Browsing by Author "Suvak, Burak"

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Akalazya
(2015) Dülger, Ahmet Cumhur; Suvak, Özlem; Suvak, Burak
Akalazya primer özofagus motor hastalığıdır. Disfaji, göğüs ağrısı, regürjitasyon ve kilo kaybına nedenolmasının yanında prekanserözdür. Etyolojisi hala bilinmediğinden tüm tedavi seçenekleri alt özofagussfinkterinin zayıflatılmasına yönelik palyatiftir. Medikal, endoskopik, cerrahi tedavi seçenekleri vardır. Yakınzamanda peroral endoskopik myotomi diye adlandırılan yeni bir teknik tanımlanmıştır.
Brucellosis-Related Acute Pancreatitis: a Rare Complication of a Universal Disease
(Sage Publications Ltd, 2016) Suvak, Burak; Dulger, Ahmet Cumhur; Karadas, Sevdegul; Gonullu, Hayriye; Bayram, Yasemin; Gonullu, Edip; Guducuoglu, Huseyin
Objectives To determine the prevalence and determinants of acute pancreatitis in patients with acute brucellosis. Methods Adult patients with brucellosis were retrospectively recruited. Brucellosis and acute pancreatitis were diagnosed according to standard criteria. Laboratory analyses included Wright agglutination titre, serum biochemical parameters and blood count. Results Patients with acute pancreatitis (n=21) had significantly higher Wright agglutination titres, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, -glutamyl transpeptidase, amylase, lipase and serum glucose concentrations, and significantly lower haemoglobin concentrations and haematocrit than patients with brucellosis alone (n=326). Conclusions Hyperglycaemia, anaemia, and liver transaminase and cholestatic enzyme concentrations may represent new approaches for assessing disease severity in patients with brucellosis and acute pancreatitis.
Delta Hepatitis-Related Thyroid Disease: a Unique Phenomenon
(Termedia Publishing House Ltd, 2015) Suvak, Burak; Dulger, Ahmet Cumhur; Aykac, Mehmet Coskun; Gonullu, Hayriye; Gonullu, Edip
Introduction: Hepatitis delta virus (HDV) infection is a serious health problem worldwide. Thyroid disturbances represent a major limitation to the efficacy of interferon treatment targeting chronic HDV (C-HDV) infection. Moreover, pre-treatment thyroid diseases may be influenced by interferon therapy. Despite this, the characteristic features of the thyroid diseases in C-HDV patients remain poorly characterised. Aim: To determine the prevalence of thyroid diseases and evaluate the impact of delta hepatitis on thyroid function tests. Material and methods: We retrospectively reviewed the charts of 127 hepatitis C virus (HCV)-negative adults, treatment-naive outpatients with C-HDV, between July 2013 and July 2014. Thyroid-stimulating hormone (TSH) and thyroid antibodies (TAbs) including anti-thyroid peroxidase antibodies (anti-TPO), liver transaminases, and other routine laboratory tests were conducted during the study period. Results: A total of 127 C-HDV patients (female 52.9%, mean age 54.5 +/- 8.01 years) were enrolled. The rate of hypothyroidism, defined as a TSH level above 10 IU/l, was 4.7%. No patient had hyperthyroidism. Both elevated levels of liver transaminases and HDV ribonucleic acid (HDV-RNA) were positively correlated with high levels of thyroid autoantibodies. Conclusions: The rate of hypothyroidism is higher than the rate of hyperthyroidism at baseline. Most remarkably, for the first time we discovered a correlation between disturbed thyroid autoantibodies and elevated liver transaminases as well as high HDV-RNA levels even in euthyroid delta hepatitis patients. But in order to have an adequate understanding of such correlations, further studies are needed.
A Dilemma in Staging of Esophageal Cancer: How Should We Stage Ypt0 N2 M0 Esophageal Cancer After Neoadjuvant Therapy
(Hindawi Ltd, 2015) Celik, Sebahattin; Erten, Remzi; Batur, Abdulsamed; Suvak, Burak
Background. Since neoadjuvant treatment in esophageal cancer began to become popular, a complete pathological response at the primary tumour site has been commonly reported. An issue of conflict is whether complete response in the esophageal lumen means that the esophagus is completely tumour-free. Another important issue is whether lymph nodes that are retrieved from pathologically complete response cases are also tumour-free or not. There is a gap in the esophageal cancer staging system for ypT0 N2 M0 tumours that have received neoadjuvant therapy. Here, we will discuss the problem about staging of esophageal cancer associated with neoadjuvant therapy. Case. A female aged 40 years complaining of dysphagia was diagnosed as having locally advanced thoracic esophageal cancer. Neoadjuvant therapy decision was taken by oncology committee. Six weeks after neoadjuvant therapy, with a curative intention, minimal invasive surgery was performed. The pathology report was as follows. "There were no neoplastic cells in the suspected area of the esophageal mucosa upon examination with all staining. There was no cancer at resection margins. Four metastatic lymph nodes were infiltrated with squamous cell cancer." Conclusion. Despite the growing use of neoadjuvant treatment in locally advanced esophageal cancer in world, we do not have a protocol for the evaluation of these patients' pathology reports. We believe that new studies and new ideas are needed to resolve this dilemma associated with neoadjuvant therapy.
