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

Developing Turkish sentiment analysis models using machine learning and e-commerce data

With the increment of Internet usage, there has been a significant increase in the access and interaction of users in social media, blogs, forums, and criticism sites recently. With social media, access to a large amount of data on various products, services, social and political events is provided. Important feedback about products and services can be obtained as a result of analyzing such data. This study aims to determine the sentiments expressed via texts on social media using machine learning methods. As a result of initial research, it is determined that the best case in which texts and emotions match was the product reviews and ratings used on e-commerce websites. Reviews on different products along with review scores from an e-commerce website have been converted into a table to be used in the machine learning-based sentiment analysis models. Reviews have been classified into three groups as positive, negative, and neutral using the review scores. Considering this claim, Turkish sentiment analysis models were developed using support vector machine (SVM), random forest (RF), decision tree (DT), logistic regression (LR), and k-nearest neighbors (KNN). Cross-validation results on independent test data taken from the same e-commerce website show that the SVM-based and RF-based sentiment analysis models outperform the other models. In more detail, there is no strict order between SVM-based and RF-based prediction models, but the results of the SVM-based and RF-based models, in general, are the highest or, in the worst case, similar if we compare them with the scores obtained by using the DT-based, LR-based, and KNN-based models. It can be concluded that SVM and RF are viable methods that can be used to classify product reviews into three groups as positive, negative, and neutral within acceptable error rates

The use of furosemide during Intravenous Immunoglobulin therapy should not always be considered contraindicated

Aims: Endothelial damage in acute respiratory distress syndrome (ARDS) increases capillary permeability, resulting in an increase in free lung fluid, interstitial pulmonary edema, and ventilation-perfusion imbalance. Due to their high osmolarity, Intravenous Immunoglobulin (IVIG) treatment may deepen hypoxemia by increasing lung fluid leakage. Adding furosemide to IVIG treatment in ARDS secondary to COVID-19 (CARDS) cases may increase treatment tolerance and success. Materials and methods: In our study, we aimed to measure the effectiveness of this treatment combination in CARDS cases and to report the observed complications. Patients who were followed up in the 34-bed adult COVID intensive care unit between March 2020/2021 and who received IVIG, high-dose corticosteroid, and furosemide combination therapy were included in the study. Patients' age, gender, comorbidities, Acute Physiology, and Chronic Health Assessment II (APACHE-II), and Sequential Organ Failure Assessment (SOFA) scores were recorded. The day IVIG duration of treatment, additional medical treatments, respiratory support treatments, laboratory examinations, the percentage of involvement of lung lesions (Covid Visual Assessment Scale), clinical outcomes, and treatment complications were recorded. Results: Combination therapy with found to improve respiratory failure in 50 % of patients. Troponin elevation was found in two patients, femoral artery embolism in one patient, and thrombosis in the femoral vein in one patient. In addition to IVIG treatment, the administration of two doses of immune plasma increased the chance of discharge (P = 0.037) Conclusion: In severe viral ARDS refractory to standard therapy, using furosemide in addition to IVIG therapy has an acceptable side-effect profile and may increase treatment success. Furosemide given during IVIG therapy should not be considered a contraindication in every patient

The Importance of Microscopic Polyangiitis in Differential Diagnosis of Hemoptysis

Microscopic polyangiitis (MPA) is non-granulomatous necrotizing vasculitis, which affect small vessels of kidney, skin and lung. This disease is characterized by the absence of immune deposits and positive ANCA in biopsy. In this article, we describe a microscopic polyangiitis case that presenting with hemoptysis, dyspnea and progressive cough and emphasized that if a patient with nonspesific pulmonary symptoms, we should consider in the differential diagnosis of vasculitis

The impact of pH and biopolymer ratio on the complex coacervation of Spirulina platensis protein concentrate with chitosan

Yücetepe, Aysun ( Aksaray, Yazar )Spirulina platensis is one of the most significant multicellular blue-green Cyanobacterium microalgae with a high protein content. The complex coacervation as an encapsulation technique allows the formation of proteins with improved functional properties and thermal stability. In this study, the effects of pH and Spirulina platensis protein concentrate (SPPC)—chitosan ratio on complex coacervation formation were examined in terms of ζ-potential, turbidity, visual observation and microscopic images. Based on the results, the strongest interaction between SPPC and chitosan occurred at pH of 5.5 and SPPC—chitosan ratio of 7.5:1 with a precipitation in the test tubes. Stable dispersions were obtained at a pH range of 2–4 for the SPPC—chitosan ratio of 7.5:1 inhibiting the precipitation which occurs at individual SPPC solutions at this pH range. Characteristic organic groups in the individual SPPC and chitosan solutions as well as the SPPC—chitosan coacervate formed at the optimal conditions were identified by using Fourier Transform Infrared (FT-IR) spectroscopy technique. Furthermore, thermal stability of the individual SPPC and chitosan solutions and the SPPC—chitosan coacervates were investigated using differential scanning calorimetry (DSC). The glass transition temperature and enthalpy were 209.5 °C and − 3.414 W/g for the complex coacervates and 180.5 °C and − 0.877 W/g for SPPC. It means that complex coacervation provided more thermally-stable SPPC in chitosan—SPPC coacervate than that of the individual SPPC. Our results might have important implications for the utilization of Spirulina platensis proteins especially for acidic beverage applications