Publications by authors named "Mustafa Kaplan"

104 Publications

Associations between Gilbert's syndrome and personality characteristics.

Trends Psychiatry Psychother 2021 Apr 2. Epub 2021 Apr 2.

Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

Objective: Gilbert's syndrome (GS) is a benign genetic disorder that is characterized by intermittent mild jaundice in which the liver doesn't process bilirubin properly. The aim of this study was to determine whether GS patients have a different personality structure and if there are associations between properties of temperament and character and total bilirubin levels.

Methods: A total of 1665 young male individuals aged from 19 to 30 who were admitted for occupational examinations were included in this study. Careful patient history was taken, a detailed physical examination was conducted, and hematologic and biochemical tests and abdominal ultrasonography were performed. The Turkish version of the Temperament and Character Inventory (TCI) was administered to all participants. 81 patients diagnosed with GS and 150 randomly chosen healthy individuals (control group) were investigated with comparison and correlation analyses.

Results: GS patients had higher scores than healthy controls for disorderliness (NS4) (p = 0.018), sentimentality (RD1) (p = 0.042), and fatigability (HA4) (p = 0.03). Moreover, Gilbert syndrome patients scored lower than controls for empathy (C2) (p = 0.041) and transpersonal identification (ST2) (p = 0.044). Bilirubin levels were positively associated with disorderliness (NS4) (r = 0.141, p = 0.032) and fatigability (HA4) (r = 0.14, p = 0.033).

Conclusions: GS patients may have some different personality characteristics from healthy individuals. This study is an initial exploration of the personality structure of GS patients and the findings should be interpreted with caution. Further prospective studies are needed to identify the relationship between Gilbert disease and personality characteristics.
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http://dx.doi.org/10.47626/2237-6089-2020-0003DOI Listing
April 2021

A very uncommon clinical entity: Lansoprazole-induced symptomatic hyponatremia in a young woman.

Turk J Gastroenterol 2020 Dec;31(12):957-959

Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

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http://dx.doi.org/10.5152/tjg.2020.19374DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7928252PMC
December 2020

Predictive value of CAR for In-Hospital Mortality in Patients with COVID-19 Pneumonia: A Retrospective Cohort Study.

Arch Med Res 2021 Feb 10. Epub 2021 Feb 10.

Health Science University, Sultan II. Abdülhamid Han Training and Research Hospital, Department of Internal Medicine, Istanbul, Turkey.

Background: In the current literature, there is a growing evidence that supports the significant role of inflammation in the progression of viral pneumonia, including patients with coronavirus disease 2019 (COVID-19).

Aim: The present study aimed to investigate the predictive value of C-reactive protein/albumin ratio (CAR) for in-hospital mortality in patients with COVID-19.

Material And Methods: This retrospective study included the data of 275 consecutive COVID-19 patients who were hospitalized in a referral pandemic center. The CAR ratio was obtained by dividing the CRP level with albumin level. The study population was divided into tertiles (T1, T2, and T3) according to their admission CAR values. The endpoint of the study was a composite outcome of in-hospital mortality.

Results: During the in-hospital course, 33 (12%) patients died. The patients classified into T3 group had significantly higher CAR compared those classified into T2 and T1 groups. After the adjustment for the confounders, T3 group had 8.2 (95% CI: 4.2-48.1) times higher rates of in-hospital mortality compared to T1 group (the reference group) in a logistic regression model using CAR values.

Conclusion: To the best of our knowledge, this is the first study to demonstrate the predictive value of CAR for in-hospital mortality in COVID-19 patients.
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http://dx.doi.org/10.1016/j.arcmed.2021.02.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874980PMC
February 2021

Investigation of Isolated Blastocystis Subtypes from Cancer Patients in Turkey.

Acta Parasitol 2021 Jan 2. Epub 2021 Jan 2.

Department of Medical Parasitology, Faculty of Medicine, Fırat University, 23119, Elazığ, Turkey.

Purpose: It is not clear that Blastocystis remains without damage to the digestive tract or has a pathogenic effect in relation to subtypes in immunocompromised people, such as cancer patients. The present study aimed to investigate the frequency and subtype distribution of Blastocystis in cancer patients who were followed-up and treated in the Oncology clinic of Firat University Hospital and to determine the clinical signs of infected sufferers.

Methods: 201 patients aged ≥ 18 with a diagnosis of cancer were enrolled in this cross-sectional study. Patients' stool samples were examined between September 2017 and August 2019 by native-Lugol, trichrome staining. Microscopy-positive stool samples were subjected to DNA isolation and subtyped by Sequence Tagged Site (STS)-PCR analysis. The symptoms and demographic characteristics of the patients were also evaluated.

