Browsing by Author "Özkahraman, Adnan"

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Are Noninvasive Biochemical Parameters an Alternative Toliver Biopsy in Patients With Chronic Hepatitis B
(2021) Konür, Şevki; Dertli, Ramazan; Özkahraman, Adnan; Kayar, Yusuf; Akçadağ, Neslihan Sürmeli
Aim: Although there is a gold standard liver biopsy in showing the histological activity of the disease, there are contradictory results in the studies conducted for using some non-invasive methods that are alternatively biochemically calculated due to being an invasive procedure. We aimed to investigate the relationship of FIB-4, APRI, API and AAR values with histopathology in patients undergoing liver biopsy due to chronic hepatitis B virus (HBV) infection. Materials and Method: Patients with follow-up between November/2016-October/2019 with the diagnosis of chronic HBV were included. Demographic data and histopathological data were documented. Accompanying comorbid diseases, medications and previous operations were questioned. Patients were grouped as mild, moderate and advanced fibrosis according to fibrosis scoring. Sensitivity, specificity, cutt-of, AUC values of biochemical parameters were calculated between the groups. Results: A total of 151 patients, 64(42.3%) women, were included in the study. As a result of the liver biopsy; mild fibrosis was found in 73(48.3%) patients, moderate fibrosis in 33(21.8%) patients and advanced fibrosis in 45(29.9%) patients. There was a significant correlation between fibrosis level and age, liver function tests, bilirubin and albumin (p<0.05). While there was no relationship between fibrosis stage and HBV-DNA, there was a significant relationship between groups with AAR, API, APRI and FIB4 (p<0.05).Conclusions: Although FIB-4, APRI, AAR and API values are important in determining the level of hepatic fibrosis, the effect of biochemical parameters on various factors negatively affects the specificity and sensitivity of these tests. For this reason, liver biopsy is still seen as the gold standard.
The Effect of Gluten-Free Diet on Mean Platelet Volume, Neutrophil and Neutrophil/Lymphocyte Ratio in Children With Celiac Disease
(2020) Kayar, Yusuf; Konur, Şevki; Dertli, Ramazan; Akçadağ, Neslihan Sürmeli; Ağın, Mehmet; Özkahraman, Adnan
Aim: Celiac Disease (CD) is a chronic, autoimmune and systemic disease. In the present study, the purpose was to investigate theeffect of a gluten-free diet on Mean-Platelet-Volume (MPV), neutrophil and neutrophil/lymphocyte Ratio (NLR).Material and Methods: A total of 106 patients who were diagnosed with CD and who were followed-up by the Pediatric GastroenterologyClinic of the Hospital, and 50 healthy children were included in the study. The demographic data of the patients and the neutrophil,lymphocyte, platelet, NLR were recorded before the diagnosis and one-year after gluten-free diet. The hematologic parameters of thepatients were compared with the healthy control group at the diagnosis time. Following a one-year gluten-free diet, the hematologicparameters of the patients were compared with the parameters at the diagnosis time.Results: The mean age of the patients was 12.1±3.2 years (7-16 years), and the mean age of the control group was 14.5±4.1 years(12-16 years). A total of 48% (51/106) of the patients were female and 34% (17/50) of the control group was female. Hematologicalparameters of patients compared pre-dietary and post-dietary; lymphocyte and platelet ratios were significantly higher, whereasneutrophils, MPV and NLR were significantly lower. Neutropenia was detected in 15 patients before the diet. It was observed thatneutrophil level reached the normal range after gluten-free diet in patients with neutropenia.Conclusions: The MPV, neutrophil and NLR values, that was low during the diagnosis, may be ameliorative with the gluten-free diet.In addition, CD should be considered in the differential diagnosis of neutropenic patients.
Helikobakter Pilori Enfeksiyonu ve Kan Grubu Arasındaki İlişki
(2020) Bilgili, Mehmet Ali; Kayar, Yusuf; Dertli, Ramazan; İliklerden, Ümit Haluk; Özkahraman, Adnan; Konür, Şevki
Amaç: Bu çalışmadaki amacımız Helikobakter Pilori (HP) ile kan grubu ve diğer risk faktörleri arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntem: Çalışmaya Mart-2017 ile Haziran-2018 tarihleri arasında hastanemizde, üst gastrointestinal sistem (GİS) endoskopisi yapılarak mide doku biyopsileri alınan 373 hasta alındı. Tüm hastaların demografik verileri, risk faktörleri, endoskopik görünüm ve histopatolojik verileri dökümante edildi. HP varlığına göre hastalar HP-pozitif ve HP-negatif olarak 2 gruba ayrıldı. Gruplar kan grubu ve risk faktörleri açısından karşılaştırıldı. Bulgular: Çalışmaya alınan olguların 190 (%50,9)'ı kadın idi ve tüm hastaların ortalama yaşları 45,1±14,9 (aralık: 18-86 yıl) idi. Çalışmaya alınan olguların %53.8’inde HP pozitif idi. HP pozitif hastaların daha genç olduğu görüldü. Ayrıca HP pozitifliği ile çalışma durumu, el hijyeni, sigara ve alkol kullanımı arasında anlamlı ilişki varken (p<0.05), kan grubu ile anlamlı bir ilişki saptanmadı (p>0.05). Sonuç: Sonuç olarak bu çalışmada yaş, çalışma durumu, el hijyeni, sigara ve alkol kullanımı gibi sosyo-demografik faktörler HP pozitifliği için bir risk faktörü olarak bulunurken, ABO kan grupları ile HP arasında anlamlı bir ilişki görülmedi.
