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Öğe Anti-Inflammatory Effect of Crude Momordica charantia L. Extract on 2,4,6-Trinitrobenzene Sulfonic Acid-Induced Colitis Model in Rat and the Bioaccessibility of its Carotenoid Content(Mary Ann Liebert, Inc, 2020) Unal, Nalan Gulsen; Kozak, Ayseguel; Karakaya, Sibel; Oruc, Nevin; Barutcuoglu, Burcu; Aktan, Cagdas; Ozutemiz, Ahmet OmerMomordica charantia L., known as bitter melon (BM), is a plant that belongs to the family Cucurbitaceae. Aims of this study are to investigate the anti-inflammatory effect of crude BM extract on 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced experimental colitis model in rat. It was also aimed to determine the content and bioaccessibility of carotenoids of BM. BM was purchased from local markets in Izmir, Turkey. Fruits of BM were lyophilized, powdered, and used in the experiment. Carotenoids were determined by high-performance liquid chromatography. To determine the bioaccessibility of beta-carotene, in vitro digestion was performed. Wistar albino rats were divided into four groups: group A (BM+TNBS), group B (BM), group C (TNBS), and group D (control). BM solution was given 300 mg/(kg center dot day) for 6 weeks orally. Colitis was induced by 0.25 mL of a solution containing 100 mg/kg 5% (w/v) TNBS in 50% ethanol (w/v) intrarectally after 6 weeks. After sacrification, macroscopic and microscopic evaluations were performed. Myeloperoxidase, cytokines levels (interleukin-17 [IL-17], TNF-alpha, and interleukin-10 [IL-10]) were measured in serum and colonic samples by ELISA test. Institutional Animal Ethics Committee approval was obtained. Total carotenoid content of BM was determined 11.7 mg/g dry weight as beta-carotene equivalents. Bioaccessibility of total carotenoids was determined as 2.1% with in vitro digestion. Pretreatment with crude BM extract significantly reduced weight loss, macroscopic, and microscopic colitis damages in colonic samples (P = .000), (P = .015), and (P = .026), respectively. Serum anti-inflammatory cytokine IL-10 increased significantly in both treatment groups (P = .000). BM is a rich source of carotenoids, but the bioaccessibility of its carotenoids is low. This study displays that BM has protective anti-inflammatory effects on TNBS-induced colitis.Öğe A Case of Taenia saginata Infestation Presenting with Chronic Constipation(Bilimsel Tip Yayinevi, 2023) Kurtulmus, Ilkce Akgun; Buyruk, Abdullah Murat; Ozutemiz, Ahmet OmerTaenia saginata is a parasitic infectious agent of the cestode class, which is transmitted to humans by the raw consumption of beef containing the larvae of Cysticercus bovis. Although the infection is usually asymptomatic in humans, it can cause symptoms such as nausea, vomiting, diarrhea, weight loss, and swelling in the abdomen. Chronic constipation, according to the Rome IV classification criteria, is a gastroenterological condition characterized by straining during defecation, infrequent defecation, and a sense of incomplete rectal emptying persisting for at least six months. This case report aims to highlight the concurrent infestation of Taenia saginata and the improvement in constipation symptoms after treatment in a patient who had been presenting to our outpatient clinic with chronic constipation for four years.Öğe Common SPINK-1 genetic mutations do not predispose to Crohn disease(Tubitak Scientific & Technical Research Council Turkey, 2017) Oruc, Nevin; Osmanoglu, Necla; Aktan, Cagdas; Berdeli, Afig; Ozutemiz, Ahmet OmerÖğe Correlation of liver-to-spleen ratio, lung CT scores, clinical, and laboratory findings of COVID-19 patients with two consecutive CT scans(Springer, 2020) Guler, Ezgi; Unal, Nalan Gulsen; Cinkooglu, Akin; Savas, Recep; Kose, Timur; Pullukcu, Husnu; Ozutemiz, Ahmet OmerPurpose Given the lack of information about abdominal imaging findings and correlation with clinical features of COVID-19, we aimed to evaluate the changes in hepatic attenuation during the course of disease. Our aim was to correlate the liver-to-spleen ratio (L/S), clinical, laboratory findings, and lung CT scores of patients with COVID-19 who had two consecutive chest CTs. Methods A retrospective search was performed between March 1, 2020 and April 26, 2020 to identify patients who had positive RT-PCR