associated with chronic non-specific duodenitis and intestinal lymphangiectasia. Treatment of the underlying causes, including H. pylori eradication, proton pump inhibitors and diet decreased the density of the SWSs.
Collapse
Affiliation(s)
- Adnan Taş
- Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey.
| | | | | | | | | | | | | |
Collapse
|
36
|
Beyazit Y, Koklu S, Ozturk ZA, Yüksel O, Ibis M, Arhan M, Gultuna S, Sezer S, Yuksel I, Babali A. Inclusion of a spasmolytic in bowel cleansing: a prospective randomized study. Gastroenterol Nurs 2011; 34:352-5. [PMID: 21979395 DOI: 10.1097/sga.0b013e318229bc90] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The quality of colon cleansing and the tolerance of patients to the procedure are two major determinants of the quality of a colonoscopy. Many bowel-cleansing regimens are known, but there is no ideal regimen. Alverine citrate (Relaxyl, Spasmonal) is a spasmolytic agent that has been shown to affect responses of mechanoreceptors of the intestine to both mechanical and chemical stimuli. Patients who underwent colonoscopies at four centers were randomly assigned two different bowel-cleansing procedures. The bowel-cleansing methods were oral sodium phosphate (NaP) (Group I) and oral NaP plus alverine citrate (Group II). Patients were randomized into one of these regimens. The quality of colon cleansing was assessed by an endoscopist with an empirical, clinically meaningful 3-point scale. Both groups were similar with respect to age, gender, and pre- and postcolonoscopic diagnosis. In Group I, 76 patients (47 women and 29 men; aged 39.53 ± 7.87 years) and in Group II, 71 patients (41 women and 30 men; aged 39.78 ± 8.27 years) were included in the study. In Groups I and II, 37 (48.7%) and 41 (57.7%) patients had perfect bowel cleansing, respectively. The overall colon cleansing in the group with NaP plus alverine citrate was comparable with that in the NaP group. The tolerability of patients to the colonoscopy in the two groups was also similar. Based on the present data, adding oral alverine citrate to NaP does not increase either the quality of bowel cleansing or the tolerance of patients to the procedure.
Collapse
Affiliation(s)
- Yavuz Beyazit
- Department of Gastroenterology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Cakal B, Koklu S, Beyazit Y, Ozdemir A, Beyazit F, Ulker A. Fatal colonic perforation in a pregnant with Behçet's disease. J Crohns Colitis 2011; 5:273-4. [PMID: 21575900 DOI: 10.1016/j.crohns.2011.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 03/02/2011] [Indexed: 02/08/2023]
|
38
|
Unverdi S, Ceri M, Öztürk MA, Akbal E, Ensari A, Yılmaz R, Kocak E, Inal S, Koklu S, Duranay M. A Patient with Crohn's Disease who Presented with Thrombotic Thrombocytopenic Purpura/Hemolytic Uremic Syndrome. Ren Fail 2011; 33:244-5. [DOI: 10.3109/0886022x.2010.541577] [Citation(s) in RCA: 5] [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: 11/13/2022] Open
|
39
|
Abstract
Celiac disease (CD) is a genetically based chronic inflammatory disorder of the small bowel induced by the dietary gluten and possibly other environmental cofactors. The objective of this study was to investigate the relation of adenosine deaminase (ADA), a cytoplasmic enzyme involved in the catabolism of purine bases, as an index of altered immune response, with adult CD patients. ADA has been shown to increase in several inflammatory conditions, but there is no literature data indicating an alteration in CD. Serum levels of ADA were investigated in newly diagnosed 20 CD patients. ADA levels were compared in patients with CD and in healthy controls. Correlation analysis was also performed between ADA and other serum markers of CD (anti-gliadin and anti-endomysial antibodies) Mean serum ADA levels were significantly elevated in CD patients compared with control group. ROC curve analysis suggested that the optimum ADA level cut-off point for CD was 12.27 U/l. At a cut-off value of 12.27 U/l, the sensitivity was 80% and specificity was 100%. There was no statistically significant correlation between ADA and anti-gliadin and anti-endomisium antibodies. Serum ADA levels elevated significantly in CD patients, suggesting a partial role in activated T-cell response in the disease pathophysiology. ADA can be used as a supportive diagnostic marker in patients with CD.
