34 research outputs found

    Social stigmatization in Turkish patients with chronic hepatitis B and C

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    Background and aim: Viral hepatitis is the most important cause of chronic hepatitis worldwide. Stigmatization is defined as a feeling of rejection and isolation of patients by society due to illness. There are no studies on chronic viral hepatitis in the literature in English, which has its own religious and socio-cultural structure. In our study, we aimed to investigate the presence of social stigmatism and psychosocial effects on patients with different stages of chronic viral hepatitis B and C. Methods: Forty-five patients with chronic hepatitis C and 114 patients with chronic hepatitis B were enrolled in the study. Berger’s scale was used for stigmatization, composed of 40 four-point Likert items that have four subscales: personalized stigma, disclosure, negative self-image, and public attitude. Stigma score ranges between one and four. Stigma is accepted as present if the overall score is above two. Results: Overall the mean stigma scores were 1.97 ± 0.58 and 2.14 ± 0.57 for chronic hepatitis B and C, respectively. There was stigma in 47.4% of the patients with chronic hepatitis B, and 60% of the patients with chronic hepatitis C. Being male was the risk factor on overall stigma, disclosure and public attitude in chronic hepatitis C. Living in an urban setting was the risk factor on negative self-image in chronic hepatitis C and on personalized stigma and disclosure in chronic hepatitis B

    Can neutrophil to lymphocyte ratio be a non-invasive indicator of the presence of duodenal ulcer related Helicobacter pylori in dyspeptic patients?

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    Background and aims: Neutrophil to lymphocyte ratio (NLR), a novel inflammatory marker, has been shown to increase in various systemic inflammatory conditions. In this way, we want to evaluate the relationship between the presence of H. pylori, duodenal ulcer related H. pylori and NLR in dyspeptic patients. Material and methods: The patients were divided into three groups after evaluating of the EGD and histopathology results. The groups were determined as follow; Group A: H. pylori positive and DU negative, Group B: H. pylori positive and DU positive, Group C: H. pylori negative and DU negative. Then, groups were compared with each other for demographic features, laboratory tests and NLR. Results: There were significant differences between groups for NLR when groups compared with each other. Significantly high NLR was seen in group A (H. pylori positive, DU negative) and group B (H. pylori positive, DU positive) when compared with group C (H. pylori negative, DU negative) (respectively p < 0.042, p < 0.001). Significantly higher NLR was determined in the group B when compared with group A and group C (respectively p < 0.021, p < 0.001). The cut-off value for NLR was 2,17 with a specificity of 61% and sensitivity of 66% for group B comparing with Group C (AUC:0,66). Conclusions: Significantly higher NLR was determined in patients with H. pylori and DU. As a result, NLR may be used as a non-invasive test for documenting the presence of H. pylori and H. pylori related DU

    Time to give up traditional methods for the management of gastrointestinal neuroendocrine tumours

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    Neuroendocrine tumors (NETs) are a rare and heterogeneous disease group and constitute 0.5% of all malignancies. The annual incidence of NETs is increasing worldwide. The reason for the increase in the incidence of NETs is the detection of benign lesions, incidental detection due to the highest use of endoscopic and imaging procedures, and higher recognition rates of pathologists. There have been exciting developments regarding NET biology in recent years. Among these, first of all, soma tosta tin receptors and downstream pathways in neuroendocrine cells have been found to be important regulatory mechanisms for protein synthesis, hormone secretion, and proliferation. Subsequently, activation of the mammalian target of rapamycin pathway was found to be an important mechanism in angiogenesis and tumor survival and cell metabolism. Finally, the importance of proangiogenic factors (platelet-derived growth factor, vascular endothelial growth factor, fibroblastic growth factor, angiopoietin, and semaphorins) in the progression of NET has been determined. Using the combination of biomarkers and imaging methods allows early evaluation of the appropriateness of treatment and response to treatment

    Successful Management of an Esophageal Foreign Body with a Rigid Bronchoscopy

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    Ingestion of a sharp foreign object can lead to esophageal hemorrhage and perforation, which is related to high morbidity and mortality. To avoid such complications, early and adequate therapeutic management of these cases is crucial. Herein, we would like to present two cases of esophageal foreign bodies that were successfully managed with rigid bronchoscopy after failed attempts with upper gastrointestinal endoscopic intervention. [Med-Science 2015; 4(2.000): 2340-3

    Is History of Adenotonsillectomy a Protective Factor for Helicobacter pylori Gastritis?

