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Öğe A rare cause of abdominal pain: Mesenteric panniculitis(2021) Düzenli, Tolga; Köseoğlu, HüseyinA 54-year-old woman presented to the emergency department with complaint of abdominal pain lasting for 3 days. Her abdominal pain was in the epigastric region spreading to the left lower quadrant. Oral and IV contrasted abdominal computed tomography (CT) revealed inflammation surrounded by heterogeneous pseudocapsule in the mesenteric fatty tissue starting from the mesenteric root. This inflammation encircled the mesenteric artery and veins and there was a fat halo sign around the vein (Fig. 1). The patient’s condition significantly improved with conservative treatment including antibiotics (ceftriaxone i.v.) and nonsteroidal anti-inflammatory drugs (NSAIDs) (diclofenac i.m.).Öğe Endoscopic Retrograde Cholangiopancreatography During the COVID-19 Pandemic: Effects of Enhanced Personal Protective Equipment(Springer, 2021) Düzenli, Tolga; Köseoğlu, HüseyinBackground and Aims Personal protective equipment (PPE) decreases the risk of disease contagion, and because of the COVID-19 pandemic, enhanced PPE (EPPE) is widely used during endoscopic procedures including endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to investigate the effects of EPPE on ERCP success parameters compared to standard PPE (SPPE). Methods ERCP procedures were evaluated retrospectively and ERCP outcomes were compared for similar time periods as before and after the COVID-19 pandemic. Primary outcomes were cannulation time, number of cannulation attempts, cannulation success rate, difficult cannulation rate, undesired pancreatic duct cannulation rate, ERCP-related adverse events, and length of hospital stay. Results Three hundred and eighty ERCP procedures were examined. One hundred and fifty-nine procedures were excluded due to missing data, previous sphincterotomy or altered anatomy. Of the final eligible sample size of 221 ERCPs, 93 were performed using SPPE and 128 were performed under EPPE. Indications of ERCP and demographic parameters were similar between groups. The majority of the ERCP cases included were for benign biliary obstruction of common bile duct stones (88.7%). No significant differences were detected in overall technical success (91.4% vs 92.2%, p = 0.832), cannulation success rates (94.6% vs 96.8%, p = 0.403), cannulation times (median times of both groups were 3 min, p = 0.824), difficult cannulation rates (37.6% vs 33.6%, p = 0.523), undesired pancreatic duct cannulation rates (29% vs 22.7%, p = 0.593), number of cannulation attempts (2.80 vs 2.71, p = 0.731), ERCP-related adverse events (9.7% vs 10.9%, p = 0.762), and length of hospital stay (6.63 vs 6.92 days, p = 0.768) between SPPE and EPPE groups, respectively. Conclusion Biliary obstructions of common bile duct stones were the major indication of ERCP in the current study. The use of EPPE had no negative effects on ERCP performance in this patient group. ERCP can be effectively performed under EPPE.Öğe Endoscopic Retrograde Cholangiopancreatography in Patients with Post-Operative Bile Duct Injuries: Experience of a Tertiary Center in Turkey(Aves, 2021) Düzenli, Tolga; Köseoğlu, Hüseyin; Aktı, Elif Sümeyye; Yılmaz, BarışObjective: The aim of this study was to determine the effectiveness and safety of endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and treatment of post-operative bile duct injuries and to share our experience of a tertiary referral center. Methods: Patients who underwent ERCP in our hospital due to biliary injuries after biliary surgery between January 2017 and March 2020 were included in this study. Demographic data, etiologies, clinical conditions, endoscopic treatment methods, and results of the patients were analyzed. Results: A total of 30 patients (16 females and 14 males) were included in this study. Twenty-six patients experienced bile leakage or stenosis after cholecystectomy, and four patients had hepatic hydatid cyst surgery. ERCP was successful in 25 patients (83.3%), but four (13.3%) patients underwent surgery and one patient (3.3%) underwent percutaneous