Results: Totally, 29 (14.4%) samples were positive for Blastocystis after all methods. 15 (51.7%) out of 29 samples were successfully subtyped by the sequenced-tagged site(STS)-PCR, while 14 (48.3%) could not be typed. Three subtypes of Blastocystis were detected: ST3 (40%), ST2 (33%), ST1 (20%), and one mixed infections with ST1/ST2 (6%). There was no statistically significant difference in terms of clinical findings and demographic characteristics.

Conclusion: The outcomes of our study promote the idea that Blastocystis could be an asymptomatic and harmless commensal organism. However, more comprehensive molecular and clinical studies are needed to fully determine the pathogenicity and epidemiology of Blastocystis in cancer patients.
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http://dx.doi.org/10.1007/s11686-020-00322-yDOI Listing
January 2021

Endoscopic retrograde cholangiography via a permanent access loop.

Turk J Gastroenterol 2020 Apr;31(4):318-323

Department of Gastroenterology, Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey.

Background/aims: The aim of this study was to investigate the indications, technical and clinical success, and complications of the endoscopic retrograde cholangiography (ERC) via a permanent access loop (PAL).

Materials And Methods: Twenty patients who underwent ERC through PAL between 2009 and 2017 were included in this study. The technical success was described as achieving access to the bile ducts through PAL and the clinical success was described as the clinical and laboratory improvement of the patients after the procedure.

Results: The study was performed with 20 patients. The median follow-up duration was 24 months (3-96) and the median number of ERC sessions was 3.9 (1-10). The most common ERC indications through PAL were stones (40%) and cholangitis (30%). In 16 patients (75%), anastomotic or branched strictures were observed. The improvement of strictures via intermittent stenting and dilatation was observed in 6 patients, but no improvement was observed in 5 patients. The treatment of those 5 patients continues. In this study, the technical success was 100% and clinical success was 85%. While no mortality due to PAL-mediated ERC was observed, free wall perforation was seen in one patient who was referred to surgery.

Conclusion: PAL-mediated ERC procedure is a technique with high technical and clinical success and low complication rate in patients who require frequent percutaneous procedures and those with difficult access to the biliary tract.
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http://dx.doi.org/10.5152/tjg.2020.19229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236647PMC
April 2020

treatment in Turkey: Current status and rational treatment options.

North Clin Istanb 2020 11;7(1):87-94. Epub 2019 Jul 11.

Department of Gastroenterology, Acibadem University, Istanbul, Turkey.

According to the TURHEP study, the prevalence of in Turkey is 82.5%. After FDA approval in 1995, many countries have used standard triple therapy (proton pump inhibitor 40 mg b.i.d clarithromycin 500 mg b.i.d and amoxicillin 1 gr b.i.d) for treatment. In the beginning, eradication rates were above 90% in many countries; however, current studies have demonstrated a prominent decrease in successful treatment rates, even down to 60%. This unfavorable reduction stimulated searches for new treatment protocols. Treatment protocols differ according to country, prevalence, cost-effectiveness, antibiotic resistance, CYP2C19 polymorphism and eradication rates. Thus, each country/region needs to revise its own therapeutic results and the efficacy of various eradication regimens in the treatment of . This report aims to review the current status of treatment in Turkey and to provide recommendations for rational therapeutic considerations for the eradication of the bacterium.
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http://dx.doi.org/10.14744/nci.2019.62558DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103748PMC
July 2019

Bezoar in upper gastrointestinal endoscopy: A single center experience.

Turk J Gastroenterol 2020 Feb;31(2):85-90

Department of Gastroenterology, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

Background/aims: We aimed to investigate the association of bezoar with endoscopic findings, risk factors for bezoar occurrence, and the success of endoscopic treatment in a tertiary center.

Materials And Methods: This retrospective study was conducted between January 2012 and December 2015. Overall, 8200 endoscopy records were examined and 66 patients with bezoar were included in the study.

Results: We enrolled 29 (44%) female and 37 (56%) male patients in this study. The mean age of the patients was 63±9.4 years. The most frequent risk factors were history of gastrointestinal surgery (23%), diabetes mellitus (17%), trichophagia (9%), and anxiety disorder (6%). Gastric ulcer, duodenal ulcer, erosive gastritis, and reflux esophagitis were present in 27%, 11%, 20%, and 23% of the patients, respectively. While bezoars were most commonly observed in the stomach (70%), the majority of them were phytobezoars (91%). The mean number of interventions for each patient was 1.5 (range, 1-6). Endoscopy was successful in removing bezoars in 86.5% of the patients. Among those referred to surgery, seven patients underwent gastrostomy (10.5%); one (1.5%) patient underwent gastroenterostomy because of concomitant pyloric stenosis; and one (1.5%) patient underwent fistula repair surgery due to the development of duodenal fistula caused by bezoar.

