Firdevs Topal

The Relationship Between Mean Platelet Volume Levels and the Inflammation in Helicobacter Pylori Gastritis

Helicobacter pylori is a cause of chronic gastritis. Mean platelet volume (MPV) has been started to be used as a simple inflammatory indicator in some diseases. We have aimed especially to investigate the usability of MPV as a simple indicator that may reflect severity of inflammation in gastric mucosa. Included in the study were a total of 114 patients who visited the outpatient clinic of gastroenterology with complaint of dyspepsia. Blood MPV levels in hemogram results were evaluated. Esophagogastroduodenoscopy was performed on patients included in the study, and histological analysis was performed by obtaining 2 specimens from each of antrum, corpus, and incisura angularis. All specimens were evaluated according to the updated Sydney System. No statistically significant result was found among blood MPV levels, the intensity of H pylori, and the severity of inflammation of gastric mucosa. However, it is interesting that mean MPV levels in cases with lymphoid follicle were lower. We suggest that MPV level cannot be used as a simple marker to reflect H pylori intensity and severity of inflammation in gastric endoscopic biopsies.

Relationship of the intensity of Helicobacter pylori and severity of inflammation with beta-2 microglobulin levels in serum according to the updated Sydney system.

Objective: Helicobacter pylori (HP) is a cause of chronic gastritis. Beta-2 microglobulin has been used as a simple inflammatory indicator in some diseases. We investigate the usability of beta-2 microglobulin as a simple marker that may reflect the severity of inflammation and intensity of HP in gastric mucosa. Materials and Methods: A total of 114 patients was included in the study, who applied to an outpatient gastroenterology clinic with complaint of dyspepsia. Serum beta-2 microglobulin levels were evaluated in 109 patients. Esophagogastroduodenoscopy was performed on patients included in the study, and histological analysis was performed by obtaining two specimens from each of antrum, corpus, and incisura angularis. All specimens were evaluated according to the updated Sydney System. Results: No statistically significant result was found between serum beta-2 microglobulin levels and the intensity of HP and the severity of inflammation of gastric mucosa. However, it was observed that the serum beta-2 microglobulin level in specimens taken from corpus was found to be higher in patients with moderate-severe HP intensities compared to those with lower HP intensities. Conclusions: Although HP is the cause of the chronic active gastritis characterized with the infiltration of lymphocytes, plasma cells, and neutrophils, it is accompanied by local involvement apart from diseases with a course of systemic involvement. We suggest that the serum beta-2 microglobulin level cannot be used as a simple marker of HP intensity and severity of inflammation in gastric endoscopic biopsies.

Paraneoplastic presentation of cholestatic jaundice in renal cell carcinoma.

A 46-year-old female was admitted to the hospital with jaundice and pruritus. The patient had no previous history of liver or biliary disease. She had no reported any drug use nor had she any history of cigarette smoking or drinking alcohol. In the physical exam, she had icterus in the sclera of her eyes, and no pathologic exam finding was observed other than mild painless hepatomegaly. There were no palpable lymph nodes, splenomegaly, or ascites. Laboratory findings revealed: hemoglobin 11.6 g/dL, white blood cells 7200/μL, platelets 368,000/ μL, aspartate aminotransferase (AST) 103 IU/L, alanine aminotransferase (ALT) 77 IU/L, gamma-glutamyl transpeptidase (γ-GT) 122 IU/L, alkaline phosphatase (ALP) 183 IU/L, total bilirubin 8.9 mg/dL, conjugated bilirubin 6.3 mg/dL, and albumin 3.3 mg/dL. Thyroid function tests, blood urea nitrogen, and serum creatinine were all within normal limits.

Strontium Chloride: Can It Be a New Treatment Option for Ulcerative Colitis?

