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Atacan H, Erkut M, Değirmenci F, Akkaya S, Fidan S, Coşar AM, Cosar AM. A Single Tertiary Center 14-year Experience With Mesenteric Panniculitis in Turkey: A Retrospective Study of 716 Patients. Turk J Gastroenterol 2023; 34:140-147. [PMID: 36843301 PMCID: PMC10081023 DOI: 10.5152/tjg.2023.22514] [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 Mesenteric panniculitis is a chronic inflammatory process seen in mesenteric tissue. The purpose of this study was to assess the prevalence, clinical, laboratory, and radiological findings, and malignancy in patients diagnosed with mesenteric panniculitis using computed tomography. METHODS A total of 716 patients with mesenteric panniculitis were retrospectively evaluated by screening all computed tomography scans performed between January 2005 and December 2018. RESULTS Among 65 278 patients undergoing CT, 716 were diagnosed with mesenteric panniculitis. The prevalence of mesenteric panniculitis was 1.1%. The mean age was 56 ± 14 (20-91) years. The malignant and nonmalignant groups comprised 354 (49.4%) and 362 (50.6%) patients, respectively. The mean age of the malignant group was significantly higher than the nonmalignant group (P < .001). The most common malignancy was breast cancer (12.2%). A history of abdominal surgery was present in 179 (25%) patients with mesenteric panniculitis and it is higher in the malignant group than the nonmalignant group (128 [36.1%], 51 [14%], respectively, P < .001). Mean hemoglobin level and leukocyte count were lower in the malignant group than in the nonmalignant group (P < .001, P < .001, respectively). The mean erythrocyte sedimentation rate was higher in the malignant group than in the nonmalignant group (P = .030). Radiological criterion 2 was less common and radiological criterion 5 was more common in the malignant group than the nonmalignant group (91.0%, 96.4%, P = .004; 35.9%, 27.1%, respectively, P = .011). CONCLUSIONS It is recommended to conduct research for malignancy in patients with mesenteric panniculitis, especially in the presence of clinical, laboratory, and radiological findings with high-risk features.
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Affiliation(s)
- Hüseyin Atacan
- Department of Internal Medicine, Bulancak State Hospital, Giresun, Turkey
| | - Murat Erkut
- Department of Gastroenterology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Ferhat Değirmenci
- Department of Radiology, Health Sciences University, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Selçuk Akkaya
- Department of Radiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Sami Fidan
- Department of Gastroenterology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Arif M Coşar
- Department of Gastroenterology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
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Erkut M, Erkut N, Bektaş Ö, Fidan S, Coşar AM, Sönmez M, Sonmez M. Effect of Clinical, Endoscopic, Radiological Findings, and Complications on Survival in Patients with Primary Gastrointestinal Lymphoma. Turk J Gastroenterol 2022; 33:909-917. [PMID: 36262100 PMCID: PMC9797772 DOI: 10.5152/tjg.2022.211003] [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] [Indexed: 11/07/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the clinical, endoscopic, and radiological characteristics, complications, survival outcomes, and prognostic factors of patients with primary gastrointestinal lymphoma. METHODS This study retrospectively analyzed the demographic, laboratory, endoscopic, and radiological characteristics and treatment outcomes of 43 patients with newly diagnosed primary gastrointestinal lymphoma. RESULTS The median age was 62 years (range: 26-83). The primary lesion location was the gastric in 33 (77%) patients and the intestinal in 10 (23%) patients. The most common lesions were the corpus (33%) and corpus+antrum (24%) in primary gastric lymphoma and the ileum (60%) in primary intestinal lymphoma. The most common endoscopic findings were diffuse infiltrative lesion (23%) and massforming (33%), while the most common computed tomography finding was wall thickening (53%). Wall thickening and mass-forming at computed tomography were greater in primary intestinal lymphoma than in primary gastric lymphoma (P = .034). Complications were observed in 9 (21%) patients and 13 (31%) patients who underwent surgery. Complication and surgery rates were higher in primary intestinal lymphoma than in primary gastric lymphoma (P = .003 and P = .014, respectively). Five-year overall survival and 5-year eventfree survival rates were 75% and 72%, respectively. Univariate analysis showed that intestinal involvement, advanced clinical stage, a high International Prognostic Index score, mass-forming and wall thickening at computed tomography, extranodal involvement, and complication were found to adversely affect survival. Multivariate analysis revealed that intestinal involvement and a high International Prognostic Index score were independent prognostic factors for overall survival and event-free survival. CONCLUSION Patients with primary gastrointestinal lymphoma with intestinal involvement and high International Prognostic Index score should be followed closely.
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Affiliation(s)
- Murat Erkut
- Department of Gastroenterology, Karadeniz Technical University Faculty of Medicine, Trabzon,Corresponding author: Murat Erkut, e-mail:
| | - Nergiz Erkut
- Department of Hematology, Karadeniz Technical University Faculty of Medicine, Trabzon,Corresponding author: Murat Erkut, e-mail:
| | - Özlen Bektaş
- Department of Hematology, Karadeniz Technical University Faculty of Medicine, Trabzon
| | - Sami Fidan
- Department of Gastroenterology, Karadeniz Technical University Faculty of Medicine, Trabzon
| | - Arif Mansur Coşar
- Department of Gastroenterology, Karadeniz Technical University Faculty of Medicine, Trabzon
| | - Mehmet Sönmez
- Department of Hematology, Karadeniz Technical University Faculty of Medicine, Trabzon
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Fidan E, Fidan S, Merev E, Kazaz N. The Relationship between albumin-Bilirubin grade and survival in hepatocelluler carcinoma patients treated with sorefanib. Niger J Clin Pract 2022; 25:173-177. [PMID: 35170443 DOI: 10.4103/njcp.njcp_525_20] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Background Hepatocellular carcinoma (HCC) is one of the most common hepatic malignancies and the sixth most common cancer worldwide. Prognosis is affected by tumor stage, hepatic disfunction and patient performance. Albumin - bilirubin grade was developed to assess the hepatic function in patient with HCC. Aims: The purpose of this study was to examine the relationship between albumin-bilirubin (ALBI) grade and survival in HCC patients receiving sorafenib. We also planned to investigate whether ALBI scores in advanced stage patients are prognostic and predictive. Patients and Methods Patients presenting to the Karadeniz Technical University Medical Faculty Medical Oncology Clinic and diagnosed with HCC in 2010-2018 were included in the study. Fifty-six patients using sorafenib with Eastern Cooperative Oncology Group (ECOG) performance scores of 0, 1, or 2, who had not previously received systemic therapy were enrolled. Results Patients' median age was 64.8 years (range: 23-86), and 80.4% were men. The highest proportion of patients were infected with hepatitis B virus (46.4%), 37 patients were ECOG 1 (66.1%), and 40 were ALBI grade 2 (71.4%). The change occurring in ALBI scores after sorafenib therapy compared to pre-sorafenib values was found to affect progression-free survival. Prognosis was better in the group with decreasing ALBI scores than in the increasing score group (p: 0.028). Multivariate regression analysis revealed that the change occurring in ALBI scores after sorafenib therapy compared to pre-sorafenib values was predictive of progression-free survival independently of alpha-fetoprotein (AFP) levels. Conclusion This study shows that ALBI grade affects survival independently of AFP, Hand-Foot Syndrome (HFS), and other prognostic factors. ALBI grading can be used as a prognostic parameter in patients using sorafenib.
