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Asfuroğlu Kalkan E, Kalkan Ç, Kaçar S, Barutçu S, Yüksel M, Güçbey Türker Ö, Göre B, Canlı T, Asfuroğlu U, Barutçu Asfuroğlu B, Hamamcı M, Kılıç V, Köseoğlu T, Özaslan E, Ödemiş B, Kılıç M, Yüksel İ, Ersoy O, Altıparmak E, Ateş İ, Soykan İ. Similarities and Differences Between Gerontal and Young Patients with Acute Pancreatitis: Evaluation of Clinical Characteristics and Outcomes. Turk J Gastroenterol 2022; 33:874-884. [PMID: 36205509 PMCID: PMC9623137 DOI: 10.5152/tjg.2022.22227] [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] [Indexed: 11/07/2022]
Abstract
Background: Acute pancreatitis is an abrupt inflammatory disease of the exocrine pancreas and it can occur in different severities. It is becoming more common and more mortal in the gerontal population. The aim of our study was to explore the similarities and differences between young and gerontal patients with acute pancreatitis, with a special emphasis on patients over 80 years of age. Methods: Medical records of patients (n = 1150) with acute pancreatitis were analyzed retrospectively. Several scoring systems including Bedside index for severity in acute pancreatitis, Ranson’s score, Harmless acute pancreatitis score, Acute Physiology and Chronic Health Evaluation, Balthazar Grade, Glasgow score, and Japanese severity score were applied at admission. Patients were divided into 3 groups; group I, young group (n = 706), if they were aged <65 years; group II, older group (n = 338), if they were aged ≥65 years to <80 years; group III, octogenarian group (n = 106), if they were aged ≥ 0 years. Results: In total, 1150 patients with acute pancreatitis were analyzed. Octogenarian group (n = 42, 39.6%) showed a more severe acute pancreatitis compared to patients in group I (n = 15, 2.1%) and II (n = 50, 14.8%, P < .001). Complications were more common in patients in group III (P < .001). Mortality rate was higher in patients in group III (n = 53, 50%) compared to group I (n = 8, 1.1%) and group II (n = 53, 15.7%) (P < .001). Conclusion: Gerontal patients with acute pancreatitis tend to have more severe disease and systemic and local complications. Mortality rates were higher in older patients compared to younger patients.
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Affiliation(s)
- Emra Asfuroğlu Kalkan
- Department of Internal Medicine, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Çağdaş Kalkan
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Sabite Kaçar
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Sezgin Barutçu
- Department of Gastroenterology, Gaziantep University Hospital, Gaziantep, Turkey
| | - Mahmut Yüksel
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Özge Güçbey Türker
- Department of Internal Medicine, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Burak Göre
- Department of Internal Medicine, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Tolga Canlı
- Department of Internal Medicine, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Umut Asfuroğlu
- Department of Radiology, Ministry of Health, Abdulkadir Yüksel Hospital, Gaziantep, Turkey
| | | | - Mevlüt Hamamcı
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Vedat Kılıç
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Tankut Köseoğlu
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Ersan Özaslan
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Bülent Ödemiş
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Mesut Kılıç
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - İlhami Yüksel
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Osman Ersoy
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Emin Altıparmak
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - İhsan Ateş
- Department of Internal Medicine, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - İrfan Soykan
- Department of Gastroenterology, Ankara University Faculty of Medicine, İbni-Sina Hospital, Ankara, Turkey,Corresponding author: İrfan Soykan, e-mail:
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Asfuroğlu Kalkan E, Kalkan Ç, Barutcu S, Küçükşahin O, Güçbey Ö, Köseoğlu T, Şendil A, Hamamcı M, Özaslan E, Ateş İ, Altıparmak E, Soykan İ. Prevalence and Determinants of Gastrointestinal Manifestations in Patients with Selected Rheumatologic Diseases. Turk J Gastroenterol 2022; 33:576-586. [PMID: 35879915 PMCID: PMC9404860 DOI: 10.5152/tjg.2022.21780] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/20/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Many rheumatic diseases may cause gastrointestinal manifestations. The goal of this study was to analyze the prevalence and predictors of gastrointestinal involvement in patients with rheumatic disorders. METHODS A retrospective chart review was performed for patients with systemic lupus erythematosus, rheumatoid arthritis, and sys- temic sclerosis who have consulted due to gastrointestinal symptoms. The relationship between clinical