Papers by Arif M Coşar Trb
Background and Aims: The purpose of this study was to investigate the value of platelet level and... more Background and Aims: The purpose of this study was to investigate the value of platelet level and spleen size for discrimination of compensated cirrhosis from chronic hepatitis. Methods: Ninety-two patients with liver cirrhosis, 73 patients with chronic hepatitis (CH) and 91 healthy controls were enrolled in this study. The cut-off values of peripheral platelet count and spleen area were determined for chronic hepatitis and liver cirrhosis by receiver operating curve analysis. Results: The mean platelet levels were significantly lower in liver cirrhosis and chronic hepatitis patients (mean±SD: 109.6±43 K/μL and 237.3±45 K/μL, respectively) compared with the controls (296.1±52 K/μL, p
Annali italiani di chirurgia, 2016
Ulcerative colitis (UC) is one of the major forms of chronic relapsing inflammatory bowel disease... more Ulcerative colitis (UC) is one of the major forms of chronic relapsing inflammatory bowel diseases. The ability to identify type, severity and responsiveness to therapy of UC using laboratory parameters has long been the aim of clinical studies. The aim of this study was to assess the relation betweenplasma viscosity (PV) and disease activity and response to medical treatment in patients with UC. The study included 105 patients with UC and 42 healthy volunteers. Blood samples were assessed for PV, erythrocyte sedimentation rate (ESR), high sensitive C-reactive protein (hs-CRP), D-dimer, and fibrinogen. Patients with UC were grouped according to disease activity, i.e. active (n= 59) and remission (n= 46). PV was higher in those with active UC compared with those with UC in remission or healthy subjects. It was significantly higher in both UC refractory to steroid compared to UC responsive to steroid (p< 0.001) and UC refractory to cyclosporine compared to UC responsive cyclosporin...
Türkiye Klinikleri Journal of Case Reports, 2018
nder normal conditions, kidneys assist glucose homeostasis by synthesizing glucose via gluconeoge... more nder normal conditions, kidneys assist glucose homeostasis by synthesizing glucose via gluconeogenesis and preventing urinary glucose loss via tubulary glucose reabsorption. 1 Reabsorption of glucose which is freely filtered in the glomeruli almost completely occur in proximal tubules only. This glucose reabsorption is mostly (90%) carried out by sodium-glucose cotransporters type 2 (SGLT-2) and glucose transporters 2 (GLUT2). So in patients with normal kidney function, significant glycosuria does not generally occur until the plasma glucose concentration exceeds 180 mg/dL (10 mmol/L). 2 Glycosuria may be due to either the inability of the kidney to reabsorb filtered glucose in the proximal tubule despite normal plasma glucose concentration, or to an overflow scenario related to high plasma glucose concentrations overwhelming the capacity of the renal tubules to reabsorb glucose. The commonest cause of glycosuria is uncontrolled diabetes mellitus. Abnormally elevated levels of glucose in the blood result in high amount of filtered glucose waiting to be reabsorbed through overactive SGLT2 which execute reabsorption eventually. When glycosuria occurs with a normal plasma glucose, a primary defect of proximal tubule reabsorption (renal glycosuria) needs to be considered. 1,2 Renal glycosuria is a rare and long
Turkiye Klinikleri Gastroenterohepatology - Special Topics, 2018
Respiratory Care, Jun 20, 2017
BACKGROUND: Pulmonary thromboembolism is a serious cardiovascular condition with considerable mor... more BACKGROUND: Pulmonary thromboembolism is a serious cardiovascular condition with considerable morbidity and mortality. Clinical studies have indicated that hyperuricemia is an independent risk factor for cardiovascular events. The aim of this study was to investigate possible value of the serum levels of uric acid (UA) in predicting 30-d pulmonary thromboembolism-related mortality. METHODS: Pulmonary thromboembolism was confirmed by computed tomography pulmonary angiography, demographic data, troponin, systolic pressure and pulse on admission, and simplified pulmonary embolism severity index assessment. UA levels were analyzed on admission. The primary end point was all-cause mortality during the first 30 d. RESULTS: A total of 337 acute pulmonary thromboembolism subjects, of whom 59% were females, were enrolled. The median (interquartile range) serum UA level was 5.35 (4.1-7.3) mg/dL. Serum UA levels of deceased subjects were higher than those of alive subjects during the study period (6.9 [4.6-10.0] mg/dL vs 5.2 [4.1-7.0] mg/dL, P ؍ .038). In the receiver operating characteristic analysis, the area under the curve was 0.650 (CI 0.732-0.960) for UA levels for all-cause mortality. A level of serum UA > 5 mg/dL showed 73% sensitivity and 88% negative predictive value for all-cause 30-d mortality. A weak correlation was determined between the UA levels and age (r ؍ 0.25, P < .001) and any troponin (r ؍ 0.267, P < .001). Serum UA level was an independent predictor of short-term mortality in pulmonary thromboembolism (odds ratio 1.2, P ؍ .002). CONCLUSIONS: Serum UA levels may be a potential biomarker for predicting outcome in patients with acute pulmonary thromboembolism.
