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Öğe Are Pattern Recognition Receptors Associated with Hepatocellular Carcinoma?(Aves, 2021) Dertli, Ramazan; Asil, Mehmet; Biyik, Murat; Karakarcayildiz, Ahmet; Keskin, Muharrem; Kayar, Yusuf; Basdemirci, MuserrefBackground: Hepatocellular carcinoma (HCC) is one of the important causes of mortality due to malignancy. Toll-like receptors (TLRs) are very important in liver pathophysiology in terms of their roles in the innate immune system, such as the regulation of inflammation, wound healing, stimulation of adaptive immune responses, promotion of epithelial regeneration, and carcinogenesis. In this study, we planned to examine the role of TLR1 (rs4833095, rs5743551) and nucleotide-binding oligomerization domain (NOD2) (rs2066844, rs2066845, rs2066847) polymorphisms in the development of HCC and their effects on the clinical presentation of HCC patients. Methods: Our study was designed prospectively. Cirrhotic and HCC patients who were followed up in our clinic between January 2015 and September 2018 were included in the study. Sex, age, cirrhosis etiology, Child-Pugh class, and MELD scores were recorded. TLR1 and NOD2 polymorphisms were studied by the PCR method. Results: HCC developed in 88 (31.4%) of the 280 patients who were followed up, either during the recruitment phase of our study or during the follow-up. The mean follow-up time of our patient group was 17.04 +/- 11.72 months, and the mean follow-up time of HCC patients was 12.09 +/- 10.26 months. TLR1 (rs5743551) polymorphism was associated with HCC development (P =.003). TLR1 (rs5743551) and NOD2 (rs2066844) polymorphisms were associated with the development of spontaneous bacterial peritonitis (SBP) in the HCC patient group (P =.013 and P =.021, respectively). Conclusion: We think that increased bacterial translocation in cirrhotic patients may contribute to HCC development by causing chronic inflammation, especially in patients with TLR 1 (rs5743551) polymorphism.Öğe Authors' Reply to the Letter to the Editor: Comprehensive Assessment of Inflammatory Indices to Predict Outcomes in Acute Pancreatitis(Taylor & Francis Inc, 2023) Biyik, Murat; Asil, Mehmet; Keskin, Muharrem; Biyik, Zeynep[Abstract Not Availabe]Öğe Can Hematological Inflammatory Parameters Predict Mortality in Hepatocellular Carcinoma?(Springer, 2021) Dertli, Ramazan; Asil, Mehmet; Biyik, Murat; Karakarcayildiz, Ahmet; Keskin, Muharrem; Goktepe, Hakan Mevlut; Kayar, YusufPurpose Hepatocellular carcinoma (HCC) is one of the most common malignant tumors. Inflammatory and hematological parameters such as neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) provided useful information especially in the diagnosis, treatment, and follow-up of malignancies. In this study, we planned to demonstrate the efficacy of NLR and PLR levels in the evaluation of the prognosis of patients with HCC in our clinic. Material and Methods This study was planned as a prospective observational cohort study. The study included 105 patients with HCC on the base of cirrhosis. Our study group was classified according to Barcelona Clinic Liver Cancer (BCLC), Okuda staging system, and Milan criteria at the time of admission. Results The mean age of all cases was 60.6 +/- 12.4 years, and 77 (73.3%) of the patients were male. The mean life expectancy of all patients was 7.7 +/- 4.3 months. During 1-year follow-up, 61 (58.1%) HCC patients died. The mean survival of the patients who died was 4.6 +/- 3.0 months. In our study, patients with NLR > 2.7, patients with PLR > 100.29, BCLC advanced stage, and Okuda advanced stage, and patients who did not meet the Milan criteria had shorter survival duration. NLR > 2.7, BCLC advanced stage, and Child C were determined as independent risk factors affecting mortality. Conclusion There was a strong correlation between NLR-PLR levels and mortality. PLR and NLR levels can be used in conjunction with other staging systems to regulate, monitor, and predict the survival of HCC patients.