Background/Aims: In previous studies that investigated the impact of direct-acting antiviral (DAA) treatment on lipid metabolism and insulin resistance (IR) in chronic hepatitis C patients, the end-of-treatment or posttreatment values have been compared with baseline values. The results are inconsistent. We evaluated patients during and after the treatment. Materials and Methods: A total of 121 patients were included in the study. Of these, 93 patients were treated with sofosbuvir/ledipas-vir±ribavirin (RBV), and 28 patients were treated with ombitasvir/paritaprevir/ritonavir+dasabuvir±RBV. Total cholesterol (TC), low-density lipoprotein (LDL), triglyceride (TG), and homeostatic model assessment-insulin resistance (HOMA-IR) levels were measured at the onset of treatment, after the first month of treatment, at the end of treatment, and at 6 and 12 months after the end of treatment. Results: A total of 117 patients were genotype 1. Sustained virological response was 98.4%. HOMA-IR values during treatment were significantly higher than at the beginning of treatment (p=0.0001). At 12 months, there was a decrease in HOMA-IR, but this was not statistically significant (p=0.2048). TC and LDL levels were significantly increased in the first month of treatment (TC: 159±30, 180±34 mg dL-1 and LDL: 84±28, 100±30 mg dL-1) (p<0.0001), and this increase was present during and after treatment. There was no statistically significant increase in TG (p=0.120). Both treatment regimens showed similar effects on HOMA-IR, TC, and LDL. Conclusion: Patients with hepatitis C virus treated with DAA drugs showed increased IR, TC, and LDL cholesterol levels during treatment. After the end of treatment, IR went back to normal, whereas the elevated TC and LDL levels persisted indefinitely.

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Background and Objectives: It has been demonstrated that parameters such as the Controlled Nutrition Status (CONUT) score and Prognostic Nutrition Index (PNI) are beneficial for the assessment of patients’ nutrition. In this study, our objective was to investigate the potential benefits of CONUT and, as a prognostic marker of acute pancreatitis, the PNI. Materials and Methods: The data of 361 patients were analysed retrospectively. The PNI and CONUT scores of these patients were retrospectively calculated. They were categorised as CONUT-high (≥3) and CONUT-low (≤2). A PNI ≥ 45 was considered high and a PNI < 45 low. The AP severity and organ failure due to disease were evaluated based on Atlanta 2012. Results: According to the CONUT score, it was found that 209 patients had normal to mild, whereas 152 patients had severe malnutrition. A total of 293 patients had mild AP and 68 thereof had severe AP. The patients with a high CONUT score used more antibiotics, were hospitalised more in intensive care units and experienced organ failure more frequently. There were no intensive care hospitalisations, mortalities, surgical needs and local complications among the patients with a higher PNI score. Conclusions: CONUT and the PNI have proven to be useful prognostic markers not only for predicting nutritional status but also for estimating the severity and results of AP.

Aim:Percutaneous needle liver biopsy (PLB) is frequently associated with pain and anxiety. This may discourage the patients for biopsy, and rebiopsies, if needed. We planned a study to investigate the efficacy of additional analgesia or sedation for PLB.Materials and methods:The study has been designed as a single-center, prospective study. The PLB was planned for 18- to 65-year-old consecutive patients who were included in the study. The patients were divided into three premedication groups as control, Meperidine, and Midazolam. Hospital Anxiety and Depression Scale (HADS) was used to measure each subject’s anxiety level. Fifteen minutes before the biopsy, 1 mL 0.9% NaCl subcutaneously (sc), 1 mg/kg (max 100 mg) Meperidine sc, or 0.1 mg/kg (max 5 mg) Midazolam intravenously was administered to patients respectively. Then PLB was done with 16 G Menghini needle. The day after, the patients were asked about feelings regarding biopsy.Results:Groups were similar by gender and age. The HADS scores prior to PLB and on visual analog scale (VAS, 1-10 points) score during PLB were similar. In the three groups, 7, 12, and 7 patients, respectively, experienced no pain. Other patients explained pain as mild or moderate or severe. The number of patients who agreed for possible rebiopsy was higher in Meperidine and Midazolam groups than in the control group.Conclusion:Premedication with Meperidine or Midazolam in PLB would improve patients’ tolerance, comfort, and attitude against a possible repeat PLB.How to cite this article: Sezgin O, Yaras S, Ates F, Altintas E, Saritas B. Effectiveness of Sedoanalgesia in Percutaneous Liver Biopsy Premedication. Euroasian J Hepato-Gastroenterol 2017;7(2):146-149.

Background: Non-functional pancreatic neuroendocrine tumors (NF-PNET) are rare tumors increasingly being diagnosed incidentally. Choice of treatment for small (2cm or less) NF-PNETs is difficult as their malignant potential is difficult to predict. This is reflected in the current recommendations-some favor surgery, while others suggest wait-and-see policy.[1e6] As these tumors are rare, previous clinical series are small. The aim of this study was to identify factors affecting prognosis after surgery for small NF-PNETs in a multicenter study. Methods: Patients were identified from the databases of 16 European centers and data was extracted retrospectively. Uni-and multivariate (Cox) analyses were used to identify risk factors for recurrence. Results: 210 patients (median age 60y) were included. Median tumor size was 15mm, 65% were asymptomatic, and 42% underwent parenchyma-sparing surgery. Severe mordibidity was noted in 14% and 1 patient died postoperatively. 10% had metastatic lymph nodes. 5-year disease-free survival was excellent, 93.5%. Tumor size, presence of bile or pancreatic duct dilation, and WHO grade 2-3 were identified as independent risk factors for recurrence. Tumors <11mm in size did not recur during follow-up. Parenchyma-sparing pancreatectomy carried highest risk for pancreatic fistula, but was also associated with favorable disease-free survival. Conclusion: Presence of bile or pancreatic duct dilation or WHO grade 2-3 advocate for surgical treatment of small (2cm or less) NF-PNETs.