symptoms, gastroscopic/colo- noscopic findings, and histopathological results with current drugs and disease duration was evaluated. RESULTS A total of 364 patients with rheumatic disorders and 740 people as control group were included in the study. Abdominal bloating followed by abdominal pain, regurgitation, and heartburn were reported as the main complaints by more than half of the patients. Most of the patients had gastric mucosal changes expressed as Lanza score, and the presence of major polypharmacy was the most important factor affecting Lanza score (odds ratio: 10, 95% CI: 1.882-54.111, P < .007) followed by disease duration (odds ratio: 1.559, 95% CI: 1.369-1.775, P < .001) and age (odds ratio: 1.069, 95% CI: 1.030-1.109, P < .001). In general, approximately 30% of the patients were posi- tive for Helicobacter pylori infection and 35% showed intestinal metaplasia in histopathological examination. Most of the colonoscopic findings were associated with colonic polyps (n = 81). In multivariate analysis, disease duration was the only factor that affected the pres- ence of colonic lesions (Area Under the Receiver Operating Characteristic (ROC) Curve (AUROC): 0.871, 95% CI: 0.824-0.918, P < .001). CONCLUSION Patients with rheumatologic diseases frequently have gastrointestinal manifestations. The most encountered gastrointes- tinal symptom was abdominal bloating, followed by abdominal pain. Being aware of gastrointestinal manifestations and their determi- nants may help physicians manage and follow patients with rheumatologic disorders.
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Affiliation(s)
- Emra Asfuroğlu Kalkan
- Department of Internal Medicine, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Çağdaş Kalkan
- Department of Gastroenterology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Sezgin Barutcu
- Department of Gastroenterology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Orhan Küçükşahin
- Department of Rheumatology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Özge Güçbey
- Department of Internal Medicine, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Tankut Köseoğlu
- Department of Gastroenterology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ateş Şendil
- Şendil’s Physical Therapy and Sports Medicine Center, Ankara, Turkey
| | - Mevlüt Hamamcı
- Department of Gastroenterology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ersan Özaslan
- Department of Gastroenterology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - İhsan Ateş
- Department of Internal Medicine, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Emin Altıparmak
- Department of Gastroenterology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - İrfan Soykan
- Department of Gastroenterology, Ankara University Faculty of Medicine, İbni-Sina Hospital, Ankara, Turkey
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Kalkan Ç, Soykan İ. Utility of a laboratory score in the prediction of altered autonomic nervous system function in autoimmune gastritis. Turk J Gastroenterol 2018; 29:32-35. [PMID: 29391305 PMCID: PMC6322619 DOI: 10.5152/tjg.2018.17295] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 09/22/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND/AIMS Autoimmune gastritis patients may have autonomic nerve dysfunction. The goal of our study was to explore the predictive value of two scoring systems in the differentiation of altered autonomic nerve function in autoimmune gastritis patients. MATERIALS AND METHODS Seventy-five patients with autoimmune gastritis were evaluated by using cardiovascular reflex tests in order to delineate autonomic nerve function. Data were analyzed by using two laboratory-based scoring systems: "global score" (hemoglobin, mean corpuscular volume, gastrin, vitamin B12, and chromogranin A) and "simple score" (hemoglobin, mean corpuscular volume, gastrin) in order to discriminate deranged and normal autonomic nerve function. RESULTS Mean "simple" and "global" scores were significantly higher in subjects with altered autonomic dysfunction than in subjects with normal autonomic function (3.55±1.88 vs. 0.908±0.409, p<0.001 and 5.95±2.07 vs 2.46±1.28, p<0.001, respectively). Receiver operatör characteristic (ROC) analysis revealed that the optimum "simple score" cutoff point was 0.75 with a sensitivity of 86.7% and specificity of 92.3% for discriminating autoimmune gastritis patients with autonomic nerve dysfunction from patients with normal autonomic nerve function [area under the curve (AUC): 88.3, positive predictive value (PPV): 97.5% and negative predictive value (NPV): 66.6%; 95% confidence interval (CI), 88.4-99.7]. CONCLUSION Simple score and global score have a high predictive value in the assessment of autoimmune gastritis patients with autonomic nerve dysfunction. These scoring systems may help physicians while evaluating autoimmune gastritis patients for the existence of autonomic nerve dysfunction instead of complex cardiovascular reflex tests.
