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Biomedical subjects

B Sivri

Publications and source records attributed to B Sivri.

27 records · Page 2Linked to original sources
PubMed1989

The expanding spectrum of a disease. Behçet's disease associated with amyloidosis.

In this report, we present a series of 6 patients with Behçet's disease (BD) associated with amyloidosis whose illnesses date back at least 4 years. In all the cases, nephrotic syndrome heralded the onset of amyloidosis, which was diagnosed by percutaneous kidney biopsies. After the diagnosis of amyloidosis, all subjects received colchicine, and steroids were discontinued. Three patients have benefited from treatment. It was suggested that amyloidosis may be an intrinsic feature of BD or that the suppurative lesions may play a role in the accumulation of amyloid in the tissues. The literature was reviewed and discussed.

Adult↗
PubMed1988

Vasculitis of breast in Behçet's disease--a case report.

This is the case report of a thirty-one-year-old woman who presented with a large skin lesion on a breast that was first thought to be a malignant or inflammatory process. After a biopsy, the lesion was diagnosed as nonspecific vasculitis. No similar case has been found in a review of the literature.

Adult↗
PubMedDate not supplied

What has the surgeon to know about pathophysiology of reflux disease?

Much has been learned about the pathophysiology of gastro-esophageal reflux (GER) since it was initially described by Asher Winkelstein in 1935. With the development and refinement of esophageal function tests in the past decades, the diagnostic modalities have become available for a deliberate and systematic evaluation of antireflux mechanisms. Some of the newer concepts of the pathogenesis of reflux esophagitis are reviewed in this article.

Esophagogastric Junction↗
PubMedDate not supplied

A prospective randomized trial from Turkey comparing octreotide versus injection sclerotherapy in acute variceal bleeding.

BACKGROUNDS/AIMS: Bleeding from gastroesophageal varices continues to be a life threatening complication of chronic liver diseases and portal hypertension. The purpose of this randomized prospective study is to compare the efficacy of octreotide administration and emergency injection sclerotherapy for the control of actively bleeding esophageal varices and prevention of early rebleeding in patients with cirrhosis. METHODOLOGY: A total of 66 episodes of endoscopically proven active variceal bleeding in 52 patients were included in this study. Following admission to the hospital, the patients were resuscitated with blood and plasma, and fiberoptic endoscopy was performed within 2 hours. Thirty-six bleeds in 28 patients and 30 bleeds in 24 patients were randomized to endoscopic variceal sclerotherapy (1% polidocanol) and to octreotide infusion (at 50 micrograms/h for 12 hours following the initial 50 micrograms i.v. bolus), respectively. RESULTS: Bleeding was initially controlled within 6 hours in 75% of episodes by endoscopic variceal sclerotherapy and in 73.3 by octreotide infusion (P > 0.05). There were no significant differences between the 2 groups in early rebleeding (within 72 hours of randomization) (22% vs. 22.7%), blood transfusion (4.2 +/- 1.8 units vs. 4.8 +/- 2.9 units), or hospital mortality (3.6% vs. 3.3%). Treatment failed in 9 episodes (25%) in the sclerotherapy group and in 8 episodes (26.7%) in the octreotide group. CONCLUSIONS: We consider that Octreotide would appear to be as effective as sclerotherapy in both the early control of variceal hemorrhage and in the prevention of early recurrent bleeding and should therefore be considered the treatment of choice in those centers where 24-hour endoscopy is not available. Furthermore, even in hospitals that do have a 24-hour endoscopy service there is good evidence that octreotide therapy should be commenced as soon as a patient enters hospital with a suspected variceal bleed to achieve rapid homeostasis. When initial hemostasis is achieved, elective endoscopic therapies can be undertaken with greater success.

Acute Disease↗
PubMedDate not supplied

Percutaneous drainage of hepatic abscesses: therapy does not differ for those with identifiable biliary fistula.

BACKGROUND/AIMS: Surgical drainage of pyogenic and amoebic hepatic abscesses has been an accepted therapy for decades. Modern imaging modalities have changed both the diagnostic and therapeutic management of many hepatic lesions, particularly abscesses. Specifically, percutaneous aspiration and drainage with either ultrasound or computed tomography guidance has been reported as an alternative treatment for hepatic abscesses in recent years. Little is known about aspiration of hepatic abscesses that communicate with the biliary tree. MATERIAL AND METHODS: Fifteen patients with hepatic abscesses treated by percutaneous aspiration and drainage are herein reported. Six had a demonstrable fistulous communication between the abscess and the biliary tree. RESULTS: During a four year period of follow-up, only two of these 15 patients experienced a recurrence. Neither had a biliary fistula complicating their abscess initially. CONCLUSIONS: Based upon this experience, it is suggested that percutaneous aspiration and drainage should be the initial treatment of choice of both pyogenic and amoebic liver abscesses even when large. Abscesses with demonstratable biliary fistulas have a larger mean volume than do those without fistulous involvement. The finding of a communication between the abscess and the biliary tree should not change this treatment approach.

Adult↗
PubMedDate not supplied

Congenital hepatic fibrosis associated with cavernous transformation of the portal vein.

BACKGROUND/AIMS: Congenital hepatic fibrosis (CHF), which is one of the fibropolycystic diseases, occurs in various forms. Portal hypertension, a very common clinical feature of this condition, has been attributed to the compression of portal vein radicles in the fibrous bands. We investigated whether there are any other contributing factors in the development of portal hypertension in patients with CHF. METHODOLOGY: A total of 1285 patients with portal hypertension of different etiologies were studied using ultrasonography as the screening test. Forty-seven (including portal vein involvement and/or CHF) of these 1285 patients were prospectively studied to evaluate the etiology of the portal hypertension by portography, abdominal computed tomography, exploratory laparotomy, peritonoscopy, liver biopsy and laboratory tests. The patients with CHF were divided into two groups, according to whether or not they had portal vein involvement. RESULTS: Eleven (0.8%) of the 1285 patients with portal hypertension had CHF, and 41 (3.2%) had cavernous transformation of the portal vein (CTPV), resulting from different or unknown etiologies. Five patients had both pathologies (CTPV and CHF). In the 11 patients with CHF, there was CTPV in 5 patients, Caroli's disease in 2 patients, cholangiocarcinoma in 1 patient, inferior vena caval obstruction in 1 patient, and CHF in only 2 patients. There were statistically significant differences in the age of the CHF patients at clinical onset, the incidence of bleeding from esophageal varices, and laboratory findings between the 2 groups with and without CTPV. Despite a thorough investigation, we could not distinguish any predisposing factor in 25 of the 41 patients with CTPV. The incidence of CTPV was 48% in patients with CHF and 3.2% in patients with portal hypertension. CONCLUSIONS: These results suggest that the association of CTPV with CHF is not coincidental, but that CTPV may be associated with CHF and a new possible factor in portal hypertension, and that it can be a major factor in the manifestation of esophageal bleeding from varices.

Adolescent↗