Conclusion: The findings of this study indicated that bezoars are more common among subjects with history of gastrointestinal surgery, diabetes mellitus, or psychiatric disorders; bezoars are closely related to peptic ulcer and reflux esophagitis; and they can be successfully treated with endoscopy.
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http://dx.doi.org/10.5152/tjg.2020.18890DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062142PMC
February 2020

Presepsin:albumin ratio and C-reactive protein:albumin ratio as novel sepsis-based prognostic scores : A retrospective study.

Wien Klin Wochenschr 2020 Apr 14;132(7-8):182-187. Epub 2020 Feb 14.

Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

Objective: To investigate the prognostic value of the presepsin:albumin ratio and C‑reactive protein:albumin ratio in patients with sepsis in the intensive care unit (ICU).

Methods: A total of 228 (129 males and 99 females) patients with newly diagnosed sepsis were included in the study. The relationship between the C‑reactive protein:albumin ratio, presepsin:albumin ratio, clinicopathologic parameters, and overall survival were investigated. The associations between C‑reactive protein:albumin ratio and presepsin:albumin ratio were evaluated alongside other inflammation-based prognostic scores such as quick Sepsis Related Organ Failure Assessment (qSOFA).

Results: The presepsin:albumin ratio was significantly higher in non-survivors (p < 0.01). Patients with a high presepsin:albumin ratio had worse overall survival compared with patients with high C‑reactive protein:albumin ratio levels (p < 0.001).

Conclusion: Presepsin and presepsin:albumin ratio are markers of adverse prognosis in patients with sepsis and are superior to C‑reactive protein and C‑reactive protein:albumin ratio for this purpose. Presepsin:albumin ratio may be a novel marker of poor prognosis in patients with sepsis in intensive care units.
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http://dx.doi.org/10.1007/s00508-020-01618-9DOI Listing
April 2020

Review-Current Concepts in Inflammatory Skin Diseases Evolved by Transcriptome Analysis: In-Depth Analysis of Atopic Dermatitis and Psoriasis.

Int J Mol Sci 2020 Jan 21;21(3). Epub 2020 Jan 21.

Department of Dermatology, Heidelberg University Hospital, 69120 Heidelberg, Germany.

During the last decades, high-throughput assessment of gene expression in patient tissues using microarray technology or RNA-Seq took center stage in clinical research. Insights into the diversity and frequency of transcripts in healthy and diseased conditions provide valuable information on the cellular status in the respective tissues. Growing with the technique, the bioinformatic analysis toolkit reveals biologically relevant pathways which assist in understanding basic pathophysiological mechanisms. Conventional classification systems of inflammatory skin diseases rely on descriptive assessments by pathologists. In contrast to this, molecular profiling may uncover previously unknown disease classifying features. Thereby, treatments and prognostics of patients may be improved. Furthermore, disease models in basic research in comparison to the human disease can be directly validated. The aim of this article is not only to provide the reader with information on the opportunities of these techniques, but to outline potential pitfalls and technical limitations as well. Major published findings are briefly discussed to provide a broad overview on the current findings in transcriptomics in inflammatory skin diseases.
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http://dx.doi.org/10.3390/ijms21030699DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037913PMC
January 2020

Pentoxifylline has favorable preventive effects on experimental chronic pancreatitis model.

Scand J Gastroenterol 2020 Feb 16;55(2):236-241. Epub 2020 Jan 16.

Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

To investigate the protective efficacy of pentoxifylline through biochemical parameters and histopathological scores in a caerulein- and alcohol-induced experimental model of chronic pancreatitis in rats. A model of chronic pancreatitis with caerulein and alcohol was created in female rats of the genus Sprague Dawley. Pentoxifylline was administered in doses of 25 mg/kg (low dose) and 50 mg/kg (high dose) as a protective agent. Each group contained 8 animals. The groups were: group 1 (control group); caerulein + alcohol, group 2 (low-dose pentoxifylline group); caerulein + alcohol + pentoxifylline 25 mg/kg, group 3 (high-dose pentoxifylline group); caerulein + alcohol + pentoxifylline 50 mg/kg, group 4 (placebo); caerulein + alcohol + saline, group 5 (sham group); only saline injection.Rats were sacrificed 12 h after the last injection, and TNF-α, TGF-β, MDA, and GPx concentrations were measured in blood samples. The histopathologic examination was conducted by a pathologist who was unaware of the groups. The biochemical results of the treatment groups (group 2 and group 3) were statistically significantly lower compared with the control group (group 1) ( < .05). The difference between the low-dose treatment group (group 2) and high-dose treatment group (group 3) was significant in terms of biochemical parameters ( < .05). The difference between group 2 and the control group was not significant in terms of histopathologic scores ( > .05), whereas the difference between the group 3 and the control group was statistically significant ( < .05). As a result, pentoxifylline, which has anti-inflammatory and antioxidant properties, was shown to have protective efficacy in an experimentally generated model of chronic pancreatitis.
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http://dx.doi.org/10.1080/00365521.2020.1712471DOI Listing
February 2020

Cloning and molecular characterization of thiol-specific antioxidant gene of Leishmania tropica Turkey isolate

Turk J Med Sci 2019 Feb 11;49(1):392-402. Epub 2019 Feb 11.

Background/aim: Thiol-specific antioxidant (TSA) protein is one of the most promising molecules among candidates for vaccine against cutaneous leishmaniasis. It was found to be significantly protective against different Leishmania species. In this study, cloning and molecular characterization of thiol-specific antioxidant gene of L. tropica Turkey isolate (LtTSA) were aimed.

Materials And Methods: LtTSA was amplified by PCR using the specific primers of TSA gene and cloned into the pcDNA3.1 vector. The cloning was confirmed by PCR screening, restriction enzyme reactions, and DNA sequence analysis. Finally, three-dimensional structure and antigenic properties of the protein encoded by the LtTSA were determined

Results: Six hundred base pair bands belonging to LtTSA were shown with electrophoresis. It was found that LtTSA and its encoded protein have high similarity with different Leishmania species. LtTSA protein consisting of 199 amino acids was found to have 7 different antigenic regions.

Conclusion: LtTSA and its encoded TSA protein were found to be highly immunogenic and similar to TSA proteins previously tested as a vaccine candidate.
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http://dx.doi.org/10.3906/sag-1808-98DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350880PMC
February 2019

Platelet-to-lymphocyte Ratio and Neutrophil-to-lymphocyte Ratio Predict Mucosal Disease Severity in Ulcerative Colitis.

J Med Biochem 2018 Apr 1;37(2):155-162. Epub 2018 Apr 1.

Türkiye Yüksek htisas Training and Research Hospital, Gastroenterology, Kecioren Turkey.

Background: We investigated the sensitivity of neutrophil to lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as well as a combination of NLR and PLR to predict endoscopic disease severity based on mucosal assessment in ulcerative colitis (UC).

Methods: The study group consisted 104 patients with active UC, 104 patients in remission, and 105 healthy individuals. Disease activity was described with Rachmilewitz endoscopic activity index (EAI). Curve analysis was used to determine the optimal cutoff values of NLR and PLR for obtaining remission. The patients with both PLR and NLR values higher than the cutoff values were coded as »high risk,« those with one parameter higher were coded as »moderate risk«, those with both parameters lower than the cutoff values were coded as »low-risk« patients.

Results: The mean NLR and PLR values in the endoscopically active disease group were higher than the others, with higher values in the endoscopic remission group compared with the control group (p<0.001). Rachmilewitz EAI in high-risk patients was significantly higher than that in others (p<0.001). In Cox regression analyses, moderate and high risk, high erythrocyte sedimentation rate and high EAI were found as independent predictors of endoscopic active disease.

Conclusions: This is the first study that investigated the use of NLR and PLR combination to assess endoscopic disease severity in UC. Either high NLR or PLR levels can predict active endoscopic disease. However, the use of these parameters in combination is more accurate in evaluating mucosal disease and inflammation in UC.
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http://dx.doi.org/10.1515/jomb-2017-0050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294094PMC
April 2018

A New Marker to Determine Prognosis of Acute Pancreatitis: PLR and NLR Combination.

J Med Biochem 2018 Jan 1;37(1):21-30. Epub 2018 Jan 1.

Turkey Yuksek Ihtisas Training and Research Hospital, Department of Gastroenterology, Ankara, Turkey.

Background: We aimed to investigate the prognostic importance of platelet-lymphocyte ratio (PLR) and neutro - phil-lymphocyte ratio(NLR) combination for patients diagnosed with acute pancreatitis and its relationship with mortality.

