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Öğe ANGIOTENSIN-CONVERTING ENZYME GENOTYPE AND ACUTE PANCREATITIS IN TURKEY(Macedonian Acad Sciences Arts, 2009) Kasap, E.; Akyildiz, M.; Tekin, F.; Akarca, U.The renin-angiotensin system (RAS) has been implicated in the pathogenesis of acute and chronic pancreatitis. Angiotensin-converting enzyme (ACE) is the key enzyme which activates RAS. The ACE intron 16 insertion/deletion (I/D) polymorphism is associated with ACE activity and is considered to be a risk factor for several inflammatory processes. We investigated this polymorphism in 68 patients with acute pancreatitis (AP) and 157 healthy Turkish control subjects. Patients were evaluated with ultrasonography, abdominal tomography and laboratory markers and grouped by status for diabetes mellitus (DM), hypertension (HT), and both these diseases and by etiology. Genotyping of the I/D polymorphism was performed by polymerase chain reaction (PCR). The DD genotype was more prevalent in healthy controls, however, genotype II was significantly more frequent in AP patients (p < 0.05). In severe AP patients, the genotype II frequency was significantly higher than in controls (p < 0.05). Acute pancreatitis patients with both DM and HT had lower frequencies of genotype DD and of the D allele, and higher frequencies of genotype II and of the I allele than patients with either DM or HT (p < 0.05).Öğe CHOLANGITIS OF PANCREATITIS? DOES THE ANGIOTENSIN-CONVERTING ENZYME GENOTYPE FAVOR EITHER?(Macedonian Acad Sciences Arts, 2009) Kasap, E.; Akyildiz, M.; Akarca, U.Acute cholangitis and pancreatitis are serious complications of gallstones, with considerable morbidity and mortality. Angiotensin-converting enzyme (ACE) is an exopeptidase that is important in regulating blood pressure, metabolizing bradykinin and in maintaining an inflammatory response. To determine whether the ACE genotype determines occurrence of cholangitis or pancreatitis we examined ACE I/D genotypes in 31 patients who had cholangitis, 44 patients with biliary pancreatitis and 157 healthy individuals. The patients had been hospitalized at the Department and Intensive Care Faculty of Medicine, Ege University, Izmir, Turkey. The patients were recalled 4 years later and their prognosis was evaluated. The ACE II genotype was found at a higher frequency in the cholangitis and biliary pancreatitis patients when compared with the healthy subjects (p < 0.05). There was no significant difference between cholangitis and biliary pancreatitis cases regarding the genotype and allele distribution (p > 0.05). Recurrence of infection occurred more frequently in the patients with the DD genotype, although it was not significant according to the first assessment (p > 0.05). The ACE gene polymorphism did not seem to favor development of either cholangitis or pancreatitis.Öğe Entecavir (ETV) treatment through 96 weeks results in virologic and biochemical improvement in HBeAg(-) chronic hepatitis B patients (study ETV-027)(Blackwell Publishing, 2006) Akarca, U.; Hatzis, G.; Kitis, G.; Shouval, D.; Lai, C.; Cheinquer, H.; Chang, T.; Zink, R.; Zhu, J.; Brett-Smith, H.Öğe ESTIMATION OF HEPATITIS C COSTS IN TURKEY VIA EXPERT OPINION: DELPHI PANEL(Elsevier Science Inc, 2014) Ormeci, N.; Akarca, U.; Aladag, M.; Balik, I; Kadayifci, A.; Kalayci, C.; Kaymakoglu, S.; Koksal, I; Ozkan, H.; Tabak, F.; Saka, G.