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Affiliation(s)
- E Fidan
- Department of Medical Oncology, Karadeniz Technical University, Trabzon, Turkey
| | - S Fidan
- Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - E Merev
- Department of Medical Oncology, Karadeniz Technical University, Trabzon, Turkey
| | - N Kazaz
- Department of Medical Oncology, Karadeniz Technical University, Trabzon, Turkey
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Fidan E, Yildirim A, Kazaz N, Fidan S, Cekic AB. The relationship between albumin-bilirubin score and survival in patients operated for pancreatic cancer. J PAK MED ASSOC 2022; 72:1340-1344. [DOI: 10.47391/jpma.2413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objective: To investigate whether albumin-bilirubin score can be used as a prognostic marker in pancreatic cancer patients post-surgery.
Method: The retrospective study was conducted at the Medical Oncology Clinic, Karadeniz Technical University, Trabzon, Turkey, and comprised data from 2010 to 2018 of pancreatic cancer patients who had undergone distal pancreatectomy or pancreaticoduodenectomy and were followed up for 3 years. Preoperative and postoperative serum albumin, carcinoembryonic antigen, carbohydrate antigen 19-9, bilirubin, neutrophil:lymphocyte ratio and platelet:lymphocyte ratio were compared as inflammation markers, while albumin-bilirubin scores were calculated using the equation linear predictor. Data was analysed using SPSS 17.
Results: Of the 39 patients, 23(59%) were men and 16(41%) were women. The mean age of the sample was 62.4±10.2 years. No statistically significant changes were observed between preoperative and postoperative albumin-bilirubin scores, carcinoembryonic antigen, neutrophil:lymphocyte ratio and platelet:lymphocyte ratio (p>0.05). Significant decreases were observed in postoperative carbohydrate antigen 19-9, aspartate transaminase and alanine transaminas levels (respectively<0.05). No significant change was determined in postoperative albumin-bilirubin grade distributions compared to preoperative values (p=0.180). Although the rate of recurrence increased in line with preoperative albumin-bilirubin scores, the finding was not statistically significant (p=0.055). Mortality rate increased significantly in line with preoperative albumin-bilirubin scores (p=0.013).
Conclusion: The albumin-bilirubin score affected survival in patients with pancreatic cancer, and can be employed as a prognostic factor in this patient group.
Key Words: Pancreatic cancer, Albumin-bilirubin score, Prognostic factors.
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Toka B, Köksal AŞ, Dertli R, Şirin G, Fidan S, Ülger Y, Harmandar F, Yıldırım AE, Eminler AT, Asil M, Kayar Y, Bıyık M, Kuran S, Uslan MI, Hülagü S. Hepatitis B Reactivation in Patients Treated with Direct-Acting Antivirals for Hepatitis C. Dig Dis 2022; 40:635-643. [PMID: 35108715 DOI: 10.1159/000521298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 12/01/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION There is limited research about HBV reactivation (HBVr) due to direct-acting antivirals (DAA) for HCV and most are limited by short duration of follow-up, small sample size, and absence of baseline HBV DNA. We aimed to determine the incidence and clinical course of HBVr in HBsAg and/or anti-HBcIgG positive patients treated with DAA for HCV. METHODS Seven centers retrospectively analyzed their database on HCV patients treated with DAA between 2015 and 2019. Patients with HBV coinfection or resolved HBV infection were enrolled. Serum transaminases, HBsAg, HBeAg, and HBV DNA were followed every 4 weeks during DAA treatment and every 12 weeks 1 year after treatment. Entecavir or tenofovir disoproxil fumarate was started in case of HBVr. The development of HBVr, HBV flare, liver failure, and mortality were determined. RESULTS 852 patients received DAA treatment for HCV. Among them, 35 (4.1%) had HBV coinfection and 246 (28.9%) had resolved HBV infection. 257 patients (53.3% male, mean age: 63 ± 9) constituted the study group (29 with coinfection and 228 with resolved infection). Three patients with coinfection were HBV DNA positive. HBVr developed in 10 (34.5%) HBsAg positive patients, either during (n = 3) or 12-48 weeks after finishing DAA treatment. HBV flare and acute liver failure developed in 1 patient (3.4%), each. Two patients with resolved infection developed HBVr (0.87%) and one (0.44%) had HBV flare. Overall, none of the patients died or underwent liver transplantation due to HBVr. CONCLUSION Patients with HBV/HCV coinfection have a high risk of HBVr after DAA treatment and should receive antiviral prophylaxis. Patients with resolved infection have a low risk of HBVr and can be monitored by serial ALT measurements.