Methods: This retrospective study was included 142 patients diagnosed with acute pancreatitis. Ranson, Atlanta and BISAP 0h, 24h and 48h scores of the patients were calculated by examining their patient files. The patients were divided into three groups as low-risk, medium-risk and high-risk patients according to their PLR and NLR levels.

Results: The number of patients with acute pancreatitis complications such as necrotizing pancreatitis, acute renal failure, sepsis and cholangitis was significantly higher in the high-risk group compared to other groups. Mortality rate was found to be 90% in the high-risk group, 16% in the medium-risk group, and 1.9% in the low-risk group. The number of patients with a Ranson score of 5 and 6, a severe Atlanta score, a BISAP 0h score of 3 and 4, a BISAP 24h and 48h score of 4 and 5 was higher in the high-risk group compared to other groups. PLR-NLR combination, Atlanta and Ranson scores, and C-reactive protein level were determined to be independent risk factors predicting mortality in stepwise regression model. PLR-NLR combination had the highest area under curve value in terms of predicting acute claspancreatitis prognosis and had a similar diagnostic discrimination with other scoring systems.

Conclusion: In our study it was found that PLR-NLR combination had a similar prognostic importance with other scoring systems used to determine acute pancreatitis prognosis.
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http://dx.doi.org/10.1515/jomb-2017-0039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294107PMC
January 2018

Comment on "Early enteral nutrition is associated with reduced in-hospital mortality from sepsis in patients with sarcopenia".

J Crit Care 2019 02 28;49:193. Epub 2018 Oct 28.

Department of Physical Medicine and Rehabilitation, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

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http://dx.doi.org/10.1016/j.jcrc.2018.10.021DOI Listing
February 2019

Comment on "Improvement of Body Composition and Quality of Life Following Intragastric Balloon".

Obes Surg 2018 09;28(9):2918

Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

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http://dx.doi.org/10.1007/s11695-018-3364-zDOI Listing
September 2018

The role of the PLR-NLR combination in the prediction of the presence of and its associated complications.

Saudi J Gastroenterol 2018 Sep-Oct;24(5):294-300

Department of Gastroenterology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.

Background/aim: The aim of this study was to investigate the role of the platelet-to-lymphocyte ratio (PLR)-neutrophil-to-lymphocyte ratio (NLR) combination, in the prediction of the presence of Helicobacter pylori (HP) and its associated complications in the gastrointestinal system.

Patients And Methods: In all, 1289 patients who underwent esophagogastroduodenoscopy and biopsy for HP were included in the study.

Results: The ratio of patients with moderate and severe chronic gastritis was higher in HP (+) group than HP (-) group. The ratio of patients with levels 1-3 atrophy and intestinal metaplasia was higher in HP (+) group. Compared with HP (-) group, HP (+) had higher PLR and NLR levels. The ratio of HP (+) patients was higher in high-risk group compared with low- and medium-risk groups. HP invasion stage, the intestinal metaplasia level, and the ratio of patients with atrophy level "3" were higher in high-risk group compared with low- and medium-risk groups. Regression analysis showed that the PLR-NLR combination was an independent risk factor for both HP presence and moderate and severe chronic gastritis.

Conclusion: We found the PLR-NLR combination to be a good predictor of HP presence and gastrointestinal complications associated with HP.
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http://dx.doi.org/10.4103/sjg.SJG_29_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152001PMC
December 2018

Comparison of organically and conventionally produced Batavia type lettuce stored in modified atmosphere packaging for postharvest quality and nutritional parameters.

J Sci Food Agric 2019 Jan 20;99(1):226-234. Epub 2018 Jul 20.

Department of Horticulture, Akdeniz University, Antalya, Turkey.

Background: The impacts of organic and conventional production systems on postharvest life and quality parameters of Batavia type 'Caipira' lettuce heads (Lactuca sativa L.) were investigated. Harvested lettuce heads grown in two different production systems were stored at 0 °C temperature and 95-98% relative humidity for 20 days in modified atmosphere packaging.

Results: The lowest weight loss, the highest ascorbic acid content and antioxidant activity were obtained from the organic production system (Org-2). The conventional production system had higher total soluble solids, titratable acidity, and total phenolic contents. During the shelf-life period at 20 °C, the weight losses of lettuce heads grown conventionally were higher than with the other production system. Conventionally grown heads had higher titratable acidity and total phenolic contents than organically grown heads. The highest titratable acidity and h° values were obtained from the plants grown under conventional and organic production systems (Org-2), while the highest chroma value and antioxidant activity were detected from the control treatment. The highest ascorbic acid content was detected in the control treatment, but the effects of control, organic (Org-2) and conventional production systems on ascorbic acid content were not statistically significant.

