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    Alışılmadık sebebi bilinmeyen ateş olgusu: Kikuchi-fujimoto hastalığı
    (2008) Dursun, Mehmet; Tüzün, Yekta; Yılmaz, Şerif; Bayan, Kadim; Altıntaş, Abdullah; Çil, Timuçin
    Histiyositik nekrotizan lenfadenit olarak da isimlendirilen ve kendini sınırlayıcı özelliğe sahip Kikuchi-Fujimoto hastalığı (KFH) çoğunlukla Asyalı genç kadınlarda görülür. KFH’nın etyolojisi bilinmemektedir. Hastalar özellikle servikal bölgede lenfadenopati, ateş, lökopeni ve yüksek eritrosit sedimantasyon hızı ile başvururlar. Hastalık bazen malign lenfoma olarak yanlış tanı alır. Hastalığın tanısı tutulan lenf nodunun histopatolojik incelemesi ile doğrulanır. Burada sebebi bilinmeyen ateş ile gelen ve Kikuchi hastalığı tanısı konan genç bayan hasta sunulmuştur. Sebebi bilinmeyen ateş ve lenfadenopati ile gelen hastaların ayırıcı tanısında KFH’nın da düşünülmesi gerektiğini öneriyoruz.
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    Analysis of inherited thrombophilic mutations and natural anticoagulant deficiency in patients with idiopathic portal hypertension
    (Springer, 2009) Bayan, Kadim; Tuzun, Yekta; Yilmaz, Serif; Canoruc, Naime; Dursun, Mehmet
    Idiopathic portal hypertension (IPH) is characterized by non-cirrhotic presinusoidal intrahepatic portal hypertension. The etiopathogenesis of the disease is poorly understood. Obliteration with microthrombosis of the small portal vein branches may lead to lesions underlying portal hypertension. We aimed to put forward a comprehensive thrombophilic mutation profile in IPH and its probable contribution to pathogenesis. Eleven patients and 12 controls were included. We used the CVD-StripAssay which is based on the reverse-hybridization principle to identify a total of 12 thrombophilic gene mutations: Factor V R506Q, Factor V H1299R, prothrombin G20210A, Factor XIII V34L, beta-Fibrinogen -455 G-A, PAI-1 4G/5G, platelet GPIIIa L33P, MTHFR C677T, MTHFR A1298C, ACE I/D, Apo B R3500Q and Apo E2/E3/E4, respectively. We also evaluated some blood parameters and protein C, protein S, AT-III levels using commercially available assays. IPH patients and controls were similar in respect to gender distribution (P = 1.000). Mean age was 31.2 in patients and 29.1 in controls (P = 0.622). Pica history was present in 54.5% of the patients. Mean protein C and AT-III levels were lower in patients than that of controls (P = 0.002 and 0.001, respectively). Factor XIII V34L, PAI-1, GPIIIa L33P, MTHFR C677T and MTHFR A1298C frequencies of genetic polymorphisms were found to be significantly higher among patients than that of controls. Apolipoprotein E2/E3/E4 analysis showed an inverse relationship with IPH when E2 plus E4 compared with E3. A higher frequency of Beta-Fibrinogen -455G-A mutation was observed in patients, but this difference did not reach a statistical significance. Our data represent the most comprehensive study to date with respect to thrombophilic gene polymorphisms in IPH. The data support a possible pathogenetic role in IPH, at least by some of the prothrombotic mutations. In order to confirm or refuse this proposal, a larger cohort of patients is needed.
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    A Case of Polycythemia Vera Accompanied with Neurofibromatosis Type 1
    (Akad Doktorlar Yayinevi, 2010) Pasa, Semir; Altintas, Abdullah; Bayan, Kadim; Tuzun, Yekta; Cil, Timucin; Ayyildiz, Orhan
    Classical myelofibrosis syndromes (MPS) most frequently occur in adults, but MPS unique to childhood also exist. Such syndromes include juvenile chronic myelomonocytic leukemia (JMML), the MPS of monosomy 7 in childhood, familial chronic myeloid leukemia (CML), the transient MPS of infants with trisomy 21, and childhood forms of myelofibrosis. Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder with pigmentary abnormalities and are predisposed to benign and malignant neoplasms, mostly in children. MPSs were disproportionately common among children with NF1. Herein we reported a case of polycythemia vera (PV) accompanied to NF1 in an adult patient. The co-existance of NF1 and childhood MPS is a well known condition. The same relation was not demonstrated in adulthood NF1 patients according to our screening of the literature. Most of the reported cases were define a relation with JMML and monosomy 7 syndrome. Probably this is the first case of PV, a type of classic adult MPS accompanied to NF1.
