Adana Military Hospital

Adana, Turkey

Adana Military Hospital

Adana, Turkey

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Gunes O.,Agri Military Hospital | Sertoglu E.,Ankara Mevki Military Hospital | Serdar M.A.,Acibadem University | Kayadibi H.,Adana Military Hospital
Chemistry and Physics of Lipids | Year: 2014

Background/objective Cytokines released from the adipose tissue and fatty acids (FAs) derived from lipolysis or uptake of fats go in to competition with glucose to be uptaken from the liver leads to insulin resistance (IR). We aimed to show the associations among serum lipid profile, FA compositions and IR.Methods Anthropometrical measurements, biochemical parameters and erythrocyte membrane (EM) FA levels of 95 obese adolescents (41 with IR) and 40 healthy controls were compared.Results LDL-C, fasting insulin levels, HOMA-IR were significantly higher and HDL-C levels were significantly lower in obese patients than in controls (p = 0.013, p < 0.001, p < 0.001 and p < 0.001, respectively). EM C 24:0, C 16:1 ω7 and C 22:1 ω9 FA levels were significantly higher, while C 20:5 ω3 (EPA) levels were significantly lower in obese subjects than in controls (p < 0.001, p = 0.018, p < 0.001, p = 0.043 and p < 0.001, respectively). Moreover, when obese subjects divided into two groups according to the presence of IR; EM C 16:1 ω7 levels were still significantly higher and EPA levels were still significantly lower in both obese subjects with and without IR compared to controls (p < 0.001 for both).Conclusion Saturated FA intake should be decreased because of its role in the development of obesity and IR, and ω-3 group FA intake should be increased. © 2014 Elsevier Ireland Ltd. All rights reserved.


Kara M.,GATA Haydarpasa Training Hospital | Genc H.,Izmir Military Hospital | Sertoglu E.,Ankara Mevki Military Hospital | Kayadibi H.,Adana Military Hospital
European Journal of Gastroenterology and Hepatology | Year: 2015

Objectives It has been reported that the neutrophil-to-lymphocyte ratio (NLR) can be measured relatively easily and can serve as a valuable index for much clinical pathology. The aim of this study was to investigate the association between NLR and hepatic histological findings in patients with nonalcoholic fatty liver disease (NAFLD). Design and methods A total of 226 consecutive patients with biopsy-proven NAFLD [nonalcoholic steatohepatitis (NASH, n=105), borderline-NASH (n=74), and simple steatosis (n=47)] were enrolled. NASH and fibrosis were diagnosed histologically using the NAFLD Clinical Research Network criteria. Results Significant differences were found in aspartate aminotransferase (P<0.001), alanine aminotransferase (P<0.001) levels, and white blood cell (P=0.007) and neutrophil counts (P=0.042) between the three groups of patients. In addition, significantly higher BMI (P=0.024), waist circumference (P=0.011), aspartate aminotransferase (P=0.003), alanine aminotransferase (P=0.005), insulin (P=0.008), and homeostasis model assessment-insulin resistance (P=0.009) levels were found in patients with fibrosis (n=133) in comparison with those without fibrosis (n=93). There was no correlation between NLR and glucose, homeostasis model assessment-insulin resistance, lipid parameters, and the NAFLD activity score. Analysis of the NLR in relation to histological findings also showed no association between these parameters. Conclusion To the best of our knowledge, this is the largest study that has investigated these relationships in this clinically relevant condition. The findings of the present study show that NLR is not associated with the severity of hepatic inflammation or fibrosis and thus cannot be recommended as a surrogate marker of liver injury in patients with NAFLD. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Kayadibi H.,Adana Military Hospital | Yasar B.,Haydarpasa Numune Training Hospital | Ozkara S.,Haydarpasa Numune Training Hospital | Kurdas O.O.,Haydarpasa Numune Training Hospital | Gonen C.,Haydarpasa Numune Training Hospital
Scandinavian Journal of Clinical and Laboratory Investigation | Year: 2014

Aim. To provide a simple fibrosis index combining the routine laboratory markers for predicting significant fibrosis (SF) and cirrhosis in patients with chronic HCV. Methods. Platelet count, ALT, AST, AST to ALT Ratio, AST to Platelet Ratio Index (APRI), Forns index, FIB-4 and Age Platelet Index of 202 liver biopsy performed HCV-infected patients were reviewed. METAVIR classification was used to determine the stage of liver fibrosis. The predictive fibrosis index was constructed by multiple linear regression analysis (- 2.948 + 0.562 × Forns index + 0.288 × APRI + 0.006 × platelet count [109/L]). Results. Median (25th-75th interquartile range) age was 52 (42-59) years, and 61% were male. 65.8% (n = 133) had SF (F2-F4) and 23.3% (n = 47) had cirrhosis (F4). For discrimination of SF, AUROCs were: Fibrosis index = 0.869, Forns index = 0.837, APRI = 0.814, platelet count = 0.764. For cirrhosis, AUROCs were: Fibrosis index = 0.911, Forns index = 0.883, APRI = 0.847, platelet count = 0.827. A cut-off point of ≤ 1.2 for fibrosis index excluded SF in 89% of patients with sensitivity of 96%, while > 2.0 predicted SF in 88% of patients with specificity of 86%. Threshold of ≤ 1.9 excluded cirrhosis in 95% of patients with sensitivity of 94%, while > 2.7 showed cirrhosis in 88% of patients with specificity of 95%. In multivariate logistic regression analysis, OR (95% CI) of fibrosis index was 7.825 (3.682-16.629) for SF (p < 0.001) and was 8.672 (4.179-17.996) for cirrhosis (p < 0.001). Conclusion. SF and cirrhosis were predicted with accuracy of 82% and 89% and were excluded with accuracy of 74% and 82% using this fibrosis index which may potentially decrease the need for liver biopsy in 76% and 83% of patients, respectively. © 2014 Informa Healthcare.


