1
|
Buldukoglu OC, Ocal S, Cekin AH. Strict diagnostic criteria can lead to underestimation of risk of acute diverticulitis. Scand J Gastroenterol 2024; 59:631. [PMID: 38328908 DOI: 10.1080/00365521.2024.2314144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/09/2024]
Affiliation(s)
- Osman Cagin Buldukoglu
- Department of Gastroenterology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Serkan Ocal
- Department of Gastroenterology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Ayhan Hilmi Cekin
- Department of Gastroenterology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| |
Collapse
|
2
|
Ocal R, Buldukoglu OC, Hasoglan MG, Korucuk M, Cekin Y, Ocal S. Migraine and gasdermin D: a new perspective on the inflammatory basis of migraine. Acta Neurol Belg 2024:10.1007/s13760-024-02523-y. [PMID: 38526645 DOI: 10.1007/s13760-024-02523-y] [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] [Received: 09/07/2023] [Accepted: 03/01/2024] [Indexed: 03/27/2024]
Abstract
Migraine is a common and disabling primary headache disorder and inflammation is a proposed factor in the complex ethiology of the disease. Gasdermin D (GSDMD) is a membrane pore-forming protein acting through the caspase system. End result is cell death caused by leakage of intracellular components to extracellular space which also results in inflammation. Stemming from this knowledge, the potential role of GSDMD in migraine was investigated in this prospective study. This prospective study was conducted between September 2022 to April 2023. 47 patients with migraine were designated as the patient group, whereas 47 healthy volunteers were designated as the control group. Serum GSDMD levels of both groups were compared, with an additional comparison between migraine patients during symptom-free and attack periods. Migraine related characteristics of the patients were also included in the study. Median GSDMD levels of the patient and control group did not reveal a significant difference. Nausea, vomiting and severity of headache were found to be correlated with GSDMD levels in migraine patients. Patients with nausea revealed a higher GSDMD level compared to patients without nausea during both symptom-free and attack periods (p = 0.021 and p = 0.01, respectively). Nausea was correlated to higher GSDMD levels in the patient population during symptom-free period (p = 0.030). The severity of pain was positively correlated with GSDMD levels during the attack period (p < 0.001). Gasdermin family and GSDMD in particular are promising prospects for therapy in a wide spectrum of disorders. Gasdermin proteins are candidates to be the focus for future studies both related to pathogenesis and drug therapy in migraine and varying inflammatory-driven clinical pictures.
Collapse
Affiliation(s)
- Ruhsen Ocal
- Department of Neurology, Antalya Training and Research Hospital, Antalya, Turkey.
| | | | | | - Meltem Korucuk
- Department of Neurology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Yesim Cekin
- Department of Medical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Serkan Ocal
- Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
| |
Collapse
|
3
|
Buldukoglu OC, Ocal S, Cekin AH. Fecal microbiota transplantation as an early therapeutic option in treatment refractory Clostridioides difficile infection. J Gastroenterol Hepatol 2024. [PMID: 38454297 DOI: 10.1111/jgh.16535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/24/2024] [Indexed: 03/09/2024]
Affiliation(s)
- O C Buldukoglu
- Department of Gastroenterology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - S Ocal
- Department of Gastroenterology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - A H Cekin
- Department of Gastroenterology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| |
Collapse
|
4
|
