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Bayram HM, Iliaz R, Gunes FE. Effects of Cornus mas L. on anthropometric and biochemical parameters among metabolic associated fatty liver disease patients: Randomized clinical trial. J Ethnopharmacol 2024; 318:117068. [PMID: 37611681 DOI: 10.1016/j.jep.2023.117068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 08/25/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cornus mas L. (Cornelian cherry, CM) fruits have been utilized for decades in numerous European and Asian countries as traditional cuisine and folk medicine. CM has antioxidant, anti-diabetic, anti-inflammatory, anti-obesity, and hypolipidemic activities due to its rich bioactive compounds, and CM fruits and other parts have been used for the prevention and treatment of a diverse variety of diseases in folk medicine. Obesity, insulin resistance, and inflammation are strongly associated with metabolic-associated fatty liver disease (MAFLD), therefore, CM may be hope for MAFLD patients. AIM OF THE STUDY The study aimed to evaluate the effect of lyophilized CM fruit powder with/without diet therapy on biochemical parameters and anthropometric measurements in patients with MAFLD. MATERIALS AND METHODS This randomized clinical trial was conducted on 87 patients with MAFLD and 21 healthy individuals. Patients were randomly assigned into 4 groups: group-1 receiving 30 g/d lyophilized CM fruit powder plus diet therapy, group-2 receiving only diet therapy, group-3 receiving only 30 g/d lyophilized CM fruit powder, and group-4 had not undertaken any pharmacological treatment and diet therapy or lyophilized CM fruit powder for 8 weeks. Biochemical parameters, and anthropometric measurements at baseline and after the intervention were taken. RESULTS After 8 weeks of intervention, a significant decrease in body weight, body mass index, body fat mass, waist and hip circumferences, fasting blood glucose, insulin, hbA1c, liver enzymes, total triglycerides, low-density lipoprotein, total cholesterol were found in group-1, 2 and 3. CONCLUSION Lyophilized CM fruit powder in addition to diet therapy and only diet therapy had a positive and similar effect on anthropometric measurements and biochemical parameters in MAFLD patients. Furthermore, only lyophilized CM fruit powder improved glycemic parameters. Therefore, lyophilized CM fruit powder may be beneficial for adult patients with MAFLD.
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Affiliation(s)
- Hatice Merve Bayram
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Gelisim University, Istanbul, Turkey.
| | - Raim Iliaz
- Division of Gastroenterology and Hepatology, Istanbul Atlas University, Istanbul, Turkey.
| | - Fatma Esra Gunes
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Medeniyet University, Istanbul, Turkey.
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Evirgen S, Cavus B, Gokturk S, Iliaz R, Ozkan ZG, Baran B, Ormeci AC, Soyer OM, Karaca C, Demir K, Besisik SF, Poyanli A, Akyuz F, Kaymakoglu S. Is the Y90-radioembolization treatment effective on the intermediate-advanced stage of hepatocellular carcinoma and what is the albumin-bilirubin score's prediction factor for survival? Hepatol Forum 2023; 4:103-107. [PMID: 37822305 PMCID: PMC10564249 DOI: 10.14744/hf.2022.2022.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/13/2023] [Indexed: 10/13/2023]
Abstract
Background and Aim Radioembolization (RE) is a one of the palliative treatments that have been used to down stage and/or increase the survival time in intermediate-advanced stages of HCC. We aimed to evaluate the clinical impact of RE and the clinical use of the albumin-bilirubin (ALBI) score as a predictor for survival in HCC patients. Materials and Methods Fifty-nine unresectable hepatocellular carcinoma (HCC) patients were enrolled. RE was performed in 28 of them (group 1) and 31 patients were followed up in the natural course (NC) (group 2). Patients were classified according to the Child-Pugh score (only cirrhotic patients), Barcelona clinic liver cancer (BCLC) staging, and ALBI scores were also calculated. Results All patients in Group 1 were cirrhotic and their BCLC stages were as follows: 60.7% stage B and 39.3% stage C. In Group 2, 83.9% of patients were cirrhotic and their BCLC stages were as follows: 9.7% stage B, 51.6% stage C, and 38.7% stage D. Mortality rates were 82% and 100% in Groups 1 and 2, respectively. The median overall survival (OS) was 13.5 months (95% CI: 10.4-16.6 months) and 4.5 months (95% CI: 3.5-5.5 months) in Groups 1 and 2, respectively (p=0.000). When RE was applied to patients with ALBI Grade 1 and 2, the median OS was statistically higher than in the NC group, respectively (p<0.001, p<0.001). Conclusion RE is an effective treatment method at the advanced stages of HCC. The ALBI score is a more useful and practical than the other prognostic tools.
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Affiliation(s)
- Sami Evirgen
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Bilger Cavus
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Suut Gokturk
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Raim Iliaz
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Zeynep Gozde Ozkan
- Department of Nuclear Medicine, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Bulent Baran
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Asli Ciftcibası Ormeci
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Ozlem Mutluay Soyer
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Cetin Karaca
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Kadir Demir
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Selman Fatih Besisik
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Arzu Poyanli
- Department of Radiology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Filiz Akyuz
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
| | - Sabahattin Kaymakoglu
- Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
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Ozturk NB, Tsagkaris C, Dolek N, Iliaz R. Clinical presentation of peritoneal tuberculosis. Proc AMIA Symp 2023; 36:259-260. [PMID: 36876276 PMCID: PMC9980671 DOI: 10.1080/08998280.2022.2144706] [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: 11/16/2022] Open
Abstract
Peritoneal tuberculosis arises from hematogenous spread of pulmonary foci or from direct spread from an adjacent structure. Diagnosis of peritoneal tuberculosis can be challenging due to nonspecific symptoms, insidious onset, and variable imaging findings. Herein, we report a patient presenting with ascites who was eventually diagnosed with peritoneal tuberculosis.
