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

Are serum quantitative hepatitis b surface antigen levels, liver histopathology and viral loads related in chronic hepatitis b-infected patients?

Background/Aims: Fluctuations in hepatitis B virus (HBV) DNA and alanine transaminase (ALT) levels complicate assessment of the phases of chronic hepatitis B (CHB) infection and correct identification of the inactive HBV carrier state. In this study, we aimed to examine the role of HBsAg quantification (qHBsAg) in the identification of the phases of HBV and to evaluate its association with liver histopathology. Patients and Methods: Inactive HBV carriers (IC) (n = 104) and CHB patients (n = 100) were enrolled in the study. Demographic characteristics of patients were evaluated; biochemical parameters and serum qHBsAg levels were studied, and liver biopsy and histopathology were assessed. Results: Serum qHBsAg levels were found to be significantly low in IC (5150.78 ± 8473.16 IU/mL) compared with the HBeAg-negative CHB (7503.21 ± 8101.41 IU/mL) (P = 0.001) patients. The diagnostic accuracy of qHBsAg to differentiate HBeAg-negative CHB from IC was found to be moderate (c-statistic: 0.695) and the cutoff level for qHBsAg in diagnosis was found as 1625 IU/mL (specificity: 80%; sensitivity: 49%). No correlation was noted between serum qHBsAg level and ALT, histologic activity index (HAI), and fibrosis in IC and CHB. A moderate and positive correlation was observed between the serum qHBsAg level and HBV-DNA in HBeAg-positive CHB patients. Conclusions: Serum qHBsAg levels may prove to be useful in the differentiation between IC and HBeAg-negative CHB when used in conjunction with HBV DNA. Furthermore, patients diagnosed solely on the basis of HBV DNA and ALT may present with higher grade and stage of liver histopathology than expected

Cumhuriyet Dönemi’nin ilk kadın mühendisi Sabiha Rıfat Gürayman

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2014.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by Öztürk, İbrahim Mert

DOES SALT PRE-TREATMENT PROVIDE AMELIORATION EFFECT ON TOXIC BORON LEVELS IN TWO SUNFLOWER CULTIVARS?

Boron (B) is an essential micronutrient for plant growth and development such as photosynthesis and plasma membrane integrity, however its toxicity levels limit productivity throughout the world. This study was conducted to reveal whether the salt (NaCl) pre-treatment alleviate the adverse effects of increasing B concentrations on two sunflower (Helianthus annuus L., Tarsan-1018 and Sanbro) cultivars. On the 15th day after sowing, plants were divided into two groups, NaCl pre-treated (75 mM for 5 days) and/or B treated (2, 4 and 8 mM B for 10 days). The responses of the photosynthetic activities of two genotypes against the treatments was investigated by measuring polyphasic chlorophyll a fluorescence. Photochemical activity was decreased with increasing boron concentrations in both cultivars. PIabs and some JIP test parameters [PHI(D0), DI0/RC, FV/F0, TR0/RC, TR0/ABS] were changed significantly in both cultivars. In addition to that, the electron acceptor side of PSI [RE0/ET0, RE0/ABS] were negatively affected in only Sandro cultivar. Meanwhile, water content and, shoot and root growth were decreased in both cultivars, on the other hand membrane damage was increased with increasing B concentrations. These results indicated that the cultivars are adversely affected from increasing B concentrations. However, salt pre-treatment ameliorated the adverse effects of the B toxicity in both cultivars. Consequently, Tarsan-1018 protected photosynthetic apparatus, exhibiting better performance compared to Sanbro against B toxicity

The accuracy of references in Turkish journals in orthopedics and traumatology Türkiye'deki ortopedi ve travmatoloji dergilerinde kaynak kullanim hatalari.

OBJECTIVES: The accuracy of references was assessed in Turkish journals of orthopedics and traumatology. METHODS: All references cited in four journals (Acta Orthopaedica et Traumatologica Turcica, Arthroplasty Arthroscopic Surgery, Hacettepe Journal of Orthopaedic Surgery, and The Journal of Turkish Spinal Surgery) throughout 1995 to 1999 were numbered consecutively. One percent of references from each journal was randomly selected to be evaluated in comparison with primary sources. Errors were classified in three categories. Another randomized selection was made to check 50 references from each journal. The results were assessed by the t-test. RESULTS: Of 18,193 references cited in four journals, 182 references were checked. Errors were found in 117 references (63%), seven of which were major errors that prevented location of the primary source. When 50 references were checked from each journal, the mean inaccuracy rate was 60%. No significant differences were found between the journals with respect to the frequency of erroneous references. CONCLUSION: The high rate of inaccuracy emphasizes the need for greater care in the use of references on the part of authors, journal editors, and reviewers

Docosahexaenoic Acid Provides Protective Mechanism in Bilaterally Mptp-Lesioned Rat Model of Parkinson'S Disease

Docosahexaenoic acid (DHA), a major polyunsaturated fatty acid (PUFA) in the phospholipid fraction of the brain, is essential for normal cellular function. Neurodegenerative disorders such as Parkinson's disease (PD) often exhibit significant declines in PUFAs. The aim of this study was to observe the effects of DHA supplementation in an experimental rat model of PD created with '1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine' (MPTP). Adult male Wistar rats were divided into four groups: (1) Control; (2) DHA-treated; (3) MPTP-induced; and (4) MPTP-induced + DHA-treated. Motor activity was investigated using the 'vertical pole' and 'vertical wire' tests. The dopaminergic lesion was determined by immunohistochemical analysis for tyrosine hydroxylase (TH)-immunopositive cells in substantia nigra (SN). Immunoreactivities of Bcl-2, Akt and phosphorylated-Akt (p-Akt) in SN were evaluated by immunohistochemistry. MPTP-induced animals exhibited decreased locomotor activity, motor coordination and loss of equilibrium Diminished Parkinsonism symptoms and decreased dopaminergic neuron death were detected in the MPTP-induced + DHA-treated group compared to the MPTP-induced group. Moderate decreases in Akt staining were found in the MPTP-induced and MPTP-induced + DHA-treated groups compared to controls. p-Akt immunoreactivity decreased dramatically in the MPTP-induced group compared to the control; however, it was increased in the MPTP-induced + DHA-treated group compared to the MPTP-induced group. The staining intensity for Bcl-2 decreased prominently in the MPTP-induced group compared to the control, while it was stronger in the MPTP-induced + DHA-treated group compared to the MPTP-induced group. In conclusion, DHA significantly protects dopaminergic neurons against cell death in an experimental PD model. Akt/p-Akt and Bcl-2 pathways are related to this protective effect of DHA in experimental PD. (Folia Histochemica et Cytobiologica 2012, Vol. 50, No. 2, 228-238)WoSScopu