Öğe Can neutrophil-lymphocyte ratio predict mortality in acute non-variceal upper gastrointestinal bleeding?(Turkish Assoc Trauma Emergency Surgery, 2022) Dertli, Ramazan; Toka, Bilal; Asil, Mehmet; Kayar, Yusuf; Karakarcayildiz, Ahmet; Goktepe, Mevlut Hakan; Biyik, MuratBACKGROUND: Acute non-variceal upper gastrointestinal bleeding (NVUGIB) is one of the common gastrointestinal problems and has a high mortality, especially in patients with poor hemodynamics. Therefore, treatment and follow-up should be managed dynamically. Neutrophil-lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) are fast workable, cheap, and easy to calculate hematological parameters. We need easily accessible parameters as well as routine classifications such as Rockall score in the treatment and follow-up of NVUGIB patients, whose hemodynamics are unstable and progress with high mortality. In this study, we planned to evaluate NLR and PLR levels in patients with NVUGIB in the treatment follow-up with other scoring systems and their relationship with mortality in these patients. METHODS: Two hundred and forty-nine patients who were admitted to our clinic between January 2015 and January 2017 diagnosed with NVUGIB, and who underwent necessary examinations and follow-ups, were included in the study. The patients' Glasgow Blacthford, Rockall Score, NLR, and PLR levels were calculated at the first admission. RESULTS: One hundred and fifty-six of the patients were male (70.6%) and the mean age of all patients was 64.5 +/- 18.0 years. After follow-up and treatment, 28 (11.2%) patients died due to bleeding. High NLR and tachycardia at the time of admission and high patient age were found to be independent risk factors affecting the long of hospital stay. High Rockall score, high NLR at admission, and hypotension at admission were shown to be independent risk factors affecting mortality. CONCLUSION: Besides the use of various scoring systems in patients with NVUGIB, we think that the use of simple hematological parameters may be appropriate and the use of these hematological parameters may be useful in the management of patients with unstable hemodynamics.Öğe Can neutrophil-lymphocyte ratio predict mortality in acute non-variceal upper gastrointestinal bleeding?(Turkish Assoc Trauma Emergency Surgery, 2022) Dertli, Ramazan; Toka, Bilal; Asil, Mehmet; Kayar, Yusuf; Karakarcayildiz, Ahmet; Goktepe, Mevlut Hakan; Biyik, MuratBACKGROUND: Acute non-variceal upper gastrointestinal bleeding (NVUGIB) is one of the common gastrointestinal problems and has a high mortality, especially in patients with poor hemodynamics. Therefore, treatment and follow-up should be managed dynamically. Neutrophil-lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) are fast workable, cheap, and easy to calculate hematological parameters. We need easily accessible parameters as well as routine classifications such as Rockall score in the treatment and follow-up of NVUGIB patients, whose hemodynamics are unstable and progress with high mortality. In this study, we planned to evaluate NLR and PLR levels in patients with NVUGIB in the treatment follow-up with other scoring systems and their relationship with mortality in these patients. METHODS: Two hundred and forty-nine patients who were admitted to our clinic between January 2015 and January 2017 diagnosed with NVUGIB, and who underwent necessary examinations and follow-ups, were included in the study. The patients' Glasgow Blacthford, Rockall Score, NLR, and PLR levels were calculated at the first admission. RESULTS: One hundred and fifty-six of the patients were male (70.6%) and the mean age of all patients was 64.5 +/- 18.0 years. After follow-up and treatment, 28 (11.2%) patients died due to bleeding. High NLR and tachycardia at the time of admission and high patient age were found to be independent risk factors affecting the long of hospital stay. High Rockall score, high NLR at admission, and hypotension at admission were shown to be independent risk factors affecting mortality. CONCLUSION: Besides the use of various scoring systems in patients with NVUGIB, we think that the use of simple hematological parameters may be appropriate and the use of these hematological parameters may be useful in the management of patients with unstable hemodynamics.