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Affiliation(s)
- Çağdaş Kalkan
- Division of Gastroenterology, Department of Internal Diseases, Ankara University School of Medicine, Ibni Sina Hospital, Ankara, Turkey
| | - İrfan Soykan
- Division of Gastroenterology, Department of Internal Diseases, Ankara University School of Medicine, Ibni Sina Hospital, Ankara, Turkey
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Kalkan Ç, Karakaya F, Soykan İ. Factors associated with elevated serum chromogranin A levels in patients with autoimmune gastritis. Turk J Gastroenterol 2017; 27:515-520. [PMID: 27852542 DOI: 10.5152/tjg.2016.16486] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS Chromogranin A is an important tool in the diagnosis of neuroendocrine tumors. Autoimmune gastritis is an autoimmune disorder marked by hypergastrinemia, which stimulates enterochromaffin-like cell proliferation. Chromogranin A is also elevated in autoimmune gastritis patients with a different level of increase in each patient. The goal of this study is to explore constituents that influence serum chromogranin A levels in autoimmune gastritis patients. MATERIALS AND METHODS One hundred and eighty-eight autoimmune gastritis patients and 20 patients with type I gastric carcinoid tumors were analyzed retrospectively and compared to 110 functional dyspepsia patients in terms of factors that might affect serum chromogranin A levels. RESULTS The mean serum chromogranin A level was 171.17±67.3 ng/mL in autoimmune gastritis patients (n=62) without enterochromaffin-like cell hyperplasia, and 303.3±102.82 ng/mL in patients (n=126) with enterochromaffin-like cell hyperplasia (p<0.001). The presence of corpus atrophy (p=0.026, OR: 5.03, CI 95%: 1.21-20.88, β=1.61) and presence of enterochromaffin-like cell hyperplasia (p=0.017, OR: 6.59, CI 95%: 1.4-31.08, β=1.88) were found as risk factors associated with serum chromogranin A level. CONCLUSION Factors influencing raised serum chromogranin A levels in autoimmune gastritis were the presence of ECL cell hyperplasia and serum gastrin levels. Serum chromogranin A levels maybe helpful in distinguishing autoimmune gastritis patients and gastric carcinoid type I from the control group, but not useful in the differentiation of individuals with autoimmune gastritis from patients with gastric carcinoids.
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Affiliation(s)
- Çağdaş Kalkan
- Department of Gastroenterology, Ankara University School of Medicine İbn-i Sina Hospital, Ankara, Turkey.
