1.A Lower Serum Gamma-Glutamyltransferase Level Does Not Predict a Sustained Virological Response in Patients with Chronic Hepatitis C Genotype 1.
Fatih GUZELBULUT ; Mesut SEZIKLI ; Zuleyha Akkan CETINKAYA ; Selvinaz OZKARA ; Can GONEN ; Ayse Oya Kurdas OVUNC
Gut and Liver 2013;7(1):74-81
BACKGROUND/AIMS: Low gamma-glutamyltransferase (GGT) level was shown to be an independent predictor of a sustained virological response (SVR) in chronic hepatitis C. We aimed to determine factors associated with high GGT level, and to evaluate whether low GGT level is an independent predictor of a SVR in chronic hepatitis C genotype 1. METHODS: We retrospectively reviewed our data of patients with chronic hepatitis C genotype 1 treated with pegylated interferon-alpha and ribavirin. Baseline features were compared between patients with normal and high GGT levels. Factors associated with high GGT level and those associated with a SVR were determined by univariate and multivariate analysis. RESULTS: This study included 57 patients. Mean age was 52.28+/-9.35 years. GGT levels was elevated in 27 patients (47.4%). GGT levels were normal in 63.3% of the patients who achieved a SVR and in 40.7% of those who did not achieve a SVR (p>0.05). By multivariate logistic regression analysis, the presence of cirrhosis (odds ratio [OR], 9.41; 95% confidence interval [CI], 1.08 to 102.61) and female gender (OR, 6.77; 95% CI, 1.23 to 37.20) were significantly associated with high GGT level, and only rapid virological response was associated with a SVR (OR, 8.369; 95% CI, 1.82 to 38.48). CONCLUSIONS: Low GGT level does not predict a SVR; however, it may be a predictor of high fibrosis scores.
Female
;
Fibrosis
;
gamma-Glutamyltransferase
;
Genotype
;
Hepatitis C, Chronic
;
Hepatitis, Chronic
;
Humans
;
Interferon-alpha
;
Logistic Models
;
Retrospective Studies
;
Ribavirin
2.Red Cell Distribution Width: A Novel Marker of Activity in Inflammatory Bowel Disease.
Atakan YESIL ; Ebubekir SENATES ; Ibrahim Vedat BAYOGLU ; Emrullah Duzgun ERDEM ; Refik DEMIRTUNC ; Ayse Oya KURDAS OVUNC
Gut and Liver 2011;5(4):460-467
BACKGROUND/AIMS: Studies concerning red cell distribution width (RDW) for use in the assessment of inflammatory bowel disease (IBD) activity are limited. We investigated whether RDW is a marker of active disease in patients with IBD. METHODS: In total, 61 patients with ulcerative colitis (UC) and 56 patients with Crohn's disease (CD) were enrolled in the study group, and 44 age- and-sex-matched healthy volunteers were included as the control group. A CD activity index >150 in patients with CD indicated active disease. Patients with moderate and severe disease based on the Truelove-Witts criteria were considered to have active UC. In addition to RDW, serum C-reactive protein levels, erythrocyte sedimentation rates, and platelet counts were measured. RESULTS: Twenty-nine (51.7%) patients with CD and 35 (57.4%) patients with UC had active disease. The RDW was significantly higher in patients with CD and UC than in controls (p<0.001 and p<0.001, respectively). A subgroup analysis indicated that for a RDW cut-off of 14%, the sensitivity for detecting active CD was 79%, and the specicity was 93% (area under curve [AUC], 0.935; p<0.001). RDW was the most sensitive and specific marker for active CD. However, it was not valid for UC, as the ESR at a cutoff of 15.5 mm/hr showed a sensitivity of 83% and a specicity of 76% (AUC, 0.817; p<0.001), whereas the RDW at a cutoff of 14% showed 17% sensitivity and 84% specicity for detecting active UC. CONCLUSIONS: RDW was elevated in IBD in comparison with healthy controls and increased markedly in active disease. RDW may be a sensitive and specific marker for determining active CD, whereas ESR is an important marker of active UC.
Blood Sedimentation
;
C-Reactive Protein
;
Colitis, Ulcerative
;
Crohn Disease
;
Erythrocyte Indices
;
Humans
;
Inflammatory Bowel Diseases
;
Platelet Count
3.Efficacy of the Combination of Tetracycline, Amoxicillin, and Lansoprazole in the Eradication of Helicobacter pylori in Treatment-Naive Patients and in Patients Who Are Not Responsive to Clarithromycin-Based Regimens: A Pilot Study.
Mesut SEZIKLI ; Zuleyha Akkan CETINKAYA ; Fatih GUZELBULUT ; Atakan YESIL ; Mustafa Erhan ALTONOZ ; Nuriye ULU ; Ayse Oya OVUNC KURDAS
Gut and Liver 2012;6(1):41-44
BACKGROUND/AIMS: The aim of this study was to evaluate the eradication rate of a triple therapy regimen that included a proton pump inhibitor, amoxicillin, and tetracycline instead of clarithromycin in treatment-Naive patients and in patients who did not respond to standard triple therapy. METHODS: This study included 110 patients infected with Helicobacter pylori. Patients in groups A and B were treatment-Naive, and those in group C were not responsive to previous standard triple therapy. Patients in group A (n=40) received lansoprazole 30 mg b.i.d., amoxicillin 1,000 mg b.i.d., and clarithromycin 500 mg b.i.d. for 14 days. Patients in groups B (n=40) and C (n=30) received lansoprazole 30 mg b.i.d., amoxicillin 1,000 mg b.i.d., and tetracycline 500 mg q.i.d. for 14 days. RESULTS: In group A, eradication was achieved in 18 (45%) of the 40 patients included in the intention-to-treat (ITT) analysis and in 18 (47.4%) of the 38 patients included in the per-protocol (PP) analysis. In group B, eradication was achieved in 15 (37.5%) of the 40 patients included in the ITT analysis and in 15 (39.3%) of the 38 patients included in the PP analysis. In group C, eradication was achieved in 14 (46.6%) of the 30 patients included in the ITT analysis and in 14 (43.8%) of the 29 patients included in the PP analysis. There was no statistically significant difference among the 3 groups with regard to eradication rates (p>0.05). CONCLUSIONS: Despite the low rate of resistance to tetracycline, the combination of lansoprazole, amoxicillin, and tetracycline instead of clarithromycin is not a good option for the eradication of H. pylori.
2-Pyridinylmethylsulfinylbenzimidazoles
;
Amoxicillin
;
Clarithromycin
;
Helicobacter
;
Helicobacter pylori
;
Humans
;
Pilot Projects
;
Proton Pumps
;
Tetracycline