Öğe Conjunctival Impression Cytology and Dry Eye in Patients With Ulcerative Colitis: A Pilot Study(Lippincott Williams & Wilkins, 2018) Oltulu, Pembe; Oltulu, Refik; Asil, Mehmet; Satirtav, Gunhal; Mirza, EnverPurpose: The aim of this study was to compare signs of dry eye between ulcerative colitis (UC) patients and healthy subjects. Methods: Fifteen patients with UC (group 1) and 15 healthy subjects (group 2) were enrolled in this study. Tear volume measurement, Schirmer-I test with no anesthetic, tear break-up time, and conjunctival impression cytology (CIC) were evaluated in both groups. Results: Patients with UC showed lower tear volumes when compared with healthy subjects (P<0.05). There was a statistically significant difference in distribution of CIC grades between groups 1 and 2 (P<0.05). Tear break-up time and Schirmer-I measurements were significantly lower in group 1 compared with group 2 (P<0.05). Conclusions: The results of this study indicate that UC is associated with demonstrable disturbances in tear function and conjunctival cytology.Öğe Dynamic thiol-disulfide homeostasis is disturbed in patients with non-alcoholic fatty liver disease(Walter De Gruyter Gmbh, 2018) Asil, Mehmet; Dertli, Ramazan; Biyik, Murat; Yolacan, Ramazan; Erel, Ozcan; Neselioglu, Salim; Ataseven, HuseyinBackground: Oxidative stress has been implicated in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Plasma thiols are major defense mechanisms against oxidative stress and undergo oxidation to form disulfides under oxidative conditions. This study was conducted to investigate thiol-disulfide homeostasis in NAFLD patients. Methods: Thirty patients with biopsy proven non-alcoholic steatohepatitis (NASH), 40 patients with simple steatosis and 50 healthy controls were included in the study. Serum total and native thiol concentrations and serum disulfide concentration were measured using the Erel and Neselioglu's method. Results: The mean serum total thiol concentrations in the NASH, simple steatosis and control groups were 415 +/- 64 mu mol/L, 447 +/- 38 mu mol/L and 480 +/- 37 mu mol/L, respectively (p < 0.001). The mean serum native thiol concentrations in the NASH, simple steatosis and control groups were 378 +/- 62 mu mol/L, 416 +/- 41 mu mol/L and 451 +/- 36 mu mol/L, respectively (p < 0.001). The mean serum disulfide concentrations in the NASH, simple steatosis and control groups were 18.5 +/- 6.3 mu mol/L, 15.5 +/- 4.8 mu mol/L and 14.9 +/- 3.6 mu mol/L, respectively (p = 0.005). The native thiol/total thiol ratio was significantly lower and the disulfide/total thiol and disulfide/native thiol ratios were significantly higher in the NASH group than in the simple steatosis and control groups. Conclusions: Thiol-disulfide homeostasis is disturbed and shifted toward disulfide side in NAFLD and NASH patients.