Investigation of Biliary Canal Variations as a Cause of Stone Formation in the Choledochal Canal

The present study aimed to investigate if there is an association between the diameter of the choledochal duct and choledochal duct stone formation. The present study consisted of 79 patients who had endoscopic interventions and MRCP procedure with surgery history. Some followed due to disorders of the liver, gall bladder, and biliary tract and some of whom presented hepatobiliary complaints between 2017 and 2019. The choledochal duct diameter measured from MRCP images and choledochal duct stone had examined; the type classified according to Huang classification. Among the cases classified, 29 patients, was Huang Type A1, 27 patients were Huang Type A2, 16 patients were Huang Type A3, and seven patients were Huang Type A4. There was not any statistically significant association in terms of choledochal diameter regarding the types. Choledochal duct diameter was statistically higher in female patients than male patients (p<0.05). According to the age group, a statistically significant difference detected for choledochal duct stone formation; individuals over 45 years of age present an increase for choledochal duct stone (p<0.05). The choledochal duct diameter was found higher in female patients compared with male patients; stone formation has found increased in both gender over 45 years of age. It should consider before surgical procedures and radiological tests

Mean platelet volume measurements affecting evaluation of parameters in dialysis patients (The affective of mean platelet volume)

Background: We aimed to show the levels of mean platelet volum and also; the existence of effects parameters was investigated on mean platelet volum levels; in patients with dialysis replasman treatment. Materials: This study was included to the control group and patients with peritoneal dialysis and patients with hemodialysis treatments and their dialysis adequate were ensured. Venous blood samples were taken from all of the cases and mean platelet volum levels, platelet, hemoglobin, insulin resistance, C- peptide and biochemical parameters were measured. Results: Insulin resistance and C-peptid levels were found higher in the control group than in the dialysis groups. Platelet levels were found significiantly higher in dialysis groups than the control group and platelet levels were determined to be higher in the peritoneal dialysis group than the patients with hemodialysis group. Mean platelet volum levels were found higher in the dialysis patient groups than the control group. No difference statistical was observed for the levels of mean platelet volum; between dialysis groups. The relationship between was not shown to the levels of mean platelet volum with other parameters; in patients with dialysis treatment. Positive correlation was found the between platelet counts with mean platelet volum; in the control group. Conclusion: We thought that the precence of end stage renal disease and dialysis therapies might cause to increase of mean platelet volum levels; in dialysis patients. This condition can be explained by the increase of atherosclerotic complication risk and inflammation risk; in dialysis patients.This study was approved by the Ethics Committee of Bakirkoy Dr. Sadi Konuk Training and Research Hospital (Grand number: 491/2014) and conducted in accordance with the principles of the Declaration of Helsinki. This study was not supported from any third party and the work was received any financial support

Septoplasti ameliyatlarinda dikiş tekniği ve nazal tampon uygulamasinin oksidatif stres üzerine etkisi.

PubMed: 18443401OBJECTIVES: We investigated the effect of nasal packing or suturing of the nasal septum after septoplasty on oxidative stress. PATIENTS AND METHODS: The study included 37 patients who underwent septoplasty for isolated septal deviation. At the end of the operation, intranasal packing was used in 18 patients (5 women, 13 men; mean age 30+/-10 years; range 18 to 47 years), and nasal septal suturing was used in 19 patients (5 women, 14 men; mean age 31+/-12 years; range 18 to 54 years). Nasal packs were removed after 48 hours. Plasma levels of malondialdehyde (MDH), total sulphydryl content (SH), and nitric oxide (NO) were measured at four sequential times to evaluate oxidative stress. RESULTS: There were no significant changes in plasma levels of MDH, SH, and NO in both treatment groups (p>0.05). Levels of MDH and NO did not differ significantly at four sequential times between the two treatment groups, whereas postoperative SH levels were always significantly higher following septal suturing (p<0.05). CONCLUSION: High levels of SH observed in the suturing group favor this technique over nasal packing application in terms of antioxidant systems and oxidative stress

