22 research outputs found
The relationship between sphincteratomy methods and post ercp pancreatitis
No full textPost (ERCP) pancreatitis (PEP) is the most commonly seen complication after endoscopic retrograde cholangio-pancreaticography (ERCP). It is associated with pancreatic hyperamylasemia and persistent abdominal pain. It can be classified as mild, moderate and severe. During ERCP, bile ducts or pancreatic duct can be cannulated using standard sphincteratomy or needle-tipped sphincteratomy methods and contrast material is injected in order to view these ducts. In this study, we aimed to examine whether the use of sphincterotomy methods and pancreatic canal interventions poses a risk in the development of PEP, which is the most common complication after ERCP. Of the 445 patients who underwent ERCP, 270 had standard sphincterotomy and 175 had Needle-knife sphincterotomy (NKS). Patients who were cannulated with pancreatic duct and injected with contrast agent during the procedure and patients who were diagnosed with PEP according to the revised Atlanta criteria, were included in the study. Of 445 patients, 187 were male (39.7%) and 258 were female (60.3%). After successful sphincterotomy, stone extraction basket and / or balloon procedure was applied to all patients. Of the 270 patients, 13(2.9%) patients developed PEP and 9 of these patients had pancreatic duct cannulation and contrast agent injection during the procedure. PEP development was statistically significant in patients with pancreatic duct cannulation (p [Med-Science 2019; 8(1.000): 173-5
The correlation between tissue Helicobacter pylori severity and the increase in serum neutrophil/lymphocyte ratio in patients with active chronic gastritis
No full textIntroduction: Helicobacter pylori are a microaerophile gram-negative bacteria and the most frequent factor of chronic gastritis. Recently, there has been an inclination to various non-invasive tests to determine the severity of H. pylori infection in the gastric tissue. The serum neutrophils/lymphocytes rate (NLR) is a simple, safe, non-invasive and active inflammation reagent. The purpose of this study is examining the correlation between the increase in the positivity/severity of H. pylori infection and the increase in the NLR. Material and method: 149 patients were included into the study by considering the Sydney criteria in accordance with H. pylori severity degrees in 3 groups; Mild (n=49), Moderate-Severe (n=67) and Severe (n=33). A Control Group was also formed (n=22) with negative H. pylori by three experienced pathologists. Result: It has been determined that the severity has increased among the groups with H. pylori positive as regard to the increase in serum NLR (r: 0.295, p: 0.017), there has been a significant correlation has been determined between the Control Group and the Moderate-Severe patients (p:0.014), the Severe patients (p:0.002). Conclusion: It is suggested that the serum NLR, which can be used in order to predict the severity of the H. pylori Infection in patients with chronic gastritis, can be a practical, inexpensive and non-invasive test.WOS:00040732420002
Predictive Value of Mean Platelet Volume in Variceal Bleeding due to Cirrhotic Portal Hypertension
No full textABSTRACT
Aim
To investigate whether mean platelet volume (MPV) is a predictor of variceal bleeding in patients with cirrhotic portal hypertension.
Materials and methods
This prospective cohort was performed in the internal medicine department of our tertiary care center. Cirrhotic patients were allocated into two groups: Group I consisted of 31 cases without a history of variceal bleeding, whereas group II was made up of 31 patients with a history of variceal bleeding. Data derived from medical history, physical examination, ultrasonography, gastrointestinal system endoscopy, complete blood count, hepatic, and renal function tests were recorded and compared between two groups. On physical examination, encephalopathy and ascites were evaluated and graded with respect to Child–Pugh–Turcotte classification.
Results
There was no significant difference between the two groups in terms of age, duration of the disease, and gender of the patient. The only remarkable difference was that hemoglobin (p = 0.02) and hematocrit (p = 0.02) values were lower in group II. Neither the etiology of bleeding was different between groups nor did MPV seem to have a noteworthy impact on bleeding. Interestingly, risk of variceal bleeding increased in parallel to the higher grade of varices.
Conclusion
Our results imply that there is a correlation between the grade of varices and esophageal variceal bleeding in cirrhotic patients. However, association between MPV and variceal bleeding could not be demonstrated. Utilization of noninvasive tests as predictors in these patients necessitates further controlled trials on larger series.
How to cite this article
Erdogan MA, Benli AR, Acmali SB, Koroglu M, Atayan Y, Danalioglu A, Kayhan B. Predictive Value of Mean Platelet Volume in Variceal Bleeding due to Cirrhotic Portal Hypertension. Euroasian J Hepato-Gastroenterol 2017;7(1):6-10.