Sertoglu E.,Ankara Mevki Military Hospital | Kayadibi H.,Adana Military Hospital | Genc H.,Izmir Military Hospital | Kara M.,Etimesgut Military Hospital
Clinical Biochemistry | Year: 2014

Objectives: Non-alcoholic fatty liver disease (NAFLD) is a clinicopathological entity which is characterized by the presence of fat droplets in hepatocytes without alcohol consumption, representing a spectrum of hepatic injuries, ranging from simple steatosis (SS) to non-alcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. In recent years, experimental and observational studies suggest a role for serum uric acid (SUA) in NAFLD. However, there are few reports investigating SUA in histologically proven NAFLD. The aim of the present study was to evaluate the relationship of SUA with liver histology in non-diabetic patients with NAFLD. Design and methods: A total of 242 male patients with NAFLD (102 with NASH and 140 with SS) were included. Histopathological evaluation was carried out according to Kleiner's scoring scale. Hyperuricemia was diagnosed as SUA of more than 7. mg/dL. Results: The prevalence of hyperuricemia was 33.4%. SUA levels in patients with NASH were significantly higher than those of SS (p. = 0.035). Univariate and multivariate analyses both demonstrated that hyperuricemia had a significant association with younger age [OR (95%CI), 0.930 (0.884-0.979), p. = 0.005], higher body mass index [OR (95%CI), 1.173 (1.059-1.301), p. = 0.002] and hepatocellular ballooning [OR (95%CI), 1.678 (1.041-2.702), p. = 0.033]. Conclusions: Hyperuricemia is a common finding in patients with NAFLD and is independently associated with early histological findings in this clinically relevant condition. Further longitudinal studies are needed to characterize the role of SUA in the natural history of NAFLD. © 2014 The Canadian Society of Clinical Chemists.


Sertoglu E.,Ankara Mevki Military Hospital | Serdar M.A.,Acibadem University | Kayadibi H.,Adana Military Hospital
Chemistry and Physics of Lipids | Year: 2014

Background In this study, we aimed to compare the serum lipid profile and fatty acid (FA) compositions of erythrocyte membrane (EM) and plasma in three different patient groups (group 1: type 2 diabetes mellitus (T2DM) + end-stage renal disease (ESRD), group 2: ESRD, group 4: T2DM) and healthy controls (group 3) simultaneously. Methods 40 ESRD patients treated with hemodialysis (HD) in Gulhane School of Medicine (20 with T2DM) and 32 controls (17 with T2DM, 15 healthy controls) were included in the study. Plasma and EM FA concentrations were measured by gas chromatography-flame ionization detector (GC-FID). Results Plasma and EM palmitic acid (PA) and stearic acid (SA) levels were significantly higher in T2DM patients compared to controls (p = 0.040 and p = 0.002 for plasma, p = 0.001 and p = 0.010 for EM, respectively). EM docosahexaenoic acid (DHA) levels were also significantly lower in patients with ESRD + T2DM and ESRD compared to controls (p = 0.004 and p = 0.037, respectively). Conclusions Patients with insulin resistance display a pattern of high long chain saturated FAs (PA, SA and arachidic acids). However, while there are no recognized standards for normal EM DHA content, decreased levels of EM DHA in ESRD patient groups (groups 1 and 2) suggest that there may be reduced endogenous synthesis of DHA in HD subjects, due to the decreased functionality of desaturase and elongase enzymes. Because membrane PUFA content affects membrane fluidity and cell signaling, these findings are worthy of further investigation. © 2013 Elsevier Ireland Ltd.


