Yazar "Kayar, Yusuf" seçeneğine göre listele
Listeleniyor 1 - 8 / 8
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Are noninvasive biochemical parameters an alternative to liver biopsy in patients with chronic hepatitis B?(2021) Konur, Sevki; Surmeli, Neslihan; Ozkahraman, Adnan; Dertli, Ramazan; Kayar, YusufAim: Although there is a gold standard liver biopsy in showing the histological activity of the disease, there are contradictory results in the studies conducted for using some non-invasive methods that are alternatively biochemically calculated due to being an invasive procedure. We aimed to investigate the relationship of FIB-4, APRI, API and AAR values with histopathology in patients undergoing liver biopsy due to chronic hepatitis B virus (HBV) infection. Materials and Method: Patients with follow-up between November/2016-October/2019 with the diagnosis of chronic HBV were included. Demographic data and histopathological data were documented. Accompanying comorbid diseases, medications and previous operations were questioned. Patients were grouped as mild, moderate and advanced fibrosis according to fibrosis scoring. Sensitivity, specificity, cutt-of, AUC values of biochemical parameters were calculated between the groups. Results: A total of 151 patients, 64(42.3%) women, were included in the study. As a result of the liver biopsy; mild fibrosis was found in 73(48.3%) patients, moderate fibrosis in 33(21.8%) patients and advanced fibrosis in 45(29.9%) patients. There was a significant correlation between fibrosis level and age, liver function tests, bilirubin and albumin (p<0.05). While there was no relationship between fibrosis stage and HBV-DNA, there was a significant relationship between groups with AAR, API, APRI and FIB4 (p<0.05). Conclusions: Although FIB-4, APRI, AAR and API values are important in determining the level of hepatic fibrosis, the effect of biochemical parameters on various factors negatively affects the specificity and sensitivity of these tests. For this reason, liver biopsy is still seen as the gold standard.Öğe The effect of gluten-free diet on mean platelet volume, neutrophil and neutrophil/lymphocyte ratio in children with celiac disease(2020) Agin, Mehmet; Kayar, Yusuf; Dertli, Ramazan; Konur, Sevki; Surmeli, Neslihan; Ozkahraman, AdnanAim: Celiac Disease (CD) is a chronic, autoimmune and systemic disease. In the present study, the purpose was to investigate the effect of a gluten-free diet on Mean-Platelet-Volume (MPV), neutrophil and neutrophil/lymphocyte Ratio (NLR).Material and Methods: A total of 106 patients who were diagnosed with CD and who were followed-up by the Pediatric Gastroenterology Clinic of the Hospital, and 50 healthy children were included in the study. The demographic data of the patients and the neutrophil, lymphocyte, platelet, NLR were recorded before the diagnosis and one-year after gluten-free diet. The hematologic parameters of the patients were compared with the healthy control group at the diagnosis time. Following a one-year gluten-free diet, the hematologic parameters of the patients were compared with the parameters at the diagnosis time.Results: The mean age of the patients was 12.1±3.2 years (7-16 years), and the mean age of the control group was 14.5±4.1 years (12-16 years). A total of 48% (51/106) of the patients were female and 34% (17/50) of the control group was female. Hematological parameters of patients compared pre-dietary and post-dietary; lymphocyte and platelet ratios were significantly higher, whereas neutrophils, MPV and NLR were significantly lower. Neutropenia was detected in 15 patients before the diet. It was observed that neutrophil level reached the normal range after gluten-free diet in patients with neutropenia.Conclusions: The MPV, neutrophil and NLR values, that was low during the diagnosis, may be ameliorative with the gluten-free diet. In addition, CD should be considered in the differential diagnosis of neutropenic patients.Öğe Factors affecting hepatitis B immunization in celiac disease(2019) Kayar, Yusuf; Dertli, RamazanAim: While 90-95% of the adult population responds to hepatitis-B vaccination, it is known that, this rate is lower in patients with CD. In our study, determination of response rates of vaccinated celiac patients, and the affecting factors associated with vaccine responses were the aims of our investigation. Material and Methods: The study included 280 celiac patients who applied to the polyclinic between 2015-2019 years. Demographic, anthropometric characteristics (age, gender, onset age, disease duration, smoking, body mass index(BMI), waist-hip ratios) and symptoms in patients were documented. Hepatitis B, C, delta serology were examined. The prevalence of chronic hepatitis and associated risk factors were evaluated. Hepatitis-B vaccination rates and vaccine responses were determined. The risk factors associated with the immune response were reviewed. Results: 212 (75.7%) of the patients were female, the mean-age of the patients was 33.4±10.8 and the disease duration was 4.9±3.7 years. In 14 (5%) of the patients there were chronic viral infections, 18 (6.4%) had natural immunity, 92 (32.9%) were immunized, 58 (56.4%) were not encountered with viral infection. No significant correlation was found between the presence of chronic viral hepatitis and risk factors. 