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Öğe Age-based computer-aided diagnosis approach for pancreatic cancer on endoscopic ultrasound images(Wolters Kluwer Medknow Publications, 2016) Özkan, Murat; Çakıroğlu, Murat; Kocaman, Orhan; Kurt, Mevlüt; Yılmaz, Bülent; Can, Güray; Korkmaz, UğurAim: The aim was to develop a high-performance computer-aided diagnosis (CAD) system with image processing and pattern recognition in diagnosing pancreatic cancer by using endosonography images. Materials and Methods: On the images, regions of interest (ROI) of three groups of patients (<40, 40-60 and >60) were extracted by experts; features were obtained from images using three different techniques and were trained separately for each age group with an Artificial Neural Network (ANN) to diagnose cancer. The study was conducted on endosonography images of 202 patients with pancreatic cancer and 130 noncancer patients. Results: 122 features were identified from the 332 endosonography images obtained in the study, and the 20 most appropriate features were selected by using the relief method. Images classified under three age groups (in years; <40, 40-60 and >60) were tested via 200 random tests and the following ratios were obtained in the classification: accuracy: 92%, 88.5%, and 91.7%, respectively; sensitivity: 87.5%, 85.7%, and 93.3%, respectively; and specificity: 94.1%, 91.7%, and 88.9%, respectively. When all the age groups were assessed together, the following values were obtained: accuracy: 87.5%, sensitivity: 83.3%, and specificity: 93.3%. Conclusions: It was observed that the CAD system developed in the study performed better in diagnosing pancreatic cancer images based on classification by patient age compared to diagnosis without classification. Therefore, it is imperative to take patient age into consideration to ensure higher performance.Öğe Bactericidal permeability increasing protein gene polymorphism is associated with inflammatory bowel diseases in the Turkish population(Medknow Publications & Media Pvt Ltd, 2015) Can, Güray; Akın, Hakan; Özdemir, Filiz Türe; Can, Hatice; Yılmaz, BülentBackground/Aims: Inflammatory bowel disease, a chronic inflammatory disease with unknown etiology, affects the small and large bowel at different levels. It is increasingly considered that innate immune system may have a central position in the pathogenesis of the disease. As a part of the innate immune system, bactericidal permeability increasing protein has an important role in the recognition and neutralization of gram-negative bacteria. The aim of our study was to investigate the involvement of bactericidal permeability increasing protein gene polymorphism (bactericidal permeability increasing protein Lys216Glu) in inflammatory bowel disease in a large group of Turkish patients. Patients and Methods: The present study included 528 inflammatory bowel disease patients, 224 with Crohn's disease and 304 with ulcerative colitis, and 339 healthy controls. Results: Bactericidal permeability increasing protein Lys216Glu polymorphism was found to be associated with both Crohn's disease and ulcerative colitis (P = 0.0001). The frequency of the Glu/Glu genotype was significantly lower in patients using steroids and in those with steroid dependence (P = 0.012, OR, 0.80; 95% confidence interval [CI]: 0.68-0.94; P = 0.0286, OR, 0.75; 95% CI: 0.66-0.86, respectively). There was no other association between bactericidal permeability increasing protein gene polymorphism and phenotypes of inflammatory bowel disease. Conclusions: Bactericidal permeability increasing protein Lys216Glu polymorphism is associated with both Crohn's disease and ulcerative colitis. This is the first study reporting the association of bactericidal permeability increasing protein gene polymorphism with steroid use and dependence in Crohn's disease.