Person: BİBERCİ KESKİN, ELMAS
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Publication Metadata only Comparison of scoring systems used in acute pancreatitis for predicting major adverse events.(2020-01-07T00:00:00Z) Taşlıdere, B; Biberci, Keskin; Şentürk, H; İnce, ALİ TÜZÜN; Gülen, B; BİBERCİ KESKİN, ELMAS; TAŞLIDERE, BAHADIR; KOÇHAN, KORAY; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKANOBJECTIVES:Timely identification of patients with acute pancreatitis who are likely to have a severe disease course is critical. Based on that, many scoring systems have been developed throughout the years. Although many of them are currently in use, none of them has been proven to be ideal. In this study, we aimed to compare the discriminatory power of relatively newer risk scores with the historical ones for predicting in-hospital major adverse events, 30-day mortality and 30-day readmission rate.PATIENTS AND METHODS:Patients who had been admitted due to acute pancreatitis were retrospectively investigated. Five risk scoring systems including HAPS, Ranson, BISAP, Glasgow, and JSS were calculated using the data of the first 24h of admission. Predictive accuracy of each scoring system was calculated using the area under the receiver-operating curve method.RESULTS:Overall 690 patients were included in the study. In-hospital major adverse events were observed in 139 (20.1%) patients of whom, 19 (2.5%) died during hospitalization. 30-day all-cause mortality and 30-day readmission were observed in 22 (3.2%) and 27 (3.9%) patients respectively. Negative predictive value of each score was markedly higher compared to positive predictive values. Among all, JSS scoring system showed the highest AUC values across all end-points (0.80 for in-hospital major adverse events; 0.94 for in-hospital mortality; 0.91 for 30-day mortality). However, all five scoring systems failed to predict 30-day readmission.DISCUSSION:JSS was the best classifier among all five risk scoring systems particularly owing to its high sensitivity and negative predictive valuePublication Open Access Can serum histone H4 levels predict mucosal healing in Crohn-s disease?(2021-01-01T00:00:00Z) KÖKER, İBRAHİM HAKKI; SÜMBÜL, BİLGE; KİREMİTÇİ, SERCAN; KOÇHAN, KORAY; İNCE, ALİ TÜZÜN; BİBERCİ KESKİN, Elmas; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; SÜMBÜL, BİLGE; KİREMİTÇİ, SERCAN; KOÇHAN, KORAY; İNCE, ALİ TÜZÜN; BİBERCİ KESKİN, ELMAS; ŞENTÜRK, HAKANIntroduction: Mucosal healing (MH) has been a treatment target with the introduction of biological agents in Crohn's disease (CD). Histone H4 increases in chronic inflammation. Aim: Our goal was to investigate the role of serum histone H4 in predicting MH. Material and methods: The study included 44 patients who applied to the endoscopy unit for ileocolonoscopic evaluation with the diagnosis of ileocecal CD and 26 healthy controls. After ileocolonoscopic evaluation, we divided the patients into 2 groups: those with and those without MH, according to the presence of endoscopic ulcer or erosion findings. Blood samples were taken from these patients to analyse serum histone H4 before the endoscopic procedure. We first compared serum histone H4 levels between CD patients and the healthy control group and then between those with and those without MH among the CD patients. Finally, we compared CRP, ESR, and serum histone H4 levels in patients with CD according to the presence of MH and symptoms. Results: Serum histone H4 levels were significantly higher in ileocolonic CD patients compared to the healthy control group (p = 0.002). Also, serum histone H4 levels were significantly higher in CD patients with no MH (p = 0.028) or symptomatic patients (p = 0.033). We did not find a significant difference in C-reactive protein and erythrocyte sedimentation rate levels between CD patients in the presence of MH (p = 0.281 and p = 0.203, respectively) or symptoms (0.779 and 