Endoskopska pretraga u bolesnika sa zadebljanjem stijenke kolona otkrivenim kompjutoriziranom tomografijom

Colorectal wall thickening is a condition which is occasionally encountered on computed tomography (CT) investigations. Malignancies and inflammatory bowel disease (IBD) may be the most common and most important pathologies in some cases. Our objective in this study was to evaluate colonoscopy results in patients with increased colorectal wall thickness identified on CT. Patients with colorectal wall thickening detected on abdominal CT taken for different indications in different healthcare facilities between October 2009 and March 2015 were evaluated. These patients were referred to gastroenterology department, received colonoscopy, and the results were compared retrospectively and statistically. A total of 132 patients having undergone colonoscopy for colonic wall thickening detected on CT were evaluated retrospectively. With the colonoscopies performed, malignancies were detected in 38 (28.8%), Crohn’s disease in two (1.5%), diverticulitis in 18 (13.6%) and colorectal polyp in 30 (22.7%) patients. Colonoscopy results were normal in 44 patients. All patients with colorectal malignancies were over 60 years of age, yielding a statistically significant figure (p=0.01). The mean hemoglobin level was 12.8 g/dL in patients with normal colonoscopy as compared with 9.5 g/dL in those with malignancies (p=0.001). On multivariate analysis, hemoglobin and age were the only significant variables to predict an abnormal result on endoscopy. Detecting colonic wall thickening on CT may indicate malignancy, especially in patients who are over 50 years of age and have hemoglobin values less than 10 g/dL.Zadebljanje stijenke kolona je stanje koje se ponekad vidi kod pretrage kompjutoriziranom tomografijom (computerized tomography, CT). Najčešće i najvažnije patologije u nekim slučajevima mogu biti maligne bolesti i upalne bolesti crijeva (inflammatory bowel disease, IBD). Cilj ovoga istraživanja bio je procijeniti rezultate kolonoskopije u bolesnika s povećanom debljinom kolorektalne stijenke utvrđenom na CT-u. Studija je obuhvatila bolesnike sa zadebljanjem kolorektalne stijenke otkrivenim na CT-u abdomena zbog različitih indikacija od listopada 2009. do ožujka 2015. godine. Ovi bolesnici su upućeni u kliniku za gastroenterologiju, napravljena im je kolonoskopija, a rezultati su retrospektivno statistički analizirani. Retrospektivno su analizirana 132 bolesnika podvrgnuta kolonoskopiji zbog zadebljanja stijenke kolona otkrivenog na CT-u. Na kolonoskopiji su otkrivene zloćudne promjene u 38 (28,8%), Crohnova bolest u dvoje (1,5%), divertikulitis u 18 (13,6%) i kolorektalni polip u 30 (22,7%) bolesnika. Rezultati kolonoskopije bili su normalni u 44 bolesnika. Svi bolesnici s kolorektalnim malignim promjenama bili su stariji od 60 godina, što je bilo statistički značajno (p=0,01). Srednja vrijednost hemoglobina bila je 12,8 g/dL u bolesnika s normalnim nalazom kolonoskopije u usporedbi s 9,5 g/dL u onih sa zloćudnim promjenama (p=0,001). Multivarijatna analiza pokazala je da su hemoglobin i dob jedine značajne varijable koje pretkazuju nenormalan endoskopski rezultat. Otkrivanje zadebljanja stijenke kolona na CT-u može ukazivati na malignitet, poglavito u bolesnika starijih od 50 godina s vrijednostima hemoglobina nižim od 10 g/dL

CA 19-9 levels in patients with acute pancreatitis due to gallstone and metabolic/toxic reasons

OBJECTIVE: Acute pancreatitis (AP) is an important clinical event with an increased frequency due to increased life expectancy, obesity, and alcohol use. There are some data about the elevation of carbohydrate antigen (CA) 19-9 levels in benign and malignant pancreaticobiliary events in the literature, but in AP they are limited. The aim of this study was to evaluate the CA 19-9 level in patients with AP and determine its relationship according to the cause

Relation of hepatitis B core antigen expression with histological activity, serum HBeAg, and HBV DNA levels

Background: Hepatitis B virus (HBV) is a potentially life-threatening liver infection which may progress to liver failure and cirrhosis. Intrahepatic expression patterns of viral antigens detected by immunohistochemistry may have prognostic implications in disease process. Aim: In this study, we aimed to investigate the relationship between the HBV core antigen (HBcAg) expression and histological activity index (HAI), fibrosis, serum hepatitis B e-antigen (HBeAg) status and HBV DNA levels in patients with chronic HBV infection. Materials and Methods: A total of 114 liver biopsies from patients with chronic HBV infection were included in the study. Immunohistochemical expression of HBcAg and its relation with HAI, fibrosis, serum alanine aminotransferase (ALT) levels, HBeAg status and HBV DNA levels were assessed. Results: The presence of nuclear expression of HBcAg did not show any correlations with ALT levels, HAI and fibrosis score. When the groups were categorized according to the HBeAg status, nuclear HBcAg expression was found to be high in HBeAg positive patients. However, HBcAg nuclear expression showed significant correlations with HBV DNA levels and fibrosis scores in HBeAg negative but not HBeAg positive patients. HBV DNA levels were also significantly associated with HAI and fibrosis scores in HBeAg negative patients. Conclusions: Significant differences found between HBeAg positive and negative patients suggest that HBeAg negative disease is different from HBeAg positive disease, and also point outs that in HBeAg negative disease, patients with nuclear HBcAg expression and increased levels of HBV DNA levels are at a higher risk of developing progressive liver disease

Hyperuricemia and its related factors in an urban population, Izmir, Turkey

The aim of this study was to examine the prevalence of hyperuricemia and its associated factors in an urban area of Izmir, located in western Turkey. Our study group was selected by computerized sampling from the participants of a larger population-based study searching for the prevalence of rheumatoid arthritis in Balcova and Narlidere districts of Izmir. A total of 132 subjects (69 women and 63 men) were included in this study. Serum uric acid, glucose, creatinine and lipid levels were studied. Body composition along with body fat percentage was determined anthropometrically. A total of 16 subjects had hyperuricemia (4 women and 12 men). The overall prevalence of hyperuricemia was 12.1% and the mean uric acid level was 4.9 +/- A 1.3 mg/dl. Males had significantly higher uric acid levels than females (P < 0.05; 5.5 +/- A 1.3 vs. 4.3 +/- A 1.1 mg/dl, respectively). The prevalence of hypertension, diabetes, obesity and metabolic syndrome was 24.4, 5.3, 28 and 26.5%, respectively. There was no gouty subject. Sum of skinfold thickness (SFT) measurements and creatinine levels were the independent predictors of hyperuricemia (beta = 0.45, 0.47, respectively). Uric acid measurement is important not only for inflammatory rheumatic disorders but also for predicting metabolic syndrome and related coronary artery disease. There is sex difference in uric acid levels in favor of women most probably explained by gonadal hormones. Hyperuricemia is significantly predicted by anthropometric measure of SFT which is a simple clinical screening method along with creatinine levels