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  • Küçük Resim
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    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 Ziya
    Background: 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 suffering
  • Küçük Resim Yok
    Öğe
    KRONİK HEPATİT B HASTALARINDA İNSULİN DİRENCİ SIKLIĞI
    (2015) Yılmaz, Bülent; Dindar, Gökhan; Duman, Ali Erkan; Yılmaz, Hasan; Öztürkler, Murat; Korkmaz, Uğur; Şentürk, Ömer
    Amaç: Bu çalışmada kronik hepatit B hepatiti tanısı olan hastalarda insülin rezistansı sıklığı ile karaciğer biyopsisinde saptanan fibrozis üzerine etkisini değerlendirmek amaçlanmıştır. Metod: 2010-2012 yılları arasında kronik viral hepatit B tanısı ile takip edilen ve karaciğer biyopsisi yapılan 52 hasta değerlendirildi. Tüm hastalarda tam kan sayımı, glukoz ve biyokimya tetkikleri, hepatit belirteçleri, Hepatit B Virüs DNA düzeyleri çalışıldı. Vücut kitle indeksi (kg/m2) ve insülin direnci (HOMA-IR) = [açlık insülin (µU/mL) X AKŞ (mmol/L)] / 22.5 olarak hesaplandı. Karaciğer histo- lopatolojisi histolojik aktivite indeksi ve fibrozis yönünden Ishak sınıflamasına göre değerlendirildi. Bulgular: Çalışmadaki 52 hastanın 34’inde (%65) insulin direnci mevcuttu. İnsulin direnci olan kronik HBV hastaları ile insulin direnci olmayan Hepatit B Virüs (HBV) hastaları arasında yaş, Alanin Aminotransferaz (ALT), Aspartat Aminotransferaz (AST), fibrozis ve histolojik aktivite indeksi açısından anlamlı fark saptanmadı. Bununla birlikte insulin direnci olan kronik HBV hastalarının insulin direnci olmayan Hepatit B Virüs (HBV) hastalarına göre istatistiksel olarak anlamlı olarak yüksek Vücut Kitle İndeksi (BMİ) ve düşük Hepatit B Virüs DNA değerlerine sahip oldukları görüldü. Sonuç: İnsulin direnci kronik hepatit B hastalarında sıklıkla saptanmaktadır. Kronik hepatit B hastalarında insulin direnci araştırılmalı ve bu hastalara diabetes mellutis hakkında bilgi verilmelidir.