Red cell distribution width for assessment of activity of inflammatory bowel disease

Cakal B. | Akoz A.G. | Ustundag Y. | Yalinkilic M. | Ulker A. | Ankarali H.

Article | 2009 | Digestive Diseases and Sciences54 ( 4 ) , pp.842 - 847

Background Impaired iron absorption or increased loss of iron was found to correlate with disease activity and markers of inflammation in inflammatory bowel disease (IBD). Red cell distribution width (RDW) could be a reliable index of anisocytosis with the highest sensitivity to iron deficiency. Aim The importance of RDW in assessment of IBD disease activity is unknown. In this study, we aimed to determine if RDW could be useful in detecting active disease in patients with IBD. Materials and methods A total of 74 patients with ulcerative colitis (UC) and 22 patients with Crohn's disease (CD) formed the study group with 20 age- and s . . .ex-matched healthy volunteers as the control group. CD activity index higher than 150 in patients with CD was considered to indicate active disease. Patients with moderate and severe disease according to the Truelove-Witts scale were accepted as having active UC. In addition to RDW, serum C-reactive protein (CRP) and fibrinogen levels, erythrocyte sedimentation rates (ESR), leukocyte, and platelet counts were measured. Results Fourteen (63.6%) of the patients with CD and 43 (58.1%) of the patients with UC had active disease. RDW, fibrinogen, CRP, ESR, and platelet counts were all significantly elevated in patients having active IBD compared with those without active disease and controls (P < 0.05). The study subjects were further classified into two subgroups: cases with active and inactive UC and those with active and inactive CD. A subgroup analysis indicated that for an RDW cutoff of 14, the sensitivity for detecting active UC was 88% and the specificity was 71% (area under curve [AUC] 0.81, P = 0.0001). RDW was the most sensitive and specific parameter indicating active UC. However, the same was not true for CD since CRP at a cutoff of 0.54 mg/dl showed a sensitivity of 92% and a specificity of 63% (AUC 0.92, P = 0.001), whereas RDW at a cutoff of 14.1 showed 78% sensitivity and 63% specificity to detect active CD. Conclusion Among the laboratory tests investigated, including fibrinogen, CRP, ESR, and platelet counts, receiver operating characteristic (ROC) curve analysis indicated RDW to be the most significant indicator of active UC. For CD, CRP was an important marker of active disease. © 2008 Springer Science+Business Media, LLC Daha fazlası Daha az

The effect of Helicobacter pylori on insulin resistance

Aydemir S. | Bayraktaroglu T. | Sert M. | Sokmen C. | Atmaca H. | Mungan G. | Gun B.D.

Article | 2005 | Digestive Diseases and Sciences50 ( 11 ) , pp.2090 - 2093

Helicobacter pylori causes a lifelong infection in the stomach after exposure. H. pylorihas been shown to be associated with peptic ulcer and gastric cancer development. Moreover, it is held responsible for some other nongastric diseases. Among them, coronary heart disease attracts much debate. Many studies have demonstrated a close relationship between insulin resistance and atherosclerosis. Chronic inflammation and alterations in counter-regulatory hormones are deemed responsible for the etiology of insulin resistance. We aimed to examine the effect of H. pylori on insulin resistance. Sixty-three patients were enrolled in the stud . . .y. Patients were divided into two groups according to H. pylori presence. HOMA-IR (homeostasis model assessment of insulin resistance) level was used to assess insülin resistance. Thirty-six patients were H. pylori positive and 27 were H. pylori negative. There was no difference between the two groups with regard to age, gender, or body mass index. HOMA-IR level was 1.73± 1.1 in the H. pylori-negative group, whereas it was 2.56 ± 1.54 in the H. pylori-positive group (P < 0.05). This study provides the first direct evidence for an association between chronic H. pylori infection and insulin resistance. © 2005 Springer Science + Business Media, Inc Daha fazlası Daha az

Analysis of adverse events associated with endoscopic papillary large-balloon dilation

Ustundag Y. | Ersoz G. | Saritas U.

Letter | 2013 | Digestive Diseases and Sciences58 ( 8 ) , pp.2426 - 2428

[No abstract available]

NaOH-induced Crohn's colitis in rats: A novel experimental model

Koçak E. | Köklü S. | Akbal E. | Taş A. | Karaca G. | Astarcı M.H. | Güven B.

