An investigation of NIS expression in gastric tissue of obese individuals.

Obesity is seen as one of the top ten (10) illness's listed by World Health Organization (WHO). It is a global problem that can affect people of all ages. Obesity is identified one of the most important factors leading to diabetes, heart disease and hypertension. Individuals with a Body Mass Index (BMI) above 40 kg/m2 are defined with morbid obesity. Sodium Iodide Symporter (NIS) gene is a plasma membrane glycoprotein that mediates iodide uptake in thyroid glands, stomach, salivary glands, lactating mammary glands and intestine. NIS gene transports iodide from the blood to the gastric epithelial cells. NIS gene expression and regulatory role of NIS gene in gastrointestinal tract, hasn't been studied yet in the individuals with obesity (i.e., BMI >40 kg/m2). In this study, gastric tissues were obtained by laparoscopic sleeve gastrectomy from 33 individuals diagnosed with obesity. Control group consisted of gastric tissue of 21 subjects with normal BMI obtained by endoscopy. RNA isolation, cDNA synthesis and qRT-PCR analyses were performed on the samples to determine NIS gene expression. Expression levels of NIS gene were compared between obese and control individuals, although an increase was observed in obese patients this difference was not found to be statistically important (p>0.05).

The prevalence of metabolic-associated fatty liver disease in the Turkish population: A multicenter study.

Background and Aim: The objective of the present study was to investigate the prevalence of metabolic-associated fatty liver disease (MAFLD) in patients with dyspepsia. Materials and Methods: A total of 909 consecutive patients who presented with dyspepsia at 8 tertiary care centers in Turkey between March 2019 and December 2019 were included. Results: The median age was 47 years. Among them, 30.3% of the patients were obese, 18.8% had type 2 diabetes mellitus (T2DM), 35.1% had metabolic syndrome, 84.8% had dyslipidemia, and 23.9% had hypertension. The prevalence of MAFLD was 45.5%. Among the patients with MAFLD, the prevalence of obesity, T2DM, metabolic syndrome, dyslipidemia, and hypertension was 43.3%, 24.9%, 52.5%, 92.3%, and 31.9%, respectively. MAFLD was significantly associated with all of the metabolic comorbidities (p<0.001). The median Fibrosis-4 Index score of the MAFLD patients was 0.88 (range: 0.1-9.5). Of note, 53 patients with hepatic steatosis did not meet the MAFLD criteria. Conclusion: The results of the present study indicated that there was a significantly high prevalence of MAFLD observed in daily clinical practice in Turkey. Early diagnosis and prevention efforts should be implemented to reduce disease progression, and a region-based strategy is recommended.

Hemobilia Causing Acute Cholecystitis and Pancreatitis after Percutaneous Liver Biopsy: A Case Report and Review of the Literature.

We report a case of a 75-year-old woman who developed acute cholecystitis and acute pancreatitis due to hemobilia after a percutaneous liver biopsy. She was admitted to our hospital 13 days after the procedure. The patient presented with cholangitis and acute biliary pancreatitis and underwent endoscopic retrograde cholangiopancreatography (ERCP). Active hemobilia was observed during the ERCP, and sphincterotomy and stent placement were carried out. Angiography was performed because of ongoing bleeding and demonstrated multiple arterioportal fistulas. The bleeding vessel was successfully embolized through an angiographic catheter with microcoils and Histoacryl glue.

The relationship between reflux symptoms and glycogenic acanthosis lesions of the oesophagus.

INTRODUCTION: Glycogenic acanthosis (GA) is a benign, polypoid lesion frequently seen in upper endoscopy with little known aetiology. Information about how it occurs and its clinical significance is lacking. AIM: In this study, the relationship between GA and reflux symptoms was investigated in patients who underwent endoscopy due to reflux symptoms. MATERIAL AND METHODS: Sixty patients undergoing endoscopy for reflux symptoms and 60 controls without reflux symptoms were included in the study. Among the patients with reflux symptoms, two groups were formed: GA group 1 (n = 30) and non-GA group 2 (n = 30). RESULTS: The mean age of all patients participating in the study was 44.65 ±15.54 years; in group 1 it was 52.56 ±10.90 years and in group 2 it was 39.40 ±13.87 years. The mean age of group 1 patients was statistically significantly higher than that of group 2 patients (p < 0.05). The incidence of GA was higher in group 1 than in the control group (p = 0.001). In the reflux group, group 1 and group 2 were compared in terms of oesophagitis; group 1 had a higher incidence of oesophagitis (p < 0.05). In the reflux group, in those with GA, the risk of oesophagitis was 6.6 times higher than among those without GA (OR = 6.571; 95% CI: 2.109-20.479). CONCLUSIONS: We think that GA is associated with advanced age, reflux disease, and oesophagitis in our study.

Serum hepcidin levels are related to serum markers for iron metabolism and fibrosis stage in patients with chronic hepatitis B: A cross-sectional study.

