Browsing by Author "Gokturk, Huseyin Savas"

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A Comparison of Five Different Treatment Regimens as the First-Line Treatment of Helicobacter pylori in Turkey
(2016) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Gokturk, Huseyin Savas; Karakoca, Aydin; Erinanc, Ozgur Hilal; 0000-0001-6503-3872; 0000-0003-1401-6356; 0000-0003-0182-002X; 26621567; AAF-8985-2020; AAL-1268-2021; AAG-3273-2020
BackgroundThe H. pylori eradication success is low in countries with high antibiotic resistance to H. pylori. ObjectiveWe retrospectively assessed the eradication rates achieved by five different regimens and aimed to compare the efficiency of bismuth enhanced sequential therapy and other treatments in a gastroenterology outpatient clinic a university-affiliated hospital. DesignOur study was carried out with a retrospective cohort design. SettingThis study assessed the gastroscopy examinations of patients. PatientsA total of 621 patients were included in the study. There were 122 patients in the quadruple treatment group, 168 patients in the classical sequential treatment group, 130 patients in the bismuth enhanced sequential therapy, 113 patients in the sequential treatment with levofloxacin, and 88 patients in the hybrid treatment. MeasurementsEradication rates of different regimens was analyzed by performing Chi-square and Tukey's honest significant difference test. ResultsEradication rates by ITT and PP analysis achieved by treatment groups were 74.6 and 75.6% in the quadruple treatment; 70.2 and 70.4% in the sequential treatment with clarithromycin, 88.5 and 90.3% in the bismuth enhanced sequential therapy, 77.9 and 78.5% in the sequential treatment with levofloxacin, and 76.1 and 76.2% in the hybrid treatment. LimitationsThe main limitation of our study was its retrospective nature. Different proton pump inhibitors were used in the treatment arms. ConclusionsBismuth-enhanced sequential therapy can be recommended to overcome resistance.
Conscious Sedation : Clues for Diagnosing Obstructive Sleep Apnea Syndrome
(2016) Unler, Gulhan Kanat; Gokturk, Huseyin Savas; Dogan, Rusina; Kivanc, Tulay; Karakoca, Aydin; 0000-0003-0182-002X; 0000-0001-6503-3872; 27821023; AAG-3273-2020
Background and aims: The use of anesthetic agents for endoscopic sedation has recently increased. However, sedation introduces additional risks in patients with obstructive sleep apnea syndrome (OSAS). The presence of sleep apnea is not often enough questioned in clinical practice. The purpose of this study was to determine whether patients with sedation-induced snoring and decreased arterial oxygen saturation during gastroscopy are more likely to have OSAS. Methods: This study considered 600 consecutive patients undergoing elective outpatient upper gastrointestinal endoscopy under conscious sedation for evaluation of dyspepsia. Ten patients with observed snoring and decreased arterial saturation during the gastroscopy procedure were enrolled in the study. The control group was comprised of 13 patients matched by sex, age, and body mass index (BMI) who did not snore and had a more stable oxygen saturation under conscious sedation during an elective outpatient gastroscopy for the evaluation of dyspepsia and were selected using a computer-generated randomized sequence. Patients were monitored and an overnight polysomnography was performed in the study group. Statistically significant differences between groups were assessed using the nonparametric Wilcoxon and independent-samples t-tests. Results: There was no significant difference in age or BMI between the two groups (p>0,05) Mean minimum oxygen saturation was significantly different between the two groups (p=0.011). In the study group, 7 patients were found to have moderate OSAS necessitating a continuous positive airway pressure device. Conclusion: Patients with hypoxia and snoring, under conscious sedation are more likely to have OSAS. "Out-of-operating-room" sedoanalgesia is therefore critical.
Does the Presence of Endometrial Polyp Predict Colorectal Polyp ?