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Üstün Y, Kilincalp S, Çoban Ş, Coşkun Y, Yüksel İ, Ongun A, Soykan İ, Bektaş M, Törüner M, Çetinkaya H, Örmeci N. Evaluation of Early Atherosclerosis Markers in Patients with Inflammatory Bowel Disease. Med Sci Monit 2016; 22:3943-3950. [PMID: 27773920 PMCID: PMC5094468 DOI: 10.12659/msm.898160] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate relationships between early atherosclerosis and inflammatory bowel disease (IBD) using laboratory, functional, and morphological markers of atherosclerosis. MATERIAL AND METHODS In the present prospective single-center study, 96 patients with IBD (58 patients with ulcerative colitis and 36 patients with Crohn's disease) and 65 healthy control subjects were included. The demographic data of each patient and control subject were recorded. The patients with IBD and healthy controls were compared in terms of the carotid intima-media thickness (CIMT), the values of flow-mediated dilatation (FMD) and nitroglycerine-mediated dilatation (NMD), and the levels of von Willebrand factor antigen (VWF-Ag), D-dimer, and lipoprotein (a). RESULTS There were no significant differences between the IBD patients and controls in terms of age, sex, BMI, systolic and diastolic BPs, serum levels of total cholesterol, low-density lipoprotein, or triglycerides. IBD patients had significantly higher levels of VWF-Ag (156.6±58.9 vs. 104.2±43.3, P<0.001) and D-dimer (337.2±710.8 vs. 175.9±110.9, P<0.001) as compared to the controls. No significant differences were determined between the 2 groups in terms of FMD and NMD values. Although statistically not significant, the CIMT values were higher in the IBD patients than in the controls (0.517±0.141 mm vs. 0.467±0.099 mm, P=0.073). In the correlation analysis, the CIMT was found to be correlated negatively with FMD and positively with high sensitive C-reactive protein, VWF-Ag, and D-dimer. CONCLUSIONS These findings suggest that VWF-Ag and D-dimer can be beneficial early atherosclerosis markers in IBD patients.
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Affiliation(s)
- Yusuf Üstün
- Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
- Corresponding Author: Yusuf Üstün, e-mail:
| | - Serta Kilincalp
- Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Şahin Çoban
- Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Yusuf Coşkun
- Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - İlhami Yüksel
- Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Aydan Ongun
- Department of Cardiology, Ankara University, School of Medicine, Ankara, Turkey
| | - İrfan Soykan
- Department of Gastroenterology, Ankara University, School of Medicine, Ankara, Turkey
| | - Mehmet Bektaş
- Department of Gastroenterology, Ankara University, School of Medicine, Ankara, Turkey
| | - Murat Törüner
- Department of Gastroenterology, Ankara University, School of Medicine, Ankara, Turkey
| | - Hülya Çetinkaya
- Department of Gastroenterology, Ankara University, School of Medicine, Ankara, Turkey
| | - Necati Örmeci
- Department of Gastroenterology, Ankara University, School of Medicine, Ankara, Turkey
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Bektaş M, Saraç N, Çetinkaya H, Törüner M, Erdemli E, Keskin O, Soykan İ, Oktay EI, Korkut E, Üstün Y, Bahar K. Effects of Helicobacter pylori infection and long-term proton pump inhibitor use on enterochromaffin-like cells. Ann Gastroenterol 2012; 25:123-127. [PMID: 24714139 PMCID: PMC3959398] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 02/13/2012] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Excessive release of gastrin leads to hypertrophy and hyperplasia of enterochromaffin-like cells (ECL) and prolonged stimulation of these cells causes functional impairment. The purpose of this study was to investigate the effect of Helicobacter pylori (H. pylori) infection and long-term proton pump inhibitors (PPI) use on ECL cells. METHODS Fifteen patients who underwent endoscopy because of dyspeptic symptoms were enrolled in the present study. Biopsies were taken from corpus and antrum and existence of H. pylori was investigated with culture, cytology and CLOtest. The patients were divided into 3 groups. Group-A: H. pylori-negative, never treated previously with PPI; Group-B: H. pylori-positive, never treated previously with PPI; and group-C: H. pylori-negative and continuously treated with PPI for more than 6 months before the subject recruitment period. The features of ECL cell in oxyntic glands were examined with electron microscopy on biopsy specimens. RESULTS ECL cells were completely normal in Group A. In group B, moderate hyperplasia and vacuolization was seen in ECL cells. In group C, ECL cell hyperplasia was observed and vacuoles with greater amounts of granules in enlarged vesicles were found more intensely in cytoplasm. CONCLUSION The use of PPI for a long period of time and presence of H. pylori infection are risk factors for ECL hyperplasia.