Article | 2011 | Digestive Diseases and Sciences56 ( 10 ) , pp.2833 - 2837

Aim: Several models of experimental ulcerative colitis have been previously reported. To date, only one model of Crohn's colitis that was induced by trinitrobenzene sulfonic acid has been described. Materials and Methods: Twenty-one male albino rats were divided into three groups: group I: sham control group (n = 7), group II: acetic acid group (n = 7), group III: NaOH group (n = 7). On the day of induction, all rats were lightly anesthetized with intramuscular ketamine (8 mg/kg). A 6F plastic catheter was inserted rectally until the tip was 5 cm proximal to the anus. Then, 2 ml of 0.9% saline, 2 ml of 4% acetic acid, and 2 ml of 6. . . .25% NaOH was administered to groups I, II, and III, respectively. All rats were sacrificed 5 days after colitis induction. The distal colon segment was assessed macroscopically and microscopically. In addition, malondialdehyde (MDA) and nitric oxide (NO) levels of the colonic tissue and changes in body weight were measured. Results: Macroscopic and microscopic examinations of colonic tissue samples showed morphological similarities to human Crohn's disease (CD). The MDA and NO levels of the colonic tissues were significantly higher in the NaOH group compared to the acetic acid and sham control groups (P = 0.001). Conclusion: NaOH may be used to induce Crohn's colitis as an experimental model. © 2011 Springer Science+Business Media, LLC Daha fazlası Daha az

Intrapancreatic lipoma and morgagni hernia: A previously unrecognized association

Erdem L.O. | Erdem C.Z. | Comert M.

Article | 2004 | Digestive Diseases and Sciences49 ( 11.Dec ) , pp.1962 - 1964

[No abstract available]

Role of radial endosonography in the diagnosis of acute cholangitis

Alper E. | Unsal B. | Buyrac Z. | Baydar B. | Akca S. | Arslan F. | Ustundag Y.

Article | 2011 | Digestive Diseases and Sciences56 ( 7 ) , pp.2191 - 2196

Background and Study Aim: We aimed to assess radial endoscopic ultrasound (EUS) features of the bile duct wall as well as biliary luminal liquid characteristics in cases with acute cholangitis. Patients and Methods: This prospective study was performed during the period from January 2009 to February 2010 in a tertiary referral center. Twenty-eight patients with acute cholangitis and 60 patients without acute cholangitis but with cholestasis due to gallstone disease were enrolled in the study. During radial EUS examination, sonographic features of the common bile duct wall, the intraductal luminal content, and nearby periductal struc . . .tures were investigated. Mild hyperechogenic-heterogenic appearances with waving-type movements without acoustic shadowing enclosing one-third of the common bile duct were noted as purulent materials. Results: EUS indicated an increased focal and/or diffuse concentric bile duct wall thickness (>1.5 mm) in 68 and 27% of the cases with and without acute cholangitis, respectively. The mean bile duct wall thickness was 1.9 mm (0.9-2.9 mm) and 1.1 mm (0.6-2.1 mm) in the study and control groups, respectively (P < 0.05). On EUS, a pericholedochal hypoechoic strand more than 1.5 cm in length was present in 13 of 28 patients with acute cholangitis (46%). It was less than 1 cm long in 11 cases without acute cholangitis (18%). Bile duct content with heterogenous dense echogenicity without acoustic shadowing was present in 18 patients (64%) with acute cholangitis and in two patients (3%) without cholangitis. Those 20 patients were successfully drained with a same-day endoscopic retrograde cholangiography (ERCP) procedure which confirmed purulent biliary content after sphincterotomy. Same-day ERCP revealed no purulent material drainage from the bile duct in the other eight patients without cholangitis. The accuracy and positive and negative predictivity of diffuse concentric wall thickening and a peribiliary hypoechoic strand of greater than 1.5 cm in length for a diagnosis of acute cholangitis were 91, 86.3, and 67.1%, and 76, 72, and 54%, respectively. For purulent material, the accuracy and positive and negative predictive values of EUS for acute cholangitis were noted to be 87, 93.3, and 82%, respectively. Conclusion: Through this study, it was concluded that EUS findings such as diffuse and/or concentric wall thickening of more than 1.5 mm and intraductal heterogenous echogenicity without acoustic shadowing are highly accurate and predictive for diagnosing acute cholangitis. © 2011 Springer Science+Business Media, LLC Daha fazlası Daha az

The Janeway gastrostomy tube for recurrent gastric intubations: A novel and simple animal model

Emre A.U. | Karadeniz G.Ç. | Tascilar O. | Ucan B.H. | Irkorucu O. | Karakaya K. | Comert M.

Article | 2008 | Digestive Diseases and Sciences53 ( 2 ) , pp.410 - 412

Access to the gastric lumen can be achieved by different methods. Orogastric tubes and tube gastrostomies are frequently used but these routes have some disadvantages when recurrent gastric intubations or infusions are concerned. The Janeway gastrostomy tube is a simple-to-perform procedure and can serve as an excellent way to reach the gastric lumen of animals. It is also possible to insert large caliber devices such as cameras to examine the gastric lumen. Plugging of the pylorus is also possible with Fogarty catheters either blind or under radiological guidance. The Janeway gastric tube seems to be useful for long-lasting gastroi . . .ntestinal procedures, for example gastric cancer studies. © 2007 Springer Science+Business Media, LLC Daha fazlası Daha az

Splenic vein aneurysm demonstrated by magnetic resonance angiography

Cömert M. | Erdem L.O. | Özdolap Ş. | Erdem C.Z. | Sarikaya S.

Article | 2005 | Digestive Diseases and Sciences50 ( 7 ) , pp.1344 - 1346

[No abstract available]

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