Investigation of liver fibrosis with serum biochemical parameters before treatment with direct-acting antivirals, at the end of treatment, and in the first and third year after treatment in patients with chronic hepatitis C.

Aim of the study: In the treatment of chronic hepatitis C, the need for non-invasive methods, other than invasive methods, is increasing for the detection of fibrosis before and after treatment. In our study, we aimed to determine the changes in histological response with post-treatment biochemical scoring in patients treated with direct-acting antivirals. Material and methods: Between June 1, 2016, and January 1, 2020, 125 patients followed up with a diagnosis of chronic hepatitis C, who presented to Haseki Training and Research Hospital, were enrolled in the study. Scores of APRI, Fibro Q, Fibrosis-4 (FIB-4) index, Doha score, Fibro alpha, and fibrosis-cirrhosis index were used to evaluate the liver fibrosis of the patients with examinations before treatment, at the end of treatment and at the 12th week, first year, and third year after treatment. The study was conducted as a retrospective observational case series. Results: One hundred twenty-five patients were enrolled in the study. The mean age was 55.5 ±15.9 years. Patients were divided into two groups according to their baseline FIB-4 values: cirrhotic/noncirrhotic. Seven (5.6%) patients had compensated cirrhosis; there were no decompensated cirrhotic patients. There was a statistically significant decrease in scores of APRI, FIB-4, Fibro Q, and Doha score calculated during the end-of-treatment three-year follow-up period. Conclusions: It was shown that serum fibrosis scores, such as APRI, FIB-4, Fibro Q, and Doha score, could be used to detect fibrosis before treatment and to follow histological improvement after treatment with direct-acting antivirals (DAA) in chronic hepatitis C patients.

Long-term effects of COVID-19 on lungs and the clinical relevance: a 6-month prospective cohort study.

Background: We aimed to explore the prevalence of prolonged symptoms, pulmonary impairments and residual disease on chest tomography (CT) in COVID-19 patients at 6 months after acute illness. Methods: In this prospective, single-center study, hospitalized patients with radiologically and laboratory-confirmed COVID-19 were included. Results: A high proportion of the 116 patients reported persistent symptoms (n = 54; 46.6%). On follow-up CT, 33 patients (28.4%) demonstrated residual disease. Multivariate analyses revealed that only neutrophil-to-lymphocyte ratio was an independent predictor for residual disease. Conclusion: Hospitalized patients with mild/moderate COVID-19 still had persistent symptoms and were prone to develop long-term pulmonary sequelae on chest CT. However, it did not have a significant effect on long-term pulmonary functions.

[Leptomeningeal metastasis of EGFR (+) lung adenocarcinoma: a case report]. / EGFR (+) akciger adenokarsinomunun leptomeningeal metastazi: Olgu sunumu.

Leptomeningeal metastasis is a very rare complication of infiltration of leptomeninges and subarachnoid space with malignant cells. It is an indicator of poor prognosis. Its incidence is 3.8% in non-small cell lung carcinoma (NSCLC). This rate is higher in patients with epidermal growth factor receptor (EGFR) mutation. Brain magnetic resonance imaging (MRI) is the first choice in the diagnosis. The diagnosis of leptomeningeal metastasis is difficult and often bypassed because it is rare and does not cause gross mass lesions such as brain metastasis. Systemic chemotherapy, intrathecal therapy, cranial radiotherapy and targeted treatment agents are an option in the treatment. It has been shown that targeted therapies can be promising because of the ability to switch to cerebrospinal fluid in appropriate patients. We present the case with EGFR positive lung adenocarcinoma whit leptomeningeal metastasis (LM) due to its rarity, difficulty in diagnosis and its association with EGFR mutation.