Mahmut Yüksel - Academia.edu (original) (raw)

Papers by Mahmut Yüksel

Research paper thumbnail of Predictive value of C-reactive protein/albumin ratio in acute pancreatitis

Hepatobiliary & pancreatic diseases international : HBPD INT, Jan 15, 2017

Serum C-reactive protein (CRP) increases and albumin decreases in patients with inflammation and ... more 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. 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. 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 ris...

Research paper thumbnail of A New Marker to Determine Prognosis of Acute Pancreatitis: PLR and NLR Combination

Journal of Medical Biochemistry, 2017

SummaryBackground: We aimed to investigate the prognostic importance of platelet-lymphocyte ratio... more SummaryBackground: 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 s...

Research paper thumbnail of Thiol/disulphide homeostasis in celiac disease

World Journal of Gastrointestinal Pharmacology and Therapeutics, 2017

AIM To determine dynamic thiol/disulphide homeostasis in celiac disease and to examine the associ... more AIM To determine dynamic thiol/disulphide homeostasis in celiac disease and to examine the associate with celiac autoantibodies and gluten-free diet. METHODS Seventy three patients with celiac disease and 73 healthy volunteers were enrolled in the study. In both groups, thiol/disulphide homeostasis was examined with a new colorimetric method recently developed by Erel and Neselioglu. RESULTS In patients with celiac disease, native thiol (P = 0.027) and total thiol (P = 0.031) levels were lower, while disulphide (P < 0.001) level, disulphide/native thiol (P < 0.001) and disulphide/total thiol (P < 0.001) ratios were higher compared to the control group. In patients who do not comply with a gluten-free diet, disulphide/native thiol ratio was found higher compared to the patients who comply with the diet (P < 0.001). In patients with

Research paper thumbnail of Herpes Zoster after Transcatheter Arterial Chemoembolization (TACE) in a Patient with Hepatocellular Carcinoma: Case Report

Turkiye Klinikleri Journal of Gastroenterohepatology, 2015

Research paper thumbnail of Factors associated with increased irisin levels in type 1 diabetes mellitus

Endocrine Abstracts, 2016

Research paper thumbnail of Characterization of de novo colonic stricture due to Crohn’s disease

The Turkish Journal of Gastroenterology, 2015

The development of colonic stenosis is a rare complication of Crohn's disease (CD) without a post... more The development of colonic stenosis is a rare complication of Crohn's disease (CD) without a postsurgical anastomose history. The management and long term follow-up results of colonic stricture due to CD have not been clearly defined. In this study, we aimed to characterize de novo colonic stricture due to CD. We evaluated 702 patients with CD to investigate for colonic stricture. Colonic stricture was considered to exist when passage of a standard colonoscope was not possible and diagnosed radiologically and endoscopically in this study. Of the 702, 14 had colonic stricture according to the above definition criteria. Of the 14, 8 were male. Stricture diagnosed date varied from 0 to13 years after the CD was diagnosed. Localization of the strictures differed from rectum to the ceacum. Of the 14, 3 patients had more than 1 stricture. Pathologic examination of the stricture showed no dysplasia or malignancy at the beginning and during the follow-up. De novo colonic stricture due to CD is a rare condition according to the presented study's results. Distribution of the stricture varied from the rectum to ceacum without an increased colonic cancer risk. We observed antifibrotic role of tiopurines and biologics in this study, limitedly.

Research paper thumbnail of Diverticulum With Papillae

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2015

The presence of peripapillary diverticulum (PPD) can cause some biliary diseases, especially comm... more The presence of peripapillary diverticulum (PPD) can cause some biliary diseases, especially common bile duct stones, and also, literally, can change the technique of endoscopic retrograde cholangiopancreatography (ERCP) and affect the complication ratio of this procedure. In this study, we investigate the effect of localization and position of the papilla according to the diverticulum on the success of therapeutic ERCP procedures. The study was conducted prospectively in the patients with naive papillae, who underwent ERCP for a period of 16 months. In all patients, the position of papillae according to the diverticulum (the periphery of the diverticulum is thought as the clock circumference, and the position of papillae is defined as the dials of clock), the success rate of biliary cannulation, total procedure time, overall treatment success rate of ERCP, and the complications are investigated. During this period, 222 (18.5%) of the 1205 enrolled patients who underwent ERCP had PPD. Of the patients with PPD, 123 (55.4%) were female and 99 (44.6%) were male, and the median age was 68.9±10.1 years. According to the position of the papilla by the diverticulum, 90 (40.5%) patients have it on 7 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock position, 64 (28.8%) patients have on 6 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock position, 63 (28.3%) patients have on 5 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock position, and 5 (2.3%) patients have on 1 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock position. In the cases of the papilla on 1 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock position according to the diverticulum, cannulation procedures were found to be more difficult than other patients (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). The presence of the diverticulum did not affect the success of therapeutic procedures and did not increase the ratio of complications. In the presence of PPD, additional cannulation techniques may be required for the procedure. Particularly, the aid of percutaneous techniques may be needed for the papilla on 1 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock position.

Research paper thumbnail of The role of soluble tumor necrosis factor like weak inducer of apoptosis and interleukin-17A in the etiopathogenesis of celiac disease