(2016) Unler, Gulhan Kanat; Gokturk, Huseyin Savas; Toprak, Erzat; Erinanc, Ozgur Hilal; Korkmaz, Huseyin; https://orcid.org/0000-0003-0182-002X; https://orcid.org/0000-0002-2877-1232; https://orcid.org/0000-0003-1401-6356; 26897266; ABI-5902-2020; AAL-1268-2021
Introduction: Endometrial polyps (EPs) and colorectal polyps (CPs) are common disorders and the incidence of both increase rapidly with aging. CPs are focal lesions and incidence increases with age. Aim: In this study, we aimed to analyze retrospectively the relationship between the EPs and CPs sharing similar clinical and genetic factors in their etiopathogenesis. Materials and Methods: This study was retrospectively performed between 2010 and 2013 and it included patients diagnosed to have eEPs. The study group and the control group consisted of patients who were diagnosed with or without EPs and who underwent colonoscopy at the same period. Results: The study group was formed by 57 patients with diagnosis of EP who underwent colonoscopy during the same period. The control group consisted of 71 patients without EP examined with colonoscopy. Among 128 patients assessed in this study, 24 were diagnosed with CPs, all of which were adenomatous polyps smaller than 1 cm. No hyperplastic or inflammatory polyps were diagnosed. While 18 of 57 patients with EPs had CPs, 6 of 71 control subjects had CPs. Hence, the risk of having CP was 5 times greater in patients with EP compared to those without (P < 0.05). Conclusion: The present study demonstrated that the prevalence of CPs increased significantly in postmenopausal patients with EPs. Recommending colonoscopy to these patients irrespective of age may be beneficial for detecting more CPs and preventing colorectal cancer.
Does the Urea Breath Test Predict Eradication of Helicobacter Pylori Infection
(2016) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Gokturk, Huseyin Savas; Durukan, Elif; Erhamamci, Seval; https://orcid.org/0000-0003-0182-002X; https://orcid.org/0000-0002-8579-5564; 26852756; AAJ-8621-2021
Background/Aim : Helicobacter pylori infection is common world-wide and has been linked to development of gastric and duodenal ulcers, gastric adenocarcinoma, and gastric lymphoma. However, antimicrobial resistance has decreased H. pylori eradication rates worldwide. This study aimed to evaluate the effect of-bacterial load on eradication rate. Method : This prospective study included 237 consecutive patients who presented to our institution with dyspeptic symptoms and underwent both upper endoscopy and urea breath tests (UBT). The patients were divided into three equal sized groups according to their UBT values. All subjects received a standard triple eradication regimen, followed by a bismuth-based quadruple eradication regimen if triple eradication was not successful. The three groups were compared with respect to age, endoscopic findings, sex, and eradication rates. Results : Our results were consistent with those of previous studies : higher UBT values were associated with failure of standard 14-day triple treatment (p < 0.05). However, in patients who received a quadruple eradication regimen, differences between groups were not significant (p = 0.434). There was no relationship between UBT values and gastric pathologies (p = 0.751). Age and sex also did not differ significantly between groups (p = 0.061). Conclusions : Our study and others have found that high bacterial loads are negatively associated with achievement of eradication with triple treatment. However, differences between groups were not significant in patients who received a quadruple eradication regimen. Comparisons of treatment results according to bacterial density may be informative. The importance of H. pylori density should be further evaluated with new treatment protocols.