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    A case of polycythemia vera accompanied with neurofibromatosis type 1
    (2010) Tüzün, Yekta; Bayan, Kadim; Altıntaş, Abdullah; Çil, Timuçin; Paşa, Semir; Ayyıldız, Orhan
    Klasik miyeloproliferatif sendromlar (MPS) daha sık erişkinlerde görülürse de çocukluk çağında da görülebilir. Bu sendromlar içinde jüvenil kronik miyelomonositik lösemi (JMML), çocukluktaki monozomi 7’nin MPS’u, familyer kronik myeloid lösemi, trizomi 21’li infantlarda görülen transient MPS ve miyelofibrozisin çocukluk formları sayılabilir. Nörofibromatozis tip 1 (NF1), pigmentasyon anomalileri, başta çocuklar olmak üzere benign ve malign neoplazi sıklığının artmış olduğu otozomal dominant kalıtılan genetik bir hastalıktır. NF1 hastası çocuklarda daha yüksek sıklıkta görülmektedir. Biz bu yazımızda erişkin bir NF1 hastasında gelişen polistemia vera olgusu sunduk. Çocukluk yaşta NF1 ile MPS’ ın birlikteliği iyi bilinen bir durumdur. Benzer birliktelik erişkin hastalarda ise gösterilememiştir. Literatür taramalarımıza göre, JMML ve monozomi 7 ile birliktelikler tanımlanmış olsa da muhtemelen polistemia vera ile ilk saptanmış birlikteliktir.
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    Changes in pulse oximetry levels and factors affecting oxygen saturation during routine upper gastrointestinal endoscopy with or without sedation
    (2006) Dursun, Mehmet; Tüzün, Yekta; Yılmaz, Şerif; Bayan, Kadim; Kılıç, Mehmet; Canoruç, Fikri
    Endoskopinin ve premedikasyonda kullanılan midazolamın oksijen desaturasyonuna yol açıp açmadığını, bunun yanında ortaya çıkacak oksijen desaturasyonuna etkili olabilecek faktörleri araştırmayı hedefledik. Yöntem: Çalışmaya, Dicle Üniversitesi Hastanesi Endoskopi Ünitesi'ne çeşitli endikasyonlarla üst gastrointestinal endoskopi için başvuran 103'ü erkek, 97'si kadın toplam 200 hasta dâhil edildi. Hastaların anam-nezleri ve antropometrik değerleri alındı. İşlem öncesi oksijen saturasyonu, hemoglobin düzeyi ve dakikalık kalp hızı kaydedildi. Başlangıçta oksijen saturasyonu %90'ın altında olan hastalar çalışmaya dâhil edilmedi. Hastalar 2 gruba ayrıldı. 100 kişilik hasta grubuna sedasyonsuz (l.grup), 100 kişilik diğer hasta grubuna ise sedasyonlu (2.grup) olarak endoskopi işlemi uygulandı. Sedasyon amacı ile midazolam (2-5mg) kullanıldı. Premedikasyon uygulanan olgulara endoskopi bitiminde intra-venöz flumazenil (0.2 mg) uygulandı. Hastalar sedasyon ve oro-farinks anestezisi öncesinden başlanarak, işlem bitiminden bir dakika sonrasına kadar devamlı şekilde oksijen saturasyonu ve kalp hızı bakımından monitörize edildiler. Endoskopi işlemi süresince en düşük oksijen saturasyonu ve en yüksek kalp hızı değerleri kaydedildi. İşlem boyunca oksijen saturasyonunun ne kadar süre ile % 90'ın altında kaldığı kaydedildi ve bu sürenin endoskopi işleminin toplam süresi ile ilişkisi değerlendirildi. Bulgular: Çalışmaya alınan 200 hastanın yaş ortalaması l.grupta 45, 2.grupta ise 44 idi. Her iki gurup arasında vücut kitle indeksi, sigara içimi, hemoglobin ve bazal en yüksek nabız düzeyi, endoskopi süresi, bazal en düşük oksijen saturasyonu, hipoksi süresi ve hipoksiye girme zamanı bakımından fark yoktu. Cinsiyet, endoskopi süresi, bazal nabız, hemoglobin düzeyi ile oksijen desaturasyonu arasında herhangi bir ilişki saptan¬madı. Sigara içiminin oksijen desaturasyonuna anlamlı katkıda bulunduğu saptandı. Sonuç: Üst gastrointestinal sistem endoskopisi için midazolam premedikasyonu güvenilir bir uygulamadır ve bu işlem, ciddi komorbiditesi olmayan bireylerde ek risk oluşturmamaktadır. Sigara alışkanlığı, endoskopi hastalarında dikkate alınmalıdır.
