Cengiz Bolukbas

Relationship between levels of DNA damage in lymphocytes and histopathological severity of chronic hepatitis C and various clinical forms of hepatitis B

Background and Aim:  A significant proportion of cancer is attributable to DNA damage caused by chronic infection and inflammation. Because both hepatitis B and C viruses (HBV and HCV, respectively) cause chronic infection and inflammatory disease, the aim of the present study was to investigate whether there is a difference in peripheral DNA damage in patients with chronic HCV compared with patients with chronic HBV; and whether there is an association in the level of peripheral DNA damage with a natural history of HBV infection.

The Relationship Between Leptin Level and Oxidative Status Parameters in Hemodialysis Patients

Both serum leptin level and oxidative stress are increased in hemodialysis (HD) patients. In the present study, we aimed to investigate whether there is association between oxidative status and leptin level in HD patients. Thirty-five HD patients and 25 healthy controls were enrolled in the present study. Serum leptin level, total peroxide (TP) level, total antioxidant capacity (TAC), and oxidative stress index (OSI) were determined. Serum leptin level, TP level, and OSI were significantly higher in HD patients than controls (all P < 0.001) while TAC was lower (P < 0.001). In HD patients, serum leptin level was significantly correlated with TP level and OSI (r = 0.372, P < 0.001 and r = 0.409, P < 0.001, respectively). The correlation of serum leptin level with TP level and OSI remained statistically significant after adjusting for age, gender, and body-fat percentage (r = 0.446, P < 0.001 and r = 0.463, P < 0.001, respectively). Hyperleptinemia seems to be associated with increased oxidative stress in HD patients, and this association may provide better understanding about the disorders related to either elevated serum leptin levels and/or increased oxidative stress in HD patients.

D-dimer--can it be a marker for malignant gastric lesions?

(14 of these had metastasis), 5 (14%) had stage IIIB, 7 (20%) had IIIA, and 2 (6%) had stage II disease. Plasma D-dimer levels were significantly higher in patients with malignant gastric lesions (5.159 /10.46 mcg/ml [range: 0.22 � /40.75 mcg/ml] for adenocarcinoma vs 0.759 /1.09 mcg/ml [range: 0.04 � /4.72 mcg/ml] for benign lesions, p B /0.001). This was also true for patients with stages I to III gastric cancer compared with benign lesions (1.369 /1.16 mcg/ml for stages I to III patients vs 0.759 /1.09 mcg/ml for benign lesions; pB /0.001). The cut-off point of 0.585 mcg/ml was selected as best lower than median D-dimer level for benign lesions. The group with gastric cancer and the group with benign gastric diseases were used to calculate sensitivity and specificity. The sensitivity at a D-dimer level of 0.585 mcg/ml was 86% (95% confidence interval 71% to 95%). The specificity at this value was 81% (95% confidence interval 64% to 93%). The positive and the negative predictive value were both 84%. There were 29 patients with gastric cancer whose levels were 0.585 mcg/ml, while only 6

Intrahepatic Cholestasis of Pregnancy: Spontaneous vs in vitro Fertilization

Aim: Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy. Although it was shown that multiple pregnancy and hormone therapies increase the risk of ICP, there is limited information that compared spontaneous fertilization and in vitro fertilization (IVF) from the aspect of developing ICP. In our study, we investigated the potential relationship between ICP and IVF/ spontaneous pregnancy. Materials and methods: We reviewed the records (between June 2007 and December 2014) of pregnancies with ICP who were referred to gastroenterology clinics in three different hospitals. Fifty-nine pregnancies (43 spontaneous fertilization, 16 IVF) with ICP were analyzed from the aspect of age, fertilization type, multiple/singleton pregnancy, delivery week, and biochemical results. Results: We found that serum bile acid levels were higher in the IVF group than the spontaneous fertilization group (32.8 ± 20 vs 19.6 ± 19 μmol/L; p < 0.05). There was a significant inverse correlation between serum bile acid levels and gestational age (r = -0.42, p < 0.01) in the whole group. There was no difference between IVF and spontaneous fertilization groups in term of age, onset time of symptoms, serum alanine aminotransferase (ALT), alkaline phosphatase (ALP), total and direct bilirubin levels, prothrombin time (PT), international normalized ratio (INR), and platelet count. Conclusion: Our results suggest that the serum bile acid levels are higher in IVF than in spontaneous pregnancies with ICP, but its clinical implications are not clear. Further prospective studies with large number of ICP cases are needed to clarify the effect of IVF on ICP. How to cite this article: Bolukbas FF, Bolukbas C, Balaban HY, Aygun C, Ignak S, Ergul E, Yazicioglu M, Ersahin SS. Intrahepatic Cholestasis of Pregnancy: Spontaneous vs in vitro Fertilization. Euroasian J Hepato-Gastroenterol 2017;7(2):126-129.

Changes in the prevalence of HBV infection in pregnant women in Turkey between 1995 and 2015: a 20-year evaluation

Objective To determine changes in hepatitis B virus (HBV) prevalence across three different time periods in pregnant women. Methods This was a retrospective study of pregnant women attending four healthcare centres between January 1995 and May 2015. Data for serum hepatitis B surface antigen (HBsAg) and anti-HBs levels were collected from routine antenatal screening records. The 20-year study was divided into three periods: 1995–2001, 2002–2008 and 2009–2015. The results are presented by the womens age and gravidity as possible determinants of HBV infection. Results 7605 pregnant women (56.0% primigravidae) (mean age 23.4±4.8 years) were tested for markers of HBV infection. 3010 pregnant women were screened between 1995 and 2001, 2995 between 2002 and 2008, and 1600 between 2009 and 2015. The overall prevalence of HBsAg and anti-HBs positivity in the 7605 pregnant women was 1.5% (n=114) and 11.5% (n=877), respectively. Regarding temporal change in the prevalence of HBV markers, HBsAg decreased significantly from 2.6% to 0.8% (p<0.01), while anti-HBs increased significantly from 9.5% to 17.5% (p<0.01), between the first and last study periods. Multigravidae and older women had higher HBsAg and anti-HBs positivity compared to primigravidae. Conclusions The data suggest that the prevalence of HBsAg positivity is gradually decreasing among pregnant women, while the level of HBsAg antibody seropositivity is lower than expected. HBV carrier rate increases with increasing age and gravidity. In addition to the national HBV immunisation programme, the prevention of perinatal transmission should also be prioritised to decrease the HBV pool of infection.