Öğe Dynamic thiol-disulfide homeostasis is disturbed in patients with non-alcoholic fatty liver disease(Walter De Gruyter Gmbh, 2018) Asil, Mehmet; Dertli, Ramazan; Biyik, Murat; Yolacan, Ramazan; Erel, Ozcan; Neselioglu, Salim; Ataseven, HuseyinBackground: Oxidative stress has been implicated in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Plasma thiols are major defense mechanisms against oxidative stress and undergo oxidation to form disulfides under oxidative conditions. This study was conducted to investigate thiol-disulfide homeostasis in NAFLD patients. Methods: Thirty patients with biopsy proven non-alcoholic steatohepatitis (NASH), 40 patients with simple steatosis and 50 healthy controls were included in the study. Serum total and native thiol concentrations and serum disulfide concentration were measured using the Erel and Neselioglu's method. Results: The mean serum total thiol concentrations in the NASH, simple steatosis and control groups were 415 +/- 64 mu mol/L, 447 +/- 38 mu mol/L and 480 +/- 37 mu mol/L, respectively (p < 0.001). The mean serum native thiol concentrations in the NASH, simple steatosis and control groups were 378 +/- 62 mu mol/L, 416 +/- 41 mu mol/L and 451 +/- 36 mu mol/L, respectively (p < 0.001). The mean serum disulfide concentrations in the NASH, simple steatosis and control groups were 18.5 +/- 6.3 mu mol/L, 15.5 +/- 4.8 mu mol/L and 14.9 +/- 3.6 mu mol/L, respectively (p = 0.005). The native thiol/total thiol ratio was significantly lower and the disulfide/total thiol and disulfide/native thiol ratios were significantly higher in the NASH group than in the simple steatosis and control groups. Conclusions: Thiol-disulfide homeostasis is disturbed and shifted toward disulfide side in NAFLD and NASH patients.Öğe Evaluation of serum neutrophil gelatinase-associated lipocalin (NGAL), asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) levels, and their relations with disease type and activity in inflammatory bowel diseases(Tubitak Scientific & Technological Research Council Turkey, 2021) Korkmaz, Huseyin; Asil, Mehmet; Temel, Tuncer; Ozturk, Bahadir; Kebapcilar, LeventBackground/aim: Inflammatory bowel disease (IBD) mainly encompass two entities called ulcerative colitis (UC) and Crohn's disease (CD), both of which are chronic, progressive and, inflammatory conditions of the gastrointestinal tract. Various indicators and non-invasive markers have been sought and used in IBD patients to help assessing disease activity and treatment effectiveness although none of them are proven to yield definite results in full correlation with the clinical, endoscopic, and histopathological examinations. The aim of the current study was to investigate the relationship of serum neutrophil gelatinase-associated lipocalin (NGAL), asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) levels with disease type and activity and to assess their potential use in establishing diagnosis and activity status of IBD, namely UC and CD. Materials and methods: A total of 111 IBD patients with determined active and inactive disease periods and 70 matched controls were recruited. Serum NGAL levels of the patients and the control group were measured using commercially available ELISA kits. ADMA and SMDA levels were measured by high performance liquid chromatography. Results: The IBD group had significantly higher serum levels of NGAL (p = 0.001), ADMA (p = 0.0001), and SDMA (p = 0.0001) in comparison to the control group. Likewise, serum NGAL, ADMA, and SDMA levels were significantly higher in the active IBD group compared to the inactive IBD group (p = 0.0001). Active UC and active CD patients similarly had significantly higher levels of serum NGAL, ADMA, and SDMA than the respective levels in inactive UK and inactive CD patients (p = 0.0001). Conclusion: Serum NGAL, ADMA and SMDA levels are increased in patients with IBD, and serum NGAL, ADMA and SMDA concentrations are significantly higher in active IBD patients than inactive IBD patients. Our results suggest these biomarkers may serve in estimating IBD activity and severity.