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Affiliation(s)
- Mehmet Bektaş
- Department of Gastroenterology (Mehmet Bektaş, Hülya Çetinkaya, Murat Törüner, Onur Keskin, İrfan Soykan, Esen Ismet Oktay, Esin Korkut, Yusuf Üstün, Kadir Bahar),
Correspondence to: Mehmet Bektaş, Ankara University, School of Medicine, Department of Gastroenterology, İbn-i Sina Hastanesi, Sıhhiye, Ankara, Turkey, Tel: +90 31250 82166, Fax: +90 31236 36213, e-mail:
| | - Nurşen Saraç
- Department of Histology and Embryology (Nurşen Saraç, Esra Erdemli), Ankara University School of Medicine
| | - Hülya Çetinkaya
- Department of Gastroenterology (Mehmet Bektaş, Hülya Çetinkaya, Murat Törüner, Onur Keskin, İrfan Soykan, Esen Ismet Oktay, Esin Korkut, Yusuf Üstün, Kadir Bahar)
| | - Murat Törüner
- Department of Gastroenterology (Mehmet Bektaş, Hülya Çetinkaya, Murat Törüner, Onur Keskin, İrfan Soykan, Esen Ismet Oktay, Esin Korkut, Yusuf Üstün, Kadir Bahar)
| | - Esra Erdemli
- Department of Histology and Embryology (Nurşen Saraç, Esra Erdemli), Ankara University School of Medicine
| | - Onur Keskin
- Department of Gastroenterology (Mehmet Bektaş, Hülya Çetinkaya, Murat Törüner, Onur Keskin, İrfan Soykan, Esen Ismet Oktay, Esin Korkut, Yusuf Üstün, Kadir Bahar)
| | - İrfan Soykan
- Department of Gastroenterology (Mehmet Bektaş, Hülya Çetinkaya, Murat Törüner, Onur Keskin, İrfan Soykan, Esen Ismet Oktay, Esin Korkut, Yusuf Üstün, Kadir Bahar)
| | - Esen Ismet Oktay
- Department of Gastroenterology (Mehmet Bektaş, Hülya Çetinkaya, Murat Törüner, Onur Keskin, İrfan Soykan, Esen Ismet Oktay, Esin Korkut, Yusuf Üstün, Kadir Bahar)
| | - Esin Korkut
- Department of Gastroenterology (Mehmet Bektaş, Hülya Çetinkaya, Murat Törüner, Onur Keskin, İrfan Soykan, Esen Ismet Oktay, Esin Korkut, Yusuf Üstün, Kadir Bahar)
| | - Yusuf Üstün
- Department of Gastroenterology (Mehmet Bektaş, Hülya Çetinkaya, Murat Törüner, Onur Keskin, İrfan Soykan, Esen Ismet Oktay, Esin Korkut, Yusuf Üstün, Kadir Bahar)
| | - Kadir Bahar
- Department of Gastroenterology (Mehmet Bektaş, Hülya Çetinkaya, Murat Törüner, Onur Keskin, İrfan Soykan, Esen Ismet Oktay, Esin Korkut, Yusuf Üstün, Kadir Bahar)
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Idilman R, Çetinkaya H, Savaş İ, Aslan N, Sak SD, Baştemir M, Sarioğlu M, Soykan İ, Bozdayı M, Colantoni A, Aydıntuğ O, Bahar K, Uzunalimoğlu Ö, Van Thiel DH, Numanoğlu N, Dökmeci A. Bronchoalveolar lavage fluid analysis in individuals with chronic hepatitis C. J Med Virol 2001. [DOI: 10.1002/jmv.2108] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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