Collapse
Affiliation(s)
- Basak Cakal
- Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
40
|
Karakas E, Tuna Y, Basar O, Koklu S. Primary pancreatic hydatid disease associated with acute pancreatitis. Hepatobiliary Pancreat Dis Int 2010; 9:441-2. [PMID: 20688612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
41
|
Gulsen MT, Beyazit Y, Guclu M, Koklu S. Testing for hepatitis B and C virus infection before upper gastrointestinal endoscopy: justification for dedicated endoscope and room for hepatitis patients. Hepatogastroenterology 2010; 57:797-800. [PMID: 21033232] [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: 05/30/2023]
Abstract
BACKGROUND/AIMS Endoscopic interventions have become a significant tool in the diagnosis and treatment of gastrointestinal disorders. In order to avoid transmission of associated diseases, cleaning and disinfection/sterilization procedures of endoscopes and accessories are crucial. Hepatitis B virus and Hepatitis C virus infections are among the most common viral infections globally and maintain their position as a serious public health problem. METHODOLOGY One thousand patients visiting our gastroenterology department were diagnosed and, except for cirrhosis, were enrolled in this study. For patients with HBsAg and Anti-HCV positive, Aspartate Aminotransferase, Alanine Aminotransferase, hemogram and prothrombin time were examined and ultrasonography was performed. RESULTS Five hundred and seventy three patients (57.3%) were female and 427 patients (42.7%) were male. Among 1000 patients in total, 39 patients were detected to have hepatitis (3.9%). Of these patients, 28 (2.8%) had HBsAg (+), 10 (1%) had Anti-HCV (+), 1 (0.1%) had both HBsAg (+) and Anti-HCV (+). CONCLUSIONS It would be beneficial to include a determination of hepatitis serology of patients prior to endoscopy in daily practice. In addition, like dialysis machines, there is a need for further studies evaluating the cost effectiveness of using separate endoscopy devices allocated to groups of patients with HBV, HCV or to those who do not carry hepatitis.
Collapse
Affiliation(s)
- Murat Taner Gulsen
- Department of Gastroenterology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | | | | | | |
Collapse
|
42
|
Filik L, Koklu S, Cakal B. Amyloidosis-associated delayed postpolypectomy bleeding. Endoscopy 2009; 41:572. [PMID: 19533568 DOI: 10.1055/s-0029-1214743] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
|
43
|
Kisacik B, Akdogan A, Yilmaz G, Karadag O, Yilmaz FM, Koklu S, Yuksel O, Ertenli AI, Kiraz S. Serum adenosine deaminase activities during acute attacks and attack-free periods of familial Mediterranean fever. Eur J Intern Med 2009; 20:44-7. [PMID: 19237091 DOI: 10.1016/j.ejim.2008.04.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 11/01/2007] [Revised: 03/20/2008] [Accepted: 04/26/2008] [Indexed: 11/17/2022]
Abstract
BACKGROUND Familial Mediterranean Fever (FMF) is a systemic relapsing autoinflammatory disorder. Adenosine deaminase (ADA) is an enzyme widely distribute in tissues and body fluids. Circulating levels of ADA have been shown to increase in several inflammatory conditions. This study was designed to evaluate the serum ADA in patients with FMF during acute attacks and attack-free periods. METHODS The study groups comprised 23 FMF patients in attack-free period (male/female: 11/12), 30 FMF patients in attack period (male/female: 11/19) and 20 healthy control (male/female:10/10). The groups were similar for age, gender and disease duration. RESULTS The mean age of FMF patients in attack-free period, patient with acute attack were 34.3+/-11.7 and 29.4+/-11.1 respectively. The disease durations were 13.1+/-10.2 and 8.2+/-7.6 years for patients in attack-free periods and patients with acute FMF attack, respectively. Patients with acute attack had significantly higher ADA levels than both patients with attack-free periods and healthy controls (for each, p<0.001). CONCLUSION In this study we demonstrated that FMF patients with acute attacks had higher serum ADA levels than attack-free periods and healthy controls. It is likely that ADA may have a role in the cytokine network of the inflammatory cascade of FMF. Also, elevated ADA levels may be a part of the activated Th1 response in the disease. ADA may be used as a supportive marker to differentiate FMF attacks from attack-free periods. Further larger-scale studies are needed to support this result.