Turkiye Klinikleri Gastroenterohepatology - Special Topics, 2019
Akademik Gastroenteroloji Dergisi, Dec 1, 2010
Thrombositopeni hepatit C virusune sekonder karaciger sirozlu hastalarda karsilasilabilen bir dur... more Thrombositopeni hepatit C virusune sekonder karaciger sirozlu hastalarda karsilasilabilen bir durumdur. Bu hastalardaki trombositopeniden sorumlu mekanizmalar olarak hipersplenizm ve dolasimda artmis platelet otoantikorlari gosterilmektedir. Hepatit C virusune sekonder siroz ve dokumante edilmis portal hipertansiyon ve hipersplenizmi oldugu bilinen 55 yasinda erkek hasta siddetli trombositopeni (900/microL) ve dis eti kanamasi nedeniyle basvurdu. Kortikosteroid tedavisine cevap vermeyen hastaya radyolojik olarak polyvinyl alkol partikulleri ile parsiyel splenik embolizasyon yapildi. Embolizasyonu takiben dalak volumu %45 azaltildi. Islemi takip eden 10 gun icinde platelet sayisi progressif olarak 4,450 den 89,700/ microL'ye kadar yukseldi. Postembolizasyon sendromu olarak hayati tehlike yaratmayan bazi yan etkiler goruldu. Sonuc olarak parsiyel splenik embolizasyon sirotik hastalardaki hipersplenizm tedavisinde guvenli ve etkili bir tedavi yontemidir.
Akademik Gastroenteroloji Dergisi, Dec 1, 2010
Background and Aims: The purpose of this study was to investigate the value of platelet level and... more Background and Aims: The purpose of this study was to investigate the value of platelet level and spleen size for discrimination of compensated cirrhosis from chronic hepatitis. Methods: Ninety-two patients with liver cirrhosis, 73 patients with chronic hepatitis (CH) and 91 healthy controls were enrolled in this study. The cut-off values of peripheral platelet count and spleen area were determined for chronic hepatitis and liver cirrhosis by receiver operating curve analysis. Results: The mean platelet levels were significantly lower in liver cirrhosis and chronic hepatitis patients (mean±SD: 109.6±43 K/μL and 237.3±45 K/μL, respectively) compared with the controls (296.1±52 K/μL, p
PubMed, 2016
Aim: Ulcerative colitis (UC) is one of the major forms of chronic relapsing inflammatory bowel di... more Aim: Ulcerative colitis (UC) is one of the major forms of chronic relapsing inflammatory bowel diseases. The ability to identify type, severity and responsiveness to therapy of UC using laboratory parameters has long been the aim of clinical studies. The aim of this study was to assess the relation betweenplasma viscosity (PV) and disease activity and response to medical treatment in patients with UC. Material and methods: The study included 105 patients with UC and 42 healthy volunteers. Blood samples were assessed for PV, erythrocyte sedimentation rate (ESR), high sensitive C-reactive protein (hs-CRP), D-dimer, and fibrinogen. Results: Patients with UC were grouped according to disease activity, i.e. active (n= 59) and remission (n= 46). PV was higher in those with active UC compared with those with UC in remission or healthy subjects. It was significantly higher in both UC refractory to steroid compared to UC responsive to steroid (p< 0.001) and UC refractory to cyclosporine compared to UC responsive cyclosporine (p= 0.003). IncreasedSimple Clinical Colitis Activity Index (SCCAI), Endoscopic Grading Scale (EGS), and Histological Disease Activity (HAD) scores were significantly associated with higher PV in patients with UC. Conclusion: PV is a useful marker in predicting response to steroid or cyclosporine treatment in patients with active UC. It could be replaced by ESR or hs-CRP as a measure of the acute phase response in UC since it is sufficiently sensitive. These findings may help identify patients with active UC who will require colectomy. Key words: Biomarkers, Disease activity, Medical treatment, Steroid-refractory ulcerative colitis, Ulcerative colitis.
