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Öğe Association between pan-immune inflammatory value and ulcerative colitis(Taylor & Francis Ltd, 2024) Yildirim, Aslihan Mete; Yildirim, OguzhanObjective: Ulcerative colitis is a chronic idiopathic disease that causes inflammation of the colon and rectum, progressing with relapses and remissions. Systemic inflammatory index (SII) and pan-immune inflammatory value (PIV) are newly developed biomarkers. There are many studies in the literature showing the relationship between SII and PIV with malignancies and inflammatory diseases. In this study we aimed to determine the relationship between SII and PIV with the activity of ulcerative colitis. Materials and methods: 146 Ulcerative colitis patients were retrospectively investigated by the time of diagnosis based on clinical, endoscopic and histolopathological findings. Patients and healthy individuals SII and PIV levels were calculated and compared with each other; and Mayo, DUBLIN, UCIES endoscopic subscores of patients were also obtained. Roc curve analysis were used to determine the cut-off value for PIV. Results: SII (468.6 +/- 203.5 vs. 823.1 +/- 555.1; p < .001), PIV (288.2 +/- 159.9 vs. 912.2 +/- 924.1; p < .001), were statistically different between groups. PIV (OR: 1.157; (1.041-1.432), p = .036), was also observed to be the independent predictor of ulcerative colitis. The best cut off value of PIV in the prediction of ulcerative colitis was >= 506 with 89.6% sensitivity and 63.7% specificity (AUC = 0.812; 95% CI 0.763-0.854, p < .001). Conclusion: Based on the results of our study, we found that SII and PIV levels were significantly increased in ulcerative colitis patients at the time of diagnosis and were associated with disease severity in the endoscopic scores RACHMILEWITZ, UCEIS and DUBLIN scores, but not for MES score.Öğe Association of CagA-positive Helicobacter pylori infection with severity of obstructive sleep apnea syndrome(Scientific Publishers India, 2016) Yildirim, Oguzhan; Bali, Ilhan; Tulubas, Feti; Mete, Rafet; Topcu, Birol; Seckin, Yuksel; Cagin, Yasir FurkanAim: To investigate the association between Helicobacter pylori cytotoxin-associated gene-A (CagA) status and the severity of OSA syndrome in infected patients. Methods: Ninty-six patients with obstructive sleep apnea syndrome (OSAS) and 30 age-and sex-matched control subjects with no history of OSA or gastrointestinal complaints were included in the study. Patients' apnea-hypopnea index (AHI) was determined by polysomnography (PSG), and serum H. Pylori IgG and cytotoxin-associated gene-A IgG was assayed by enzyme-linked immunosorbent assay (ELISA). Based on their AHI score, subjects were assigned to one of three groups: a control group (AHI<5), a mild-moderate OSAS group (AHI >= 5 and < 30), and a severe OSAS group (AHI >= 30). Results: The prevalence of H. pylori IgG seropositivity was significantly higher in the severe OSAS group compared to the mild-moderate OSAS group [ 29 (90.6%) patients versus 41 (64%) patients, (p=0.007)]. In addition, CagA seropositivity was present in 10 control patients (58.8%), 23 mild-moderate OSAS patients (56%), and 25 severe OSAS patients (86.2%). There was a significantly higher prevalence of CagA seropositivity in the severe OSAS group compared to mild-moderate OSAS group (p=0.027). There was no significant difference in CagA seropositivity between the mild-moderate OSAS group and the control group (p=0.059). Conclusion: Our findings suggest that H. pylori strains expressing CagA may be considered a risk factor in the severity of OSAS.Öğe Does the tumor necrosis factor a predictor factor in patients with chronic hepatitis B and C(Allied Acad, 2017) Bilgic, Yilmaz; Seckin, Yuksel; Cagin, Yasir Furkan; Yildirim, Oguzhan; Yilmaz, Cengiz; Harputluoglu, Murat; Harputluoglu, HakanAim: In our research, we aimed to investigate the importance and pattern of Tumor Necrosis Factor (TNF) alpha in response to the combinatorial treatment of lamuvidin (LAM) and Pegile interferon (PEG INF) 2a + Ribavirin (RIB) in patients with Chronic Hepatitis B (CHB) and Chronic Hepatitis C (CHC). Material and method: Thirty four CHB and 25 CHC patient samples were taken before and after the treatment and stored appropriately. CHB patients were treated with LAM and CHC patients were treated with using the combination of PEG INF 2a and RIB. HBV DNA, anti HBe, ALT, AST and TNF