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    Clarifying the Relationship Between ABO/Rhesus Blood Group Antigens and Upper Gastrointestinal Bleeding
    (Springer, 2009) Bayan, Kadim; Tuzun, Yekta; Yilmaz, Serif; Dursun, Mehmet; Canoruc, Fikri
    Background and Aim The relationship between blood group antigens and peptic ulcer disease has been widely evaluated in the past. Data concerning the same association with upper gastrointestinal bleeding are very limited. We aimed to evaluate this association and we thought it was worthwhile to try to determine whether these components take some part in this complication. Methods The study population consisted of 1,098 adults (364 patients and 734 volunteer blood donors as controls). Demographic features, comorbid illnesses, and use of aspirin/nonsteroidal anti-inflammatory drugs (NSAIDs) were recorded. Blood groups were examined by gel centrifugation method. We included only patients with bleeding from peptic ulcer disease and erosive gastropathy. Ulcers were classified by using Forrest's classification system in terms of rebleeding risk. Helicobacter pylori was examined by histology. Results The gender distribution was similar in both groups. The ABO blood group phenotype distribution in patients and controls (respectively) was as follows: 46.2% versus 34.9% for group O, 32.4% versus 39.5% for group A, 15.7% versus 18.4% for group B, and 5.8% versus 7.2% for group AB. Blood group O was found to have higher frequency in the patient group than in the control group (P = 0.004). Rh positivity was also higher in patients than in controls (P = 0.007). H. pylori positivity was similar between blood groups among patients. The rebleeding and mortality rates between blood groups were also similar. Conclusion ABO blood group O had an important role in patients with upper gastrointestinal bleeding. The impact of blood group on rebleeding and mortality may be a focus for further studies.
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    The comparison of adefovir dipivoxil or combination with lamivudine in patients with lamivudine resistant chronic hepatitis B
    (Elsevier Science Bv, 2015) Ayaz, Celal; Celen, M. Kemal; Geyik, M. Faruk; Bayan, Kadim; Dal, Tuba; Altindis, Mustafa
    [Abstract Not Available]
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    A comprehensive analysis of 12 thrombophilic mutations and related parameters in patients with inflammatory bowel disease
    (Springer, 2006) Yilmaz, Serif; Bayan, Kadim; Tuezuen, Yekta; Batun, Sabri; Altintas, Abdullah
    Background Possible association of inflammatory bowel disease (IBD) with the most common inherited prothrombotic conditions has been the focus of many investigations. Advance in modern molecular biology is expanding the thrombophilia evaluation steadily. We tried to put forward a comprehensive thrombophilic profile in IBD and to see the probable role of this profile in pathogenesis. Methods A total of 60 adults (33 patients and 27 healthy controls) were included. We used the CVD-StripAssay which is based on the reverse-hybridization principle to identify a total of 12 thrombophilic gene mutations: Factor V R506Q, Factor V H1299R, prothrombin G20210A, Factor XIII V34L, beta-Fibrinogen-455 G-A, PAI-1 4G/5G, platelet GPIIIa L33P, MTHFR C677T, MTHFR A1298C, ACE I/D, Apo B R3500Q and Apo E2/E3/E4, respectively. Besides, we evaluated many related blood parameters such as protein C, protein S, AT-III, IL-6, TNF-alpha, Apo-A1, Apo-B100, homocysteine (tHcy) etc. using commercially available assays. Results The frequencies of genetic polymorphisms were found to be statistically insignificant among patients and controls, except for three: Beta-Fibrinogen-455G-A, MTHFR A1298C and ACE-I/D. Two patients with a history of deep venous thrombosis had more than one polymorphism. Patients with MTHFR C677T and MTHFR A1298C gene mutations had a similar mean tHcy levels with controls. Patients with Apolipoprotein B R3500Q and Apolipoprotein E4 gene mutations had similar mean LDL-cholesterol levels. Mean total cholesterol and triglyceride levels were similar in patients and controls of Apo E2, E3, E4 alleles. Conclusion Predominantly, the presence of genetic mutations that predispose to hypercoagulable states does not appear to be in correlation with IBD. There was a statistical difference between the proportions of the mutated allele frequencies of Beta-Fibrinogen-455G-A, MTHFR A1298C and ACE-I/D in IBD.