Medicine, 2016

Our aim in this study was to determine soluble tumor necrosis factor (TNF)-like weak inducer of a... more Our aim in this study was to determine soluble tumor necrosis factor (TNF)-like weak inducer of apoptosis (sTWEAK) and interleukin-17A (IL-17A) levels in celiac disease, and their association with the gluten diet and autoantibodies. Eighty patients with celiac diagnosis and 80 healthy control individuals with similar age, gender and body mass index to the patient group were included in the study. Serum sTWEAK and IL-17A levels were measured by the serum enzyme-linked immunosorbent assay kit. The median IL-17A (117.5 pg/mL vs. 56.7 pg/mL; P = 0.001) level in celiac patients was higher than in the control group, while the median sTWEAK (543 pg/mL vs. 643 pg/mL; P = 0.016) level in patients was determined to be lower. In the patient group, patients who complied with the gluten diet had a lower level of median IL-17A (98.1 pg/mL vs. 197.5 pg/mL; P = 0.034) and a higher level of sTWEAK (606 pg/mL vs. 522.8 pg/mL; P = 0.031) than those who did not adhere. Furthermore, the IL-17A level was higher and the sTWEAK level was lower in celiac patients with positive antibody than those with negative antibody. A positive correlation was determined among anti-gliadin antibody IgA, anti-gliadin antibody IgG, anti-tissue transglutaminase IgG levels and the IL-17A level, and a negative correlation was determined with the sTWEAK level. In celiac disease, the sTWEAK and IL-17A levels differ between patients who cannot adapt to the gluten diet and who are autoantibody positive, and patients who adapt to the diet and are autoantibody negative. We believe that sTWEAK and IL-17A are associated with the inflammation in celiac pathogenesis.

Research paper thumbnail of Are sTWEAK and IL-17A Levels in Inflammatory Bowel Disease Associated with Disease Activity and Etiopathogenesis?

Inflammatory bowel diseases, Jan 8, 2015

We aimed to identify the levels of soluble tumor necrosis factor-like weak inducer of apoptosis (... more We aimed to identify the levels of soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and interleukin 17A (IL-17A) in inflammatory bowel disease (IBD) and to examine their relationship with disease activity. A total of 92 patients with IBD, in which 54 patients were diagnosed with ulcerative colitis and 38 patients with Crohn's disease (CD), and 104 healthy controls were included in the study. The Rachmilewitz endoscopic activity index was calculated in ulcerative colitis, and the CD activity index was calculated in CD. sTWEAK (P < 0.001) and IL-17A (P = 0.006) levels were higher in the IBD group than in the control group. Both in the IBD group and ulcerative colitis and CD subgroups, in active patients, sTWEAK and IL-17A levels were found to be higher than in inactive and control groups. In the IBD group, a positive correlation was determined between sTWEAK and IL-17A, and C-reactive protein, endoscopic activity index, and CD activity index. In multivariab...

Research paper thumbnail of Kolonoskopik Polipektomi Takip Aralığını Önerilenden Erken Yapmanın Yararı Var mı?

Endoskopi Gastrointestinal, 2017

lanımı endişesi artmaktadır (4). Amerikan Gastroenteroloji Derneği'ne (AGA) göre ilk kolonoskopid... more lanımı endişesi artmaktadır (4). Amerikan Gastroenteroloji Derneği'ne (AGA) göre ilk kolonoskopide polip bulunan hastalarda 10 yıl sonra, 1 veya 2 küçük adenomda 5 yıl sonra, 3-10 arası adenoma veya 1 cm'den büyük adenom, villöz histoloji ve yüksek dereceli displazide 3 yıl sonra takip kolonoskopi yapılması önerilmektedir (5). Çalışmamızın amacı kliniğimizde KRK surveyans takip kılavuzlarına uyum durumunu belirlemek ve daha erken takip aralıklarının ileri adenomatöz polip (AAP) ve KRK yakalama oranına etkisini belirlemektir. GİRİŞ Kolorektal kanser (KRK) taraması, mortaliteyi azaltmada etkinliği kanıtlanmış bir metod olup yaygın olarak önerilmektedir. Kohort çalışmalar, kolonoskopik polipektomiden sonra kolorektal kanser insidansının ve mortalitesinin azaldığını göstermiştir (1). Güncel kılavuzlar 50 yaş üstü hastaların taranmasını tavsiye etmektedir (2). Tarama sıklığı giderek artmakta olup, bir çalışmada 2002 yılında %54 olan tarama oranının 2010 yılında %65'e çıktığı bildirilmiştir (3). KRK tarama oranları arttıkça, kolonoskopinin potansiyel aşırı kullanımı da dahil olmak üzere, endoskopinin verimsiz kul-Backgrounds and Aims: After the colonoscopic polypectomy, patients were followed-up according to international guidelines. In this study, we aimed to determine whether there was compliance with follow-up intervals as specified by the guidelines. Also, we researched whether there is any beneficial effect of reduced follow-up intervals for detecting AAP and/or colon carcinoma. Material and Methods: Patients who had a colonoscopy between January 2008 and December 2015 in Türkiye Yüksek İhtisas Training and Research Hospital, Gastroenterology Department, Endoscopy Unit were enrolled in the study. Patients who had detected adenoma on their first colonoscopy were divided into two groups: Group A and Group B. In Group A, colonoscopic surveillance was performed earlier according to the current guideline, and in Group B, colonoscopic surveillance was performed properly according to the current guideline. Between the two groups, the detection rate of AAP and/or colon carcinoma were compared. Results: Overall, 270 patients (mean age: 56.8 years) were included in the study. At their first colonoscopies, 759 polyps, 528 adenomas, and 95 AAPs were detected. In our clinical practice, the interval between the first and second colonoscopy was 21 months. Group A had 228 patients (84.1%), and Group B had 42 patients (15.9%). Between the two groups, the detection rates of AAP and cancer could be compared. Between the two groups, the presence of AAP (6.6% vs. 11.9%; p = 0.2) and colon carcinoma (0.4% vs. 0%; p = 1.0) was not different. Conclusion: Compared with current guidelines, reduced follow-up intervals between the first and second colonoscopies are not associated with conferring additional beneficial effects to patients.

Research paper thumbnail of Toxic hepatitis and hyponatremia: Case report

The Turkish Journal of Gastroenterology, 2019

Anti-colon cancer activity of Bifidobacterium metabolites on colon cancer cell line SW742

Research paper thumbnail of Hemoklips ile endoskopik tedaviye rağmen devam eden duodenal ülser kanaması olan bir hastada “Ankaferd Blood Stopper” ile kanama kontrolünün sağlandığı bir olgu

Endoskopi Gastrointestinal, 2015

Research paper thumbnail of The Role of Oxidative Stress in the Etiopathogenesis of Gluten-Sensitive Enteropathy Disease

Journal of Medical Biochemistry, 2017

SummaryBackground:The objective here is to examine the role of overall oxidative stress in the et... more SummaryBackground: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 recipr...

