Browsing by Author "Irak, Kader"

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Akut pankreatit tanılı hastaların etyolojik ve prognostik faktörlerinin retrospektif incelenmesi
(Uludağ Üniversitesi, 2012-04-10) Coşkun, Belkıs Nihan; Tandoğan, Gülen; Eroğlu, Ayça; Karadayı, Derya; Irak, Kader; Cangür, Şengül; Kıyıcı, Murat; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Gastroenteroloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.
Bu çalışmada akut pankreatit (AP) tanısı ile takip edilen hastaları etiyoloji ve komplikasyonlar açısından değerlendirmeyi amaçladık. 2005- 2010 tarihleri arasında hastanemizde AP tanısı alan 184 hasta geriye dönük olarak incelendi. Olguların demografik özellikleri, laboratuvar bulguları, görüntüleme sonuçları, hastalık şiddeti, prognoz ve hastanede yatış süresi kaydedildi. Hastalık şiddeti ile etyolojik faktörler, yaş, cinsiyet, yatış süresi ve prognoz arasındaki ilişki incelendi. Erkek hastaların sayısı 79 (%42,9), kadın hastaların sayısı 105 (%57,1) ve ortalama yaş 55,5±17,01 idi. Yüz on iki olguda (% 60,9) akut biliyer pankreatit saptandı. Şiddetli pankreatit 50 olguda (%27,2) gözlendi. Mortalite oranı % 3,8 (7 olgu) bulundu. Hastalık şiddeti ile demografik özellikler ve laboratuar bulgular arasında ilişki saptanmadı. Mortalite ve yatış süresi şiddetli grupta daha yüksekti (p< 0,001). AP ölümcül seyredebilen önemli bir klinik sorundur. Etyolojisi çok çeşitli olup en sık neden safra kesesi taşıdır. Şiddet ve prognozun belirlenmesinde bilgisayarlı tomografi şiddet indexi uygun bir göstergedir.
AST/ALT ratio is not useful in predicting the degree of fibrosis in chronic viral hepatitis patients
(Lippincott Williams & Wilkins, 2015-12) Eminler, Ahmet Tarık; Ayyıldız, Talat; Irak, Kader; Kıyıcı, Murat; Gürel, Selim; Dolar, Enver; Gülten, Macit; Nak, Selim G.; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; 0000-0002-3208-6211; AAG-9177-2021; AAI-4213-2021; 37080733400; 6507627491; 7003706434; 6602075084; 6603629209; 6603336505
Background and aim Noninvasive tests are primarily used for staging hepatic fibrosis in patients with chronic liver disease. In clinical practice, serum aminotransferase levels, coagulation parameters, and platelet count have been used to predict whether or not a patient has cirrhosis. In addition, several studies have evaluated the accuracy of combinations (or ratios) of these measures. The present study aimed to investigate the relationship between five noninvasive models [AST/ALT ratio (AAR), aspartate aminotransferase to platelet ratio index (APRI), Bonacini cirrhosis discriminant score (CDS), age-platelet index (APind), and King's score] and the degree of hepatic fibrosis as determined by biopsy in patients with chronic hepatitis B and C. Patients and methods A total of 380 patients with viral hepatitis (237 with chronic hepatitis B and 143 with chronic hepatitis C) who were seen at our clinic between January 2005 and January 2011 were retrospectively analyzed. The degree of fibrosis was determined using the Ishak score. Patients with a fibrosis score of 0-2 were considered to have low fibrosis and those with a score between 3 and 6 were considered to have high fibrosis. Five noninvasive