Ocal S, Cerci K, Buldukoglu OC, Atar GE, Harmandar FA, Cekin AH. Effect of serum vitamin D levels on the severity of acute pancreatitis: A prospective study. Pancreatology 2024; 24:206-210. [PMID: 38262841 DOI: 10.1016/j.pan.2024.01.004] [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: 05/24/2023] [Revised: 11/27/2023] [Accepted: 01/09/2024] [Indexed: 01/25/2024]
Abstract
Acute pancreatitis (AP) is a serious and complex disorder with varying disease course and severity. Early and prompt interventions are crucial in management of AP. Vitamin D, being a prominent actor in calcium metabolism, also takes part in immunity and thus in immune-system related disorders, ranging from infections to cancer. In this study, the role of vitamin D status of a patient on the severity of AP was investigated. This study was conducted between June 2021 to August 2022 with a total of 315 patients. Blood samples were obtained upon admission. A 25-(OH)D3 level less than 10 ng/ml was defined as vitamin D deficiency. 10-19 ng/ml was defined as vitamin D insufficiency whereas 20 ng/ml or above was considered to be sufficient. Scoring systems (Ranson score, CTSI, BISAP, Revised Atlanta Classification (RAC) were applied. Serum 25-(OH)D3 levels of patients with AP were found to be negatively correlated with severity of the disease according to RAC (p < 0.001). In concordance to this finding, both Ranson score and BISAP were found to be statistically significantly related to 25-(OH)D3 levels. Both scoring systems revealed higher scores in patients with insufficient or deficient levels of 25-(OH)D3. Serum 25-(OH)D3 levels were not found to be related to intensive care unit admission or mortality. This study revealed that serum 25-(OH)D3 level is related to the severity of AP. In the future, interventional studies with vitamin D therapy in otherwise serum 25-(OH)D3 deficient AP patients might reveal a new potential therapeutic agent in this mechanically complex, burdensome disorder.
Collapse
Affiliation(s)
- Serkan Ocal
- Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Kubra Cerci
- Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
| | - Osman Cagin Buldukoglu
- Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey.
| | - Galip Egemen Atar
- Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ferda Akbay Harmandar
- Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ayhan Hilmi Cekin
- Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
| |
Collapse
|
5
|
Buldukoglu OC, Ocal R, Ocal S. Crohn's Disease and Herpes Zoster: Being Mindful of Vaccination. Indian J Med Microbiol 2024; 48:100553. [PMID: 38403267 DOI: 10.1016/j.ijmmb.2024.100553] [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] [Received: 09/23/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 02/27/2024]
Abstract
Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract. Immunosuppressive therapy is the main treatment modality in Crohn's disease. Herpes zoster (HZ), caused by Varicella-zoster virus, is a relatively common albeit burdensome clinical picture mainly affecting adult population with immunosuppressive status. In this paper, we aimed to report a Crohn's disease patient with HZ to raise awareness on vaccination. There are commercially available vaccines that are shown to be safe and effective against HZ reactivation. Crohn's disease patients should be evaluated and informed about preventive options against HZ to prevent unwanted HZ-related complications.
Collapse
Affiliation(s)
- Osman Cagin Buldukoglu
- Antalya Training and Research Hospital, Department of Gastroenterology, Antalya, Turkey.
| | - Ruhsen Ocal
- Antalya Training and Research Hospital, Department of Neurology, Antalya, Turkey.
| | - Serkan Ocal
- Antalya Training and Research Hospital, Department of Gastroenterology, Antalya, Turkey.
