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Biomedical subjects

S Boyacioğlu

Publications and source records attributed to S Boyacioğlu.

At least 37 records · Page 2Linked to original sources
PubMed1998

Hepatitis G virus infection in haemodialysis patients and its relationship with hepatitis C virus RNA positivity.

A novel RNA virus designated hepatitis G virus (HGV) was identified recently in patients with acute and chronic liver disease. Since HGV may be transmitted parenterally, chronic haemodialysis (HD) patients are at increased risk for acquiring this infection. 110 chronic HD patients were studied (56 HCV-RNA and anti-HCV-positive, and 54 HCV-RNA and anti-HCV-negative). HGV-RNA and HCV-RNA were studied by RT-PCR. HCV genotype determination was applied to all 56 HCV-RNA-positive patients. 28 of 110 (25%) patients were found be HGV-RNA-positive. HCV-RNA-positive patients had higher rate of HGV-RNA positivity compared with HCV-RNA-negative patients. The HCV genotypes of HGV-RNA-positive patients were mostly 4 (48%) and 1b (33%). HGV was not linked with HBsAg positivity. While there was a significant correlation between HCV-RNA positivity and the number of blood transfusions and duration of HD, we did not observe this relationship in HGV-RNA-positive patients. These results indicate that the prevalence of HGV is high in HD patients and that HGV-RNA positivity is higher in HCV-RNA-positive patients.

Adult↗
PubMed1997

Helicobacter pylori infection in haemodialysis patients and renal transplant recipients.

BACKGROUND: It is known that Helicobacter pylori (Hp) plays an important role in gastritis and peptic ulcer disease in the general population. Although dyspeptic complaints are frequent in haemodialysis (HD) patients and renal transplant recipients, there are few reports regarding the prevalence of Hp and its possible effects on this group of patients. This study was performed to examine the prevalence of Hp infection in patients on regular HD treatment and to detect its role in the pathogenesis of dyspepsia in this group of patients. METHODS: Two hundred and one patients with dyspeptic complaints were included in the study. The groups consisted of 47 HD, 54 renal transplant recipients, and 100 non-renal disease patients. Upper gastro-intestinal endoscopies were performed and gastric antral biopsies were obtained for urease test in all patients. RESULTS: Twenty-eight (60%) of the 47 HD and 38 (70%) of the 54 RTR were positive for Hp. Sixty-four (64%) of the 100 patients with various gastrointestinal complaints and known to have no renal dysfunction were positive for Hp. The Hp prevalences among the three groups were not significantly different (P > 0.05). The prevalence of Hp infection did not correlate with the haemodialysis duration nor the post-transplantation duration (P > 0.05). There was no correlation between the prevalence of Hp infection and duration of haemodialysis therapy or time post-transplantation. CONCLUSION: These findings suggest that HD patients are not protected against Hp infection as the Hp prevalences are as high as that for the non-renal disease group. The increased dyspeptic complaints may be partly related to Hp infection.

Adult↗
PubMed1997

Histopathological impacts of hepatitis virus infection in hemodialysis patients: should liver biopsy be performed before renal transplantation?

To evaluate the histologic changes in the livers of renal transplant candidates who were infected with hepatitis viruses, we performed a percutaneous liver biopsy in each of 74 regular hemodialysis patients. Forty percent of them were seropositive for the antibody to hepatitis C virus (anti-HCV) whereas 29.7% had anti-HCV and antibody to hepatitis B surface antigen (anti-HBs) concomitantly. Seven (9.5%) were seropositive for only hepatitis B surface antigen HBsAg. Histopathological examination revealed that 30% of patients had chronic active hepatitis (CAH), 11% had chronic persistent hepatitis (CPH), and 3% displayed histopathological evidence of cirrhosis. Eleven of 22 patients with CAH were positive for only anti-HCV, and 2 of 22 were positive for only HBsAg. One patient had HBsAg and anti-HCV together, and 8 of 22 had anti-HBs and anti-HCV concomitantly. None of the anti-HBs positive patients exhibited abnormal histopathological changes. We found no statistically significant difference in histopathological findings between the HBsAg positive and anti-HCV positive patients. As 32 of 74 patients (43%) had some degree of chronic liver disease, we concluded that it is prudent to evaluate liver histology in HBsAg and anti-HCV seropositive renal transplant candidates before transplantation.

Adult↗
PubMed1995

Recombinant alpha-interferon in renal allograft recipients with chronic hepatitis C.

