Pulmonary complications, mainly hepatopulmonary syndrome (HPS), are frequently observed in liver cirrhosis. In this study, the aim was to investigate the frequency of hypoxemia and impairment of pulmonary function tests (PFT) in patients with liver cirrhosis and to examine the relationships of these impairments with liver failure. A total of 39 patients with cirrhosis, 24 males and 15 females, were included in our study. The mean age of the patients was 47.5 +/- 17.2 years. Arterial blood gases, PFT, and carbon monoxide diffusion tests (DLCO) were performed in all patients. Out of 39 cirrhotic patients, 21 (53.8%) had ascites, whereas 18 (46.2%) did not. Seven patients were in the Child-Pugh A group, 21 in the Child-Pugh B group, and 11 patients were in the Child-Pugh C group. Hypoxia was found in 33.3% of the patients. Although the PaO2 and SaO2 values of patients with ascites were lower compared to those without ascites (P < 0.05), no statistically significant difference was determined in the comparison of hypoxia between the groups (P > 0.05). Among the PFT parameters, FEV1/FVC and FEF25-75% values were found to be lower in patients with ascites than those without (P < 0.05). No differences were established between these two groups of patients in terms of DLCO (P > 0.05). While no differences were found in comparison of the DLCO values in between the groups (P > 0.05), there was a statistically significant difference in the ratio of DLCO to the alveolar ventilation (DLCO/VA) in between the groups (P < 0.05). On the other hand, a negative correlation was found between the DLCO/VA and Child points when the relationship between the Child-Pugh score and PFT parameters were investigated (r = -0.371, P < 0.05). Consequently, a relationship was established between the severity of liver failure and diffusion tests showing pulmonary complications invasively. We believe diffusions tests should be performed in addition to the PFT in order to determine pulmonary involvements particularly in patients who are candidates for liver transplantation.

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Gastric mucosal lesions are very common in portal hypertension and cirrhosis. The aim of this study was to assess for oxidative gastric tissue damage in cirrhosis and evaluate relations with portal hypertension and cirrhosis parameters. The study included 30 patients with cirrhosis and 30 controls. Each patient's history, physical examination, and laboratory findings were recorded, and multiple biopsies of the gastric antrum were obtained at endoscopy. A set of antral biopsies was also collected from each control subject. Each tissue specimen was analyzed for levels of glutathione peroxidase (GPX), superoxide dismutase (SOD), and catalase (CAT) activity and level of malondialdehyde (MDA). Patients' gastric GPX, SOD, and CAT levels were significantly lower, and MDA levels were higher, than in the control group. The GPX activity level in the specimens was moderately negatively correlated with portal vein diameter (P<0.05, r=-0.45) and spleen length (P<0.05, r=-0.45). In this study gastric tissue oxidative markers showed that antral oxidative factors worsen in cirrhosis. Oxidative stress may not be a clinical condition but it obviously shows gastric tissue damage and may explain many patients' gastric lesions and hemorrhage.

The study included 114 women (70.8%) and 47 men (29.2%). The mean age of the patients was 36.82 ± 10.41 years, and the mean BMI was 46.05 ± 3.76 kg/m. H. pylori infection was detected in 103 (64%), chronic gastritis in 156, chronic active gastritis in 47, intestinal metaplasia in eight, and atrophy in seven patients. The rate of H. pylori-associated chronic gastritis was 64%, that of chronic active gastritis was 24.2%, that of lymphoid aggregation was 62.2%, and that of intestinal metaplasia and atrophy was 3.1%. There was a significant relationship between H. pylori infection and chronic gastritis, chronic active gastritis, and lymphoid aggregation; however, no significant relationship was found between intestinal metaplasia and atrophy. CONCLUSıON: Clinicians should be aware of the histopathological findings requiring clinical follow-up for LSG-treated patients. Given the complications of H. pylori infection such as lymphoma and malignancy, periodic follow-up of patients and eradication therapy may be a suitable approach for treating intestinal metaplasia and atrophic changes.