Etiology of Cirrhosis in Turkey: A National Cohort Study
(2021) Yildirim, Abdullah Emre; Ucbilek, Enver; Oruncu, M. Berk; Turan, Ilker; Demir, Mehmet; Koksal, Aydin; Uyanikoglu, Ahmet; Yilmaz, Nimet; Akarsu, Mesut; Tozlu, Mukaddes; Avcioglu, Ufuk; Haktaniyan, Busra; Aladag, Murat; Yolacan, Ramazan; Toka, Bilal; Kefeli, Ayse; Ormeci, Asli Ciftcibasi; Haciyev, Ferid; Balci, Hatice Rizaoglu; Yurci, Mustafa Alper; Balaban, Hatice Yasemin; Fidan, Sami; Gunduz, Feyza; Gencdal, Genco; Simsek, Cem; Ebik, Berat; Cavus, Bilger; Karatay, Eylem; Sezgin, Gulten Can; Yaras, Serkan; Karabulut, Umit; Gokturk, Huseyin Savas; Uzel, Ali; Ekin, Nazim; Barutcu, Sezgin; Cosar, Arif Mansur; Keklikkiran, Caglayan; Batu, Kerim Deniz; Alkim, Huseyin; Acar, Sencan; Yogun, Yasar; Harputluoglu, Murat; Yalcin, Kendal; Gunsar, Fulya; Sezgin, Orhan; Akarca, Ulus; Kaymakoglu, Sabahattin; Karasu, Abdullah Zeki; Ozdogan, Osman Cavit; Idilman, Ramazan
Gastric Polyps: A Retrospective Analysis of Endoscopic Biopsies: A Single Center Study in Central Anatolia
(2019) Erinanc, Hilal; Unler, Gulhan Kanat; Gokturk, Huseyin Savas; Ozgur, Gulsum Teke
Objective: Gastric polyps accounts for %6 of gastrointestinal endoscopy. Geographical differences occur in the prevalence of them. We aimed to determine the spectrum of gastric polyps. Matherial and method: Data including demographics, medical history and histological characteristics of polyps and Helicobacter pylori were obtained retrospectively. Results: Of the 24568 endoscopies performed, 184 patients were identified as having gastric polyps. The most frequently encountered were hyperplastic polyps (62%), followed by fundic gland polyps (19,3%) and adenomatous polyps (3, 8%). The corpus (36,4 %) was the most common site and the antrum (25%) was the second. Female patients were more affected than male patients (64,7%). Majority of the polyps (88%) were smaller than 1 cm in diameter. The mean age was 62,10+13,4 (range:30-90) years. Fundic gland polyps were observed at younger age (mean age: 56,58) compared to other gastric polyps. Intestinal metaplasia was more frequently encountered in hyperplastic polyps than in fundic gland polyps. Conclusion: In this study, hyperplastic polyps are the most common in our population however there was no association between the hyperplastic polyps and H. pylori infection. H. pylori infection ratio was similar in both hyperplastic polyps and fundic gland polyps however all of the patient have chronic gastritis. This findings suggest chronic gastritis also play role in hyperplastic polyps development. The study also showed that H. Pylori infection is still common in our country and further studies need to find efficacy of H.pylori treatment.
Impaired Coronary Microvascular and Left Ventricular Diastolic Function in Patients with Inflammatory Bowel Disease
(2015) Caliskan, Zuhal; Gokturk, Huseyin Savas; Caliskan, Mustafa; Gullu, Hakan; Ciftci, Ozgur; Ozgur, Gulsum Teke; Guven, Aytekin; Selcuk, Haldun; 0000-0003-2579-9755; 0000-0002-8445-6413; 0000-0002-6463-6070; 25128749; AAJ-8546-2021; JYO-9455-2024; IXD-5147-2023; AAJ-6976-2021; A-7318-2017
Background and aim: Increased incidence of coronary vascular events in patients with inflammatory bowel disease (IBD) is known. However, the association between coronary microvascular function and IBD has not been fully defined. We aimed to investigate whether coronary flow reserve (CFR) and left ventricular diastolic function were impaired in IBD patients. Methods: Seventy-two patients with IBD (36 patients with ulcerative colitis [UC] and 36 Crohn's disease [CD]) were registered. Each subject was evaluated after a minimum 15-day attack-free period. For the control group, 36 age- and sex-matched healthy volunteers were included into the study. IBD clinical disease activity in UC was assessed by the Truelove-Witts Index (TWAS) and in CD by the Crohn's Disease Activity Index (CDAI). In each subject, CFR was measured through transthoracic Doppler echocardiography. Results: Compared to the controls, the CD group and UC group had significantly higher high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate. Baseline diastolic peak flow velocity (DPFV) of the left anterior descending artery (LAD) was significantly higher in the IBD group (24.1 +/- 3.9 vs. 22.4 +/- 2.9, p < 0.05), and hyperemic DPFV (56.1 +/- 12.5 vs. 70.6 +/- 15.3, p < 0.05) and CFR (2.34 +/- 0.44 vs. 3.14 +/- 0.54, p < 0.05) were significantly lower in the IBD group than in the control group. In stepwise linear regression analysis, hs-CRP and lateral Em/Am ratio were independently correlated with CFR. Conclusion: CFR, reflecting coronary microvascular function, is impaired in patients with IBD. CFR and left ventricular diastolic function parameters are well correlated with hs-CRP. (C) 2014 Published by Elsevier Inc.