| |
Collapse
|
6
|
Buldukoglu OC, Ocal S, Atar GE, Yildirim MB, Akbay Harmandar F, Duman A, Cekin AH. A RARE CAUSE OF DRUG-INDUCED ACUTE PANCREATITIS: SULFASALAZINE. Gastroenterol Nurs 2023; 46:249-252. [PMID: 37053374 DOI: 10.1097/sga.0000000000000718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/06/2022] [Indexed: 04/15/2023] Open
Affiliation(s)
- Osman Cagin Buldukoglu
- Osman Cagin Buldukoglu, MD, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Serkan Ocal, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Galip Egemen Atar, is Fellow, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Mustafa Burak Yildirim, is Resident, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
- Ferda Akbay Harmandar, is Assistant Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Adil Duman, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Ayhan Hilmi Cekin, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Serkan Ocal
- Osman Cagin Buldukoglu, MD, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Serkan Ocal, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Galip Egemen Atar, is Fellow, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Mustafa Burak Yildirim, is Resident, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
- Ferda Akbay Harmandar, is Assistant Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Adil Duman, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Ayhan Hilmi Cekin, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Galip Egemen Atar
- Osman Cagin Buldukoglu, MD, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Serkan Ocal, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Galip Egemen Atar, is Fellow, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Mustafa Burak Yildirim, is Resident, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
- Ferda Akbay Harmandar, is Assistant Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Adil Duman, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Ayhan Hilmi Cekin, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Mustafa Burak Yildirim
- Osman Cagin Buldukoglu, MD, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Serkan Ocal, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Galip Egemen Atar, is Fellow, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Mustafa Burak Yildirim, is Resident, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
- Ferda Akbay Harmandar, is Assistant Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Adil Duman, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Ayhan Hilmi Cekin, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ferda Akbay Harmandar
- Osman Cagin Buldukoglu, MD, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Serkan Ocal, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Galip Egemen Atar, is Fellow, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Mustafa Burak Yildirim, is Resident, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
- Ferda Akbay Harmandar, is Assistant Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Adil Duman, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Ayhan Hilmi Cekin, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Adil Duman
- Osman Cagin Buldukoglu, MD, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Serkan Ocal, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Galip Egemen Atar, is Fellow, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Mustafa Burak Yildirim, is Resident, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
- Ferda Akbay Harmandar, is Assistant Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Adil Duman, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Ayhan Hilmi Cekin, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ayhan Hilmi Cekin
- Osman Cagin Buldukoglu, MD, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Serkan Ocal, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Galip Egemen Atar, is Fellow, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Mustafa Burak Yildirim, is Resident, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
- Ferda Akbay Harmandar, is Assistant Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Adil Duman, is Specialist Doctor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
- Ayhan Hilmi Cekin, is Professor, Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey
| |
Collapse
|
7
|
Yildirim AE, Korkmaz M, Altun R, Sandikçi SC, Ocal S, Selçuk H. Is there any association between irritable bowel syndrome subgroups and autonomous dysfunction. Eur Rev Med Pharmacol Sci 2016; 20:1315-1322. [PMID: 27097952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Irritable bowel syndrome (IBS) is a common functional intestinal disorder. Although there are marked improvements in the conceptualization of IBS pathophysiology in brain-intestinal interaction disorder, there is no definite consensus in the role of autonomic dysfunction (AD) in disease development and symptom progression. The aim of this study was to evaluate autonomous dysfunction in IBS subgroups. PATIENTS AND METHODS A total of 50 patients and 49 healthy controls were included. IBS subgroup types and demographic characteristics of patients were recorded. AD investigations were made up of parasympathetic and sympathetic tests. RESULTS There was no statistically significant difference was determined between the groups in accordance to demographic characteristics such as age, gender, BMI and resting heart rate (p > 0.05). Three parasympathetic and one sympathetic autonomic neuropathy tests were found significantly different (respectively p < 0.001, p = 0.001, p = 0.016, p < 0.001, p = 0.375). There were significant decreases in parasympathetic tests in IBS-C patients; however, in the control group, there were significant decreases in sympathetic tests when compared with IBS-D patients (p < 0.001). The severity of AD in IBS-C subgroup was more pronounced than the IBS-D subgroup. No correlation was determined between dysautonomia and disease duration (p > 0.05). CONCLUSIONS AD may have a role in IBS pathophysiology. Deterioration of the autonomous system not only affects the gastrointestinal system but also other systems including the cardiovascular system. Patients may also be susceptible to more diverse problems.