models were compared between the groups with low and high fibrosis. Results There were statistically significant differences between the hepatitis B and C patients with high and low fibrosis with respect to APind (4.492.35 vs. 2.41 +/- 1.84; P<0.001 in hepatitis B and 4.83 +/- 2.25 vs. 2.92 +/- 1.88; P<0.001 in hepatitis C), APRI (1.00 +/- 1.17 vs. 0.47 +/- 0.39; P<0.001 in hepatitis B and 1.01 +/- 1.01 vs. 0.41 +/- 0.29; P<0.001 in hepatitis C), CDS (4.53 +/- 1.90 vs. 3.58 +/- 1.30; P<0.001 in hepatitis B and 4.71 +/- 2.03 vs. 3.42 +/- 1.49; P<0.05 in hepatitis C), and King's score (24.31 +/- 3.14 vs. 7.65 +/- 6.70; P<0.001 in hepatitis B and 24.82 +/- 2.55 vs. 8.33 +/- 7.29; P<0.001 in hepatitis C). There were no significant differences in the AAR between the hepatitis B and C patients with high and low fibrosis (0.78 +/- 0.31 vs. 0.74 +/- 0.34; P=0.082 in hepatitis B and 0.91 +/- 0.40 vs. 0.85 +/- 0.27; P=0.25 in hepatitis C). The area under the receiver-operating characteristic curve of the APind, APRI, CDS, and King's score in the hepatitis B group were 0.767, 0.710, 0.646, and 0.770, respectively; these values were 0.732, 0.763, 0.677, and 0.783, respectively, in the hepatitis C group. Conclusion In conclusion, our data suggest that four of the five noninvasive methods evaluated in this study can be used to predict advanced fibrosis in patients with hepatitis B and C. However, there was no significant relationship between the degree of hepatic fibrosis and the AAR score, indicating that AAR is not useful in estimating the fibrosis stage in hepatitis B and C patients.
A case of torsion of the wandering spleen presenting as hypersplenism and gastric fundal varices
(Türk Gastroenteroloji Derneği, 2011-02) Irak, Kader; Esen, İrfan; Keskin, Murat; Eminler, Ahmet Tarık; Ayyıldız, Talat; Kaya, Ekrem; Kıyıcı, Murat; Gürel, Selim; Nak, Selim Giray; Gülten, Macit; Dolar, Enver; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji ve Hepatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Genel cerrahi Anabilim Dalı.; 0000-0001-6262-2866; ABF-1568-2021; AAG-4473-2019; AAG-9177-2021; R-8751-2019; AAI-4213-2021; 37080733400; 49861308400; 23050640000; 23050640000; 24066287600; 6603155277; 7004568109; 6507627491; 7003706434; 6603336505; 6603629209; 6602075084
Wandering spleen is the displacement of the spleen from its normal location due to the loss or weakening of ligaments that hold the spleen in the left upper quadrant. The possibility of torsion of the spleen is high due to the long and mobile nature of the vascular pedicle. Generally, cases are asymptomatic. Under conditions of delayed diagnosis, symptoms of splenomegaly, left portal hypertension, gastric fundal varices, and hypersplenism. may present as a result of development of vascular congestion associated with chronic torsion. There are only a few cases in the literature reporting the association of wandering spleen and fundal vat-ices. We report herein the case of a 55-year-old female who admitted to our clinic with complaints of fatigue and epigastric pain. She was determined to have gastric fundal varices and hypersplenism secondary to the development of left portal hypertension due to chronic splenic torsion.
