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Öğe Assessment of Evidence for Positive Association and Seroprevalence of Hepatitis B and C in Diabetic Patients in a Developing Country(BMJ PUBLISHING GROUP, 2015) Korkmaz, Huseyin; Kesli, Recep; Pamuk, Bans Onder; Ipekci, Suleyman Hilmi; Terzi, Yuksel; Kebapcilar, LeventBackground and Aim: The data related to the association between hepatitis virus infections and diabetes mellitus (DM) are conflicting. The aim of this study was to investigate the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) and to determine the risk factors affecting the prevalence in Turkish patients with type 1 DM and type 2 DM. Methods: The study consisted of 736 diabetic and 505 nondiabetic patients. Serological investigation for the hepatitis B surface antigen (HBsAg) and the HCV antibody (anti-HCV) was performed with a third-generation commercial chemiluminescence assay. The presence of HBsAg was considered as indicator of HBV infection. The HCV infection in the patients with positive anti-HCV was confirmed by a real-time polymerase chain reaction assay. The patients were divided according to their HBV and HCV infection status, and their demographic features, diabetes properties, general risk factors, and aminotransferase levels were analyzed. Results: There was no significant difference in the seropositivity rate for the HBsAg (3.8% vs 3.0%, P > 0.43; odds ratio, 1.292; 95% confidence interval, 0.683-2.444). However, anti-HCV seropositivity was significantly increased in the DM group (3.3% vs 1.8%, P < 0.03; odds ratio, 2.398; 95% confidence interval, 1.025-5.609). Increased aminotransferase levels and a history of blood transfusions were positively correlated with both HBV and HCV infection. Moreover, a history of surgical procedures and high glycated hemoglobin A1c levels were positively associated with HBsAg antigen seropositivity. Conclusions: Although no significant difference in the seropositivity of the HBsAg was determined, a high prevalence of HCV infection was detected in the DM patients compared to healthy controls.Öğe Autoimmune hepatitis-primary biliary cirrhosis overlap syndrome concomitant with immune hemolytic anemia and immune thrombocytopenic purpura (Evans syndrome)(ELSEVIER MASSON, CORPORATION OFFICE, 2013) Korkmaz, Huseyin; Bugdaci, Mehmet Sait; Temel, Tuncer; Dagli, Mehmet; Karabagli, PinarAutoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) associated with Evans syndrome; combination of autoimmune hemolytic anemia (AIHA) and immune thrombocytopenic purpura (ITP) has rarely been reported. We report the case of a 53-year-old patient who presented with weakness, myalgia, arthralgia, shortness of breath and purpura. Initial laboratory investigations revealed liver dysfunction, anemia and thrombocytopenia. Anti-nuclear (ANA) and antimitochondrial M2 (AMA M2) antibodies were positive. Diagnose of PBC-AIH overlap was made by clinical, serological and histological investigations. AIHA and ITP was identified with clinical-laboratory findings and bone marrow puncture. She was treated with IVIG followed by prednisolone and ursodeoxycholic acid. Hemoglobin-thrombocytes increased rapidly and transaminases improved at day 8. We have reported the first case in the literature with AIH-PBC overlap syndrome concurrent by ITP and AIHA which suggest the presence of shared genetic susceptibility factors in multiple autoimmune conditions including AIH, PBC, ITP and AIHA. (C) 2012 Elsevier Masson SAS. All rights reserved.Öğe Comparison of the Diagnostic Accuracy of Five Different Stool Antigen Tests for the Diagnosis of Helicobacter pylori Infection(WILEY, 2013) Korkmaz, Huseyin; Kesli, Recep; Karabagli, Pinar; Terzi, YukselBackground: Several noninvasive diagnostic tests based on the detection of Helicobacter pylori stool antigen (HpSA) have been developed. The aim of the study was to compare the diagnostic accuracy of 5 HpSA tests-2 monoclonal enzyme immunoassay tests (EIAs: the Premier Platinum HpSA Plus test and Helicobacter pylori Antigen (Hp Ag) test) and 3 rapid immunochromatographic assay (ICA) tests (the ImmunoCard STAT! HpSA test, one step HpSA test, and H. pylori fecal antigen test)-for diagnosing