Background/Aims. Patients with ulcerative colitis still need effective therapy without major side effects. It has been found that strontium can suppress NFκB activation induced by TNF-α. This opens a gate to a new anti-TNF agent which is cheap and can be given orally. We for the first time aimed to investigate the effect of strontium chloride (SrCl2) on inflammation in experimental colitis. Methods. Thirty female Wistar albino rats were divided into 5 groups each containing 6 rats. The rats in groups 1 and 2 served as the healthy control and colitis group, respectively. The rats in groups 3, 4, and 5 had colitis and received 40 mg/kg SrCl2, 160 mg/kg SrCl2, and 1 mg/kg prednisolone by oral gavage, respectively. The rats were sacrificed for histological evaluation and determination of serum neopterin, TNF-α, and IFN-γ levels. Results. The neopterin, TNF-α and IFNγ levels of group 2 was significantly higher than the other groups. The neopterin, TNF-α, and IFN-γ levels of controls and other treatment groups were comparable. There were a significant difference in macroscopic and microscopic healing between group 2 and other groups histologically. But there was not a significant difference within treatment receiving groups. Conclusion. SrCl2 had comparable therapeutic efficiency with prednisolone.

Is P2/MS score valuable for prediction in HBV-related variceal bleeding?

Objective: To determine the predictive value of P2/MS in patients with chronic HBV-related cirrhosis, and to predict high-risk esophageal varices, and obtain a cut-off value. Methods: A total of 412 patients with HBV-related cirrhosis who were admitted to our hospital between August 2014 and August 2017 were retrospectively evaluated. A diagnosis of cirrhosis was made with standard laboratory, radiological and physical examination findings. According to these evaluations, esophageal varices were classified as small, medium and large. For all obtained data, P2/MS was calculated. Two threshold values (P2/MS<11 and P2/MS>25) were considered in predicting the presence of high-risk EVs during recording. And the optimal cutoff value of the P2/MS index was determined for high-risk esophageal varices in patients with chronic viral hepatitis B. Results: A total of 375 patients who met the inclusion criteria were included in the study. When the P2/MS index was compared with other noninvasive tests, the mean and median P2/MS scores were respectively 54.17 and 33.25. The P2/MS value of the patients without esophageal varices was higher than that of the patients with esophageal varices. When these results were evaluated, the higher the score, the lower the risk of varices. We obtained a positive predictive value of 93.80% [95% CI (80.20-98.70)] when the cut-off value of P2/MS was taken as <11, and obtained a negative predictive value of 94.30% [95% CI (86.20-98.20%)] when the cut-off value of P2/MS was taken as >25. Conclusions: We could predict the patients with high-risk esophageal varices within this group at a extremely good rate. We also compared the results of this test with other non-invasive tests and achieved successful results. We have shown that P2/MS can be used in order to optimally select patients for endoscopic screening and prevent all of the expensive and unnecessary procedures safely.

Is there a link between neutrophil-lymphocyte ratio and patient compliance with gluten free diet in Celiac Disease?

Celiac disease (CD) is a chronic, autoimmune and inflammatory disease with an incidence of 0.5 to 1% in the general population (1, 2). Patients usually present with gastrointestinal symptoms such as abdominal pain, diarrhea, nausea, and vomiting. However, extraintestinal manifestations such as iron deficiency anemia, vitamin B12 and folic acid deficiencies, osteoporosis and neuropsychiatric symptoms are not rare (2, 3).

Duodenumda ascaris lumbricoides

36 yasinda bayan hasta, kilo kaybi, bulanti, kusma yakinmalari ile poliklinigimize basvurdu. Fizik muayenesi kasetik gorunumu disinda normaldi. Ozgecmisinde ozellik yoktu, biliyer operasyon veya ERCP islemi yapilmamisti. Rutin laboratuvar tetkiklerinde onemli bir bulgusu yoktu. Tum batin ultrasonografisi normaldi. Kasektik gorunumu ve kusma yakinmasi oldugu icin gastrointestinal malignite veya colyak hastaligi on tanisi ile yapilan ust gastrointestinal sistem endoskopisinde duodenum icerisinde yaklasik 30 cm boyutunda, lumende oldukca hizli hareket eden, kirli sarimtirak renkte intestinal parazit izlendi (Ascaris Lumbricoides) (Resim 1, 2). Mevcut parazitin polipektomi sneare ile cikartilmasi dusunuldu, fakat parazit cok haraketli oldugundan dolayi basarili olunamadi. Hastaya askariyozis icin pyrantel pamoate tedavisi verildi.