BACKGROUND AND STUDY AIMS: The clinical significance of serum parameters of iron metabolism and hepcidin in liver disease remains unknown. Therefore, this study aimed to evaluate the association of serum hepcidin levels with fibrosis stage and serum iron parameters in patients with chronic hepatitis B (CHB). PATIENTS AND METHODS: This cross-sectional study included 126 treatment-naïve patients with CHB (median age, 39.0 years; 64.3% males) who were positive for hepatitis B surface antigen and 23 healthy controls (median age, 33.0 years; 52.2% males). Data on patient demographics, serum hepcidin levels, liver function tests and serum iron parameters and liver biopsy findings including fibrosis grade, histological activity index (HAI) and liver iron level were recorded. RESULTS: The median (minimum-maximum) serum hepcidin levels were significantly lower in the CHB group than in the control group [71.2 (13.3-672.7) vs. 657.5 (201.7-2714.2) pg/mL, p < 0.001]. Higher fibrosis stage was associated with higher transferrin saturation (p = 0.029), serum ferritin level (p < 0.001) and viral load (p < 0.001). Fibrosis stage and HAI were positively correlated with ferritin (r = 0.407, p < 0.001 and r = 0.415, p < 0.001, respectively) and transferrin saturation (r = 0.219, p = 0.026 and r = 0.290, p = 0.003, respectively) levels, whereas hepcidin level was negatively correlated with fibrosis stage (r = -0.175, p = 0.051), viral load (r = -0.209, p = 0.020) and ferritin level (r = -0.244, p = 0.006) level. There were no significant differences in serum iron level, total iron binding capacity and liver iron level among patients with different stages of fibrosis. CONCLUSION: Reduced hepcidin levels and elevated transferrin saturation and ferritin levels are linked to fibrosis severity and HAI in patients with CHB.

The Prevalence of Helicobacter Pylori babA, homB, aspA, and sabA Genes and Its Relationship with Clinical Outcomes in Turkey.

Background and Aims: The cag A and vac A genes of Helicobacter pylori (H. pylori) are closely associated with the pathogenicity of bacteria. However, the significance of H. pylori babA, homB, aspA, and sabA genes is not clear in phenotypic characteristics of virulence. This study aimed to investigate the frequency and importance of these genes in patients with H. pylori positive peptic ulcer (PU). Materials and Methods: Patients with a PU or nonulcer dyspepsia (NUD) based on the upper gastrointestinal (UGI) endoscopy findings were included in the study. Biopsy samples from antrum and corpus were cultured into Columbia agar. H pylori were characterized by urease, catalase, oxidase test, and gram staining. Genomic DNA was extracted and stored. The babA, homB, aspA, and sabA genes were determined by using polymerase chain reaction analysis. Results: A total 214 patients were included (99 PU and 115 NUD) and H. pylori could be isolated in 82 patients (36 PU and 46 NUD). The frequency of the babA (25% vs. 15.2%, p=0.25), homB (2.7% vs. 4.3%, p=1), aspA (69.4% vs. 73.9%, p=0.2), and sabA (2.7% vs. 10.8%, p=0.88) genotypes was not different between PU and NUD patients. There were some correlations between the presences of these genes. Conclusion: This study managed to determine babA, homB, aspA, and sabA genes of H. pylori by PCR. However, the frequency of these factors was not different in patients with PU and NUD. There is no role of babA, homB, aspA, and sabA genes for the development of peptic ulcer in Turkish population.

Relationship between liver injury and serum cytokeratin 18 levels in asymptomatic hepatitis B virus carriers and in patients with chronic hepatitis B infection.

BACKGROUND AND STUDY AIMS: Apoptosis represents a well-known mechanism of cell death involved in most chronic liver injuries. Our aim was to investigate the serum fragment level of cytokeratin 18 (CK18), M30, in asymptomatic hepatitis B virus (HBV) carriers and patients with chronic hepatitis B (CHB) and to evaluate the relationship between serum M30 levels and the severity of hepatic injury. PATIENTS AND METHODS: Asymptomatic HBV carriers (n=169), patients with CHB (n=100), and healthy control subjects (n=43) were enrolled in the study. Serum CK18 (M30) levels were analysed in all subjects. Liver biopsy for histopathological assessment was performed in asymptomatic HBV carriers and in patients with CHB infection. RESULTS: Serum CK18 (M30) levels were significantly higher in asymptomatic HBV carriers (198.77±77.62U/L) than in healthy control subjects (146.92±40.18U/L). Patients with CHB (283.02±147.45U/L) had significantly higher CK18 (M30) levels than asymptomatic HBV carriers (p=0.001). The diagnostic efficacy of CK18 (M30) levels in distinguishing patients with HBeAg-negative CHB from asymptomatic HBV carriers was found to be moderate (c-statistics: 0.695), and the diagnostic cut-off value of CK18 (M30) was 262U/L (specificity: 85%, sensitivity: 48%, positive likelihood ratio: 3.35, and negative likelihood ratio: 0.60). There was a positive correlation between serum CK18 (M30) levels and histological activity index scores in asymptomatic HBV carriers and patients with CHB. CONCLUSIONS: Serum CK18 (M30) levels may be a valuable indicator in distinguishing asymptomatic HBV carriers from patients with HBeAg-negative CHB when considered together with ALT and HBV-DNA levels.