Öğe Beliefs about medicines and adherence to treatment in Turkish patients with inflammatory bowel disease(AVES, 2022) Can, Güray; Yozgat, Ahmet; Tezel, Ahmet; Ünsal, Gülbin; Soylu, Ali RızaBackground: Although studies are investigating the perception and beliefs about treatment and adherence to treatment in different societies related to inflammatory bowel disease, there are no studies on this subject in Turkish people with different sociocultural structures. In our study, we aimed to evaluate the beliefs about treatment and its effect on adherence to treatment in the Turkish population with inflammatory bowel disease. Methods: In the study, the Medication Adherence Report Scale and Beliefs about Medicines Scale scales were used to evaluate the treatment compliance and perception and beliefs about treatment. Characteristics that could affect treatment compliance were evaluated by statistical analysis. Results: A total of 253 patients, 167 with ulcerative colitis and 86 with Crohn's disease, were included in the study. The non-adherence rate to the treatment was found as 41.9% in ulcerative colitis and 24.4% in Crohn's disease (P =.006). Intentional (29.3% in ulcerative colitis and 16.3% in Crohn's disease [P =.031] and unintentional non-adherence to treatment (28.1% in ulcerative colitis, 16.3% in Crohn's disease [P =.037] were significantly higher in ulcerative colitis than in Crohn's disease. Female gender (odds ratio = 2.59, P =.005), low education level (odds ratio = 4.8, P =.015), distal involvement in ulcerative colitis (P =.014), and thoughts about the disease would last too soon in Crohn's disease (odds ratio = 4.17, P =.049) were risk factors for non-adherence to treatment. Conclusion: The negative perception of treatment in inflammatory bowel disease affects adherence to the treatment. Considering some social factors that affect adherence to the treatment and taking measures to enhance the adherence to treatment will increase the success of treatment.Öğe Characteristics of patients with hepatocellular carcinoma: A multicenter study(Kare Publishing, 2022) Güzelbulut, Fatih; Karaoğullarından, Ümit; Akkız, Hikmet; Altıntaş, Engin; Demirtaş, Coşkun Özer; Can, GürayBackground and Aim: The aim of the present study was to examine the etiology of hepatocellular carcinoma (HCC) by underlying cause and determine the characteristics and clinical features of patients with HCC. Materials and Methods: The study comprised 1802 HCC patients diagnosed and followed up by Liver Diseases Outpatient Clinics in 14 tertiary centers in Turkey between 2001 and 2020. Results: The mean age was 62.3 +/- 10.7 years, and 78% of them were males. Of the patients, 82% had cirrhosis. Hepatitis B virus (HBV) infection was the most common etiology (54%), followed by hepatitis C virus (HCV) infection (19%) and nonalcoholic fatty liver disease (NAFLD) (10%). Of the patients, 56% had a single lesion. Macrovascular invasion and extrahepatic spread were present in 15% and 12% of the patients, respectively. The median serum alpha-fetoprotein level was 25.4 ng/mL. In total, 39% of the patients fulfilled the Milan Criteria. When we compared the characteristics of patients diagnosed before and after January 2016, the proportion of NAFLD-related HCC cases increased after 2016, from 6.6% to 13.4%. Conclusion: Chronic HBV and HCV infections remain the main causes of HCC in Turkey. The importance of NAFLD as a cause of HCC is increasing.