Öğe Historical epidemiology of hepatitis C virus (HCV) in selected countries(Wiley, 2014) Bruggmann, P.; Berg, T.; Ovrehus, A. L. H.; Moreno, C.; Brandao Mello, C. E.; Roudot-Thoraval, F.; Marinho, R. T.; Sherman, M.; Ryder, S. D.; Sperl, J.; Akarca, U.; Balik, I.; Bihl, F.; Bilodeau, M.; Blasco, A. J.; Buti, M.; Calinas, F.; Calleja, J. L.; Cheinquer, H.; Christensen, P. B.; Clausen, M.; Coelho, H. S. M.; Cornberg, M.; Cramp, M. E.; Dore, G. J.; Doss, W.; Duberg, A. S.; El-Sayed, M. H.; Ergor, G.; Esmat, G.; Estes, C.; Falconer, K.; Felix, J.; Ferraz, M. L. G.; Ferreira, P. R.; Frankova, S.; Garcia-Samaniego, J.; Gerstoft, J.; Giria, J. A.; Goncales, F. L., Jr.; Gower, E.; Gschwantler, M.; Guimaraes Pessoa, M.; Hezode, C.; Hofer, H.; Husa, P.; Idilman, R.; Kaberg, M.; Kaita, K. D. E.; Kautz, A.; Kaymakoglu, S.; Krajden, M.; Krarup, H.; Laleman, W.; Lavanchy, D.; Lazaro, P.; Marotta, P.; Mauss, S.; Mendes Correa, M. C.; Muellhaupt, B.; Myers, R. P.; Negro, F.; Nemecek, V.; Ormeci, N.; Parkes, J.; Peltekian, K. M.; Ramji, A.; Razavi, H.; Reis, N.; Roberts, S. K.; Rosenberg, W. M.; Sarmento-Castro, R.; Sarrazin, C.; Semela, D.; Shiha, G. E.; Sievert, W.; Starkel, P.; Stauber, R. E.; Thompson, A. J.; Urbanek, P.; van Thiel, I.; Van Vlierberghe, H.; Vandijck, D.; Vogel, W.; Waked, I.; Wedemeyer, H.; Weis, N.; Wiegand, J.; Yosry, A.; Zekry, A.; Van Damme, P.; Aleman, S.; Hindman, S. J.Chronic infection with hepatitis C virus (HCV) is a leading indicator for liver disease. New treatment options are becoming available, and there is a need to characterize the epidemiology and disease burden of HCV. Data for prevalence, viremia, genotype, diagnosis and treatment were obtained through literature searches and expert consensus for 16 countries. For some countries, data from centralized registries were used to estimate diagnosis and treatment rates. Data for the number of liver transplants and the proportion attributable to HCV were obtained from centralized databases. Viremic prevalence estimates varied widely between countries, ranging from 0.3% in Austria, England and Germany to 8.5% in Egypt. The largest viremic populations were in Egypt, with 6358000 cases in 2008 and Brazil with 2106000 cases in 2007. The age distribution of cases differed between countries. In most countries, prevalence rates were higher among males, reflecting higher rates of injection drug use. Diagnosis, treatment and transplant levels also differed considerably between countries. Reliable estimates characterizing HCV-infected populations are critical for addressing HCV-related morbidity and mortality. There is a need to quantify the burden of chronic HCV infection at the national level.Öğe Is telbivudine-induced polyneuropathy/myopathy reversible in liver transplant recipients?(Lippincott Williams & Wilkins, 2018) Turan, I.; Yapali, S.; Bademkiran, F.; Gunsar, F.; Zeytunlu, M.; Ersoz, G.; Akarca, U.; Karasu, Z.Öğe A Pilot Study: Longer Duration of Posttransplant Hepatitis C Virus Therapy May Increase the Sustained Response Rate(Elsevier Science Inc, 2009) Karasu, Z.; Akay, S.; Yilmaz, F.; Akarca, U.; Ersoz, G.; Gunsar, F.; Kilic, M.Background. Although end of treatment virological responses are similar in posttransplant patients with recurrent chronic hepatitis C virus infection and nontransplant patients, the sustained virological response rate is lower in the posttransplant setting. We investigated the efficacy of a longer duration (3 years) of therapy. Methods. Thirteen patients with biopsy-proven recurrent hepatitis C were included in the study. In the first year of therapy, all patients were treated with a standard regimen of interferon alpha 2b 3MU 3 times in a week plus ribavirin (800 to 1000 mg/d). After the availability of pegylated interferon, patients were converted to pegylated interferon (1.5 mu g/kg body weight). Hepatitis C virus RNA was evaluated at months 3, 6, 9, 12, 24, 36, and 42. If hepatitis C virus RNA was negative at month 12, the patients continued treatment for 36 months. Results. Hepatitis C virus RNA was negative in six patients at 12 months, including two who became hepatitis C virus RNA negative after 3 months; two, after 6 months; and two, after 12 months of therapy. Those six continued treatment completing 3 years of treatment with a sustained virological response. Four of those six patients with sustained virological response required colony-stimulating factors during treatment. Conclusion. Although the hepatitis C virus RNA status of patients at 12 weeks is a good marker to predict a sustained virological response in the nontransplant setting, it is not valid in posttransplant patients. A prolonged duration of therapy for patients who are viral responders at 12 months may prevent recurrence and increase the sustained virological response rate.