1
|
Toy M, Güler B, Somay K, Gençdal G, Yurdaydin C. Hepatitis delta virus infection in Turkey: A meta-analysis of prevalence. IJID Reg 2024; 10:228-234. [PMID: 38444561 PMCID: PMC10912444 DOI: 10.1016/j.ijregi.2024.02.003] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/14/2024] [Accepted: 02/17/2024] [Indexed: 03/07/2024]
Abstract
Objectives Hepatitis delta virus (HDV) infection has been granted orphan disease status by the US Food and Drug Administration and the European Medicines Agency owing to its rarity and relatively limited research and treatment options. Turkey is considered an endemic country for the virus. We aimed to provide a current and updated country- and region-specific HDV infection prevalence. Methods In this meta-analysis, we searched databases, including MEDLINE, PUBMED, EMBASE, and UlakBim (Turkish Medical Index) published between January 1, 2006, and December 31, 2022. We included blood donor studies, outpatient clinic studies that comprised patients without cirrhosis, and inpatient clinical studies that comprised patients with cirrhosis. Turkey was divided into three regions: West, Central, and East Turkey. Results After a systematic assessment, 41 studies were included. Using a random-effects model, the estimated HDV prevalence among hepatitis B surface antigen-positive blood donors, outpatient clinic, and inpatient clinic patients were 3.37% (confidence interval [CI] 1.99-6.11), 5.05% (CI 4.00-6.23), and 29.06% (CI 10.45-51.79), respectively. The HDV prevalence among outpatient clinic patients in Western, Central, and Eastern regions were 3.38% (CI 2.47-4.44), 2.15% (CI 1.37-3.09), and 9.81% (CI 6.61-13.55), respectively. Conclusions East Turkey continues to have a high burden of HDV. Public health efforts, such as screening, should be targeted accordingly.
Collapse
Affiliation(s)
- Mehlika Toy
- Stanford University School of Medicine, Department of Surgery, Stanford, USA
| | - Begüm Güler
- Koç University Medical School, Department of Gastroenterology & Hepatology, Istanbul, Turkey
| | - Kayra Somay
- Koç University Medical School, Department of Gastroenterology & Hepatology, Istanbul, Turkey
| | - Genco Gençdal
- Koç University Medical School, Department of Gastroenterology & Hepatology, Istanbul, Turkey
| | - Cihan Yurdaydin
- Koç University Medical School, Department of Gastroenterology & Hepatology, Istanbul, Turkey
| |
Collapse
|
2
|
Özbaş B, Keskin O, Hecker H, Karahan I, Özbaş C, Kalkan Ç, Kartal A, Önder FO, Öncü BK, Gençdal G, Akyildiz M, Günşar F, Idilman R, Weissenborn K, Özütemiz Ö, Yurdaydin C. Determination of Turkish norms of psychometric tests for diagnosing minimal hepatic encephalopathy and proposal of a high sensitive screening test battery. Hepatol Int 2021; 15:1442-1455. [PMID: 34085147 DOI: 10.1007/s12072-021-10207-5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Psychometric hepatic encephalopathy score (PHES) needs local standardization. AIMS This study aimed at standardizing PHES for Turkish patients and compare them with German norms; to determine minimal hepatic encephalopathy (mHE) prevalence with two different methods [PHES battery and Critical Flicker Frequency (CFF)] and to assess whether sub-tests of the battery can be used for screening for mHE. METHODS Healthy volunteers (n = 816; 400 male) and cirrhotics (n = 124; 58 male) were included. For mHE diagnosis PHES score threshold was set at ≤ - 5 points and that of CFF at < 39 Hz. For comparing German and Turkish norms, datasets were combined. Multiple backward procedure was applied to assess effects of age, sex and education on single tests of the battery. Receiver operating characteristic (ROC) curves were created for assessing diagnostic capabilities of subtests of the battery. RESULTS PHES norms for Turks were developed. MHE prevalence in compensated cirrhotics was 29.8% and 27.4% with PHES and CFF tests, respectively, with low compatibility (kappa coefficient 0.389); mHE prevalence decreased to 16% when both tests were combined. Turks performed worse vs Germans in the digit symbol (DS) and serial dotting (SD) subtests but performed better in other subtests. In ROC analyzes of subtests, the combination of DS + SD tests achieved an AUROC of 0.974 versus PHES. CONCLUSIONS Use of two methods for diagnosing mHE is important for research purposes. From a clinical perspective, sensitivity with acceptable specificity may suffice for screening instruments for mHE. Combined use of DS and SD subtests of the PHES battery appears suitable for this purpose.
