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Öğe Are there differences in the management of acute pancreatitis cases due to severe hypertriglyceridemia in pregnant women?(International Scientific Information, Inc., 2018) Kılınç, Faruk; Şenateş, Ebubekir; Demircan, Fatih; Pekkolay, Zafer; Gözel, Nevzat; Güven, Mehmet; Bahçecioǧlu, İbrahim Halil; Tuzcu, Alpaslan KemalBackground: The aim of this study was to determine the prognosis of severe disease and treatment approaches of both normal and pregnant, especially in patients with severe pancreatitis due to hypertriglyceridemia. Material/Methods: We included 30 patients (20 females and 10 males) in this study whose follow-ups and treatments were performed after a diagnosis of hypertriglyceridemia-induced acute pancreatitis between January 2011 and May 2017. Patient personal information, such as age, sex, pre-treatment and post-treatment triglyceride levels, receipt of anti-hyperlipidemic treatments or plasmapheresis, and family history, were collected from hospital records and patient files. Patients with severe pancreatitis history, score, and prognosis were included to increase the value of our study. Mild and moderate cases were excluded. Results: The mean age of the patients was 35±6 years. Twenty-four patients (80%) received an anti-hyperlipidemic treatment before their pancreatitis attacks. Plasmapheresis was performed on 8 patients before their pancreatitis attacks. Eighteen patients (60%) had a family history suggesting familial hypertriglyceridemia. Twelve patients (40%) were pregnant. Conclusions: The treatment of hypertriglyceridemia-induced acute pancreatitis was mostly confined to supportive, palliative treatments. However, plasmapheresis is a possible treatment option and should be used in the early stages of this disease. The response to medical treatment and support treatment was better in pregnant patients than in the other patient group, and pregnant patients did not require plasmapheresis.Öğe Herediter hemorajik telenjektazili bir vakanın, argon plazma koagülasyonu ve destek tedavisi kombinasyonuyla başarılı yönetimi(2013) Şenateş, Ebubekir; Kayataş, Kadir; Yeşil, Atakan; Şenateş, Banu Erkalma; Güçlütürk, Alper; Demirtunç, RefikHerediter hemorajik telenjiektazi, otozomal dominant geçişli, birçok klinik bulguyla karakterize, anormal vasküler formasyonla ilişkili nadir gözlenen bir hastalıktır. Biz bu vakada, gastrointestinal sistemin multiple bölgesinde (özofagus, mide korpus ve antrumu, duodenum) anjiodisplazik lezyonlarla seyreden, öyküsünde dört kez geçirilmiş miyokard infarktüsü bulunan, acil servise melena ile başvuran 65 yaşındaki olguya tanı anında yapılan argon plazma koagülasyon ve supportif yaklaşım kombinasyonun tedavi başarısını gözlemledik. Tanı anında uygulanan argon plazma koagülasyon ve bipolar koagülasyon yöntemleri bir çok çalışmada tercih edilen yöntemler olmuştur. Bu nedenle biz bu olgumuzda argon plazma koagülasyon yöntemini ve çalış- malarda etkisi kanıtlanmış konservatif tedavi kombinasyonunu tercih ettik. Bizim vakamızın argon plazma koagülasyon yöntemiyle beraber destek teda- visine verdiği hızlı cevap argon plazma koagülasyonun herediter hemorajik telenjiektaziye bağlı anjiodisplazik lezyonlarda seçkin tedavi yöntemi olduğu görüşünü desteklemektedirÖğe İnflamatuvar barsak hastalığı tanılı olgularımızda ekstraintestinal tutulum tipleri ve sıklığı(2013) Kayataş, Kadir; Koçhan, Koray; Gönen, Can; Yeşil, Atakan; Şenateş, Banu Erkalma; Erdem, Emrullah Düzgün; Şenateş, EbubekirAmaç: İnflamatuvar barsak hastalıkları; ülseratif kolit ve Crohn hastalığı olarak iki önemli hastalığı içerir. Barsak hastalıkları olarak nitelendirilmelerine rağmen sistemik tutulumları da mevcuttur. Bu çalışmadaki amacımız kliniğimizde yatırarak takip ettiğimiz inflamatuvar barsak hastalarındaki