alpha results were obtained from CHB patients before and 48th week of the treatment. HCV RNA, ALT, AST and TNF alpha results were also obtained from CHC patients before and in the 6th month of completing the treatment. Responses to the treatment were taken as negative result of HBV DNA in CHB patients after finishing the treatment and as negative result of HCV RNA in CHC patients after 6 months of finishing the 48 weeks of PEG INF treatment. Results: At the level of decreasing TNF-alpha in CHB patients when the group responding to the treatment compared to the group not responding to the treatment, a significant difference was observed in favor of the respondent group (p< 0.0001). At the level of decreasing TNF-alpha in CHC patients when the group responding to the treatment compared to the group not responding to the treatment, a significant difference was also obtained in favor of the respondent group (p< 0.0001). In the analysis for emphasizing the importance of TNF alpha level in response to the treatment in CHB patients, it was found that predicting the response to the treatment of TNF alpha was 78.6% sensitivity and 75% specificity for 68.78 cutoff. In the analysis for emphasizing the importance of TNF alpha level in response to the treatment in CHC patients, it was found that determining the response of TNF alpha to the treatment was 100% sensitivity and 100% specificity for 122.4 cutoff. Conclusions: With the treatment a decrease in TNF alpha is occured in CHB and CHC patients; however, TNF alpha decrease in the groups responding to the treatment is more significant. The results of this research show that TNF alpha level may be an important non-invasive marker for foresight and determining the response to the treatment.Öğe Early therapeutic plasma exchange may improve treatment outcomes in severe acute toxic Hepatitis(Pergamon-Elsevier Science Ltd, 2021) Berber, Ilhami; Cagin, Yasir Furkan; Erdogan, Mehmet Ali; Ataman, Engin; Gozukara, Harika; Erkurt, Mehmet Ali; Yildirim, OguzhanBackground and objectives: Acute toxic hepatitis can result in a different clinical course from a completely curable disease to subacute hepatitis, chronic hepatitis, and fulminant hepatitis failure, which is quite mortal. For this purpose, therapeutic plasma exchange (TPE) can be used for improving treatment outcomes by reducing the harmful substances caused with and/or without liver function in acute toxic hepatitis. We aimed to evaluate treatment outcomes in severe acute toxic hepatitis patients who applied early TPE procedure. Materials and Methods: A total of 335 patients who received TPE between 2010-2021 were retrospectively screened and 59 (male/female, 30/29; min/max-age, 22-84) patients with acute toxic hepatitis who underwent TPE in the first 24 h were included in the study. TPE was performed in patients who had high total bilirubin level (>10 mg/dL). Laboratory parameters of the patients before and after the TPE procedure, number of patients developed complications of acute toxic hepatitis and mortality rates were evaluated for effectiveness of TPE. Results: Acute toxic hepatitis was associated with hepatotoxic drugs in 44 (74.5 %), herbal medication 6 (10.2 %), mushroom poisoning 6 (10.2 %) and with substance abuse 3 (5.1 %) in patients. When the patients were compared based on INR, liver function tests, ammonia, lactate and Model For End-Stage Liver Disease (MELD) score at baseline, 48 h after TPE (independently of TPE number) and before final state a statistically significant decrease was observed in all parameters (p < 0.05). Fifty three (90 %) of patients improved without complications, the remaining 6 (10 %) patients were diagnosed with fulminant hepatitis. All these remaining patients died before liver transplantation (LTx) could be performed. Conclusion: TPE is a safe, tolerable therapy option and early TPE may improve treatment outcomes in severe acute toxic hepatitis.