Öğe Chronic hepatitis B associated with hepatic steatosis, insulin resistance, necroinflammation and fibrosis(Makerere Univ, Fac Med, 2015) Yılmaz, Bülent; Köklü, Seyfettin; Büyükbayram, Hüseyin; Yalçın, Kendal; Korkmaz, Uğur; Poşul, Emrah; Can, Güray; Kurt, MevlütBackground: The effect of hepatitis B virus (HBV) infection on fatty liver disease is unclear.. Objectives: The aim of this study was to investigate the viral and host causes of fatty liver in chronic hepatitis B (CHB) patients. This study included 88 CHB patients of which 17 were not treated. Liver biopsy was performed in each patient. Group 1 included those with hepatic steatosis (n=28) and group 2 those without hepatic steatosis. The groups were compared in terms of age, body mass index (BMI), Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), viral load, biochemical parameters and histological findings. Patients in group 1 were subdivided according to the degree of steatosis as follows: grade 1 (15 patients, 53.6%), grade 2 (6 patients, 21.4%), and grade 3 (7 patients, 25%). Results: In group 1 (n=28), mean age, BMI, cholesterol, and HOMA-IR were found to be significantly higher than in group 2 (n=60). There were no significant differences in the positivity of viral load, HbeAg, treatment, fibrosis and other laboratory parameters between the two groups. HOMA-IR was the only independent predictive factor of liver steatosis in patients with CHB in logistic regression analysis. Conclusion: Hepatic steatosis in CHB patients was associated with host metabolic factors.Öğe ÇÖLYAK HASTALIĞINDA FİBROMİYALJİ SIKLIĞI VE FİBROMİYALJİNİN HASTALAR ÜZERİNE ETKİSİNİN DEĞERLENDİRİLMES(2021) Yozgat, Ahmet; Can, Güray; Gürler, Müjgan; Kahveci, Samet; Yildirim, MehmetAMAÇ: Çölyak hastalığı, gluten ilişkili bir enteropati olmakla birlikte malabsorbsiyona bağlı bütün vücudu etkileyebilen bir hastalıktır. Diğer yandan antijen maruziyeti sebebiyle kronik inflamasyona da zemin hazırlamaktadır. Kronik inflamasyonun vücutta sistemik etkilerinin olduğu bilinmektedir. Çölyak hastalığının sistemik etkileri farklı mekanizmalar üzerinden fibromiyalji sendromunu (FMS) tetikliyor olabilir. Çalışmamızın amacı Çölyak hastalarında FMS prevalansını belirlemek ve FMS’nin Çölyak hastaları üzerindeki etkisini değerlendirmektir. GEREÇ VE YÖNTEM: Çalışmaya 1 Şubat-10 Haziran 2019 tarihleri arasında Gastroenteroloji kliniğimize başvuran 24 Çölyak hastası (7 aktif, 17 Çölyak diyeti altında) ve 20 kontrol gönüllü olarak dahil edildi. FMS tanısı için 2010 American College of Rheumatology kriterleri kullanıldı. WSPI (yaygın ağrı indeksi), SSS (somatik semptom ağırlık skoru) ve toplamından FMS skoru hesaplandı. Bütün katılımcılara fibromiyalji etki anketi uygulandı. Veriler istatistiksel olarak karşılaştırıldı. BULGULAR: Çölyak hastaları ve kontrol grubunda FMS sıklığı birbirleriyle karşılaştırıldığında anlamlı farklılık saptanmadı; Çölyak hastalarında %12,5, gönüllü kontrol grubunda %5 (p: 0,61). Kadın ve erkeklerdeki FMS sıklığı benzerdi. Gruplar arasında WSPI, SSS ve FMS skorları açısından anlamlı fark yoktu. FMS etki skalası skorları yönünden FMS olanlar ile olmayanlar karşılaştırıldığında gönüllü kontrol grubunda anlamlı fark yoktu (23,9±18,8 ve 21,5±0; p: 0,90). Çölyak hastalığı olanlarda, FMS etki skoru FMS olanlarda olmayanlara göre daha yüksek olmasına rağmen anlamlılık düzeyine ulaşmamıştır (51,9±25,5 ve 28,5±17,7; p: 0,25). SONUÇ: Türk toplumunda Çölyak hastalarında FMS sıklığını gösteren ilk çalışmadır. Normal popülasyona göre Çölyak hastalığında FMS sıklığı artmamaktadır. Çölyak hastalığında aktivitenin FMS üzerine etkisi yoktur. FMS tanısı olan Çölyak hastalarında olmayanlara göre hayat kalitesi daha çok etkilenmektedir. Daha geniş bir popülasyonda yapılacak çalışmalara ihtiyaç vardır.