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    Introduction: Helicobacter pylori is a gram-negative bacillus seen worldwide, affecting around half of the world’s population. It is reported that the adenotonsillar region is a colonisation area and plays a role in contamination. Based on this finding, there are some studies suggesting that history of previous adenotonsillectomy may be a protective factor for the colonization of H. pylori in the stomach. In this study, it was aimed to investigate whether the history of previous adenotonsillectomy was a protective factor for H. pylori gastritis. Materials and Methods: A total of 150 patients, including 75 patients with previous history of adenotonsillectomy and 75 patients without history of adenotonsillectomy, who were admitted to the gastroenterology clinic of Hitit University Corum Erol Olcok Training and Research Hospital for the first time with dyspeptic complaints and who underwent endoscopic biopsy of the antrum, were enrolled into the study. Endoscopic biopsy samples of the patients were stained histochemically with Hematoxylin Eosin (HE) and Giemsa to detect the presence of H. pylori. All cases were evaluated by the same pathologist according to the updated Sydney system. Results: The ages of the patients belonging to the group of previous history of adenotonsillectomy ranged from 22 to 80 years, with an average of 46.5 years (± 17.5 SD), and the ages of patients in the group of without history of adenotonsillectomy ranged from 24 to 75 years, with an average of 38.3 years (± 14.0 SD), and the age difference between these two groups was statistically significant. H. pylori gastritis was found in 52 (69%) of the 75 patients in the group of patients without history of adenotonsillectomy, and in 33 (44%) of the 75 patients in the group of patients with previous history of adenotonsillectomy, whose difference was statistically significant (p= 0.021). When all patients in both groups were compared, H. pylori density average was 1.6 in the group of patients without history of adenotonsillectomy, whereas H. pylori density average was 0.8 in the group of patients with previous history of adenotonsillectomy, which was statistically significant (p= 0.012). When H. pylori density in patients with H. pylori gastritis in both groups was compared, the mean value of the group of patients without history of adenotonsillectomy was 2.3, while the mean value of the group of patients with previous history of adenotonsillectomy was 1.8, which was statistically significant (p= 0.022). Conclusion: Several studies have shown that the adenotonsillar region is a colonization site for H. pylori, using different methods. In our study, adenotonsillectomy was considered to play a protective role in reducing H. pylori spread and H. pylori gastritis, as it would prevent colonization in this region

    Is emergency endoscopic retrograde cholangiopancreatography safe in COVID-19 pandemic?

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    Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 is now a pandemic worldwide and clinicians have many questions about the safety of interventional procedures, even in an emergency [1]. Here, we will present an endoscopic retrograde cholangiopancreatography (ERCP) case safely performed in emergency situations in a case known to be COVID-19 positive. An 81-year-old male patient was admitted to the emergency department with right upper quadrant pain, jaundice and fever of the last 2 days. In his evaluation, obstructive jaundice due to cholelithiasis and cholangitis was determined. ERCP was performed by duodenoscope (Olympus, TJF-150) with needle-knife sphincterotomy (Microtech) and precut. The procedure was completed without acute complications, after ERCP his bilirubin levels and complaints improved. On the fourth day of ERCP, he had an acute coronary syndrome, coronary angiography was performed and a coronary stent was inserted. Due to stent insertion, 600 mg clopidogrel, 300 mg acetylsalicylic acid, and 6000 IU enoxaparin were given to the patient. On the fifth day of ERCP, he had melena, with a 2 g/dl decrease in hemoglobin levels. Because he was having a 38.5°C of fever and cough, COVID-19 rapid blood test (OVIOSR) determining the serology of Corona virus-19 was performed which was positive. We performed ERCP again, with maximum protection using appropriate equipment (Fig. 1). On the sphincterotomy line, there were blood cloths and they were cleaned with serum physiologic. Coagulation was achieved with the tapered tip sphincterotome (Microtech), choledoch was selectively cannulated, and 10F 10 cm plastic stent (10F, 10 cm; Microtech) was inserted. Two hemoclips (Sureclip, MicroTech) were inserted, and at the end of the procedure, there was no bleeding. After ERCP, because COVID-19 rapid blood test was positive, the real-time PCR test for nucleic acid determination in respiratory samples for COVID-19 was sent to the laboratory which was positive and thorax computerized tomography was performed which revealed bilateral ground-glass opacities in basal parts of the lungs. Instantly, COVID-19 treatment including hydroxychloroquine (2 × 400 mg loading and 2 × 200 mg maintenance) and azitromycine (1 × 500 mg loading and 1 × 250 mg maintenance) started [2]. On follow-ups, his hemoglobin levels did not decrease and his vital signs were stable. After 7 days of treatment for Coronavirus-19 in ICU, his real-time PCR test for nucleic acid determination in respiratory samples (NCOV-19) was negative and he was discharged. Due to the contact history, rapid test results and PCR in healthcare workers in this team were negative, and no COVID symptom was observed during the 14-day follow-up. In conclusion, if adequate precautions are taken, emergency ERCP procedures can be performed safely without any harm to the healthcare workers and patients