tests and two unenhanced chest CTs. Scans that were obtained at hospital admission and follow-up were reviewed to assess L/S and lung CT scores. Patients were divided into two groups based on lung CT scores (non-progressive vs progressive). Patient demographics, laboratory findings, length of hospital stay, and survival were noted from electronic medical records. Results Twenty patients in the progressive group and 7 patients in the non-progressive group were identified. the mean L/S of the progressive group (1.13 +/- 0.3) was lower than that of the non-progressive group (1.21 +/- 0.29) at hospital admission but there was no significant difference between the two groups (p = 0.547). L/S at follow-up was significantly different between the groups as the mean L/S values of the progressive and non-progressive groups were 1.02 +/- 0.23 and 1.25 +/- 0.29, respectively (p = 0.009). L/S was negatively correlated with AST and ALT (r = - 0.46,p = 0.016 andr = - 0.534,p = 0.004, respectively). There were significant differences between the two groups in terms of WBC, neutrophil, lymphocyte, monocyte, and platelet counts that were obtained at hospital admission. Length of hospital stay was significantly longer in patients in the progressive group (p = 0.035). Conclusions Decrease in L/S may be observed in patients with elevated lung CT scores at follow-up. WBC, neutrophil, lymphocyte, monocyte, and platelet counts at hospital admission may predict the progression of COVID-19.Öğe Dieulafoy lesions: One patient, two different localizations(Turkish Assoc Trauma Emergency Surgery, 2022) Senkaya, Ali; Celik, Ferit; Ozutemiz, Ahmet OmerDieulafoy lesions (DLs) are dilated submucosal arterial structures visualized on endoscopy as bleeding foci on the superficial mucosa without erosion or ulceration. DLs account for 1-5.8% of acute non-variceal upper gastrointestinal bleeding cases. A 72-year-old male patient with known Alzheimer's disease and coronary artery disease, being followed up at a nursing home, presented to our emergency department with foul-smelling, loose, and tarry stool. Esophagogastroduodenoscopy revealed a 3 mm DL immediately adjacent to the Z line in the distal esophagus, demonstrating a fresh blood clot without the appearance of a surrounding ulcer. Two endoscopic hemo-clips were applied to this lesion. The patient was monitored at the intensive care unit for the following 2 days and later transferred to internal medicine inpatient unit. He developed hematochezia on the 8th day of hospitalization. Emergent rectosigmoidoscopy was per-formed showing two separate 3 and 4 mm sized DLs, located immediately proximal to the dentate line. These lesions were successfully treated using two endoscopic band ligations. DLs can occur synchronously, albeit very rarely, and a careful search for multiple lesions is necessary to avoid further bleeding.Öğe Dual-energy CT enterography in evaluation of Crohn's disease: the role of virtual monochromatic images(Springer, 2020) Guler, Ezgi; Unal, Nalan Gulsen; Hekimsoy, Ilhan; Kose, Timur; Harman, Mustafa; Ozutemiz, Ahmet Omer; Elmas, Nevra ZehraPurpose To assess the use of virtual monochromatic images (VMI) for discrimination of affected and non-affected bowel walls in patients with Crohn's disease (CD) as well as to compare mural enhancement between patients with and without CD. Materials and methods This retrospective study included 61 patients (47 with CD, 14 without CD). Attenuation value (AV), signal-to noise ratio (SNR), and contrast-to-noise ratio (CNR) were obtained at VMI energy levels from 40 to 110 keV in 10 keV increment. Analyses were performed among affected and non-affected bowel walls in CD patients, as well as from bowel walls in patients without CD. Image quality and mural enhancement were evaluated at VMI energy levels at 40, 70, and 110 keV. Results At all energy levels of VMI, each quantitative data for AV, SNR, and CNR showed statistically significant difference between diseased and non-diseased bowel walls in CD patients. in the quantitative assessment of patients with and without CD, the optimal AV and SNR were obtained at 40 keV, and the optimal CNR was obtained at 70 keV. For the qualitative assessment, the best image quality and mural enhancement were obtained at 70 keV and 40 keV, respectively. Conclusion VMI are helpful for the differentiation of affected bowel walls in CD patients, providing high diagnostic accuracy.