Importance of Malnutrition in Patients with Cirrhosis
(2015) Gokturk, Huseyin Savas; Selcuk, Haldun; 0000-0002-8445-6413; 26038997; AAJ-6976-2021
Malnutrition is common in patients with chronic liver disease and is associated with poor outcomes. Inadequate intake, poor quality diet, maldigestion, malabsorption, altered macronutrient metabolism, and hypermetabolism all contribute to the development of malnutrition in this patient population. Although it is generally easy to detect, clinicians often overlook malnutrition and its measurement is complicated by the lack of a simple, standardized diagnostic method. Early detection of malnutrition and multidisciplinary treatment approaches greatly increase the probability for successful outcomes.
Improvement of Work Productivity and Quality of Life with Anti-Tumor Necrosis Factor Treatment Used in Crohn's Disease in Routine Clinical Practice in Turkey
(2022) Toruner, Murat; Basaranoglu, Metin; Atug, Ozlen; Senturk, Omer; Akyuz, Filiz; Cekic, Cem; Hamzaoglu, Hulya Over; Tekin, Fatih; Sezgin, Orhan; Akpinar, Hale; Celik, Aykut Ferhat; Tezel, Ahmet; Gokturk, Huseyin Savas; Kav, Taylan; 35678798
Background: Patients with Crohn's disease experience major deterioration in work productivity and quality of life. We aimed to provide the long-term effects of anti-tumor necrosis factor agents on work productivity and activity impairment and quality of life in patients with Crohn's disease using the Inflammatory Bowel Disease Questionnaire and the Short-Form Health Survey-36. Methods: Patients with Crohn's disease and initiated an anti-tumor necrosis factor treatment were included and followed up for 12 months in this observational study. Results: A total of 106 patients were included in this study, and 64.2% of the patients were males. Mean [+/- standard deviation] age was 36.8 [+/- 10.9] years. At baseline, mostly perianal fistulas [65.7%] were observed [n = 23]. Intestinal stenosis was detected in 34.9% of the patients [n = 37], and most of the stenosis was located in the ileum [70.6%] followed by the colon [20.6%]. Extraintestinal symptoms were observed in 24 patients [22.6%]. Most frequent extraintestinal symptom was arthritis with 71.4% [n = 15]. Mean time from first symptom to initiation of anti-tumor necrosis factor treatment was 6.3 [+/- 5.0] years. Improvements in work productivity and activity impairment scores throughout 12 months were -24.1% [P =.003] for work time missed, -18.0% [P =.006] for impairment at work, -8.5% [P =.160] for overall work impairment, and -17.0% [P <.001] for daily activity impairment. Similarly, significant improvements [P <.001] were detected in all components of the Inflammatory Bowel Disease Questionnaire when compared to baseline. Statistically significant improvements [P <.05] were detected for all components of Short-Form Health Survey-36 except for mental health [P =.095]. Conclusion: Our study indicates the significant improvement in work productivity and activity impairment and quality of life of patients with Crohn's disease who receive long-term anti-tumor necrosis factor treatment.
Is Activation in Inflammatory Bowel Diseases Associated with Further Impairment of Coronary Microcirculation?
(2016) Caliskan, Zuhal; Keles, Nursen; Gokturk, Huseyin Savas; Ozdil, Kamil; Aksu, Feyza; Ozturk, Oguzhan; Kahraman, Resul; Kostek, Osman; Tekin, Ahmet S.; Ozgur, Gulsum Teke; 27541650
Background: Inflammatory bowel disease [IBD] includes a number of chronic relapsing diseases. In IBD intestinal microvascular endothelial cells are damaged by an abnormal immune response. Several studies have shown that IBD may cause increment in risk of developing atherosclerosis. IBD in activation was related to enhanced risks of worse cardiovascular [CV] outcome, on the other hand no risk increment was seen in remission comparing to control group in those studies. Coronary FlowReserve [CFR] reflects coronary microvascular circulation. Coronary microvascular dysfunction may be defined as a predictor of CV outcome combined with previous described atherosclerotic risk factors. The present study was purposed to further evaluate whether or not CFR in the left anterior descending artery [LAD] is disturbed in IBD patients with activation in comparison to remission and healthy subjects. Methods: 62 patients with IBD and 39 healthy volunteers were enrolled into the study. Patients' demographics were recorded. CFR evaluation of patients with IBD in both activation and remission period and control group were performed with transthoracic echocardiography. Results: CFR was significantly lowest in the active period of the IBD [2.26 [2.08-2.55] vs. 2.55 [2.18-3.00] and 3.10 [2.85-3.29] p < 0.001]. CFR is negatively correlated with disease activity scores of IBD. Conclusion: This study showed that CFR is more prominently disturbed in patients with IBD in activation. The activation of disease may have a major role in the progression of coronary microcirculatory dysfunction and future cardiovascular events. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
Is there any association between colonic polyps and gastric intestinal metaplasia?