Collapse
Affiliation(s)
- Burak Özbaş
- Department of Internal Medicine, Ankara University Medical School, Ankara, Turkey
| | - Onur Keskin
- Department of Gastroenterology, Ankara University Medical School, Ankara, Turkey
| | - Hartmut Hecker
- Department of Biometrics, Hannover Medical School, Hannover, Germany
| | - Irfan Karahan
- Department of Internal Medicine, Ankara University Medical School, Ankara, Turkey
| | - Cansu Özbaş
- Department of Public Health, Gazi University Medical School, Ankara, Turkey
| | - Çağdaş Kalkan
- Department of Gastroenterology, Ankara University Medical School, Ankara, Turkey
| | - Aysun Kartal
- Department of Gastroenterology, Ankara University Medical School, Ankara, Turkey
| | - Fatih Oğuz Önder
- Department of Internal Medicine, Ankara University Medical School, Ankara, Turkey
| | - Burcu Kahveci Öncü
- Department of Psychiatry, Ankara University Medical School, Ankara, Turkey
| | - Genco Gençdal
- Department of Gastroenterology and Hepatology, Koç University Medical School, Istanbul, Turkey
| | - Murat Akyildiz
- Department of Gastroenterology and Hepatology, Koç University Medical School, Istanbul, Turkey
| | - Fulya Günşar
- Department of Gastroenterology, Ege University Medical School, Izmir, Turkey
| | - Ramazan Idilman
- Department of Gastroenterology, Ankara University Medical School, Ankara, Turkey
| | | | - Ömer Özütemiz
- Department of Gastroenterology, Ege University Medical School, Izmir, Turkey
| | - Cihan Yurdaydin
- Department of Gastroenterology, Ankara University Medical School, Ankara, Turkey.
- Department of Gastroenterology and Hepatology, Koç University Medical School, Istanbul, Turkey.
| |
Collapse
|
3
|
Gençdal G, Zeybel M, Yurdaydin C. Editorial: natural history of hepatitis delta virus-induced liver disease - less severe today but still needs attention. Aliment Pharmacol Ther 2021; 54:519-520. [PMID: 34331811 DOI: 10.1111/apt.16527] [Citation(s) in RCA: 1] [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] [Indexed: 01/06/2023]
Affiliation(s)
- Genco Gençdal
- Department of Gastroenterology and Hepatology, Koç University Medical School, Istanbul, Turkey
| | - Müjdat Zeybel
- Department of Gastroenterology and Hepatology, Koç University Medical School, Istanbul, Turkey
| | - Cihan Yurdaydin
- Department of Gastroenterology and Hepatology, Koç University Medical School, Istanbul, Turkey
| |
Collapse
|
4
|
Gençdal G, Yurdaydin C. Developing New Therapies for Delta Hepatitis: The Race Is On. Hepatol Commun 2021; 5:556-558. [PMID: 33860114 PMCID: PMC8034575 DOI: 10.1002/hep4.1685] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Genco Gençdal
- Department of Gastroenterology and HepatologyKoç University Medical SchoolIstanbulTurkey
| | | |
Collapse
|
5
|
|
6
|
Gençdal G, Türker G, Yazıcı Gençdal I, Ekinci B, Acar Ş, Dinçkan A, Akyıldız M. Assessment of sleep pattern and quality before and after liver transplantation using different methods. Turk J Gastroenterol 2020; 31:581-587. [PMID: 32915146 DOI: 10.5152/tjg.2020.18809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND/AIMS Sleep disorders (SDs) are frequently seen in patients with liver cirrhosis. Polysomnography (PSG), actigraphy, and electroencephalogram (EEG) are the common objective methods to diagnose SDs. The most commonly used subjective methods are the Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS). We aimed to evaluate the effect of liver transplantation (LTx) on SDs using a combination of objective (PSG and EEG) and subjective (PSQI and ESS) methods. MATERIALS AND METHODS A total of 18 patients with cirrhosis on an LTx waiting list were included in this study. Patient clinical status and biochemical parameters were evaluated. All patients completed the validated Turkish forms of the PSQI and ESS before and 9 months after LTx. All patients underwent EEG and PSG before and 9 months after LTx. RESULTS In total, 18 patients with liver cirrhosis (men: 12; 66.7%, mean age: 53.22±10.43 years) were included in this study. Pretransplant mean PSQI and ESS scores were 8.4±3.11 and 7.28±3.89, respectively; 9-month posttransplant mean PSQI and ESS scores were 4.5±2.8 and 4.72±2.91 (p<0.01), respectively. Before transplantation, metabolic encephalopathy was detected in 6 patients by EEG, whereas metabolic encephalopathy was detected in only 1 patient posttransplant. Posttransplantation PSG sleep duration (all stages) increased relative to pretransplant PSG values. Sleep latency and rapid eye movement latency were found to be reduced compared to the pretransplant values. CONCLUSION This pilot study compared SDs in patients with pre- and post-LTx by combining the subjective and objective methods. Significant SD improvements were found at the 9th month.