    Gastrointestinal Bleeding Caused by Meckels Diverticulum Diagnosed by Double Balloon Enteroscopy: Three Cases and a Brief Literature Review

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    Meckel's diverticulum is a small bulge in the small intestine present at birth and is the most frequent malformation of the gastrointestinal tract. Although Meckel diverticulum is usually of no medical significance, tendency to gastrointestinal bleeding can require clinical attention. Despite the availability of modern imaging techniques, diagnosis is still challenging. We herein report three cases of undiagnosed gastrointestinal bleeding despite a number of imaging techniques. In all of these cases double balloon enteroscopy was successfully used and the diagnosis of Meckels diverticulum was established. We discuss the use of this successfully technique in obscure gastrointestinal (GI) bleeding caused by Meckel's diverticulum in relation to the pertinent literature. [Med-Science 2015; 4(3.000): 2528-35

    Inefficacy of triple therapy and comparison of two different bismuth-containing quadruple regimens as a firstline treatment option for helicobacter pylori

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    Background/Aim: Increasing resistance of Helicobacter pylori to antimicrobials necessitated the development of new regimens and the modification of existing regimens. The present study aimed to compare the efficacy of two bismuth-containing quadruple regimens-one including clarithromycin (C) instead of metronidazole (M) and triple therapy. Patients and Methods: Patients with H. pylori infection given the following regimens were sequentially enrolled in this retrospective study: (1) Triple therapy: Lansoprazole 30 mg b.i.d., clarithromycin 500 mg b.i.d., and amoxicillin 1 g b.i.d., (2) bismuth group C: Lansoprazole 30 mg b.i.d., clarithromycin 500 mg b.i.d., amoxicillin 1 g b.i.d., and bismuth subsalicylate 524 mg b.i.d., and (3) bismuth group M: Lansoprazole 30 mg b.i.d., amoxicillin 1 g b.i.d., metronidazole 500 mg t.i.d., and bismuth subsalicylate 524 mg b.i.d. for 14 days. Gastroscopy and 14 C-urea breath test were performed before enrollment, and urea breath test was repeated four weeks after the treatment. Results: At per-protocol analysis, the eradication rates were 64.7% (95% confidence interval 60.4-68.7) with the triple therapy (n = 504), 95.4% (95% confidence interval 91.5-99.4) with the bismuth group C (n = 501), and 93.9% (95% confidence interval 89.7-98.7) with the bismuth group M (n = 505). The eradication rates were similar between the two bismuth groups (P > 0.05) but significantly greater than that of the triple therapy (P < 0.05). Conclusion: In our study, both of the bismuth-containing quadruple therapies reached high eradication rates, whereas triple therapy was shown to be ineffective. Moreover, clarithromycin may also be a component of bismuth-containing quadruple therapy

    Influence of aluminum salts on COVID-19 infected patients

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    Background/aim: Based on the antiviral and antibacterial properties of aluminum salts, we aimed to find out the influence of aluminum salts on COVID-19 infected patients. Materials and methods: We performed an observational retrospective cohort study which includes the patients diagnosed as COVID-19 and received aluminum salts in addition to actual treatments during hospitalization as the treatment group (Alum Group). Patients who received standard COVID-19 treatment protocols in the Infectious Diseases Clinics were included as the Control Group. Clinical findings, laboratory parameters, length of stay, survival, radiological follow-up, intensive care and mechanical ventilation needs, the presence of comorbidity, polymerase chain reaction (PCR) tests, symptoms, symptom recovery times, hospital stay times, treatment protocols, and clinical presence of pneumonia were examined in all patients. Advanced chemical composition analyzes of existing aluminum salts were also performed. Results: A total of 109 patients, 54 in the alum group and 55 in the control group, were included in the study. None of the patients in the aluminum group developed side effects due to the intake of aluminum salt. Survival status was significantly different between the two groups as there were 5 loss in the Control Group and none in the Alum Group (P = 0.023). The symptom recovery time was significantly shorter in the Alum Group; 2 (1-3) vs. 1 (1-2) days, P= 0.003. According to the paired samples analyses of the comparison between hospitalization and discharge, CRP levels significantly drops in the Alum Group (from 54.09 to 27, P = 0.001) but not in the Control Group. The drop was significantly same for the lactate dehydrogenase (LDH) and procalcitonin levels with P = 0.001. Conclusion: It has been observed that aluminum salts have beneficial effects in COVID-19 infected cases. Considering the low systemic toxicity of intermittent oral intake of aluminum salts as food supplements and the fact that pandemic control is still not achieved, the use of aluminum salts is promising
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