Öğe Combination of novel c.3484g > t/p.glu162ter variant in abcb11 and c.208g > a/p.asp70asn variant in atp8b1 are associated with severe symptoms in progressive family ıntrahepatic cholestasis(Georg Thieme Verlag Kg, 2020) Bekdaş, Mervan; Can, Güray; Eröz, Recep; Düzcü, Selma ErdoğanProgressive family intrahepatic cholestasis (PFIC) is an autosomal recessive disease that causes chronic cholestasis. It is associated with pathogenic variants in genes that encode proteins involved in bile secretion to canaliculus from hepatocytes. In this study, we present a 16-year-old boy who presented with severe pruritus and cholestatic jaundice. All possible infectious etiologies were negative. A liver biopsy was consistent with intrahepatic cholestasis and portal fibrosis. DNA was isolated from a peripheral blood sample, and whole exome sequencing was performed. A novel c.3484G > T/p.Glu162Ter variant in theABCB11gene and a c.208G> A/p.Asp70Asn variant in theATP8B1gene were detected. Despite traditional treatment, the patient's recurrent severe symptoms did not improve. The patient was referred for a liver transplantation. This novel c.3484G > T/p.Glu162Ter variant is associated with a severe and recurrent presentation, and the two compound variants could explain the severity of PFIC.Öğe Comparison of the efficacy of entecavir and tenofovir in reducing hepatocellular carcinoma risk in chronic hepatitis b patients: A real-life study in Turkey(AVES, 2021) Güzelbulut, Fatih; Gökçen, Pınar; Can, Güray; Adalı, Gupse; Saltürk, Ayça Gökçen DeğirmenciBackground: It is controversial whether entecavir or tenofovir differs in reducing hepatocellular carcinoma (HCC) risk. We aimed to compare the efficacy of entecavir and tenofovir in reducing HCC risk in chronic hepatitis B (CHB) patients. Methods: This retrospective study included 607 nucleos(t)ide naive CHB patients who had received entecavir or tenofovir. Patients who developed HCC during the first 12 months of therapy were excluded. Cumulative HCC incidences at years 2, 3, 4, 5 and 10 were compared between entecavir and tenofovir groups. Factors associated with HCC were determined by univariate and multivariate analyses. Results: Nineteen (3.1%) patients developed HCC, 12 (4.8%) in entecavir group and 7 (1.9%) in tenofovir group (P = .045). In the entire cohort, cumulative HCC incidences at years Z 3, 4, 5 and 10 were 1.8%, 2.9%, 4.4%, 5.2% and 9.9% in entecavir group, and 0.6%, 2.4%, 2.4%, 2.4% and 3.7% in tenofovir group, respectively (log-rank P = .130). In multivariate analysis, age >= 50 years, cirrhosis, decompensated cirrhosis, high GGT and low platelet levels were associated with HCC in the entire cohort. In advanced fibrosis/cirrhosis cohort, cumulative HCC incidences at years 2, 3, 4, 5 and 10 were 4.6%, 7.1%, 8.6%,12.1% and 15.5% in entecavir group, and 1.8%, 5.6%, 5.6%, 5.6% and 8.5% in tenofovir group, respectively (log-rank P = .267). In multivariate analysis, age >= 50 years, decompensated cirrhosis, high GOT and low platelet levels were associated with HCC in the advanced fibrosis/cirrhosis cohort. Conclusion: Entecavir and tenofovir are similarly effective in reducing HCC risk in CHB patients.Öğe Correlation between physician disease assessment in ulcerative colitis and burden of disease: ICONIC 2-year data of 120 patients in Turkey(Oxford University Press, 2021) Sezgin, Orhan; Atuğ, Özlen; Gönen, C.; Can, Güray; Duman, Ali Erkan; Erzin, Yusuf ZiyaBackground: Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD), and the overall burden is increasing at the global level. Differences in perceptions of UC-related burden may highlight dramatic degree insufficient patient-physician communication. ICONIC is a prospective, non-interventional, observational study assessing disease burden in adults with UC using Pictorial Representation of Illness and Self Measure (PRISM). The local results of ICONIC study for Turkey are presented. Methods: Patients aged ≥18 years with early UC (diagnosed ≤36 months) were enrolled. At baseline and every 6 months, patient and physician reported outcomes were collected using PRISM, the Simple Clinical Colitis Activity Index (SCCAI and P-SCCAI), The Rating Form of IBD Patients’ Concerns (RFIPC), the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and the Patient Health Questionnaire-9 (PHQ-9). Correlations between the patient assessed PRISM and other measurement tools were evaluated