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Affiliation(s)
- Nazli Begum Ozturk
- Division of Gastroenterology and Hepatology, Istanbul University School of Medicine, Istanbul, Turkey.,Department of Internal Medicine, Beaumont Health, Royal Oak, Michigan
| | | | - Naile Dolek
- Department of Radiology, Atlas University, Istanbul, Turkey
| | - Raim Iliaz
- Division of Gastroenterology and Hepatology, Atlas University, Istanbul, Turkey
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Gokce AH, Gokce FS, Iliaz R, Gulaydin N. Transcutaneous Tibial Nerve Stimulation as Therapy for Functional Constipation. Turk J Gastroenterol 2022; 33:565-569. [PMID: 35879913 PMCID: PMC9404683 DOI: 10.5152/tjg.2022.21342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 10/12/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Functional constipation is a common disorder that is difficult to treat on occasion. Symptoms of this condition can per- sist despite dietary modification, exercise, and medication. Results of neuromodulation with nerve stimulation have been promising in terms of efficiency for treatment-resistant patients. This study aimed to investigate the efficacy of bilateral transcutaneous tibial nerve stimulation as a noninvasive treatment method for functional constipation. METHODS We evaluated 105 patients with functional constipation diagnosed using the Rome IV criteria. Bilateral transcutaneous elec- trical nerve stimulation was utilized for transcutaneous tibial nerve stimulation for 6 weeks; 3 sessions were conducted every week, with each session lasting for at least 30 minutes. The Constipation Severity Instrument was used before treatment, at the end of 6 weeks, and at 12 weeks (6 weeks after the end of treatment). The effects of transcutaneous tibial nerve stimulation on the time spent in the toilet and the use of softeners were investigated. RESULTS Of the 105 patients included in the study, 41 (39%) were male. The mean age was 43.1 (range, 19-64 years). Transcutaneous tibial nerve stimulation was found to reduce the time patients spent in the toilet. The use of softeners decreased from 76.2% to 20% (P < .001). Obstructive defecation (P < .001), colonic inertia (P < .001), pain (P < .001), and Constipation Severity Instrument total score (P < .001) improved after the 6-week treatment period. The treatment effect persisted until the 12th week. CONCLUSION Bilateral transcutaneous tibial nerve stimulation is a noninvasive, easily applicable, and effective treatment for functional constipation, without major adverse effects. Large randomized controlled trials are required so that transcutaneous tibial nerve stimula- tion can be established as an alternative treatment for functional constipation that is resistant to standard care and laxative agents.
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Affiliation(s)
- Aylin Hande Gokce
- Department of General Surgery, Istanbul Atlas University Faculty of Medicine, Istanbul, Turkey
| | - Feridun Suat Gokce
- Department of General Surgery, Istanbul Atlas University Faculty of Medicine, Istanbul, Turkey
| | - Raim Iliaz
- Department of Gastroenterology, Istanbul Atlas University Faculty of Medicine, Istanbul, Turkey
| | - Nihat Gulaydin
- Department of General Surgery, Istanbul Atlas University Faculty of Medicine, Istanbul, Turkey
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Gulaydin N, Iliaz R, Ersoz F. Inverted colonic diverticulum: An endoscopic examination and presentation. J Dig Dis 2021; 22:152-158. [PMID: 33559397 DOI: 10.1111/1751-2980.12972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/09/2020] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We aimed to determine the frequency, morphological features, differential diagnosis, possible adverse events of inverted colonic diverticulum (ICD), which may be misdiagnosed as polyps. METHODS In all, 810 patients who underwent a colonoscopy between April 2016 and November 2019 were included in the study, and their data were evaluated retrospectively. Colonoscopic procedures were performed at a single center by the same endoscopist. RESULTS Among all the 810 patients, the prevalence of diverticulum was 29.58% (121/409) in men and 25.19% (n = 101/401) in women, respectively. ICD was observed in 1.73% (n = 14) of all patients, including 11 (78.57%) men (aged 63.2 ± 12.95 years [range 47-90 years]) and three women (60.3 ± 4.04 years [range 58-65 years]). Most (63.16% [12/19]) ICD lesions were localized in the sigmoid colon. And the diagnosis was confirmed by eversion using biopsy forceps in 78.95% of them. One patient developed perforation after polypectomy with hot biopsy forceps and was treated by surgical operation. CONCLUSIONS ICD is a common lesion that may lead to serious adverse events if misdiagnosed as polyps. Differential diagnosis of ICD is crucial during the colonoscopy.