Öğe Isolated Esophageal Involvement in Pemphigus Vulgaris Confused with Esophageal Cancer(Istanbul Training & Research Hospital, 2019) Daye, Munise; Temiz, Selami Aykut; Asil, Mehmet; Esen, Haci HasanPemphigus is a disease characterized by the formation of intraepithelial blisters due to acantholysis caused by immunoglobulin G antibodies against the keratinocyte cell surface holding the mucous membranes and skin. While the oral mucosa is the most affected region, all body cells with multilayered horizontal epithelia such as the conjunctiva, pharynx, larynx, esophagus, vagina, penis, and anus might be affected. Although few pemphigus cases with esophageal involvement have been reported, the incidence of actual involvement is thought to be higher. Our case was guided by an external endoscopy center because of the appearance of esophagus cancer. This pre-diagnosis was excluded in the endoscopic biopsy, and lesions regressed entirely with the treatment given for pemphigus. The co-existence of pemphigus vulgaris and esophagus squamous cell carcinoma has been reported. However, it has not been previously reported that the esophageal involvement of pemphigus, as in our case, has been confused with esophageal cancer. In this case report, we present a pemphigus case with isolated esophageal involvement in a pemphigus patient in clinical remission. We found it worthy of presentation because of the confusion with esophageal cancer due to an endoscopy result from an external center.Öğe KDIGO (Kidney Disease: Improving Global Outcomes) Criteria As a Predictor of Hospital Mortality in Cirrhotic Patients(2016) Bıyık, Murat; Ataseven, Hüseyin; Bıyık, Zeynep; Asil, Mehmet; Çifçi, Sami; Sayın, Serhat; Demir, Ali; Tombul, Halil ZekiBackground/Aims: Acute kidney injury (AKI) is frequent in cirrhotic patients and is associated with a poor prognosis. Recently, the Kidney Disease: Improving Global Outcomes (KDIGO) organization recommended new criteria for the diagnosis and staging for AKI. The aim of this study was to evaluate the presence of AKI according to KDIGO criteria in cirrhotic patients admitted to the hospital and to determine its association with hospital mortality.Materials and Methods: This retrospective study included 277 cirrhotic patients admitted to the intensive care unit and gastroenterology service of a tertiary referral hospital from January 2008 to January 2012. AKI was diagnosed and classified according to the KDIGO criteria.Results: The overall incidence of AKI in cirrhotic patients was 39%, and the overall hospital mortality was 15.5%. Patients without AKI had a hospital mortality rate of 2.4%, whereas the mortality rate for patients with AKI was 36.1%. The peak AKI stage detected during hospitalization was stage 1 for 58 patients (53.7%), stage 2 for 20 patients (18.5%), and stage 3 for 30 patients (27.7%). Mortality was found to be associated with the presence, stage, and progression of AKI. Multivariate analysis showed that AKI was an independent factor significantly associated with mortality (odds ratio: 9.1; 95% confidence interval: 2.89-29.1; p>0.001).Conclusion: KDIGO criteria can be used to evaluate AKI in cirrhotic patients. The prevalence of AKI in patients with cirrhosis is high, and AKI is associated with mortality. If early preventive measures are taken, it may be possible to prevent AKI progression and thus mortalityÖğe May Neutrophil Gelatinase-Associated Lipocalin (NGAL) Level Predict Mortality in Patients with Hepatocellular Carcinoma (HCC)?(Springer, 2020) Dertli, Ramazan; Biyik, Murat; Yolacan, Ramazan; Karakarcayildiz, Ahmet; Keskin, Muharrem; Kayar, Yusuf; Asil, MehmetPurpose Hepatocellular carcinoma (HCC) ranks fifth among the common cancers worldwide. Hepatocarcinogenesis is a multiple-phases process, which involves changes in cellular genomes including high cell proliferation.In this study, we aimed to evaluate the relationship of NGAL level at the time of diagnosis with mortality in patients diagnosed with HCC. Material and Methods A total of 35 patients who developed HCC on the ground of HBV(+) and 30 healthy subjects were included in the study. Barcelona Clinic Liver Cancer (BCLC), Okuda staging system, and Milan criteria were used for staging of the patients with HCC. Results The mean age of all patients was 59.54 +/- 11.57 years. Seventeen (48.6%) HCC patients died during 1-year follow-up. Survival of the patients who met the Milan criteria was longer (log-rank (Mantel-Cox) test, chi 2 = 5.353,p= 0.021). Kaplan-Meier curve was drawn for NGAL cut-off value, mortality was found to be higher in patients with a NGAL level higher than 217.50 (log-rank (Mantel-Cox) test, chi 2 = 15.540,p< 0.001). Conclusion In this study, we found that high levels of NGAL at the time of diagnosis were associated with poor prognosis in HCC patients.