Conclusion: The results indicated that the organic production system (Org-2) was the most effective treatment in prolonging postharvest life and protecting the quality of Batavia type 'Caipira' lettuce heads stored in modified atmosphere packaging. © 2018 Society of Chemical Industry.
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http://dx.doi.org/10.1002/jsfa.9164DOI Listing
January 2019

Evaluation of Sarcopenia in Children.

J Surg Res 2019 05 31;237:112. Epub 2018 Mar 31.

Department of Physical Medicine and Rehabilitation, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

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http://dx.doi.org/10.1016/j.jss.2018.03.008DOI Listing
May 2019

Letter to the Editor. Thoracolumbar surgery and sarcopenia.

J Neurosurg Spine 2018 05 2;28(5):568-569. Epub 2018 Mar 2.

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http://dx.doi.org/10.3171/2017.12.SPINE171332DOI Listing
May 2018

Comment to "Preoperative sarcopenia determinants in pancreatic cancer patients".

Clin Nutr 2018 06 15;37(3):1089. Epub 2018 Feb 15.

Department of Physical Medicine and Rehabilitation, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

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http://dx.doi.org/10.1016/j.clnu.2018.01.038DOI Listing
June 2018

Sarcopenia and Gynecologic Malignancy.

Int J Gynecol Cancer 2018 02;28(2):423

Departments of Internal Medicine and Paliative Care, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey Department of Physical Medicine and Rehabilitation, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

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http://dx.doi.org/10.1097/IGC.0000000000001177DOI Listing
February 2018

Letter To The Editor: Ertapenem-Induced Acute Pancreatitis in a Cirrhotic Patient.

Ochsner J 2017 ;17(4):305

Department of Gastroenterology, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718436PMC
January 2017

Efficacy of tocilizumab treatment in cerulein-induced experimental acute pancreatitis model in rats.

Turk J Gastroenterol 2017 Nov 25;28(6):485-491. Epub 2017 Oct 25.

Department of Internal Medicine, Sultan Abdulhamit Training and Research Hospital, İstanbul, Turkey.

Background/aims: Acute pancreatitis (AP) is a disease that can cause local and systemic complications that may have high morbidity and mortality. Currently, there is not any specific treatment for AP. In this study, we created an experimental model of AP in rats, and we aimed to demonstrate the histological effectiveness of tocilizumab treatment that antagonizes interleukin-6 (IL-6), one of the key cytokines in the development of AP.

Materials And Methods: Forty-eight rats were divided into six groups for this study. AP model was created by subcutaneous injections of cerulein (20 μg/kg) four times at 1-h intervals. Tocilizumab 4 mg/kg was administered to one of the treatment groups and 8 mg/kg to the other treatment group intraperitoneally. The effects of tocilizumab were revealed by examining pancreatic tissue of the rats histopathologically according to the Schonberg scoring system.

Results: A comparison between tocilizumab treatment group and AP control group provides statistically significant improvement in AP (p<0.0001). Furthermore, the dose of 8 mg/kg is shown to be more effective than 4 mg/kg (p=0.004).

Conclusion: Our study points out that tocilizumab may be an effective agent for pancreatitis treatment.
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http://dx.doi.org/10.5152/tjg.2017.16738DOI Listing
November 2017

Is Oxidative Stress Associated with Activation and Pathogenesis of Inflammatory Bowel Disease?

J Med Biochem 2017 Oct 28;36(4):341-348. Epub 2017 Oct 28.

Turkey Yuksek Ihtisas Training and Research Hospital, Department of GastroenterologyAnkara, Turkey.

Background: We aimed to determine the levels of total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI) and paraoxonase1/arylesterase levels in inflammatory bowel disease (IBD), and the relation be - tween these molecules and the activity index of the disease.

Methods: Eighty IBD patients (ulcerative colitis (UC)/Crohn disease (CD) 40/40) and 80 control group participants were included in the study. Oxidative stress parameters were measured using the colorimetric method. As disease activity indexes, the endoscopic activity index (EAI) was used for UC and the CD activity index (CDAI) was used for CD.