with Pearson correlation coefficient. Results: One hundred and twenty patients were included (77 [64.2%] female; mean age 35.2 years). Physician-assessed disease severity was: severe 23 [19.2%], moderate 42 [35.0%], mild 40 [33.3%], in remission 15 [12.5%]. The mean ± SD physician- and patient-assessed PRISM scores were 4.8 ± 2.3 cm (range: 0.0–9.0) and 4.1 ± 2.6 cm (range: 0.0–8.5) at baseline and increased to 6.1 ± 2.3 cm (range: 0.1– 8.5) and 5.5 ± 2.7 cm (range: 0.0–9.3) at the final visit, respectively, indicating an improvement in the perceived disease burden. The mean values of physician-SCCAI and P-SCCAI were 3.8 ± 3.5 and 5.5 ± 4.3 at baseline and decreased to 1.4 ± 2.5 and 2.7 ± 3.2 at the final visit, respectively, showing a decrease in disease activity. At baseline, the RFIPC and PHQ-9 values were 2.7 ± 1.7 and 8.0 ± 5.5 and decreased to 2.2 ± 2.0 and 5.2 ± 4.5 at the final visit, respectively. Patient-assessed SIBDQ was 43.8 ± 14.5 at baseline and increased to 54.0 ± 13.0 at the final visit. The strongest correlation of patient-assessed PRISM was with the physician-assessed PRISM (Spearman rho = 0.69, p<0.0001), followed by SCCAI (rho = -0.56, p<0.0001). Differences between physician- and patient-assessed PRISM scores were statistically significant (baseline: p=0.0010 vs. final visit: p=0.0206), highlighting an underestimation of patient’s suffering by physicians. Conclusion: In the Turkish ICONIC sub-study, majority of patients on treatment showed improved outcomes during the follow-up period. A moderate correlation between patient-assessed PRISM and other measurement instruments represents that PRISM may be used as surrogate marker for patient sufferingÖğe Crohn's disease presenting as multiple pulmonary nodules in FDG PET/CT scan(Aves, 2015) Kurt, Mevlüt; Posul, Emrah; Can, Güray; Yılmaz, Bülent; Korkmaz, Uğur; Kurt, Özlem Kar; Gürel, Kamil; Dağıstan, Emine; Özyalvaçlı, GülzadeÖğe Does the fibromyalgia affect the quality of life in the patients with inflammatory bowel disease(2021) Dilekci, Erdal; Can, Güray; Gürler, Müjgan; Dilekçi, Esra Nur Ademoğlu; Kayhan, Meral AkdoğanAim: Data on soft tissue rheumatism, especially fibromyalgia syndrome is limited in inflammatory bowel disease. Our aim in our study is to determine the prevalence of fibromyalgia syndrome and to evaluate the impact on quality of life in inflammatory bowel disease. Material and Method: 60 ulcerative colitis and 34 Crohn’s disease patients were included. 2010/2011 and 2016 American College of Rheumatology criteria were used for fibromyalgia syndrome diagnosis. A Fibromyalgia impact survey was applied to all patients. Results: According to the American College of Rheumatology-2010/2011 criteria, fibromyalgia syndrome frequencies were determined as 29.8% in inflammatory bowel disease, 23.4% in Crohn’s disease, and 33.3% in ulcerative colitis (P>0.05). The frequency of fibromyalgia syndrome was significantly higher in inflammatory bowel disease and especially more in females. There was no significant difference between ulcerative colitis and Crohn’s disease in terms of widespread-pain-index, somatic- symptom-severity, and fibromyalgia syndrome scores. Fibromyalgia impact scores were found significantly higher in those with fibromyalgia syndrome in inflammatory bowel disease, ulcerative colitis, and Crohn’s disease. Conclusions: This is the first study to show the frequency of fibromyalgia syndrome in patients with inflammatory bowel disease in the Turkish population. Fibromyalgia syndrome is increased in inflammatory bowel disease patients and more in ulcerative colitis and female. The quality of life is more affected in inflammatory bowel disease patients with fibromyalgia syndrome.