transhepatic cholangiography after failed ERCP. Among the patients who had biliary stenting, biliary leakage was recovered in all of the patients, and repeat ERCP revealed that 18.2% of the patients had stones or mud in the common bile duct. The median time to ERCP was 6.5 days, and there was no difference between early (first 10 days) or late (10-30 days) ERCPs in terms of effectiveness and safety. Conclusion: ERCP is a safe and effective method that should be considered before percutaneous procedures and surgery, whether surgery to ERCP time is early or late. Biliary stenting effectively recovers biliary leakage, and stent removal by repeat ERCP should be performed to check the common bile duct for stones or mud, instead of solely stent removal.Öğe Evaluation of Monocyte to High-Density Lipoprotein Cholesterol and Neutrophil to High-Density Lipoprotein Cholesterol Ratios as Indicators of Inflammation in Patients with Celiac Disease(ERCIYES UNIV SCH MEDICINE, 2022) Düzenli, Tolga; Köseoğlu, Derya; Köseoğlu, HüseyinObjective: Celiac disease (CD) is an autoimmune disease with multisystemic manifestations that may be consequences of autoimmunity, inflammation, or malabsorption. The monocyte to high-density lipoprotein cholesterol ratio (MHR) and the neutrophil to high-density lipoprotein cholesterol ratio (NHR) are recent markers of inflammation. The aim of the present study was to analyze the relationship between the MHR, NHR, and CD and to examine whether these measures might be used as inflammatory markers in CD. Materials and Methods: This cross-sectional, retrospective study included 153 participants. The data of 50 patients with CD and 103 healthy individuals enrolled as a control group were evaluated. Receiver operating characteristic (ROC) analysis and the corresponding area under the curve (AUC) calculation were performed to assess the discriminatory ability of the MHR and the NHR. Results: The MHR and the NHR were both high in the study participants with CD (p<0.001). ROC analysis revealed an AUC value of 0.725 (95% confidence interval [CI]: 0.639-0.811) for the MHR and 0.695 (95% CI: 0.598-0.792) for the NHR (p<0.001). The cut-off value for MHR was 9.312 (sensitivity: 76.7%, specificity: 65%) and 77.79 for NHR (sensitivity: 67.4%, specificity: 65%). No statistically significant correlation was seen between the MHR and NHR values and the modified Marsh scores of the patients with CD. Conclusion: The current study is believed to be the first in the literature to explore and demonstrate that the MHR and the NHR may be indicators in patients with CD. The MHR and the NHR may be promising diagnostic markers for CD.Öğe Global Publication Trends and Research Hotspots of the Gastric Neuroendocrine Neoplasms: A Bibliometric Analysis of the Current Situation(Pera Yayincilik Hizmetleri, 2024) Köseoğlu, Hüseyin; Kaya, Muhammed; Durak, İbrahim; Düzenli, Tolga; Kaymazlı, Mustafa; Sezikli, MesutObjective: Gastric neuroendocrine neoplasms (gNENs) are uncommon tumors, with growing understandings about the disease. Bibliometric analyzes have the advantage of visually depicting the dynamic evaluation of scientific knowledge of a specific topic. The aim of this study was to perform and report bibliometric analysis of gNENs, which was not formerly studied in the literature. Methods: Articles published between 1980 and 2022 within the database of Web of Science Core Collection were included in this bibliometric analysis. Vosviewer package program and Datawrapper were used for bibliometric data interpretation. Results: A total of 2270 articles about gNENs was detected with 63240 citations and an H index of 103. A remarkable increase was detected among the articles for years. Research have focused on gastroenterology and hepatology, endocrinology and metabolism, oncology, general medicine, pathology and surgery areas. Norwegian University of Science Technology was the leading institution about gNENs literature. Modlin IM, had the highest number of articles and citations among the authors. United States, Japan and Italy were the top three countries with the most published articles. Conclusion: This bibliometric study provides an engrossing, insightful conclusion to the research and development trajectory in gNENs with a future perspective.