(2016) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Gokturk, Huseyin Savas; Korkmaz, Huseyin; Erinanc, Ozgur Hilal; 27210777
Background/Aims: Chronic gastritis progression is a multistep process of atrophy, intestinal metaplasia (IM), and dysplasia, which may lead to invasive carcinoma. In this study, we identified an association of colonic polyps with gastric IM in patients undergoing colonoscopy. Materials and Methods: This retrospective case-control, cross-sectional study was conducted in a tertiary-care institution in Turkey. Pathology and endoscopy reports were reviewed. The study group comprised 400 patients with colonic adenomatous polyps, and the control group comprised 360 patients without colonic adenomatous polyps on colonoscopy. Results: The risk of gastric IM was 1.42-fold higher in the study group (p<0.05). The risk of IM in patients aged >= 50 years with colonic polyps was 3.35-fold higher than in those aged <50 years (p<0.05). The risk of Helicobacter pylori infection in the study group was 1.07-folder higher than that in the control group (p<0.05). H. pylori infection prevalence was higher only in patients with high-grade colonic polyp dysplasia (p<0.05). There were no statistically significant differences in the proportion of incomplete IM between the groups (p<0.05). Conclusion: This study observed increased rates of gastric IM with colonic polyps. An increased risk of gastric IM was associated with higher grades of polyp dysplasia.
Leser-Trelat sign or Leser-Trelat syndrome?
(2016) Gokturk, Huseyin Savas; Unler, Gulhan Kanat; Dursun, Recep
A New Technique for the Removal of A Transmigrated Intrauterine Device with Rectum Penetration
(2015) Toprak, Erzat; Gokturk, Huseyin Savas; Tolu, Ahmet; 0000-0002-2877-1232; 0000-0002-2877-1232; 25698284; GRR-9885-2022; ABI-5902-2020
Non-Invasive Estimation of Disease Activity and Liver Fibrosis in Non-Alcoholic Fatty Liver Disease Using Anthropometric Biochemical Characteristics, and 13C-Methionine Breath Test
(2015) Korkmaz, Huseyin; Unler, Gulhan K.; Gokturk, Huseyin Savas; Schmidt, Wolfgang E.; Kebapcilar, Levent
A Rare Cause of Acute Dysphagia: Abscess of the Base of the Tongue
(2015) Ozgur, Gulsum Teke; Akdogan, Mehmet Volkan; Unler, Gulhan Kanat; Gokturk, Huseyin Savas; 25802771
Dysphagia represents a difficulty in passage of solid or liquid foods from the oral cavity into the stomach and is considered as an alarm symptom of gastrointestinal system. It often indicates an organic disease and needs to be explained. In this paper, a case of 61-year-old manwith posterior tongue abscess is presented.
A Rare Type of Eosinophilic Gastroenteritis: Eosinophilic Ascites
(2015) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Erinanc, Ozgur Hilal; Gokturk, Huseyin Savas
Eosinophilic gastrointestinal diseases are a group of inflammatory disorders characterized by signs and symptoms associated with eosinophil infiltration of the gastrointestinal tissues with the absence of any secondary cause of eosinophilia such as parasitic infection, vasculitis and malignancy. Eosinophilic gastrointestinal diseases are rare and eosinophilic ascite is probably the least common and least reported form. We reported a case of 24-year old women presented with eosinophilic ascites and we want to point out a rare cause of ascites that can be managed appropriately.