Öğe Efficacy and safety of direct-acting antivirals in elderly patients with chronic hepatitis C: A nationwide real-life, observational, multicenter study from Turkey(2022) Önlen, Yusuf; Bal, Tayibe; Çabalak, Mehmet; Çuvalcı, Nefise Öztoprak; Sarı, Nagehan Didem; Can, Güray; Sırmatel, FatmaBackground: The number and proportion of elderly patients living with chronic hepatitis C are expected to increase in the coming years. We aimed to compare the real-world efficacy and safety of direct-acting antiviral treatment in elderly and younger Turkish adults infected with chronic hepatitis C. Methods: In this multicenter prospective study, 2629 eligible chronic hepatitis C patients treated with direct-acting antivirals between April 2017 and December 2019 from 37 Turkish referral centers were divided into 2 age groups: elderly (>= 65 years) and younger adults (<65 years) and their safety was compared between 2 groups in evaluable population. Then, by matching the 2 age groups for demographics and pretreatment risk factors for a non-sustained virological response, a total of 1516 patients (758 in each group) and 1244 patients (622 in each group) from the modified evaluable population and per-protocol population were included in the efficacy analysis and the efficacy was compared between age groups. Results: The sustained virological response in the chronic hepatitis C patients was not affected by the age and the presence of cirrhosis both in the modified evaluable population and per-protocol population (P =.879, P =.508 for modified evaluable population and P =.058, P =.788 for per-protocol population, respectively). The results of the per-protocol analysis revealed that male gender, patients who had a prior history of hepatocellular carcinoma, patients infected with non-genotype 1 hepatitis C virus, and patients treated with sofosbuvir + ribavirin had a significantly lower sustained virological response 12 rates (P <.001, P =.047, P =.013, and P =.025, respectively). Conclusion: Direct-acting antivirals can be safely used to treat Turkish elderly chronic hepatitis C patients with similar favorable efficacy and safety as that in younger adults.Öğe The efficacy of tyrosine kinase inhibitor dasatinib on colonic mucosal damage in murine model of colitis(Elsevier Masson, Corporation Office, 2016) Can, Güray; Ayvaz, Süleyrnan; Can, Hatice; Karaboğa, İhsan; Demirtaş, Selim; Korkmaz, Uğur; Kurt, MevlütBackground and objective: Ulcerative colitis is an inflammatory condition of the colon in the gastrointestinal system. Currently, the most potent medications used for ulcerative colitis produce no response in 20-30% of cases. There is a need for more efficient and reliable medications. Tyrosine kinase inhibitors have shown efficacy in some inflammatory diseases. Although dasatinib, a tyrosine kinase inhibitor, suppresses proinflammatory cytokines in colonic tissue, there are a few cases of hemorrhagic colitis with dasatinib. There is no study investigating the effect of dasatinib on experimental colitis. We aimed to investigate the effect of dasatinib in a colitis model induced with acetic acid in our study. Methods: In the study, 24 male Sprague-Dawley rats randomly distributed into 4 groups of 6 rats each as control, dasatinib, colitis and dasatinib + colitis groups. For colitis induction, 4% acetic acid was used. Sacrificing of the rats was performed on the seventh day. Disease activity, morphologic and histological injury, superoxide dismutase, myeloperoxidase and malondialdehyde activity, TNF alpha and CD3 expression were assessed in colonic tissue. Results: Apart from malondialdehyde, significant difference in all parameters between the control and colitis groups was determined. Difference between the colitis and colitis + dasatinib groups was not significant in only weight loss and biochemical parameters. Though dasatinib does not fully resolve the changes in colitis, there was significant regression. Conclusions: Dasatinib decreased the inflammation in a rodent model of colitis. It may be provide this effect by the suppression of TNF alpha. Dasatinib may be one of the treatment options for ulcerative colitis. (C) 2016 Elsevier Masson SAS. All rights reserved.