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    Cure in Chronic Hepatitis C! Does it Prevent the Risk of Hepatocellular Carcinoma?
    (Bilimsel Tip Yayinevi, 2018) Celen, Mustafa Kemal; Akdemir, Irem; Bayan, Kadim
    In 5%-20% of chronic HCV patients, cirrhosis or other complications like liver cancer may be seen and these may be directly or undirectly related. The development of a sustained viral response (SVR) does not change this fact. In the case of a 52-year-old female diabetic patient whose Anti-HCV was positive, HCV-RNA 2.230.000 IU/mL was decided to be followed up due to an ALT 68 UI/L, AST 55 UI/L. As a result of the biopsy (ISHAK, fibrozis= 2, HAI= 8), Pegile interferon alfa 2a 180 mu g/week + ribavirin 1000 mg/day was started. The patient was put under treatment for 48 weeks and as a result, SVR was obtained and the patient accepted as cure. The patient was told to come for check-up every six months. This patient who had actually started getting better stopped coming to our center in 2015 and did not return for a long time. The patient came back in 2016 with a fatigue complaint. As a result of the examination, AFP was 38.6 and all other parameters were found normal. Although there was no sign of a mass image in her liver ultrasound, there was a hepatocellular carcinoma (HCC) compatible lesion which was 190 x 150 x 90 mm in segment 6-7 in her contrasted MR result. The patient was urgently referred to a transplant center. However, it was determined at the center that since the tumor had made a vein invasion, there was no chance for a transplant. The patient died in June 2017. The cure in HCV treatment does not exclude the reality of HCC, which shows that patients who get the treatment must be followed up very closely. Routine clinical follow up, AFP level screening, effective ultrasound and dynamic imagination are of utmost importance.
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    The distribution of telomerase activity in patients with helicobacter pylori positive gastritis
    (TÜBİTAK, 2010) Canoruç, Naime; Kale, Ebru; Yılmaz, Şerif; Bayan, Kadim; Dursun, Mehmet; Batun, Sabri; Kaplan, Abdurrahman
    Aim: Helicobacter pylori is considered a class I carcinogen by the World Health Organization. We aimed to determine whether H. pylori has an effect on telomerase activity in patients with H. pylori related non-specific gastritis, atrophy, and intestinal metaplasia. Materials and methods: One hundred and seventy-two adult patients who underwent upper gastroduodenoscopy were enrolled in the study. Three biopsy specimens were taken from the antrum: 1 from the incisura angularis and 2 from the mid-antrum. Biopsy specimens taken from the incisura angularis were evaluated using the urease test for detection of H. pylori. The mid-antrum specimens were sent for histopathology and tissue telomerase activity testing. The histopathologic evaluation was performed based on the updated Sydney system. Quantitative detection of hTERT mRNA was performed with the available method for telomerase activity. Results: Of the 172 patients, 119 were eligible for the study. H. pylori was positive in 68 (57.14%) and negative in 51 (42.85%) of the cases (P > 0.05). Of the 119 patients, 6 had intestinal metaplasia, 27 had glandular atrophy, 62 had neutrophilic activation, and 102 had chronic inflammation. The telomerase activity of the H. pylori positive and negative groups did not show a statistically significant difference in patients with intestinal metaplasia, glandular atrophy, neutrophilic activation, and chronic inflammation (P > 0.05, for each). hTERT activity was higher in H. pylori positive patients who had glandular atrophy and intestinal metaplasia than the negative group. However, the differences were insignificant. Conclusion: We could not find any significant relationship between telomerase activity and H. pylori related non-specific gastritis, atrophy, and intestinal metaplasia. hTERT activity was higher in patients who had glandular atrophy and intestinal metaplasia (early stages of gastric carcinogenesis) in the H. pylori positive group. However, these differences were not significant. H. pylori, which is considered an oncogenic agent, may influence telomerase activity of further stages of carcinogenesis, particularly those after intestinal metaplasia.