Öğe Endoscopic treatment of biliary complications in donors after living donor liver transplantation in a high volume transplant center(Aves, 2020) Erdogan, Mehmet Ali; Cagin, Yasir Furkan; Atayan, Yahya; Bilgic, Yilmaz; Yildirim, Oguzhan; Caliskan, Ali Riza; Aladag, MuratBackground/Aims: Although living donor liver transplantation (LDLT) has been accepted as a primary treatment for adults with endstage liver disease, concerns about donor health have emerged. As LDLT is technically complex, it creates perioperative morbidity and mortality risk in donors. Biliary complications such as stricture and leakage are seen most frequently in donors after liver transplantation. While some of these complications get treated with a conservative approach, endoscopic, surgical, and percutaneous interventions may be required in some others. We aimed to present endoscopic retrograde cholangiopancreatography (ERCP) results in donors who developed biliary complications after LDLT. Materials and Methods: Between June 2010 and January 2018, a total of 1521 donors (1291 right lobe grafts, 230 left lobe grafts) who underwent LDLT were retrospectively reviewed. Sixty-three donors who underwent ERCP due to biliary complication were included in the study. Results: Biliary stricture was found in 1.6% (25/1521), biliary leakage in 2.1% (33/1521), and stricture and leakage together in 0.3% (5/1521) donors. Our endoscopic success rates in patients with biliary leakage, biliary stricture, and stricture and leakage were 85% (28/33), 92% (23/25), and 80% (4/5), respectively. Surgical treatment was performed on 12.6% (8/63) donors who failed ERCP. Conclusion: We found that ERCP is a successful treatment for post-LDLT donors who have biliary complications.Öğe Eosinophilic ascites, as a rare manifestation of eosinophilic gastroenteritis: A case report(2018) Cagin, Yasir Furkan; Berber, İlhami; Bilgic, Yilmaz; Erdogan, Mehmet Ali; Yildirim, Oguzhan; Altunel Kilinc, Elif; Seckin, Yuksel; Akatli, Ayşe NurEosinophilic ascites (EA) can present as an unusual finding of eosinophilic gastroenteritis. We presented this case to remind eosinophilic acid in cases with unexplained etiology. A 29-years old man presented to an emergency department with abdominal swelling, progressively worsening nausea, and fatigue over one month. The patient had no history of allergic disease. There was moderate ascites in the physical examination. Percent eosinophil was 60% in peripheral blood smear while IgE level was increased in the serum. There was ascites on abdominal computed tomography (CT) scan. Serum ascites-albumin gradient (SAAG) was non-portal. Eosinophilic infiltration was detected biopsy samples obtained by upper GI tract endoscopy and in bone marrow aspiration and biopsy. The abdominal pain, ascites and all laboratory tests were completely recovered after 12 weeks of prednisolone therapy. Eosinophilic gastroenteritis should be considered in case of markedly increased eosinophilia in ascites fluid.Öğe Evaluation of stent applications for upper gastrointestinal disorders(2024) Caliskan, Ali Riza; Yildirim, OguzhanAim: Gastrointestinal stents are predominantly used for palliating malignant dysphagia in patients with esophageal cancer when surgical intervention is deemed inappropriate. This research aims to elucidate the diagnostic and follow-up processes of patients who underwent stent placement for upper gastrointestinal system pathologies at our clinic. Materials and Methods: A retrospective analysis assessed 61 patients who received stents for upper gastrointestinal tract stenosis due to various causes. Patient demographics, including age and gender, underlying pathology, benign-malignant status, location of the pathology, prior surgical or bougie dilation interventions, post-stent survival status, and, if applicable, the duration between the procedure and decease, were evaluated. Patient health records were accessed from the hospital’s electronic medical database. Results: Pre-stent bougie dilation was performed in 26.2% (n=16) of patients, while pre-stent surgery was undertaken in 41% (n=25). Repeat stenting was necessitated in 6.6% (n=4) of cases. Of the patients, 86.9% (n=53) succumbed to their condition, while 13.1% (n=8) survived. Post-stent survival times for deceased patients after stent surgery ranged from 0 to 55 months, with a median survival time of two months. Surviving patients exhibited varied post-stent durations between 65 and 122 months, with a mean stent utilization period of 101 months. A statistically significant correlation was observed between pre-stent surgery and survival status, indicating a higher surgery rate in patients who survived than those who did not (p<0.05). Conclusion: Consequently, due to its cost-effectiveness, stents can be a viable alternative to surgery for both benign and malignant gastrointestinal disorders. This is attributed to its notable advantages, including flexibility and high resistance.