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Affiliation(s)
- Nihat Gulaydin
- Department of General Surgery, Atlas University, Istanbul, Turkey
| | - Raim Iliaz
- Department of Gastroenterology, Atlas University, Istanbul, Turkey
| | - Feyzullah Ersoz
- Department of General Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey
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Idilman R, Demir M, Aladag M, Erol C, Cavus B, Iliaz R, Koklu H, Cakaloglu Y, Sahin M, Ersoz G, Koksal İ, Karasu Z, Ozgenel M, Turan İ, Gunduz F, Ataseven H, Akdogan M, Kiyici M, Koksal AS, Akhan S, Gunsar F, Tabak F, Kaymakoglu S, Akarca US. Low recurrence rate of hepatocellular carcinoma following ledipasvir and sofosbuvir treatment in a real-world chronic hepatitis C patients cohort. J Viral Hepat 2019; 26:666-674. [PMID: 30740820 DOI: 10.1111/jvh.13075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 08/09/2018] [Accepted: 01/11/2019] [Indexed: 01/05/2023]
Abstract
The aims of the present study were to evaluate the efficacy and tolerability of ledipasvir/sofosbuvir (LDV/SOF) with or without ribavirin in the treatment of chronic hepatitis C (CHC) in patients with advanced liver disease and to analyse whether the use of LDV/SOF treatment is associated with a new occurrence of hepatocellular carcinoma (HCC) during and after LDV/SOF treatment. The Turkish Early Access Program provided LDV/SOF treatment to a total of 200 eligible CHC patients with advanced liver disease. The median follow-up period was 22 months. All patients were Caucasian, 84% were infected with genotype 1b, and 24% had a liver transplantation before treatment. The sustained virological response (SVR12) was 86.0% with ITT analysis. SVR12 was similar among patients with Child-Pugh classes A, B and C disease and transplant recipients. From baseline to SVR12, serum ALT level and MELD score were significantly improved (P < 0.001). LDV/SOF treatment was generally well tolerated. Only one patient developed a new diagnosed HCC. Seventeen of the 35 patients, who had a history of previous HCC, developed HCC recurrence during the LDV/SOF treatment or by a median follow-up of 6 months after treatment. HCC recurrence was less commonly observed in patients who received curative treatment for HCC compared with those patients who received noncurative treatment (P = 0.007). In conclusion, LDV/SOF with or without ribavirin is an effective and tolerable treatment in CHC patients with advanced liver disease. Eradication is associated with improvements in liver function and a reduced risk of developing a new occurrence of HCC.
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Affiliation(s)
- Ramazan Idilman
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
| | - Mehmet Demir
- Department of Gastroenterology, Mustafa Kemal University School of Medicine, Hatay, Turkey
| | - Murat Aladag
- Department of Gastroenterology, İnönü University School of Medicine, Malatya, Turkey
| | - Cihan Erol
- Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Bilger Cavus
- Department of Gastroenterology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Raim Iliaz
- Department of Gastroenterology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Hayrettin Koklu
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Yilmaz Cakaloglu
- Department of Gastroenterology, Memorial Sisli Hospital, İstanbul, Turkey
| | | | - Galip Ersoz
- Department of Gastroenterology, Ege University School of Medicine, İzmir, Turkey
| | - İftihar Koksal
- Department of Infectious Disease, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
| | - Zeki Karasu
- Department of Gastroenterology, Ege University School of Medicine, İzmir, Turkey
| | - Meric Ozgenel
- Department of Gastroenterology, Osmangazi University School of Medicine, Eskişehir, Turkey
| | - İlker Turan
- Department of Gastroenterology, Ege University School of Medicine, İzmir, Turkey
| | - Feyza Gunduz
- Department of Gastroenterology, Marmara University School of Medicine, İstanbul, Turkey
| | - Huseyin Ataseven
- Department of Gastroenterology, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey
| | - Meral Akdogan
- Department of Gastroenterology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
| | - Murat Kiyici
- Department of Gastroenterology, Uludag University School of Medicine, Bursa, Turkey
| | - Aydın Seref Koksal
- Department of Gastroenterology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Sila Akhan
- Department of Gastroenterology, Kocaeli University School of Medicine, Department of Infectious Disease and Clinical Microbiology, Kocaeli, Turkey
| | - Fulya Gunsar
- Department of Gastroenterology, Ege University School of Medicine, İzmir, Turkey
| | - Fehmi Tabak
- Department of Infectious Disease and Clinical Microbiology, İstanbul University Cerrahpasa School of Medicine, İstanbul, Turkey
| | - Sabahattin Kaymakoglu
- Department of Gastroenterology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Ulus S Akarca
- Department of Gastroenterology, Ege University School of Medicine, İzmir, Turkey
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Abstract
Background Neurologic and liver involvement in Wilson's disease (WD) is well-documented, however, few reports demonstrated cardiac involvement. Tpe and Tpe/QT are new measures of ventricular repolarization which were recently suggested as predictor of arrythmogenesis. We aimed to evaluate ventricular depolarization and repolarization parameters including QT, QTc, Tpe intervals, Tpe/QT, Tpe/QTc ratios, and QT dispersion (QTd) in patients with WD. Materials and methods Thirty-five patients with WD and 30 healthy controls were included in the study. Patients were evaluated by a neurologist in addition to MR imaging. Twenty-one of 35 patients were diagnosed as neuroWilson (NW), whereas 14 patients as non-NW. ECG recordings were obtained using a 12-lead commercial device (Cardiac Science, Burdick s500,USA). All patients underwent standard echocardiographic evaluation. These two groups of patients and healthy controls were compared. Results There were no difference between patients with WD and healthy controls in terms of age sex, BMI, liver, and kidney functions where as patients with WD were anemic and thrombocytopenic. Left atrial, ventricular dimensions, left ventricular systolic, and diastolic functions were similar between patients and healthy control. QT interval was prolonged in patient group, however, QTc, Tpe intervals, Tpe/QT, and Tpe/QTc ratios and QTd did not differ between groups. When patients with NW and non-NW were compared, both QT and QTc intervals were significantly longer in patients with NW, however, Tpe interval, Tpe/QT and Tpe/QTc ratios, and QTd did not differ. Conclusion QT and QTc intervals are prolonged in patients with Wilson's disease and neurologic involvement.
