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Karaoğlan BB, Tulunay C, Uzun Ç, Peker E, Özyüncü N, Ellik Z, Kuru D, Turhan S, Savaş B, Erden A, Idilman R, Idilman R. Determining Subclinical Cardiovascular and Cardiac Diseases in Patients with Non-Alcoholic Fatty Liver Disease. Turk J Gastroenterol 2023; 34:242-253. [PMID: 36445056 PMCID: PMC10152151 DOI: 10.5152/tjg.2022.22075] [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] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aims of the present study were to determine the subclinical coronary atherosclerosis and myocardial dysfunction in patients with non-alcoholic fatty liver disease, who were asymptomatic for cardiac disease. METHODS A total of 61 non-alcoholic fatty liver disease patients were enrolled in the study. The 10-year probability of cardiovascular events was evaluated according to the pooled cohort equation risk score (atherosclerotic cardiovascular disease). The coronary artery calcium score was measured. Conventional echocardiographic examination was followed by 2- and 3-dimensional speckle tracking echocardiography. RESULTS Patients with non-alcoholic steatohepatitis had significantly higher insulin resistance (P = .018), serum alanine aminotransferase (P = .002) and aspartate aminotransferase levels (P = .021), hepatic steatosis (P = .023), and fibrosis (P = .001) than non-alcoholic fatty liver disease patients. The mean Atherosclerotic Cardiovascular Disease score was 7.5% ± 6.9% and 37% of the patients had medium and high cardiovascular disease risk. Cardiovascular disease (>1) was found in 30% of the patients. Interestingly, 56% had significant and extended atherosclerotic plaques. Among the patients with moderate-to-high atherosclerotic cardiovascular disease scores, 63% had significant atherosclerotic plaques and 21% had extensive plaque burden. The presence of non-alcoholic steatohepatitis did not significantly affect cardiovascular risk. Non-alcoholic steatohepatitis was deleterious on left ventricle diastolic functions. Mean A velocity in non-alcoholic steatohepatitis patients was significantly increased compared to non-alcoholic fatty liver disease patients (87.0 ± 17.5 cm/s vs. 72.3 ± 13.6 cm/s, P = .002). Mean E/e' ratio was 8.1 ± 2.0. Submyocardial fibrosis detected had a slightly higher occurrence in non-alcoholic steatohepatitis patients than in non-alcoholic fatty liver disease patients (P = .530). CONCLUSION The presence of non-alcoholic steatohepatitis did not significantly increase the risk of cardiovascular disease and subclinical myocardial dysfunction in asymptomatic patients for cardiac disease compared to non-alcoholic fatty liver disease patients.
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Affiliation(s)
- Beliz Bahar Karaoğlan
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Cansın Tulunay
- Department of Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Çağlar Uzun
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Elif Peker
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nil Özyüncü
- Department of Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Zeynep Ellik
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Diğdem Kuru
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sibel Turhan
- Department of Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Berna Savaş
- Department of Pathology, Ankara University Faculty of Medicine, Ankara, Turkey; Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ayşe Erden
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ramazan Idilman
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
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Karakaya MF, Er E, Kırımker O, Gümüşsoy M, Bodakçi E, Özercan M, Doğanay Erdoğan B, Gökcan H, Koloğlu M, Karayalçın K, Yurdaydın C, Tüzüner A, Haznedaroğlu S, Çınar K, Özkan H, Idilman R, Idilman R. Management of Biliary Complications in Liver Transplant Recipients with Duct-To-Duct Anastomosis: A Single-Center Experience. Turk J Gastroenterol 2023; 34:177-181. [PMID: 36843302 PMCID: PMC10081117 DOI: 10.5152/tjg.2023.22724] [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] [Indexed: 02/25/2023]
Abstract
BACKGROUND The aims of this study were to investigate biliary complications in liver transplant recipients with choledochocholedocho stomy anastomosis, to identify the risk factors for the development of such complications, and to evaluate the success of endoscopic approaches in liver transplant recipients. METHODS Between January 2013 and May 2021, a total of 238 patients with liver diseases underwent liver transplantation: 174 recipients undergoing choledochocholedochostomy anastomosis were included in the analysis. RESULTS Their median age was 54.0 years. The median posttransplant follow-up period was 29 months. Hepatitis B virus infection (33%) was the most common indication for liver transplantation. Most patients (87%) received living donor liver transplantation. The overall prevalence of posttransplant biliary complications was 31%. Anastomotic biliary strictures were the most common biliary complications (72%), followed by biliary leakage (13%). The median time between endoscopic retrograde cholangiography and liver transplantation was 4 months, with a mean of 3 ± 1.6 sessions. Endoscopic retrograde cholangiography-guided drainage and balloon dilation with or without stent placement was the most common treatment modalities for recipients with biliary strictures. The overall success rate of endoscopic treatment modalities was 83.3%, with 65% of the recipients exhibiting complete biochemical and endoscopic responses. The response did not differ significantly between living donor liver transplantation and cadaveric donor liver transplant recipients (P > .05). Three recipients required revision surgery for biliary complication repair. Six patients died due to biliary sepsis. CONCLUSION Biliary stricture and leakages were the most common biliary complications after liver transplantation. Endoscopic treatment was successful in most recipients.