Comparison of Early and Interval Laparoscopic Cholecystectomy for Treatment of Acute Cholecystitis. Which is Better? A Multicentered Study.

INTRODUCTION: The aim of this study was to compare early laparoscopic cholecystectomy (LC) and LCs performed at different time intervals for treatment of acute cholecystitis, contribute to the literature with data obtained from different centers, and provide assistance to clinicians about the timing of LC in acute cholecystitis. MATERIALS AND METHODS: The study was designed as a retrospective, observational, and multicentered study. The data of 470 patients who had undergone LC for treatment of acute cholecystitis between January 2010 and March 2016 were included. Four different centers contributed to the study. The patients were divided into 4 groups. The groups were identified according to the timing of LC following the onset of findings and symptoms of acute cholecystitis as group 1 (first week), group 2 (1 to 4 wk), group 3 (4 to 8 wk), and group 4 (>8 wk). The clinical and demographical characteristics, comorbidities, complications, hospital stay, duration of operation, conversion rates, and rehospitalizations in the following 30 days of patients in the groups were compared. RESULTS: A significant increase was found in group 4 compared with groups 1 and 2 in relation to comorbidities (P<0.01) (P=0.042). No statistically significant difference was observed among the groups for the comparison of operation durations, conversion rates, and total number of complications (P>0.05). The groups were compared with regard to the mean hospital stay, and the hospital stay was found to be significantly higher in group 4 than in group 1 (P=0.001). In our study, the 30-day readmission rate was determined to be significantly higher in the >8-week group (group 4) compared with the first-week (group 1) and 1- to 4-week group (group 2) (P<0.05). CONCLUSIONS: Interval LC does not decrease the complication rate, conversion rate, or the operation time. Early LC could be preferred for treatment of acute cholecystitis as no significant differences related to the conversion rate, operation time, and overall complication rate are observed between the early and delayed LCs; however, a shorter hospital stay and lower 30-day readmission rate are observed in early LC for the treatment of acute cholecystitis.

Study of ideal topical pharyngeal anesthesia in upper gastrointestinal system endoscopy: A double-blind, randomized, controlled trial.

BACKGROUND/AIMS: This study is designed to determine which drug forms provide ideal pharyngeal anesthesia when used during upper gastrointestinal system endoscopy. MATERIALS AND METHODS: A total of 180 patients were included in the study. Using the random number table, these patients were divided into three groups. Group 1, lidocaine gel+isotonic spray; Group 2, base lubricant gel+lidocaine spray; and Group 3: lidocaine gel+lidocaine spray. Data were collected from the patient identification form, compliance to operation form, and State Anxiety Inventory. RESULTS: Anesthetization and compliance to procedure scores were higher and anxiety scores were lower in Group 3 than in other groups (p<0.05). It was observed that as the compliance score increased, the anesthetization and satisfaction scores also increased; however, coughing during the procedure, duration of the procedure, and anxiety scores decreased (p<0.05). It was determined that as anesthetization scores increased, discomfort in the throat caused by the device, coughing during the procedure, and anxiety scores decreased (p<0.05). CONCLUSION: Lidocaine gel and spray combination is the most ideal pharyngeal anesthesia to ensure the adaptation of the patient to the procedure and to decrease anxiety and discomfort during the procedure.

Peginterferon alfa related psoriasis in a patient with acute hepatitis C and review of the literature.

The Interferon (IFN) which is the standard treatment for Hepatitis C, may cause a lot of side effects including dermatological anomalies. This paper presents a psoriasis case which occurred in relation with the treatment of acute hepatitis C (AHC) with peginterferon alfa (peg-IFN-α). A 60-year-old male patient came to the hospital with symptoms of high liver enzymes. The patient with history of a recent operation showed anti-HCV(+), HCVRNA 3.5 million IU/mL and HCV genotype 1b in the tests. Without any other etiological factors found in the patient, we started a treatment of peg-IFNα-2b with the diagnosis of AHC. After 3 weeks, psoriatic plaques were observed in various parts of the body. Antiviral treatment of the patient was concluded within 6 months. His psoriasis treatment initially commenced with local agents followed by phototherapy. Permanent viral response was seen in the patient and his lesions recovered rapidly after the antipsoriatic and antiviral treatment. Psoriasis and other autoimmune diseases should be considered even though they are encountered rarely,and the patients should be informed of the possible risks before planning treatment with peg-IFN-α.