Öğe NLR and PLR as novel prognostic biomarkers of mucosal healing in ulcerative colitis patients treated with anti-TNF(Oxford University Press, 2020) Düzenli, Tolga; Köseoğlu, Hüseyin; Akyol, TanerTo the Editors, We read with curiosity the recently published article titled “Novel Prognostic Biomarkers of Mucosal Healing in Ulcerative Colitis Patients Treated with Anti-TNF: Neutrophil to Lymphocyte Ratio and Platelet-toLymphocyte Ratio” by Bertani et al.1 In the article, authors aimed to assess whether neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) could be used as prognostic markers of antitumor necrosis factor (anti-TNF) treatment response in patients with ulcerative colitis.Öğe NLR as a prognostic marker in metastatic gallbladder cancer?(Elsevier Sci Ltd, 2020) Düzenli, Tolga; Köseoğlu, HüseyinWe recently read with great interest the article by Mady et al. titled ‘Neutrophil to lymphocyte ratio as a prognostic marker in metastatic gallbladder cancer’.Öğe Physician awareness of hepatitis C virus among different departments(Termedia Publishing House Ltd, 2020) Düzenli, Tolga; Köseoğlu, HüseyinAim of the study: To determine the anti-hepatitis C virus (HCV) positivity in our region and to evaluate physician awareness of HCV among different inpatient and outpatient departments in a tertiary reference center in Turkey. Material and methods: This retrospective study was conducted between January 2017 and January 2020. The patients tested for anti-HCV for any reason were enrolled from the data of all patients admitted to our hospital, which is the reference center of the region. Results: A total of 121,492 anti-HCV assays were screened from the computerized database. Total number of patients with a positive anti-HCV result was 891 (0.81 %). HCV RNA was positive in 147 (16.5%) of 891 patients and negative in 389 (43.7%) patients. Unfortunately HCV RNA was not tested in 355 (39.8%) patients. The percentages of the untested patients regarding the departments were 65.38% (n = 85/130) in medical inpatient clinics, 61.02% (n = 72/118) in surgical clinics, 16.67% (n = 88/528) medical outpatient departments, 96.8% (n = 91/94) in surgical outpatient departments, and 90.5% (n = 19/21) in the emergency department. Conclusions: The prevalence of anti-HCV positivity was found to be 0.81% and was stable in Turkey. However, the level of physician awareness for HCV was unsatisfactory, and differed between departments. Because HCV is commonly asymptomatic, positive patients should not be overlooked and adequate treatment should be administered. Awareness of physicians should be increased to prevent delays in the diagnosis of hepatitis C and to reduce the number of untreated patients.Öğe Predictive factors of complications and 30-day mortality in patients undergoing percutaneous endoscopic gastrostomy: the utility of C-reactive protein to albumin ratio(Univ Catholique Louvain-Ucl, 2021) Düzenli, Tolga; Ketenci, Melis; Akyol, Tuğba; Köseoğlu, Hüseyin; Tanoğlu, Alpaslan; Kaplan, Mustafa; Yazgan, YusufBackground and study aims : Percutaneous endoscopic gastrost only (PEG) is a procedure that provides long term enteral nutrition. To investigate the predictors of PEG-related complications and 30-day mortality rates and evaluate the indicators for deciding whether to recommend elective PEG insertions, we sought to determine the complications and early mortality rates of patients who underwent PEG. Patients and methods : We performed a retrospective analysis of consecutive adult patients who had undergone PEG for the first time between October 2016 and January 2019. The predictors of complications and 30-day modality were analyzed with receiver operating characteristic (ROC) and logistic regression analysis. Results : This study included 309 patients. Patients were excluded from the study if they were < 18 years of age or there were missing data about them. Out of 253 patients, 33 (13%) had complications and 32 (12.6%) died within one month after PEG insertion. A