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Affiliation(s)
- Bilal Toka
- Department of Gastroenterology, Health Sciences University Konya Training and Research Hospital, Konya, Turkey
| | - Aydın Şeref Köksal
- Department of Gastroenterology, Sakarya University Faculty of Medicine, Adapazarı, Turkey
| | - Ramazan Dertli
- Department of Gastroenterology, Malatya Education and Research Hospital, Malatya, Turkey
| | - Göktuğ Şirin
- Department of Gastroenterology, Kocaeli University School of Medicine, İzmit, Turkey
| | - Sami Fidan
- Department of Gastroenterology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Yakup Ülger
- Department of Gastroenterology, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Ferda Harmandar
- Department of Gastroenterology, Health Sciences University Antalya Training and Research Hospital, Antalya, Turkey
| | - Abdullah Emre Yıldırım
- Department of Gastroenterology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Ahmet Tarik Eminler
- Department of Gastroenterology, Sakarya University Faculty of Medicine, Adapazarı, Turkey
| | - Mehmet Asil
- Department of Gastroenterology, Konya Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Yusuf Kayar
- Department of Gastroenterology, University of Health Sciences, Van Education and Research Hospital, Van, Turkey
| | - Murat Bıyık
- Department of Gastroenterology, Konya Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Sedef Kuran
- Department of Gastroenterology, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Mustafa Ihsan Uslan
- Department of Gastroenterology, Sakarya University Faculty of Medicine, Adapazarı, Turkey
| | - Sadettin Hülagü
- Department of Gastroenterology, Kocaeli University School of Medicine, İzmit, Turkey
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Kisioglu SV, Habiboglu I, Gunay YE, Durak S, Karakullukcu S, Fidan S. Gastrointestinal Bleeding Risk Factors in Patients with Type 2 Diabetes Mellitus. J Coll Physicians Surg Pak 2022; 32:15-19. [PMID: 34983141 DOI: 10.29271/jcpsp.2022.01.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/09/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the factors leading to the development of gastrointestinal bleeding (GIB) by comparing patients with diabetes mellitus Type 2 (T2DM) with dyspeptic complaints without GIB; and patients with T2DM who had GIB, regardless of the presence of helicobacter pylori. STUDY DESIGN Analytical study. PLACE AND DURATION OF STUDY Department of Endocrinology and Gastroenterology, Faculty of Medicine, Karadeniz Technical University, from January 2018 to June 2019. METHODOLOGY The patients were divided into GIB and dyspepsia groups. After the identification of patients in both groups, demographic characteristics, drugs, comorbidities, presence of diabetic macro- and micro-vascular complications, and endoscopic findings were examined retrospectively for each patient. RESULTS There were 106 patients, with 53 patients in each group. Mean age was significantly higher in the GIB group compared to the dyspepsia group (p<0.001). Body mass index (BMI) was significantly lower in the GIB group (p<0.001). Frequency of congestive heart failure (CHF), chronic kidney disease (CKD), and cerebrovascular disease (CVD), heart valve disease, and cardiac arrhythmia was significantly higher in GIB group (p <0.05 for all). No significant correlation was found between acetylsalicylic acid (ASA) use and GIB (p=0.103). The use of nonsteroidal anti-inflammatory drugs (NSAID), novel oral anticoagulants (NOAC), and clopidogrel was significantly higher in the GIB group (p=0.032, p=0.031, and p=0.032, respectively). Proton pump inhibitor (PPI) use was significantly higher in the dyspepsia group (p=0.002). CONCLUSION Age, and poly medications were associated with increased frequency of GIB. The use of ASA, when not administered with other agents that may induce GIB, does not increase the risk of developing GIB in obese T2DM patients younger than 65 years of age, who have increased HbA1c levels. Key Words: Type 2 diabetes mellitus, Dyspepsia, Gastrointestinal bleeding, Acetylsalicylic acid, Risk factors, Obesity, Medication.
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Affiliation(s)
- Savas Volkan Kisioglu
- Department of Endocrinology, Istinye University, Yildizli Medical Park Hospital, Trabzon, Turkey
| | - Ihsan Habiboglu
- Department of Gastroenterology, Sivas Numune Hospital, Sivas, Turkey
| | - Yasemin Emur Gunay
- Department of Endocrinology, Karadeniz Technical University, Trabzon, Turkey
| | - Serdar Durak
- Department of Gastroenterology, Karadeniz Technical University, Trabzon, Turkey
| | | | - Sami Fidan
- Department of Gastroenterology, Karadeniz Technical University, Trabzon, Turkey
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Güneş A, Fidan S, Dulkadir R, Ünlü E. Evaluation of risk factors associated with first episode febrile seizure. Eur Rev Med Pharmacol Sci 2021; 25:7089-7092. [PMID: 34859873 DOI: 10.26355/eurrev_202111_27261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Febrile convulsion (FC) is one of the most common neurological findings in children. This study was aimed to investigate the difference in laboratory parameters between Febrile Seizure and control groups. PATIENTS AND METHODS In this study, 169 children admitted to the pediatric emergency department with their first episode of FS and 189 control groups were retrospectively analyzed. The demographic characteristics and laboratory parameters of children were obtained from their files. RESULTS Upper respiratory tract infection (URTI) was determined the most common disease (81.6%) in the FC group followed by acute gastroenteritis (AGE) (15.4%) and urinary tract infection (UTI) (3%), respectively. Similarly, URTI was detected as the most common disease (81.8%) in control groups. It was determined that there was no statistically significant difference between the two groups in terms of diseases. The leukocyte and neutrophil counts of the children with FC were significantly higher but the mean corpuscular volume of lenfosit and lenfosit/neutrophil ratio was significantly lower than the control groups (p= 0.009, <0.001, 0.001, <0.001, <0.001, respectively). Children with FC had significantly higher blood glucose, urea, creatinine, creatine kinase, alkaline phosphatase and albumin levels compared with the control groups (p<0.001, in all parameters). On the other hand, the potassium, sodium and chlorine levels of the Children with FCs were significantly lower than control groups (p=0.017, <0.001, p <0.001, respectively). CONCLUSIONS To conclude, febrile patients with high leukocyte counts, high neutrophil counts, and several biochemical parameters should be carefully monitored for FCs due to the increasing seizure risk.
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Affiliation(s)
- A Güneş
- Department of Pediatrics, Medical School, Ahi Evran University, Kırşehir, Turkey.
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Erkut M, Uzun DY, Kaklıkkaya N, Fidan S, Yoğun Y, Coşar AM, Akyıldız E, Topbaş M, Özgür O, Arslan M. Sociodemographic characteristics and clinical risk factors of Helicobacter pylori infection and antibiotic resistance in the Eastern Black Sea region of Turkey. Turk J Gastroenterol 2021; 31:221-233. [PMID: 32343234 DOI: 10.5152/tjg.2020.18631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIMS The aim of this study was to assess the clinical and sociodemographic risk factors of Helicobacter pylori infection and antibiotic resistance in the eastern Black Sea region of Turkey. MATERIALS AND METHODS In total, 344 patients with dyspeptic symptoms who completed an extended questionnaire were enrolled in the study. Diagnosis of H. pylori infection was made by rapid urease test, histopathological investigation, and culture. Susceptibility of H. pylori strains was assessed by agar dilution (amoxicillin, tetracycline, metronidazole, levofloxacin) and E-test (clarithromycin) methods. RESULTS The H. pylori positivity rate was 40.4% (139/344). Logistic regression analysis indicated that age and the presence of duodenal ulcer were independent risk factors associated with H. pylori positivity (odds ratio (OR): 0.96, 95% CI: 0.93-0.99, p=0.013; OR: 5.42, 95% CI: 1.96-14.98, p=0.001, respectively). Of 104 H. pylori-positive cultures, 43 strains (41%) were susceptible to all antibiotics, whereas 61 (59%) were resistant to at least one antibiotic. H. pylori resistance rates were 34% for levofloxacin, 31.1% for metronidazole, 28.2% for clarithromycin, 2.9% for amoxicillin, and 1% for tetracycline. Logistic regression analysis indicated that previous use of clarithromycin was the only independent risk factor for H. pylori resistance (OR: 6.25, 95% CI: 1.59-24.52, p=0.009). CONCLUSION An understanding of the risk factors for H. pylori positivity and antibiotic resistance in an extended anamnesis may affect treatment choice and facilitate H. pylori eradication. In regions where antibiotic resistance rates are elevated, performing antibiotic susceptibility tests may lead to effective eradication treatment.
