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Öğe Black esophagus(Springer-Verlag Italia Srl, 2021) Aslan, EkremA 68-year-old man, with a history of hypertension, type 2 diabetes mellitus, chronic renal failure, ischemic cerebrovascular accident, and congestive heart failure was admitted to the emergency department with hematemesis and syncope. It has been learned that he has taken apixaban for the last 1 week as well as his antihypertensive, antidiabetic, and antiischemic drugsÖğe Comparison of the efficacy of entecavir and tenofovir in reducing hepatocellular carcinoma risk in chronic hepatitis B patients: a real-life study in Turkey(AVES, 2021) Güzelbulut, Fatih; Gökçen, Pınar; Can, Güray; Adalı, Gupse; Saltürk, Ayça Gökçen Değirmenci; Aslan, Ekrem; Özdil, Kamil; Doganay, Hamdi LeventBackground: It is controversial whether entecavir or tenofovir differs in reducing hepatocellular carcinoma (HCC) risk. We aimed to compare the efficacy of entecavir and tenofovir in reducing HCC risk in chronic hepatitis B (CHB) patients. Methods: This retrospective study included 607 nucleos(t)ide naive CHB patients who had received entecavir or tenofovir. Patients who developed HCC during the first 12 months of therapy were excluded. Cumulative HCC incidences at years 2, 3, 4, 5 and 10 were compared between entecavir and tenofovir groups. Factors associated with HCC were determined by univariate and multivariate analyses. Results: Nineteen (3.1%) patients developed HCC, 12 (4.8%) in entecavir group and 7 (1.9%) in tenofovir group (P = .045). In the entire cohort, cumulative HCC incidences at years Z 3, 4, 5 and 10 were 1.8%, 2.9%, 4.4%, 5.2% and 9.9% in entecavir group, and 0.6%, 2.4%, 2.4%, 2.4% and 3.7% in tenofovir group, respectively (log-rank P = .130). In multivariate analysis, age >= 50 years, cirrhosis, decompensated cirrhosis, high GGT and low platelet levels were associated with HCC in the entire cohort. In advanced fibrosis/cirrhosis cohort, cumulative HCC incidences at years 2, 3, 4, 5 and 10 were 4.6%, 7.1%, 8.6%,12.1% and 15.5% in entecavir group, and 1.8%, 5.6%, 5.6%, 5.6% and 8.5% in tenofovir group, respectively (log-rank P = .267). In multivariate analysis, age >= 50 years, decompensated cirrhosis, high GOT and low platelet levels were associated with HCC in the advanced fibrosis/cirrhosis cohort. Conclusion: Entecavir and tenofovir are similarly effective in reducing HCC risk in CHB patients.Öğe The effect of laparoscopic sleeve gastrectomy on nonalcoholic fatty liver disease(Lippincott Williams & Wilkins, 2019) Batman, Burçin; Altun, Hasan; Pınarbaşı Şimşek, Binnur; Aslan, Ekrem; Koç, Şule NamlıObesity is associated with nonalcoholic fatty liver disease which is one of the most common causes of chronic liver disease. FibroScan is a noninvasive tool for liver stiffness measurement and controlled attenuation parameter to evaluate liver steatosis and fibrosis. We aimed to demonstrate the effect of laparoscopic sleeve gastrectomy on liver steatosis and fibrosis. Of the 120 consecutive patients screened, 72 were enrolled in this study. FibroScan M probe and XL probe were used for the evaluation of liver steatosis and fibrosis. Fifty-two patients (72.2%) were female individuals and 20 (27.8%) were male individuals; the mean age was 37.9 +/- 10.4 years. Percentage of excess weight loss was significant at the third and sixth months: 57.2 +/- 18.3 (P<0.05) and 81.4 +/- 24.6 (P<0.05), respectively. Mean preoperative controlled attenuation parameter and liver stiffness measurement values were 309.2 +/- 68.7 dB/m and 7.5 +/- 5.0 kPa, respectively, and significantly declined to 217.4 +/- 56.4 dB/m and 5.6 +/- 2.5 kPa, respectively, at sixth postoperative month (P<0.001 and <0.01, respectively). These results suggest that laparoscopic sleeve gastrectomy is associated with significant improvement in liver steatosis and fibrosis. Bariatric surgery has a beneficial effect on nonalcoholic fatty liver disease in morbidly obese patients.