higher C-reactive protein (CRP) to albumin ratio was the only independent factor predicting the complications (odds ratio (OR) : 3.17 ; 95% CI : 1.26-8.00 ; p = 0.014). The independent predictive factors for 30-day mortality after PEG placement included higher urea levels and higher CRP to albumin ratios (OR : 3.78 ; 95% CI : 1.41-10.17 ; p = 0.008) (OR : 6.67 ; 95% CI : 1.87-23.75 ; p = 0.003). The only predictor for both complications and 30-day mortality was the CRP to albumin ratio. Conclusions : When appropriate, the PEG procedure can provide a safe and effective method for enteral feeding. The CRP to albumin ratio can be used to predict complications and early mortality after PEG insertion. Because PEG is elective, higher CRP to albumin ratios can be helpful in deciding to select patients for the procedure.Öğe Predictive role of neutrophil to lymphocyte ratio in patients with intrahepatic cholangiocarcinoma submitted to treatment of 90Y-microspheres(Lippincott Williams & Wilkins, 2020) Düzenli, Tolga; Köseoğlu, HüseyinWe read the recently published article entitled ‘Prognostic value of neutrophil-to-lymphocyte ratio and its correlation with fluorine-18-fluorodeoxyglucose metabolic parameters in intrahepatic cholangiocarcinoma submitted to 90Y-radioembolization’ by Filippi et al. [1] with interestÖğe Relationship between liver histology and platelet parameters in patients with chronic hepatitis B(2019) Çoşgun, Cihat; Karabulut, Alpaslan; Yılmaz, Barış; Köseoğlu, Hüseyin; Demir, EmrePurpose: Many noninvasive tests have been studied for the diagnosis and determining the liver fibrosis score. In this study, we aimed to research the correlation of platelet parameters and stage of liver fibrosis in patients with chronic hepatitis B (CHB). Materials and Methods: A total of 140 biopsy-proven naive CHB cases were included in the study. HBV-DNA level, liver enzymes and function tests, white blood cell count, platelet parametres, hemoglobin, histological activity index (HAI) and other routine biochemical parameters were tested. Patients were divided into two groups as F0-2 and F3-6 with Ishak scoring system according to the severity of liver fibrosis. Results: There was no significant difference between the groups F0-2 and F3-6 in terms of, platelet (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT). There was a significant difference between these two groups for HAI, aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), age and lymphocyte (LYM) parameters. The formulation of (AST x Age x LYM) / ?PLT)which was formed from many different combinations, was investigated in order to be used in predicting the liver fibrosis stage. Conclusion: Although our new index is more sensitivitythan other noninvasive scoring systems, it is needed to have a larger sample size in patients with severe stage liver fibrosis in order to be used safely as a noninvasive marker.Öğe The predictive value of neutrophil-lymphocyte ratio and mean platelet volume in patients with colorectal carcinoma(2020) Köseoğlu, Hüseyin; Akar, Mustafa; Sarı, Sevil Özer; Solakoğlu, Tevfik; Polat, Yunus Halil; Tahtacı, Mustafa; Ersoy, OsmanAim: This study aimed to investigate neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) for predicting colorectal cancer (CRC). Material and Methods: We investigated retrospectively patients who underwent colonoscopy. The study consisted of 75 patients with CRC and 91 study participants with normal colonoscopy as control group, and MPV and NLR were compared between groups. MPV and NLR were also investigated for tumor stage and metastasis. Results: Among the CRC patients the mean NLR value (3.09 vs 2.26) and PLT count (287080 vs 251857) were significantly higher, whereas the mean MPV (9.62 vs 10.68 fL) and hemoglobin level (11.62 vs 14.18 g/dl) were significantly lower in the CRC group. WBC count was not significantly different between the groups. Mean NLR in metastatic patients and non-metastatic patients were 3.56 and 2.73, respectively (p:0.01). Conclusion: We showed that high NLR and low MPV are associated with CRC. Elevated NLR is related with presence of CRC and it can be used for risk prediction. Although we found lower MPV levels, conflicting results about MPV in CRC prevents it from using as a marker in CRC.