Öğe The relationship between nutritional status and Fetuin-A in Inflammatory Bowel Disease patients(Kuwait Medical Assoc, 2021) Barutcuoglu, Burcu; Unal, Nalan Gulsen; Ak, Gunes; Parildar, Zuhal; Oruc, Nevin; Ozutemiz, Ahmet OmerObjective: To investigate the relationship between fetuin-A and nutritional index parameters body mass index (BMI), fat mass (FM), fat free mass (FFM) and mini nutritional assessment (MNA (R)) in inflammatory bowel disease (IBD) patients. Design: Randomized, prospective study Setting: Department of Clinical Biochemistry and Gastroenterolgy, Medical School, Ege University, Izmir, Turkey Subjects: Seventy-six consecutive IBD out-patients and 24 healthy volunteers were enrolled in this study. IBD patients were grouped into: 1. BMI<18.5 kg/m(2); 2. BMI=18.5-24.9 kg/m(2); and 3. BMI >= 25 kg/m(2) and according to MNA (R) score as: 1. MNA (R) <17, 2. MNA (R)=17.5-23.5 and 3. MNA (R)>= 24. Interventions: Demographical data and nutritional index parameters (BMI, FM, FFM) were evaluated. MNA was assessed by a questionnaire. Main outcome measures: Fasting serum levels of albumin, glucose, total cholesterol, triglyceride, C-reactive protein (CRP), vitamin B12, folic acid, ferritin, fetuin-A, hemoglobin and white blood cell count were measured. Results: The level of CRP was significantly higher and fetuin-A was significantly lower (both P<.001) in IBD patients than in healthy subjects. Age (P<.001), MNA (R) total score (P=.001), FM (P<.001), FFM (P=.003) and fetuin-A (P=.012) were significantly different between the BMI groups. There was a significant difference in BMI (P<.001), FM (P<.001), FFM (P<.001), levels of Fetuin-A (P=.030) and CRP (P=.030) between MNA (R) groups. There was a weak correlation between fetuin-A and BMI (r=0.249,P=.030). Conclusion: in this study, fetuin-A, a negative acute phase protein is shown to be related to BMI in IBD patients. Serum fetuin-A levels were the lowest both in MNA<17 and BMI<18.5 kg/m(2), which showed us that it can predict nutritional status in IBD patients.Öğe Retrospective Evaluation of the Frequency of Acute Pancreatitis in Adult Hospitalized Patients with COVID-19 Infection(Galenos Publ House, 2022) Elik, Dilsah Baskol; Oruc, Nevin; Guler, Ezgi; Erdem, Huseyin Aytac; Akarca, Funda Karbek; Sipahi, Oguz Resat; Ozutemiz, Ahmet OmerIntroduction: Data on the relationship between Coronavirus disease-2019 (COVID-19) and acute pancreatitis are limited. This study aimed to investigate the possible role of COVID-19 in the etiology of acute pancreatitis in a tertiary-care educational university hospital by retrospectively evaluating the incidence of acute pancreatitis in adult hospitalized patients with COVID-19. Materials and Methods: Severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) polymerase chain reaction (PCR)-positive adult inpatients from March 15, 2020, to February 1, 2021, constituted the study group in our hospital. This cohort was analyzed for acute pancreatitis criteria, including acute abdominal pain, increased amylase and/or lipase more than three times the normal value, and radiological finding supporting the disease. Patients who met at least two of the acute pancreatitis diagnostic criteria were determined, and those who met the criteria during or after SARS-CoV-2 PCR positivity detection were included in the study. These patients were further analyzed for COVID-19-related data and pancreatitis severity status. Results: Our hospital had 1227 inpatients with COVID-19 diagnosis in one year. A total of four cases met the inclusion criteria. Acute pancreatitis rates were detected at 0.3% and 1.07% for all cohorts (n=1227) and the pancreatic enzyme-tested group (n=372), respectively. Of these four patients, two (50%) were females (50%) and the mean age was 70.7 (range: 64-79) years. There was no correlation between COVID-19 pneumonia and pancreatitis severity scores, including Ranson, Acute Physiologic Assessment and Chronic Health Evaluation 2, and modified computed tomography severity scores. Conclusion: COVID-19 is a rare risk factor for acute pancreatitis and did not affect the pancreatitis severity or mortality in our cohort.