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Affiliation(s)
- Semi Ozturk
- Department of Cardiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Seyfeddin Gurbuz
- Meram Faculty of Medicine, Department of Cardiology, Necmettin Erbakan University, Konya, Turkey
| | - Suleyman Cagan Efe
- Department of Cardiology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Raim Iliaz
- Department of Gastroenterology, Medicine Hospital, Istanbul, Turkey
| | - Mutse Banzragch
- Department of Gastroenterology, Acıbadem University Faculty of Medicine, Kocaeli Hospital, Kocaeli, Turkey
| | - Kadir Demir
- İstanbul Faculty of Medicine, Department of Gastroenterology, Istanbul University, Istanbul, Turkey
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Iliaz R, Cavus B, Yegen G, Alcin G, Gulluoglu M, Karaca C, Demir K, Besısık F, Kaymakoglu S, Turkmen C, Akyuz F. Should we worry about incidental gastrointestinal tract involvement in positron emission tomography/computed tomography as gastroenterologist? Acta Gastroenterol Belg 2018; 81:471-475. [PMID: 30645914] [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: 06/09/2023]
Abstract
BACKGROUND AND AIM Positron emission tomography/computed tomography(PET/CT) scans detects benign clinical conditions in addition to malignancy, and this leads to additional investigation and expenditure. The purpose of our study was to assess the endoscopic and histopathologic results of incidental 18F-FDG uptake in the GI tract. PATIENTS AND METHOD We enrolled 110 patients who underwent gastroscopy/colonoscopy for incidental GI tract involvement in PET/CT. Histopathologic and endoscopic results were compared with FDG uptake level, pattern of uptake(diffuse/focal), and site of involvement. RESULTS In our study, 52.7% of the patients were male and the mean age was 57±11 years. Among the participants, 47.3% and 52.7% of patients had upper GI tract and colorectal involvement in PET/CT, respectively. Gastritis and colonic polyps were the most common endoscopic diagnoses that caused FDG uptake in the upper and lower GI tract, respectively. Endoscopic evaluation was normal in 23.6% of patients with pathologic FDG involvement. The rates of adenomatous polyps, malignancy, and hyperplastic polyps were 18.5%, 13.6%, and 6.8%, respectively. The mean SUVmax were higher in malignant lesions than in non-malignant lesions (14.3±8.9 vs. 9.3±5.3)(p=0.02). Diffuse or focal FDG involvement patterns on PET/CT did not help to discriminate malignancy in the GI tract. CONCLUSION Malignancy was detected in only 13.6% of patients with FDG involvement in the GI tract, and the involvement pattern(diffuse/focal) and SUVmax did not differentiate malignancy.
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Affiliation(s)
- R Iliaz
- Biruni University Medical Faculty, Department of Gastroenterology
| | - B Cavus
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology
| | - G Yegen
- Istanbul University, Istanbul Medical Faculty, Department of Pathology
| | - G Alcin
- Karadeniz Technical University, Department of Nuclear Medicine
| | - M Gulluoglu
- Istanbul University, Istanbul Medical Faculty, Department of Pathology
| | - C Karaca
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology
| | - K Demir
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology
| | - F Besısık
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology
| | - S Kaymakoglu
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology
| | - C Turkmen
- Istanbul University, Istanbul Medical Faculty, Department of Nuclear Medicine
| | - F Akyuz
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology
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Ozturk N, Ozkan E, Avci M, Iliaz R, Atasoy A, Akyuz F, Demir K, Kaymakoglu K, Gulluoglu M, Besisik F. S22-2NON-ALCOHOLIC HEPATIC STEATOSIS AND LIVER FEATURES AMONG PATIENTS WITH CHRONIC HEPATITIS B. Alcohol Alcohol 2017. [DOI: 10.1093/alcalc/agx075.85] [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: 11/12/2022] Open
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Iliaz R, Akyuz U, Tekin D, Serilmez M, Evirgen S, Cavus B, Soydinc H, Duranyildiz D, Karaca C, Demir K, Besisik F, Kaymakoglu S, Akyuz F. Role of several cytokines and adhesion molecules in the diagnosis and prediction of survival of hepatocellular carcinoma. Arab J Gastroenterol 2017; 17:164-167. [PMID: 27916547 DOI: 10.1016/j.ajg.2016.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 07/18/2016] [Revised: 09/24/2016] [Accepted: 10/30/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND STUDY AIMS There is still need for accurate markers for early diagnosis of hepatocellular carcinoma (HCC) and assessment of prognosis. The aim of this study is to investigate interleukin (IL)-32, IL-1 beta, IL-18, vascular cell adhesion molecule (VCAM)-1, and epithelial cell adhesion molecule (EpCAM) in the diagnosis and assessment of prognosis of HCC. PATIENTS AND METHODS Fifty patients with HCC and 15 healthy volunteers were enroled into this prospective study. Serum samples were obtained at the first admission before any treatment was given. Serum IL-32, IL-1 beta, IL-18, VCAM-1, and EpCAM levels were determined using ELISA kits. RESULTS The mean age of the patient group and controls was 60±9years and 56±8years, respectively. The mean serum level of IL-32 was higher in patients with HCC than in the control subjects (65.1 vs. 14.1pg/mL; p<0.001). IL-18 levels were significantly higher in the HCC group (546.5 vs. 157.8pg/mL; p<0.001). EpCAM (20.3 vs. 1.5pg/mL; p<0.001) and VCAM (6.5 vs. 1.8μg/mL; p<0.001) levels were also higher in patients with HCC. The mean level of IL-1 beta in the HCC group was similar to that in the control subjects (1.9 vs. 1.9pg/mL; p=0.97). Fifty-eight per cent of the patients with HCC died at 7.3months (median). Cytokine levels except EpCAM did not correlate with survival (p>0.05). Alpha-foetoprotein, IL-32, IL-18, EpCAM, and VCAM had valuable cutoff levels to differentiate between patients with HCC and control group (p<0.001). CONCLUSIONS Although cytokines can be a diagnostic marker for HCC, they did not have any significant prognostic value in patients with HCC. Only EpCAM may be used to determine the prognosis of HCC, thereby assisting with treatment management.
