PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item Successful Treatment With Direct-Acting Antiviral Agents of Hepatitis C in Patients With End-Stage Renal Disease and Kidney Transplant Recipients(2019) Etik, Digdem Ozer; Suna, Nuretdin; Ocal, Serkan; Selcuk, Haldun; Dagli, Ulku; Colak, Turan; Hilmioglu, Fatih; Boyacioglu, Ahmet Sedat; Haberal, Mehmet; 0000-0003-3719-9482; 0000-0003-0664-0976; 0000-0002-9370-1126; 30719954; ABH-4817-2020; AAE-7637-2021; S-4068-2018Objectives: The introduction of direct-acting antiviral agents has allowed significant chances for treatment for difficult-to-treat populations. This study aimed to investigate the efficacy, tolerability, and safety of these therapies in both patients with end-stage renal disease and kidney transplant recipients with chronic hepatitis C virus infection. Materials and Methods: This study was a retrospective analysis with prospective follow-up of patients. The antiviral combination of ombitasvir 25 mg, paritaprevir 75 mg, ritonavir 50 mg, and dasabuvir 50 mg was prescribed to patients with end-stage renal disease or kidney transplant recipients with noncirrhotic or compensated cirrhotic liver disease. The other antiviral combination consisted of sofosbuvir 400 mg and ledipasvir 90 mg, which was recommended to patients with decompensated cirrhosis or those who could not tolerate the first combination regimen. Ribavirin was given to all patients with genotype 1a hepatitis C virus infection. All clinical and laboratory data were recorded at week 4, at end of the treatment, and at 12 weeks after completion of treatment. Results: In terms of efficacy, sustained virologic response at 12 weeks was achieved in 94% of patients in the end-stage renal disease group and 92% of patients in the kidney transplant group. In terms of tolerability, antiviral treatment was well tolerated in both groups. Cardiac arrest and cerebrovascular accident were seen in the end-stage renal disease group; severe mucositis and glossitis were seen in the kidney transplant group. Hospitalization was needed in 2 patients for treatment of drug interactions with tacrolimus and sirolimus. Renal allograft function worsened in 2 patients, with 1 patient having biopsyproven antibody-mediated rejection. Conclusions: We observed great efficacy and safety in both kidney transplant recipients and patients with end-stage renal disease with these agents in treatment of chronic hepatitis C. However, clinicians should remain aware of drug interactions and adverse events in this fragile patient population.Item The role of lifestyle changes in gastroesophageal reflux diseases treatment(2017) Dagli, Ulku; Kalkan, Ismail Hakki; 0000-0003-0664-0976; 29199165; S-4068-2018Lifestyle modification has an important role in the treatment of gastroesophageal reflux disease (GERD). The development of GERD symptoms with various foods shows individual differences. Although there is not enough evidence that certain substances in a diet could lead to GERD symptoms, the literature suggests that there might be a relationship between reflux development and salt, salted foods, chocolate, fatty foods, and fizzy drinks. Because lying on the left side and raising the head of the bed in a supine position reduces the development of nocturnal reflux symptoms, the head should be elevated for patients with reflux symptoms at night, and the patient should lie on the left side. Smoking and obesity (especially abdominal) trigger GERD symptoms. Whereas excessive physical activity is a significant risk factor for the development of GERD, regular and mild-moderate physical activity has been shown to reduce the symptoms of reflux.Item Treatment of reflux disease during pregnancy and lactation(2017) Dagli, Ulku; Kalkan, Ismail Hakki; 0000-0003-0664-0976; 29199169; S-4068-2018Gastroesophageal reflux disease (GERD) is frequently seen during pregnancy. In the medical treatment of pregnant women with GERD, alginic acid and sucralfate can be used. Calcium- and magnesium-based antacids can also be used, particularly for patients with preeclampsia. In particular, ranitidine -a histamine-2 receptor blocker-is preferred. In the case of non-responsiveness to the abovementioned treatments, proton pump inhibitors (PPIs), except omeprazole, can be given considering the benefit-harm ratio for the mother and fetus after the first trimester. In cases with GERD during the lactation period, drugs having minimum systemic absorption, such as sucralfate and alginic acid, are preferable but there is no data.