Implementation of screening colonoscopy amongst first- degree relatives of patients with colorectal cancer in Turkey: a cross-sectional questionnaire based survey.

OBJECTIVE: To evaluate the implementation of screening colonoscopy amongst first-degree relatives (FDRs) of patients with colorectal cancer (CRC) in Turkey. MATERIALS AND METHODS: A total of 400 first-degree relatives (mean(SD)age: 42.5(12.7) years, 55.5% were male) of 136 CRC patients were included in this cross-sectional questionnaire based survey. Data on demographic characteristics, relationship to patient and family history for malignancy other than the index case were evaluated in the FDRs of patients as were the data on knowledge about and characteristics related to the implementation of screening colonoscopy using a standardized questionnaire form. RESULTS: The mean(SD) age at diagnosis of CRC in the index patients was 60.0(14.0) years, while mean(SD) age of first degree relatives was 42.5(12.7) years. Overall 36.3% of relatives were determined to have knowledge about colonoscopy. Physicians (66.9%) were the major source of information. Screening colonoscopy was recommended to 19.5% (n=78) of patient relatives, while 48.7% (n=38) of individuals participated in colonoscopy procedures, mostly (57.9%) one year after the index diagnosis. Screening colonoscopy revealed normal findings in 25 of 38 (65.8%) cases, while precancerous lesions were detected in 26.3% of screened individuals. In 19.0% of FDRs of patients, there was a detected risk for Lynch syndrome related cancer. CONCLUSIONS: In conclusion, our findings revealed that less than 20% of FDRs of patients had received a screening colonoscopy recommendation; only 48.7% participated in the procedure with detection of precancerous lesions in 26.3%. Rise of awareness about screening colonoscopy amongst patients with CRC and first degree relatives of patients and motivation of physicians for targeted screening would improve the participation rate in screening colonoscopy by FDRs of patients with CRC in Turkey.

The protective effect of L-carnitine on hepatic ischemia-reperfusion injury in rats.

BACKGROUND/AIMS: Ischemia-reperfusion injury may occur during liver transplantation and remains a serious concern in clinical practice. This study was designed to study the potential benefit of L-carnitine on experimental warm hepatic ischemia-reperfusion injury in rats. MATERIALS AND METHODS: Forty-five male Wistar Albino rats were divided into three groups; Group 1 sham-operation without ischemia-reperfusion (n=15); Group 2, ischemia-reperfusion (n=15); and Group 3, which was administered L-carnitine (200 mg/kg, intraperitoneal, for 4 days) prior to ischemia-reperfusion (n=15). The study animals were then sacrificed to obtain hepatic tissue and serum samples. Tissue levels of malondialdehyde and reduced glutathione and serum levels for aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase were assessed. RESULTS: Mean aspartate aminotransferase levels were significantly higher in Group 2 (405.2 U/L) when compared to Groups 1 (137.1 U/L) and 3 (267.6 U/L). Mean alanine aminotransferase levels were significantly higher in Group 2 (257.1 U/L) when compared to Groups 1 (37.2 U/L), and 3 (118.1 U/L) (p< 0.001 for each). Mean lactate dehydrogenase levels were significantly higher in Group 2 (2943.8 U/L) when compared to Groups 1 (1496.5 U/L), and 3 (2185.3U/L) (p < 0.001 for each). Mean malondialdehyde levels were significantly higher in Group 2 (54.3 nmol/g) compared to Groups 1 (41.0 nmol/g) and 3 (42.1 nmol/g) (p < 0.001 for each). Mean reduced glutathione levels were significantly lower in Group 2 (5.9 nmol/mg) and Group 3 (7.4 nmol/mg) compared to Group 1 (9.1 nmol/mg) (p < 0.001 for each). CONCLUSIONS: In conclusion, our data supports a protective effect of L-carnitine against oxidative damage in hepatic ischemia-reperfusion injury in rats. This is evidenced by improvement of the antioxidant defense system and lipid peroxidation levels.

The Role of Helicobacter pylori and NSAIDs in the Pathogenesis of Uncomplicated Duodenal Ulcer.

Background/Aim. To identify the etiological role of Helicobacter pylori (Hp) and nonsteroidal anti-inflammatory drugs (NSAIDs) in endoscopically diagnosed duodenal ulcers (DUs). Methods. Patients undergoing esophagogastroduodenoscopy in two major hospitals in Antalya and Adiyaman were included in this study and assigned as duodenal ulcer (n = 152; median age: 41.0 (16-71) years; 58.6% males) or control group (n = 70; median age: 41.0 (18-68) years; 57.1% males). Patient demographics, risk factors, and NSAID/acetylsalicylic acid (ASA) use were recorded. Results. HP was more commonly located in the corpus (75.0 versus 50.0%; odds ratio [OR] = 3.00; 95% confidence interval [CI]: 1.66-5.44; P < 0.001), incisura (75.7 versus 60.0%; OR = 2.07; 95% CI: 1.13-3.79; P = 0.017), and antrum (80.3 versus 60.0%; OR = 2.71; 95% CI: 1.45-5.05; P = 0.001) among DU patients than controls. Hp positivity was 84.9% while Hp was negative in 15.1% of patients including those accompanied with NSAID and/or ASA use (9.2%), and those were negative for all three etiological factors (5.9%). Conclusion. Our findings indicate the substantial role of Hp in the pathogenesis of DU disease as identified in 84.9% of DU patients compatible with the background prevalence of 61.4% among age-matched control subjects. Hp was the single causative factor in 44.1% of our patients, while NSAID/ASA exposure was in 9.2%.

Early effect of peginterferon alpha-2b plus ribavirin treatment on blood pressure and insulin resistance in patients with chronic hepatitis C.

BACKGROUND/AIM: To investigate the early effects of peginterferon alpha-2b plus ribavirin therapy on blood pressure and related cardiovascular risk parameters, and also insulin resistance in patients with chronic hepatitis C virus (HCV) infection. METHODOLOGY: Twenty-nine patients with chronic hepatitis C (CHC) were enrolled in the study. Twenty-four hour ambulatory blood pressure monitoring (ABPM) of all patients was recorded in the pre-treatment period, and after the 1st and 8th weeks of treatment. Lipid profile, insulin resistance (IR), body mass index (BMI), complete blood counts and transaminase levels were also recorded at the same time periods. RESULTS: Fifteen of the 29 patients studied were hypertensive before treatment. The baseline, 1st week and 8th week recordings of ABPM (daytime, nighttime, mean systolic and diastolic measurements) did not show any significant change. Among hypertensive patients, differences in pretreatment, 1st and 8th week of treatment values of median systolic and diastolic blood pressures were not statistically significant. After the 8th week, total cholesterol, LDL, HDL, hemoglobin, white blood cell, platelet and AST/ALT were significantly decreased (p<0.05). Serum triglyceride levels increased significantly (p<0.0001) and HOMA-IR decreased (p=0.07). CONCLUSION: Peginterferon alpha-2b plus ribavirin therapy did not cause any increase in blood pressure in hypertensive and normotensive CHC patients in the early period of treatment. This treatment resulted in early but not significant changes in the IR status of CHC patients.