Research paper thumbnail of Central Diabetes Insipidus Due to Parasetamol Induced Subacute Fulminant Liver Failure: Case Report

The World Clinics Journal of Medical Sciences, 2017

entral diabetes insipidus (CDI) is a clinic condition characterized by polyuria and antidiuretic ... more entral diabetes insipidus (CDI) is a clinic condition characterized by polyuria and antidiuretic hormone (ADH) deficiency. Autoimmunity is mostly responsible for the etiology but rarely travma, encephalopathy, surgery and genetic disorders can play role in the etiology. 1 Paracetamol intoxication is the most common cause of acute liver failure and the disease associated with encephalopathy. 2 We present a case of neurogenic diabetes insipidus that developed after paracetamol induced subacute fulminant liver failure.

Research paper thumbnail of İnflamatuvar Barsak Hastalıklarında Tromboz Sıklığı Ve Trombozun Hastalık Seyrine Olan Etkisi

Endoskopi Gastrointestinal, 2017

Backgrounds and Aims: Inflammatory bowel disease increases the risk of thrombosis. Here we have p... more Backgrounds and Aims: Inflammatory bowel disease increases the risk of thrombosis. Here we have present our patients with ulcerative colitis and Crohn's disease having thrombosis, their clinical course, and the properties of thrombosis in these patients. Materials and Methods: A total of 3.128 patients who were followed up in the Türkiye Yüksek İhtisas Training and Research Hospital Inflammatory Bowel Disease Department were investigated for thrombosis. Results: Of the total, 20 patients with thrombosis were included in the study. The median age of the patients was 40,45 (22-70 years). Of these, 16 patients were men and 6 were women. Thrombosis was diagnosed in deep veins in 10 patients. In addition, 4 patients were diagnosed with pulmonary emboly with deep vein thrombosis, 3 thrombophlebitis, 1 with cerebral vein thrombosis, 1 with mesenteric vein thrombosis, and 2 with portal and hepatic vein thrombosis. The median time between the first inflammatory bowel disease diagnosis and the thrombosis diagnosis was 16 months (2-240). Thrombosis was diagnosed in 15 patients while they were in the active phase of their disease. The treatment of 13 patients was upgraded during their clinical course. Conclusion: Inflammatory bowel disease is a thrombophilic condition. An early diagnosis and appropriate treatment of these patients are essential in order to reduce morbidity and mortality. Thrombosis may predict severe disease. An active disease must be considered as a pre-thrombotic situation, and prophylactic anticoagulation must be integrated within the treatment.

Research paper thumbnail of Crohn Hastalığının Üst Gastrointestinal Sistem Tutulumu: Tek Merkez Deneyimi

Endoskopi Gastrointestinal, 2017

ğinde takip edilen 3.128 hastanın takip dosyaları retrospektif olarak tarandı. Klinik, radyolojik... more ğinde takip edilen 3.128 hastanın takip dosyaları retrospektif olarak tarandı. Klinik, radyolojik, endoskopik ve histopatolojik olarak CH tanısı konulan 954 hastanın verileri incelendi. Üst GİS tutulumu olan hastaların bilgileri; ulaşılabildiyse hastaların kendilerinden, hasta dosyaları ve hastane otomasyon sisteminden elde edildi. BULGULAR Çalışmamıza toplam 10 hasta alındı. Hastaların yaş ortancası 40,5 (31-53) olup 6 hasta (%60) erkek 4 hasta (%40) ise kadındı. Ortanca takip süresi 29 (1-228) ay olup hastaların 4 tanesinde (%40) izole üst GİS tutulumu varken geri kalan 6 hastanın (%60) beraberinde ileal veya ileokolonik hastalığı vardı. Organ tutulumlarına bakıldığında 1 hastada (%10) özofagus, 2 hastada mide (%20) ve 7 hastada (%70) duodenum tutulumu izlendi (Şekil 1). Fenotipik olarak 8 hastada GİRİŞ Crohn hastalığı (CH) ilk tanımlandığında terminal ileumun etkilendiği bir hastalık olarak kabul edilmiştir (1). Yıllar içinde CH'nın sadece terminal ileumu etkilemediği, ağızdan anüse kadar gastrointestinal sistemin (GİS) herhangi bir kısmını etkileyebildiği görülmüştür. Montreal sınıflaması içinde CH, GİS tutulum yerine göre L1'den L4'e kadar dört alt gruba ayrılmış olup üst GİS tutulumu olan hastalar L4 alt sınıfında incelenir (2). Literatürde CH'nda üst GİS tutulumu için bildirilen oran %0,5-4 arasında değişir (3,4). CH'da üst GİS'in tutulması hastaların tedavi ve takiplerini ileokolonik hastalıktan daha farklı hale getirebilmektedir. Biz bu çalışmada kliniğimizde CH'nın üst GİS'i etkilediği hastalarımızı sunduk.

Research paper thumbnail of Parameters of ventricular repolarization in patients with autoimmune hepatitis

Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir, 2017

Autoimmune hepatitis (AIH) is a liver disorder that affects both children and adults. It is chara... more 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. 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...