BACKGROUND: Although chronic hepatitis C infection is one of the factors that can lead to morbidity and mortality in renal allograft recipients, treatment procedures have not been well documented. Interferon treatment has been shown to be effective in the normalization of biochemical hepatitis C and in the clearing of hepatitis C virus RNA. However, little is known concerning the efficacy and safety of interferon treatment in renal allograft recipients with chronic hepatitis C. Interferon has also been accused of increasing renal allograft rejection. METHODS: Recombinant alpha-interferon in a dose of 4.5 million units three times per week was given to five renal-allograft recipients with chronic hepatitis C for 6 months. Besides biochemical investigations, liver histopathologies before and after the treatment course were also studied. RESULTS: Interferon treatment was effective in two of the patients, in another two cases renal function deteriorated during the treatment. In the last case ALT increased again after cessation of interferon therapy. CONCLUSION: We conclude that interferon seems to be moderately effective in treating chronic hepatitis C in renal allograft recipients, but a risk of renal functional deterioration and rejection remains.

Adult↗
PubMed1993

Ultrasonographic scoring system: an auxiliary to differential diagnosis of gastric pathologies.

In a prospective clinical study, 64 patients with gastric pathologies (27 malignant and 37 benign) were examined ultrasonographically. Gastric wall layer changes, gastric wall thickness, lesion length, and protrusion into the lumen were evaluated. A scoring system was defined based on the distribution of these parameters and the score of each patient was calculated retrospectively. Six of the malignant cases had scores in the benign range and 3 of the benign cases had scores in the malignant range. Sensitivity of this scoring system in terms of detecting malignancy was 78% and specificity 92%. The positive predictive value was 88%, the negative predictive value was 85%, and overall diagnostic accuracy was 86%. This scoring system was considered to be a useful aid in the differential diagnosis of gastric pathologies.

Diagnosis, Differential↗
PubMed1991

The ultrasonographic diagnosis of bleeding into a pancreatic pseudocyst.

Bleeding into a pancreatic pseudocyst is a rare but life-threatening entity. Early diagnosis is crucial in its management. There are reports suggesting that computed tomography (CT), scintigraphy, endoscopic retrograde cholangiopancreatography (ERCP), and angiography could be the diagnostic maneuvers. In this report, we present a case of arterial bleeding into a pancreatic pseudocyst, which was diagnosed by the turbulent echo-currents seen in real-time ultrasonography.

Female↗
PubMedDate not supplied

Portacaval shunt creation using the percutaneous transhepatic-transjugular technique.

BACKGROUND: The feasibility and efficacy of portacaval shunt creation through the transhepatic and transjugular approach were evaluated in patients with portal hypertension whose hepatic venous anatomies were unsuitable for the standard shunt procedure. METHODS: Portacaval shunts were created via percutaneous transhepatic access in six patients. We used snares to target the portal vein and the inferior vena cava. Then a needle was introduced percutaneously and advanced through the snares. A guidewire was advanced through the needle and snared in the inferior vena cava. The wire was then withdrawn through the transjugular sheath. The rest of the procedure was completed in standard fashion. The transhepatic tracts were embolized. RESULTS: The portacaval shunt procedures were successful in all patients. There were no major complications during the procedures, but one patient died of sepsis 1 week later. Two patients developed shunt occlusion, and in one case the shunt was revised successfully. The other patient with occlusion underwent orthotopic liver transplantation. The shunts in the remaining three patients and the revised shunt were patent at 5 to 20 months of follow-up. CONCLUSION: Direct portacaval shunt creation using the percutaneous transhepatic and transjugular technique is a good alternative when standard portosystemic shunt creation is difficult or impossible.

Adult↗
PubMedDate not supplied

Association of helicobacter pylori infection with nutritional status in hemodialysis patients.

The presence of Helicobacter pylori (HP) infection may adversely influence outcome in renal transplant candidates because of its strong association with gastrointestinal disorders. We examined the association between HP infection and nutritional parameters in symptom-free hemodialysis patients and assessed prospectively the nutritional changes in patients who received therapy for the disease. The 163 study patients, including 114 men and 69 women of mean age 41.5 +/- 12.9 years on dialysis for 67.2 +/- 47.6 months, were selected from among the group who underwent routine endoscopic evaluation according to our renal transplant protocol. Patients with active peptic ulcer, acute gastritis, chronic inflammatory disease, malignancy, or diabetes mellitus were excluded. Endoscopy results revealed normal findings in 60 (group 1), gastritis in 86 (group 2), or gastritis with HP in 17 patients (group 3). Group 3 patients received a 2-week course of triple therapy (omeprazole, amoxicillin, clarithromycin). The patient groups were compared for nutritional metrics (albumin, phosphorus, interdialytic weight gain [IDWG], body mass index [BMI]), inflammatory indices (CRP, fibrinogen), and iPTH levels. Group 3 patients were observed to be malnourished when compared with groups 1 and 2, namely abnormal values of albumin (P <.0001), phosphorus (P <.009), IDWG (P <.03), and BMI (P <.02). Repeat endoscopy revealed a 94% rate of eradication of HP with increased levels of albumin and phosphorus in group 3. Although symptom-free hemodialysis patients with HP-associated gastritis displayed a state of malnutrition; its eradication improved the nutritional status. Therefore, the presence of HP infection should be sought and its eradication mandatory for this patient population.

