1.Durability of Sustained Virologic Response in Chronic Hepatitis C.
Ahmet UYANIKOGLU ; Sabahattin KAYMAKOGLU ; Ahmet DANALIOGLU ; Filiz AKYUZ ; Fatih ERMIS ; Binnur PINARBASI ; Kadir DEMIR ; Fatih BESISIK ; Yilmaz CAKALOGLU
Gut and Liver 2013;7(4):458-461
BACKGROUND/AIMS: The aim of this study is to investigate the rate of sustained virologic response (SVR) in chronic hepatitis C patients receiving antiviral treatment. METHODS: The files of patients with chronic hepatitis C treated with interferon+/-ribavirin between 1995 and 2009 were reviewed retrospectively. Six months after the end of treatment, patients with negative hepatitis C virus (HCV)-RNA (<50 IU/mL, as determined by the polymerase chain reaction method) were enrolled in the study. RESULTS: The mean age of 196 patients (89 males) was 46.13+/-11.10 years (range, 17 to 73 years). In biopsies, the mean stage was 1.50+/-0.94; histological activity index was 7.18+/-2.43. In total, 139 patients received pegylated interferon (IFN)+ribavirin, 21 patients received classical IFN+ribavirin, and 36 patients received IFN alone. The HCV genotypes of 138 patients were checked: 77.5% were genotype 1b, and 22.5% were other genotypes. After achievement of SVR, the median follow-up period was 33.5 months (range, 6 to 112 months), and in this period relapse was only detected in two patients (1.02%) at 18 and 48 months after treatment. CONCLUSIONS: In total, 98.9% of patients with SVR in chronic hepatitis C demonstrated truly durable responses over the long-term follow-up period of 3 years; relapsed patients had intermittent or low-grade viremia.
Achievement
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Biopsy
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Follow-Up Studies
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Genotype
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Hepacivirus
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Hepatitis C, Chronic
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Hepatitis, Chronic
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Humans
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Interferons
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Polymerase Chain Reaction
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Recurrence
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Retrospective Studies
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Viremia
2.Belching in Irritable Bowel Syndrome: An Impedance Study.
Tuba OBEKLI ; Filiz AKYUZ ; Umit AKYUZ ; Serpil ARICI ; Raim İLIAZ ; Suut GOKTURK ; Sami EVIRGEN ; Bilger CAVUS ; Cetin KARACA ; Kadir DEMIR ; Fatih BESISIK ; Sabahattin KAYMAKOGLU
Journal of Neurogastroenterology and Motility 2017;23(3):409-414
BACKGROUND/AIMS: There are limited data about the relation between belching and irritable bowel syndrome (IBS). We aim to evaluate belching in patients with IBS. METHODS: Twenty-five patients with IBS and 12 healthy volunteers were enrolled in the study. IBS was diagnosed in accordance with the Rome III criteria. All patients were questioned about the presence of symptoms for belching, gastroesophageal reflux disease, and dyspepsia. Esophageal manometry and 24-hour pH-impedance were performed in all patients and healthy volunteers. Each of the patients with IBS underwent gastroscopy and colonoscopy. RESULTS: Demographic features were similar in both groups (P > 0.05). The belching rate was 32% in patients with IBS. The mean DeMeester score was significantly higher in IBS patients (13.80 ± 14.40 vs 6.04 ± 5.60, P = 0.027) and 24% of patients had pathologic acid reflux (DeMeester score > 14). Gastroscopy was normal in all patients. Symptom association probability positivity was detected in 24% of patients in the impedance study. The rate of weak acid reflux was also significantly higher in patients with IBS (97.00 ± 56.20 vs 58.20 ± 29.30, P = 0.025). The number of supine gas reflux (7.50 ± 6.40 vs 2.42 ± 2.80, P = 0.001) and supragastric belches was significantly higher in patients with IBS (51.20 ± 41.20 vs 25.08 ± 15.20, P = 0.035). Although the number of gastric belching was higher in controls, the difference did not reach statistical significance (12.10 ± 17.60 vs 4.90 ± 3.80, P = 0.575). We did not find any correlation between belching and any symptoms of IBS. CONCLUSIONS: Belching is frequent in patients with IBS. Non-erosive reflux disease is frequent in IBS, which may be related to supragastric belching.
Colonoscopy
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Dyspepsia
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Electric Impedance*
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Eructation*
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Gastroesophageal Reflux
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Gastroscopy
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Healthy Volunteers
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Humans
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Irritable Bowel Syndrome*
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Manometry
3. Risk factors associated with progression to intestinal complications of Crohn disease
Yusuf KAYAR ; Bulent BARAN ; Asli Cifcibasi ORMECI ; Filiz AKYUZ ; Kadir DEMIR ; Fatih BESISIK ; Sabahattin KAYMAKOGLU
Chinese Medical Journal 2019;132(20):2423-2429
Background:
Crohn disease is a chronic bowel disease that causes serious complications. Prevalence of Crohn disease is increasing. Studies have shown that the behavior of the disease is not stable and severe complications secondary to behavior change over time have been shown. In this study, we aimed to evaluate the prognostic risk factors associated with phenotypic change in Crohn disease in a Turkish patient cohort.
Methods:
Patients followed up from March 1986 to August 2011 were evaluated for demographic and clinical characteristics to determine possible risk factors and initial clinical phenotype of the disease based on the Montreal classification. The cumulative probabilities of developing stricturing or penetrating intestinal complications were estimated using the Kaplan-Meier analysis. Univariate and multivariate Cox-proportional hazard models were used to assess associations between baseline clinical characteristics and intestinal complications.
Results:
Three hundred and thirty patients (mean age, 30.6 ± 11.1 years; 148 female) were included in the study. Mean follow-up duration was 7.4 ± 5.3 years (range: 1.0-25.0 years). At baseline 273 patients had inflammatory-type disease, 57 patients experienced stricturing/penetrating intestinal complications before or at the time of diagnosis. The cumulative probability of developing complicated disease was 37.4% at 5 years, 54.3% at 10 years, 78.8% at 25 years. Independent predictors associated with progression to intestinal complications were current smoking, perianal disease, extra-intestinal manifestations, and location of disease.
Conclusions
Location of disease is the most powerful indicator for the development of stenosis and penetrating complications in inflammatory-type disease. Patients with ileal involvement should be considered for more aggressive immunosuppressive therapy.