Öğe The effect of laparoscopic sleeve gastrectomy on nonalcoholic fatty liver disease [letter](Lippincott Williams & Wilkins, 2019) Batman, Burçin; Altun, Hasan; Pınarbaşı Şimşek, Binnur; Aslan, Ekrem; Koç, Şule NamlıamlıIn this study, our aim was to determine the changes in values of controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) after bariatric surgery. Our aim was not to make a diagnosis of liver disease. Because of this, we did not detect any cut-off point in this study. Also, cut-off levels for specific stages of hepatic fibrosis vary according to the etiology of the chronic liver diseases.Öğe Evaluation of the Efficacy and Safety of Self-Expanding Metal Stents in Malignant Esophageal Strictures Due to Esophageal and Extraesophageal Cancers: A Retrospective Cross-Sectional Cohort Study(Kare Yayıncılık, 12.11.2024) Aslan, Ekrem; Salturk, Ayca; Koçhan, Koray; Özer, Serhat; Şahin, Halil; Bedir, Osman; Kiyak, Mevlut; Kanatsız, Emine; Surmelioglu, Ali; Gönen, Can; Güzelbulut, FatihIntroduction: Malignant esophageal obstructions can lead to malnutrition, mortality, and difficulties in managing the underlying malignancy. Endoscopic stent placement is a palliative treatment method that can provide rapid improvement in dysphagia. The aim of this study is to investigate the short-term effectiveness and safety of endoscopic stent placement in patients with malignant esophageal obstructions. Methods: Patients who underwent endoscopic stent placement due to malignant esophageal strictures between January 2012 and January 2018 were retrospectively reviewed. Demographics, dysphagia scores, complications, and mortality data of the patients with stent placement were evaluated. Results: The mean age of the 46 patients was 67.1±13.3 years, and 19 (41.3%) were female. Endoscopic stents were placed mostly for esophageal cancer in 26 (56.5%) patients. The most common pathological diagnosis was esophageal squamous cell carcinoma (58.6%). A fully covered self-expanding metallic stent was placed in 19 (41.3%) and a partially covered one in 27 (58.7%) patients. The technical success rate was 100%. Forty (86.9%) patients began to eat soft foods 24 hours after stent placement. The most common complication was retrosternal pain (56.5%). Complications requiring endoscopic intervention occurred in 5 (10.8%) patients. Mortality occurred in 40 (87%) patients, and 11 (27.5%) survived for more than 3 months (Min-max: 125-512 days). Discussion and Conclusion: Although the endoscopic placement of a self-expanding metallic stent in patients with malignant dysphagia may have the potential to cause complications, it is a reliable palliative treatment method that can be preferred due to its high technical success rate and rapid relief of dysphagia.Öğe Periampullary nodularity in an asymptomatic patient(Ediciones Doyma, S.L., 2022) Aslan, Ekrem; Tecimer, TuüayPeriampullary nodularity in an asymptomatic patientÖğe A rare subepithelial lesion in the stomach: gastric adenomyoma(Blackwell Publishing Ltd, 2021) Abbasov, Aykhan; Aslan, Ekrem; Ekici, Asiye Işın Doğan; Dolay, KemalGastric adenomyomas are rare benign tumours and most often localized in the gastric antrum. The tumour generally consists of glandular cells and smooth muscle bundles. The size of a gastric adenomyoma (GA) can be up to 4.5 cm and can affect patients any age of their life. In cases with GA most of the patients are asymptomatic. However, non-specific gastrointestinal symptoms such as epigastric pain, vomiting and nausea can be seen. Differential diagnosis of GA difficult due to non-specific radiological and endoscopic findings. Imaging techniques and endoscopic examinations can not distinguish GAs from other intramuscular lesions of the stomach. Surgical excision is used in both diagnosis and treatment. In this article, we present a 46-year-old male patient with long-term dyspeptic complaints admitted to our department and diagnosed as gastric adenomyoma by performing subtotal gastrectomy.