Collapse
Affiliation(s)
- A E Yildirim
- Department of Gastroenterology, Department of Internal Medicine, Başkent University, Faculty of Medicine, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
8
|
Yıldırım AE, Altun R, Ocal S, Kormaz M, Ozcay F, Selcuk H. The safety and efficacy of ERCP in the pediatric population with standard scopes: Does size really matter? Springerplus 2016; 5:128. [PMID: 26933627 PMCID: PMC4760957 DOI: 10.1186/s40064-016-1749-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 02/12/2016] [Indexed: 02/07/2023]
Abstract
Experience with endoscopic retrograde cholangiopancreatography in the pediatric population is limited. The aim of this study was to evaluate the outcomes of ERCP in the pediatric population performed by adult gastroenterologists with standard duodenoscopes. This study is a structured retrospective review of endoscopic reports, computerized and paper medical records, and radiographic images of patients under the age of 18 who underwent ERCP for any indication at a tertiary referral centre. Data regarding demographic characteristics and medical history of patients, indications, technical success rate, final clinical diagnosis, and complications were analyzed. Forty-eight children with a mean age of 13 years (range 2–17) underwent a total of 65 ERCPs. The indications of ERCP were as follows; suspected choledocholithiasis (55 %), post-liver transplantation anastomotic biliary strictures (21 %), post-surgical bile duct injury (10 %), choledochal cyst (2 %), recurrent or chronic pancreatitis (10 %), and trauma (2 %). The cannulation success rate in the overall procedure was 93.8 %. Therapeutic interventions were performed in 70.7 % of patients. Post ERCP pancreatitis was the most common complication occurring in 9.2 % of patients, and no procedure related mortality occurred. When performed by well-trained adult gastroenterologists, the use of endoscopic retrograde cholangiopancreatography with standard duodenoscopes is safe in pediatric population.
Collapse
Affiliation(s)
- Abdullah Emre Yıldırım
- Department of Gastroenterology, Faculty of Medicine, Başkent University, 06500 Bahcelievler, Ankara, Turkey
| | - Reskan Altun
- Department of Gastroenterology, Faculty of Medicine, Başkent University, 06500 Bahcelievler, Ankara, Turkey
| | - Serkan Ocal
- Department of Gastroenterology, Faculty of Medicine, Başkent University, 06500 Bahcelievler, Ankara, Turkey
| | - Murat Kormaz
- Department of Gastroenterology, Faculty of Medicine, Başkent University, 06500 Bahcelievler, Ankara, Turkey
| | - Figen Ozcay
- Department of Pediatric Gastroenterology, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Haldun Selcuk
- Department of Gastroenterology, Faculty of Medicine, Başkent University, 06500 Bahcelievler, Ankara, Turkey
| |
Collapse
|
9
|
Kekilli M, Onal IK, Ocal S, Dogan Z, Tanoglu A. Inefficacy of triple therapy and comparison of two different bismuth-containing quadruple regimens as a firstline treatment option for helicobacter pylori. Saudi J Gastroenterol 2016; 22:366-369. [PMID: 27748322 PMCID: PMC5051220 DOI: 10.4103/1319-3767.191141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND/AIM Increasing resistance of Helicobacter pylori to antimicrobials necessitated the development of new regimens and the modification of existing regimens. The present study aimed to compare the efficacy of two bismuth-containing quadruple regimens-one including clarithromycin (C) instead of metronidazole (M) and triple therapy. PATIENTS AND METHODS Patients with H. pylori infection given the following regimens were sequentially enrolled in this retrospective study: (1) Triple therapy: Lansoprazole 30 mg b.i.d., clarithromycin 500 mg b.i.d., and amoxicillin 1 g b.i.d., (2) bismuth group C: Lansoprazole 30 mg b.i.d., clarithromycin 500 mg b.i.d., amoxicillin 1 g b.i.d., and bismuth subsalicylate 524 mg b.i.d., and (3) bismuth group M: Lansoprazole 30 mg b.i.d., amoxicillin 1 g b.i.d., metronidazole 500 mg t.i.d., and bismuth subsalicylate 524 mg b.i.d. for 14 days. Gastroscopy and 14 C-urea breath test were performed before enrollment, and urea breath test was repeated four weeks after the treatment. RESULTS At per-protocol analysis, the eradication rates were 64.7% (95% confidence interval 60.4-68.7) with the triple therapy (n = 504), 95.4% (95% confidence interval 91.5-99.4) with the bismuth group C (n = 501), and 93.9% (95% confidence interval 89.7-98.7) with the bismuth group M (n = 505). The eradication rates were similar between the two bismuth groups (P > 0.05) but significantly greater than that of the triple therapy (P < 0.05). CONCLUSION In our study, both of the bismuth-containing quadruple therapies reached high eradication rates, whereas triple therapy was shown to be ineffective. Moreover, clarithromycin may also be a component of bismuth-containing quadruple therapy.