Effects of immunosuppressive drugs on COVID-19 severity in patients with autoimmune hepatitis
(Wiley, 2021-11-28) Efe, Cumali; Lammert, Craig; Taşcılar, Koray; Dhanasekaran, Renumathy; Ebik, Berat; Higuera-de la Tijera, Fatima; Çalışkan, Ali R.; Peralta, Mirta; Gerussi, Alessio; Massoumi, Hatef; Catana, Andreea M.; Purnak, Tuğrul; Rigamonti, Cristina; Aldana, Andres J. G.; Khakoo, Nidah; Nazal, Leyla; Frager, Shalom; Demir, Nurhan; Irak, Kader; Melekoğlu-Ellik, Zeynep; Kaçmaz, Hüseyin; Balaban, Yasemin; Atay, Kadri; Eren, Fatih; Alvares-da-Silva, Mario R.; Cristoferi, Laura; Urzua, Alvaro; Eskazan, Tuğçe; Magro, Bianca; Snijders, Romee; Barutcu, Sezgin; Lytvyak, Ellina; Zazueta, Godolfino M.; Demirezer-Bolat, Aylin; Aydın, Mesut; Heurgue-Berlot, Alexandra; De Martin, Eleonora; Ekin, Nazım; Yıldırım, Sümeyra; Yavuz, Ahmet; Bıyık, Murat; Narro, Graciela C.; Kıyıcı, Murat; Akyıldız, Murat; Kahramanoğlu-Aksoy, Evrim; Vincent, Maria; Carr, Rotonya M.; Günşar, Fulya; Reyes, Eira C.; Harputluoğlu, Murat; Aloman, Costica; Gatselis, Nikolaos K.; Ustundağ, Yücel; Brahm, Javier; Vargas, Nataly C. E.; Güzelbulut, Fatih; Garcia, Sandro R.; Aguirre, Jonathan; Anders, Margarita; Ratusnu, Natalia; Hatemi, İbrahim; Mendizabal, Manuel; Floreani, Annarosa; Fagiuoli, Stefano; Silva, Marcelo; Idılman, Ramazan; Satapathy, Sanjaya K.; Silveira, Marina; Drenth, Joost P. H.; Dalekos, George N.; Assis, David N.; Bjornsson, Einar; Boyer, James L.; Yoshida, Eric M.; Invernizzi, Pietro; Levy, Cynthia; Montano-Loza, Aldo J.; Schiano, Thomas D.; Ridruejo, Ezequiel; Wahlin, Staffan; KIYICI, MURAT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; FHW-0015-2022
Background We investigated associations between baseline use of immunosuppressive drugs and severity of Coronavirus Disease 2019 (COVID-19) in autoimmune hepatitis (AIH). Patients and methods Data of AIH patients with laboratory confirmed COVID-19 were retrospectively collected from 15 countries. The outcomes of AIH patients who were on immunosuppression at the time of COVID-19 were compared to patients who were not on AIH medication. The clinical courses of COVID-19 were classified as (i)-no hospitalization, (ii)-hospitalization without oxygen supplementation, (iii)-hospitalization with oxygen supplementation by nasal cannula or mask, (iv)-intensive care unit (ICU) admission with non-invasive mechanical ventilation, (v)-ICU admission with invasive mechanical ventilation or (vi)-death and analysed using ordinal logistic regression. Results We included 254 AIH patients (79.5%, female) with a median age of 50 (range, 17-85) years. At the onset of COVID-19, 234 patients (92.1%) were on treatment with glucocorticoids (n = 156), thiopurines (n = 151), mycophenolate mofetil (n = 22) or tacrolimus (n = 16), alone or in combinations. Overall, 94 (37%) patients were hospitalized and 18 (7.1%) patients died. Use of systemic glucocorticoids (adjusted odds ratio [aOR] 4.73, 95% CI 1.12-25.89) and thiopurines (aOR 4.78, 95% CI 1.33-23.50) for AIH was associated with worse COVID-19 severity, after adjusting for age-sex, comorbidities and presence of cirrhosis. Baseline treatment with mycophenolate mofetil (aOR 3.56, 95% CI 0.76-20.56) and tacrolimus (aOR 4.09, 95% CI 0.69-27.00) were also associated with more severe COVID-19 courses in a smaller subset of treated patients. Conclusion Baseline treatment with systemic glucocorticoids or thiopurines prior to the onset of COVID-19 was significantly associated with COVID-19 severity in patients with AIH.
Kronik aktif gastritli olgularda helicobacter pylori sıklığı
(Uludağ Üniversitesi, 2010-02-23) Konakçı, Numan; Gülten, Macit; İbanoğlu, Mahmut Serbülent; Yorulmaz, Hakan; Veyseloğlu, Latif; Ayyıldız, Talat; Irak, Kader; Eminler, Ahmet Tarık; Dolar, Enver; Gürel, Selim; Kıyıcı, Murat; Nak, Selim Giray; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Ana Bilimdalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim dalı/İç Hastalıkları Anabilim Dalı/Gastroenteroloji Bilim Dalı.