Cukurova Medical Journal, Mar 31, 2023
The prevalence of precancerous or cancerous lesions in the upper gastrointestinal tract in acrome... more The prevalence of precancerous or cancerous lesions in the upper gastrointestinal tract in acromegalic patients is not well known. The aim of this study is to evaluate the endoscopic findings of the upper gastrointestinal system (GIS) of patients with acromegaly and to assess whether the pathological findings are related to the disease and the use of somatostatin analogs. Materials and Methods: Between January 2010 and October 2021, patients diagnosed with acromegaly were identified by retrospective medical record scanning. This study included 49 patients with acromegaly who underwent upper GIS endoscopy. The acromegaly patients were divided into two groups: those who were taking somatostatin analogs at the time of endoscopy and those who were not. It was investigated whether there was a difference between these two groups in terms of lesion development. The patients with acromegaly and the control group were compared in terms of endoscopic findings and biopsy results. Results: Of these patients, 53% (n=26) were male and 46.9% (n=23) were female. The incidence of Helicobacter pylori (HP) was significantly higher in the acromegaly patients than in the control subjects. In the acromegaly group, 62.5% (n=15) of the 24 patients with antral and pangastritis were taking somatostatin analogs. There was no significant difference between the use of somatostatin analogs and the development of gastritis. The development of esophagitis was statistically higher in patients with acromegaly taking somatostatin analogs. Conclusion: The incidence of HP was higher in patients with acromegaly than in the normal population. No clear results were found regarding the development of gastritis. The incidence of esophagitis was high in acromegalic patients taking somatostatin analogs. Large-scale studies Amaç: Akromegalik hastalarda üst gastrointestinal sistemdeki prekanser öz veya kanserlilezyonların prevalansıiyi bilinmemektedir. Çalışmamızda Akromegali hastalarının üst gastrointestinal sistem(GİS) endoskopi bulgularının incelenmesi ve patolojik bulguların hastalık ve somatostatin analoğu kullanımı ile ilişkisinin olupol madığının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Ocak 2010 ile Ekim 2021 arasında akromegali tanısı konulan hastalar tıbbi kayıtlar geriye dönük taranarak belirlendi. Bu çalışmayaüst GİS endoskopisiyapılan 49 akromegali hastası dahil edildi. Akromegali hastaları endoskopi anında somatostatin analogu kullanan ve kullanmayanlar olarak iki gruba ayrıldı. Bu iki grup arasında lezyon gelişimi açısından fark olup olmadığı incelendi. Akromegali hastaları ve control grubu endoskopik bulgular ve biyopsi sonuçları açısından karşılaştırıldı. Bulgular: Hastaların %53'ü (n=26) erkek, %46,9'u (n=23) kadındı. Akromegali hastalarında Helicobakterpilori (HP) insidansı kontrollere göre anlamlı derecede yüksekti. Akromegali grubunda antral ve pangastriti olan 24 hastanın %62,5'i (n=15) somatostatin analoglarıalıyordu. Somatostatin analoglarının kullanımı ile gastrit gelişimi arasında anlamlı bir fark yoktu. Somatostatin analogları kullanan akromegali hastalarında özofajit gelişimi istatistiksel olarak daha yüksek saptandı. Sonuç: Akromegali hastalarında HP görülmesıklığı normal popülasyona göre yüksek saptanmıştır. Gastrit gelişiminde ise net sonuçlar ortaya konamamıştır. Somatostatin analogları kullananak romegali hastalarında özofajit sıklığı yüksek bulundu. Etyolojisinin hastalık ve kullanılan ilaçlarla ilişkisinin net bir şekilde ortaya konulabilmesi açısından geniş çaplı çalışmalara gereksinim duyulmaktadır. Durak et al. Cukurova Medical Journal are needed to uncover the relationship between the etiology of the disease and the drugs taken.