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Affiliation(s)
- Raim Iliaz
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology, Istanbul, Turkey
| | - Umit Akyuz
- Yeditepe University, Department of Gastroenterology, Istanbul, Turkey
| | - Didem Tekin
- Istanbul University, Istanbul Medical Faculty, Institute of Oncology, Istanbul, Turkey
| | - Murat Serilmez
- Istanbul University, Istanbul Medical Faculty, Institute of Oncology, Istanbul, Turkey
| | - Sami Evirgen
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology, Istanbul, Turkey
| | - Bilger Cavus
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology, Istanbul, Turkey
| | - Hilal Soydinc
- Istanbul University, Istanbul Medical Faculty, Institute of Oncology, Istanbul, Turkey
| | - Derya Duranyildiz
- Istanbul University, Istanbul Medical Faculty, Institute of Oncology, Istanbul, Turkey
| | - Cetin Karaca
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology, Istanbul, Turkey
| | - Kadir Demir
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology, Istanbul, Turkey
| | - Fatih Besisik
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology, Istanbul, Turkey
| | - Sabahattin Kaymakoglu
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology, Istanbul, Turkey
| | - Filiz Akyuz
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterology, Istanbul, Turkey.
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Iliaz S, Tanriverdio E, Chousein EGU, Ozturk S, Iliaz R, Cetinkaya E, Caglar E. Importance of pulmonary artery to ascending aorta ratio in chronic obstructive pulmonary disease. Clin Respir J 2017; 12:961-965. [PMID: 28085229 DOI: 10.1111/crj.12612] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 12/20/2016] [Accepted: 12/21/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Recent articles revealed that an increased main pulmonary artery to ascending aorta ratio (PA/A) in thorax computed tomography (CT) correlated with pulmonary hypertension, and might be linked to a high probability of chronic obstructive pulmonary disease (COPD) exacerbations. OBJECTIVES In this study, our aim was to evaluate the clinical importance of PA/A in patients with exacerbations of COPD and investigate its relationship with the number of exacerbations in 1 year or short/long-term mortality after hospital discharge. METHODS One hundred fifty-six patients hospitalized for COPD exacerbations who fulfilled our inclusion criteria were enrolled in the study. We recorded the number of exacerbations in 1 year from hospital records, checked mortality status, and calculated the PA/A ratio from thorax CT images. RESULTS PA/A ratio positively correlated with the number of hospitalizations for COPD exacerbations and the total number of exacerbations (hospitalized or not) in 1 year, and baseline PaCO2 level during hospitalization (r = 0.376, P < 0.001, r = 0.230, P = 0.004, and r = 0.328, P < 0.001, respectively). There was no relationship between mortality and PA/A. CONCLUSION Our study showed that PA/A was related with the number of hospitalizations and the total number of exacerbations due to COPD in 1 year. However, there was no relationship between PA/A and mortality.
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Affiliation(s)
- Sinem Iliaz
- Department of Pulmonary Medicine, Koc University Hospital, Istanbul, Turkey
| | - Elif Tanriverdio
- Department of Pulmonary Medicine, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Efsun Gonca Ugur Chousein
- Department of Pulmonary Medicine, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sakine Ozturk
- Department of Pulmonary Medicine, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Raim Iliaz
- Department of Internal Medicine, Istanbul University, Istanbul Medical Faculty Hospital, Istanbul, Turkey
| | - Erdogan Cetinkaya
- Department of Pulmonary Medicine, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Emel Caglar
- Department of Pulmonary Medicine, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
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12
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Iliaz R, Iliaz S. The neutrophil-lymphocyte ratio as an inflammatory marker in acute exacerbation of COPD. Wien Klin Wochenschr 2016; 128:672-3. [PMID: 27380509 DOI: 10.1007/s00508-016-1022-9] [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] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 05/19/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Raim Iliaz
- Istanbul Medical Faculty, Department of Gastroenterology, Istanbul University, Istanbul, Turkey.