Öğe The relationship between severity of ulcerative colitis and thiol-disulphide homeostasis(Comenius University, 2018) Neşelioğlu, Salim; Keşke, P. B.; Senat, Aydın A.; Tayfur Yürekli, Öykü; Erdoğan, S. Ayça; Alışık, Murat; Ergin, Merve; Köseoğlu, Hüseyin; Ersoy, Özlem; Erel, ÖzcanOBJECTIVES: The aim of the study was to determine dynamic thiol-disulphide homeostasis in patients with ulcerative colitis, compare it with those of healthy control and to investigate the relationship between the severity of the disease and homeostasis METHODS: A total of 78 patients and 58 healthy subjects were included in the study. Serum native thiol, total thiol and disulphide amounts were measured by using a novel automated method. Obtained results were compared and relationships were determined by correlation analysis. RESULTS: Serum native thiol, total thiol, disulphide amounts and disulphide/native thiol percent ratio (index) were significantly lower (p = 0.003 for index ratio and p < 0.001 for other parameters) in patients with ulcerative colitis than in healthy controls. Native thiol, total thiol and disulphide amounts were significantly higher (p < 0.001) in patients with ulcerative colitis in remission than in patients with active ulcerative colitis and near to those of healthy control. There were significant negative correlations between the severity of the disease and thiol-disulphide homeostasis parameters (r = -0.55, p < 0.001 for native thiol; r = -0.64, p < 0.0001 for total thiol; r = -0.65, p < 0.001 for disulphide and r = -0.33, p = 0.011 for index). CONCLUSION: The thiol-disulphide homeostasis was weakened in ulcerative colitis. Strong correlations between the activity of the disease and thiol-disulfide homeostasis indicate that homeostasis may play a role in the pathogenesis of the disease. © 2018, Comenius University.Öğe The use of prealbumin as a predictor of malnutrition in cirrhotic patients and the effect of nutritional support in patients with low prealbumin levels(2020) Dağ, Zuhal; Köseoğlu, Hüseyin; Kekilli, MuratBackground/aim: Malnutrition is an important and commonly seen prognostic factor in patients with cirrhosis. The diagnosis of malnutrition in cirrhosis patients may be challenging, and an easily measured and widely usable marker is lacking. Prealbumin, however, is an easily measured marker. In the current study we measured prealbumin levels in cirrhotic patients with no clinically apparent malnutrition and used it as a malnutrition marker. Another aim of this study was to evaluate the effect of nutritional support on patient with low prealbumin levels. Materials and methods: Fifty-two patients with Child A and Child B cirrhosis were selected for the study. Prealbumin levels were studied, and Child and MELD scores were calculated. Patients with prealbumin levels ?180 mg/L were considered to have malnutrition, and two different types of nutritional products were given to these patients. The patients given nutritional support were investigated a month later, and parameters were compared. Results: According to the prealbumin threshold of 180 mg/L, malnutrition frequencies were 59.3% for Child A and 95% for Child B cirrhosis. After the provision of nutritional support statistically significant improvements in albumin and INR levels were detected. In addition, the MELD score decreased; however, it was not statistically significant (P: 0.088). A statistically significant decrease in the MELD score was only obtained in patients with Child B cirrhosis (P: 0.033). When the oral replacement therapies were investigated separately, a statistically significant decrease in MELD scores was detected with product 1 (P: 0.043). Conclusion: Prealbumin can be used as an easily measured parameter for earlier detection of malnutrition in patients with cirrhosis and without clinically apparent malnutrition. Oral nutritional support, especially with products containing relatively high carbohydrate levels and low protein, may have a favorable effect on MELD scores.