Mide mukozasının inflamasyonu gastrit olarak tanımlanır. H.pylori küçük (0.5-3 mikron), gram negatif, spiral, kıvrımlı, 4-6 flagellası olan hareketli bir bakteridir. Bugün dünya nüfusunun yaklaşık yarısının H.pylori ile infekte olduğu kabul edilmektedir. H.pylori ile infekte kişilerin hemen hepsinde gastrit ve midede fonksiyonel değişiklik, %15-20’sinde peptik ülser, %2-12’sinde ülser komplikasyonu, %1-3’ünde mide kanseri, %0,1’inde primer gastrik lenfoma, az oranda da fonksiyonel dispepsi gelişme riski vardır. Bu çalışmada Mart 2007 ve Mart 2009 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Gastroenteroloji polikliniği veya Genel Dahiliye polikliniğine dispepsi şikayetleriyle başvurup, şikayetleri neticesinde tanıya yönelik endoskopik girişim yapılan ve bunun sonucunda mide biyopsisi kronik aktif gastrit saptanan 218 olgunun dosyaları retrospektif olarak incelendi. 218 hastanın 110’unda H.pylori pozitif iken (%50.5), 108’inde H.pylori negatif (%49,5) olarak saptandı ve tanı grupları arasında H.pylori varlığı bakımından farklılık saptanmadı. Diğer çalışmalarla kıyaslandığında bu oranın düşük bulunmasının sebepleri arasında ortamda H.pylori’nin yeterli düzeyde olmaması, üreaz oluşturan diğer bakterilerin varlığı ve özellikle de H.pylori’nin mide mukozasında yamalı biçimde dağılım göstermesi sayılabilir. Her ne kadar çalışmamızda H.pylori sıklığı diğer çalışmalara nazaran düşük çıksa da gerek biyopsi sonucuyla, gerek üre nefes testi ile mutlaka H.pylori araştırılmalıdır ve gerekli eradikasyon tedavisi yapılmalıdır. Tedavi sonrası mutlaka H.pylori nüksü açısından hasta değerlendirilmelidir. Erken eradikasyonların mide malignitelerini önlediği bilinmektedir.
Kronik viral hepatit B ve C'li hastalarda karaciğer fibrozisin noninvaziv değerlendirilmesinde hyaluronik asit, tip IV kollajen, prokollajen tip III amino-terminal peptid düzeyi
(Uludağ Üniversitesi, 2011) Irak, Kader; Nak, Selim Giray; ludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Gastroenteroloji Bilim Dalı.