Öğe Neutrophil to lymphocyte ratio is increased in chronic helicobacter pylori infection and returns to normal after successful eradication(2016) Asil, Mehmet; Dertli, RamazanAmaç: Nötrofil lenfosit oranı birçok hastalıkla ilişkisi gösterilmiş ucuz bir belirteçtir. Biz de bu çalışmada kronik Helicobacter pylori enfeksiyonu olan hastalarda nötrofil lenfosit oranını araştırmayı planladık. Gereç ve Yöntem: Kronik Helicobacter pylori enfeksiyonu olan 286 hasta ve 130 Helicobacter pilori (-) kontrol grubuna ait klinik ve laboratuar verileri retrospektif olarak analiz edildi. Bulgular: Ortalama nötrofil lenfosit oranı Helicobacter pylori () grupta 1,980,76 ve Helicobacter pylori (-) grupta 1,640,44 olup aradaki fark istatistiksel olarak anlamlıydı (p0,001). Ortalama lökosit ve nötrofil sayıları, Helicobacter pylori () grupta sırasıyla 7,281,55/?L ve 4,271,17 /?L ve Helicobacter pylori (-) grupta sırasıyla 6,901,38 /?L ve 3,821,04 /?L olarak saptanmış olup her iki grup arasındaki fark gerek ortalama lökosit sayısı açısından (p0,011) gerek se ortalama nötrofil sayısı açısından (p0,001) anlamlı bulundu. Her iki grup arasında ortalama lenfosit sayısı, hemoglobin, hematokrit, RDW, trombosit sayısı, MPV, PDW açısından fark yoktu. 253 hastaya Helicobacter pylori eradikasyon tedavisi verilmişti. 76 hastada tedavi sonrası hematolojik veriler mevcuttu. Bu hastaların 45'inde (%59,2) eradikasyon tedavisinin başarılı olduğu (grup 1), 31 hastada (%40,8) ise eradikasyonun başarısız olduğu görüldü. Grup 1 için tedavi öncesi ve sonrası ortalama nötrofil lenfosit oranlarının 1,990,75 ve 1.700.60 olduğu ve aradaki farkın istatistiksel olarak anlamlı olduğu (p0,004), grup 2 için ise tedavi öncesi ve sonrası ortalama nötrofil lenfosit oranlarının 1,930,59 ve 1.760.56 olduğu ve aradaki farkın istatistiksel olarak anlamlı olmadığı görüldü. Sonuç: Kronik Helicobacter pylori enfeksiyonunda nötrofil lenfosit oranı artmıştır. Başarılı eradikasyon tedavisi sonrası artmış nötrofil lenfosit oranı normale döner.Öğe The Neutrophil-to-Lymphocyte Ratio as A Noninvasive Marker in Patients with Biopsy-Proven Non-Alcoholic Steatohepatitis(Aves, 2016) Asil, Mehmet; Dertli, RamazanObjective: Non-alcoholic fatty liver disease is a global health problem with an increasing prevalence. The neutrophil-to-lymphocyte ratio is a cheap inflammatory parameter that can be easily calculated from routine complete blood count tests. This study was designed to investigate the neutrophil-to-lymphocyte ratio in patients with non-alcoholic steatohepatitis and simple hepatosteatosis. Methods: Fifteen patients with biopsy-proven non-alcoholic steatohepatitis, 65 patients with simple steatosis diagnosed with abdominal ultrasound, and 65 healthy controls were included. Anthropometric measurements were obtained during a routine physical examination. The neutrophil-to-lymphocyte ratio was calculated from routine complete blood count tests, and its relationship with various clinical and laboratory parameters was analyzed. Results: The mean neutrophil-to-lymphocyte ratio was 2.16+/-0.49 in the patients with non-alcoholic steatohepatitis, 1.62+/-0.43 in the patients with simple steatosis, and 1.51+/-0.31 for healthy controls; the difference among the groups of patients were statistically significant (p<0.001). A paired analysis revealed that patients with non-alcoholic steatohepatitis had a significantly higher neutrophil-to-lymphocyte