Research paper thumbnail of Karaciğer kist hidatiğine bağlı gelişen bronkobiliyer fistül: olgu sunumu

Endoskopi Gastrointestinal, 2015

Bronkobiliyer fistül, biliyer sistem ile bronş sistemi arasında defektif geçiş olması ile karakte... more Bronkobiliyer fistül, biliyer sistem ile bronş sistemi arasında defektif geçiş olması ile karakterize nadir görülen bir durumdur. Daha çok karaciğer kist hidatik veya amibik hastalığı, kolelitiazis, koledokolitiazis, peptik ülser, malignite, konjenital malformasyonlar ve cerrahiye sekonder bir komplikasyon olarak ortaya çıkmaktadır. Tedavisinde cerrahi yöntemlerinde, morbidite ve mortalite oranı yüksek olduğundan günümüzde daha az invaziv yöntemler tercih edilmektedir. Bu yazıda karaciğer kist hidatiğine bağlı gelişen bronkobiliyer fistüllü olgunun, endoskopik retrograd kolanjiopankreatografi yöntemi ile hem tanı konulmasını hem de tedavi edilmesini sunuyoruz. Anahtar kelimeler: Bronkobiliyer fistül, endoskopik retrograd kolanjiopankreatografi Bronchobiliary fistula is a rare condition characterized by an abnormal connection between the biliary and bronchial system. The condition can be caused by hydatid cysts, amoebic disease, cholelithiasis, choledocholithiasis, peptic ulcer, malignancies, congenital malformations and surgery. The risk of morbidity and mortality inherent with surgical intervention makes less invasive methods preferred. Herein, we report a case in which endoscopic retrogradcholangio pancreatography was used for the diagnosis and treatment of a bronchobiliary fistula.

Research paper thumbnail of Candida Esophagitis: Prevalence, Risc Factors and Treatment Resistance in Non-HIV Turkish Population

Turkiye Klinikleri Journal of Internal Medicine, 2017

Kandida özofajiti (KÖ) enfeksiyöz özofajitlerin en sık sebebidir. Türk toplumunda risk faktörleri... more Kandida özofajiti (KÖ) enfeksiyöz özofajitlerin en sık sebebidir. Türk toplumunda risk faktörleri, görülme sıklığı ve hastalarda direnç oranı net olarak bilinmemektedir. Literatürde endoskopik görüntü ile biyopsi uyumunu ve Helikobakter Pylori'nin KÖ ile ilişkisini araştıran çalışma bulunmamaktadır. Bu çalışmada, 3. basamak bir merkezde 10.000 hastanın endoskopik taramasında KÖ prevalansı, risk faktörleri, endoskopi-biyopsi uyumu, tedavi başarısı-tedavi direnç oranı ve KÖ ile H. pylori arasındaki ilişki araştırıldı. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu çalışma Ocak 2012-Aralık 2015 tarihleri arasında Türkiye Yüksek İhtisas Hastanesi Gastroenteroloji Kliniğinde endoskopi yapılan 10.000 hastanın hasta kayıtları incelenerek retrospektif olarak yapılmıştır. Endoskopide kandida plakları görülen toplamda 300 hasta incelenmiştir. Bu hastalardan ilaç öyküsü ve risk faktörleri belli olmayanlar, H. pylori testi yapılmayanlar ve 18 yaşından küçük olanlar çalışmadan dışlanmıştır. Final çalışma 92 hasta üzerinden yapılmıştır. B Bu ul lg gu ul la ar r: : Araştırmaya 34 (%37) kadın ve 58 (%63) erkek hasta olmak üzere 92 hasta katıldı. Hastaların %23,9'unda inhaler steroid kullanımı, %20,6'sında proton pompa inhibitörü veya H2 reseptör antagonisti kullanımı, %13'ünde oral steroid veya immünsüpresan ilaç alımı, %10,8'inde malign hastalık, %10,8'inde siroz, %6,5'inde diabetes mellitus, %5,4'ünde kronik böbrek yetmezliği, %4,3'ünde özofagus motilite bozukluğu saptandı. Hastaların %70,7'sinde gastrit, %17,4'ünde hiyatal herni, %16,3'ünde reflü özofajit, %14,1'inde peptik ülser endoskopi bulgusu saptandı. Hastalarda fırça örnek alınma oranı %68,5 olup, bunların %88,8'ü endoskopi ile uyumlu idi. Hastaların %80,4'ü oral nistatin+ flukonazol tedavisi alır iken, diğerleri tedavi almadı. Kontrol endoskopisi olan 79 hastanın %19'unda kandida direnci saptandı. Hastalarda H. pylori oranı %55 olarak tespit edildi. S So on nu uç ç: : Bu çalışma Türkiye'de KÖ ile yapılmış en kapsamlı çalışmalardan biridir. Çalışmamızda KÖ prevalansı %3 civarında bulunur iken, inhaler steroid ve asit süpresif tedavinin en önemli risk faktörleri olduğu gösterilmiştir. İyi bir endoskopist tarafından konulan tanının patolojik tanı ile çoğu zaman uyuşabileceği belirtilmiştir. Oral nistatin+flukonazol tedavisinin iyi bir şeçenek olduğu, ancak bazı durumlarda tedaviye direnç gelişebileceği gösterilmiştir. Çalışmamızda H. pylori prevalansının genel populasyondan düşük olması nedeni ile H. pylori ile KÖ arasında ilişki olmayabileceği saptanmıştır.

Research paper thumbnail of Tp-e Interval, Tp-e/QTc Ratio, and Fragmented QRS Are Correlated with the Severity of Liver Cirrhosis

Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, Jan 7, 2016

Arrhythmias and electrocardiographic changes are reported in several noncardiac diseases, includi... more Arrhythmias and electrocardiographic changes are reported in several noncardiac diseases, including liver cirrhosis (LC). We intended to evaluate the interval from the peak to the end of the electrocardiographic T wave (Tp-e), Tp-e/QTc ratio, and fQRS as presumed markers of arrhythmias in LC. In this cross-sectional study, a total of 88 consecutive patients with LC according to clinical, biological, ultrasonographic, or histological criteria and 73 control subjects were enrolled. The severity of cirrhosis was classified according to Pugh-Child's classification and Model for End-Stage Liver Disease (MELD) score. Tp-e interval, Tp-e/QTc ratio, and fQRS rates were measured from the 12-lead electrocardiogram. Tp-e interval, Tp-e/QTc ratio and fQRS rates were significantly increased in parallel to the severity of LC (P < 0.001, P < 0.001, and P = 0.003, respectively). In correlation analysis, Pugh-Child stage showed a significantly positive correlation with Tp-e interval (r = 0...