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    Does adding misoprostol to standard intravenous proton pump inhibitor protocol improve the outcome of aspirin/NSAID-induced upper gastrointestinal bleeding?
    (Springer, 2007) Yilmaz, Serif; Bayan, Kadim; Dursun, Mehmet; Canoruc, Fikri; Kilinc, Nihal; Tuzun, Yekta; Danis, Ramazan
    Aspirin and nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal bleeding is recognized as an important health problem. We performed a single-center randomized clinical trial to compare the effect of high-dose intravenous proton pump inhibitor (omeprazole) alone (group 1) with omeprazole in combination with a low-dose prostaglandin analog (misoprostol; group 2) on clinical outcomes in patients with aspirin/NSAID-induced upper gastrointestinal bleeding. Additionally, we evaluated the contribution of Helicobacter pylori eradication therapy on the late consequences. Patients were recruited to the study if they had upper gastrointestinal bleeding with history of taking aspirin or other NSAIDs within the week before the onset of bleeding. All were evaluated in terms of probable risk factors. After the standard treatment protocol, patients with histologically proven H pylori infection were prescribed a triple eradication therapy for 14 days. The primary end points were recurrent bleeding, surgery requirement, and death rates before discharge and at the end of follow-up period. This study lasted for 2 years. A total of 249 patients with upper gastrointestinal bleeding were admitted, and 49.7% of these patients were users of aspirin/NSAIDs. There were 67 patients in group 1 and 56 in group 2. The distributions for gender, age, comorbidity, H pylori infection, and high-risk ulcer rate were similar in both groups. Among aspirin/NSAID users, endoscopy revealed duodenal ulcer in 47 (38.2%), gastric ulcer in 10 (8.1%), and erosive gastropathy in 33 (26.8%). The overall rebleeding occurred in 12.2%, death in 2.4% of the patients. The in-hospital death (P=.414), rebleeding (P=.925), and surgery (P=.547) rates were similar in both treatment groups. After the follow-up period of 3 months, overall rebleeding occurred in 4.1%, and death in 4.8% of the patients. The overall mortality rate was highest in those > 65 years old, who were chronic low-dose aspirin users with comorbidity. One died of transfusion-related graft-versus-host disease. In this pilot study, we indicated that adding misoprostol (600 mu g/day) to standardized proton pump inhibitor treatment did not improve or change the rebleeding or mortality rates of patients with upper gastrointestinal bleeding related to aspirin/NSAID use. Other prospective studies on higher doses of misoprostol are needed to establish the coeffect. One should bear in mind that all blood products must be irradiated before transfused to the host.
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    Dubin-Johnson Sendromu tanılı bir olgu nedeniyle konjuge hiperbilirubinemiler
    (Dicle Üniversitesi Tıp Fakültesi, 2008) Bayan, Kadim; Tüzün, Yekta; Özcan, Mansur; Yılmaz, Şerif; Turgutalp, Sezer
    Dubin-Johnson sendromu (DJS) hafif derecede kronik konjuge hiperbilirübinemi ile karakterize nadir görülen bir hastalıktır. Bu konjenital sendromda, konjuge anyonların safra kanalikülüne itrahında bozukluk vardır. Safra asitlerinin atılımı genellikle normaldir. DJS’lu hastalarda multidrug resistans related protein (MRP-2) geninde farklı mutasyonlar tespit edilmiştir. Hastalar asemptomatik olmakla birlikte bazen müphem karın ağrısı, hafif sarılık, halsizlik gibi bünyesel semptomlar görülebilir. Ondokuz yaşında erkek hasta doğduğundan beri mevcut olan sarılık yakınması ile kliniğe yatırıldı. Hastada müphem karın ağrısı ve sarılık mevcuttu. Kaşıntı yoktu. Tam kan sayımı, protrombin zamanı ve serum tarnsaminazlar, alkalen fosfataz, safra asitleri, kolesterol ve albumin değerleri normal sınırlardaydı. Serum total bilirübin konsantrasyonu 6,5 mg/dL, direkt bilirübin konsantrasyonu 4.9 mg/dL idi. 99mTc-HIDA ile yapılan hepatobiliyer sintigrafi incelemesinde karaciğer normal olup safra kesesi ise enjeksiyondan sonra geç görüntülendi. Karaciğer biyopsisinde santral ven çevresinde yoğun pigmentasyon izlendi. Bu yazıda konjuge hiperbilirübineminin nadir nedenlerinden biri olan Dubin-Johnson sendromunu sunmayı ve herediter sarılık ayırıcı tanısını vurgulamayı amaçladık.