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Liver Enzyme Elevations in Rheumatoid Arthritis: Clinical Relevance and Influence on Treatment Strategies
No full textBackground and Aim: Rheumatoid arthritis (RA) is a chronic inflammatory polyarthritis of unknown etiology that symmetrically involves the synovial joints and leads to erosive arthritis. However, when inflammation remains uncontrolled, it not only affects the joints but also increases the risk of various systemic complications, particularly cardiovascular diseases, osteoporosis, and malignancies such as lymphoma. Early initiation of disease-modifying antirheumatic drugs (DMARDs) has been shown to yield superior outcomes in terms of both clinical response and the prevention of joint damage. Nevertheless, the development of hepatotoxicity during treatment may necessitate dose adjustments or even modifications of the therapeutic protocol. Our aim in this study was to retrospectively evaluate the changes in liver enzyme levels in RA patients before and during treatment, especially in MTX and combination therapies using MTX, and to evaluate how these abnormalities affect treatment strategies. Materials and Methods/Results: Among the 33 patients included in this study, 15 exhibited elevated liver enzymes prior to treatment, whereas 18 developed hepatic enzyme abnormalities during therapy. Of the 12 patients receiving methotrexate (MTX) monotherapy and the 15 patients using MTX within a combination regimen, a total of 7 patients (21%) continued to present with elevated liver enzymes during follow-up. Among these, 5 patients (19%) were managed successfully by reducing the MTX dose, while MTX therapy had to be completely discontinued in 2 patients (7%). Notably, all 7 patients who required treatment modification due to persistent enzyme elevation belonged to the group with pre-existing liver enzyme abnormalities and were receiving MTX as part of a combination therapy regimen. Conclusions: These findings indicate that hepatotoxicity risk in RA patients can be effectively managed through close laboratory monitoring and timely dose reduction, with treatment discontinuation being required only in rare cases
Relation between pathogenesis of liver cirrhosis, hepatic encephalopathy and serum cytokine levels-what is the role of tumor necrosis factor-alpha?
No full textBackground and objective: Hepatic encephalopathy (HE) is a major complication characterized with neuropsychiatric symptoms that occurs as a consequence of acute or chronic liver disease. It's etiology and pathogenetical mechanisms are not clearly understood and probably it is multifactorial. There are some reported studies about the role of tumor necrosis factor-alpha (TNF-?) and other inflammatory cytokines on the pathogenesis of HE. In this study, we aimed to investigate the relation between pathogenesis of HE and TNF-?, IL-1?, IL-2R, IL-6, IL-8 and IL-10, relation between the severity of HE and the levels of these cytokines. Methods: Eighty patients with liver cirrhosis [50 patients with clinical findings of HE (group 1) and 30 without any symptoms of HE (group 2)] and 30 healthy controls (group 3) were included into the study. Serum TNF-?, IL-1 ?, IL-2R, IL-6, IL-8 and IL-l0 levels of patients and control subjects were studied with chemiluminescent method. Results: There were statistical difference between serum TNF-?, IL-1 ?, IL-2R, IL-6, IL-8 levels of patients with liver cirrhosis and healthy subjects (P < 0.05), and between patients with and without HE (P < 0.05). There was a correlation between the severity of liver cirrhosis according to Child-Pugh classification and cytokine levels. The severity of HE (grade 1-4) was closely related with cytokine levels, especially TNF-?. On the other hand, there was no relation between cytokine levels and the etiological factors. Conclusion: We found a positive correlation between serum inflammatory cytokine levels (TNF-?, IL-1?, IL-2R, IL-6, IL-8) and the severity of liver cirrhosis. In addition, our findings suggested that this relation is independent from etiological factors
The Relation Between Pathogenesis of Liver Cirrhosis, Hepatic Encephalopathy and Serum Cytokine Levels: What is the Role of Tumor Necrosis Factor Alpha?
No full textBackground/Aims: Hepatic encephalopathy (HE) is a major complication of acute or chronic liver disease characterized by neuropsychiatric symptoms. It's etiology and pathogenetical mechanisms are not clearly understood and probably it is multifactorial. In this study, we aimed to investigate the relation between pathogenesis of HE and TNF-alpha, IL-1 beta, IL-2R, IL-6, IL-8 and IL-10, and between the severity of HE and the levels of these cytokines. Methodology: Eighty patients with liver cirrhosis [50 patients with clinical findings of HE (group 1) and 30 without any symptoms of HE (group 2)] and 30 healthy controls (group 3) were included into the study. Serum TNF-alpha, IL-1 beta, IL-2R, IL-6, IL-8 and IL-10 levels of patients and control subjects were studied with the chemiluminescent method. Results: There were statistically significant difference between serum TNF-alpha, IL-1 beta, IL-2R, IL-6 and IL-8 levels of patients with liver cirrhosis and healthy subjects (p<0.05), and between patients with and without HE (p<0.05). There was a correlation between the severity of liver cirrhosis according to Child-Pugh classification and cytokine levels. The severity of HE (grade 1-4) was closely related with cytokine levels, especially TNF-alpha. On the other hand, there was no relation between cytokine levels and the etiological factors. Conclusion: We found a positive correlation between serum inflammatory cytokine levels (TNF-alpha, IL-1 beta, IL-2R, IL-6, IL-8) and the severity of liver cirrhosis. In addition, our findings suggested that this relation is independent from etiological factors
The portrayal of the Russian Revolution of 1917 in the Norwegian labor movement: a study of the editorials of the Social-Demokraten, 1915—1923.