Öğe A Pilot Study: Longer Duration of Posttransplant Hepatitis C Virus Therapy May Increase the Sustained Response Rate(Elsevier Science Inc, 2009) Karasu, Z.; Akay, S.; Yilmaz, F.; Akarca, U.; Ersoz, G.; Gunsar, F.; Kilic, M.Background. Although end of treatment virological responses are similar in posttransplant patients with recurrent chronic hepatitis C virus infection and nontransplant patients, the sustained virological response rate is lower in the posttransplant setting. We investigated the efficacy of a longer duration (3 years) of therapy. Methods. Thirteen patients with biopsy-proven recurrent hepatitis C were included in the study. In the first year of therapy, all patients were treated with a standard regimen of interferon alpha 2b 3MU 3 times in a week plus ribavirin (800 to 1000 mg/d). After the availability of pegylated interferon, patients were converted to pegylated interferon (1.5 mu g/kg body weight). Hepatitis C virus RNA was evaluated at months 3, 6, 9, 12, 24, 36, and 42. If hepatitis C virus RNA was negative at month 12, the patients continued treatment for 36 months. Results. Hepatitis C virus RNA was negative in six patients at 12 months, including two who became hepatitis C virus RNA negative after 3 months; two, after 6 months; and two, after 12 months of therapy. Those six continued treatment completing 3 years of treatment with a sustained virological response. Four of those six patients with sustained virological response required colony-stimulating factors during treatment. Conclusion. Although the hepatitis C virus RNA status of patients at 12 weeks is a good marker to predict a sustained virological response in the nontransplant setting, it is not valid in posttransplant patients. A prolonged duration of therapy for patients who are viral responders at 12 months may prevent recurrence and increase the sustained virological response rate.Öğe The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm(Wiley, 2014) Razavi, H.; Waked, I.; Sarrazin, C.; Myers, R. P.; Idilman, R.; Calinas, F.; Vogel, W.; Mendes Correa, M. C.; Hezode, C.; Lazaro, P.; Akarca, U.; Aleman, S.; Balik, I.; Berg, T.; Bihl, F.; Bilodeau, M.; Blasco, A. J.; Brandao Mello, C. E.; Bruggmann, P.; Buti, M.; Calleja, J. L.; Cheinquer, H.; Christensen, P. B.; Clausen, M.; Coelho, H. S. M.; Cramp, M. E.; Dore, G. J.; Doss, W.; Duberg, A. S.; El-Sayed, M. H.; Ergor, G.; Esmat, G.; Falconer, K.; Felix, J.; Ferraz, M. L. G.; Ferreira, P. R.; Frankova, S.; Garcia-Samaniego, J.; Gerstoft, J.; Giria, J. A.; Goncales, F. L., Jr.; Gower, E.; Gschwantler, M.; Guimaraes Pessoa, M.; Hindman, S. J.; Hofer, H.; Husa, P.; Kaberg, M.; Kaita, K. D. E.; Kautz, A.; Kaymakoglu, S.; Krajden, M.; Krarup, H.; Laleman, W.; Lavanchy, D.; Marinho, R. T.; Marotta, P.; Mauss, S.; Moreno, C.; Murphy, K.; Negro, F.; Nemecek, V.; Ormeci, N.; Ovrehus, A. L. H.; Parkes, J.; Pasini, K.; Peltekian, K. M.; Ramji, A.; Reis, N.; Roberts, S. K.; Rosenberg, W. M.; Roudot-Thoraval, F.; Ryder, S. D.; Sarmento-Castro, R.; Semela, D.; Sherman, M.; Shiha, G. E.; Sievert, W.; Sperl, J.; Starkel, P.; Stauber, R. E.; Thompson, A. J.; Urbanek, P.; Van Damme, P.; van Thiel, I.; Van Vlierberghe, H.; Vandijck, D.; Wedemeyer, H.; Weis, N.; Wiegand, J.; Yosry, A.; Zekry, A.; Cornberg, M.; Muellhaupt, B.; Estes, C.The disease burden of hepatitis C virus (HCV) is expected to increase as the infected population ages. A modelling approach was used to estimate the total number of viremic infections, diagnosed, treated and new infections in 2013. In addition, the model was used to estimate the change in the total number of