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In mild cases, it is difficult to diagnose pancreatic exocrine insufficiency (PEI). There is no gold standard method for the diagnosis of PEI. A reliable method is needed for preliminary diagnosis of PEI. The PEI-TEST was applied to the patients with nonspecific gastrointestinal complaints. Serum amylase, lipase, serum trypsinogen, and fecal elastase 1 (FE-1) were analyzed from each patient. According to the PEI-TEST, PEI was present in 42 (47.7%) and PEI was not present in 46 (52.3%) patients. No significant difference was observed between the 2 groups with regard to age, gender and amylase, lipase, serum trypsinogen, and FE-1. When an FE-1 value of <200 µg/dL was considered as indicating PEI, the sensitivity and specificity of the test were found to be 47.4% and 52.2%, respectively. Although it is promising that PEI-TEST is a validated test in our country and suitable for our society, it is not suitable for pediatric patients. [ABSTRACT FROM AUTHOR]

Aim: The differentiation of inflammatory bowel diseases (IBD) from other gastrointestinal diseases in pediatric patients is highly important and the definitive diagnosis of IBD is established by endoscopic examination. The use of non-invasive methods (clinical symptoms and laboratory tests) allows for the early and accurate referral of patients from first step health centers to advanced health centers. We aimed to investigate the effectiveness of fecal calprotectin (FC) in the differentiation of IBD from other gastrointestinal diseases in children. Materials and Methods: This retrospective study included patients who had undergone FC testing and colonoscopy. The demographic characteristics, alarm symptoms (AS), and abnormal laboratory findings (ALF) were recorded for each patient. A negative calprotectin result was considered to be less than 50 µg/g, and a second cut-off value for FC was accepted as 150 µg/g. Definitive diagnosis was established by colonoscopy in each patient. Results: The study included 88 consecutive patients (mean age, 10.2±6.1 years; 51.1% female). Of these, 20 (22.7%) patients were diagnosed with IBD. No significant difference was found between IBD and non-IBD patients with regard to the presence of AS except for involuntary weight loss (p<0.001). The prevalence of increased C-reactive protein and hypoalbuminemia was significantly higher in the IBD patients (p=0.002 and p=0.026, respectively). FC>50 µg/g [80.0 vs 39.7%, p=0.044, odds ratio (OR): 6.07, 95% confidence interval (CI) 1.83 to 23.42] and >150 µg/g (60.0 vs 16.2%, p=0.002, OR: 7.78, 95% CI 1.83 to 20.14) was significantly higher in the IBD patients compared to the non-IBD patients. AS combined with ALF and FC>150 µg/g had the highest specificity (95.12%). Conclusion: Although primary care clinicians often use AS and laboratory parameters in the differentiation of IBD from non-IBD diseases, FC was found to have a relatively higher diagnostic value. [ABSTRACT FROM AUTHOR]

Objective: Anemia is a common problem in outpatient clinics, and endoscopic interventions are one of the initial steps to rule out the gastrointestinal causes. In this study, we aimed to analyze the diagnostic yield of endoscopic interventions in children with severe anemia. Materials and Methods: The demographic features, laboratory findings, and endoscopic and histopathological findings of 65 children with severe anemia (hemoglobin <7 g/dL) (mean age of 12.1 ± 4.4 years, 73.8% female) who underwent endoscopic interventions were recorded from the files. Patients were divided into 2 groups according to the presence of positive endoscopic findings and/or histopathological examination. Factors that may predict the presence of positive endoscopic findings and/or histopathological examination were analyzed. Results: After a colonoscopy and/or upper gastrointestinal endoscopy, the etiology of anemia was identified in 35 patients, and the major diagnosis of Helicobacter pylori gastritis in 16.9% and gastrointestinal ulcer in 10.8% of the patients was made. No gastrointestinal pathology was detected in 30 patients. The diagnostic yield of endoscopic examination in patients with severe anemia was 53.8% (95% CI: 63.3-67.7). Presence of hypoalbuminemia (P = .021), high erythrocyte sedimentation rate (P = .006), and high C-reactive protein (P = .03) was significantly associated with positive findings in endoscopic interventions. Conclusion: We recommend performing upper gastrointestinal endoscopy and/or colonoscopy in patients with severe anemia associated with gastrointestinal symptoms and using laboratory findings of hypoalbuminemia, high erythrocyte sedimentation rate, and C-reactive protein in order to rule out gastrointestinal pathologies. [ABSTRACT FROM AUTHOR]