Collapse
Affiliation(s)
- Genco Gençdal
- Department of Gastroenterology, Yeni Yüzyıl University, GOP Hospital, Organ Transplantation Center, İstanbul, Turkey
| | - Gamze Türker
- Department of Chest Disease, Yeni Yüzyıl University, GOP Hospital, Organ Transplantation Center, İstanbul, Turkey
| | - Işıl Yazıcı Gençdal
- Department of Neurology, Dr. Sadi Konuk Bakırköy Training and Research Hospital, İstanbul, Turkey
| | - Burçak Ekinci
- Department of Neurology, Yeni Yüzyıl University, GOP Hospital, Organ Transplantation Center, İstanbul, Turkey
| | - Şencan Acar
- Department of Internal Medicine, Memorial Ataşehir Hospital, Organ Transplantation Center, İstanbul, Turkey
| | - Ayhan Dinçkan
- Department of General Surgery, Yeni Yüzyıl University, GOP Hospital, Organ Transplantation Center, İstanbul, Turkey
| | - Murat Akyıldız
- Department of Gastroenterology, Memorial Ataşehir Hospital, Organ Transplantation Center, İstanbul, Turkey
| |
Collapse
|
7
|
Gök M, Gençdal G. A Single-Center Experience: Long-Term Results of Stretta Procedure in Patients with Gastroesophageal Reflux.. [DOI: 10.31923/pooltext-preprint-4731-3710-0069] [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: 09/07/2023]
|
8
|
Abaylı B, Gençdal G. A Single-Center Experience: The Diagnostic Role of Peritoneoscopy in Patients with Exudative Ascites. J Laparoendosc Adv Surg Tech A 2018; 29:51-54. [PMID: 30300097 DOI: 10.1089/lap.2018.0274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND AIM The causes of exudative and transudative ascites can be detected through noninvasive methods nowadays. In selected cases, peritoneoscopy could be necessary for definitive diagnosis. In this retrospective study, we aimed to present the peritoneal biopsy results of patients who had exudative ascites with unclear etiology. MATERIALS AND METHODS A retrospective analysis was performed in 86 patients who had exudative ascites of unclear etiology. All the patients showed abnormalities of the peritoneum or greater omentum as determined by abdominal ultrasonography and underwent peritoneoscopy between January 2012 and December 2015. Patient data were obtained from hospital records. RESULTS Eighty-six patients (male: 22; 25.6%, mean age ± standard deviation: 57.97 ± 15.97) who had exudative ascites of unclear etiology were included to the study. The success rate of the procedures was 100% (86/86). A specific histopathological diagnosis was made in all patients, with an overall diagnostic accuracy of 100%. Among the 86 diagnosed patients, 43 (50%) were peritonitis carcinomatosa, 21 (24.4%) were tuberculous peritonitis, 14 (16.3%) were mesothelioma, 4 (4.7%) were chronical inflammation, and 1 (1.2%) was lymphoma. Three (3.5%) patients had normal peritoneal biopsy findings. DISCUSSION Peritoneoscopy is a safe and efficient alternative method due to its high diagnostic capacity in selected patients who have exudative ascites of unclear etiology.
Collapse
Affiliation(s)
- Bahri Abaylı
- 1 Department of Gastroenterology and Hepatology, Cukurova Dr. Askım Tufekci Hospital, Adana, Turkey
| | - Genco Gençdal
- 2 Department of Gastroenterology and Hepatology, Center of Transplantation, Yeni Yuzyıl, School of Medicine, İstanbul, Turkey
| |
Collapse
|
9
|
Abaylı B, Gençdal G, Değirmencioğlu Ş. Correlation between neutrophil/lymphocyte ratio and Ranson score in acute pancreatitis. J Clin Lab Anal 2018; 32:e22437. [PMID: 29575044 PMCID: PMC6816873 DOI: 10.1002/jcla.22437] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 03/01/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Acute pancreatitis (AP) is characterized by inflammation of the pancreas, elevated pancreatic enzymes, and abdominal pain. The neutrophil to lymphocyte ratio (NLR) is used as a marker of inflammation. In this retrospective study, we aimed to investigate novel early prognostic predictors of AP, such as NLR and its correlation with the Ranson score. METHODS A total 435 patients (Male: 152; 34.9%, Age: 63.53 ± 17.22 years) were included in the study. Data were collected by two clinicians scanning the registered hospital records. RESULTS Classification of the patients according to the aetiologies revealed gallstone(s) 58.6% (n = 255), hyperlipidaemia 2.2% (n = 9), viruses 0.7% (n = 3), malignancies 0.5% (n = 2), and alcohol 0.2% (n = 1). No reason was discovered in 37.9% (n = 165) of patients. Age, duration in the intensive care unit, serum aspartate aminotransferase (AST) levels, alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), total bilirubin, direct bilirubin, lactate dehydrogenase (LDH), white blood cell (WBC) count, neutrophil count, lymphocyte count, and the NLR were greater in the group with a Ranson score ≥3 than the group with a Ranson score <3. DISCUSSION Quick diagnosis is essential in AP. Current scoring systems for AP diagnosis are complicated, whereas NLP is a simple, practical, and effective marker.