Collapse
Affiliation(s)
- Murat Kekilli
- Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey,Address for correspondence: Dr. Murat Kekilli, Department of Gastroenterology, Ankara Education and Research Hospital, Şükriye Mh. Ulucanlar Cd. No: 89, 06340 Altındağ, Ankara, Turkey. E-mail:
| | - Ibrahim K. Onal
- Department of Gastroenterology, Oncology Education and Research Hospital, Ankara, Turkey
| | - Serkan Ocal
- Department of Gastroenterology, Corum State Hospital, Corum, Turkey
| | - Zeynal Dogan
- Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Alpaslan Tanoglu
- Department of Gastroenterology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
| |
Collapse
|
10
|
Kekilli M, Tanoglu A, Sakin YS, Kurt M, Ocal S, Bagci S. Is the neutrophil to lymphocyte ratio associated with liver fibrosis in patients with chronic hepatitis B? World J Gastroenterol 2015; 21:5575-5581. [PMID: 25987782 PMCID: PMC4427681 DOI: 10.3748/wjg.v21.i18.5575] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 08/22/2014] [Accepted: 09/30/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine the association between the neutrophil to lymphocyte (N/L) ratio and the degree of liver fibrosis in patients with chronic hepatitis B (CHB) infection.
METHODS: Between December 2011 and February 2013, 129 consecutive CHB patients who were admitted to the study hospitals for histological evaluation of chronic hepatitis B-related liver fibrosis were included in this retrospective study. The patients were divided into two groups based on the fibrosis score: individuals with a fibrosis score of F0 or F1 were included in the “no/minimal liver fibrosis” group, whereas patients with a fibrosis score of F2, F3, or F4 were included in the “advanced liver fibrosis” group. The Statistical Package for Social Sciences 18.0 for Windows was used to analyze the data. A P value of < 0.05 was accepted as statistically significant.
RESULTS: Three experienced and blinded pathologists evaluated the fibrotic status and inflammatory activity of 129 liver biopsy samples from the CHB patients. Following histopathological examination, the “no/minimal fibrosis” group included 79 individuals, while the “advanced fibrosis” group included 50 individuals. Mean (N/L) ratio levels were notably lower in patients with advanced fibrosis when compared with patients with no/minimal fibrosis. The mean value of the aspartate aminotransferase-platelet ratio index was markedly higher in cases with advanced fibrosis compared to those with no/minimal fibrosis.
CONCLUSION: Reduced levels of the peripheral blood N/L ratio were found to give high sensitivity, specificity and predictive values in CHB patients with significant fibrosis. The prominent finding of our research suggests that the N/L ratio can be used as a novel noninvasive marker of fibrosis in patients with CHB.