Öğe Gastrointestinal amyloidosis occurring in three different patterns: Case serie(2019) Cagin, Yasir Furkan; Caliskan, Ali Riza; Bilgic, Yilmaz; Yildirim, Oguzhan; Erdogan, Mehmet Ali; Seckin, Yuksel; Alan, Saadet; Karadag Soylu, NeseSystemic amyloidosis is a rare disease characterized by extracellular accumulation of amyloid protein in one or more organs. In patients with systemic amyloidosis, the most frequently affected organs are kidney and heart, followed by the nervous system, soft tissues, and lungs. Small bowel and liver involvement are also frequent in systemic amyloidosis. Gastrointestinal (GI) findings are common, and the degree of organ involvement determines the symptoms. Patients usually have nonspecific findings such as abdominal pain, nausea, diarrhea, and dysphagia, which may delay the appropriate diagnosis. Liver involvement occurs in the majority of patients, but the symptoms typically do not happen unless a marked hepatic amyloid deposition occurs. Diagnosis is by tissue biopsy. Treatment and prognosis depend on the underlying disease. GI system involvement is a sign of poor prognosis. In this case series, five patients who were diagnosed with gastrointestinal system amyloidosis in our clinic are presented.Öğe The influence of vitamin D deficiency on eradication rates of Helicobacter pylori(Wroclaw Medical Univ, 2017) Yildirim, Oguzhan; Yildirim, Tulay; Seckin, Yuksel; Osanmaz, Pelin; Bilgic, Yilmaz; Mete, RafetBackground. Helicobacter pylori eradication therapy improves the healing of various gastro-duodenal diseases such as chronic gastritis and peptic ulcer, and also reduces gastric cancer incidence. Several studies have reported on risk factors other than antibiotic resistance related to Helicobacter pylori eradication failure. Objectives. In this study, we aimed to investigate whether or not the serum levels of 25-hydroxy-vitamin D (25(OH)D) influence eradication rates of H. pylori. Material and methods. 220 patients diagnosed with H. pylori gastritis using endoscopic biopsy had their 25-OH vitamin D levels measured via the electrochemiluminescence method before beginning eradication therapy of H. pylori. Gastric biopsies obtained at endoscopy were examined for H. pylori strains and histopathologic findings. All patients were treated with bismuth-containing quadruple therapy for 14 days. H. pylori eradication was determined via the 14C-urea breath test performed 4 weeks after the end of therapy. Based on the 25-OH vitamin D levels, the patients were divided into 2 groups: group 1 (deficient) had a vitamin D level of < 10 ng/mL, while group 2 (sufficient) had a vitamin D level of >= 10 ng/mL. Results. Eradication was successful in 170 (77.2%) patients and failed in 50 (22.7%) patients. The prevalence of 25(OH)D deficiency was 30.5%. Mean 25(OH)D levels were significantly lower in the eradication failure group compared to the successful treatment group (9.13 +/- 4.7 vs 19.03 +/- 8.13; p = 0.001). There were significantly more patients with deficient 25(OH)D levels in the failed treatment group compared to the successful treatment group (p = 0.001). Conclusions. Our findings suggest that 25-OH vitamin D deficiency may be considered a risk factor related to eradication failure of H. pylori, which may lead to a need for supplementation of vitamin D before eradication of H. pylori.Öğe The risk factors of portal vein thrombosis in patients with liver cirrhosis(Spandidos Publ Ltd, 2019) Cagin, Yasir Furkan; Bilgic, Yilmaz; Berber, Ilhami; Yildirim, Oguzhan; Erdogan, Mehmet Ali; Firat, Feyza; Arslan, Ahmet KadirThis study was designed to identify and assess risk factors for portal vein thrombosis (PVT) in patients with cirrhosis. A total of 98 cirrhosis patients with PVT were identified and 101 cirrhosis patients without PVT were chosen as the control group in this retrospective study. Several variables were measured and the two groups PVT and non-PVT were compared statistically. PVT was identified in 98 patients (10%). Significant differences in hematocrit, international normalized ratio, albumin, bilirubin and glucose were determined between the groups (P<0.05). Out of the thrombophilic risk factors in the patients with PVT factor V Leiden was identified in 8.8%, prothrombin gene 6.6% and methylenetetrahydrofolate reductase 2.2%. There was no difference in survival time between groups (P>0.05).