HCV infections, the disease progression and mortality in 2013-2030. Finally, expert panel consensus was used to capture current treatment practices in each country. Using today's treatment paradigm, the total number of HCV infections is projected to decline or remain flat in all countries studied. However, in the same time period, the number of individuals with late-stage liver disease is projected to increase. This study concluded that the current treatment rate and efficacy are not sufficient to manage the disease burden of HCV. Thus, alternative strategies are required to keep the number of HCV individuals with advanced liver disease and liver-related deaths from increasing.Öğe Strategies to manage hepatitis C virus (HCV) disease burden(Wiley, 2014) Wedemeyer, H.; Duberg, A. S.; Buti, M.; Rosenberg, W. M.; Frankova, S.; Esmat, G.; Ormeci, N.; Van Vlierberghe, H.; Gschwantler, M.; Akarca, U.; Aleman, S.; Balik, I.; Berg, T.; Bihl, F.; Bilodeau, M.; Blasco, A. J.; Brandao Mello, C. E.; Bruggmann, P.; Calinas, F.; Calleja, J. L.; Cheinquer, H.; Christensen, P. B.; Clausen, M.; Coelho, H. S. M.; Cornberg, M.; Cramp, M. E.; Dore, G. J.; Doss, W.; El-Sayed, M. H.; Ergor, G.; Estes, C.; Falconer, K.; Felix, J.; Ferraz, M. L. G.; Ferreira, P. R.; Garcia-Samaniego, J.; Gerstoft, J.; Giria, J. A.; Goncales, F. L., Jr.; Guimaraes Pessoa, M.; Hezode, C.; Hindman, S. J.; Hofer, H.; Husa, P.; Idilman, R.; Kaberg, M.; Kaita, K. D. E.; Kautz, A.; Kaymakoglu, S.; Krajden, M.; Krarup, H.; Laleman, W.; Lavanchy, D.; Lazaro, P.; Marinho, R. T.; Marotta, P.; Mauss, S.; Mendes Correa, M. C.; Moreno, C.; Muellhaupt, B.; Myers, R. P.; Nemecek, V.; Ovrehus, A. L. H.; Parkes, J.; Peltekian, K. M.; Ramji, A.; Razavi, H.; Reis, N.; Roberts, S. K.; Roudot-Thoraval, F.; Ryder, S. D.; Sarmento-Castro, R.; Sarrazin, C.; Semela, D.; Sherman, M.; Shiha, G. E.; Sperl, J.; Starkel, P.; Stauber, R. E.; Thompson, A. J.; Urbanek, P.; Van Damme, P.; van Thiel, I.; Vandijck, D.; Vogel, W.; Waked, I.; Weis, N.; Wiegand, J.; Yosry, A.; Zekry, A.; Negro, F.; Sievert, W.; Gower, E.The number of hepatitis C virus (HCV) infections is projected to decline while those with advanced liver disease will increase. A modeling approach was used to forecast two treatment scenarios: (i) the impact of increased treatment efficacy while keeping the number of treated patients constant and (ii) increasing efficacy and treatment rate. This analysis suggests that successful diagnosis and treatment of a small proportion of patients can contribute significantly to the reduction of disease burden in the countries studied. The largest reduction in HCV-related morbidity and mortality occurs when increased treatment is combined with higher efficacy therapies, generally in combination with increased diagnosis. With a treatment rate of approximately 10%, this analysis suggests it is possible to achieve elimination of HCV (defined as a >90% decline in total infections by 2030). However, for most countries presented, this will require a 3-5 fold increase in diagnosis and/or treatment. Thus, building the public health and clinical provider capacity for improved diagnosis and treatment will be critical.Öğe TELBIVUDIN: MORE CAUTION IS NEEDED IN LIVER TRANSPLANT RECIPIENTS(Elsevier Science Bv, 2014) Karasu, Z.; Turan, I.; Duman, S.; Sozbilen, M.; Gunsar, F.; Ersoz, G.; Akarca, U.Öğe An unusual cause of massive upper gastrointestinal bleeding: Dieulafoy's lesion within a giant mid-esophageal diverticulum(Georg Thieme Verlag Kg, 2008) Turan, I.; Ozturk, A.; Akarca, U.; Ozutemiz, O.Öğe A virological response to PEG-IFNa treatment of hepatitis delta is associated with an improved clinical long-term outcome: 10 years follow-up of the HIDIT-1 study(Elsevier Science Bv, 2018) Wranke, A.; Yurdaydin, C.; Heidrich, B.; Kalliopi, Z.; Yalcin, K.; Fehmi, T.; Akarca, U.; Lammert, F.; Haeussinger, D.; Mueller, T.; Woebse, M.; Manns, M. P.; Wedemeyer, H.; Hardtke, S.