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    The effects of nonsteroidal anti-inflammatory drugs on platelet function and severity of upper gastrointestinal haemorrhage
    (Springer, 2009) Pasa, Semir; Bayan, Kadim; Kucukoner, Mehmet; Tuzun, Yekta; Altintas, Abdullah; Cil, Timucin; Danis, Ramazan
    Nonsteroidal anti-inflammatory drugs (NSAIDs) cause gastrointestinal (GI) damage primarily due to the inhibition of prostaglandin synthesis in gastric mucosa, which is an important factor in mucosa protection. Platelets are a cardinal feature of vascular repair. A variety of angiogenic stimulators are stored in platelets and are released during clotting at the wound. When there is a defect in any of these functions and/or platelet number, haemostasis is usually impaired and there may be an associated increased risk and severity of bleeding. While the mechanism of mucosal injury and bleeding are well documented with the use of NSAIDs, very little is known about the platelet function abnormalities and their effects on severity of upper GI bleedings. We performed a prospective analysis of 49 patients who had a history of NSAIDs use to investigate the association between the platelet function impairment associated with NSAIDs and severity of upper GI haemorrhages. Thirty-six of 49 patients (73.5%) had deteriorated platelet function. Mean severity score of patients with deteriorated platelet functions was 3.39, and that of patients with normal platelet functions was 2.46. Mean severity score was statistically significantly higher in patients with deteriorated platelet functions. In conclusion, impaired platelet functions associated with NSAIDs may cause more severe upper GI bleeding. Clinicians should be alert for GI complications especially in older patients and in those with a history of ulcer bleeding.
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    Elbasvir/Grazoprevir Experience - A New Glance at HCV Treatment: Case Report
    (Galenos Yayincilik, 2017) Celen, Mustafa Kemal; Akdemir, Irem; Tekin, Recep; Bayan, Kadim; Ayaz, Celal
    Hepatitis C is a viral disease having a worldwide importance and posing a risk for liver complications. With the new treatment options, it is easy to manage with higher rates of success. Among them, one of the most recent one is elbasvir/grazoprevir option. This study presents the results of two treatment-naive patients treated with elbasvir/grazoprevir. The first case was a male non-cirrhotic patient and the second one was a female who suffered from compensated hepatic cirrhosis. Both patients received elbasvir/grazoprevir 50/100 mg in a single tablet for 12 weeks. Persistent viral response was achieved in both patients and no side effect was observed during the treatment. Elbasvir/grazoprevir combination, one of the recent treatments, was considered effective and tolerable.
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    Epidemiological and clinical aspects of liver cirrhosis in adult patients living in southeastern anatolia: Leading role of HBV in 505 cases
    (H G E Update Medical Publishing S A, 2007) Bayan, Kadim; Yilmaz, Serif; Tuzun, Yekta; Yildirim, Yasar
    Background/Aims: Liver cirrhosis is the terminal condition of liver disorders resulting from various causes. Literature lacks data on epidemiological and clinical aspects of liver cirrhosis in Turkey. We aimed to evaluate the main features of liver cirrhosis in this study. Methodology: We included in the study a total of 505 patients referred to Dicle University Hospital in the last five years and evaluated retrospectively. Demographic features, etiology, clinical findings, disease severity, complications and mortality rates were all recorded. Results: Of the patients, 136 (27%) were female and 369 were (73%) male. Mean age was 50.4. The etiologic spectrum consisted of 368 HBV (72.9%), 41 HCV (8.1%), 12 alcohol (2.4%). Rate for cryptogenic cirrhosis (CC) was 11.1% with mean age of 45.4. HDV superinfection was present in 17.8%. Most of the patients were in Child-Pugh class B. Number of decompensated cirrhosis cases was 278 (55%). Hepatocellular cancer (HCC) was seen in 8.9% of patients and 88% had HBV with a mean age of 60. HCC was seen more commonly in HDV superinfected patients (p=0.035). In-patient mortality was observed in 13.2%. Conclusions: HBV is the leading etiological factor of liver cirrhosis in Southeastern Anatolia and strict measures must be taken against perinatal or horizontal transmission of contagious pathogens. Alcohol had a marginal role in cirrhosis in our region. Although HDV superinfection is decreasing with time, it may increase HCC risk. Patients with cryptogenic cirrhosis were younger and had lower Child-Pugh scores.