High Prevalence of Chronic Hepatitis D Virus Infection in Eastern Turkey: Urbanization of the Disease
(Termedia Publishing House Ltd, 2016) Dulger, Ahmet Cumhur; Suvak, Burak; Gonullu, Hayriye; Gonullu, Edip; Gultepe, Bilge; Aydin, Ibrahim; Olmezi, Sehmus
Introduction: Both hepatitis B virus (HBV) and hepatitis D virus (HDV) infection play an increasingly important role in liver diseases. The main objective of this study was to investigate the socio-epidemiological, laboratory and radiological aspects of both HBV and HDV infection near the Iranian border of Turkey. Material and methods: The study included 3352 patients with HBV and HDV infection. Socioepidemiological, laboratory and radiological aspects of the study subjects were retrospectively examined. Comorbid metabolic diseases were not assessed due to the retrospective design of the study. Results: Most of the study subjects were HBe antigen negative. No significant difference in terms of HBV-DNA levels or HBe antigen seropositivity was detected between the city centre and rural areas (p > 0.005). The mean HBV-DNA level in the anti-HDV-positive group was significantly lower than in the anti-HDV-negative group (p < 0.001). The rate of HDV-RNA positivity in women was higher than in their male counterparts (p = 0.017). Anti-HDV-IgG was detected in 18.4% of tested subjects who came from an urban area. In contrast, 12.5% of subjects of the rural group had a positive result for anti-HDV-IgG. Among 134 ultrasonographically evaluated delta hepatitis patients, 37.3% had liver cirrhosis. On the other hand, in 1244 patients with hepatitis B monoinfection, there were 90 patients with liver cirrhosis. Radiologically, the rate of hepatic steatosis in delta hepatitis patients was lower than in those with HBV monoinfection. Conclusions: Hepatitis D virus infection was particularly prevalent among the urban population as well as in female subjects. More broadly, the current observations are the first to suggest an inverse correlation between delta hepatitis and ultrasonography-proven hepatic steatosis.
Is Computerised Tomography Better Than Fibreoptic Gastroscopy for Early Detection of Gastric Varices
(Termedia Publishing House Ltd, 2017) Suvak, Burak; Kekilli, Murat; Beyazit, Yavuz; Okten, Sarper; Tanoglu, Alpaslan; Sasmaz, Nurgul
Introduction: Video endoscopic diagnosis of gastric varices is particularly limited, owing to the deep submucosal or subserosal location of the varices and the normal appearance of the overlying mucosa. Aim: We present and emphasise the value of computerised tomography (CT) examination in the early detection of gastric varices (GVs). Material and methods: In this retrospective study, a total of 216 consecutive patients with cirrhosis were evaluated at the Turkiye Yuksek Ihtisas Training and Research Hospital between September 2008 and March 2011. Results: One hundred and thirty patients with cirrhosis were enrolled in the study. The mean age of the male (88 cases) patients was 59.45 +/- 2.42 years, and the mean age of the female (42 cases) patients was 56.29 +/- 1.14 years. Computerised tomography identified oesophageal varices (EVs) in 103/130 patients, and endoscopy identified EVs in 103/130 patients. Computerised tomography identified GVs in 86/130 patients, and endoscopy identified GVs in 26/130 patients. After endoscopic elastic band ligation (EBL), CT identified GVs in 22/26 patients, and endoscopy identified GVs in 7/26 patients. Conclusions: Gastric varices lie in the submucosa, deeper than EVs, and distinguishing GVs from gastric rugae may be dif.cult with video endoscopy. This study demonstrated that CT is a sensitive method for early detection of GVs and has been used previously in the evaluation of GVs.
Kolanjiyokarsinom ile Karışan Rekürren Piyojenik Kolanjit
(2016) Batur, Abdussamet; Arabul, Mahmut; Soysal, Dilek Ersil; Aydın, Mesut; Dülger, Ahmet Cumhur; Suvak, Burak
Rekürren piyojenik kolanjit, sosyoekonomik düzeyi düşük toplumlarda daha sık görülen, etyolojisi tam bilinmeyen fakat düşük protein içerikli beslenme, paraziter enfestasyonlar gibi faktörlerin suçlandığı, safra yolu destrüksiyonu, striktürler, tekrarlayan taş oluşumu ve kolanjit atakları ile seyreden ve bazen maligniteler ile karışabilen bir hastalıktır. Bu olgu sunumunda kolanjiyokar- sinom ön tanısı ile takip edilen ve rekürren piyojenik kolanjit olduğunu tes- pit ettiğimiz nadir rastlanan bir olguyu sunmayı amaçladık.