Some studies showed that the increase of tumor size has a negative effect on survival in colon cancers. Our study aims to assess the effects of tumor volume on lymph node positivity and prognosis in stage pT3 colon cancers. All patients who underwent surgery for colon cancer in our clinic were evaluated retrospectively. The study included 213 patients who were diagnosed with colon adenocarcinoma and reported as pathologic. Preoperative abdomen computed tomography scans were used for measurements of tumor volume. Tumor volumes were compared according to the pathological lymph node involvement. Cut-off values were determined with ROC analysis. The cases were divided into groups according to the determined cut-off value and data compared. Mean tumor volume was found to be higher in the lymph node-positive group (p=0.01). The higher number of removed lymph nodes and lymph node positivity was detected more in cases that were above the cut-off value (p=0.003 and p=0.004, respectively). The mean survival time was 37.3±1.3 months. There was no correlation between tumor volume and the overall survival time (p=0.21). According to data comparison of the lymph node positivity, Kaplan-Meier analysis showed that the increase of the N stage reduces the 5-year survival rate (for the N0, N1, N2 stages, 60%, 52%, 35%, respectively). Tumor volume is correlated with lymph node involvement. It has been shown that increasing the N stage has a negative effect on prognosis. Our study showed that tumor volume has no significant impact on survival but may have an indirect effect on prognosis. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the effects of alpha lipoic acid (ALA), which is a strong antioxidant, on endometriosis (EMS). Methods: Thirty sexually-mature, female Wistar albino rats weighing 180-220 grams were separated into three groups: sham (n=10), EMS (n=10) and EMS + ALA (n=10). Blood samples were taken from the rats and were centrifuged and stored at -80 °C before forming the experimental EMS model. ALA at a dose of 50 mg/kg was orally administered to EMS + ALA group. At the end of this procedure, blood samples were taken again and were centrifuged and stored at -80 °C. Plasma total antioxidant status (TAS), plasma total oxidant status, oxidative stress (OS) index and cancer antigen 125 were studied from these samples. Results: There were no differences between the groups in terms of baseline results. According to the second blood test results, all parameters in the sham group and all parameters other than plasma TAS in EMS + ALA group were statistically different than in EMS group (p<0.05). Considering the 1st and 15th day changes in the parameters of the groups, it was observed that ALA had positive effects. Conclusion: ALA reduces OS in EMS; thus, may have a positive effect on the severity and stage of the illness and reduce recurrence after treatment. [ABSTRACT FROM AUTHOR]

Background: Acute liver failure (ALF) is a rare multisystemic disease occurring in individuals with no history of liver disease, characterized by coagulopathy and / or hepatic encephalopathy secondary to acute liver injury. It is mostly caused by viral infections, drug intoxication, and metabolic diseases (MD), and can also have an indeterminate etiology. In this study, we aimed to evaluate the demographic and clinical characteristics and clinical outcomes of the patients that presented to our clinic with MD‐associated ALF. Methods: This retrospective study reviewed age, gender, parental consanguinity, family history, presence of encephalopathy, laboratory parameters, and clinical outcomes of the patients that presented to our clinic between January 2009 and January 2019. Patients with MD‐associated ALF were compared with patients in whom ALF was associated with other etiologies. Results: The study included 39 patients (53.8% boys; mean age + SD 6.13 ± 1.43 years). The total and direct bilirubin, international normalized ratio, and ammoniac levels were significantly higher in patients with MD than in the others (P < 0.05). Moreover, the incidences of hypoglycemia, death of a sibling and / or a family history of liver disease were also higher in patients with MD than in the others (P < 0.05). On the other hand, alanine aminotransferase (ALT) levels were significantly higher in patients with other etiologies. Conclusions: Metabolic diseases should be kept in mind in patients with a history of parental consanguinity and a positive family history of liver disease along with less increased alanine aminotransferase than expected, and increased bilirubin, international normalized ratio, and ammoniac levels and hypoglycemia. As the number of these parameters increases, the chance of diagnosis increases. [ABSTRACT FROM AUTHOR]