Evaluation of epicardial adipose tissue and carotid intima-media thickness as a marker of atherosclerosis in patients with inflammatory bowel disease

Background and aim: this study aimed to compare carotid intima media (CIMT) and epicardial adipose tissue (EAT) measurements, which are considered as markers for the detection of early atherosclerosis in healthy controls and inflammatory bowel disease (IBD) cases. Methods: a total of 60 IBD patients (25 Crohn’s disease and 35 ulcerative colitis) and 60 healthy patients (as a control group) were included in the study. The measurements of CIMT and EAT were performed using echocardiography and ultrasonography, respectively. Statistical analysis was used to determine the relationship between the parameters. Results: the thickness of bilateral (right and left) CIMT and EAT were significantly higher in IBD than in the control group (p < 0.05). There was a positive correlation between EAT and bilateral (right and left) CIMT in IBD patients (p < 0.05)

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

kistik pankreatik neoplazmi taklit eden primer pankreatik kist hidatik: Iki olgu sunumu]

Liver and lungs are the most common locations for hydatid disease. Primary pancreatic hydatid cyst is a rarely seen form and accounts for about 0.19% to 2% of the cases. It usually mimicks the cystic neoplasm of pancreas. The aim of this case report is to focus on the diagnosis and management of pancreatic hydatid disease in endemic areas. We hereby present the medical records of two patients mimicking the cystic pancreatic neoplasm treated with distal subtotal pancreatectomy and splenectomy. During the two year follow-up period, there was no reccurence or other organ involvement. Pancreatic hydatid disease, although a very rare entity, should be considered in endemic areas, and in order to prevent reccurrences it, should be treated with complete resection without any contamination

Twelve years of experience using double-balloon enteroscopy for diagnosing and treating patients with obscure gastrointestinal bleeding

&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;Double-balloon enteroscopy (DBE) is a medical procedure employed for the assessment of small intestines that are inaccessible by standard endoscopes and colonoscopes. This study aimed to assess the data obtained from DBE procedures conducted to investigate the underlying causes of iron deficiency anemia and gastrointestinal bleeding when traditional diagnostic approaches were inconclusive.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and Methods: &lt;/strong&gt;The present investigation is a retrospective study conducted at a single center. The medical data pertaining to DBE procedures conducted at the Gastroenterology Clinic of Ankara Türkiye Yüksek Ihtisas Training and Research Hospital was collected by the researchers for the period spanning from January 2007 to December 2018. The present investigation employed exclusion criteria to eliminate individuals with inadequate medical records and those who were transferred to another institution without a confirmed diagnosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study comprised a sample size of 118 individuals, with 45 (38.1%) being female and 73 (61.9%) being male. The average age of the participants was found to be 54.98 ± 16.1 years. A total of 88 patients received the procedure utilizing an anterograde (oral) method, while in 13 patients it was performed retrograde (anal). Additionally, 17 patients got the procedure utilizing both approaches. The observed lesions consisted of 18 (31.5%) inflammatory, 26 (45.6%) vascular, 9 (15.7%) neoplastic, and 4 (7%) diverticular kinds. Using double-balloon enteroscopy (DBE), it was found that 49.1% of the patients with obscure gastrointestinal bleeding (OGIB) had a positive result. A total of 22 instances (18.6%) necessitated the use of interventional techniques.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Consequently, the diagnostic efficacy of double-balloon enteroscopy in obscure gastrointestinal bleeding was very limited. The frequent location of the lesion varied depending on its nature; however, this variation did not yield a statistically significant difference when considering the presence of overt or occult bleeding.&lt;/p&gt