Effects of COVID-19 Pandemic and Post-Vaccination Period on Gastroenterology Practice in Turkey.

BACKGROUND: The sudden and intense burden due to the novel coronavirus (coronavirus disease 2019) pandemic has changed the priority of many health services. The highly contagious new variants and vaccination services have greatly impacted the daily practice of gastroenterologists. In the present study, we tried to evaluate the change in the daily practice of Turkish gastroenterologists in the coronavirus disease 2019 pandemic and the post-vaccination periods. METHODS: A questionnaire was prepared using Google forms and sent online to 214 gastroenterologists registered with the Turkish Gastroenterology Association. RESULTS: Approximately half of the gastroenterologists moved their endoscopy unit or gastroenterology clinic to another location in the hospital during the pandemic and about one-third of the endoscopy units were completely closed. About 56% of the respondents reported the interruption of endoscopic procedures and inpatient services. In total, 85% of gastroenterologists thought that follow-up and treatment of chronic patients were disrupted due to patients obtaining their medicine directly from pharmacies. After the first case in Turkey, 74% of gastroenterologists worked in coronavirus disease 2019 patient care services, 28% of gastroenterologists were infected with coronavirus disease 2019, and 3% believed they had a cross-infected patient(s). A total of 78% of gastroenterologists reported that patient management became difficult due to the change in the priority of other departments, and 60% of gastroenterologists confirmed that they experienced a decrease in income. In the post-vaccination period, 70% of gastroenterologists returned to their pre-pandemic working schedule and 31% noticed an increase in endoscopic cancer detection. CONCLUSION: Prolongation of the pandemic has seriously damaged the practice of gastroenterology and multidisciplinary patient management.

Evaluation of Plasma Urokinase-Type Plasminogen Activator Receptor (UPAR) in Patients With Chronic Hepatitis B, C and Non-Alcoholic Fatty Liver Disease (NAFLD) as Serological Fibrosis Marker.

BACKGROUND/AIMS: Progressive hepatic fibrosis is the main predictor of outcome and prognosis in chronic liver diseases. The importance of the coagulation cascade has been defined in liver fibrosis; however, the role of the fibrinolytic pathway has not been clear yet. We aimed to evaluate the association between the plasma levels of soluble urokinase Plasminogen Activator Receptor (uPAR) and the severity of liver fibrosis in chronic hepatitis B, C and Non-Alcoholic Fatty Liver Disease (NAFLD). METHODS: 96 chronic hepatitis B, 22 chronic hepatitis C and 11 NAFLD patients together with 47 healthy controls were enrolled in the study. uPAR plasma levels were detected by Enzyme-Linked Immunosorbent Assay (ELISA) method. RESULTS: The plasma levels of uPAR in patients with chronic hepatitis B and C significantly exceeded those of healthy controls (P < 0.001) while mean uPAR levels in patients with NAFLD were not different from healthy controls. Mean uPAR levels in chronic viral hepatitis patients with F1-F3 fibrosis and F4-F6 fibrosis were higher than those of control group (P < 0.001). Mean uPAR level in patients with F4-F6 fibrosis was significantly higher than that of patients with F1-F3 fibrosis (P < 0.001). CONCLUSION: This is the first study that investigated uPAR as a fibrosis marker in NAFLD and chronic hepatitis B patients. It is suggested that plasma levels of uPAR are closely related to the fibrosis stage in chronic hepatitis B and C and that uPAR might be a noninvasive marker of liver fibrosis.