Research paper thumbnail of Predictive value of C-reactive protein/albumin ratio in acute pancreatitis

Hepatobiliary & pancreatic diseases international : HBPD INT, Jan 15, 2017

Serum C-reactive protein (CRP) increases and albumin decreases in patients with inflammation and ... more 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. 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. 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 ris...

Research paper thumbnail of A New Marker to Determine Prognosis of Acute Pancreatitis: PLR and NLR Combination

Journal of Medical Biochemistry, 2017

SummaryBackground: We aimed to investigate the prognostic importance of platelet-lymphocyte ratio... more SummaryBackground: 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 s...

Research paper thumbnail of Thiol/disulphide homeostasis in celiac disease

World Journal of Gastrointestinal Pharmacology and Therapeutics, 2017

AIM To determine dynamic thiol/disulphide homeostasis in celiac disease and to examine the associ... more AIM To determine dynamic thiol/disulphide homeostasis in celiac disease and to examine the associate with celiac autoantibodies and gluten-free diet. METHODS Seventy three patients with celiac disease and 73 healthy volunteers were enrolled in the study. In both groups, thiol/disulphide homeostasis was examined with a new colorimetric method recently developed by Erel and Neselioglu. RESULTS In patients with celiac disease, native thiol (P = 0.027) and total thiol (P = 0.031) levels were lower, while disulphide (P < 0.001) level, disulphide/native thiol (P < 0.001) and disulphide/total thiol (P < 0.001) ratios were higher compared to the control group. In patients who do not comply with a gluten-free diet, disulphide/native thiol ratio was found higher compared to the patients who comply with the diet (P < 0.001). In patients with

Research paper thumbnail of Herpes Zoster after Transcatheter Arterial Chemoembolization (TACE) in a Patient with Hepatocellular Carcinoma: Case Report

Turkiye Klinikleri Journal of Gastroenterohepatology, 2015

Research paper thumbnail of Factors associated with increased irisin levels in type 1 diabetes mellitus

Endocrine Abstracts, 2016

Research paper thumbnail of Characterization of de novo colonic stricture due to Crohn’s disease

The Turkish Journal of Gastroenterology, 2015

The development of colonic stenosis is a rare complication of Crohn's disease (CD) without a post... more The development of colonic stenosis is a rare complication of Crohn's disease (CD) without a postsurgical anastomose history. The management and long term follow-up results of colonic stricture due to CD have not been clearly defined. In this study, we aimed to characterize de novo colonic stricture due to CD. We evaluated 702 patients with CD to investigate for colonic stricture. Colonic stricture was considered to exist when passage of a standard colonoscope was not possible and diagnosed radiologically and endoscopically in this study. Of the 702, 14 had colonic stricture according to the above definition criteria. Of the 14, 8 were male. Stricture diagnosed date varied from 0 to13 years after the CD was diagnosed. Localization of the strictures differed from rectum to the ceacum. Of the 14, 3 patients had more than 1 stricture. Pathologic examination of the stricture showed no dysplasia or malignancy at the beginning and during the follow-up. De novo colonic stricture due to CD is a rare condition according to the presented study's results. Distribution of the stricture varied from the rectum to ceacum without an increased colonic cancer risk. We observed antifibrotic role of tiopurines and biologics in this study, limitedly.

Research paper thumbnail of Diverticulum With Papillae

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2015

The presence of peripapillary diverticulum (PPD) can cause some biliary diseases, especially comm... more The presence of peripapillary diverticulum (PPD) can cause some biliary diseases, especially common bile duct stones, and also, literally, can change the technique of endoscopic retrograde cholangiopancreatography (ERCP) and affect the complication ratio of this procedure. In this study, we investigate the effect of localization and position of the papilla according to the diverticulum on the success of therapeutic ERCP procedures. The study was conducted prospectively in the patients with naive papillae, who underwent ERCP for a period of 16 months. In all patients, the position of papillae according to the diverticulum (the periphery of the diverticulum is thought as the clock circumference, and the position of papillae is defined as the dials of clock), the success rate of biliary cannulation, total procedure time, overall treatment success rate of ERCP, and the complications are investigated. During this period, 222 (18.5%) of the 1205 enrolled patients who underwent ERCP had PPD. Of the patients with PPD, 123 (55.4%) were female and 99 (44.6%) were male, and the median age was 68.9±10.1 years. According to the position of the papilla by the diverticulum, 90 (40.5%) patients have it on 7 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock position, 64 (28.8%) patients have on 6 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock position, 63 (28.3%) patients have on 5 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock position, and 5 (2.3%) patients have on 1 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock position. In the cases of the papilla on 1 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock position according to the diverticulum, cannulation procedures were found to be more difficult than other patients (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). The presence of the diverticulum did not affect the success of therapeutic procedures and did not increase the ratio of complications. In the presence of PPD, additional cannulation techniques may be required for the procedure. Particularly, the aid of percutaneous techniques may be needed for the papilla on 1 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock position.

Research paper thumbnail of The role of soluble tumor necrosis factor like weak inducer of apoptosis and interleukin-17A in the etiopathogenesis of celiac disease