A new index for predicting malignant causes in patients with extrahepatic biliary obstruction: the hemoglobin, albumin, lymphocyte, and platelet (HALP) score

OBJECTIVE: The study aimed to investigate whether the pre-procedural hemoglobin, albumin, lymphocyte, and platelet (HALP) scores can distinguish between benign and malignant causes of obstruction in patients who undergo endoscopic retrograde cholangiopancreatography (ERCP) for extrahepatic biliary obstruction (EBO). PATIENTS AND METHODS: The HALP scores of the patients were calculated according to the values before ERCP. The patients were divided into two groups as malignant and benign according to their diagnosis after ERCP. The HALP scores, demographic characteristics, and some laboratory data of the groups were compared. The cut-off values of the HALP scores were found to detect malignant obstructive causes using the receiver operating characteristic (ROC) curve analysis. RESULTS: A total of 295 patients had benign and 50 had malignant causes of obstruction among the total of 345 patients. The HALP score was found to be lower in the patient group with malignant biliary obstruction (p = 0.013). The ROC curve analysis was used to determine the diagnostic efficiency, and an area under the curve (AUC) of 0.610 was obtained (0.526-0.693, 95% CI) (p = 0.013). For the HALP score, the sensitivity was found to be 82.4% and the specificity was 30% when a cut-off value of <12.54 was used, and the sensitivity was 61.4% and specificity was 52% when the cut-off value was <21.25. CONCLUSIONS: The study showed that a low HALP score can distinguish malignant causes in patients with EBO. We think that the HALP score, which is a low-cost index that can be easily calculated with simple tests, can be used in this patient population because it may allow early diagnosis of malignant causes in patients with EBO

Frequencies of serum antibodies to Helicobacter pylori CagA and VacA in a Turkish population with various gastroduodenal diseases

WOS: 000240404300019PubMed: 16669834Infection with Helicobacter pylori (H. pylori) strains secreting cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA) proteins is associated with more severe gastroduodenal pathologies. However, this association varies among geographical regions and ethnic groups. We investigated the frequencies of antibodies to CagA and VacA proteins in 131 H. pylori-infected dyspeptic patients [40 duodenal ulcer (DU), 19 gastric ulcer (GU), 28 gastric cancer (GC), and 44 non-ulcer dyspepsia (NUD)] across 30 H. pylori-infected and endoscopically normal asymptomatic subjects (AS). Anti-CagA and anti-VacA antibodies were detected by Western blotting. The positivity rates of anti-CagA and anti-VacA antibodies were higher in patients with DU (92.5 and 75%), GU (89.5 and 84.2%) and GC (96.4 and 85.7%) than patients with NUD (70.5 and 50%) and AS (50 and 23.3%) (p < 0.05). CagA(+)VacA(+) phenotype was more frequent in patients with DU, GU and GC than patients with NUD and AS (75, 84.2, 85.7 vs. 47.7 and 20%, respectively) (p < 0.01). Our results showed that there is a significantly positive association between the presence of anti-CagA and anti-VacA antibodies and DU, GU and GC in our region

Supplementing Vitamins C and E to standard triple therapy for the eradication of Helicobacter pylori

