Esophageal dysphagia (ED) is often underestimated in neuromuscular disorders (NMD) and it is impo... more Esophageal dysphagia (ED) is often underestimated in neuromuscular disorders (NMD) and it is important to evaluate the esophageal phase of swallowing with an easy and rapid screening test. We aimed both to assess the prevalence of ED in NMD and to perform validity and reliability study of the brief easophageal dysphagia questionnaire (BEDQ) screening test in NMD patients. This prospective cross-sectional clinical study was performed on NMD patients. Demographic features and disease characteristics were recorded. Endoscopic evaluation for oropharyngeal dysphagia (OD) and high-resolution esophageal manometry for ED were performed. In addition, the BEDQ and the 10-item eating assessment tool (EAT-10) were used to all subjects. Cronbach’s α and principle components factor analysis (PFCA) with varimax rotation were used for reliability. The Chicago Classification version 3 (CCv3) level (high-resolution esophageal manometry) and EAT-10 was used for validity. A total of 50 patients were included in the study. Thirty-four (68%) patients were diagnosed with myasthenia gravis and 16 (32%) patients were diagnosed with myopathy. Esophageal dysphagia according to the CCv3 was found in 33 (66%) of patients. While the Cronbach’s α was excellent as 0.937 for test overall the T-BEDQ scale. The PCFA included all scale items and resulted in a single factor (eigenvalue = 5.72, 71.5%). The all BEDQ scores were demonstrated good correlation with EAT-10 score and very good correlation with CCv3 level. Evaluation of swallowing in patients with NMD should include not only the oropharyngeal phase of swallowing, but also esophageal phase. For this purpose, the BEDQ can be used as a rapid, valid, and reliable test for the evaluation of ED.
Acute pancreatitis is a paranchymal inflamatory disease of the pancreas. According to the clinica... more Acute pancreatitis is a paranchymal inflamatory disease of the pancreas. According to the clinical presentation, pancreatitis is divided into two groups; mild (edematous) and severe (necrotizing) pancreatitis. Gall stones and alcohol use are the most common etiologic reasons. Hypertriglyceridemia is a rare etiological factor in non-biliary pancreatitis. Serum amylase levels may be at normal ranges in acute pancreatitis due to hypertriglyceridemia. Radiological screening and serum lipase levels are helpful for diagnosis. Herein we present a case of acute pancreatitis secondary
In this study, we aimed to define the predictive role of liver function tests at admission to the... more In this study, we aimed to define the predictive role of liver function tests at admission to the hospital in outcomes of hospitalised patients with COVID‐19.
Background Faecal microbiota transplantation (FMT) provides replacement of pathogenic bacteria wi... more Background Faecal microbiota transplantation (FMT) provides replacement of pathogenic bacteria with more favourable microbiomes in recipients with dysbiosis. The aim of the present study was to prospectively investigate the efficacy of FMT by assessing the clinical and endoscopic response in patients with ulcerative colitis (UC) who had failed anti-inflammatory, immunosuppressive and TNF-α inhibitors (Infliximab, Adalimumab, Vedolizumab) therapy. Methods In this prospective and uncontrolled study, 116 patients with UC were enrolled. All medications except mesalazine were discontinued 1 week before FMT. Colonoscopy was performed both before and after FMT. To assess the efficacy of FMT, Mayo scores were calculated at weeks 0, 24 and 48. A total of 400–600 ml of extracted fresh faecal suspension was administered into the 20 to 30 cm of terminal ileum of recipients. Results After 4.5 years of FMT experience with 116 patients, who have completed their 6 months after 236 procedures of FM...