Adult↗
PubMedDate not supplied

Colonoscopy is a useful diagnostic tool for transplant recipients with lower abdominal symptoms.

Transplant recipients are at higher risk for infection and malignancy due to therapies aimed at preventing rejection. Early detection and successful treatment of such complications is of pivotal importance for both patient and graft survival. In this study, we evaluated findings of 91 colonoscopies and colonic histopathologic findings in recipients who presented with lower gastrointestinal system complaints between January 1996 and January 2003. The study group included 79 renal and liver transplant patients. The indications for colonoscopy were diarrhea (n = 58), abdominal pain (n = 5), hematochezia (n = 19), unexplained anemia (n = 5), thickening of a colonic segment detected on computerized tomography (n = 2), screening for lymphoma (n = 1), and Kaposi's sarcoma (n = 1). During the procedures, all suspicious lesions were biopsied and specimens of normal-appearing mucosa collected when deemed necessary in relation to the clinical complaints. The endoscopic findings were classified as follows: 0 = "normal," with clear visualization of the vascular network and normal-appearing mucosa; 1 = "erythema", with tissues showing erythema, edema, hyperemia, and loss of normal vascular network; 2 = "ulcerative," with tissues exhibiting ulceration and fragility; and 3 = "coincidental findings," such as polyp or angiodysplasia. Colonoscopic and/or histopathologic abnormalities were detected in 44.5% of the 91 colonoscopy procedures. The results indicate that colonoscopy is a valuable diagnostic tool for evaluation of transplant recipients with lower gastrointestinal complaints. After an initial workup colonoscopy is important to establish an accurate diagnosis.

Adolescent↗
PubMedDate not supplied

Investigation of possible clinical and laboratory predictors of liver fibrosis in hemodialysis patients infected with hepatitis C virus.

Hepatitis C virus (HCV) infection is common in patients with end-stage renal disease. The severity of liver damage, including fibrosis, in these cases varies widely. Although many investigators have searched for noninvasive alternatives to liver biopsy for evaluating the extent of liver fibrosis, no useful noninvasive predictors have been found. Currently, liver biopsy is essential to assess the degree of fibrosis. The aim of this retrospective study was to investigate a range of clinical and laboratory parameters in HCV-infected hemodialysis (HD) patients and identify possible predictors of fibrosis. Ninety-five consecutive HD patients with HCV infection underwent liver biopsy. Each specimen was evaluated for fibrosis stage. Correlations were sought between the degree of fibrosis and the age, HD duration, time since first possible HCV exposure, body mass index, HCV RNA titer, serum ferritin level, and serum alanine aminotransferase (ALT) level. The analysis revealed no significant correlations between fibrosis stage and the parameters investigated (mean age: r =.017, P =.89; mean HD duration: r =.066, P =.576; body mass index r =.231, P =.152; HCV RNA titer: r =.015, P =.091; serum ferritin: r =.134, P =.32; serum ALT r =.108, P =.927). Links with serum ALT were reevaluated with upper normal levels arbitrarily set at 30 IU/L and 20 IU/L, but these analyses also revealed no correlations between fibrosis stage and ALT level (P =.98 and P =.449, respectively). Therefore liver biopsy is still essential for accurate assessment of liver pathology in HD patients with HCV.

Biopsy↗
PubMedDate not supplied

MRI of hydatid disease of the liver: a variety of sequences.

Hydatid disease is a parasitic manifestation that is most commonly seen in the liver. Diagnosis of this condition in the liver is usually straightforward and achieved through US and CT. Complicated cases and the often bizarre appearance of the disease can frequently create problems for the diagnostician, however. MRI has become an important diagnostic tool in the evaluation of complicated liver masses, with routine application of fat-suppressed, fast, and breath-hold techniques. In this pictorial essay, we demonstrate various features of hydatid disease using these new methods.

Contrast Media↗