Results: In IBD patients, mean TAS (1.3±0.2 vs 1.9±0.2, respectively; p<0.001) and arylesterase (963.9±232.2 vs 1252.9±275, respectively; p<0.001) levels were found to be lower and TOS level (5.6±1.6 vs 4.0±1.0, respectively; p<0.001) and OSI rate (4.5±1.6 vs 2.2±0.8, respectively; p<0.001) were found to be higher compared to the control group. A strong positive correlation was found between EAI and TOS levels (r=0.948, p<0.001) and OSI rate (r=0.894, p<0.001) for UC patients. A very strong positive correlation was found between EAI and TOS levels (r=0.964, p<0.001) and OSI rate (r=0.917, p<0.001) for CD patients. It was found in a stepwise regression model that C-reactive protein, OSI and arylesterase risk factors were predictors of IBD compared to the control group. Conclusion: Increased oxidative stress level in IBD patients and the detection of OSI rate as an independent predictor for disease activity indexes lead to the idea that oxidative stress might be related to the pathogenesis of IBD.
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http://dx.doi.org/10.1515/jomb-2017-0013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294084PMC
October 2017

An unusual method to diagnose a rare disease: Upper gastrointestinal endoscopy.

Turk J Gastroenterol 2017 11 19;28(6):522-523. Epub 2017 Sep 19.

Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey.

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http://dx.doi.org/10.5152/tjg.2017.17224DOI Listing
November 2017

Predictive value of C-reactive protein/albumin ratio in acute pancreatitis.

Hepatobiliary Pancreat Dis Int 2017 Aug;16(4):424-430

Department of Gastroenterology, Turkey Yuksek Ihtisas Training and Research Hospital, Ankara 06100, Turkey.

Background: Serum C-reactive protein (CRP) increases and albumin decreases in patients with inflammation and infection. However, their role in patients with acute pancreatitis is not clear. The present study was to investigate the predictive significance of the CRP/albumin ratio for the prognosis and mortality in acute pancreatitis patients.

Methods: This study was performed retrospectively with 192 acute pancreatitis patients between January 2002 and June 2015. Ranson scores, Atlanta classification and CRP/albumin ratios of the patients were calculated.

Results: The CRP/albumin ratio was higher in deceased patients compared to survivors. The CRP/albumin ratio was positively correlated with Ranson score and Atlanta classification in particular and with important prognostic markers such as hospitalization time, CRP and erythrocyte sedimentation rate. In addition to the CRP/albumin ratio, necrotizing pancreatitis type, moderately severe and severe Atlanta classification, and total Ranson score were independent risk factors of mortality. It was found that an increase of 1 unit in the CRP/albumin ratio resulted in an increase of 1.52 times in mortality risk. A prediction value about CRP/albumin ratio >16.28 was found to be a significant marker in predicting mortality with 92.1% sensitivity and 58.0% specificity. It was seen that Ranson and Atlanta classification were higher in patients with CRP/albumin ratio >16.28 compared with those with CRP/albumin ratio ≤16.28. Patients with CRP/albumin ratio >16.28 had a 19.3 times higher chance of death.

Conclusion: The CRP/albumin ratio is a novel but promising, easy-to-measure, repeatable, non-invasive inflammation-based prognostic score in acute pancreatitis.
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http://dx.doi.org/10.1016/S1499-3872(17)60007-9DOI Listing
August 2017

Evaluation of endothelial dysfunction in patients with nonalcoholic fatty liver disease: Association of selenoprotein P with carotid intima-media thickness and endothelium-dependent vasodilation.

Clin Res Hepatol Gastroenterol 2017 Oct 29;41(5):516-524. Epub 2017 Jul 29.

GATA Haydarpasa Training Hospital, Department of Gastroenterology, 34668 Uskudar, Istanbul, Turkey.

Background: In patients with NAFLD, there is an increased risk of cardiovascular disease (CVD). Selenoprotein P (SelP), a hepatokine, is associated with insulin resistance (IR) and serum SelP was found to be elevated in patients with NAFLD.

Aim: This study aimed to determine the risk of CVD in NAFLD patients and the association of serum SelP levels with this NAFLD related CVD risk.

Methods: Ninety-three patients with NAFLD and 37 healthy controls were included in the study. Complete blood count, C-reactive protein (CRP), fasting glucose, serum lipid levels, and SelP levels were tested from fasting blood samples. Moreover, body mass index (BMI), HOMA-IR, carotid intima-media thickness (cIMT) and flow-mediated dilatation (FMD) were measured.

