Browsing by Author "Altun, Reskan"

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Effect of HLA on Hepatitis C Virus Clearance and Persistence in Anti-HCV-positive End-stage Renal Disease Patients
(2014) Ocal, Serkan; Selcuk, Haldun; Korkmaz, Murat; Altun, Reskan; Yildirim, Abdullah E.; Akbas, Enver; 24976281
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+ Tlymphocytes. 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 Cw*6 and HLA class II DRB*10 alleles were observed more frequently in the viral clearance group (P < 0.05). The HLA class I B*38 allele group was more prone to develop chronic hepatitis C (P < 0.01). Conclusions: These findings suggest that HLA class I Cw*6 and HLA class II DRB*10 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.
Lansoprazole-induced Acute Pancreatitis
(2014) Ocal, Serkan; Korkmaz, Murat; Yildirim, Abdullah Emre; Altun, Reskan; Akbas, Enver; Selcuk, Haldun; https://orcid.org/0000-0003-3719-9482; https://orcid.org/0000-0002-9333-782X; https://orcid.org/0000-0002-4386-9297; https://orcid.org/0000-0002-8445-6413; 25417626; ABH-4817-2020; AAM-1330-2020; AAG-6561-2020; F-3628-2015; AAJ-6976-2021
Özofagial semptomlarla başvurulan hastalarda eozinofilik özofajit sıklığı
(Başkent Üniversitesi Tıp Fakültesi, 2011) Altun, Reskan; Yılmaz, Uğur
Eozinofilik özofajit özofagus disfonksiyonu ile ilişkili semptomlar ve eozinofilden zengin inflamasyon ile karakterize kronik, immun/ antijen aracılı bir özofagus hastalığıdır. Son yıllarda hastalığın tanısında belirgin artış vardır. Türkiye’ de eozinofilik özofajitin prevelansı bilinmemektedir. Bu çalışmanın birincil amacı kliniğimize özofagial semptomlarla başvuran erişkin hastalarda eozinofilik özofajit sıklığını belirlemektir. Kasım 2010- Mayıs 2011 tarihleri arasında kliniğimize özofagial semptomlarla başvurmuş 311 hasta çalışmaya dâhil edilmiştir. Tüm hastalara endoskopi yapılmış ve biyopsiler alınmıştır. Tanı bağımsız bir patoloji uzmanı tarafından onaylanmıştır. Kliniğimize özofagial semptomlarla başvuran erişkin hastalarda eozinofilik özofajit sıklığı %2,6 (n=8; 4 erkek ve 4 kadın)’ dır. Tanı anında ortalama yaş 40,2 ± 8 ‘dir. Eozinofilik özofajitli hastalarda en sık görülen semptom (hastaların %75’ inde) retrosternal yanmadır ve hastaların %87,5’ inin (n=7) tanı anında birden fazla semptomu vardır. Hastaların yaklaşık %38’ inin (n=3) allerjik hastalık özgeçmişi vardır. Endoskopik bulgular; geçici/ sabit özofagial halkalar (%25), beyaz eksuda (%25) ve normal görünüm (%50)’ dür. Periferik kanda ortanca eozinofil sayısı 208 (93-659)/ mm³’ dir. Özofagus proksimal-orta 1/3 ve distal 1/3’ deki ortanca intraepitelyal eozinofil sayıları sırasıyla 0 (0-50)/ hpf ve 37 (16-50)/ hpf’ dir. Sonuç olarak eozinofilik özofajit Türkiye’ de nadir değildir ve özofagial semptomlu hastaların ayırıcı tanısında düşünülmelidir.
The safety and efficacy of ERCP in the pediatric population with standard scopes: Does size really matter?
(2016) Yildirim, Abdullah Emre; Altun, Reskan; Ocal, Serkan; Kormaz, Murat; Ozcay, Figen; Selcuk, Haldun; 26933627
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.
Terlipressin and albumin for type 1 hepatorenal syndrome: does bacterial infection affect the response?
(2015) Altun, Reskan; Korkmaz, Murat; Yildirim, Emre; Ocal, Serkan; Akbas, Enver; Selcuk, Haldun; 26722626
Vasoconstrictor therapy with terlipressin and concomitant albumin can improve renal function in patients with hepatorenal syndrome (HRS) type 1, but the efficacy of therapy in patients with active infection is controversial. The aim of this study was to investigate the efficacy, adverse effects, and predictors of terlipressin therapy and to find out whether there was a difference in response rates between the patients with or without active infections. Data of 58 patients with type 1 HRS treated with terlipressin and albumin were retrospectively evaluated. Twenty-six patients (44.8 %) showed complete response to treatment. Response rates of patients with or without active bacterial infection were 47 and 43.9 %, respectively (p > 0.05). Only baseline serum creatinine level was significantly related to response in univariate/ multivariate analyses (p < 0.05). Twenty-three patients (39.6 %) developed adverse effects probably related to treatment. In 8.6 % of patients, treatment was discontinued because of adverse effects of therapy. Four patients (6.9 %) developed ischemic adverse events, including nonfatal myocardial infarction, intestinal ischemia, and cutaneous necrosis. Terlipressin plus albumin therapy improved renal function in nearly half of patients with type 1 HRS. Thus, it seems a reasonable treatment for patients with active bacterial infections. Baseline serum creatinine level is a potential predictor of terlipressin response.
Transjugular Intrahepatic Portosystemic Shunt: Where Are We?
(2014) Altun, Reskan; Yildirim, Emre; Ocal, Serkan; Akbas, Enver; Harman, Ali; Korkmaz, Murat; Selcuk, Haldun; https://orcid.org/0000-0003-3719-9482; https://orcid.org/0000-0002-7386-7110; https://orcid.org/0000-0002-9333-782X; https://orcid.org/0000-0002-8445-6413; 25141319; F-3628-2015; C-2392-2009; ABH-4817-2020; K-9824-2013; AAM-1330-2020; AAJ-6976-2021
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.