Collapse
Affiliation(s)
- Bunyamin Kisacik
- Hacettepe University Faculty of Medicine Department of Internal Medicine Division of Rheumatology, Ankara, Turkey.
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Erer B, Yilmaz G, Yilmaz FM, Koklu S. Assessment of adenosine deaminase levels in rheumatoid arthritis patients receiving anti-TNF-alpha therapy. Rheumatol Int 2008; 29:651-4. [PMID: 18953538 DOI: 10.1007/s00296-008-0750-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Accepted: 10/05/2008] [Indexed: 12/01/2022]
Abstract
Anti-TNF-alpha agents are increasingly used in rheumatoid arthritis (RA) treatment and that is known to increase the risk of tuberculosis (TB) reactivation. Adenosine deaminase (ADA) levels are shown to increase to high levels in TB patients. Our aim is to investigate the serum ADA levels in RA patients being treated with anti-TNF-alpha and to compare the results with the patients on DMARD therapy. The study groups comprised of 56 RA patients (45 female, mean age 49) who were treated either with two or three DMARDs, 32 RA patients with anti-TNF-alpha treatment (26 female, mean age 46) and 20 healthy controls (10 female, mean age 48). All patients fulfilled the 1987 ACR criteria for RA. DAS28 score was calculated for all subjects. When compared to healthy controls, ADA levels were measured statistically higher both in patient groups (P = 0.046, 0.002). ADA levels in anti-TNF-alpha group were similar to conventional therapy (11.3 +/- 2.7, 10.9 +/- 4.01; P = 0.76). PPD was positive in 17 RA patients in the anti-TNF-alpha treatment group (%53). The ADA levels were found to be similar in the anti-TNF-alpha group when compared according to the PPD positivity (positive, 12.4 +/- 3.7; negative, 10.5 +/- 2.1; P = 0.02). No correlation was found between the ADA levels and age, disease duration, ESR, CRP, DAS 28 and HAQ score. In this study, we observed that RA patients at remission taking DMARD or anti-TNF-alpha therapy have similar levels of serum ADA. Although serum ADA levels during TB infection increase much higher, in our study, ADA levels of all RA patients were lower than 15 IU/L. Elevated ADA levels may be a clue for diagnosis of TB in patients who were on anti-TNF-alpha therapy.
Collapse
Affiliation(s)
- Burak Erer
- Department of Rheumatology, Umraniye Education and Research Hospital, Istanbul, Turkey.
| | | | | | | |
Collapse
|
45
|
Abstract
Hypertrichosis in a newborn girl infant of a diabetic mother with congenital hypothyroidism is reported. Both neonatal hyperinsulism and increased testosterone levels were documented. The hypertrichosis resolved after 3 months' of thyroxine replacement treatment. The possible causal association between hypothyroidism, and hypertrichosis has not been previously reported in neonatal period. Thyroid function should be evaluated in all newborn babies with hypertrichosis or abnormal distribution of body hair.
