A key problem and challenge for hepatology: Obesity-related metabolic liver diseases

With the arrival of the new millennium, gastroenterologists have been faced with the problem of metabolic liver diseases associated with obesity. The active role of the liver in metabolism and inflammation make it a key organ in the war against the rapidly-spreading world-wide epidemic of obesity. Many lives and much money could be saved if the work of hepatologists led to the development of effective diagnostic and therapeutic strategies against this growing leader of cirrhosis

Gastric cancer prevention from the point of helicobacter

WOS: 000345025900038PubMed ID: 25254545When the first cancer estimates of world were made in 1975, gastric cancer (GC) was the most common neoplasm, making 70% of the total. Although its rate decreased to 6.8% in 2012, it is still the fifth most common malignancy after cancers of the lung, breast, colo-rectum, and prostate and the third leading cause of cancer death in both sexes worldwide (8.8%, 723,000 deaths) (1). Proximal (cardia) and distal (non-cardia) gastric adenocarcinomas have different epidemiological and clinical features. Although there is an increase in proximal GCs, most of the GCs are still distally located, and intestinal-type. H. pylori is an established trigger of gastric carcinogenesis; reversibility of precancerous conditions, including intestinal metaplasia (IM), after eradication treatment is a hot topic for research. Therefore, we read with great interest the study by Galiatsatos P et al. (2) on the sensitivity of gastric biopsy for H. pylori detection in the presence of IM. The data have once again emphasized the importance of using non-invasive tests and histopathology together in the presence of gastric IM

Intrahepatic cholestasis of pregnancy: Spontaneous vs in vitro fertilization

Aim: Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy. Although it was shown that multiple pregnancy and hormone therapies increase the risk of ICP, there is limited information that compared spontaneous fertilization and in vitro fertilization (IVF) from the aspect of developing ICP. In our study, we investigated the potential relationship between ICP and IVF/ spontaneous pregnancy.Materials and methods: We reviewed the records (between June 2007 and December 2014) of pregnancies with ICP who were referred to gastroenterology clinics in three different hospitals. Fifty-nine pregnancies (43 spontaneous fertilization, 16 IVF) with ICP were analyzed from the aspect of age, fertilization type, multiple/singleton pregnancy, delivery week, and biochemical results.Results: We found that serum bile acid levels were higher in the IVF group than the spontaneous fertilization group (32.8 ± 20 vs 19.6 ± 19 μmol/L; p < 0.05). There was a significant inverse correlation between serum bile acid levels and gestational age (r = -0.42, p < 0.01) in the whole group. There was no difference between IVF and spontaneous fertilization groups in term of age, onset time of symptoms, serum alanine aminotransferase (ALT), alkaline phosphatase (ALP), total and direct bilirubin levels, prothrombin time (PT), international normalized ratio (INR), and platelet count.Conclusion: Our results suggest that the serum bile acid levels are higher in IVF than in spontaneous pregnancies with ICP, but its clinical implications are not clear. Further prospective studies with large number of ICP cases are needed to clarify the effect of IVF on ICP

Characteristics of patients with hepatocellular carcinoma: A multicenter study

Background and Aim: The aim of the present study was to examine the etiology of hepatocellular carcinoma (HCC) by underlying cause and determine the characteristics and clinical features of patients with HCC. Materials and Methods: The study comprised 1802 HCC patients diagnosed and followed up by Liver Diseases Outpatient Clinics in 14 tertiary centers in Turkey between 2001 and 2020. Results: The mean age was 62.3 +/- 10.7 years, and 78% of them were males. Of the patients, 82% had cirrhosis. Hepatitis B virus (HBV) infection was the most common etiology (54%), followed by hepatitis C virus (HCV) infection (19%) and nonalcoholic fatty liver disease (NAFLD) (10%). Of the patients, 56% had a single lesion. Macrovascular invasion and extrahepatic spread were present in 15% and 12% of the patients, respectively. The median serum alpha-fetoprotein level was 25.4 ng/mL. In total, 39% of the patients fulfilled the Milan Criteria. When we compared the characteristics of patients diagnosed before and after January 2016, the proportion of NAFLD-related HCC cases increased after 2016, from 6.6% to 13.4%. Conclusion: Chronic HBV and HCV infections remain the main causes of HCC in Turkey. The importance of NAFLD as a cause of HCC is increasing

Outcomes following deceased and live donor liver transplantation for the indication of acute liver failure: A multicenter experience

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