Kronik hepatitli hastalarda inflamasyon ve fibrozisin derecesini belirlemede karaciğer biyopsisi `altın standart' olarak kabul edilmektedir. Tedavi öncesi yapılmasındaki temel hedef tedaviden fayda görmesi beklenen grubu (orta derecede inflamasyon ve ileri derecede fibrozisli) belirlemektir. Bununla birlikte karaciğer biyopsisinin mortalite ve morbiditeye neden olması, etik nedenlerle takip için uygun olmaması ve karaciğerdeki patolojilerin heterojen dağılımı tanıdaki rolünün tartışılmasına neden olmaktadır.Yapılan çalışmalarda biyopsi yapılmadan fibrozisin evresini belirlemeye imk?n sağlayacak invaziv olmayan biyokimyasal belirleyicilerin histolojik hasarı tespit etme ve fibrozisin ilerlemesinin takibinde yardımcı olabileceği düşünülmektedir.Çalışmamızda kronik hepatit B ve C'li hastalarda karaciğerdeki fibrozisi değerlendirmede noninvaziv belirteçlerden olan hyaluronik asit, tip IV kollajen, prokollajen III aminoterminal peptit düzeyinin karaciğer histopatolojisi ile ilişkisini ortaya koymayı amaçladık.Bu çalışmada 56 kronik hepatit B ile 24 kronik hepatit C hastası incelendi. Hastalar Ishak skorlama sistemi kullanılarak yapılan karaciğer biyopsisinde fibrozis skorlarına göre HA, PIIINP, Tip IV kollajen düzeyleri açısından karşılaştırıldı. Kronik hepatit B'de ciddi fibrozis grubunda tip IV kollajen düzeyleri istatistiksel olarak anlamlı derecede yüksekti (p<0,05). Kronik hepatit C'li hastalarda ise fibrozis skoruna göre ayrılan gruplar arasında noninvaziv belirteçlerin düzeyi ile istatistiksel anlamlılık tespit edilmedi.Dolayısıyla bu çalışmanın sonucuna göre; karaciğer fibrozisinin noninvaziv ölçümünde kullanılabilecek serum belirteçlerinin değerleri gittikçe artıyor olmasına rağmen karaciğer biyopsi örneğinin histopatolojik incelenmesi halen, karaciğer hastalığının evrelemesinde önemini korumaktadır.
Mean platelet volume is an important predictor of hepatitis c but not hepatitis b liver damage
(Wolters Kluwer Medknow Publications, 2015-09-01) Eminler, Ahmet Tarık; Uslan, Mustafa Ihsan; Ayyıldız, Talat; Irak, Kader; Kıyıcı, Murat; KIYICI, MURAT; Gürel, Selim; GÜREL, SELİM; Dolar, Enver; DOLAR, MAHMUT ENVER; Gülten, Macit; GÜLTEN, MACİT; Nak, Selim Giray; NAK, SELİM GİRAY; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; 0000-0002-0019-3207; 0000-0002-3208-6211; ABF-1568-2021; HLH-8209-2023; AAI-4213-2021; AAG-9177-2021
Background: The mean platelet volume (MPV) is the most commonly used measure of platelet size and is a potential marker of platelet reactivity. In this study, we aimed to explore the relationship between hepatic histopathology in viral hepatitis and MPV levels, which are associated with platelet count and activity. Materials and Methods: We performed a retrospective case-control study of baseline histological and clinical parameters in chronic hepatitis B and C patients in our tertiary reference center between January 2005 and January 2011. Two hundred and five chronic hepatitis B patients and 133 chronic hepatitis C patients who underwent liver biopsy were included in the study. The patients were divided into two groups: Chronic hepatitis B and chronic hepatitis C and were additionally divided into groups of two according to histological activity index (HAI) and fibrosis scores obtained by liver biopsy results (according to the Ishak scoring system). The clinical characteristics of chronic viral hepatitis patients, including demographics, laboratory (especially MPV), and liver biopsy findings, were reviewed. Results: One hundred and forty-three patients were male (69.1%), and the mean age was 41.9 +/- 12.75 with an age range of 18-71 years in hepatitis B patients. In the classification made according to HAI, 181 patients were in the low activity group (88.3%) and 24 in the high activity group (11.7%). In the evaluation made according to fibrosis score, 169 patients were found to have early fibrosis (82.4%) and 36 were found to have advanced fibrosis (17.6%). In patients with hepatitis B, there was no statistically significant difference in terms of their MPV values between the two groups, separated according to their degree of activity and fibrosis. Sixty-three patients were male (47.3%), and the mean age was 50.03 +/- 12.75 with an age range of 19-75 years. In the classification made according to HAI, 109 patients were in low activity group (81.9%) and 24 in high activity group (18.1%). In the evaluation made according to fibrosis score, 101 patients were found to have early fibrosis (75.9%) and 32 have advanced fibrosis (24.1%). There was a statistically significant difference between the activity and fibrosis groups of the hepatitis C patients (P = 0.04 and P = 0.02, respectively). Conclusion: MPV values are more reliable in hepatitis C patients than hepatitis B for predicting the advanced damage in liver histology. This finding might be useful for the detection of early fibrosis and also starting early treatment, which is important in hepatitis C.
Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir ± Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience
(Aves, 2020-10-09) Değertekin, Bülent; Demir, Mehmet; Akarca, Ulus S.; Kani, Haluk Tarık; Üçbilek, Enver; Yıldırım, Emre; Güzelbulut, Fatih; Balkan, Ayhan; Vatansever, Sezgin; Danış, Nilay; Demircan, Melek; Soylu, Aliye; Yaras, Serkan; Kartal, Aysun; Kefeli, Ayşe; Gündüz, Feyza; Yalçın, Kendal; Erarslan, Elife; Aladağ, Murat; Harputluoğlu, Murat; Özakyol, Ayşegül; Temel, Tuncer; Akarsu, Mesut; Sümer, Hale; Akın, Mete; Albayrak, Bülent; Şen, İlker; Alkim, Hüseyin; Uyanıkoğlu, Ahmet; Irak, Kader; Öztaşkın, Sinem; Uğurlu, Çağrı Burak; Güneş, Şevkican; Gürel, Selim; Nuriyev, Kenan; İnci, İsmail; Kaçar, Sabite; Dinçer, Dinç; Doğanay, Levent; Göktürk, Hüseyin Savaş; Mert, Ali; Coşar, Arif Mansur; Dursun, Hakan; Atalay, Roni; Akbulut, Sabiye; Balkan, Yasemin; Koklu, Hayrettin; Şimşek, Halis; Özdoğan, Osman; Çoban, Mehmet; Poturoğlu, Şule; Ayyıldız, Talat; Yapalı, Suna; Günşar, Fulya; Akdoğan, Meral; Özenirler, Seren; Akyıldız, Murat; Sezgin, Orhan; Özdoğan, Osman; Kaymakoğlu, Sabahattin; Besişik, Fatih; Karasu, Zeki; Idılman, Ramazan; GÜREL, SELİM; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji ve Hepatoloji Anabilim Dalı.; 0000-0002-7279-2161; HLH-8209-2023
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.
The relation between liver histopathology and GGT levels in viral hepatitis: More important in hepatitis B
(Aves, 2014-08) Eminler, Ahmet Tarık; Irak, Kader; Ayyıldız, Talat; Keskin, Murat; Kıyıcı, Murat; Gürel, Selim; Gülten, Macit; Dolar, Enver; Nak, Selim Giray; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0002-3208-6211; AAG-9177-2021; R-8751-2019; AAI-4213-2021; 24066287600; 37080733400; 6603155277; 23050640000; 6507627491; 7003706434; 6603629209; 6602075084; 6603336505
Background/Aims: To investigate the relationship between gamma-glutamyl transpeptidase (GGT) levels and histopathological status determined by biopsy in patients with chronic hepatitis B and C. Materials and Methods: Patients with chronic hepatitis B and C who were referred to the Uludag University Faculty of Medicine Gastroenterology outpatient clinic between January 2005-January 2011 and underwent liver biopsy were included in the study. Overall, 246 patients with hepatitis B and 151 patients with hepatitis C were enrolled. According to the evaluation based on the Ishak score, patients with a histological activity index (HAI) between 0-12 were defined as low activity, and those with an HAI between 13-18 were defined as high activity. In addition, patients with a fibrosis score of 0-2 were defined as low fibrosis, and those with a score between 3-6 were defined as high fibrosis; comparisons were made accordingly. Results: In patients with hepatitis B, the mean GGT level was 38.86 +/- 42.4 (IU/L) in the low activity group and 60.44 +/- 44.4 (IU/L) in the high activity group (p<0.05). In hepatitis B patients, the mean GGT level was 26.89 +/- 14.83 (IU/L) in the low fibrosis group, whereas it was 65.60 +/- 59.7 (IU/L) in the high fibrosis group (p<0.001). There was no significant difference between HAI and fibrosis group with regard to GGT levels in the hepatitis C patients. Conclusion: In conclusion, it is proposed that in patients with chronic viral hepatitis, GGT levels can be taken into consideration to predict advanced histological liver damage, especially in patients with hepatitis B.