H. pylori infection in adult patients with dyspeptic symptoms before eradication therapy. Materials and Methods: A total of 198 patients with dyspeptic symptoms were included in the study. A gastric biopsy was collected for histopathology and rapid urease testing. Stool specimens for HpSA testing were also collected. Patients were considered H. pylori positive if two invasive tests (histological and rapid urease tests) were positive. Results: The sensitivity and specificity were 92.2% and 94.4%, respectively, for the Premier Platinum HpSA Plus test; 48.9% and 88.9%, respectively, for the HP Ag test; 86.7% and 88.9, respectively, for the One Step HpSA test; 68.9% and 92.6%, respectively, for the ImmunoCard STAT! HpSA test; and 78.9% and 87%, respectively, for the H. Pylori fecal antigen test. Conclusions: The Premier Platinum HpSA Plus EIA test was determined to be the most accurate stool test for diagnosing H. pylori infections in adult dyspeptic patients. The currently available ICA-based tests are fast and easy to use but provide less reliable results.Öğe Cornea in PCOS patients as a possible target of IGF-1 action and insulin resistance(SPRINGER HEIDELBERG, 2014) Kebapcilar, Ayse Gul; Tatar, Mehmet Gurkan; Ipekci, Suleyman Hilmi; Gonulalan, Gulsum; Korkmaz, Huseyin; Baldane, Suleyman; Celik, CetinPrevious studies suggest that serum IGF-1 is higher in women with polycystic ovary syndrome (PCOS). The ophthalmologic effects of IGF-1 excess have not yet been investigated in women with PCOS. The aim of the current study is to compare the corneal thickness of patients with PCOS and those of healthy subjects. Forty three patients with PCOS and 30 age-matched and gender-matched healthy individuals were enrolled in this cross-sectional study. Central corneal thickness (CCT) was measured in patients with PCOS and in healthy individuals with an ultrasound pachymeter. IGF-1 values were also determined in the study group. Women with PCOS had significantly higher levels of IGF-1 and homeostasis model assessment (HOMA-IR) levels than the control group. Right and left CCT measurements were higher in the PCOS group than in the control group. A positive correlation between IGF-1 and right and left CCT was identified in both groups. In multiple linear stepwise regression analyses, IGF-1 independently and positively associated with HOMA-IR in women with PCOS. A correlation between total testosterone and CCT was identified in the whole group. In multiple stepwise regression analyses, total testosterone independently and positively associated with left central corneal thickness in the whole group. These findings indicate that PCOS has target organ effects on the eye. Consequently, it can change central corneal thickness. Higher IGF-1 levels seem to be the main causes of increased corneal thickness. Insulin resistance in PCOS is one of the underlying causes and promotes increase in IGF-1. We suggest a careful and detailed corneal evaluation in PCOS patients to prevent the potential risk of increased CCT, in addition to the already-known complications.Öğe Does the Presence of Endometrial Polyp Predict Colorectal Polyp?(ELSEVIER SCIENCE INC, 2016) Unler, Gulhan Kanat; Gokturk, Huseyin Savas; Toprak, Erzat; Erinanc, Ozgur Hilal; Korkmaz, HuseyinIntroduction: Endometrial polyps (EPs) and colorectal polyps (CPs) are common disorders and the incidence of both increase rapidly with aging. CPs are focal lesions and incidence increases with age. Aim: In this study, we aimed to analyze retrospectively the relationship between the EPs and CPs sharing similar clinical and genetic factors in their etiopathogenesis. Materials and Methods: This study was retrospectively performed between 2010 and 2013 and it included patients diagnosed to have eEPs. The study group and the control group consisted of patients who were diagnosed with or without EPs and who underwent colonoscopy at the same period. Results: The study group was formed by 57 patients with diagnosis of EP who underwent colonoscopy during the same period. The control group consisted of 71 patients without EP examined with colonoscopy. Among 128 patients assessed in this study, 24 were diagnosed with CPs, all of which were adenomatous polyps smaller than 1 cm. No hyperplastic or inflammatory polyps were diagnosed. While 18 of 57 patients with EPs had CPs, 6 of 71 control subjects had CPs. Hence, the risk of having CP was 5 times greater in patients with EP compared to those without (P < 0.05). Conclusion: The present study demonstrated that the prevalence of CPs increased significantly in postmenopausal patients with EPs. Recommending colonoscopy to these patients irrespective of age may be beneficial for detecting more CPs and preventing colorectal cancer.