Amaç: Bu araştırmanın amacı, primer hipotiroidizmi olan hastalarda depresif semptomların sıklığını araştırmak, bu semptomların levotiroksin (LT4) tedavisi sonrası iyileşme düzeyini belirlemek ve öngörücü semptomların varlığını değerlendirmektir.Yöntemler: 140 primer hipotiroidizmi olan kadın hasta Beck Depresyon Envanteri (BDÖ) ile değerlendirildi. Hepsi sadece LT4 ile tedavi edildi. Tiroid stimüle edici hormon (TSH) değeri tedaviden sonra test edildi ve daha önce depresif belirtiler gösteren hastalar BDÖ ile tekrar değerlendirildi.Bulgular: Çalışmamızda 72 (%51.4) hastada (BDÖ=22.8±1.1, TSH=19.1±3.7 iU/ml, yaş (yıl)=44.0±2.0) depresif belirti olduğu ve 68 hastada (%48.6) ise olmadığı gösterildi. (BDÖ=8.7±0.6, TSH=12.0±1.2 iU/ml, yaş (yıl)=45.0± 2.2). Primer hipotiroidizmin tedavisinden sonra, çalışmanın ilk bölümünde depresif belirtiler gösteren 72 hastada (TSH sonrası 1.54 iU/ml ±0.31) BDÖ tekrar uygulandı ve 54 hastanın (%75) depresif belirtilerinin ortadan kalktığı görüldü (BDÖ=9.0±1.0, TSH=1.59±0.31 iU/ml, yaş (yıl)=45.0±2.0). Hastaların 18'inde (%25) depresif semptomların devam ettiği görüldü (BDÖ=23.0±2.0, TSH=1.28±0.31 iU/ml, yaş (yıl)=42.0±2.0). Uyku bozukluğu, madde 16, tedaviden sonra belirgin kalıcılığı olan tek faktördür (p > 0.045).Sonuçlar: Hipotiroidizmli hastaların %51.4'ü depresif belirtiler gösterdi. Hipotiroidizm tedavisi tüm olgularda TSH değerlerini normal seviyesine getirmek ve %75'inde depresif belirtileri tersine çevirmek için yeterliydi. Kalan %25'lik grupta uyku bozukluğunun devam etmesi, öngörücü, yanıtsız bir semptom olarak düşünülebilir ve tanıyı tekrar değerlendirmek ve başka bir tedavinin eklenmesini göz önünde bulundurmak gerektiğine işaret eder. Anahtar kelimeler: Major depresif bozukluk, hipotiroidizm, levotiroksin, uyku bozuklukları Doi:Abstract Aim: The aim of this study was to investigate the frequency of depressive symptoms in patients with primary hypothyroidism, to determine the degree of recovery of these symptoms after levothyroxine (LT4) treatment, and to assess the presence of predictive symptoms.Methods: 140 women with primary hypothyroidism were evaluated with the Beck Depression Inventory (BDI). All were treated with LT4 alone. Thyroid stimulating hormone (TSH) value was tested after treatment and patients with previous depressive symptoms were reevaluated with BDI.Results: In our study, it was shown that 72 (51.4%) patients had depressive symptoms and 68 patients (48.6%) did not have depressive symptoms (BDI=22.8±1.1, TSH=19.1±3.7 iU/ml, (BDI=8.7±0.6, TSH=12.0±1.2 iU/ml, age (year)=45.0±2.2). After the treatment of primary hypothyroidism, BDI was reapplied in 72 patients with depressive symptoms (1.54 iU/ml±0.31 after TSH) in the first part of the study and depressive symptoms of 54 patients (75%) were found to be absent (BDI=9.0±1.0, TSH=1.59±0.31 iU/ml, age (years)=45.0±2.0). Depressive symptoms persisted in 18 (25%) of the patients (BDI=23.0±2.0, TSH=1.28±0.31 iU/ml, age (year)=42.0±2.0). Sleep disturbance, item 16, is the only persistent persistence after treat...