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Affiliation(s)
- Murat Erkut
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Doğan Yusuf Uzun
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Neşe Kaklıkkaya
- Department of Medical Microbiology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Sami Fidan
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Yaşar Yoğun
- Clinic of Gastroenterology, Gebze Fatih State Hospital, Kocaeli, Turkey
| | - Arif Mansur Coşar
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Esma Akyıldız
- Department of Medical Microbiology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Murat Topbaş
- Department of Public Health, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Orhan Özgür
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Mehmet Arslan
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
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Fidan S, Fidan E, Alandağ C, Erkut M, Cosar AM. Hepatitis B Virus Screening and Real Life Data in Patients with Solid Tumor Receiving Chemotherapy. Arch Iran Med 2020; 23:835-841. [PMID: 33356341 DOI: 10.34172/aim.2020.111] [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] [Received: 08/22/2019] [Accepted: 05/10/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Reactivation of the hepatitis B virus (HBV) either during or after chemotherapy may cause serious and sometimes fatal hepatitis. All patients undergoing chemotherapy should therefore be screened in terms of HBV before chemotherapy. The purpose of this research was to identify HBV screening rates in patients with solid cancer undergoing parenteral chemotherapy and to determine the outcomes of patients undergoing HBV screening. METHODS Data for patients undergoing parenteral chemotherapy for solid cancer from January 1, 2012 to December 30, 2018 were retrieved from our electronic health record patient files in this retrospective study. Screening was defined as hepatitis B surface antigen (HBsAg) and/or hepatitis B core antibody (HBcAb) tests carried out within six months prior the first chemotherapy session. RESULTS Four thousand fifty-eight (63%) of the 6440 patients who underwent parenteral chemotherapy were screened for HBsAg and/or HBcAb. The proportions of patients screened for HBsAg and HBcAb improved from 38.8% (2012) to 76.3% (2018), and from 0.2% (2012) to 43% (2018), respectively (P<0.001). The HBsAg and HBcAb positivity rates were 2.9% and 36.5%, respectively. Antiviral prophylaxis was started in 11.8% of HBsAg-negative/HBcAb-positive patients and 40.5% of HBsAg-positive patients. HBV reactivation did not occur in patients receiving antiviral prophylaxis, but was identified in 7.2% of HBsAg-positive patients and 0.6% of HBsAg-negative/HBcAb-positive patients without antiviral prophylaxis. CONCLUSION Although HBV screening rates before chemotherapy are increasing among solid cancer patients, the rate of initiation of antiviral prophylaxis is still low. It is therefore important to raise awareness regarding HBV reactivation during/after chemotherapy.
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Affiliation(s)
- Sami Fidan
- Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Evren Fidan
- Department of Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Celal Alandağ
- Department of Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Murat Erkut
- Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Arif Mansur Cosar
- Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Fidan S, Capkın E, Arıca DA, Durak S, Okatan IE. Risk of hepatitis B reactivation in patients receiving anti-tumor necrosis factor-α therapy. Int J Rheum Dis 2020; 24:254-259. [PMID: 33244900 DOI: 10.1111/1756-185x.14034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 09/28/2020] [Revised: 11/03/2020] [Accepted: 11/07/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of this study was to determine hepatitis B virus (HBV) screening rates in patients receiving anti-tumor necrosis factor (TNF)-α therapy and the frequency of HBV reactivation in patients with resolved hepatitis B virus infection (hepatitis B surface antigen [HBsAg] negative, hepatitis B core antibody [Anti-HBc] positive). PATIENTS AND METHODS Data from 1834 patients who underwent anti-TNF-α therapy in the Rheumatology, Gastroenterology and Dermatology Departments of our hospital between 2010 and 2020 were retrospectively analyzed. Within 6 months before the initial anti-TNF-α therapy, performing a HBsAg and/or anti-HBc test is defined as HBV screening. HBV reactivation is defined as the presence of detectable serum HBV DNA or HBsAg seroconversion from negative to positive. RESULTS The overall HBV screening rate was 82.3% before starting anti-TNF-α therapy. There was an increasing trend in HBV screening rates during the years analyzed (64% in 2010, 87.4% in 2019) (P < .001). Before anti-TNF-α therapy was initiated, 272 patients were HBsAg negative and anti-HBc positive. Among these patients, HBV reactivation did not occur in 31 patients who received antiviral prophylaxis, whereas HBV reactivation occurred in only 1 (0.4%) of the 241 patients who did not receive antiviral prophylaxis. CONCLUSION Hepatitis B virus screening rates prior to starting anti-TNF-α therapy were relatively high, and its trend was increased by year. HBV reactivation because of anti-TNF-α use rarely occurred in patients with resolved HBV infection. Further studies are needed on whether routine anti-HBc screening and/or HBV DNA follow-up are necessary in these patients aside from HBsAg.