Medicine, 2016

Our aim in this study was to determine soluble tumor necrosis factor (TNF)-like weak inducer of a... more Our aim in this study was to determine soluble tumor necrosis factor (TNF)-like weak inducer of apoptosis (sTWEAK) and interleukin-17A (IL-17A) levels in celiac disease, and their association with the gluten diet and autoantibodies. Eighty patients with celiac diagnosis and 80 healthy control individuals with similar age, gender and body mass index to the patient group were included in the study. Serum sTWEAK and IL-17A levels were measured by the serum enzyme-linked immunosorbent assay kit. The median IL-17A (117.5 pg/mL vs. 56.7 pg/mL; P = 0.001) level in celiac patients was higher than in the control group, while the median sTWEAK (543 pg/mL vs. 643 pg/mL; P = 0.016) level in patients was determined to be lower. In the patient group, patients who complied with the gluten diet had a lower level of median IL-17A (98.1 pg/mL vs. 197.5 pg/mL; P = 0.034) and a higher level of sTWEAK (606 pg/mL vs. 522.8 pg/mL; P = 0.031) than those who did not adhere. Furthermore, the IL-17A level was higher and the sTWEAK level was lower in celiac patients with positive antibody than those with negative antibody. A positive correlation was determined among anti-gliadin antibody IgA, anti-gliadin antibody IgG, anti-tissue transglutaminase IgG levels and the IL-17A level, and a negative correlation was determined with the sTWEAK level. In celiac disease, the sTWEAK and IL-17A levels differ between patients who cannot adapt to the gluten diet and who are autoantibody positive, and patients who adapt to the diet and are autoantibody negative. We believe that sTWEAK and IL-17A are associated with the inflammation in celiac pathogenesis.

Research paper thumbnail of Are sTWEAK and IL-17A Levels in Inflammatory Bowel Disease Associated with Disease Activity and Etiopathogenesis?

Inflammatory bowel diseases, Jan 8, 2015

We aimed to identify the levels of soluble tumor necrosis factor-like weak inducer of apoptosis (... more We aimed to identify the levels of soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and interleukin 17A (IL-17A) in inflammatory bowel disease (IBD) and to examine their relationship with disease activity. A total of 92 patients with IBD, in which 54 patients were diagnosed with ulcerative colitis and 38 patients with Crohn's disease (CD), and 104 healthy controls were included in the study. The Rachmilewitz endoscopic activity index was calculated in ulcerative colitis, and the CD activity index was calculated in CD. sTWEAK (P < 0.001) and IL-17A (P = 0.006) levels were higher in the IBD group than in the control group. Both in the IBD group and ulcerative colitis and CD subgroups, in active patients, sTWEAK and IL-17A levels were found to be higher than in inactive and control groups. In the IBD group, a positive correlation was determined between sTWEAK and IL-17A, and C-reactive protein, endoscopic activity index, and CD activity index. In multivariab...

Research paper thumbnail of Kolonoskopik Polipektomi Takip Aralığını Önerilenden Erken Yapmanın Yararı Var mı?

Endoskopi Gastrointestinal, 2017

lanımı endişesi artmaktadır (4). Amerikan Gastroenteroloji Derneği'ne (AGA) göre ilk kolonoskopid... more lanımı endişesi artmaktadır (4). Amerikan Gastroenteroloji Derneği'ne (AGA) göre ilk kolonoskopide polip bulunan hastalarda 10 yıl sonra, 1 veya 2 küçük adenomda 5 yıl sonra, 3-10 arası adenoma veya 1 cm'den büyük adenom, villöz histoloji ve yüksek dereceli displazide 3 yıl sonra takip kolonoskopi yapılması önerilmektedir (5). Çalışmamızın amacı kliniğimizde KRK surveyans takip kılavuzlarına uyum durumunu belirlemek ve daha erken takip aralıklarının ileri adenomatöz polip (AAP) ve KRK yakalama oranına etkisini belirlemektir. GİRİŞ Kolorektal kanser (KRK) taraması, mortaliteyi azaltmada etkinliği kanıtlanmış bir metod olup yaygın olarak önerilmektedir. Kohort çalışmalar, kolonoskopik polipektomiden sonra kolorektal kanser insidansının ve mortalitesinin azaldığını göstermiştir (1). Güncel kılavuzlar 50 yaş üstü hastaların taranmasını tavsiye etmektedir (2). Tarama sıklığı giderek artmakta olup, bir çalışmada 2002 yılında %54 olan tarama oranının 2010 yılında %65'e çıktığı bildirilmiştir (3). KRK tarama oranları arttıkça, kolonoskopinin potansiyel aşırı kullanımı da dahil olmak üzere, endoskopinin verimsiz kul-Backgrounds and Aims: After the colonoscopic polypectomy, patients were followed-up according to international guidelines. In this study, we aimed to determine whether there was compliance with follow-up intervals as specified by the guidelines. Also, we researched whether there is any beneficial effect of reduced follow-up intervals for detecting AAP and/or colon carcinoma. Material and Methods: Patients who had a colonoscopy between January 2008 and December 2015 in Türkiye Yüksek İhtisas Training and Research Hospital, Gastroenterology Department, Endoscopy Unit were enrolled in the study. Patients who had detected adenoma on their first colonoscopy were divided into two groups: Group A and Group B. In Group A, colonoscopic surveillance was performed earlier according to the current guideline, and in Group B, colonoscopic surveillance was performed properly according to the current guideline. Between the two groups, the detection rate of AAP and/or colon carcinoma were compared. Results: Overall, 270 patients (mean age: 56.8 years) were included in the study. At their first colonoscopies, 759 polyps, 528 adenomas, and 95 AAPs were detected. In our clinical practice, the interval between the first and second colonoscopy was 21 months. Group A had 228 patients (84.1%), and Group B had 42 patients (15.9%). Between the two groups, the detection rates of AAP and cancer could be compared. Between the two groups, the presence of AAP (6.6% vs. 11.9%; p = 0.2) and colon carcinoma (0.4% vs. 0%; p = 1.0) was not different. Conclusion: Compared with current guidelines, reduced follow-up intervals between the first and second colonoscopies are not associated with conferring additional beneficial effects to patients.

Research paper thumbnail of Toxic hepatitis and hyponatremia: Case report

The Turkish Journal of Gastroenterology, 2019

Anti-colon cancer activity of Bifidobacterium metabolites on colon cancer cell line SW742

Research paper thumbnail of Hemoklips ile endoskopik tedaviye rağmen devam eden duodenal ülser kanaması olan bir hastada “Ankaferd Blood Stopper” ile kanama kontrolünün sağlandığı bir olgu

Endoskopi Gastrointestinal, 2015

Research paper thumbnail of The Role of Oxidative Stress in the Etiopathogenesis of Gluten-Sensitive Enteropathy Disease

Journal of Medical Biochemistry, 2017

SummaryBackground:The objective here is to examine the role of overall oxidative stress in the et... more SummaryBackground: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 recipr...