Anatolian Current Medical Journal, Oct 22, 2022
Aim: Percutaneous endoscopic gastrostomy (PEG) is the preferred method for long-term enteral feed... more Aim: Percutaneous endoscopic gastrostomy (PEG) is the preferred method for long-term enteral feeding of patients who cannot be fed orally for various reasons and have a functioning gastrointestinal system. In this study, we aimed to present and discuss the demographic characteristics, indications, and early and late complications of patients implanted with the endoscopic PEG in our center. Material and Method: In this study, we retrospectively evaluated age, gender, chronic diseases, indication for PEG, complications during the procedure, complications arising from PEG during patient follow-up, and survival times of 84 patients who underwent PEG between January 2016 and January 2020 from the electronic medical file system. Results: Of the 84 patients enrolled in the study, 59.5% (n=50) were male and 40.5% (n=34) were female. The mean age of the patients was 61.35±19.52 years. The endoscopic PEG success rate was 97.6%. Of the requests for PEG, 58.6% (n=50) were for patients in intensive care units. The most common indications for PEG insertion were cerebrovascular accident (CVA), chronic nervous system disease, and hypoxic-ischemic encephalopathy. Complications related to PEG were observed in 11 patients. All complications were mild, and no severe complications were observed. While one of the complications developed in the early period (<30 days), the other complications occurred in the long term (> 30 days). No deaths from causes related to the PEG procedure have been observed. Conclusion: In patients with inadequate oral intake, PEG is a safe and appropriate option for continuous enteral feeding because of its low complication and mortality rates.
DergiPark (Istanbul University), Dec 1, 2010
Splenomegali kronik karaci¤er hastalar›nda s›k karfl›lafl›lan bir bulgudur. Genellikle asemptomat... more Splenomegali kronik karaci¤er hastalar›nda s›k karfl›lafl›lan bir bulgudur. Genellikle asemptomatik olmakla birlikte hipersplenizme neden olabilir (1). Trombositopeni kronik Hepatit C virüsü (HCV) infeksiyonuna sekonder sirotik hastalarda s›k karfl›lafl›lan önemli bir hematolojik anormalliktir (2, 3). Trombositopeni ço¤unlukla portal hipertansiyon nedeniyle büyümüfl olan dalakta plateletlerin göllenmesine ba¤l› iken (4), tüketim koagülapatisi sirotik hastalarda s›k de¤ildir (5). Hipersplenizme ba¤l› trombositopeni tedavisi için splenektomi, parsiyel splenektomi, parsiyel splenik embolizasyon ve TIPS gibi çeflitli tedavi yöntemleri vard›r (2, 6, 7). Splenik arter embolizasyonu, splenomegali ve hipersplenizmi olan seçilmifl HCV infeksiyonlu hastalar için güvenli, minimal invaziv ve etkili bir tedavi yöntemidir.