Collapse
|
11
|
Ozer Etik D, Ocal S, Boyacioglu AS. Hepatitis C infection in hemodialysis patients: A review. World J Hepatol 2015; 7:885-895. [PMID: 25937865 PMCID: PMC4411530 DOI: 10.4254/wjh.v7.i6.885] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 01/03/2015] [Accepted: 02/09/2015] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV)-related liver disease is a significant cause of morbidity and mortality in patients with end-stage renal disease (ESRD) who is treated with dialysis or kidney transplantation (KT). The survival rate for HCV-infected renal transplant recipients is better than that for HCV-infected hemodialysis patients on transplant waiting lists. Early diagnosis and treatment HCV infection prior to KT prevents complications post-transplantation and reduces mortality. In addition to screening for anti-HCV antibodies and detecting HCV RNA, percutaneous liver biopsy is particularly valuable for assessing the stage of liver damage in HCV-infected patients, because the stage of fibrosis is important determining optimal treatment for HCV. Studies have been demonstrated that with conventional interferon (IFN) monotherapy or pegylated IFN monotherapy are similar efficacy and safety in HCV-infected hemodialysis patients. Sustained viral responses (SVRs) with these monotherapies have ranged approximately 30% to 40%. Limited reports support the use of IFN and ribavirin combination therapy as antiviral treatment for ESRD patients or patients on hemodialysis. Ribavirin can be started at low dose and careful monitoring for side effects. Patients that show SVR after treatment are strong candidates for KT. It is also generally accepted that ESRD patients with decompensated cirrhosis and portal hypertension should be referred to the liver transplant team for consideration of combined liver-KT.
Collapse
|
12
|
Affiliation(s)
- Serkan Ocal
- Department of Gastroenterology, Başkent University Faculty of Medicine, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
13
|
Altun R, Yıldırım E, Ocal S, Akbaş E, Harman A, Kormaz M, Selçuk H. Transjugular intrahepatic portosystemic shunt: where are we? Turk J Gastroenterol 2014; 25:298-303. [PMID: 25141319 DOI: 10.5152/tjg.2014.5621] [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: 11/22/2022]
Abstract
BACKGROUND/AIMS The purpose of this study was to evaluate the technical/hemodynamic success, complications, and biochemical/ hematologic consequences of transjugular intrahepatic portosystemic shunt (TIPS) created with 10-mm bare stents in our patients. MATERIALS AND METHODS Data of 27 cirrhotic patients (18 men and 9 women; mean age, 39.7±18.7 years) with a median MELD score 14 (range 7-31) treated with TIPS between January 2000 and August 2010 were evaluated retrospectively. RESULTS The indications were refractory bleeding varices in 48.2%, refractory ascites in 22.2%, and Budd-Chiari syndrome in 29.6% of the patients. Technical and hemodynamic success rates were 96.3% and 92.3%, respectively. Mean portosystemic pressure gradient decreased from 21.5±5.3 mm Hg to 9±2.7 mm Hg (p<0.05). The rate of primary stent patency was 76.9% 1 year after the procedure. No statistically significant difference in shunt dysfunction was found between the groups of patients treated for Budd-Chiari syndrome and other indications (p>0.05). One patient (3.7%) had shunt dysfunction due to thrombosis within 24 hours. New and/or worsening hepatic encephalopathy occurred in 34.6% of patients. Increased age (≥40 years) was significantly related to hepatic encephalopathy in both univariate and multivariate analyses (p<0.05). Thirty-day mortality rate and 1-year transplant-free survival rate were 0% and 80.7%, respectively. CONCLUSION Transjugular intrahepatic portosystemic shunt procedure is a safe treatment for many patients with cirrhosis, but post-procedure hepatic encephalopathy and shunt dysfunction are still problems. Especially, patient age should be taken into consideration in predicting hepatic encephalopathy risk.
Collapse
Affiliation(s)
- Reskan Altun
- Department of Gastroenterology, Başkent University Faculty of Medicine, Ankara, Turkey.