Öğe HLA-DQ2/DQ8 frequency in adult patients with celiac disease, their first-degree relatives, and normal population in Turkey(AVES, 2019) Ozgenel, Safak Meric; Temel, Tuncer; Teke, Hava Uskudar; Yildiz, Pinar; Korkmaz, Huseyin; Ozakyol, AysegulBackground/Aims: Celiac disease is an autoimmune, familial disease that results in susceptibility to gluten in cereal and cereal products in genetically susceptible individuals. The aim of the present study was to investigate the presence of HLA-DQ2/DQ8 in patients with celiac disease, their first-degree relatives, and healthy community. Materials and Methods: HLA-DQ2/DQ8 analysis was performed in adult patients with celiac disease >= 18 years old (94 patients), their first-degree relatives (89 people), and healthy group (102 individuals). Anemia, osteoporosis, and diarrhea were interrogated in the celiac patient group and also anti-tissue transglutaminase, anti-endomysium, and anti-gliadin antibodies were recorded. Results: There was a significant relationship between HLA-DQ2/DQ8 presence in all groups, and the distribution of HLA-DQ2/DQ8 in all groups was different (p=0.000). No statistically significant correlation was found between the HLA tissue groups and diarrhea (p=0.087), osteoporosis (p=0.215), anemia (p=1.000), tissue transglutaminase antibodies (p=0.295), anti-gliadin antibodies (p=0.104), and anti -endomysium antibodies (p=0.243) in the celiac patient group. Conclusion: HLA-DQ2/DQ8 can be used to diagnose celiac disease particularly when the tests are useless and to screen first-degree relatives.Öğe Increased arterial stiffness and its relationship with inflammation, insulin, and insulin resistance in celiac disease(LIPPINCOTT WILLIAMS & WILKINS, 2015) Korkmaz, Huseyin; Sozen, Mehmet; Kebapcilar, LeventObjectiveCeliac disease (CD) is a lifelong, chronic, immune-mediated, inflammatory small bowel disorder, precipitated by exposure to dietary gluten and related proteins in genetically predisposed individuals. Recent studies have shed new light on the importance of inflammation in the pathogenesis of arterial stiffness. The aim of this study was to evaluate arterial stiffness using pulse wave velocity (PWV) in adult CD patients without cardiovascular risk factors in comparison with a control group.Patients and methodsA total of 58 patients with CD without cardiovascular risk factors and age-matched and sex-matched healthy controls were enrolled in the study. All patients completed a standard questionnaire form, and various laboratory parameters were assessed. Vascular measurements, including PWV, were carried out using a Mobil-O-Graph 24-h pulse wave analysis monitor, an automatic oscillometric device.ResultsAlthough cardiovascular risk factors, such as low-density lipoprotein cholesterol and triglyceride, were significantly lower (P<0.05) in celiac patients than in controls, the erythrocyte sedimentation rate, C-reactive protein, insulin, homeostasis model assessment of insulin resistance, homocysteine, and 24h, day, and night PWV values were higher in patients with CD than in controls (P<0.05). A multiple linear regression analysis showed that PWV was correlated positively with age and the duration of CD.ConclusionThis study found increased arterial stiffness, homocysteine, erythrocyte sedimentation rate, C-reactive protein, insulin, and homeostasis model assessment of insulin resistance in patients with CD and provides evidence for the potential contribution of these parameters and inflammation toward arterial stiffening, independent of conventional cardiovascular risk factors.