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Affiliation(s)
- Sami Fidan
- Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Erhan Capkın
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Deniz Aksu Arıca
- Department of Dermatology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Serdar Durak
- Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Ilyas Ercan Okatan
- Department of Rheumatology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Fidan S, Fidan E, Karaman E, Erkut M, Cosar AM. Hepatitis B Reactivation in HBsAg-negative Anti-HBc-positive patients receiving cytotoxic chemotherapy for solid tumors. Acta Gastroenterol Belg 2020; 83:426-431. [PMID: 33094590] [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: 06/11/2023]
Abstract
PURPOSE The prevalence of hepatitis B virus (HBV) reacti- vation in HBsAg-negative/anti-HBc-positive patients receiving chemotherapy for solid tumors is not fully known. The aim of this study was to investigate the incidence and outcomes of HBV reactivation in these patients. METHODS Data among 645 HBsAg-negative/ anti-HBc-positive patients who underwent intravenous chemotherapy were retrospectively analyzed. Patients were categorized into two groups, based on received antiviral prophylaxis (n = 43) or not (n = 602). HBV reactivation was defined as the presence of detectable serum HBV DNA or HBsAg seroconversion from negative to positive, with or without increased liver enzymes. RESULTS HBV reactivation was detected in 3 patients (0.49%) among non-antiviral prophylaxis group and in none of those with antiviral prophylaxis. Two of the HBV reactivation detected patients were successfully treated with rescue therapy, while the third died due to liver failure. CONCLUSIONS HBV reactivation is rare in HBsAg-negative and anti-HBc-positive patients receiving chemotherapy for solid tumors. However, considering the fatal outcomes patients must be closely monitored in terms of HBV-DNA positivity and/or HBsAg seroreversion and pre-emptive antiviral therapy must be initiated as soon as HBV reactivation occurs.
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Affiliation(s)
- S Fidan
- Department of Internal Medicine, Divisions of Gastroenterology
| | - E Fidan
- Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - E Karaman
- Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - M Erkut
- Department of Internal Medicine, Divisions of Gastroenterology
| | - A M Cosar
- Department of Internal Medicine, Divisions of Gastroenterology
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Cansu A, Bekircavusoglu S, Oguz S, Bulut E, Fidan S. Can diffusion weighted imaging be used as an alternative to contrast-enhanced imaging on magnetic resonance enterography for the assessment of active inflammation in Crohn disease? Medicine (Baltimore) 2020; 99:e19202. [PMID: 32080107 PMCID: PMC7034637 DOI: 10.1097/md.0000000000019202] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The present study aimed to investigate the potential use of T2-weighted sequences with diffusion weighted imaging (DWI) in magnetic resonance (MR) enterography instead of conventional contrast-enhanced MR imaging (MRI) sequences for the evaluation of active inflammation in Crohn disease.Two-hundred thirteen intestinal segments of 43 patients, who underwent colonoscopy within 2 weeks before or after MR enterography were evaluated in this retrospective study. DWI sequences, T2-weighted sequences, and contrast-enhanced T1-weighted sequences were acquired in the MR enterography scan after cleaning of the bowel and using an oral contrast agent. First, the intestinal segments that had active inflammation in MR enterography were qualitatively evaluated in T2-weighted and contrast-enhanced T1-weighted sequences and then MR activity index (MRAI 1) and MRAI 2 were formed with and without contrast-enhanced sequences in 2 separate sessions.The correlation coefficient between contrast enhanced and DWI MR enterography scores (MRAI 1 and MRAI 2) of intestinal inflammation was 0.97 for all segments. In addition, separate correlation coefficients were calculated for terminal ileum, right colon, transverse colon, left colon, and rectum, and there was a strong correlation between the MRAI 1 and MRAI 2 scores of each segment (r = 0.86-0.97, P < .001). On the other hand, MR enterography had 88.7% sensitivity, 97.9% specificity, 95.5% positive predictive value, 94.6% negative predictive value, and 94.8% accuracy for detection of active inflammation in all intestinal segments in Crohn disease.DWI and T2-weighted sequences acquired with cleaning of the bowel can be used instead of contrast-enhanced MRI sequences for the evaluation of active inflammation in Crohn disease.
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Affiliation(s)
- Aysegul Cansu
- Karadeniz Technical University, Faculty of Medicine, Department of Radiology
| | | | - Sukru Oguz
- Karadeniz Technical University, Faculty of Medicine, Department of Radiology
| | - Eser Bulut
- Trabzon Kanuni Education and Research Hospital, Department of Radiology
| | - Sami Fidan
- Karadeniz Technical University, Faculty of Medicine, Department of Gastroenterology, Trabzon, Turkey
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Toka B, Koksal AS, İskender G, Çakmak E, Üsküdar O, Sezikli M, Şirin G, Yildirim AE, Fidan S, Acar Ş, Eminler AT, Uslan MI, Hülagü S. HBV flare associated with immunosuppressive treatments: it is still dangerous in the third-generation antivirals era. Antivir Ther 2020; 25:121-129. [PMID: 32364531 DOI: 10.3851/imp3356] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND There are limited data about the mortality and morbidity of patients with HBV flare related to immunosuppressive treatments (IST) in the third-generation antivirals era. Herein, we performed a multi-centric study in patients treated with entecavir (ETV) or tenofovir disoproxil fumarate (TDF) and evaluated their clinical course. METHODS The study group included patients who were referred to gastroenterology or infectious disease specialists at eight different hospitals in Turkey. HBV flare was defined as at least a threefold elevation in alanine aminotransferase (ALT) levels above the upper limit of normal range. The demographic data, IST protocol, virological markers, liver tests, international normalized ratio (INR), HBV DNA, reactivation risk profile according to AGA guideline, MELD and MELD-Na scores were retrospectively evaluated. The primary aim of the study was to determine the liver-related mortality, including transplantation, at 12 weeks and factors predicting it. Secondary aims were to compare ETV and TDF with respect to mortality and time to ALT, bilirubin normalization and HBV DNA undetectability. RESULTS The study group included 40 patients (29 males, mean age: 57 ±12 years). Twenty-five patients (62.5%) had a high risk of reactivation. Twenty-six patients received TDF and 14 patients received ETV treatment. Eight (20%) patients developed acute liver failure and one patient (2.5%) underwent living donor liver transplantation. Seven patients died due to liver-related complications, revealing a mortality rate of 17.5%. In multivariate analysis, total bilirubin levels at the onset, ALT levels and delta-MELD score at the first week were the independent risk factors for liver related mortality (HR: 1.222, 1.003, 1.253 and 95% CI: 1.096, 1.362; 1.001, 1.004 and 1.065, 1.470, respectively). There was no significant difference between the TDF and ETV groups with respect to time to normalize ALT and bilirubin levels, HBV DNA undetectability and mortality rates (16% and 21.4%, respectively). CONCLUSIONS HBV flare associated with IST has a high mortality in the third-generation antivirals era. High total bilirubin at the onset and high ALT and delta-MELD score at the first week predict poor prognosis.
