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Öğe Blood neutrophil-to-lymphocyte ratio independently predicts survival in patients with liver cirrhosis(LIPPINCOTT WILLIAMS & WILKINS, 2013) Biyik, Murat; Ucar, Ramazan; Solak, Yalcin; Gungor, Gokhan; Polat, Ilker; Gaipov, Abduzhappar; Cakir, Ozlem O.Objectives Neutrophil-to-lymphocyte ratio (NLR) is a novel inflammation index that has been shown to independently predict poor clinical outcomes. We aimed to evaluate the role of NLR in the prediction of long-term mortality in patients with stable liver cirrhosis. Materials and methods This is a retrospective observational cohort study in which 145 stable cirrhotic patients without infection, hepatocellular carcinoma, and ongoing steroid therapy were enrolled between January 2009 and December 2011. The primary end point was survival during follow-up. NLR along with Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD) scores, and Charlson comorbidity index were assessed for the prediction of mortality. Results There were 86 men and 59 women, mean age 58.9 +/- 13.4 years. The etiologies of liver cirrhosis included viral hepatitis (n = 73), cryptogenic (50), alcoholic (12), and other (10). The mean follow-up duration was 27.8 +/- 6.8 months, during which 40 patients died. The mean NLRs were 2.08 +/- 0.99 and 4.39 +/- 3.0 in surviving and nonsurviving patients, respectively (P < 0.001). Kaplan-Meier survival analysis was carried out according to the median NLR above and below 2.72. Patients with NLR of at least 2.72 had a significantly lower survival (log rank, P < 0.001). NLR was found to be an independent predictor of mortality in all Cox Regression models (odds ratio 1.2; 95% confidence interval 1.2-1.3; P < 0.001). Receiver operating characteristic analysis showed that cut-off values of 4.22, 3.07, and 2.96 for NLR predicted 12, 24, and 36-month mortality, respectively (AUC: 0.806, P = 0.0029; 0.841, P < 0.0001 and 0.783, P < 0.0001, respectively). Conclusion NLR is a predictor of mortality independent of CTP and MELD scores in patients with liver cirrhosis. NLR could predict mortality in the subgroup of patients with low MELD scores as well. Eur J Gastroenterol Hepatol 25:435-441 (C) 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. European Journal of Gastroenterology & Hepatology 2013, 25:435-441Öğe Multidetector computed tomography and magnetic resonance imaging findings in pulmonary hydatid cysts(2019) Cebeci, Hakan; Ozlu, Mustafa Yasir; Kilincer, Abidin; Uysal, Emine; Durmaz, Mehmet Sedat; Ucar, Ramazan; Sunam, Guven SadiAim: Computed tomography (CT) and magnetic resonance imaging (MRI) are diagnostic modalities in pulmonary hydatid disease.We aimed to present CT and MRI findings in pulmonary hydatid disease.Material and Methods: CT and MRI findings of pulmonary hydatid cysts from January 2011 through June 2018 were evaluatedretrospectively. CT images of 112 patients and MRI images of 27 patients were evaluated. Patients’ gender and ages, lesion numberand distribution, concomitant organ involvement, complications, HU density of lesions on CT and signal characteristics of lesions onMRI were analyzed. T2 hypointense rim, T1 and T2 signal intensity, daughter vesicle and detached membranes were the evaluatedparameters on MRI.Results: 147 hydatid cyst lesions of 119 (66 female, 53 male) patients with a mean age of 39.419.6 years were included in the study62 (52.1%) of patients had isolated lung involvement. 79 of 119 patients (66.4%) had solitary lung lesion. Mean CT density of cystswere 16 HU. 25 of 32 cysts showed T2 hypointense rim on MRI.Conclusion: Imaging plays important role in diagnosis and presurgical evaluation of pulmonary hydatid disease. CT is mostly usedin diagnosis; MRI should be a choice particularly in pediatric population.