Öğe Increased pulse wave velocity and relationship with inflammation, insulin, and insulin resistance in inflammatory bowel disease(LIPPINCOTT WILLIAMS & WILKINS, 2014) Korkmaz, Huseyin; Sahin, Fatih; Ipekci, Suleyman H.; Temel, Tuncer; Kebapcilar, LeventObjective Both ulcerative colitis and Crohn's disease are forms of inflammatory bowel disease (IBD), which is characterized by chronic, progressive inflammation of the gastrointestinal tract. Recent studies have shed new light on the importance of inflammation in the pathogenesis of arterial stiffness. Aim This study aimed to evaluate the relationship between pulse wave velocity (PWV) measurement and biochemical parameters in inactive and active IBD patients without cardiovascular risk factors and perform a comparison with the control group. Materials and methods We enrolled 102 IBD patients without cardiovascular risk factors and 74 matched controls, and evaluated each patient in active and inactive disease periods. All patients completed a standard questionnaire form and we assessed various laboratory parameters. We carried out vascular measurements using a Mobil-O-Graph 24-h pulse wave analysis monitor, an automatic oscillometric device. Results Although cardiovascular risk factors, such as total cholesterol and low-density lipoprotein cholesterol, were significantly lower (P < 0.05) in IBD patients than the controls, 24 h, day and night PWV values, erythrocyte sedimentation rate, C-reactive protein, insulin, homeostasis model assessment of insulin resistance, and homocysteine were higher in patients with active and inactive IBD than the controls (P < 0.05). Multiple linear regression analysis showed that PWV was correlated positively with age and duration of IBD. Conclusion This study showed increased PWV, homocysteine, erythrocyte sedimentation rate, C-reactive protein, insulin, and homeostasis model assessment of insulin resistance in patients with active and inactive IBD and provides evidence of the potential contribution of inflammation and inflammation-related factors toward arterial stiffening independent from conventional cardiovascular risk factors. (C) 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.Öğe 'Letter to the Editor' of response for arterial stiffness in patients with celiac disease(LIPPINCOTT WILLIAMS & WILKINS, 2017) Korkmaz, Huseyin; Kebapcilar, Levent[Abstract not Available]Öğe Non-Invasive Estimation of Disease Activity and Liver Fibrosis in Non-Alcoholic Fatty Liver Disease Using Anthropometric Biochemical Characteristics, and C-13-Methionine Breath Test(WILEY-BLACKWELL, 2015) Korkmaz, Huseyin; Unler, Gulhan K.; Gokturk, Huseyin Savas; Schmidt, Wolfgang E.; Kebapcilar, Levent[Abstract not Available]Öğe Noninvasive estimation of disease activity and liver fibrosis in nonalcoholic fatty liver disease using anthropometric and biochemical characteristics, including insulin, insulin resistance, and C-13-methionine breath test(LIPPINCOTT WILLIAMS & WILKINS, 2015) Korkmaz, Huseyin; Unler, Gulhan K.; Gokturk, Huseyin S.; Schmidt, Wolfgang E.; Kebapcilar, LeventObjectiveThe purpose of this study was to noninvasively estimate disease activity and liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) using anthropometric and biochemical characteristics and the C-13-methionine breath test (MeBT).MethodsA total of 164 patients with histologically proven NAFLD and 56 healthy controls were included in the study. Anthropometric and biochemical analyses and the MeBT were performed on all patients and controls.ResultsBMI; waist circumference; waist-hip ratio; transaminase, lipid, -glutamyl transpeptidase (GGT), glucose, and insulin levels; and insulin resistance were significantly higher in patients with NAFLD than in controls. The GGT level and the MeBT were independent predictors of nonalcoholic steatohepatitis (NASH). Fibrosis was correlated with GGT, bilirubin, cholesterol, and insulin levels, and the MeBT, but the test was the only independent predictor of significant fibrosis. Patients with simple steatosis had similar MeBT values as controls. The MeBT values were significantly lower in NASH and NASH-cirrhosis patients (P<0.001) compared with simple steatosis patients and controls. Patients with advanced fibrosis (F2-3) had significantly lower MeBT values than patients with mild fibrosis (F0-1; P<0.001). The area under the receiving operating characteristic curve for NASH and advanced fibrosis was estimated to be 0.95 in the total cohort.ConclusionThis study indicates that anthropometric and biochemical parameters are insufficient for estimating the presence of NASH or the fibrosis stage. However, the MeBT is a suitable noninvasive method for accurately predicting which patients suffer from simple steatosis, NASH, or NASH-cirrhosis.