The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2017
Acute pancreatitis (AP) is a disease that can cause local and systemic complications that may hav... more Acute pancreatitis (AP) is a disease that can cause local and systemic complications that may have high morbidity and mortality. Currently, there is not any specific treatment for AP. In this study, we created an experimental model of AP in rats, and we aimed to demonstrate the histological effectiveness of tocilizumab treatment that antagonizes interleukin-6 (IL-6), one of the key cytokines in the development of AP. Forty-eight rats were divided into six groups for this study. AP model was created by subcutaneous injections of cerulein (20 μg/kg) four times at 1-h intervals. Tocilizumab 4 mg/kg was administered to one of the treatment groups and 8 mg/kg to the other treatment group intraperitoneally. The effects of tocilizumab were revealed by examining pancreatic tissue of the rats histopathologically according to the Schonberg scoring system. A comparison between tocilizumab treatment group and AP control group provides statistically significant improvement in AP (p<0.0001). F...
Eosinophilic esophagitis (EoE) is a chronic disease usually presenting with dysphagia and food im... more Eosinophilic esophagitis (EoE) is a chronic disease usually presenting with dysphagia and food impaction. Food allergy has been suggested as a causative trigger for some patients. Diagnosis of EoE is based on characteristic endoscopic and histological features. A ringed appearance referred to as “trachealization” is the classical endoscopic finding. Eosinophil-predominant inflammation is typical in histologic examination. The use of topical steroids is an effective and viable therapeutic option in the management of EoE in adults with relatively few side effects. Herein, we report a case of EoE presenting with severe dysphagia due to garlic impaction. Inhaled corticosteroid (budenoside) was prescribed for treatment due to the patient’s history of long-term proton-pump inhibitor use. Dysphagia complaints resolved after the prescribed treatment.
Dear Editor, We read with great interest the recently published article by Fukuda et al. The auth... more Dear Editor, We read with great interest the recently published article by Fukuda et al. The authors indicate that there is significant correlation between serum telaprevir (TVR) level and bodyweight and suggest that adjustment of TVR dose according to bodyweight would avoid renal impairment during treatment. Herein, we want to present a case in which renal impairment completely reversed after discontinuation of TVR, and ribavirin dose reduction seemed to be important in improving renal impairment until therapy. A 51-year-old woman came to our clinic 4 months ago. She had chronic active hepatitis C, and had received peginterferon-α-2b and ribavirin treatment for 48 weeks after being diagnosed in 2010; but 6 months after remission, her condition relapsed. She had no history of renal failure until the dual treatment. After evaluation of the patient, we decided to administrate triple therapy, a combination of TVR 2250 mg/day, peginterferon-α-2a 180 μg/week and ribavirin 800 mg/day. At day 10, the patient’s serum creatinine (sCr) level rose to 1.3 mg/dL and glomerular filtration rate (GFR) was 48 mL/min (pretreatment: sCr, 0.8 mg/dL; GFR, 79 mL/min). We decided to reduce the ribavirin dose and not to reduce TVR therapy after evaluation of other causes of renal failure. We reduced the ribavirin dose 200 mg every 2 weeks until 200 mg/day and did not reduce TVR and peginterferon dose, and gave fluid resuscitation. Despite replacement therapy, her sCr level rose to 2.1 mg/dL. We decided to continue treatment despite low GFR (30 mL/min), because the urine output was sufficient. Also, with high fluid replacement, her sCr level remained constant at 1.5 mg/dL with GFR of 41 mL/ min until the 12th week. After the 12 weeks of therapy with triple treatment, we stopped TVR as scheduled. After finishing TVR treatment, and continuing dual treatment with peginterferon and ribavirin, her sCr level fell to a normal level (0.8 mg/dL). Despite this study, we did not observe irreversible renal damage in our patient. Mauss et al. showed in their study that renal impairment is reversible after discontinuation of the treatment. Instead of decreasing TVR dose, ribavirin dose reduction may be appropriate. In our patient, despite low GFR levels, our patient finished hepatitis C virus treatment successfully. In patients with renal impairment with high urine output, therapy could be completed with appropriate supportive treatment, and we believe that as well as the decrease in GFR, urine output should be taken into account.
