TASL practice guidance on the clinical assessment and management of patients with nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is a multisystem disease and is significantly associated with obesity, insulin resistance, type 2 diabetes mellitus, metabolic syndrome, and cardiovascular disease. NAFLD has become the most prevalent chronic liver disease in Western countries, and the proportion of NAFLD-related cirrhosis among patients on liver transplantation waiting lists has increased. In light of the accumulated data about NAFLD, and to provide a common approach with multi-disciplines dealing with the subject, it has become necessary to create new guidance for diagnosing and treating NAFLD. This guidance was prepared following an interdisciplinary study under the leadership of the Turkish Association for the Study of the Liver (TASL), Fatty Liver Special Interest Group. This new TASL Guidance is a practical application guide on NAFLD and was prepared to standardize the clinical approach to diagnosing and treating NAFLD patients. This guidance reflects many advances in the field of NAFLD. The proposals in this guidance are meant to aid decision-making in clinical practice. The guidance is primar-ily intended for gastroenterology, endocrinology, metabolism diseases, cardi-ology, internal medicine, pediatric specialists, and family medicine specialists

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Evaluation of Articles on Rhinology Published in National Otorhinolaryngology Journals between 2010-2015.

This study aimed to investigate the articles regarding rhinology published in national otorhinolaryngology journals between 2010 and 2015 according to the manuscript type, headline, citation city, and institution, as a reference for studies that will be designed in the future

Laboratuvar Uygulamalarına Yönelik Öğrenci Görüşleri: İzmir İli Örneği

Bu çalışmanın amacı, yapılandırmacı kurama göre hazırlanan kimya ders programının uygulanmaya başlandığı ortaöğretim kurumlarında laboratuvarın ne kadar etkili kullanıldığını, yenilenen ders programına laboratuvar öğrenme ortamının ve öğretmenlerin ne kadar hazırlıklı olduklarını öğrencilerin görüşleriyle belirlemektir. Tarama modelinin kullanıldığı bu çalışmada, 2008-2009 eğitim-öğretim yılında İzmir ilinde kimya dersi alan, farklı okul türleri ve sınıf düzeylerinde yer alan 2289 ortaöğretim öğrencisine “Kişisel Bilgi Formu” ve “Laboratuvar Uygulamalarına Yönelik Görüş Anketi” (LUYA) uygulanmıştır. Öğrenciler, genelde haftalık ders programında deney için özel ders saati ayrılmadığını, deney ile ilgili önceden bilgilendirilmediklerini, öğretmenin deney adımlarının tümünü denetlediğini ancak değerlendirmede laboratuvar uygulamalarına yer verilmediğini belirtmişlerdir. Buna karşın yapılan deneylerin ders süresince işlenen konuya uygun olduğunu, deneyi bilerek yaptıklarını, güvenlik önlemlerinin alındığı ortamda uygulamaların yapıldığını ve deney sonucunun öğretmenle beraber değerlendirildiğini belirtmişlerdir. Veriler okul türü, sınıf türü ve cinsiyete göre analiz edilmiş ve sonuçlar tartışılmıştır.The purpose of this survey study was to reveal secondary school students&amp;#8217; views about to what extent science labs are in use, labs and chemistry teachers are prepared for applying revised chemistry curriculum based on constructivism at secondary schools. 2289 secondary school students from various school types and grades who had chemistry course were administered &amp;#8220;The Student Demographics Form&amp;#8221; and &amp;#8220;The Questionnaire for Views on Lab Applications&amp;#8221; (QVLA) in 2008-2009 academic year in Izmir. The students reported that no extra lesson for making experiment was scheduled; they were not informed about the experiments before performing them and although the teacher controlled each step of the experiments, lab applications were not a part of the course assesment. They also reported that the experiments were consistent with the lesson content; they made experiments consciously in secure lab settings and discussed the results of experiments with their chemistry teacher. Further analysis were conducted according to school type, grade and gender and the results were discussed accordingly

Effectiveness of caudal septal extension graft application in endonasal septoplasty

Abstract Introduction Septal deviation is a common disease seen in daily otorhinolaryngology practice and septoplasty is a commonly performed surgical procedure. Caudal septum deviation is also a challenging pathology for ear, nose, and throat specialists. Many techniques are defined for caudal septal deviation. Objective To evaluate the effectiveness of caudal septal extension graft (CSEG) application in patients who underwent endonasal septoplasty for a short and deviated nasal septum. Methods Forty patients with nasal septal deviation, short nasal septum, and weak nasal tip support who underwent endonasal septoplasty with or without CSEG placement between August 2012 and June 2013 were enrolled in this study. Twenty patients underwent endonasal septoplasty with CSEG placement. The rest of the group, who rejected auricular or costal cartilage harvest for CSEG placement, underwent only endonasal septoplasty without any additional intervention. Using the Nasal Obstruction Symptom Evaluation (NOSE) and Rhinoplasty Outcome Evaluation (ROE) questionnaires, pre- and post-operative acoustic rhinometer measurements were evaluated to assess the effect of CESG placement on nasal obstruction. Results In the control group, preoperative and postoperative minimal cross-sectional areas (MCA1) were 0.44 ± 0.10 cm2 and 0.60 ± 0.11 cm2, respectively (p < 0.001). In the study group, pre- and postoperative MCA1 values were 0.45 ± 0.16 cm2 and 0.67 ± 0.16 cm2, respectively (p < 0.01). In the control group, the nasal cavity volume (VOL1) value was 1.71 ± 0.21 mL preoperatively and 1.94 ± 0.17 mL postoperatively (p < 0.001). In the study group, pre- and postoperative VOL1s were 1.72 ± 0.15 mL and 1.97 ± 0.12 mL, respectively (p < 0.001). Statistical analysis of postoperative MCA1 and VOL1 values in the study and the control groups could not detect any significant intergroup difference (p = 0.093 and 0.432, respectively). In the study group, mean nasolabial angles were 78.15 ± 4.26º and 90.70 ± 2.38º, respectively (p < 0.001). Conclusion Endonasal septoplasty with CESG placement is an effective surgical procedure with minimal complication rate for subjects who have a deviated, short nasal septum and weak nasal tip support