Kayadibi H.,Adana Military Hospital | Sertoglu E.,Ankara Mevki Military Hospital
World Journal of Gastroenterology | Year: 2014

There is increasing evidence that neutrophil-lymphocyte ratio (NLR) may play a role in predicting recurrence in patients with hepatitis B virus-related hepatocellular carcinoma (HCC) after liver transplantation. In the original study by Yan et al, it was aimed to determine whether an elevated NLR is associated with tumor recurrence. Total tumor size (> 9 cm) and macro-vascular invasion were found to be more significant than NLR according to the multivariate logistic regression analysis. Therefore, substantive significance should be emphasized rather than NLR because total tumor size and macro-vascular invasion are easier and more expressive than NLR in assessing HCC recurrence. NLR and platelet-lymphocyte ratio (PLR) are markers which are easy to obtain and can be used as inflammation indicators. Moreover, assessment of both NLR and PLR may add some value as a good predictor of risk for post-liver transplantation HCC recurrence. However, while the study was constructed on whole blood analysis, further details about the features and performance characteristics of the whole-blood analyzer, and preanalytical/analytical variables should also be mentioned. © 2014 Baishideng Publishing Group Inc. All rights reserved.


Bullwinkle T.J.,Ohio State University | Reynolds N.M.,Ohio State University | Raina M.,Ohio State University | Moghal A.,Ohio State University | And 10 more authors.
eLife | Year: 2014

Aminoacyl-tRNA synthetases use a variety of mechanisms to ensure fidelity of the genetic code and ultimately select the correct amino acids to be used in protein synthesis. The physiological necessity of these quality control mechanisms in different environments remains unclear, as the cost vs benefit of accurate protein synthesis is difficult to predict. We show that in Escherichia coli, a non-coded amino acid produced through oxidative damage is a significant threat to the accuracy of protein synthesis and must be cleared by phenylalanine-tRNA synthetase in order to prevent cellular toxicity caused by mis-synthesized proteins. These findings demonstrate how stress can lead to the accumulation of non-canonical amino acids that must be excluded from the proteome in order to maintain cellular viability. © Bullwinkle et al.


Yasar B.,Camlica Erdem Hospital | Kayadibi H.,Adana Military Hospital | Abut E.,Umraniye Erdem Hospital | Benek D.,Camlica Erdem Hospital | And 2 more authors.
Digestive Diseases and Sciences | Year: 2014

Background: Polypectomy with jumbo forceps (JF) and polypectomy with hot biopsy forceps (HBF) are still widely used techniques for removal of diminutive colorectal polyps (DCPs). JF may be more effective for the removal of DCPs because of their larger size.Aim: To evaluate the histological quality and adequacy of DCPs resected using JF compared with HBF.Methods: One hundred and seventy-nine patients with 237 DCPs were included in this study. DCPs were removed using either JP or HBF.Results: The tissue architecture was good in 29.9 % of the HBF group, in comparison with 90 % of the JF group (p < 0.001). No cautery damage or crash artifact was observed in 93.3 % of JF group and in 8.5 % of HBF group (p < 0.001). Moreover, there were statistically significant differences between the groups with regard to the high level of cautery damage or crush artifact (p < 0.001). The overall diagnostic quality of the specimens removed using JF was significantly better than that of the specimens removed by HBF (96 vs. 80 %, respectively, p < 0.001). There were statistically significant inverse associations between cautery damage or crush artifact and overall diagnostic quality of HBF and JF (r = −0.373, p < 0.001; r = −0.382, p < 0.001, respectively). Surgical margins were determined as negative in 87.5 % of the JF group and in 76.1 % of the HBF group (p = 0.022). A total of 80.8 % of the JF specimens and 30.8 % of the HBF specimens were well evaluated for two lateral and deep surgical margins (p < 0.001).Conclusion: JF was superior to HBF for histopathological interpretation and eradication of DCPs. © 2014, Springer Science+Business Media New York.


Kayadibi H.,Adana Military Hospital | Sertoglu E.,Ankara Mevki Military Hospital | Uyanik M.,Corlu Military Hospital
Diabetology and Metabolic Syndrome | Year: 2015

Women diagnosed with gestational diabetes mellitus have an increased risk of developing diabetes mellitus, which is a known risk factor for cardiovascular disease and insulin resistance. In the recently published article by Zajdenverg et al., they aimed to identify endothelial dysfunction and cardiovascular risk factors in women with previous gestational diabetes mellitus. However, authors did not evaluate the role of total homocysteine, which has important effects for endothelial dysfunction. Vitamin B12 and folic acid are important vitamins since their deficiency may lead to the probable microvascular abnormalities by increasing the tHcy, which is an independent risk factor for endothelial dysfunction. © 2015 Kayadibi et al.; licensee BioMed Central.


PubMed | Adana Military Hospital, Corlu Military Hospital and Ankara Mevki Military Hospital
Type: | Journal: Diabetology & metabolic syndrome | Year: 2015

Women diagnosed with gestational diabetes mellitus have an increased risk of developing diabetes mellitus, which is a known risk factor for cardiovascular disease and insulin resistance. In the recently published article by Zajdenverg et al., they aimed to identify endothelial dysfunction and cardiovascular risk factors in women with previous gestational diabetes mellitus. However, authors did not evaluate the role of total homocysteine, which has important effects for endothelial dysfunction. Vitamin B12 and folic acid are important vitamins since their deficiency may lead to the probable microvascular abnormalities by increasing the tHcy, which is an independent risk factor for endothelial dysfunction.

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