No full textThe thesis is devoted to the portrayal of the Russian Revolution of 1917 in the Norwegian labor movement in the period 1915—1923. The main source of the analysis is the editorials of the newspaper Social-Demokraten. The newspaper was the print organ of the Norwegian Labor Party and had three editors in the studied period, namely Jacob Vidnes, Olav Scheflo, and Martin Tranmæl. The author analyzes the attitudes expressed to the Russian Revolution and revolutionary means, examines how the influence of the Russian Revolution manifested itself in the Social-Demokraten’s editorials, as well as how the portrayal of the Russian Revolution was changing and reshaping under the editorship of the three editors. The conceptual framework for the thesis is the self / other relations, which is applied to comprehend why the Norwegian labor movement, unlike the Russian Bolsheviks, chose the peaceful development
Beneficial effects of dexpanthenol on mesenteric ischemia and reperfusion injury in experimental rat model
No full textBackground and aim It has been reported that intestinal ischemia-reperfusion (I/R) injury results from oxidative stress caused by increased reactive oxygen species. Dexpanthenol (Dxp) is an alcohol analogue with epitelization, anti-inflammatory, antioxidant, and increasing peristalsis activities. In the present study, the aim was to investigate protective and therapeutic effects of Dxp against intestinal I/R injury. Materials and methods Overall, 40 rats were assigned into five groups including one control, one alone Dxp, and three I/R groups (40-min ischemia; followed by 2-h reperfusion). In two I/R groups, Dxp (500mg/kg, i.m.) was given before or during ischemia. The histopathological findings including apoptotic changes, and also tissue and serum biochemical parameters levels, were determined. Oxidative stress and ileum damage were assessed by biochemical and histological examination. In the control (n=8) and alone Dxp (n=8; 500mg/kg, i.m. of Dxp was given at least 30min before recording), groups were incised via laparotomy, and electrical activity was recorded from their intestines. In this experiment, the effect of Dxp on the motility of the intestine was examined by analyzing electrical activity. Results In ileum, oxidant levels were found to be higher, while antioxidant levels were found to be lower in I/R groups when compared with controls. Dxp approximated high levels of oxidants than those in the control group, while it increased antioxidant values compared with I/R groups. Histopathological changes caused by intestinal I/R injury and histological improvements were observed in both groups given Dxp. In the Dxp group, electrical signal activity markedly increased compared with the control group. Conclusions Here, it was seen that Dxp had protective and therapeutic effects on intestinal I/R injury and gastrointestinal system peristaltism
Prolonged Cholestatic Liver Disease Secondary to Methotrexate
No full textMethotrexate (MTX) is a folate antagonist which damages the DNA and classified as an antimetabolite antineoplastic agent. It is the most commonly used drug in the treatment of rheumatoid arthritis (RA) and its efficiency and reliability were well established. Drug-induced hepatotoxicity varies from non-specific liver changes to acute fulminant failure, cirrhosis and liver cancer. The mechanism in which methotrexate causes liver damage is not known. It may cause acute increase in transaminase enzymes, and on the long-term it may lead to liver fibrosis and cirrhosis. Whether it is used in high doses (eg, cyclic use of 1 gram or more) or on low doses (eg, weekly doses of 7.5 to 25 mg), MTX may lead to life threatening conditions like hepatotoxicity. Presented in this case report, a 52 year old male patient was diagnosed with rheumatoid arthritis. in which hepatic fibrosis and prolonged cholestatic liver disease occurred secondary to prolonged usage of MTX [Med-Science 2015; 4(4.000): 2903-8
An Unusual Foreign Body in the Upper Cervical Esophagus: A Case Report
No full textMajority of esophageal foreign bodies don't cause any complication by directly passing through gastrointestinal system; however, minority of them requires endoscopic or surgical treatment. Here, we presented an unusual esophageal foreign body due to its localization and shape without any risk factor, which is removed successfully by using endoscopic approach. [Med-Science 2016; 5(1.000): 284-9