28 (30.4%) patients who had not vaccine response. It was observed that; the dietary incompatibility and absence of immunological remission were significantly higher, the BMI and the waist size were significantly lower in non-response group (P0.05). Conclusions: Considering the mild-high prevalence of chronic viral infection in celiac patients, it is important to vaccinate these patients against infections. It is of great importance to implement re-vaccination protocol in the patients without vaccine response.Keywords: Celiac disease; hepatitis B; vaccination.Öğe Inflammatory parameters and insulin resistance and cigarette smoking in type 2 diabetes mellitus(2018) Kayar, Yusuf; Agin, Mehmet; Unver, NurcanAim: Smoking remains a global problem and it is known as a cause of many diseases. Globally, tobacco use is the most important cause of preventable morbidity and mortality. The aim of this study is to evaluate the impact of smoking on insulin parameters and inflammatory markers, and the variation of these parameters according to the duration of smoking cessation in patients who quit smoking. Material and Methods: 612 patients aged 18-70 years (n = 612) who were undergoing treatment and follow-up for type 2 diabetes mellitus were included in this study. The patients were categorized into 3 groups (i.e., smokers, ex-smokers, and nonsmokers). Test results ofof hemoglobin A1c (HbA1c), cholesterol, triglyceride, high density lipoprotein (HDL) levels, low density lipoprotein, leukocyte count, C-reactive protein, fibrinogen, and ferritin levels were obtained. Body mass indexes (BMI) and blood pressure were also measured. Results: Smoking was significantly associated with the male gender, HbA1c, HDL level, BMI, waist circumference, the homeostatic model assessment-insulin resistance (HOMA-IR) core, and inflammatory markers. Current smokers who smoked ≥20 packs/year demonstrated poorer metabolic results compared to those who smoked 0-10 pack(s)/year. The metabolic parameters were worse in ex-smokers who quit smoking <1 year ago compared to ex-smokers who quit 1-5 years, 5-10 years, and >10 years ago. Conclusion: We demonstrated that smoking increased insulin resistance, metabolic syndrome, and inflammation. Smoking was also observed to worsen glycemic control by further increasing insulin resistance in diabetic patients.Öğe Is neutrophil/lymphocyte and platelet/lymphocyte ratio a predictive factor for the fibrous stage in patients with chronic hepatitis B?(2021) Konur, Sevki; Surmeli, Neslihan; Ozkahraman, Adnan; Dertli, Ramazan; Kayar, YusufAim: Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are an inexpensive inflammatory marker that can be easily obtained from the blood count and can be used in many chronic diseases. In our study, we aimed to investigate the relationship between fibrosis stage and NLR, PLR in patients with chronic hepatitis B virus (HBV). Materials and Methods: 173 patients with chronic HBV were included in the study. The demographic data and hemogram parameters of all patients were recorded. Histopathological data of the patients were documented. Accompanying comorbid diseases, medications and previous operations were questioned. In chronic HBV patients, fibrosis level was compared with hematological parameters. Results: A total of 173 patients, 100 (57.8%) of whom were male, were included in the study. As a result of the liver biopsy; mild fibrosis (steage/1-2) in 83(47.9%) patients, moderate fibrosis (steage/3-4) in 35(20.3%) patients and advanced fibrosis (stage/5-6) in 55(31.8%) patients. In advanced fibrosis group, liver function tests and bilirubin levels were significantly higher and albumin level was significantly lower (p<0.05). It was found that NLR level was significantly higher in moderate fibrosis than mild fibrosis, and PLR level was significantly lower in the advanced fibrosis group than in the mild and moderate fibrosis groups (p<0.05). Conclusions: We showed that there is a significant relationship between fibrosis level and NLR, PLR. However, with the available data, it does not seem possible to say that noninvasive methods can completely replace invasive procedures such as liver biopsy. Prospectively designed studies with larger patient participation are needed.