Esophageal dysphagia (ED) is often underestimated in neuromuscular disorders (NMD) and it is impo... more Esophageal dysphagia (ED) is often underestimated in neuromuscular disorders (NMD) and it is important to evaluate the esophageal phase of swallowing with an easy and rapid screening test. We aimed both to assess the prevalence of ED in NMD and to perform validity and reliability study of the brief easophageal dysphagia questionnaire (BEDQ) screening test in NMD patients. This prospective cross-sectional clinical study was performed on NMD patients. Demographic features and disease characteristics were recorded. Endoscopic evaluation for oropharyngeal dysphagia (OD) and high-resolution esophageal manometry for ED were performed. In addition, the BEDQ and the 10-item eating assessment tool (EAT-10) were used to all subjects. Cronbach’s α and principle components factor analysis (PFCA) with varimax rotation were used for reliability. The Chicago Classification version 3 (CCv3) level (high-resolution esophageal manometry) and EAT-10 was used for validity. A total of 50 patients were included in the study. Thirty-four (68%) patients were diagnosed with myasthenia gravis and 16 (32%) patients were diagnosed with myopathy. Esophageal dysphagia according to the CCv3 was found in 33 (66%) of patients. While the Cronbach’s α was excellent as 0.937 for test overall the T-BEDQ scale. The PCFA included all scale items and resulted in a single factor (eigenvalue = 5.72, 71.5%). The all BEDQ scores were demonstrated good correlation with EAT-10 score and very good correlation with CCv3 level. Evaluation of swallowing in patients with NMD should include not only the oropharyngeal phase of swallowing, but also esophageal phase. For this purpose, the BEDQ can be used as a rapid, valid, and reliable test for the evaluation of ED.
Acute pancreatitis is a paranchymal inflamatory disease of the pancreas. According to the clinica... more Acute pancreatitis is a paranchymal inflamatory disease of the pancreas. According to the clinical presentation, pancreatitis is divided into two groups; mild (edematous) and severe (necrotizing) pancreatitis. Gall stones and alcohol use are the most common etiologic reasons. Hypertriglyceridemia is a rare etiological factor in non-biliary pancreatitis. Serum amylase levels may be at normal ranges in acute pancreatitis due to hypertriglyceridemia. Radiological screening and serum lipase levels are helpful for diagnosis. Herein we present a case of acute pancreatitis secondary
In this study, we aimed to define the predictive role of liver function tests at admission to the... more In this study, we aimed to define the predictive role of liver function tests at admission to the hospital in outcomes of hospitalised patients with COVID‐19.
Background Faecal microbiota transplantation (FMT) provides replacement of pathogenic bacteria wi... more Background Faecal microbiota transplantation (FMT) provides replacement of pathogenic bacteria with more favourable microbiomes in recipients with dysbiosis. The aim of the present study was to prospectively investigate the efficacy of FMT by assessing the clinical and endoscopic response in patients with ulcerative colitis (UC) who had failed anti-inflammatory, immunosuppressive and TNF-α inhibitors (Infliximab, Adalimumab, Vedolizumab) therapy. Methods In this prospective and uncontrolled study, 116 patients with UC were enrolled. All medications except mesalazine were discontinued 1 week before FMT. Colonoscopy was performed both before and after FMT. To assess the efficacy of FMT, Mayo scores were calculated at weeks 0, 24 and 48. A total of 400–600 ml of extracted fresh faecal suspension was administered into the 20 to 30 cm of terminal ileum of recipients. Results After 4.5 years of FMT experience with 116 patients, who have completed their 6 months after 236 procedures of FM...