Research paper thumbnail of Central Diabetes Insipidus Due to Parasetamol Induced Subacute Fulminant Liver Failure: Case Report

The World Clinics Journal of Medical Sciences, 2017

entral diabetes insipidus (CDI) is a clinic condition characterized by polyuria and antidiuretic ... more entral diabetes insipidus (CDI) is a clinic condition characterized by polyuria and antidiuretic hormone (ADH) deficiency. Autoimmunity is mostly responsible for the etiology but rarely travma, encephalopathy, surgery and genetic disorders can play role in the etiology. 1 Paracetamol intoxication is the most common cause of acute liver failure and the disease associated with encephalopathy. 2 We present a case of neurogenic diabetes insipidus that developed after paracetamol induced subacute fulminant liver failure.

Research paper thumbnail of İnflamatuvar Barsak Hastalıklarında Tromboz Sıklığı Ve Trombozun Hastalık Seyrine Olan Etkisi

Endoskopi Gastrointestinal, 2017

Backgrounds and Aims: Inflammatory bowel disease increases the risk of thrombosis. Here we have p... more Backgrounds and Aims: Inflammatory bowel disease increases the risk of thrombosis. Here we have present our patients with ulcerative colitis and Crohn's disease having thrombosis, their clinical course, and the properties of thrombosis in these patients. Materials and Methods: A total of 3.128 patients who were followed up in the Türkiye Yüksek İhtisas Training and Research Hospital Inflammatory Bowel Disease Department were investigated for thrombosis. Results: Of the total, 20 patients with thrombosis were included in the study. The median age of the patients was 40,45 (22-70 years). Of these, 16 patients were men and 6 were women. Thrombosis was diagnosed in deep veins in 10 patients. In addition, 4 patients were diagnosed with pulmonary emboly with deep vein thrombosis, 3 thrombophlebitis, 1 with cerebral vein thrombosis, 1 with mesenteric vein thrombosis, and 2 with portal and hepatic vein thrombosis. The median time between the first inflammatory bowel disease diagnosis and the thrombosis diagnosis was 16 months (2-240). Thrombosis was diagnosed in 15 patients while they were in the active phase of their disease. The treatment of 13 patients was upgraded during their clinical course. Conclusion: Inflammatory bowel disease is a thrombophilic condition. An early diagnosis and appropriate treatment of these patients are essential in order to reduce morbidity and mortality. Thrombosis may predict severe disease. An active disease must be considered as a pre-thrombotic situation, and prophylactic anticoagulation must be integrated within the treatment.

Research paper thumbnail of Crohn Hastalığının Üst Gastrointestinal Sistem Tutulumu: Tek Merkez Deneyimi

Endoskopi Gastrointestinal, 2017

ğinde takip edilen 3.128 hastanın takip dosyaları retrospektif olarak tarandı. Klinik, radyolojik... more ğinde takip edilen 3.128 hastanın takip dosyaları retrospektif olarak tarandı. Klinik, radyolojik, endoskopik ve histopatolojik olarak CH tanısı konulan 954 hastanın verileri incelendi. Üst GİS tutulumu olan hastaların bilgileri; ulaşılabildiyse hastaların kendilerinden, hasta dosyaları ve hastane otomasyon sisteminden elde edildi. BULGULAR Çalışmamıza toplam 10 hasta alındı. Hastaların yaş ortancası 40,5 (31-53) olup 6 hasta (%60) erkek 4 hasta (%40) ise kadındı. Ortanca takip süresi 29 (1-228) ay olup hastaların 4 tanesinde (%40) izole üst GİS tutulumu varken geri kalan 6 hastanın (%60) beraberinde ileal veya ileokolonik hastalığı vardı. Organ tutulumlarına bakıldığında 1 hastada (%10) özofagus, 2 hastada mide (%20) ve 7 hastada (%70) duodenum tutulumu izlendi (Şekil 1). Fenotipik olarak 8 hastada GİRİŞ Crohn hastalığı (CH) ilk tanımlandığında terminal ileumun etkilendiği bir hastalık olarak kabul edilmiştir (1). Yıllar içinde CH'nın sadece terminal ileumu etkilemediği, ağızdan anüse kadar gastrointestinal sistemin (GİS) herhangi bir kısmını etkileyebildiği görülmüştür. Montreal sınıflaması içinde CH, GİS tutulum yerine göre L1'den L4'e kadar dört alt gruba ayrılmış olup üst GİS tutulumu olan hastalar L4 alt sınıfında incelenir (2). Literatürde CH'nda üst GİS tutulumu için bildirilen oran %0,5-4 arasında değişir (3,4). CH'da üst GİS'in tutulması hastaların tedavi ve takiplerini ileokolonik hastalıktan daha farklı hale getirebilmektedir. Biz bu çalışmada kliniğimizde CH'nın üst GİS'i etkilediği hastalarımızı sunduk.

Research paper thumbnail of Parameters of ventricular repolarization in patients with autoimmune hepatitis

Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir, 2017

Autoimmune hepatitis (AIH) is a liver disorder that affects both children and adults. It is chara... more 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. 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...