| | | | | | | | | | | | | |
Collapse
|
14
|
|
15
|
Ocal S, Selcuk H, Korkmaz M, Altun R, Yildirim AE, Akbas E. Effect of HLA on hepatitis C virus clearance and persistence in anti-HCV-positive end-stage renal disease patients. Saudi J Gastroenterol 2014; 20:175-81. [PMID: 24976281 PMCID: PMC4067914 DOI: 10.4103/1319-3767.133007] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/AIMS The efficacy of immune response against hepatitis C virus (HCV) is determined by human leukocyte antigen (HLA) molecules of the host which present HCV antigens to CD4 + and CD8 + T lymphocytes. In this study, we aimed to investigate the possible relationship between the frequencies of certain HLA class I-II alleles and the natural history of HCV in patients with end-stage renal disease (ESRD). SETTINGS AND DESIGN This is a retrospective cohort study conducted in a university hospital. PATIENTS AND METHODS The present study comprised 189 ESRD patients (candidates for renal transplantation) who had positive anti-HCV antibody test. The results concerning HCV and HLA status were gathered from patients' files. The viral persistence was compared between the groups that were determined by HLA sub-typing. STATISTICAL ANALYSIS Statistical evaluation was performed using Mann-Whitney U-test, Chi-square test, and Fisher's exact test. Level of error was set at 0.05 for all statistical evaluations, and P values < 0.05 were considered statistically significant. RESULTS We found possible association between the course of HCV infection and specific HLA alleles. HLA class I CwFNx016 and HLA class II DRBFNx0110 alleles were observed more frequently in the viral clearance group (P < 0.05). The HLA class I BFNx0138 allele group was more prone to develop chronic hepatitis C (P < 0.01). CONCLUSIONS These findings suggest that HLA class I CwFNx016 and HLA class II DRBFNx0110 alleles may be associated with immunological elimination of HCV in Turkish patients on hemodialysis. HLA sub-typing could help predict the prognosis of HCV infection.
Collapse
Affiliation(s)
- Serkan Ocal
- Department of Gastroenterology, Baskent University, Faculty of Medicine, Ankara, Turkey,Address for correspondence: Dr. Serkan Ocal, Baskent University Faculty of Medicine, 06500, Bahcelievler, Ankara, Turkey. E-mail:
| | - Haldun Selcuk
- Department of Gastroenterology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - Murat Korkmaz
- Department of Gastroenterology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - Reskan Altun
- Department of Gastroenterology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - Abdullah E. Yildirim
- Department of Gastroenterology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - Enver Akbas
- Department of Gastroenterology, Baskent University, Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
16
|
Affiliation(s)
- R Altun
- Department of Gastroenterology, Baskent University Hospital, Ankara, Turkey.
| | | | | | | | | | | | | |
Collapse
|
17
|
Ocal S, Selçuk H, Korkmaz M, Unal H, Yilmaz U. Acute pancreatitis following doxycycline and ornidazole coadministration. JOP 2010; 11:614-616. [PMID: 21068497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
CONTEXT Drugs are related to the etiology of acute pancreatitis in approximately 1.4-2.0% of cases. Although antibiotics constitute a small number of the drugs suspected, tetracycline is the most encountered antibiotic among those drugs. CASE REPORT A 33-year-old woman was admitted to the emergency room complaining of nausea and abdominal pain after the use of doxycycline 500 mg and ornidazole 500 mg twice daily for three days for a vaginal infection. She experienced epigastric pain, which worsened over time and radiated to her back. After a detailed evaluation, she was diagnosed as having mild acute pancreatitis which improved with medical treatment. All other possible causes of pancreatitis were eliminated. CONCLUSIONS Antibiotic-associated pancreatitis usually has a silent and mild course. To the best of our knowledge the literature reports only two cases of doxycycline-induced acute pancreatitis reported and there are no reports of pancreatitis associated with ornidazole. Our case is the first case reported in which doxycycline and ornidazole coadministration induced acute pancreatitis.