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Affiliation(s)
- Bilal Toka
- Department of Gastroenterology, University of Medical Sciences, Konya Education and Research Hospital, Konya, Turkey
| | - Aydin Seref Koksal
- Department of Gastroenterology, University Faculty of Medicine, Sakarya, Turkey
| | - Gülşen İskender
- Department of Infectious Diseases and Clinical Microbiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Erol Çakmak
- Department of Gastroenterology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Oğuz Üsküdar
- Department of Gastroenterology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Mesut Sezikli
- Department of Gastroenterology, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Göktuğ Şirin
- Department of Gastroenterology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Abdullah Emre Yildirim
- Department of Gastroenterology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Sami Fidan
- Department of Gastroenterology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Şencan Acar
- Department of Gastroenterology, University Faculty of Medicine, Sakarya, Turkey
| | - Ahmet Tarik Eminler
- Department of Gastroenterology, University Faculty of Medicine, Sakarya, Turkey
| | - Mustafa Ihsan Uslan
- Department of Gastroenterology, University Faculty of Medicine, Sakarya, Turkey
| | - Sadettin Hülagü
- Department of Gastroenterology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
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Akbulut UE, Fidan S, Emeksiz HC, Ors OP. Duodenal pathologies in children: a single‐center experience. Jornal de Pediatria (Versão em Português) 2018. [DOI: 10.1016/j.jpedp.2017.09.026] [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: 11/17/2022] Open
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Akbulut UE, Fidan S, Emeksiz HC, Ors OP. Duodenal pathologies in children: a single-center experience. J Pediatr (Rio J) 2018; 94:273-278. [PMID: 28888898 DOI: 10.1016/j.jped.2017.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 02/06/2017] [Revised: 04/14/2017] [Accepted: 04/17/2017] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Several studies have been performed concerning pathologies of the stomach and esophagus in the pediatric age group. However, there have been very few studies of duodenal pathologies in children. The authors aimed to examine the clinical, endoscopic, and histopathological characteristics, as well as the etiology of duodenal pathologies in children. METHOD Patients aged between 1 and 17 years undergoing esophagogastroduodenoscopy during two years at this unit, were investigated retrospectively. Demographic, clinical, endoscopic data, and the presence of duodenal pathologies, gastritis, and esophagitis were recorded in all of the children. RESULTS Out of 747 children who underwent endoscopy, duodenal pathology was observed in 226 (30.3%) patients. Pathology was also present in the esophagus in 31.6% of patients and in the stomach in 58.4%. The level of chronic diarrhea was higher in patients with duodenal pathology when compared with those without duodenal pathology (p=0.002, OR: 3.91, 95% CI: 1.59-9.57). Helicobacter pylori infection was more common in patients with pathology in the duodenum (59.3%). CONCLUSION Duodenal pathology was detected in 30.3% of the present patients. A significantly higher level of chronic diarrhea was observed in subjects with duodenal pathologies compared to those with no such pathology. The rate of Helicobacter pylori infection was considerably higher than that in previous studies. In addition, there is a weak correlation between endoscopic appearance and histology of duodenitis.
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Affiliation(s)
- Ulas Emre Akbulut
- Kanuni Training and Research Hospital, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Trabzon, Turkey.
| | - Sami Fidan
- Karadeniz Technical University, Faculty of Medicine, Department of Gastroenterology, Trabzon, Turkey
| | - Hamdi Cihan Emeksiz
- Kanuni Training and Research Hospital, Department of Pediatric Endocrinology, Trabzon, Turkey
| | - Orhan Polat Ors
- Istanbul Bilim University, Faculty of Medicine, Department of Anatomy, Istanbul, Turkey
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Fidan S, Erkut M, Cosar AM, Yogun Y, Örem A, Sönmez M, Arslan M. Higher Thrombin-Antithrombin III Complex Levels May Indicate Severe Acute Pancreatitis. Dig Dis 2018; 36:244-251. [PMID: 29332096 DOI: 10.1159/000485613] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 11/13/2017] [Indexed: 02/02/2023]
Abstract
AIM Coagulation disorders may develop in association with severe acute pancreatitis (AP). Plasma thrombin-antithrombin III complex (TAT) levels are one of the principal markers of coagulation disorder. The purpose of this study was to evaluate TAT and other hemostatic parameters in patients with AP and to examine whether or not these parameters indicate the severity of AP. METHOD Forty-six patients with AP (14 severe, 32 non-severe) and a 30-member healthy control group were recruited. The severity of AP was determined using the revised Atlanta classification. ELISA was used to measure patients' plasma TAT levels. RESULTS The TAT levels of AP patients at presentation were higher than those of the control group (p = 0.005). The plasma TAT levels of patients with severe AP were also significantly higher than those of patients with non-severe AP (p = 0.05) and of the control group (p < 0.001). The general accuracy, sensitivity and specificity of TAT levels in predicting the severity of AP were 77.4, 77.8, and 77.3% respectively. CONCLUSION The coagulation cascade was activated in the AP patients in our study, and this was shown to become more pronounced as severity of the disease increased. Plasma TAT levels at the time of presentation in patients with AP can be used as a marker for predicting the severity of the disease.
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Affiliation(s)
- Sami Fidan
- Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Murat Erkut
- Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Arif Mansur Cosar
- Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Yasar Yogun
- Department of Gastroenterology, Gebze Fatih State Hospital, Kocaeli, Turkey
| | - Asım Örem
- Department of Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Mehmet Sönmez
- Department of Hematology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Mehmet Arslan
- Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Fidan S, Muhaffel F, Riool M, Cempura G, de Boer L, Zaat S, Filemonowicz AC, Cimenoglu H. Fabrication of oxide layer on zirconium by micro-arc oxidation: Structural and antimicrobial characteristics. Materials Science and Engineering: C 2017; 71:565-569. [DOI: 10.1016/j.msec.2016.11.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 10/02/2016] [Accepted: 11/08/2016] [Indexed: 10/20/2022]
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Fidan S, Kocak G, Fidan E. An Unusual Metastasis of Prostate Cancer to Duodenum. J Coll Physicians Surg Pak 2016; 26:133-134. [PMID: 28666507] [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] [Received: 01/05/2016] [Accepted: 06/18/2016] [Indexed: 06/07/2023]
Abstract
Prostate cancer is the second most common cancer in men in the world. The presentation of this cancer may range from microscopic to metastatic forms. Patients with prostate cancer may experience metastasis to the gastrointestinal system. Here, we present a case of prostate cancer metastasizing to the third portion of duodenum, a very uncommon site of metastasis. To the best of authors' knowledge, this is the first case report in the literature.