The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2017
Acute pancreatitis (AP) is a disease that can cause local and systemic complications that may hav... more Acute pancreatitis (AP) is a disease that can cause local and systemic complications that may have high morbidity and mortality. Currently, there is not any specific treatment for AP. In this study, we created an experimental model of AP in rats, and we aimed to demonstrate the histological effectiveness of tocilizumab treatment that antagonizes interleukin-6 (IL-6), one of the key cytokines in the development of AP. Forty-eight rats were divided into six groups for this study. AP model was created by subcutaneous injections of cerulein (20 μg/kg) four times at 1-h intervals. Tocilizumab 4 mg/kg was administered to one of the treatment groups and 8 mg/kg to the other treatment group intraperitoneally. The effects of tocilizumab were revealed by examining pancreatic tissue of the rats histopathologically according to the Schonberg scoring system. A comparison between tocilizumab treatment group and AP control group provides statistically significant improvement in AP (p<0.0001). F...
Eosinophilic esophagitis (EoE) is a chronic disease usually presenting with dysphagia and food im... more Eosinophilic esophagitis (EoE) is a chronic disease usually presenting with dysphagia and food impaction. Food allergy has been suggested as a causative trigger for some patients. Diagnosis of EoE is based on characteristic endoscopic and histological features. A ringed appearance referred to as “trachealization” is the classical endoscopic finding. Eosinophil-predominant inflammation is typical in histologic examination. The use of topical steroids is an effective and viable therapeutic option in the management of EoE in adults with relatively few side effects. Herein, we report a case of EoE presenting with severe dysphagia due to garlic impaction. Inhaled corticosteroid (budenoside) was prescribed for treatment due to the patient’s history of long-term proton-pump inhibitor use. Dysphagia complaints resolved after the prescribed treatment.
Dear Editor, We read with great interest the recently published article by Fukuda et al. The auth... more Dear Editor, We read with great interest the recently published article by Fukuda et al. The authors indicate that there is significant correlation between serum telaprevir (TVR) level and bodyweight and suggest that adjustment of TVR dose according to bodyweight would avoid renal impairment during treatment. Herein, we want to present a case in which renal impairment completely reversed after discontinuation of TVR, and ribavirin dose reduction seemed to be important in improving renal impairment until therapy. A 51-year-old woman came to our clinic 4 months ago. She had chronic active hepatitis C, and had received peginterferon-α-2b and ribavirin treatment for 48 weeks after being diagnosed in 2010; but 6 months after remission, her condition relapsed. She had no history of renal failure until the dual treatment. After evaluation of the patient, we decided to administrate triple therapy, a combination of TVR 2250 mg/day, peginterferon-α-2a 180 μg/week and ribavirin 800 mg/day. At day 10, the patient’s serum creatinine (sCr) level rose to 1.3 mg/dL and glomerular filtration rate (GFR) was 48 mL/min (pretreatment: sCr, 0.8 mg/dL; GFR, 79 mL/min). We decided to reduce the ribavirin dose and not to reduce TVR therapy after evaluation of other causes of renal failure. We reduced the ribavirin dose 200 mg every 2 weeks until 200 mg/day and did not reduce TVR and peginterferon dose, and gave fluid resuscitation. Despite replacement therapy, her sCr level rose to 2.1 mg/dL. We decided to continue treatment despite low GFR (30 mL/min), because the urine output was sufficient. Also, with high fluid replacement, her sCr level remained constant at 1.5 mg/dL with GFR of 41 mL/ min until the 12th week. After the 12 weeks of therapy with triple treatment, we stopped TVR as scheduled. After finishing TVR treatment, and continuing dual treatment with peginterferon and ribavirin, her sCr level fell to a normal level (0.8 mg/dL). Despite this study, we did not observe irreversible renal damage in our patient. Mauss et al. showed in their study that renal impairment is reversible after discontinuation of the treatment. Instead of decreasing TVR dose, ribavirin dose reduction may be appropriate. In our patient, despite low GFR levels, our patient finished hepatitis C virus treatment successfully. In patients with renal impairment with high urine output, therapy could be completed with appropriate supportive treatment, and we believe that as well as the decrease in GFR, urine output should be taken into account.
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