Collapse
Affiliation(s)
- M Akcakus
- Department of Pediatrics, School of Medicine, Erciyes University, Kayseri, Turkey
| | | | | | | | | | | |
Collapse
|
46
|
|
47
|
Abstract
Hepatitis A infection may result in acute hepatitis, and rarely, fulminant hepatitis may ensue. Extrahepatic manifestations of hepatitis A are uncommon. The authors present the case of a 77-year-old male who had development of acute renal failure and pericarditis during the clinical course of acute hepatitis A infection. He died as a result of septic shock on the fifth day of hospitalization. To the best of our knowledge, this is the first report of both these rare and serious complications appearing in the same patient.
Collapse
Affiliation(s)
- Yavuz Beyazit
- Faculty of Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
48
|
Abstract
AIM: To investigate the viral and host causes of fatty liver in chronic hepatitis B patients and the role of fat deposits in liver damage.
METHODS: A total of 164 patients (113 males and 51 females, average age 35±11.3 years, and range 10-62 years) with previously untreated chronic hepatitis B were included in the study. The patients were divided into two groups depending on the result of liver biopsy: group without steatosis (100 patients with <5% hepatosteatosis) and group with steatosis (64 patients with >5% hepatosteatosis). The groups were compared in terms of gender, body mass index (BMI), liver enzymes (ALT, AST, ALP, GGT), cholesterol, triglyceride, HBeAg, viral load, and histological findings. In the group with steatosis, the patients were subdivided depending on the degree of steatosis into mild group (45 patients with 5-24% steatosis), and severe group (19 patients with >25% steatosis).
RESULTS: In the group of chronic hepatitis B with steatosis, the mean age, BMI, cholesterol, and triglyceride levels were significantly higher than those in the group without steatosis (P<0.05). Steatosis was found in 53 (46.9%) of male patients and 11 (22%) of female patients (P<0.05). No significant difference was found in the positivity of ALT, AST, ALP, GGT, HBeAg, viral load, histological activity index (HAI) and stage between the two groups (P>0.05). In the group with severe steatosis, the BMI was significantly higher than that in the group with mild steatosis (P<0.05). No significant difference was found in the other parameters between the groups (P>0.05).
CONCLUSION: Steatosis in chronic hepatitis B appears to be a result of metabolic factors of the host rather than the effect of viruses. Steatosis is unrelated to the HAI and degree of fibrosis, which are considered as the histological indicators of liver damage.
Collapse
Affiliation(s)
- Emin Altlparmak
- Department of Gastroenterohepatology, Yüksek Ihtisas Hastanesi, Klinigi, Sihhiye, Ankara, Turkey.
| | | | | | | | | | | | | |
Collapse
|
49
|
Abstract
Intestinal lymphangiectasia is one of the protein-losing enteropathies. Herein, a case with intestinal lymphangiectasia responded well to diet and octreotide is presented.
Collapse
Affiliation(s)
- L Filik
- Cemal Gursel Cad., Erk Apt., No. 52/2, Kurtulus, Ankara 06600, Turkey.
| | | | | | | | | |
Collapse
|
50
|
Abstract
Alverine citrate is a commonly used smooth muscle relaxant agent. A MEDLINE search on January 2004 revealed only 1 report implicating the hepatotoxicity of this agent. A 34-year-old woman was investigated because of the finding of elevated liver function tests on biochemical screening. Other etiologies of hepatitis were appropriately ruled out and elevated enzymes were ascribed to alverine citrate treatment. Although alverine citrate hepatotoxicity was related to an immune mechanism in the first case, several features such as absence of predictable dose-dependent toxicity of alverine citrate in a previous study and absence of hypersensitivity manifestations in our patient are suggestive of a metabolic type of idiosyncratic toxicity.
Collapse
Affiliation(s)
- Mehmet Arhan
- Kavaklik mah, Ahmet Apaydln cad, Sultan Apartment, No 39/7, Sahinbey 27060, Gaziantep, Turkey
| | | | | | | | | | | | | |
Collapse
|