ratio than patients with simple steatosis and healthy controls, whereas the difference between the latter two groups of patients was not statistically significant. The neutrophil-to-lymphocyte ratio was not associated with the degree of steatosis on performing abdominal ultrasound and with histological findings of liver biopsies (p>0.05). ROC analyses for the neutrophil-to-lymphocyte ratio to differentiate patients with steatohepatitis revealed an AUC of 0.868 (95% CI: 0.781-0.956) and 86.5% sensitivity and 81% specificity for the selected cut-off value of 1.793. Conclusion: The results of this study showed that the neutrophil-to-lymphocyte ratio was higher in patients with steatohepatitis than in patients with simple steatosis and healthy controls. Taking into account that the difference between patients with simple steatosis and healthy controls was not statistically significant, the increased neutrophil-to-lymphocyte ratio in the patients with steatohepatitis can be attributed to a low level of systemic inflammation accompanying the hepatic inflammation.Öğe Nutritional habits in functional dyspepsia and its subgroups: a comparative study(Taylor & Francis Ltd, 2016) Goktas, Zeynep; Koklu, Seyfettin; Dikmen, Derya; Ozturk, Omer; Yilmaz, Bulent; Asil, Mehmet; Korkmaz, HuseyinObjective: Research data demonstrating nutritional habits of functional dyspepsia (FD) patients are very limited. This is the first study to evaluate nutritional habits in FD subgroups according to Rome III criteria. Our aim was to evaluate nutritional habits of FD patients and determine the food items that may provoke a dyspepsia symptom. Methods: A total of 168 adults with FD and 135 healthy control subjects participated in the study. FD subjects were divided into epigastric pain syndrome (EP-FD), postprandial distress syndrome (PS-FD), mixed (MX-FD) subgroups according to Rome Criteria III. Subjects completed a questionnaire that included a short-form food frequency questionnaire. Furthermore, subjects were asked to list the food items that were causing a dyspepsia symptom. Results: Functional dyspepsia subjects had a slightly higher BMI (26.1 +/- 4.97kg/m(2)) than control subjects (24.6 +/- 4.08kg/m(2)). The most common symptom triggering foods among all the FD groups were fried and fatty foods (27.1%), hot spices (26.4%), and carbonated drinks (21.8%). In FD subgroups, carbonated drinks were more likely to cause a symptom in PS-FD group (37.3%) than MX-FD (25.7%) and EP-FD (22.1%) groups. There was no difference in frequency of main meals and snacks among any of the groups. Conclusion: Fatty and spicy foods and carbonated drinks were the most common symptom triggering food items in FD group. In subgroups, carbonated drinks and legumes were more likely to cause a symptom in PS-FD. Removing these food items during the course of treatment might help alleviate the symptoms.Öğe A polypoid mass in the common bile duct(Aves, 2016) Asil, Mehmet; Dertli, Ramazan; Biyik, Murat; Oltulu, Pembe; Ataseven, Huseyin; Polat, Hakki; Demir, Ali[Abstract Not Availabe]Öğe Renal dysfunctions in cirrhosis(Modestum Ltd, 2016) Biyik, Murat; Asil, Mehmet; Biyik, ZeynepKidney dysfunction is a common and potentially life-threating event in patients with cirrhosis, and underlying mechanisms for renal dysfunction are quite variable. Acute kidney injury (AKI) is relatively frequent encountered in approximately 20% of hospitalized patients with cirrhosis. Nevertheless, chronic kidney disease (CKD) occurs in almost 1% of all patients with cirrhosis. In this review various renal problems encountered in cirrhotic patients are discussed and strategies to prevent renal dysfunction are suggested.Öğe Serum soluble TWEAK levels are decreased in treatment naive noncirrhotic chronic hepatitis B patients(Lippincott Williams & Wilkins, 2016) Asil, Mehmet; Dertli, RamazanThe mechanisms underlying hepatic inflammation and fibrogenesis in chronic hepatitis B (CHB) are complex and several cytokines are involved. Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is a member of the tumor necrosis factor superfamily which also acts as a cytokine. This study was conducted to evaluate serum soluble TWEAK (sTWEAK) levels in noncirrhotic CHB patients.Fifty-two treatment naive CHB patients and 30 healthy controls were included in the study and serum sTWEAK concentrations were measured using commercially available ELISA kits.Mean serum sTWEAK concentration was significantly lower in CHB group than healthy controls (189.663.3pg/mL in CHB group and 297.6 +/- 61.5pg/mL in control group, P<0.001). According to the degree of necroinflammation in liver biopsies mean sTWEAK concentrations were found to be 168.14 +/- 51.51, 206.96 +/- 58.51, and 223.62 +/- 78.88pg/mL in patients with mild, moderate, and severe inflammation, respectively, and the difference between groups was statistically significant (P=0.022). sTWEAK concentration was also found to be significantly higher in patients with advanced fibrosis in liver biopsy samples (169.59 +/- 52.02 and 211.17 +/- 68.22pg/mL in patients with mild and advanced fibrosis, respectively, P=0.016). Receiver operating characteristic (ROC) curves were obtained in CHB group to differentiate patients with advanced fibrosis from patients with mild fibrosis. Area under curve (AUC) was 0.676 (95% Cl; 0.526-0.825) for sTWEAK and for the specified cut-off value of 213.67pg/mL sensitivity and specificity were 60% and 81.4%, respectively. ROC curve for sTWEAK to differentiate patients with severe inflammation revealed an AUC of 0.664 (95% Cl; 0.450-0.878). A cut-off value of 243.27pg/mL yielded 54.5% sensitivity and 82.9% specificity.Serum sTWEAK concentration is decreased in treatment naive CHB patients. Further studies with simultaneous determination of circulating sTWEAK concentrations and TWEAK and factor-inducible 14 (Fn14) expressions in the liver biopsy samples would clarify the exact association of TWEAK/Fn14 pathway in the pathogenesis of CHB.Öğe Systemic Inflammation Response Index and Systemic Immune Inflammation Index Are Associated with Clinical Outcomes in Patients with Acute Pancreatitis?(Taylor & Francis Inc, 2022) Biyik, Murat; Biyik, Zeynep; Asil, Mehmet; Keskin, MuharremObjectives: The inflammatory response is critically important in acute pancreatitis (AP). Systemic immune-inflammation (SII) index and systemic inflammation response index (SIRI), which are novel inflammatory markers, have been linked to determining outcomes in various diseases. The goal of the current study was to examine the relation of the SII index and SIRI with disease severity and acute kidney injury (AKI) in subjects with AP. Methods: A total of 332 subjects with AP were analyzed retrospectively. SII index was calculated using the formula; platelet (P)xneutrophil (N)/lymphocyte (L), while SIRI was calculated as N x monocyte (M)/L count. Multivariate regression (MR) was done to determine the independent risk factors for AKI and severe AP (SAP). Results: Statistical analyses showed that both median SII index and median SIRI increased gradually with higher AP severity (p < 0.001). Both SII index and SIRI were higher in subjects with AKI compared to controls (p < 0.001). Using MR analysis, the SII index was found to independently predict both SAP (OR = 1.004, 95% CI: 1.001-1.008, p = 0.018) and AKI (OR = 1.005, 95% CI: 1.003-1.008, p < 0.001). ROC analysis showed that the SII index could accurately differentiate SAP (AUC = 0.809, p < 0.001) and AKI (AUC = 0.820, p = 0.001) in patients with acute pancreatitis. ROC analysis also showed that SIRI could also accurately differentiate SAP (0.782, p < 0.001) and AKI (AUC = 0.776, p = 0.001). Conclusions: SIRI and the SII indexes can be used as potential biomarkers in predicting both disease severity and AKI development in subjects with AP.