| | - Sinem Iliaz
- Department of Pulmonology, Koc University Hospital, Istanbul, Turkey
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13
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Iliaz R, Iliaz S. Comorbidities in elderly patients with pulmonary disease. Geriatr Gerontol Int 2016; 16:881-2. [DOI: 10.1111/ggi.12649] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Raim Iliaz
- Istanbul Medical Faculty; Department of Gastroenterology; Istanbul University; Istanbul Turkey
| | - Sinem Iliaz
- Department of Pulmonary Medicine; Koç University Hospital; Istanbul Turkey
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14
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Mirioglu S, Cavus B, Iliaz R, Besisik F. Diffuse Cavernous Hemangioma of the Colon. Acta Gastroenterol Belg 2016; 79:393-394. [PMID: 27821043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A 70-year-old man was admitted to our clinic with a history of rectal bleeding and constipation, his colonoscopy revealed varicosities and bluish nodular lesions of the rectum (Figure 1). Abdominal CT showed multiple nodular lesions beginning from the distal descending colon and extending to the rectum, calcifications suggesting phleboliths were also seen in these lesions. A contrast enhanced pelvic MRI demonstrated multiple tubular lesions showing hyperintensity on T2-weighted images and hypointensity on T1-weighted images, consistent with the affected areas on the CT scan (Figure 2). It was a diffuse cavernous hemangioma, which mostly affects the rectosigmoid colon in the gastrointestinal tract, and can clinically mimic internal hemorrhoids, ulcerative colitis or cancer (1). Gastrointestinal hemangioma is a rare benign vascular neoplasm, and might be associated with a congenital disorder like Osler-Weber-Rendu disease, Maffucci's syndrome, Klippel-Trénaunay syndrome, or the congenital blue rubber bleb nevus syndrome (2). Even though there are different medical treatment options targeting VEGF and FGF-mediated pathways such as bevacizumab and thalidomide, and endoscopic approaches like sclerotherapy and electrocautery; complete resection of the hemangioma is the only curative treatment method (1, 3). Therefore, the patient was referred to department of surgery for a definitive treatment, and lost to follow-up.
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Ortakoylu MG, Iliaz S, Bahadir A, Aslan A, Iliaz R, Ozgul MA, Urer HN. Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in various lung diseases. J Bras Pneumol 2016; 41:410-4. [PMID: 26578131 PMCID: PMC4635086 DOI: 10.1590/s1806-37132015000004493] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 06/11/2015] [Indexed: 12/25/2022] Open
Abstract
Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of lung disease, and its use is increasing worldwide. It has been used as a means of diagnosing lung cancer in its initial stages, and there are data supporting its use for the diagnosis of benign lung disease. The aim of this study was to share our experience with EBUS-TBNA and discuss its diagnostic value. Methods: We retrospectively analyzed the results related to 159 patients who underwent EBUS-TBNA at our pulmonary medicine clinic between 2010 and 2013. We recorded the location and size of lymph nodes seen during EBUS. Lymph nodes that appeared to be affected on EBUS were sampled at least twice. We recorded the diagnostic results of EBUS-TBNA and (for cases in which EBUS-TBNA yielded an inconclusive diagnosis) the final diagnoses after further investigation and follow-up. Results: We evaluated 159 patients, of whom 89 (56%) were male and 70 (44%) were female. The mean age was 54.6 ± 14.2 years among the male patients and 51.9 ± 11.3 years among the female patients. Of the 159 patients evaluated, 115 (84%) were correctly diagnosed by EBUS. The diagnostic accuracy of EBUS-TBNA was 83% for benign granulomatous diseases and 77% for malignant diseases. Conclusions: The diagnostic value of EBUS-TBNA is also high for benign pathologies, such as sarcoidosis and tuberculosis. In patients with mediastinal disorders, the use of EBUS-TBNA should be encouraged, primarily because it markedly reduces the need for mediastinoscopy.
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Affiliation(s)
- Mediha Gonenc Ortakoylu
- Department of Pulmonology, Istanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sinem Iliaz
- Department of Pulmonology, Istanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ayse Bahadir
- Department of Pulmonology, Istanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Asuman Aslan
- Department of Pulmonology, Istanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Raim Iliaz
- Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mehmet Akif Ozgul
- Department of Pulmonology, Istanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Halide Nur Urer
- Department of Pathology, Istanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
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Iliaz S, Iliaz R, Onur ST, Arici S, Akyuz U, Karaca C, Demir K, Besisik F, Kaymakoglu S, Akyuz F. Does gastroesophageal reflux increase chronic obstructive pulmonary disease exacerbations? Respir Med 2016; 115:20-5. [PMID: 27215499 DOI: 10.1016/j.rmed.2016.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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] [Received: 03/03/2016] [Revised: 04/01/2016] [Accepted: 04/18/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND The relationship between chronic obstructive pulmonary disease (COPD) exacerbations and gastroesophageal reflux (GER) has been investigated less than asthma-GER. We aimed to evaluate the presence of GER in patients with COPD and its impact on exacerbations. METHODS We included 24 patients with stable mild-moderate stage COPD and 19 volunteers as the control group. We conducted a gastroesophageal reflux disease (GERD) symptom questionnaire, gastroscopy, manometry, and an ambulatory 24-h pH-impedance study. RESULTS According to the GERD questionnaire, only 5 (20.8%) patients with COPD had typical GER symptoms. According to the 24-h pH-impedance study, the mean DeMeester score (DMS) was 38.1 ± 34.6 in the COPD group and 13.3 ± 16.8 in the control group (p = 0.01). The acid reflux (DMS > 14.7) rate was higher in patients with COPD than in controls (73.9% vs 26.3%, p = 0.01). The symptom association probability positivity rate was 17.4% (n = 4) in the COPD group, which was similar to the controls (p = 0.11). The mean proximal extension rate of reflux (Z 17 cm) was 26.4 ± 12.9% in the COPD group. The proximal extent of reflux was positively correlated with the number of COPD exacerbations per year (p = 0.03, r = 0.448). In the motility results, only 2 (20%) patients in the control group had a minor motility disorder. Seventeen (70.8%) patients in the COPD group had a minor motility disorder, and 4 (16.7%) had major motility disorders (p < 0.001). CONCLUSION In our study, gastroesophageal reflux was frequent in patients with COPD, but only a quarter had typical reflux symptoms. The proximal extent of reflux may trigger frequent exacerbations of COPD.