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Affiliation(s)
- Sami Fidan
- Department of Gastroenterology, Kanuni Research and Training Hospital, Trabzon, Turkey
| | - Gulgun Kocak
- Department of Pathology, Kanuni Research and Training Hospital, Trabzon, Turkey
| | - Evren Fidan
- Department of Medical Oncology, Kanuni Research and Training Hospital, Trabzon, Turkey
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Avci A, Fidan S, Alıcı G, Acar G, Toprak C, Izci S, Esen AM. Coronary artery perforation after crush technique for stent compression. Herz 2014; 40:554-7. [PMID: 24737403 DOI: 10.1007/s00059-014-4052-y] [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] [Received: 12/08/2013] [Accepted: 01/01/2014] [Indexed: 11/28/2022]
Affiliation(s)
- A Avci
- Cardiology Department, Kartal Koşuyolu High Specialty Education and Research Hospital Kartal/Istanbul, Denizer Cad., 34846, Kartal/Istanbul, Turkey,
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Açar G, Fidan S, Topal YK, Uslu Z, Avci A, Alizade E, Esen A. PP-225 Unusual Case of Isomerism: Demonstration of Extracardiac Venous Anomalies by CT Angiography. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.246] [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: 10/25/2022]
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Cansu A, Ahmetoglu A, Kul S, Yukunc G, Fidan S, Arslan M, Topbas M. Diagnostic performance of using effervescent powder for detection and grading of esophageal varices by multi-detector computed tomography. Eur J Radiol 2013; 83:497-502. [PMID: 24355657 DOI: 10.1016/j.ejrad.2013.11.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 08/31/2013] [Revised: 10/24/2013] [Accepted: 11/21/2013] [Indexed: 12/22/2022]
Abstract
PURPOSE To investigate the effect of using effervescent powder (EP) on the efficacy of multi-detector computed tomography (MDCT) in detection and grading of esophageal varices in cirrhotic patients by considering endoscopy as the gold standard. MATERIALS AND METHODS Ninety-two cirrhotic patients undergoing biphasic liver MDCT followed by upper gastrointestinal endoscopy within 4 weeks of MDCT were prospectively evaluated. The patients were divided into two groups before MDCT. The first group (n=50) received effervescent powder (EP) before and during MDCT procedure and the second group did not receive (n=42). The presence, size and grade of the esophageal varices were evaluated. MDCT findings were compared with endoscopic results. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of MDCT with EP and without EP were calculated and compared. Correlations between the grades of the varices for each group based on MDCT imaging and endoscopic grading were also evaluated. RESULTS The sensitivity, specificity, accuracy, PPV, and NPV of MDCT were 100%, 88%, 96%, 94%, and 100%, respectively, in the EP group, whereas they were 76%, 67%, 74%, 89%, and 43%, respectively, in the non-EP group. Correlations between the grades of the esophageal varices on MDCT and endoscopy were significant in both groups (r=0.94, p<0.001 for EP group and r=0.70, p<0.001 for non-EP group). CONCLUSION During periodic CT scanning of cirrhotic patients, use of EP increases the success rate of MDCT for detection and grading of esophageal varices.
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Affiliation(s)
- Aysegul Cansu
- Department of Radiology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey.
| | - Ali Ahmetoglu
- Department of Radiology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey
| | - Sibel Kul
- Department of Radiology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey
| | - Gokcen Yukunc
- Department of Radiology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey
| | - Sami Fidan
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey
| | - Mehmet Arslan
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey
| | - Murat Topbas
- Department of Public Health, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey
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Açar G, Fidan S, Alici G, Tabakci MM, Avci A, Pala S. Retrieval of a malpositioned left subclavian artery stent from the ascending aorta: combined percutaneous and surgical management. Herz 2013; 40:325-8. [PMID: 24297399 DOI: 10.1007/s00059-013-4005-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 10/12/2013] [Accepted: 10/15/2013] [Indexed: 11/29/2022]
Abstract
Chronic upper limb ischemia is an uncommon clinical condition and is most often caused by subclavian artery stenosis. Surgical and percutaneous treatment modalities have been shown to be effective for the management of subclavian artery occlusion. Because of lower mortality and morbidity rates, percutaneous interventions for subclavian arterial occlusions are more acceptable than surgery. Chronic total occlusions of the subclavian artery are challenging to treat percutaneously because of the structure and complexity of the lesion. The complexity of the lesion causes its own complications. In this paper, we report a case of a completely occluded left subclavian artery that was complicated by a malpositioned stent hanging into the aortic arch and the ascending aorta during percutaneous intervention, which was successfully managed by our heart team.
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Affiliation(s)
- G Açar
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Denizer Street, Cevizli Kavsagi, No: 2, 34846, Kartal/Istanbul, Turkey,
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Fidan S, Izci S, Tellice M, Alizade E, Açar G. ST elevation myocardial infarction after use of pseudoephedrine : which is more dangerous, the common cold itself or the medication used for it? Herz 2013; 40:144-6. [PMID: 23999667 DOI: 10.1007/s00059-013-3952-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 08/04/2013] [Accepted: 08/11/2013] [Indexed: 11/30/2022]
Affiliation(s)
- S Fidan
- Cardiology Clinic, Kartal Kosuyolu High Speciality Education and Research Hospital, Denizer Street, 34846, Kartal/Istanbul, Turkey,
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Fidan E, Mentese A, Kavgaci H, Orem A, Fidan S, Uzun A, Ozdemir F, Aydin F. Increased ischemia-modified albumin levels in patients with gastric cancer. Neoplasma 2012; 59:393-7. [PMID: 22489694 DOI: 10.4149/neo_2012_051] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Reactive oxygen species (ROS) are found in the development stages of carcinogenesis. Fifty two patients with gastric cancer and 35 controls were enrolled in this trial. IMA, MDA, Total Oxidant Status (TOS), Total Antioxidant Status (TAS) and Oxidative Stress Index (OSI) were evaluated. There was a significant increase in IMA and MDA levels in the patient group (0.405±0.111, 0.271±0.066; p= 0.0001 and 0.207±0.251, 0.077±0.103; p= 0.004 respectively). TOS was also higher in the patient group but it was not statistically different. TAS was statistically lower and there was significant difference in OSI (0.621±0.394, 0.996±0.37; p=0.0001 and 9.68±18.2, 2.9±3.85; p=0.001 respectively). The areas under receiver operating characteristics curves for the determination of gastric cancer were 0.842 for IMA and 0.708 for MDA. Increased levels of IMA, MDA and oxidative stress index were detected and this condition is associated with the impairment of oxidant-antioxidant balance.