0.652, respectively). Conclusions: Serum histone H4 might be a useful biomarker for MH prediction in ileocolonoscopic CD patients. Validation is needed for large numbers of patients.Publication Open Access The relationship of Serum Histone H3.3 and H4 with chronic Hepatitis B(2020-09-01T00:00:00Z) Sümbül, Bilge; Şentürk, Hakan; Köker, İbrahim Hakkı; Koçhan, Koray; İnce, Ali Tüzün; Biberci Keskin, Elmas; İNCE, ALİ TÜZÜN; BİBERCİ KESKİN, ELMAS; SÜMBÜL, BİLGE; KOÇHAN, KORAY; KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKANObjective: To determine the role of serum histone H3.3 and H4 in patients with chronic hepatitis B to explore any relationship between the two.Methods: The prospective controlled clinical pilot study was conducted in the Gastroenterology Clinic of Bezmialem Vakif University, Istanbul, Turkey, from January to October 2017, and comprised biopsy-proven patients with chronic hepatitis B and healthy controls. Demographics, hepatitis B virus deoxyribonucleic acid quantity, hepatitis B e-antigen, aspartate aminotransferase, alanine transaminase, international normalized ratio, total/direct bilirubin, albumin and thrombocyte counts as well as histological activity index and fibrosis scores were noted. Data was analysed using SPSS 22.Results: Of the 140 subjects, 70(50%) each were cases and controls. The overall mean age of the sample was 43.38±15.07 years (range: 18-70 years). There was positive correlation of histone H3.3 with hepatitis B virus deoxyribonucleic acid, aspartate aminotransferase, alanine transaminase and international normalized ratio levels. Histone H4 levels only correlated with hepatitis B virus deoxyribonucleic acid and international normalized ratio. Hepatitis B e-antigen positivity was present in 14(20%) of the cases.Conclusion: Histone H3.3 levels appeared to be associated with pathophysiological changes in chronic hepatitis B patients, suggesting that future treatments should target H3.3.Keywords: Histone H3.3, Histone H4, Extracellular histone, Chronic Hepatitis B, HBV.(JPMA 70: 1596; 2020)DOI:https://doi.org/10.5455/JPMA.19365Publication Metadata only The relationship between serum histon levels and the severity of acute pancreatitits(2019-05-01) biberci keskin, elmas; Sümbül Gültepe, Bilge; Köker, ibrahim Hakkı; Şentürk, HAKAN; BİBERCİ KESKİN, ELMAS; İNCE, ALİ TÜZÜN; KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKANPublication Metadata only The role of plasma exchange in hypertriglyceridemia-induced acute pancreatitis(2019-06-01T00:00:00Z) Koçhan, K; Şentürk, H; Köker, İH; Gülen, B; İnce, ALİ TÜZÜN; BİBERCİ KESKİN, ELMAS; KOÇHAN, KORAY; KÖKER, İBRAHİM HAKKI; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKANBackground Hypertriglyceridemia (HTG)-induced acute pancreatitis (AP) leads to higher morbidity and mortality compared with other etiologies. The role of plasma exchange (PE) in this context is still not well established. We aimed to assess the clinical outcomes of patients with HTG-induced AP who underwent PE and compare it with those who did not. Patients and methods We retrospectively evaluated the data of patients who were admitted with HTG-induced AP between January 2013 and May 2018. The endpoint of the study was to assess the clinical outcomes, which included complication rates, mortality, and pancreatitis recurrence rate. Results Overall, 41 patients were included in the final analysis. Of these, 12 (29.2%) underwent PE. Patients undergoing PE had more severe pancreatitis on the basis of the Japanese Severity Score [10 (83.3%) vs. 14 (48.3%), P=0.03, respectively). Although mortality was higher in patients who underwent PE [three (25.0%) vs. zero, P<0.01, respectively], there was no difference in terms of complications and recurrence rates. Over a median 21 months of follow-up, 11 (26.8%) patients had recurrent AP. Conclusion Although PE effectively reduced plasma triglyceride levels, there was no decrease in mortality or recurrences.