Collapse
Affiliation(s)
- Bahri Abaylı
- Department of Gastroenterology and HepatologyCukurova Dr. Askım Tufekci HospitalAdanaTurkey
| | - Genco Gençdal
- Center of TransplantationDepartment of Gastroenterology and HepatologyYeni Yuzyıl, School of MedicineİstanbulTurkey
| | - Şerife Değirmencioğlu
- Department of Internal MedicineYeni Yüzyıl University School of MedicineIstanbulTurkey
| |
Collapse
|
10
|
Gençdal G, Degirmencioglu S, Akyıldız M. Diffuse Esophageal Squamous Papillomatosis Covering the Entire Esophagus. Clin Gastroenterol Hepatol 2018; 16:A28. [PMID: 29627426 DOI: 10.1016/j.cgh.2017.09.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/06/2017] [Accepted: 09/13/2017] [Indexed: 02/07/2023]
Affiliation(s)
- Genco Gençdal
- Department of Gastroenterology and Hepatology, Yeni Yüzyıl University School of Medicine, Istanbul, Turkey
| | - Serife Degirmencioglu
- Department of Internal Medicine, Yeni Yüzyıl University School of Medicine, Istanbul, Turkey
| | - Murat Akyıldız
- Department of Gastroenterology and Hepatology, Yeni Yüzyıl University School of Medicine, Istanbul, Turkey
| |
Collapse
|
11
|
Abstract
Purpose The activity of epithelial lactase (LCT) is associated with a polymorphism 13910 bp upstream in the lactase encoding gene. Because the association between the LCT-13910 polymorphism and the risk for colorectal cancer is not clear, we investigated the role of the LCT-13910 polymorphism as a potential risk factor for colorectal cancer and colorectal polyps in the Turkish population. Methods One hundred sixty-six subjects (74 with polyps, 44 with colorectal cancer, 48 controls), who had undergone a total colonoscopy between January 2012 and November 2012 in our endoscopy unit were genotyped for the LCT-13910 polymorphism by using the polymerase chain reaction and minisequencing. Results The CC genotype in the lactose gene 13910 locus, which is accepted as the genetic indicator of lactase deficiency, was determined as 83.7%. The CC genotype rate was determined as 89.1% in patients who had a history of lactose intolerance and 81.5% in those without a history of lactose intolerance (P = 0.236). No difference was detected between the patients who had colorectal polyp(s) and/or cancer and the controls with regard to the LCT-13910 polymorphism. No differences were determined between groups when they were compared with regard to the C or the T allele. Conclusion No differences were detected between the patients who had colorectal polyp(s) and/or cancer and those with normal colonoscopy findings with regard to lactase gene polymorphisms. No differences were determined between the groups when they were compared with regard to the C or the T allele.
Collapse
Affiliation(s)
- Genco Gençdal
- Ege University School of Medicine, Department of Gastroenterology, Izmir, Turkey
| | - Esin Salman
- Ege University School of Medicine, Department of Gastroenterology, Izmir, Turkey
| | - Ömer Özütemiz
- Ege University School of Medicine, Department of Gastroenterology, Izmir, Turkey
| | - Ulus S Akarca
- Ege University School of Medicine, Department of Gastroenterology, Izmir, Turkey
| |
Collapse
|
12
|
Gençdal G, Vardar R, Bozkaya H, Meral C, Parildar M, Özütemiz Ö. Azygoesophageal fistula: a rare cause of upper gastrointestinal tract bleeding. Endoscopy 2014; 45 Suppl 2 UCTN:E219-20. [PMID: 23945919 DOI: 10.1055/s-0032-1326281] [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: 12/10/2022]
Affiliation(s)
- G Gençdal
- Department of Gastroenterology, Ege University School of Medicine, İzmir, Turkey.
| | | | | | | | | | | |
Collapse
|