Results: In patients with NAFLD, the FMD ratio was significantly lower than in controls (P=0.027). cIMT measurements were similar in both groups (P=0.996). Serum SelP levels were significantly higher than controls (P<0.001). SelP levels were significantly correlated with BMI, fasting glucose, LDL-cholesterol and HOMA-IR (r=0.395, P<0.001; r=0.322, P=0.002; r=0.353, P<0.001; r=0.521, P<0.001, respectively). Also, SelP levels were significantly lower and correlated with FMD (r=-0.674, P<0.001). SelP, ESR and CRP were significantly higher (P<0.05) and FMD ratios were significantly lower (P<0.05) in patients with nonalcoholic steatohepatitis (NASH) when compared to patients with simple steatosis.

Conclusion: These results suggest that in young NAFLD patients without additional comorbidities, there is an increased risk of CVD. FMD may be a better predictor for assessment of CVD risk when compared with cIMT. We assume that there could also be an important role of SelP in the pathogenesis of NASH.
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http://dx.doi.org/10.1016/j.clinre.2017.01.005DOI Listing
October 2017

The Role of Oxidative Stress in the Etiopathogenesis of Gluten-sensitive Enteropathy Disease.

J Med Biochem 2017 Sep 14;36(3):243-250. Epub 2017 Jul 14.

Turkey Yuksek Ihtisas Training and Research Hospital, Department of Gastroenterology, Ankara, Turkey.

Background: The objective here is to examine the role of overall oxidative stress in the etiopathogenesis of gluten-sensitive enteropathy disease and its relationship with gluten free diet and autoantibodies.

Methods: Eighty gluten-sensitive enteropathy patients and 80 control group participants were included in the study. As oxidative stress parameters, we researched total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), paraoxonase-1 and arylesterase parameters in the serum samples of gluten-sensitive enteropathy patients.

Results: In comparison to the control group, gluten-sensitive enteropathy patients had lower TAS, paraoxonase-1 and arylesterase levels and gluten-sensitive enteropathy patients had considerable TOS and OSI levels. In contrast, patients who agreed to the gluten free eating routine had a higher OSI proportion and patients who did not conform to the gluten free eating regimen had a lower paraoxonase-1 level. An affirming reciprocation was de tected amidst TOS and OSI proportion and gluten-sensitive enteropathy autoantibodies and C-reactive protein levels and a negative correlation was found between arylesterase level and gluten-sensitive enteropathy autoantibodies.

Conclusions: We observed oxidative stress levels to be higher in gluten-sensitive enteropathy patients contrasted with the control group. Oxidative stress level showed differences in gluten-sensitive enteropathy patients depending on gluten diet content and autoantibody positivity. In point of fact, C-reactive protein and gluten-sensitive enteropathy autoantibodies are identified with oxidative anxiety parameters resulting in the possibility that oxidative stress might be successful in the gluten-sensitive enteropathy pathogenesis.
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http://dx.doi.org/10.1515/jomb-2017-0017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287212PMC
September 2017

Parameters of ventricular repolarization in patients with autoimmune hepatitis.

Turk Kardiyol Dern Ars 2017 Jun;45(4):333-338

Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

Objective: Autoimmune hepatitis (AIH) is a liver disorder that affects both children and adults. It is characterized by inflammatory liver histology, elevated transaminase level, circulating nonorgan-specific autoantibodies, and increased level of immunoglobulin G in the absence of known etiology. Ventricular repolarization has been evaluated using T wave and QT interval measurements in patients with hepatic cirrhosis. Ventricular repolarization may be defined using QT interval, QT dispersion, and T wave measurements. Recently, it has been demonstrated that peak and end of the T wave (Tp-e) interval, Tp-e/QT, and Tp-e/corrected QT interval (QTc) ratios can be novel indicators for prediction of ventricular arrhythmias and mortality. In this study, an investigation of ventricular repolarization using Tp-e interval and Tp-e/QT ratio in patients with AIH was performed.

Methods: Total of 31 patients with AIH and 31 controls were enrolled in the present study. Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were measured on 12-lead electrocardiogram.

Results: QT interval (378.9±41.4 vs. 350.0±22.7; p=0.001), QTc interval (396.8±46.7 vs. 367.3±34.9; p=0.039), Tp-e interval (68.2±12.3 vs. 42.5±6.8; p<0.001), Tp-e/QT ratio (0.18±0.02 vs. 0.12±0.01; p<0.001) and Tp-e/QTc ratio (0.17±0.02 vs. 0.11±0.01; p<0.001) were significantly higher in patients with AIH than control patients.

Conclusion: The results of the present study indicated that Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were greater in patients with AIH.
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http://dx.doi.org/10.5543/tkda.2017.57870DOI Listing
June 2017