What is known and Objective: Helicobacter pylori eradication rates of currently accepted triple therapy regimens vary between geographic locations and do not exceed 70-80%. Eradication rates are much lower in locations where uncontrolled antibiotic use is common such as Turkey. In the present study, we aimed to test whether supplementing vitamins C and E to standard triple therapy, including a proton pump inhibitor plus amoxicillin plus clarithromycin, increased the H.pylori eradication rate. Methods: Two hundred patients infected with H.pylori were randomized into two groups in an open-label trial. In group A, patients (n = 160) were given standard triple therapy, including lansoprazole 30 mg BID plus amoxicillin 1000 mg BID plus clarithromycin 500 mg BID for 14 days, plus vitamin C 500 mg BID plus vitamin E 200 IU BID for 30 days. In group B, patients (n = 40) were given standard triple therapy for 14 days. The success of H.pylori eradication was defined as a negative 14C-urea breath test result, 4-6 weeks after the completion of therapy. Comaprisons were by both intention-to-treat (ITT) and per-protocol (PP) analysis. Results and Discussion: Two hundred patients (137 women, 63 men) were analysed using ITT analysis and 195 patients completed the study. In group A, H.pylori eradication was achieved in 132 of the 160 patients (82.5%) included in ITT analysis and 132 of the 157 patients (84%) included in PP analysis. In group B, H.pylori eradication was achieved in 18 of the 40 patients (45%) included in ITT analysis and 18 of the 38 patients (47.4%) included in PP analysis. Eradication rates were significantly higher in group A than in group B (P < 0.005). Eradication rates were not statistically significant between men and women in both groups. What is new and Conclusion: Adding vitamins C and E to standard triple therapy increases the eradication rate of H.pylori. Vitamins C and E may increase the eradication rate via increasing the effectiveness of the antibiotics by decreasing oxidative stress in the gastric mucosa and strengthening the immune system

Results of gastrointestinal endoscopic examinations in patients with iron defıciency anemia

Endoscopic procedures are usually carried out in order to diagnose the cause of iron deficiency anemia (IDA). We aimed to evaluate endoscopic findings of our patients with iron deficiency anemia retrospectively.Materials and methods: We retrospectively reviewed our computerized data of patients who attended to Haydarpasa Numune Education and Research Hospital Gastroentology Endoscopy Unit between 2008 and 2010 years. Patients in whom upper gastrointestinal endoscopy and/or colonoscopy were performed in order to diagnose the cause of IDA were included in this study.Results: This study included 490 patients with iron deficiency anemia in whom upper gastrointestinal endoscopy and/or colonoscopy were performed. The mean age of patients was 58.94 ± 14.8 years. Of these patients, 288 (172 female, 116 male) underwent only upper gastrointestinal endoscopy, 116 (61 female, 55 male) underwent only colonoscopy and 84 (39 male, 45 female) underwent both upper gastrointestinal endoscopy and colonoscopy. The rates of failure to reveal the cause of IDA in patients in whom either upper gastrointestinal endoscopy or colonoscopy had been performed were 18.75% and 46.55%, respectively. On other hand, the ratio of failure to reveal the cause of IDA was 3.48% in patients in whom both upper gastrointestinal endoscopy and colonoscopy had been performed.Conclusion: When referring any patient with iron deficiency anemia to endoscopy unit, ordering both upper gastrointestinal endoscopy and colonoscopy may allow us to find the reason more accurately

Helicobacter Pylori İsolation, Serology And Caga, Cage And Virb11 Detection İn Patients With Non-Ulcer Dyspepsia From Turkey: Correlation With Histopathologic Findings

Colonization with Helicobacter pylori (HP) may have major clinical consequences and HP virulence factors are associated with more severe gastroduodenal pathologies. In this study, prevalence of HP in patients with Non-Ulcer Dyspepsia (NUD) was determined by rapid urease test and culture and correlations of histopathologic changes with bacterial virulence factors and serologic profiles were investigated. Gastric biopsies from sixty-nine patients admitted to Haydarpasa Training Hospital Department of Gastroenterology were evaluated for rapid urease, HP isolation and examined histopathologically. PCR was employed for HP confirmation and detection of HP cagA, cagE and virB11 genes. For each patient, IgG and IgA antibodies and anti-cagA antibodies were also determined by ELISA tests. HID was isolated and confirmed by PCR in 74% (51/69) of the patients. Anti-HP IgG and IgA were detected in 96% (49/51) and 53% (27/51), respectively. Anti- cagA were present in 51% (26/51). cagA, cagE and virB11 were positive in 56.8% (29/51), 60.7% (31/51) and 58.8% (30/51) of the patients, respectively. Statistically significant correlation was observed between cagA PCR and inflammation/activity scores. Detection of cagA by molecular assays can be an alternative test that can be employed for individual patient assessment.WoSScopu