Reactivation of Resolved Hepatitis B Virus Infection Before The Relapse of Lymphoma : Immunosuppressive Effect of the Lymphoproliferative Disorders ?
(2016) Gokturk, Huseyin Savas; Unler, Gulhan Kanat; Gokturk, Bahar; https://orcid.org/0000-0003-0182-002X; 26852769
Hepatitis B virus (HBV) infection is a heterogeneous disease with distinct phases determined mainly by the interaction between virus replication and host immune response. HBV reactivation can occur spontaneously, developing resistance to antiviral treatment while the patient is undergoing treatment, after cessation of antiviral drugs, or be triggered by immunosuppressive drugs and chemotherapy. HBV reactivation can be severe and sometimes fatal because of liver failure. Here we report a patient with resolved HBV infection who presented with reactivation before being diagnosed with a relapse of non-Hodgkin lymphoma.
Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience
(2020) Gokturk, Huseyin Savas; 33626001
Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population. Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed. Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%). Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.
Routinely Evaluated Clinical Assays and Laboratory Tests [Real Test] And Fibrosis Stages of Chronic Hepatitis B and C
(2014) Bugdaci, Mehmet Sait; Korkmaz, Huseyin; Demir, Ali; Biyik, Murat; Temel, Tuncer; Gokturk, Huseyin Savas; Ozakyol, Aysegul; Hatemi, Ibrahim; Baysal, Birol; Karaca, Cetin; Senturk, Hakan; 25417616
Background/Aims: To provide a new mathematical formula to predict liver fibrosis in patients with chronic viral hepatitis. Materials and Methods: Patients with chronic hepatitis B and C who underwent liver biopsy at different centers were included in this study. Chronic hepatitis B was defined as immunopositivity for the hepatitis B surface antigen for at least 6 months, and chronic hepatitis C was defined as positivity for HCV RNA for at least 3 months. The histological features were evaluated by the histological activity index and fibrosis. Results: In total, 1299 patients were included in the study. The distribution and the mean of the parameters of the patients were as follows: 1009 patients with chronic hepatitis B with a mean age of 45 +/- 13/years [emale/male (F/M)=47.5/52.5%] and 290 patients with hepatitis C with a mean age of 52 +/- 10.3/years [F/M=61/39%]. When the cut-off value of the REAL TEST formula"[(age x pT x AST)/(PLT/1000)]/100" in patients with hepatitis B was determined to be >= 1.37, it was found that it could predict fibrosis with 79% specificity, 78% sensitivity, 85% negative predictive value (NPV), and 70% positive predictive value (PPV) (area under the curve (AUC)=0.852, 95% CI: 0.82-0.87). When the cut-off value of the REAL TEST formula in patients with hepatitis C was determined to be >= 1.99, it was found that it could predict significant fibrosis with 87% specificity, 90% sensitivity, 94.4% NPV, and 79.4% PPV (AUC: 0.95, 95% CI: 0.93-0.98) Conclusion: The REAL TEST formula results correlated with the pathological findings and may be a useful method for the evaluation of patients with chronic hepatitis B and C.
Should We Remember Adrenal Insufficiency in Acute Gastroenteritis?
(2016) Unler, Gulhan Kanat; Gokturk, Huseyin Savas; Ozgur, Gulsum Teke; Togan, Turhan; https://orcid.org/0000-0003-0182-002X
Introduction: Cortisol, which is released from the adrenal cortex, is a steroid hormone with vital functions. Its daily release is regulated by the hypothalamic-hypophyseal-adrenal axis. In healthy people, an adequate amount of endogenous corticosteroids is synthesized in the adrenal gland in response to stressful events, but in patients with adrenal insufficiency, there is a steroid synthesis defect that prevents the patient's requirements from being met. It may be challenging to diagnose corticosteroid deficiency in some circumstances, which can lead to catastrophic consequences, including death. Case presentation: In this article, we report a patient who had been using prednisolone 5mg/day for 10 years for rheumatoid arthritis with acute gastroenteritis whose clinical condition deteriorated despite appropriate therapy for 1 week and who was subsequently diagnosed with secondary adrenal insufficiency. Conclusion: On the basis of this case report, we remind clinicians of the necessity of rearranging steroid therapy during the course of an infectious disease in patients previously treated with prolonged steroid therapy.