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Affiliation(s)
- E Fidan
- Division of Medical Oncology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
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Fidan E, Kavgaci H, Orem A, Yilmaz M, Yildiz B, Fidan S, Akcan B, Ozdemir F, Aydin F. Thrombin activatable fibrinolysis inhibitor and thrombin-antithrombin-III-complex levels in patients with gastric cancer. Tumour Biol 2012; 33:1519-25. [PMID: 22535370 DOI: 10.1007/s13277-012-0403-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 04/13/2012] [Indexed: 10/28/2022] Open
Abstract
The relation between cancer and coagulation is the subject of investigation since a relation between tumor and thrombosis has been determined. Antithrombin III is an important thrombin inhibitor, and increased thrombin-antithrombin (TAT) complex levels activate coagulation. Activated thrombin activatable fibrinolysis inhibitor (TAFI) inhibits the conversion of plasminogen to plasmin. In addition, it directly inactivates plasmin. Defective fibrinolysis increases the risk of thrombosis. In this study, we evaluated homeostatic parameters, TAFI, and TAT levels in patients with gastric cancer applying to the medical oncology outpatient clinic. Fifty-two patients and 35 healthy controls were included. ELISA was used to measure TAFI and TAT complex levels. These were statistically higher in the patient group (p < 0.05 and p = 0.001, respectively). D-dimer levels were higher in stage IV (p = 0.05). Correlations between lymph nodes and TAFI and TAT levels were examined. Weak but positive correlation between lymph nodes and TAFI was detected (R = 0.452, p = 0.027). TAFI and TAT levels were evaluated using relative operating characteristic analysis to differentiate the disease. TAT was more specific than TAFI according to this analysis (TAFI area under curve (AUC), 0.676; TAT AUC, 0.874). Thrombotic events and bleeding disorders need to be borne in mind in gastric cancer. This situation is due to the impairment of the balance between coagulation and fibrinolysis. Further studies are now needed to evaluate the effects of TAFI and TAT on survey and prognosis as well as the potential of these parameters as tumor markers for gastric cancer.
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Affiliation(s)
- Evren Fidan
- Division of Medical Oncology, School of Medicine, Karadeniz Technical University, 61080, Trabzon, Turkey.
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Fidan E, Fidan S, Yildiz B, Durmus I, Kavgaci H, Ozdemir F, Aydin F. Bolus fluorouracil induced syncope and pulseless ventricular tachycardia: a case report. Hippokratia 2011; 15:93-95. [PMID: 21607046 PMCID: PMC3093156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
5-fluorouracil is an anti-cancer drug commonly used in oncology practice. Typical side effects are myelosupression, nausea, vomiting, diarrhea and stomatitis. Cardiotoxicity is the other toxicity. Cardiac side effects are ST segment changes, rhythm abnormalities, supraventricular and ventricular dysrhytmias. Pulseless ventricular tachycardia and ventricular fibrillation releated with bolus fluorouracil were not detected in the literature. Here we discussed a 46 year-old male patient that has no known cardiac history. After bolus fluorouracil administration, syncope and pulseless ventricular tachycardia developed in this patient. There are a few explanations about the cardiotoxicity of fluorouracil. One of these is the effect on nitric oxide. It causes a reduction in the levels of endothelial NO and this leads coronary vasospasm. Another explanation is protein kinase C mediated vasospasm. In animal studies toxic myocarditis like lesions were detected with fluorouracil infusions. Finally both myocardit and vasospasm may lead cardiac problems like sudden cardiac deaths. Bolus 5-fluorouracil is as cardiotoxic as 5-fluorouracil infusion and we must be careful about the arrhytmia after the bolus administration.
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Erem C, Hacihasanoglu A, Sari A, Onder Ersöz H, Ukinç K, Fidan S. A rare case and a rapid tumor response to therapy: dramatic reduction in tumor size during octreotide treatment in a patient with TSH-secreting pituitary macroadenoma. Endocrine 2004; 25:141-5. [PMID: 15711028 DOI: 10.1385/endo:25:2:141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 09/21/2004] [Revised: 10/17/2004] [Accepted: 11/02/2004] [Indexed: 11/11/2022]
Abstract
Thyrotropin (TSH)-secreting pituitary adenomas are the less frequent form of presentation of pituitary tumors. The presence of somatostatin receptors on TSH-secreting adenomas allows treatment of central hyperthyroidism with somatostatin analogs. We report a 21-yr-old woman with TSH-secreting pituitary macroadenoma, who was diagnosed based on the symptoms of hyperthyroidism, the lack of inhibition of serum TSH despite an increased serum free thyroxine (FT4), a low response of serum TSH to thyrotropin-releasing hormone, and a pituitary tumor as revealed by magnetic resonance imaging. The treatment with the somatostatin analog octreotid resulted in inhibition of serum TSH and FT4 to euthyroid levels with concomitant clinical improvements such as the disappearance of sweating, tachycardia, and finger tremors within 7 d. The tumor size diminished dramatically within 6 wk during treatment of one monthly im injection of 20 mg octreotide-LAR. These effects were continued over 2 yr after the start of octreotide-LAR therapy. Therefore, octreotide-LAR appears to be a useful therapeutic tool to facilitate the medical treatment of TSH-secreting pituitary tumors.
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Affiliation(s)
- Cihangir Erem
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
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Pommier J, Laurent-Beq A, Beurrier B, Fidan S, Guilhem L, Jeandel L, Ligoure V, Thomas V. [Hospital nurses' perception of public health]. Sante Publique 2004; 16:383-92. [PMID: 15360195 DOI: 10.3917/spub.042.0383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The objective of this work was to study hospital nurses' perceptions of public health based on a pedagogical exercise. A qualitative study, lead by students of a training institute for nursing care (IFSI), was conducted using semi-directed interviews of hospital nurses from different departments of a provincial hospital. The main results show that for one-third of the nurses interviewed, the hospital is not a setting for public health practice. In terms of their definition of public health, it is closely linked to the concept of prevention, with primarily individual approaches. This definition is very close to the public health activities that they conduct at the hospital and which are centred on information and disease prevention, on education related to pathologies and the relationship between the provision of care and listening to the patients and their families. Few nurses place their public health activities within the scope of the areas of hospital cleanliness, the welcoming of the patients, the organisation of services, and the improvement of the quality of care. The potential tracks which have emerged from this work lead to the need for the strengthening of training in patient education, in the hospital's work networking with external partners, and in better development of public health activities undertaken in the hospital setting.
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McLaughlin W, Miller A, Fidan S, Pejtersen K, Batsberg Pedersen W. Radiochromic plastic films for accurate measurement of radiation absorbed dose and dose distributions. ACTA ACUST UNITED AC 1977. [DOI: 10.1016/0146-5724(77)90017-6] [Citation(s) in RCA: 56] [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: 11/29/2022]
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