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Ozaslan E.,Numune Education and Research Hospital
Hepato-Gastroenterology | Year: 2010

Occult HBV infection (OBI) is an increasingly reported form of hepatitis B virus (HBV) infection. With the current knowledge, in immunocompetent individuals, OBI is mainly a diagnostic challenge and has a very low probability of transfusion risk, controversial risk of liver disease or hepatocellular carcinoma, etc. In immunosuppressed individuals, however, reactivation of OBI is a real concern even today. There are many controversies about the management of such cases, including anti-HBc and/or alanine aminotransferase monitoring, HBV DNA monitoring, vaccination or pre-emptive nucleoside analogs. We present here four OBI cases which reveal the difficulties in the diagnosis and management of OBI and include a discussion upon current literature. © H.G.E. Update Medical Publishing S.A.

Yilmaz Y.,Marmara University | Ones T.,Marmara University | Purnak T.,Numune Education and Research Hospital | Ozguven S.,Marmara University | And 4 more authors.
Alimentary Pharmacology and Therapeutics | Year: 2011

Background The presence of active brown adipose tissue (BAT) has been associated with a reduced risk of obesity in adult humans. Aim To examine whether the presence and activity of BAT in patients undergoing PET-CT examinations is related to the presence of fatty liver. Method We retrospectively analysed 3666 consecutive PET-CT whole-body scans performed on a total of 1832 patients who were referred for suspected malignancies. BAT-positive subjects (BAT+) were defined as subjects who showed substantial amounts of brown adipose tissue on PET-CT scans. In areas where uptake of [ 18F]FDG was identified by CT for BAT, the maximal standardised uptake values (SUVmax), defined as the maximum activity per millilitre within the region of interest divided by the injected dose in megabecquerels per gram of body weight, were determined. A ratio of mean liver attenuation to spleen attenuation <0.8 on CT scans was considered to indicate NAFLD. Results Thirty patients of the 1832 screened individuals (2%) demonstrated brown fat uptake (BAT+ subjects). Ninety matched individuals without evidence of BAT on PET scans (BAT- subjects) were enrolled for comparison purposes. After adjustment for potential confounders, the odds ratio for having NAFLD was significantly higher for BAT- subjects (3.12, 95% confidence interval = 1.03-9.88, P < 0.05). The SUVmax for brown fat tissue was significantly correlated with the ratio of mean liver attenuation to spleen attenuation (P < 0.05). Conclusion The presence of brown adipose tissue in adulthood is independently associated with a lower likelihood of NAFLD diagnosed by CT findings. © 2011 Blackwell Publishing Ltd.

Derbent A.U.,Antalya Training and Research Hospital | Simavli S.A.,Bolu State Hospital | Kaygusuz I.,Fatih University | Gumus I.I.,Fatih University | And 3 more authors.
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2013

Objectives: Hepcidin is considered a major regulator of iron metabolism. Despite previous studies showing elevated ferritin and hepcidin levels in type 2 diabetes mellitus (DM), no study has investigated hepcidin levels in pregnant women with gestational DM (GDM). Methods: A case-control study was conducted in 30 cases of GDM, 47 pregnant women with impaired glucose tolerance (IGT) and 72 pregnant women with normal glucose tolerance (control) between April 2009 and July 2011. Serum hepcidin and other iron metabolism parameters were analyzed in all groups. Results: Serum ferritin and serum iron were significantly elevated in the GDM group compared to controls (p=0.014, p=0.018, respectively) and to the IGT group (p=0.021, p=0.008, respectively). Hepcidin levels were elevated significantly in the diabetic patients compared to the IGT group (p=0.011) and controls (p=0.002). We found no correlation between hepcidin and other iron metabolism parameters (Hb, serum iron and ferritin), whereas positive correlations were found between hepcidin and parameters of glucose metabolism (fasting blood glucose, fasting insulin level and glucose value response to glucose challenge test). Conclusions: Serum hepcidin concentrations were increased in pregnant women with IGT and GDM and this was not related to inflammation parameters. © 2013 Informa UK Ltd.

Bozkurt B.,Selcuk University | Ozkan F.,Numune Education and Research Hospital | Yilmaz M.,Selcuk University | Okudan S.,Selcuk University
Optometry and Vision Science | Year: 2015

Purpose. The aim was to evaluate the anterior and posterior corneal topographic characteristics of three patients with posterior polymorphous corneal dystrophy (PPCD) using a rotating Scheimpflug camera combined with a Placido disc system (Sirius, CSO, Italy). Case Reports. Two children with unilateral PPCD and a 53-year-old woman with bilateral PPCD were diagnosed by the presence of vesicles and railroad track lesions at the level of the Descemet membrane with slitlamp biomicroscopy and in vivo confocal microscopy. Anisometropic and/or meridional amblyopia was detected in both children. In the 16-year-old child, there was unilateral anterior corneal steepening with high astigmatism (plano -7.00 ×170) in the eye with PPCD. The 5-year-old boy had unilateral axial myopia and against-the-rule corneal astigmatism (-12.00 -2.00 ×90). Corneal topography of the woman revealed with-the-rule astigmatism and thin corneas (464 μm OD and 445 μm OS) in both eyes. Posterior corneal steepening greater than 25 μm either in a vertical or in a horizontal pattern changing with the orientation of the railroad track band lesions was detected in all subjects. Conclusions. Besides anterior corneal changes, PPCD seems to cause posterior corneal elevation, which necessitates corneal tomographic evaluation. In unilateral or highly asymmetric cases, children with PPCD should be screened for amblyopia. Copyright © 2015 American Academy of Optometry.

Cay S.,Yuksek Ihtisas Heart Education and Research Hospital | Cagirci G.,Diskapi Yildirim Beyazit Research and Educational Hospital | Sen N.,Mustafa Kemal University | Balbay Y.,Yuksek Ihtisas Heart Education and Research Hospital | And 3 more authors.
Cardiovascular Drugs and Therapy | Year: 2010

Background: Extensively used lipid-lowering statins have also non-lipid-lowering, pleiotropic effects. Previous studies have demonstrated that a pre-procedural single dose of atorvastatin is associated with reduced peri-procedural myocardial injury. Aim: The aim of the present study was to demonstrate the effect of a single high loading dose (40 mg) of rosuvastatin on peri-procedural myocardial injury. Methods: Two hundred ninety nine statin-naive patients with stable angina and de novo lesions eligible for PCI were randomized to a rosuvastatin-treatment (n=153) and to a no-treatment (n=146) group. A 40 mg loading dose of rosuvastatin was administrated 24 h before the PCI. CK-MB and cTnI levels were measured before and 12 h after the procedure. Results: Baseline characteristics were fairly similar between the two arms. The incidence of a CK-MB and cTnI elevation >3× ULN in the rosuvastatin group was significantly lower compared to the control group (0.7% vs. 11.0%, p<0.001 and 10.5% vs. 39.0%, p<0.001, respectively). Similarly, the incidence of any CK-MB and cTnI elevation>ULN in the rosuvastatin group was significantly lower compared to the control group (10.5% vs. 34.2%, p<0.001 and 20.9% vs. 61.6%, p<0.001, respectively). In addition, CK-MB and cTnI values 12 h after the PCI were significantly lower in the rosuvastatin group compared to the control group (20.13±7.24 U/L vs. 27.02±18.64 U/L, p<0.001 and 0.14±0.34 ng/ml vs. 0.35±0.40 ng/ml, p<0.001, respectively). Conclusion: A single high loading dose of rosuvastatin reduces the incidence of peri-procedural myocardial necrosis and infarction effectively. © 2010 Springer Science+Business Media, LLC.

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