Öğe Epidemiologic features of inflammatory bowel disease in Western Blacksea region of Turkey for the last 10 years: Retrospective cohort study(Korean Assoc Internal Medicine, 2019) Can, Güray; Poşul, Emrah; Yılmaz, Bülent; Can, Hatice; Korkmaz, Uğur; Ermiş, FatihBackground/Aims: There are only a few epidemiological study about inflammatory bowel disease in the last 10 years in Turkey, especially in Western Blacksea region. In our study, we aimed to identify the changes in the incidence and the prevalence of inflammatory bowel disease in Western Blacksea region at the last 10 years. Methods: Totally 223 patients with inflammatory bowel disease (160 ulcerative colitis, 63 Crohn's disease) were enrolled in the study followed up between 2004 to 2013 years. The epidemiological characteristics of patients were recorded. Results: The prevalences were 12.53/10(5) and 31.83/10(5) for Crohn's disease and ulcerative colitis respectively. Mean annual incidences increased from 0.99/10(5) and 0.45/10(5) for ulcerative colitis and Crohn's disease (2004 to 2005 years) to 4.87/10(5) and 2.09/10(5) for ulcerative colitis and Crohn's disease respectively (2011 to 2013 years). While the prevalence was higher in urban areas in Crohn's disease (12.60/10(5)), it was higher in rural areas in ulcerative colitis (36.17/10(5)). In ulcerative colitis, mean annual incidences were 2.91/10(5) and 2.86/10(5) for urban and rural areas respectively. In Crohn's disease, they were 1.37/10(5) and 1.08/10(5) for urban and rural areas respectively. Conclusions: The incidence of inflammatory bowel disease seems to increase in Western Blacksea region at the last 10 years. This increment is more prevalent in rural areas.Öğe Evaluation of epicardial adipose tissue and carotid intima-media thickness as a marker of atherosclerosis in patients with inflammatory bowel disease(ARÁN EDICIONES, S.L., 2021) Ekmen, Nergiz; Can, Güray; Yozgat, Ahmet; Can, Hatice; Bayraktar, Muhammed Fatih; Demirkol, Muhammed Emin; Kayhan, Meral Akdoğan; Sasani, HadiBackground and aim: this study aimed to compare carotid intima media (CIMT) and epicardial adipose tissue (EAT) measurements, which are considered as markers for the detection of early atherosclerosis in healthy controls and inflammatory bowel disease (IBD) cases. Methods: a total of 60 IBD patients (25 Crohn’s disease and 35 ulcerative colitis) and 60 healthy patients (as a control group) were included in the study. The measurements of CIMT and EAT were performed using echocardiography and ultrasonography, respectively. Statistical analysis was used to determine the relationship between the parameters. Results: the thickness of bilateral (right and left) CIMT and EAT were significantly higher in IBD than in the control group (p < 0.05). There was a positive correlation between EAT and bilateral (right and left) CIMT in IBD patients (p < 0.05). Conclusion: IBD is associated with an increased thickness of EAT and CIMT. Chronic inflammation in IBD may increase the risk of atherosclerotic heart disease. Thus, only measur ing the thickness of EAT and CIMT can be used as an objec tive, easy, simple, affordable, non-invasive and accessible assessment method in order to screen for this riskÖğe Gamma-glutamyl-transferase may predict COVID-19 outcomes in hospitalised patients(Wiley-Hindawi, 2021) Kasapoğlu, Benan; Yozgat, Ahmet; Tanoğlu, Alpaslan; Can, Güray; Sakin, Yusuf SerdarAim In this study, we aimed to define the predictive role of liver function tests at admission to the hospital in outcomes of hospitalised patients with COVID-19. Material and Method In this multicentric retrospective study, a total of 269 adult patients (>= 18 years of age) with