The relationship of the degree of hepatic fibrosis with hyaluronic acid, type 4 collagen, and procollagen type 3 N-terminal peptide levels in patients with chronic viral hepatitis
(Galenos Yayıncılık, 2015-04-01) Irak, Kader; Eminler, Ahmet Tarık; Ayyıldız, Talat; Keskin, Murat; Nak, Selim Giray; Kıyıcı, Murat; Gürel, Selim; Gülten, Macit; Dolar, Enver; Irak, Kader; Eminler, Ahmet Tarık; Ayyıldız, Talat; Keskin, Murat; NAK, SELİM GİRAY; KIYICI, MURAT; GÜREL, SELİM; GÜLTEN, MACİT; DOLAR, MAHMUT ENVER; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; 0000-0002-0019-3207; 0000-0003-4526-4352; 0000-0002-3208-6211; DVB-0510-2022; R-8751-2019; CCH-9450-2022; JZY-7001-2024; FQM-3662-2022; AAI-4213-2021; HLH-8209-2023; JGZ-0732-2023; AAG-9177-2021
Objective: To investigate the relationship of liver histopathology with the levels of noninvasive markers, namely hyaluronic acid (HA) type 4 collagen and procollagen 3 amino-terminal peptide (P3NP) used for the assessment of hepatic fibrosis in patients with chronic viral hepatitis.Materials and Methods: The study included 80 patients, 56 with chronic hepatitis B (CHB) and 24 with chronic hepatitis C (CHC) who presented to the outpatient clinic at Uludag University Faculty of Medicine, Department of Gastroenterology, and underwent pretreatment liver biopsy between 2008 and 2010. The patients were divided into 2 groups according to the degree of fibrosis: group 1 included patients with grade <= 3 fibrosis (no fibrosis, mild or moderate), group 2 included patients with grade >= 4 fibrosis (severe fibrosis). The association of hepatic fibrosis grade with HA, type 4 collagen, and P3NP was examined.Results: Among the 65 patients in group 1 whose fibrosis grade was confirmed via liver biopsy, 47 (72.3%) had HBV and 18 (27.7%) had HCV, whereas 9 of 15 (60%) in group 2 had HBV and 6 of 15 (40%) had HCV. There was no significant difference in the non-invasive fibrosis markers between the groups (p>0.05). In addition, there was not a significant difference in HA and P3NP levels between the CHB patients in groups 1 and 2 (p>0.05), but the type 4 collagen level was significantly higher in the HBV patients in group 2 (p<0.05). On the other hand, there were no significant differences in HA, type 4 collagen, and P3NP levels, or fibrosis grade between the HC patients (p>0.05).Conclusion: The use of any marker or combination of markers examined in the present study is not a substitute for liver biopsy for assessing hepatic fibrosis. The fibrosis markers examined in the present study could be further examined in research on anti-fibrotic treatment. Future clinical investigations are needed for the evaluation of the value of these tests in diagnosis and monitoring. It should not be forgotten that the basic diagnostic approach is liver biopsy.
Tuberculous peritonitis case at advanced age presenting with chylous ascites
(Aves, 2012-08) Eminler, Ahmet Tarık; Ayyıldız, Talat; Irak, Kader; Dolar, Enver; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; R-8751-2019; AAG-9177-2021; ABF-1568-2021; 24066287600; 6603155277; 37080733400; 6602075084
Chylous ascites is defined as peritoneal fluid accumulation with milky appearance rich in triglycerides. It is detected in the abdominal cavity in association with thoracic or intestinal fluid accumulation. Our case was a tuberculous peritonitis case emerging suddenly at an advanced age and presenting with chylous ascites.