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Affiliation(s)
| | - Erdem Er
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Onur Kırımker
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mesut Gümüşsoy
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emin Bodakçi
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mubin Özercan
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | | | - Hale Gökcan
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Meltem Koloğlu
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Kaan Karayalçın
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Cihan Yurdaydın
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Acar Tüzüner
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Selçuk Haznedaroğlu
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Kubilay Çınar
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Hasan Özkan
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ramazan Idilman
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
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Celasin H, Törüner M, Aghayeva S, Bayramov N, Vardanyan A, Nanaeva B, Dardanov D, Podpriatov S, Dorofeyev A, Ethem Geçim İ, Gecim IE. Perception of COVID-19 Pandemic Among IBD Clinicians and IBD Surgeons in Black Sea Region: A Cross-Sectional Questionnaire Study. Turk J Gastroenterol 2022; 33:1004-1011. [PMID: 35726844 PMCID: PMC9797775 DOI: 10.5152/tjg.2022.22009] [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] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Since December 2019, the COVID-19 pandemic has created an increasing challenge in managing inflammatory bowel dis- ease patients both medically and surgically. Although several international and national medical/surgical associations published guide- lines in this area, there is still a huge difference between daily practices and these guidelines, especially depending on regional practices and governmental policies. Therefore, we aimed to investigate and define gastroenterologists' and surgeons' fear of COVID-19 and how they have managed inflammatory bowel disease patients during this pandemic in the Black Sea region. METHODS A 20-question survey was administered to 70 gastroenterology specialists and 80 general surgeons who are mainly focused on the management of inflammatory bowel disease in 5 countries in the Black Sea region. RESULTS The majority of respondents (81.3%) mentioned that they have concerns that their inflammatory bowel disease patients were at risk of contracting COVID-19. In addition, the majority of respondents (80.3%) believed that inflammatory bowel disease itself, inde- pendent of medications, might increase the risk of contracting COVID-19. The majority of gastroenterologists told that they did not stop inflammatory bowel disease medications due to the COVID-19 pandemic unless patients had COVID-19 disease. Surgeons overwhelm- ingly reached a consensus on how to test patients for COVID-19 perioperatively and came to a conclusion on which of the patients can- not wait to be operated. Both gastroenterologists and general surgeons, usually have similar perceptions. CONCLUSION Despite the increasing number of definitive studies, it seems that there are still regional differences in the perception of COVID-19 and inflammatory bowel disease patient care during the pandemic.
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Affiliation(s)
- Haydar Celasin
- Department of Surgery, Lokman Hekim University Faculty of Medicine, Ankara, Turkey,Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey,Haydar Celasin and Murat Toruner contributed equally.Corresponding author: Murat Törüner, e-mail: ,
| | - Murat Törüner
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey,Department of Gastroenterology, Baku Medical Plaza, Baku, Azerbaijan,Haydar Celasin and Murat Toruner contributed equally.Corresponding author: Murat Törüner, e-mail: ,
| | - Sevda Aghayeva
- Department of Surgery, Medical University of Azerbaijan, Baku, Azerbaijan
| | - Nuru Bayramov
- Ryzhikh State Scientific Research Center of Coloproctology, Moscow, Russia
| | - Armen Vardanyan
- Department of Surgery, University Hospital Alexandrovska, Sofia, Bulgaria
| | - Bella Nanaeva
- Department of Surgery, University Hospital Alexandrovska, Sofia, Bulgaria
| | | | - Sergii Podpriatov
- National Medical Academy of Postgraduate Education n.a. P.L. Shupic, Ukraine
| | - Andriy Dorofeyev
- Department of Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - İbrahim Ethem Geçim
- Department of Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
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