Akademik Gastroenteroloji Dergisi, Aug 25, 2022
Background and Aims: Viral hepatitis continues to be the most important cause of liver disease al... more Background and Aims: Viral hepatitis continues to be the most important cause of liver disease all over the world. In addition, alcoholic and non-alcoholic liver diseases are also encountered with increasing frequency. The prevalence of obesity and diabetes and the increase in alcohol consumption suggest that these factors will be more important in the etiology of chronic liver diseases in the coming years. Liver fibrosis and associated cirrhosis are the main causes of morbidity and mortality in chronic liver disease. In our study, we aimed to examine the relationship between fibrosis and steatosis results obtained by elastography and biochemical and anthropometric parameters. Materials and Method: Fifty patients who applied to Karadeniz Technical University Medical Faculty Hospital Gastroenterology Clinic and underwent elastography were included in the study. The relationship between the patients' biochemical parameters and body mass index, and elastographic steatosis and fibrosis scores were evaluated. Elastography controlled attenuation parameter values are between S0 and S3 based on the scale of Li; fibrosis/elasticity values were classified between F0-F4 based on Petroff's scale. Results: Of the 50 patients included in the study, 26 were male and 24 were female. The mean age was 49.9 ± 13.4 years. The median value for body mass index was 29.4 kg/m 2. The most common comorbidities were hypertension (n = 19, 38%), diabetes mellitus (n = 19, 38%), hyperlipidemia (n = 11, 22%) and hypothyroidism (n = 7, 14%). Fibrosis scores of patients measured by transient elastography; F0-1 was 84% (n = 42), F2 4% (n = 2), F3 4% (n = 2), and F4 8% (n = 4). Elastography controlled attenuation parameter values are S0 61.2% (n = 30), S1 2% (n = 1), S2 10.2% (n = 5), S2-3 6.1% (n = 3), S4 20.4% (n = 10). In those with a degree of steatosis ≥ S2; body mass index and triglyceride levels were significantly higher (p < 0.05). Total cholesterol, high density lipoprotein, alanine aminotransferase and gamma glutamyl transferase values were significantly higher in patients with fibrosis level ≥ F2 (p < 0.05). As a result of the analysis using the receiver operating characteristic curve, the body mass index value predicting the presence of steatosis degree ≥ S2 was found to be 29.6 kg/ m 2 (73.7% sensitivity, 65.5% specificity, under the curve: 0.808, 95% confidence interval: 0.687-0.028). Conclusion: Elastographic determination of liver steatosis and fibrosis is a useful and effective method in the routine follow-up of patients, in terms of evaluating the clinical status, prognosis and treatment response. The use of non-invasive tests based on biochemical parameters should not be neglected in cases where device-dependent noninvasive tests cannot be applied for economic reasons.
Archives of Iranian Medicine, Dec 1, 2020
Background: Reactivation of the hepatitis B virus (HBV) either during or after chemotherapy may c... more Background: Reactivation of the hepatitis B virus (HBV) either during or after chemotherapy may cause serious and sometimes fatal hepatitis. All patients undergoing chemotherapy should therefore be screened in terms of HBV before chemotherapy. The purpose of this research was to identify HBV screening rates in patients with solid cancer undergoing parenteral chemotherapy and to determine the outcomes of patients undergoing HBV screening. Methods: Data for patients undergoing parenteral chemotherapy for solid cancer from January 1, 2012 to December 30, 2018 were retrieved from our electronic health record patient files in this retrospective study. Screening was defined as hepatitis B surface antigen (HBsAg) and/or hepatitis B core antibody (HBcAb) tests carried out within six months prior the first chemotherapy session. Results: Four thousand fifty-eight (63%) of the 6440 patients who underwent parenteral chemotherapy were screened for HBsAg and/or HBcAb. The proportions of patients screened for HBsAg and HBcAb improved from 38.8% (2012) to 76.3% (2018), and from 0.2% (2012) to 43% (2018), respectively (P < 0.001). The HBsAg and HBcAb positivity rates were 2.9% and 36.5%, respectively. Antiviral prophylaxis was started in 11.8% of HBsAg-negative/HBcAb-positive patients and 40.5% of HBsAg-positive patients. HBV reactivation did not occur in patients receiving antiviral prophylaxis, but was identified in 7.2% of HBsAg-positive patients and 0.6% of HBsAg-negative/HBcAb-positive patients without antiviral prophylaxis. Conclusion: Although HBV screening rates before chemotherapy are increasing among solid cancer patients, the rate of initiation of antiviral prophylaxis is still low. It is therefore important to raise awareness regarding HBV reactivation during/after chemotherapy.
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Papers by Arif M Coşar Trb