confirmed COVID-19 who were hospitalised for the treatment were enrolled. Demographic features, complete medical history and laboratory findings of the study participants at admission were obtained from the medical records. Patients were grouped regarding their intensive care unit (ICU) requirements during their hospitalisation periods. Results Among all 269 participants, 106 were hospitalised in the ICU and 66 died. The patients hospitalised in ICU were older than patients hospitalised in wards (P = .001) and expired patients were older than alive patients (P = .001). Age, elevated serum D-dimer, creatinine and gamma-glutamyl transferase (GGT) levels at admission were independent factors predicting ICU hospitalisation and mortality in COVID-19 patients. Conclusion In conclusion, in hospitalised patients with COVID-19, laboratory data on admission, including serum, creatinine, GGT and d-dimer levels have an important predictive role for the ICU requirement and mortality. Since these tests are readily available in all hospitals and inexpensive, some predictive formulas may be calculated with these parameters at admission, to define the patients requiring intensive care.Öğe Ileum and colon perforations in a young patient with Behcet's disease(Aves, 2015) Kurt, Şule; Poşul, Emrah; Can, Güray; Şit, Mustafa; Yılmaz, Bülent; Korkmaz, Uğur; Kurt, MevlütÖğe Ileum and colon perforations in a young patient with Behçet's disease(2015) Kurt, Şule; Posul, Emrah; Can, Güray; Şit, Mustafa; Yilmaz, Bülent; Korkmaz, Uğur; Kurt, Mevlüt-Öğe In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis C in Turkey(AVES, 2022) Yıldırım, Figen Sarıgül; Üser, Ülkü; Sarı, Nagehan Didem; Kurtaran, Behice; Önlen, Yusuf; Can, Güray; Sırmatel, FatmaBackground: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naive patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization's objective of eliminating viral hepatitis.Öğe İnflamatuvar Barsak Hastalıklarında Osteoporoz Sıklığı(2019) Dilekci, Erdal; Tezel, Ahmet; Can, Güray; Demirkol, Mehmet Emin; Dilekçi, Esra Nur Ademoğlu; Gürler, Müjgan; Erkuş, Edipİnflamatuvar barsak hastalıkları, ağırlıklı olarak gastrointestinal sistemi tutan sistemik kronik inflamatuvar bir hastalık grubudur. İnflamatuvar barsak hastalıklarında ekstraintestinal bulgular sıklıkla birlikte bulunmaktadır. Bunlar içinde metabolik kemik hastalıkları azımsanmayacak ölçüde sıktır. Çalışmamızda kendi inflamatuvar barsak hastalıkları kohortumuzda osteoporoz ve osteopeni sıklığını ortaya koymayı amaçladık. Bu çalışmaya 71 ülseratif kolit, 44 Crohn hastasının kemik mineral dansite verileri retrospektif olarak değerlendirildi. İnflamatuvar barsak hastalığında tanı, tutulum paterni, hastalık davranışı, cinsiyet ve kemik mineral dansite lokalizasyonlarına göre kemik dansiteleri, T ve Z skorları karşılaştırıldı. Ülseratif kolit hastalarının %53,5’inde, Crohn hastalarının %50’sinde osteopeni saptandı. Ülseratif kolit ile Crohn hastalığı arasında anlamlı fark yoktu. Ülseratif kolit hastalarının %22,5’inde, Crohn hastalarının %25’inde osteoporoz saptandı. Ülseratif kolit ile Crohn hastalığı arasında anlamlı fark yoktu. Crohn hastalığında osteopeni en sık femur boynu ve wards üçgeninde (%47,7 ve %47,7), ülseratif kolit hastalarında osteopeni en sık wards üçgeninde (%52,1) saptandı. Ülseratif kolit ve Crohn hastalığında osteoporoz en sık lomber bölgede (sırasıyla %15,5 ve %18,2) tespit edildi. Ülseratif kolit ve Crohn hastalığı arasında osteoporoz ve osteopeni açısından anlamlı fark izlenmedi. Ülseratif kolit ve Crohn hastalığında alttip, davranış, cinsiyet ve kemik mineral dansite lokalizasyon açısından karşılaştırıldığında anlamlı fark saptanmadı. İnflamatuvar barsak hastalığında osteoporoz ve osteopeni sıklığı artmıştır. Bulgularımızı doğrulamak için daha büyük örneklem büyüklüğüyle ve iyi dizayn edilmiş prospektif çalışmalara ihtiyaç vardır.