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    Erişkinlerde gastrik nodularite ve Helikobakter Pylori ile ilişkisi
    (2017) Bayan, Kadim; Canoruç, Fikri
    Giriú ve amaç: Gastrik nodularite özellikle pediatrik yaú gurubunda görüldü÷ü bildirilen endoskopik bir tanÕmlamadÕr. Birçok çalÕúma çocuklardaki noduler gastritin Helicobacter pylori enfeksiyonu ile güçlü iliúkisini ortaya koymakla birlikte, bu endoskopik paternin eriúkinlerdeki do÷al seyri ve önemi az anlaúÕlmÕúWÕr. ÇalÕúmamÕzda amaç, gastrik nodulariteli eriúkinlerin demografik özellikleri, nodularitenin Helikobakter pylori ve patojenik suúlarÕ ile olan iliúkisinin güncelleútirilmiú Sydney histopatolojik sÕQÕflama sisteminden yararlanÕlarak araúWÕUÕlmasÕ olmuútur. Materyal ve metod: Bu prospektif çalÕúmada, dispepsi gibi abdominal semptomlar için endoskopi yapÕlan eriúkin hastalar çalÕúmaya alÕndÕ. Gastrik nodularite saptananlar ‘’hasta’’, nodularitesi olmayan gastritli olgular ise ‘’kontrol’’ gurubunu oluúturdu. ÇalÕúmada 82 hasta, 86 kontrol bulundu. HastalarÕn yaú, cins, sigara veya alkol kullanÕm öyküsü, vücut kitle indeksleri, ilaç alÕm öyküsü kaydedildi. Tüm gastrik biyopsi örnekleri Sydney sÕQÕflamasÕ ile de÷erlendirildi. H.pylori pozitifli÷i histolojik yöntem ve hÕzlÕ üreaz testi ile de÷erlendirildi. Serum örneklerinde uygun ticari yöntemle Helicobacter pylori CagA ve VacA IgG antikorlarÕ çalÕúÕldÕ. Sonuçlar: Hasta gurubunda 59 kadÕn, 23 erkek, kontrol gurubunda ise 49 kadÕn ve 37 erkek vardÕ. KadÕn cinsiyet gastrik nodularite riskini yaklaúÕk 2 kat arttÕrmaktadÕr. Nodularitesi olanlarÕn %43.9’u, nodularitesi olmayanlarÕn ise %81.4’ü 24 yaúÕndan büyük idi. Yirmi dört yaúÕndan küçük olmak nodularite riskini 6 kata yakÕn arttÕrmaktaydÕ. ÇalÕúma gurubunda H.pylori pozitifli÷i %64.3 oranÕnda gözlendi. H.pylori pozitif olanlarÕn %58.3’ünde nodularite saptanÕrken, bu durum negatif olanlarÕn %31.7’sinde gözlendi. H.pylori pozitifli÷i nodularite riskini 3 kat arttÕrmÕúWÕr. CagA(+) suú taúÕyan H.pylori olgularÕQÕn %61.7’sinde nodularite saptanÕrken, %38.3’ünde nodularite izlenmedi. CagA(+)’li÷i nodularite riskini yaklaúÕk 3 kat arttÕrmÕúWÕr. VacA(+)’lerin ise %60.8’inde nodularite izlenirken, %39.2’sinde izlenmemiútir. VacA(+)’li÷inde risk artÕúÕ CagA(+) hastalara yakÕndÕ. Sonuç: Gastrik nodularite eriúkin hastalarda yaygÕndÕr. KadÕn cinsiyet bir risk faktörü olabilir. H.pylori pozitifli÷i ve özellikle patojenik suúlarÕ olan CagA ve VacA pozitifli÷i nodularite riskini önemli oranda arttÕrmaktadÕr. Sigara içimi nodularite için koruyucu olabilir. Gastrik nodulariteli eriúkinlerin uzun dönem yansÕmalarÕQÕn incelenece÷i prospektif çalÕúmalara gereksinim vardÕr.