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Affiliation(s)
- Sinem Iliaz
- Koç University Hospital, Department of Pulmonology, Istanbul, Turkey.
| | - Raim Iliaz
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey.
| | - Seda Tural Onur
- Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Department of Pulmonology, Istanbul, Turkey.
| | - Serpil Arici
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey.
| | - Umit Akyuz
- Fatih Sultan Mehmet Educational and Research Center, Department of Gastroenterohepatology, Istanbul, Turkey.
| | - Cetin Karaca
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey.
| | - Kadir Demir
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey.
| | - Fatih Besisik
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey.
| | - Sabahattin Kaymakoglu
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey.
| | - Filiz Akyuz
- Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey.
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Bahadir A, Ortakoylu MG, Iliaz S, Kanmaz ZD, Bagci BA, Iliaz R, Caglar E. Prevalence and outcomes of comorbid illnesses in elderly patients with respiratory diseases. Geriatr Gerontol Int 2015; 16:791-6. [PMID: 26178709 DOI: 10.1111/ggi.12549] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2015] [Indexed: 11/26/2022]
Abstract
AIM The aim of the present study was to determine the prevalence of comorbidities in very elderly patients hospitalized as a result of acute respiratory diseases and to analyze sex-specific differences, and to examine the effects of these comorbidities on their treatment outcomes. METHODS A total of 3316 patients were admitted to our pulmonary inpatient clinic between 2009 and 2011, and 243 of them (aged over 80 years) with acute respiratory disease were included in our study. Data were retrospectively collected, and included demographic features, comorbidities, laboratory findings, length of hospital stay and in-hospital mortality. RESULTS In total of 243, 144 patients (59.3%) were men and 99 patients (40.7%) were women. The mean age was 84 ± 3 years. The prevalence of comorbidity was 75.7% (n = 184). The most common comorbid disease in patients with chronic obstructive pulmonary disease was congestive heart failure (32.9%), and it was chronic obstructive pulmonary disease (49.4%) in patients with pneumonia. The rate of having one comorbidity was 58.2% (n = 107) and 35.3% (n = 65) had two. Approximately half (52.6%) of the in-hospital deaths occurred within the first 48 hours of hospitalization. The number of comorbidities was higher in the deceased patients compared with the living patients (P = 0.01). CONCLUSIONS The present study showed that the majority of our patients had at least one comorbidity. The first 48 hours of hospitalization was very important, especially for the patients with comorbidities, to determine the need for intensive care unit and prognosis. The coexistence of comorbidities can increase the risk of mortality in the elderly. Geriatr Gerontol Int 2016; 16: 791-796.
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Affiliation(s)
- Ayse Bahadir
- Yedikule Education and Research Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey
| | - Mediha Gonenc Ortakoylu
- Yedikule Education and Research Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey
| | - Sinem Iliaz
- Yedikule Education and Research Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey
| | - Zehra Dilek Kanmaz
- Yedikule Education and Research Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey
| | - Belma Akbaba Bagci
- Yedikule Education and Research Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey
| | - Raim Iliaz
- Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Emel Caglar
- Yedikule Education and Research Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey
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Affiliation(s)
- Raim Iliaz
- Department of Internal Medicine, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Sinem Iliaz
- Department of Pulmonary Medicine, Istanbul Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
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Iliaz S, Iliaz R. Author reply to the editor. Ann Thorac Med 2015; 10:74. [PMID: 25593614 PMCID: PMC4286852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sinem Iliaz
- Department of Pulmonary Medicine, Istanbul Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Zeytinburnu, Istanbul, Turkey. E-mail:
| | - Raim Iliaz
- Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Fatih, Istanbul, Turkey
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Iliaz S, Cagatay T, Bingol Z, Okumus G, Iliaz R, Kuran G, Kiyan E, Cagatay P. Does the 6-minute walk test predict nocturnal oxygen desaturation in patients with moderate to severe COPD? Chron Respir Dis 2014; 12:61-8. [PMID: 25480424 DOI: 10.1177/1479972314562406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Patients with chronic obstructive pulmonary disease (COPD) who have nocturnal oxygen desaturation (NOD) can be treated with nocturnal oxygen therapy (NOT) to avoid possible morbidity and mortality. Although there is no definite data recommending NOT alone, our aim is to evaluate the relationship between desaturation during the six-minute walk test (6MWT) and NOD in COPD. Fifty-five stable patients with COPD were enrolled in this study. The 6MWT and nocturnal oximetry were performed. Patients with comorbid diseases and respiratory failure were excluded. In total, 55 patients (49 males and 6 females, mean age: 65.8 ± 8.4 years) were analysed. Twenty-seven of the patients had moderate COPD and the remainder (n = 28) had severe COPD. Three patients (11%) with moderate COPD and 12 patients (42.9%) with severe COPD desaturated during 6MWT (p = 0.003). NOD was observed in five patients with severe COPD (17.9%). There were no patients with NOD in the moderate COPD group. Three (25%) of patients with severe COPD who desaturated during the 6MWT also had NOD. NOD was more common in patients with severe COPD and the patients with higher carbon dioxide levels (p = 0.02 and p = 0.001). Three patients (11%) with moderate COPD desaturated during the 6MWT; however they did not have NOD. Although the sample size in this study was too small to be conclusive, NOD was more common in desaturators during the 6MWT particularly in patients with severe COPD.