ekstraintestinal tutulum tiplerini ve sıklığını belirlemek, hastalık aktivitesiyle ilişkisini araştırmaktır. Gereç ve Yöntem: Çalışma gastroenteroloji kliniğimizde takip ettiğimiz inflamatuvar barsak hastalıkları tanısı olan 85 hasta üzerinde yapıldı. Hastalar 39 Chron hastası ve 46 ülseratif kolit hastasından oluşmaktaydı. Bulgular: Crohn hastalığı grubu ve ülseratif kolit grubu arasında yaş, cinsiyet, boy, vücut ağırlığı, beden kitle indeksi, eritrosit sedimentasyon hızı, C-reaktif protein, hemoglobin, hastalık süresi, ekstraintestinal tutulum sıklığı açısından istatistiksel anlamlı farklılık bulunmadı (p>0.05). Lökosit sayısı ortalaması Crohn hastalığı grubunda ülseratif kolit grubuna göre anlamlı düşük bulundu (p:0.003). Hastalar ekstraintestinal tutulum olup olmamasına göre ikiye ayrıldığında gruplar arasında yaş, cinsiyet, vücut ağırlığı, beden kitle indeksi, C-reaktif protein, eritrosit sedimentasyon hızı, hemoglobin, lökosit sayısı, hastalık süresi açısından anlamlı farklılık bulunmadı (p>0.05). Ekstraintestinal tutulum tipleri sıklık sırasına göre: sakroileit (%40.7), artralji (%11.1), psöriazis (%11.1) artrit (%7.4), ankilozan spondilit (%7.4), iridosiklit (%7.4), primer sklerozan kolanjit (%3.7) ve üveit (%3.7) şeklindeydi. Hastalarda ekstraintestinal tutulum varlığı ile hastalık aktivitesi, tipi ve endoskopik tutulum bölgeleri arasında anlamlı ilişki saptanmadı. Sonuç: Sonuç olarak inflamatuvar barsak hastalarımızda ekstraintestinal tutulum oranı Crohn hastalığı grubunda %38.46, ülseratif kolit grubunda %26.08 olmak üzere, literatürle uyumlu olarak sıktır. Hastaların tanı aldıkları andan itibaren ekstraintestinal bulgular açısından düzenli muayene ve takiplerinin yapılması önemlidirÖğe A potential treatment of nonalcoholic fatty liver disease with SIRT1 activators(Romanian Society of Gastroenterology, 2014) Çolak, Yaşar; Yeşil, Atakan; Mutlu, Hasan Hüseyin; Çaklılı, Özge Telci; Ulaşoğlu, Celal; Takir, Mümtaz; Köstek, Osman; Şenateş, EbubekirSirtuins (SIRTs) are members of the silent information regulator-2 family and act as nicotinamide adenine dinucleotide (NAD+)-dependent histone/protein deacetylases. The de-acetylation of proteins and histones results in an up-or down-regulation of gene transcription and protein function. In recent years, the regulatory action of the deacetylation activity of SIRT1 has been shown to have a positive impact on the pathophysiological mechanisms of nonalcoholic fatty liver disease (NAFLD). Among the effects of SIRT1 are: its healing activity on insulin sensitivity, thereby ameliorating glycemic regulation; its mimetic activity on calorie restriction; its antihyperlipidemic activity on lipid homeostasis via the liver, adipose tissues and skeletal muscles; its antiinflammatory activities; its protective effects against cardiovascular events and endothelial dysfunction; its positive influence on autophagy, apoptosis and cancer; and finally, its anti-aging activity. The current approach for the treatment of NAFLD involves the treatment of etiological factors and recommendation of life-style changes including more physical activity and a low-calorie diet. However, there are no specific medical treatments for NAFLD. The therapeutic potential of SIRT1 activity in the treatment of NAFLD discovered in humans has been presented in this article. In this review, the potential effects of SIRT1 activation on NAFLD-related pathophysiological mechanisms and on the treatment of NAFLD are discussed.