Collapse
Affiliation(s)
- Serkan Ocal
- Department of Gastroenterology, Baskent University, Ankara, Turkey
| | | | | | | | | |
Collapse
|
18
|
Selcuk H, Uruc I, Temel MA, Ocal S, Huddam B, Korkmaz M, Unal H, Kanbay M, Savas N, Gur G, Yilmaz U, Haberal M. Factors prognostic of survival in patients awaiting liver transplantation for end-stage liver disease. Dig Dis Sci 2007; 52:3217-23. [PMID: 17406825 DOI: 10.1007/s10620-007-9742-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2006] [Accepted: 01/01/2007] [Indexed: 12/14/2022]
Abstract
In this study, we investigated possible independent predictive factors for survival, other than MELD score, in patients with cirrhosis. We reviewed the serum sodium, cholesterol, albumin, and platelet levels of 99 patients with cirrhosis and investigated the possible correlation of these parameters with survival period. We found that 77% and 81% of patients with cirrhosis were hypocholesterolemic and hypoalbuminemic, respectively. We noted that the survival time of 6 months in patients with serum sodium levels <125 mM at the time of admission to the study was 27% less than that in patients with sodium levels >130 mM. Patients with cirrhosis and serum sodium levels >130 mM survived for more than 1 year (95% CI). MELD scores of patients with serum sodium levels >130, between 125 and 129, and <125 mM were 15.8 to 19.9, 19.7 to 23.6, and 23.3 to 27.2, respectively (95% CI). In conclusion, we suggest that although all of these parameters are correlated with survival in patients with cirrhosis, the serum sodium level is the most accurate prognostic factor and a valid tool for predicting survival when considered in combination with the MELD score.
Collapse
Affiliation(s)
- Haldun Selcuk
- Department of Gastroenterology, Baskent University School of Medicine, Ankara, Turkey
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Abstract
UNLABELLED Patients with end-stage renal disease are at high risk for exposure to hepatitis C virus (HCV) infection. Although both viral replication and liver disease progression are accelerated after renal transplantation, the long-term impact of chronic HCV infection is unclear. Our aim was to analyze the course of HCV infection in renal transplant recipients and the effects of HCV reactivation on patient and graft survival. METHODS We retrospectively examined the 21-year (1985-2006) data of 1274 renal transplant recipients, 43 of whom were anti-HCV positive at the time of transplantation. RESULTS The mean posttransplant follow-up of 43 patients was 62.0 +/- 7.3 months. At the time of transplantation, HCV RNA was positive in 11 (25.6%) patients and negative in 32 (74.4%) patients. HCV reactivation was seen in 19 (45.2%) patients at a mean time of 20.8 +/- 5.7 months. In 31 (72%) patients, acute rejection occurred, whereas graft loss occurred in 10 (23%) patients. Three (7%) patients died. Among 43 patients, 22 (51.2%) were treated with interferon before transplantation. There was a statistically significant association between pretransplant interferon therapy and pretransplant HCVRNA level (P=.024), but no significant association of HCV reactivation and graft rejection, mortality, or kidney survival. CONCLUSION HCV reactivation occurred in nearly half of the renal transplant recipients, mostly in the second year. Patient survival and graft survival were not affected by HCV reactivation. Anti-HCV positivity should not preclude chronic renal failure patients from renal transplantation.
Collapse
Affiliation(s)
- N Savas
- Baskent University Department of Gastroenterology, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
20
|
Yilmaz A, Kurt S, Sarikaya B, Murat Firat M, Ocal S, Yeginsu A. Recurrent Cerebral Fat Embolism Due to Pleural Irrigation: Fat Density Lesions on CT. A Case Report. Neuroradiol J 2007; 20:287-90. [PMID: 24299668 DOI: 10.1177/197140090702000306] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2007] [Accepted: 04/23/2007] [Indexed: 11/16/2022] Open
Abstract
Fat embolism syndrome is a rare, but life-threatening problem and is usually associated with severe trauma. Neurological symptoms are variable, and the clinical diagnosis is difficult. We describe a patient with fat density lesions on cranial CT sections and discuss the etiopathogenesis of cerebral fat embolism (CFE) in this patient who does not have a history of long bone fracture, but metastatic lung disease and empyema. This is probably the first case report of CFE secondary to pleural irrigation of empyema with demonstrative CT findings.
Collapse
Affiliation(s)
- A Yilmaz
- Department of Pulmonary Disease, Gaziosmanpasa University School of Medicine; Tokat, Turkey -
| | | | | | | | | | | |
Collapse
|