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Affiliation(s)
- Sinem Iliaz
- Department of Pulmonology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tulin Cagatay
- Department of Pulmonology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zuleyha Bingol
- Department of Pulmonology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Department of Pulmonology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Raim Iliaz
- Department of Internal Medicine, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Goksen Kuran
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Esen Kiyan
- Department of Pulmonology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Penbe Cagatay
- Department of Biostatistics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Iliaz S, Iliaz R, Ortakoylu G, Bahadir A, Bagci BA, Caglar E. Value of neutrophil/lymphocyte ratio in the differential diagnosis of sarcoidosis and tuberculosis. Ann Thorac Med 2014; 9:232-5. [PMID: 25276243 PMCID: PMC4166071 DOI: 10.4103/1817-1737.140135] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [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] [Received: 03/12/2014] [Accepted: 05/05/2014] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION: The differential diagnosis of sarcoidosis creates a challange due to tuberculosis also having lung and lymph node involvement. Because both diseases show granulomatous inflammation, it may not be possible to distinguish tuberculosis and sarcoidosis in pathological specimens. As a result of the complexity in the differential diagnosis of sarcoidosis and tuberculosis, new markers for differentiation are being investigated. OBJECTIVE: The aim of our study is to investigate the value of neutrophil/lymphocyte ratio (NLR) as a possible marker in differentiating sarcoidosis and tuberculosis. MATERIALS AND METHODS: In our study, 51 acid-fast bacilli (AFB) positive and/or culture-positive patients with pulmonary tuberculosis, 40 patients with biopsy-proven sarcoidosis and a control group consisting of 43 patients were included. In our study, information was collected retrospectively based on hospital records. RESULTS: Leukocyte and neutrophil counts, NLR, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) were significantly higher, and albumin was significantly lower in the tuberculosis group compared with sarcoidosis (for all parameters P < 0.001). The most appropriate cut-off value of NLR to distinguish tuberculosis from sarcoidosis was determined as 2.55. For this cut-off value of NLR there was 79% sensitivity, 69% specificity, 73% positive predictive value (PPV), 75% negative predictive value (NPV), and area under the curve (AUC) was 0.788. For differentiation of sarcoidosis from tuberculosis, accuracy of the NLR test according to this cut-off value was found as 76%. CONCLUSION: NLR as a little known marker in respiratory medicine was found to be supportive in differentiation of tuberculosis and sarcoidosis. More studies on this issue is needed.
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Affiliation(s)
- Sinem Iliaz
- Department of Pulmonary Medicine, Istanbul Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Zeytinburnu, Turkey
| | - Raim Iliaz
- Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Fatih, Istanbul, Turkey
| | - Gonenc Ortakoylu
- Department of Pulmonary Medicine, Istanbul Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Zeytinburnu, Turkey
| | - Ayse Bahadir
- Department of Pulmonary Medicine, Istanbul Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Zeytinburnu, Turkey
| | - Belma Akbaba Bagci
- Department of Pulmonary Medicine, Istanbul Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Zeytinburnu, Turkey
| | - Emel Caglar
- Department of Pulmonary Medicine, Istanbul Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Zeytinburnu, Turkey
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Iliaz S, Iliaz R, Avsar N, Tuncer S, Kilicaslan Z. Lung cancer presenting with choroidal metastasis in a pregnant woman. Indian J Chest Dis Allied Sci 2014; 56:249-251. [PMID: 25962199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 28-year-old, non-smoker pregnant woman who was initially diagnosed to have deep vein thrombosis and pulmonary thromboembolism earlier in pregnancy, presented at 22 weeks of gestation with dyspnoea, visual loss initially in the right eye and then in the left eye. Fundoscopic examination revealed metastatic foci, suggestive of choroid metastases. Computed tomography of the chest revealed a right hilar mass. Fibreoptic bronchoscopy and bronchoscopic biopsy confirmed lung adenocarcinoma. As the patient and family wished to continue with the pregnancy, chemotherapy with cisplatin and was administered from the 31st week of pregnancy and she had undergone Caesarian section in the 32nd week and the baby was healthy. We report this case as it is probably the first reported case of lung cancer presenting with choroidal metastasis in a pregnant woman.
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Iliaz S, Iliaz R, Erelel M. Two Cases of Arnold-Chiari Malformation with Respiratory Failure. Eur J Case Rep Intern Med 2014. [DOI: 10.12890/2014_000029] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sinem Iliaz
- Medical Faculty Pulmonary Medicine Department, Istanbul University, Istanbul
| | - Raim Iliaz
- Medical Faculty Internal Medicine Department, Istanbul University, Istanbul
| | - Mustafa Erelel
- Medical Faculty Pulmonary Medicine Department, Istanbul University, Istanbul
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Bahat G, Iliaz R, Selcuk Akpinar T, Tufan A, Tufan F, Kaya Z, Kiyan E, Ozkaya H, Karisik E, Tekin D, Yucel N, Erten N, Akif Karan M. An insight for chronic obstructive pulmonary disease (COPD) and risk factors among male Turkish nursing home residents. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.460] [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: 10/26/2022]
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