Öğe The prevalence of Helicobacter Pylori and related conditions in Van province and its region(2019) Agin, Mehmet; Kayar, YusufAim: The prevalence of Helicobacter Pylori (HP) is up to 90% in developing countries, whereas it is less than 40% in developed countries. This study aims to determine the prevalence of HP in Van city and its region and to investigate the relationship between the presence of HP and the clinical, endoscopic appearanceMaterial and Methods: A total of 367 cases that presented with the dyspeptic complaints to the Gastroenterology outpatient-clinic and underwent upper-gastrointestinal endoscopy and gastric biopsies between July/2017-March/2019 were included in the study. The patients included in the study were divided into three age-groups (1-5 years, 6-10 years, 11-18 years). The clinical complaints, endoscopic findings were recorded in all patients. The relationship between HP positivity and clinical complaints, the endoscopic appearance was analyzed.Results: The presence of HP was found in 234(63.8%) patients. However, the incidence of HP was 63.8% in all patients; it was found 34.6% between 1-5 years, 61.8% between 6-10 years, and 71.2% between 11-18 years, respectively. The duodenal ulcer was found in 8.5%(20/234) of HP positive cases, and 3.5%(5/133) of HP negative cases. In predicting the presence of HP, the ulcer specificity was determined 96%, the sensitivity was 8.5%, the positive predictive value was 80%, and the negative predictive value was found 37.4%Conclusion: HP should be considered in patients with recurrent and chronic abdominal pain. Endoscopic appearance of nodular antral gastritis and the ulcer should suggest HP infection. The high rate of activity and chronicity in HP positive cases indicates the importance of HP eradication therapy.Öğe The relation between life quality and subtype of the disease in patients with irritable bowel syndrome(2019) Kayar, Yusuf; Agin, Mehmet; Unver, Nurcan; Dertli, Ramazan; Kirpinar, IsmetAim: Irritable bowel syndrome (IBS) is not a life-threatening condition; however, people with IBS have a low quality of life (QOL) that might affect their education, social and professional achievements. Many studies have shown that patients who have IBS have lower QOL compared to the general population together with patients who have chronic diseases. The relation between IBS subtype and QOL is still not clear. For this reason, our study aims to evaluate the relationship between subtypes of the disease and QOL in patients who have IBS. Material and Methods: The 100 patients with IBS and 100 healthy individuals who were aged from 18 to 65 years, were included in our study. The relationship between disease subtype and quality of life in IBS patients were analyzed. Results: Regarding quality of life between the groups in the examination; the overall health scores were lower at a significant level in the patients who had IBS subtype as predominant-constipation than those who had IBS subtypes as predominant-diarrhea and mixed type (p=0.013;p=0.045;p<0.05,respectively).The vitality scores were higher at a significant level in patients whose IBS subtypes were predominant-diarrhea than those who had the IBS subtype as predominant-constipation (p=0.007;p<0.01). There were no statistically significant differences between the IBS subtypes and other parameters(p>0.05). Conclusion: It was shown that the QOL of IBS patients were significantly lower than the healthy population, but some differences were also found between the disease subtypes. QOL measurement as part of future therapeutic trials in IBS will help ensure optimal treatment.Öğe Serum soluble TWEAK levels in non-alcoholic fatty liver disease(2019) Asil, Mehmet; Demir, Ali; Unver, Nurcan; Polat, Hakki; Ataseven, Huseyin; Uysal, Saliha; Kayar, Yusuf; Keskin, Muharrem; Yolacan, Ramazan; Biyik, Murat; Dertli, RamazanAim: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. The exact pathogenesis of NAFLD has not been fully elucidated. Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is a member of TNF superfamily and it has been implicated in the pathogenesis of several diseases including liver inflammation and fibrosis. Current study was conducted to evaluate serum sTWEAK levels in patients with NAFLD.Material and Methods: Seventeen patients with biopsy proven non-alcoholic steatohepatitis (NASH), 22 patients with simple hepatosteatosis and 30 healthy controls were included in the study and serum sTWEAK concentrations were measured using commercial ELISA kits.Results: Mean serum sTWEAK concentration was significantly lower in the NASH group when compared to the simple hepatosteatosis group and healthy controls (199.6±101.2 pg/mL, 246.1±65.7 pg/mL and 277.6±117.6 pg/mL respectively, p=0.029). ROC analyses for sTWEAK to differentiate NASH patients from healthy controls and from simple hepatosteatosis revealed that AUC for sTWEAK was 0.712 (%95 CI, 0.543-0.880). For the specified cut off value, 171.1 pg/mL positive and negative predictive values calculated were 64.3% and 85.5% respectively. Conclusion: Serum sTWEAK concentration is decreasedin patients with NASH when compared to patients with simple hepatosteatosis and healthy controls. Keywords: Nonalcoholic steatohepatitis; tumor necrosis factor-like weak inducer of apoptosis; sTWEAK; fibroblast growth factor-inducible 14; Fn 14.