Öğe Relationship between color M-mode echocardiography flow propagation and cardiac iron load on MRI in patients with thalassemia major(TURKISH SOC RADIOLOGY, 2012) Ozbek, Orhan; Acar, Kadir; Kayrak, Mehmet; Ozbek, Seda; Gul, Enes Elvin; Ucar, Ramazan; Paksoy, YahyaPURPOSE Myocardial iron overload remains an important problem and results in cardiac dysfunction in patients with thalassemia major (TM). The ratio of color M-mode flow propagation velocity to early diastolic transmitral flow velocity (E/Vp) in echocardiography is a marker of increased left ventricular filling pressure, which is independent of preload, afterload, and heart rate. We examined the relationship between E/Vp and iron loading in patients with TM using cardiac magnetic resonance imaging (MRI). MATERIALS AND METHODS Twenty-one TM patients and 21 age-matched healthy controls were enrolled in the study. Transmitral flow, pulmonary vein velocities, and Vp were obtained by two blinded echocardiographers. Left ventricular isovolumetric relaxation time (IVRT) was measured in the apical long axis by echocardiography. All patients also underwent MRI for cardiac T2* evaluation of iron overload. An increased E/Vp was defined as >1.5. RESULTS The E/Vp ratio was increased in TM patients compared with control subjects (1.7+/-0.4 and 1.2+/-0.2, P < 0.01, respectively). There was no correlation between E/Vp and cardiac T2* value. E/Vp was significantly correlated with IVRT (r=0.51, P = 0.02). In addition, the cardiac T2* value was comparable in patients with an E/Vp >1.5 and E/Vp <= 1.5 (21.1+/-9.8 ms vs. 22.3+/-8.0 ms, P = 0.80, respectively). CONCLUSION E/Vp may be a marker of diastolic abnormality that is independent from myocardial iron load in TM patients with preserved left ventricular function.Öğe Renal artery embolization in severe nephrotic syndrome(WILEY-BLACKWELL, 2016) Solak, Yalcin; Koc, Osman; Ucar, Ramazan; Ozbek, Orhan; Ergenc, Hasan; Gaipov, Abduzhappar; Turk, SuleymanIntroduction Severe nephrotic syndrome is associated with increased morbidity and mortality. Renal artery embolization (RAE) has been used in a number of renal diseases such as renal tumors, arteriovenous fistulas etc. However, data regarding benefits of RAE in patients with symptomatic severe proteinuria is limited. We decided to evaluate role of RAE in the setting of severe symptomatic nephrotic syndrome. Methods Eight patients who had undergone transcatheter renal artery embolization with polyvinyl alcohol (PVA) were included. Clinico-demographic characteristics as well as baseline laboratory data including level of proteinuria, serum albumin, C-reactive protein and LDL cholesterol levels were recorded for each patient. After RAE, outpatient clinic control laboratory values were also assessed. Findings All patients except one underwent bilateral RAE (four simultaneous or three sequential). Two patients experienced postembolization syndrome characterized by flank pain, fever, and leukocytosis, which was self-limited and responded to analgesics in all patients. There was no technical complications associated with RAE procedure. All patients became anuric except one. Serum albumin levels increased and serum LDL-cholesterol levels decreased considerably in treated patients. Discussion Renal artery embolization with the purpose of amelioration in nephrotic syndrome complications was effective and free of major technical complications in our patients.Öğe Unintentional Weight Loss in a Renal Transplant Recipient: Do Not Overlook Coeliac Disease(BASKENT UNIV, 2013) Solak, Yalcin; Gaipov, Abduzhappar; Biyik, Zeynep; Ucar, Ramazan; Biyik, Murat; Esen, Hasan; Ataseven, HuseyinUnintentional weight loss in a renal transplant recipient is an important condition, requiring diagnostic search within the framework of malignancy and opportunistic infections. To the best of our knowledge, there are no data in the literature reporting underlying coeliac disease as the cause of significant weight loss after renal transplant. We report a 32-year-old woman, who complained of significant weight loss during the 3.5 years posttransplant. Diagnostic work-up revealed coeliac disease, and a gluten-free diet stabilized her weight loss. Considering the high frequency of coeliac disease, this should be kept in the differential diagnosis of renal transplant recipients presented with weight loss and other suggestive features.