Öğe Prophylactic administration of silybin ameliorates L-arginine-induced acute pancreatitis(International Scientific Literature Inc., 2016) Uçmak, Feyzullah; Ekin, Nazım; İbiloğlu, İbrahim; Arslan, Serkan; Kaplan, İbrahim; Şenateş, EbubekirBackground: Oxidative stress have been shown to play a role in the pathogenesis of acute pancreatitis. The aim of this study was to investigate the potential effect of silybin, a potent antioxidant, on L-arginine-induced acute pancreatitis in an experimental rat model. Material/Methods: Forty female Wistar Albino rats were divided into 5 groups as follows: Group 1 (C): control group (n=8), Group 2 (SL): silybin group (n=8), Group 3 (LA): acute pancreatitis group (n=8), Group 4 (SLLA): prophylaxis group (n=8), and Group 5 (LASL): treatment group (n=8). Group C (control) received 2 intraperitoneal (i.p.) injections of physiological saline at an interval of 1 h. Group SL received only a single i.p. injection of silybin. The SLLA group received a single i.p. injection of silybin before the induction of acute pancreatitis with L-arginine, whereas the LASL group received the same injection after the induction of acute pancreatitis with L-arginine. Pancreatic tissues were histopathologically examined. Levels of amylase and oxidative stress markers (total oxidant status and total anti-oxidant status) were determined in the blood samples. Oxidative stress index was calculated. Results: In comparison to the LA, the prophylaxis and treatment groups showed significant improvements in serum oxidative stress parameters (p=0.001 and p=0.005, respectively). Histopathological analysis showed that the treatment group had significant improvements in edema scores only (p=0.006), whereas the prophylaxis group had the same improvements in inflammation and necrosis scores as well as in total scores (p=0.004, 0.006, and 0.004, respectively). Conclusions: When used for prophylactic rather than therapeutic purposes, silybin ameliorates serum oxidative stress parameters and improves histopathological results via its antioxidant and anti-inflammatory properties.Öğe Vitamin D deficiency in patients with chronic hepatitis D viral infection(Termedia Publishing House Ltd., 2021) Uçmak, Feyzullah; Yılmaz, Ahmet; Ekin, Nazım; Ekinci, Aysun; Solmaz, İhsan; Şenateş, EbubekirAim of the study: Vitamin D deficiency is known to be associated with disease severity, unresponsiveness to treatment, and morbidity among patients with chronic viral hepatitis B and C, autoimmune hepatitis, and alcoholic hepatitis. This study aims to research vitamin D levels in patients suffering from cirrhotic and non-cirrhotic phases of hepatitis D. Material and methods: 170 individuals in total were included in the study in the form of two groups: the first group of 100 patients with chronic hepatitis D (CHD), 30 of whom had cirrhosis, and the second control group of 70 individuals with similar characteristics to those of the first group in terms of age, type, and seasonal sampling. Levels of 25-hydroxy vitamin D [25(OH)D] were measured in the serum collected from patients and the control group. Results: The lowest 25(OH)D levels were identified in patients with cirrhotic CHD. When these levels were compared with those of the control group, they were found to be significant (15.30 +/- 6.92 and 18.90 +/- 8.30 ng/ml, respectively, p = 0.04). 25(OH)D deficiency (< 10 ng/ml) was detected at significantly higher rates in patients with both cirrhotic and non-cirrhotic CHD compared to the healthy controls (30%, 25%, and 8.5%, respectively, p = 0.01). A significant correlation was established between 25(OH)D levels and bilirubin in patients with CHD (r = 0.252, p = 0.012). Multivariate analysis showed that chronic hepatitis D (odds ratio [OR] = 3.608, 95% confidence interval [CI]: 1.31-9.89, p = 0.013) and age (OR = 1.04, 95% CI: 1.00-1.08, p = 0.033) were associated with vitamin D deficiency. Conclusions: Frequency of 25(OH)D vitamin deficiency is higher in patients with CHD. The identification of vitamin D levels and the replacement of any deficiency may create a positive effect on disease progression, morbidity, and mortality levels.