The Prevalence and Impact of Brucellosis in Patients With Hepatitis Delta Virus Infection: Inside the Brucella Outbreak With Cirrhosis
(Termedia Publishing House Ltd, 2017) Suvak, Burak; Dulger, Ahmet Cumhur; Suvak, Ozlem; Yesilyurt, Aysun Ozel; Gultepe, Bilge; Guducuoglu, Huseyin
Introduction: Hepatitis D virus (HDV) infection is a serious health problem leading to cirrhosis and hepatocellular carcinoma (HCC). Despite evidence that zoonotic infections are associated with end-stage liver disease, brucellosis in patients with delta hepatitis related to liver disease has not been well characterized. So, we examined this relationship using recent hospital-based data. Material and methods: We analyzed data from 96 delta hepatitis patients (mean age: 52.5 +/- 12.8 years; 50 male; 52 cirrhotics) and 117 (mean age: 50.4 +/- 7 years; 60 male) control subjects who were selected from patients with splenomegaly. The BruceIla Wright test in connection with blood culture was used to detect active BruceIla infection. Demographic features, laboratory data, results of ultrasonographic examination of the abdomen and Wright agglutination titers were compared between groups. Results: There were 9 (9%) patients with active brucellosis in delta hepatitis patients. Compared to the control group, there was a statistically significant difference between groups in terms of having active brucellosis (9 vs. 2 patients; p < 0.001). Higher MELD scores were also associated with active BruceIla infection (p < 0.005). Conclusions: Patients with chronic hepatitis D related cirrhosis (CHD-C) were at risk of developing brucellosis requiring hospitalization. Higher Wright titers among patients with more advanced liver disease may reflect a unique phenomenon that requires further investigation to determine underlying causative factors.
The Prevalence of Helicobacter Pylori Among Dyspeptic Patients in an Earthquake-Stricken Area
(Hospital Clinicas, Univ Sao Paulo, 2015) Suvak, Burak; Dulger, Ahmet Cumhur; Suvak, Ozlem; Aytemiz, Enver; Kemik, Ozgur
Objectives: Helicobacter pylori is a gram-negative, spiral-shaped, urease-producing bacterium with multiple unipolar flagella. Humans are a major reservoir for H. pylori; however, there are no data on the prevalence of H. pylori among dyspeptic patients who have experienced natural disasters. Therefore, the aim of this study was to examine the prevalence of H. pylori in dyspeptic patients who survived a recent natural disaster and to compare the data between the pre-disaster and post-disaster periods. METHODS: Between December 2011 and February 2012 (similar to one month following an earthquake), 209 dyspeptic patients who underwent gastroscopy were included in the study. For microorganism identification, gastric biopsy materials from the 209 disaster survivors with dyspeptic complaints were tested for urease activity in a medium containing urea and a pH indicator. The obtained results were compared with pre-disaster data from dyspeptic patients in the same city during the corresponding period of the previous year. Furthermore, the current H. pylori prevalence was evaluated among 139 dyspeptic patients between January 2014 and May 2014. RESULTS: We found a significantly higher prevalence of H. pylori in disaster survivors with dyspepsia compared with dyspeptic patients in the pre-disaster period (p<0.005). Interestingly, the current H. pylori prevalence was found to be significantly higher than the prevalence in both the disaster and pre-disaster periods (p<0.005). CONCLUSION: These results suggest that a recent earthquake could contribute to the development of H. pylori infection in subjects who live in the disaster-stricken area. These data also highlight the exceptionally high H. pylori prevalence in dyspeptic patients. Regional variations require further analyses.
Serum Vascular Endothelial Growth Factor Receptor-3 Levels in Patients With Esophageal Squamous Cell Cancer
(Edizioni Luigi Pozzi, 2017) Sumer, Aziz; Demir, Ali; Kemik, Ahu Sarbay; Yavuz, Alpaslan; Suvak, Burak; Dulger, Ahmet Cumhur; Kemik, Ozgur
AIM: Esophageal cancer is one of the most aggressive tumors of the gastrointestinal tract. In this study, we quantified the serum vascular endothelial growth factor-3 (VEGFR-3) expression in patients with esophageal squamous cell carcinoma (ESCC) to evaluate the role of VEGFR-3 in ESCC. MATERIALS AND METHODS: Ninety five patients with ESCC were studied. Pre-therapy and preoperative samples were stored and ELISA was used to designate the concentrations of VEGFR-3. RESULTS: The serum values of VEGFR-3 were significantly higher in patients with ESCC than in healthy donors (p<0.0001). CONCLUSIONS: The results imply a very good sensitivity of VEGFR-3 in ESCC. VEGFR-3 may be a good diagnostic biomarker for ESCC.