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    Familial Mediterranean fever gene mutations in the Southeastern region of Turkey and their phenotypical features
    (Taylor & Francis Ltd, 2008) Pasa, Semir; Altintas, Abdullah; Devecioglu, Bilge; Cil, Timucin; Danis, Ramazan; Isi, Hilmi; Bayan, Kadim
    Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent inflammatory attacks of serosal membranes. Several studies have focused on the differences between frequency of the mutations and their phenotypical manifestations. The aim of this study was to evaluate whether or not this phenotypical variation is associated with the existence of particular mutations. Twelve MEFV(Mediterranean fever) gene mutations were investigated in 119 patients suffering from FMF. Heterozygote M694V(21/119), heterozygote E148Q(21/119), homozygote M694V(17/119) and heterozygote V726A(12/119) mutations were the most common mutations. Patients were grouped according to the presence of the M694V mutation: group I was M694V/M694V, group II was M694V/others, and group III was other/other. Mean severity scores for the groups were 13.94 +/- 4.10, 10.79 +/- 3.01 and 8.31 +/- 2.26, respectively. There were statistically significant differences between the mean severity scores of groups I and II(p = 0.029), groups I and III(p < 0.0001), and groups II and III(p < 0.0001). Diagnosis of amyloidosis was established in four(23%) patients of group I, and three(8%) patients of group II, but in none of the patients in group III. There was also a statistically significant difference between groups I and III(p = 0.046), but not between groups II and III(p = 0.083) and groups I and II(p = 0.317) in terms of amyloidosis development. In conclusion, we found a higher disease severity score and higher prevalence of amyloidosis in FMF patients who were M694V mutation carriers. Many ethnic groups live in Anatolia and more ethnic origin-based studies are needed to determine the real effect of these mutations on disease severity and amyloidosis.
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    FOUR-YEAR STUDY OF ENTECAVIR EFFICACY AND SAFETY IN NUCLEOS(T)IDE-NAIVE HBeAg POSITIVE CHRONIC HEPATITIS B PATIENTS
    (Sestre Milosrdnice Univ Hospital, 2014) Celen, Mustafa Kemal; Dal, Tuba; Ayaz, Celal; Bayan, Kadim; Mert, Duygu; Deveci, Ozcan; Oruc, Ebru Kursun
    Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year trial was to evaluate entecavir treatment in nucleos(t)ide-naive HBeAg-positive chronic hepatitis B patients. Forty-nine patients received entecavir and nine of them withdrew from the trial at the end of week 96. The initial mean value of alanine aminotransferase was 79.4 +/- 41.5 IU/L, and at the end of the 4-year study period, 90% of patients had alanine aminotransferase values within the normal range. At week 96, 91.7% of patients had HBV DNA <300 copies; at month 48, 90% of patients had HBV DNA <50 IU/mL. HBeAg loss was recorded in 7.1% of patients at week 96 and in 12.5% at month 48. The rate of HBeAg seroconversion was 4.8% at week 96 and 7.5% at month 48. The rate of HBsAg seroconversion was 2.1% at week 96 and 2.5% at month 48. Entecavir as a potent and safe agent leading to continuous viral suppression proved to be safe and well tolerated therapy.
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    Granular cell tumor of the esophagus and its endoscopic treatment
    (Turkish Soc Gastroenterology, 2007) Bayan, Kadim; Yilmaz, Serif; Tuezuen, Yekta; Can, Alper; Bueyuekbayram, Hueseyin
    [Abstract Not Available]
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    Granular cell tumor of the esophagus and its endoscopic treatment
    (2007) Yılmaz, Şerif; Bayan, Kadim; Can, Alper; Tüzün, Yekta; Büyükbayram, Hüseyin
    [Abstract Not Available]