Research paper thumbnail of Karaciğer kist hidatiğine bağlı gelişen bronkobiliyer fistül: olgu sunumu

Endoskopi Gastrointestinal, 2015

Bronkobiliyer fistül, biliyer sistem ile bronş sistemi arasında defektif geçiş olması ile karakte... more Bronkobiliyer fistül, biliyer sistem ile bronş sistemi arasında defektif geçiş olması ile karakterize nadir görülen bir durumdur. Daha çok karaciğer kist hidatik veya amibik hastalığı, kolelitiazis, koledokolitiazis, peptik ülser, malignite, konjenital malformasyonlar ve cerrahiye sekonder bir komplikasyon olarak ortaya çıkmaktadır. Tedavisinde cerrahi yöntemlerinde, morbidite ve mortalite oranı yüksek olduğundan günümüzde daha az invaziv yöntemler tercih edilmektedir. Bu yazıda karaciğer kist hidatiğine bağlı gelişen bronkobiliyer fistüllü olgunun, endoskopik retrograd kolanjiopankreatografi yöntemi ile hem tanı konulmasını hem de tedavi edilmesini sunuyoruz. Anahtar kelimeler: Bronkobiliyer fistül, endoskopik retrograd kolanjiopankreatografi Bronchobiliary fistula is a rare condition characterized by an abnormal connection between the biliary and bronchial system. The condition can be caused by hydatid cysts, amoebic disease, cholelithiasis, choledocholithiasis, peptic ulcer, malignancies, congenital malformations and surgery. The risk of morbidity and mortality inherent with surgical intervention makes less invasive methods preferred. Herein, we report a case in which endoscopic retrogradcholangio pancreatography was used for the diagnosis and treatment of a bronchobiliary fistula.

Research paper thumbnail of Candida Esophagitis: Prevalence, Risc Factors and Treatment Resistance in Non-HIV Turkish Population

Turkiye Klinikleri Journal of Internal Medicine, 2017

Kandida özofajiti (KÖ) enfeksiyöz özofajitlerin en sık sebebidir. Türk toplumunda risk faktörleri... more Kandida özofajiti (KÖ) enfeksiyöz özofajitlerin en sık sebebidir. Türk toplumunda risk faktörleri, görülme sıklığı ve hastalarda direnç oranı net olarak bilinmemektedir. Literatürde endoskopik görüntü ile biyopsi uyumunu ve Helikobakter Pylori'nin KÖ ile ilişkisini araştıran çalışma bulunmamaktadır. Bu çalışmada, 3. basamak bir merkezde 10.000 hastanın endoskopik taramasında KÖ prevalansı, risk faktörleri, endoskopi-biyopsi uyumu, tedavi başarısı-tedavi direnç oranı ve KÖ ile H. pylori arasındaki ilişki araştırıldı. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu çalışma Ocak 2012-Aralık 2015 tarihleri arasında Türkiye Yüksek İhtisas Hastanesi Gastroenteroloji Kliniğinde endoskopi yapılan 10.000 hastanın hasta kayıtları incelenerek retrospektif olarak yapılmıştır. Endoskopide kandida plakları görülen toplamda 300 hasta incelenmiştir. Bu hastalardan ilaç öyküsü ve risk faktörleri belli olmayanlar, H. pylori testi yapılmayanlar ve 18 yaşından küçük olanlar çalışmadan dışlanmıştır. Final çalışma 92 hasta üzerinden yapılmıştır. B Bu ul lg gu ul la ar r: : Araştırmaya 34 (%37) kadın ve 58 (%63) erkek hasta olmak üzere 92 hasta katıldı. Hastaların %23,9'unda inhaler steroid kullanımı, %20,6'sında proton pompa inhibitörü veya H2 reseptör antagonisti kullanımı, %13'ünde oral steroid veya immünsüpresan ilaç alımı, %10,8'inde malign hastalık, %10,8'inde siroz, %6,5'inde diabetes mellitus, %5,4'ünde kronik böbrek yetmezliği, %4,3'ünde özofagus motilite bozukluğu saptandı. Hastaların %70,7'sinde gastrit, %17,4'ünde hiyatal herni, %16,3'ünde reflü özofajit, %14,1'inde peptik ülser endoskopi bulgusu saptandı. Hastalarda fırça örnek alınma oranı %68,5 olup, bunların %88,8'ü endoskopi ile uyumlu idi. Hastaların %80,4'ü oral nistatin+ flukonazol tedavisi alır iken, diğerleri tedavi almadı. Kontrol endoskopisi olan 79 hastanın %19'unda kandida direnci saptandı. Hastalarda H. pylori oranı %55 olarak tespit edildi. S So on nu uç ç: : Bu çalışma Türkiye'de KÖ ile yapılmış en kapsamlı çalışmalardan biridir. Çalışmamızda KÖ prevalansı %3 civarında bulunur iken, inhaler steroid ve asit süpresif tedavinin en önemli risk faktörleri olduğu gösterilmiştir. İyi bir endoskopist tarafından konulan tanının patolojik tanı ile çoğu zaman uyuşabileceği belirtilmiştir. Oral nistatin+flukonazol tedavisinin iyi bir şeçenek olduğu, ancak bazı durumlarda tedaviye direnç gelişebileceği gösterilmiştir. Çalışmamızda H. pylori prevalansının genel populasyondan düşük olması nedeni ile H. pylori ile KÖ arasında ilişki olmayabileceği saptanmıştır.

Research paper thumbnail of Tp-e Interval, Tp-e/QTc Ratio, and Fragmented QRS Are Correlated with the Severity of Liver Cirrhosis

Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, Jan 7, 2016

Arrhythmias and electrocardiographic changes are reported in several noncardiac diseases, includi... more Arrhythmias and electrocardiographic changes are reported in several noncardiac diseases, including liver cirrhosis (LC). We intended to evaluate the interval from the peak to the end of the electrocardiographic T wave (Tp-e), Tp-e/QTc ratio, and fQRS as presumed markers of arrhythmias in LC. In this cross-sectional study, a total of 88 consecutive patients with LC according to clinical, biological, ultrasonographic, or histological criteria and 73 control subjects were enrolled. The severity of cirrhosis was classified according to Pugh-Child's classification and Model for End-Stage Liver Disease (MELD) score. Tp-e interval, Tp-e/QTc ratio, and fQRS rates were measured from the 12-lead electrocardiogram. Tp-e interval, Tp-e/QTc ratio and fQRS rates were significantly increased in parallel to the severity of LC (P < 0.001, P < 0.001, and P = 0.003, respectively). In correlation analysis, Pugh-Child stage showed a significantly positive correlation with Tp-e interval (r = 0...