Öğe Nutritional habits in functional dyspepsia and its subgroups: a comparative study(TAYLOR & FRANCIS LTD, 2016) Goktas, Zeynep; Koklu, Seyfettin; Dikmen, Derya; Ozturk, Omer; Yilmaz, Bulent; Asil, Mehmet; Korkmaz, HuseyinObjective: Research data demonstrating nutritional habits of functional dyspepsia (FD) patients are very limited. This is the first study to evaluate nutritional habits in FD subgroups according to Rome III criteria. Our aim was to evaluate nutritional habits of FD patients and determine the food items that may provoke a dyspepsia symptom. Methods: A total of 168 adults with FD and 135 healthy control subjects participated in the study. FD subjects were divided into epigastric pain syndrome (EP-FD), postprandial distress syndrome (PS-FD), mixed (MX-FD) subgroups according to Rome Criteria III. Subjects completed a questionnaire that included a short-form food frequency questionnaire. Furthermore, subjects were asked to list the food items that were causing a dyspepsia symptom. Results: Functional dyspepsia subjects had a slightly higher BMI (26.1 +/- 4.97kg/m(2)) than control subjects (24.6 +/- 4.08kg/m(2)). The most common symptom triggering foods among all the FD groups were fried and fatty foods (27.1%), hot spices (26.4%), and carbonated drinks (21.8%). In FD subgroups, carbonated drinks were more likely to cause a symptom in PS-FD group (37.3%) than MX-FD (25.7%) and EP-FD (22.1%) groups. There was no difference in frequency of main meals and snacks among any of the groups. Conclusion: Fatty and spicy foods and carbonated drinks were the most common symptom triggering food items in FD group. In subgroups, carbonated drinks and legumes were more likely to cause a symptom in PS-FD. Removing these food items during the course of treatment might help alleviate the symptoms.Öğe Routinely evaluated clinical assays and laboratory tests [real test] and fibrosis stages of chronic hepatitis B and C(AVES, 2014) Bugdaci, Mehmet Sait; Korkmaz, Huseyin; Demir, Ali; Biyik, Murat; Temel, Tuncer; Gokturk, Huseyin Savas; Ozakyol, AysegulBackground/Aims: To provide a new mathematical formula to predict liver fibrosis in patients with chronic viral hepatitis. Materials and Methods: Patients with chronic hepatitis B and C who underwent liver biopsy at different centers were included in this study. Chronic hepatitis B was defined as immunopositivity for the hepatitis B surface antigen for at least 6 months, and chronic hepatitis C was defined as positivity for HCV RNA for at least 3 months. The histological features were evaluated by the histological activity index and fibrosis. Results: In total, 1299 patients were included in the study. The distribution and the mean of the parameters of the patients were as follows: 1009 patients with chronic hepatitis B with a mean age of 45 +/- 13/years [emale/male (F/M)=47.5/52.5%] and 290 patients with hepatitis C with a mean age of 52 +/- 10.3/years [F/M=61/39%]. When the cut-off value of the REAL TEST formula"[(age x pT x AST)/(PLT/1000)]/100" in patients with hepatitis B was determined to be >= 1.37, it was found that it could predict fibrosis with 79% specificity, 78% sensitivity, 85% negative predictive value (NPV), and 70% positive predictive value (PPV) (area under the curve (AUC)=0.852, 95% CI: 0.82-0.87). When the cut-off value of the REAL TEST formula in patients with hepatitis C was determined to be >= 1.99, it was found that it could predict significant fibrosis with 87% specificity, 90% sensitivity, 94.4% NPV, and 79.4% PPV (AUC: 0.95, 95% CI: 0.93-0.98) Conclusion: The REAL TEST formula results correlated with the pathological findings and may be a useful method for the evaluation of patients with chronic hepatitis B and C.