Is Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratioa Predictive Factor for the Fibrous Stage in Patients Withchronic Hepatitis B
(2021) Özkahraman, Adnan; Kayar, Yusuf; Konür, Şevki; Akçadağ, Neslihan Sürmeli; Dertli, Ramazan
Aim: Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are an inexpensive inflammatory marker that can beeasily obtained from the blood count and can be used in many chronic diseases. In our study, we aimed to investigate the relationshipbetween fibrosis stage and NLR, PLR in patients with chronic hepatitis B virus (HBV). Materials and Methods: 173 patients with chronic HBV were included in the study. The demographic data and hemogram parameters ofall patients were recorded. Histopathological data of the patients were documented. Accompanying comorbid diseases, medicationsand previous operations were questioned. In chronic HBV patients, fibrosis level was compared with hematological parameters. Results: A total of 173 patients, 100 (57.8%) of whom were male, were included in the study. As a result of the liver biopsy; mildfibrosis (steage/1-2) in 83(47.9%) patients, moderate fibrosis (steage/3-4) in 35(20.3%) patients and advanced fibrosis (stage/5-6)in 55(31.8%) patients. In advanced fibrosis group, liver function tests and bilirubin levels were significantly higher and albumin levelwas significantly lower (p<0.05). It was found that NLR level was significantly higher in moderate fibrosis than mild fibrosis, and PLRlevel was significantly lower in the advanced fibrosis group than in the mild and moderate fibrosis groups (p<0.05). Conclusions: We showed that there is a significant relationship between fibrosis level and NLR, PLR. However, with the availabledata, it does not seem possible to say that noninvasive methods can completely replace invasive procedures such as liver biopsy.Prospectively designed studies with larger patient participation are needed.
Kronik Hepatit B Hastalarında Tenofovir Tedavisinin Renal Fonksiyona Etkisi
(2019) Özkahraman, Adnan; Konür, Şevki; Ağın, Mehmet; Dertli, Ramazan; Oflas, Nur Düzen; Akçadağ, Neslihan Sürmeli; Kayar, Yusuf
Amaç: Kronik Hepatit B virüsu (HBV) enfeksiyonu ilekronik böbrek hastalığı arasında ilişki olduğubilinmektedir. Kronik HBV tedavisinde kullanılan ajanlargüvenli ve iyi tolere edilmekle birlikte uzun vadeli yanetkileri büyük ölçüde bilinmemektedir. Biz de kronikHBV nedeniyle takipli hastalarda antiviral tedavilerinböbrek fonksiyonları üzerine olan etkilerini araştırmayıamaçladık.Gereçler ve Yöntem: Çalışmamıza 2013-2019 tarihleriarasında hastanemiz polikliniğinde kronik HBV tanısı iletedavi verilerek takibe alınan 156 hasta dahil edildi. Tümhastaların demografik verileri (yaş, cinsiyet),antropometrik özellikler, hastalık süresi, tedavi süresi,hangi antiviral tedavinin alındığı ve vücut kitle indeksi,dökümante edildi. Hastalardan tedavi öncesi ve belirliperiyotlarla laboratuvar analizi için serum numunesialındı.Bulgular: Hastalardan 92 (%58.9)’si erkek iken,hastaların ortalama yaşı 48.47±15.1 idi. Hastalık süresiortalama 91.8±13.6 ve tedavi süresi ortalama 54.9±13.6idi. Antiviral gruplar arasında demografik veriler,antropometrik ölçümler ve karaciğer fonksiyon testleriaçısından yapılan karşılaştırmada anlamlı bir farklılıksaptanmadı (p>0.05). Ayrıca tedavi grupları arasındatedavi öncesi ve tedavi sonrası yapılan laboratuvarölçümlerinde istatiksel olarak anlamlı değişikliksaptanmadı (p>0.05).Sonuç: Çalışmamızda antiviral tedavi alan gruplardatedavi öncesi ve tedavi sonrası böbrek fonksiyonlarındaanlamlı bir değişiklik görülmedi. Ancak altta bazal renalfonksiyon bozukluğunun olması, komorbiditenin eşliketmesi gibi risk faktörlerini barındıran kronik HBV'libireylerin Tenofovir tedavisi aldıkları süre boyuncaböbrek fonksiyonlarının yakından takip edilmesiönerilmektedir.