Gastric cancer is the fourth most frequent cancer and the second cause of cancer-related deaths worldwide. The early diagnosis of gastric cancer is fundamental in decreasing the mortality rates. It has been shown that MPV level is a sign of inflammation in hepatocellular carcinoma and pancreatic adenocarcinoma. The aim of this study is to examine whether MPV would be a useful inflammatory marker for differentiating gastric cancer patients from healthy controls. Thirty-one gastric cancer patients and 31 age-sexes matched healthy subjects included into the study. Patients with hypertension, hematological and renal disease, heart failure, chronic infection, hepatic disorder and other cancer were excluded from the study. MPV level was significantly higher in pre-operative gastric cancer patients compared to healthy subjects (8.31 fL vs. 7.85; p: 0.007). ROC analysis suggested 8.25 fL as the cut-off value for MPV (AUC: 0.717, sensitivity: 61%, specificity: 81%). Surgical tumor resection resulted in a significant decrease in MPV level (8.31 fL vs. 7.55 fL; p: 0.001). No significant difference was found in MPV level between the post-operative group and control subjects. We did not find statistically significant difference between MPV and TNM stages. In conclusion, changes in MPV values may be used as an easily available biomarker for monitoring the healthy patients for GC risk and may prompt physicians to make an early diagnosis of GC.
Summary
Background
Results are conflicting with respect to the renal effects of anti‐viral agents used for hepatitis B virus infection.
Aim
To compare short and long‐term renal effects in real‐life settings and to determine risk factors for renal impairment during treatment.
Methods
2221 treatment‐naïve patients were enrolled. Among these, 895 (302 lamivudine, 27 telbivudine, 282 entecavir, 273 tenofovir and 11 adefovir initiated patients) had ‘repeated measures’ of creatinine (baseline, 1st, 6th, 12th and 24th month of treatment). Telbivudine and adefovir groups were excluded from further analysis because of the low number of patients. We calculated the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) formula at each time point. Hypophosphataemia was also recorded. Risk factors for renal impairment were analysed.
Results
Tenofovir caused a decline in GFR at each time point when compared to baseline levels. However, lamivudine and entecavir did not change GFR. GFR‐shifting from ≥90 to 60–89 mL/min/1.73 m2 was comparable among groups. The proportion of patients whose baseline creatinine increased more than 25% was comparable among all anti‐virals. GFR showed a decline in patients who switched from entecavir to tenofovir. One patient with compensated cirrhosis needed to change from tenofovir because of renal safety. Seven and three patients developed transient hypophosphataemia in the tenofovir and lamivudine groups, respectively.
Conclusions
Although tenofovir caused a decline in GFR, differences between the anti‐viral agents do not appear to be so impressive. In patients with and without renal risk factors at baseline, there is no impact of anti‐virals, including tenofovir.
Fatty and spicy foods and carbonated drinks were the most common symptom triggering food items in FD group. In subgroups, carbonated drinks and legumes were more likely to cause a symptom in PS-FD. Removing these food items during the course of treatment might help alleviate the symptoms.
Vascular thrombosis and systemic hypercoagulable states are known complications of pancreatitis. Higher levels of mean platelet volume (MPV) have been associated with thrombotic diseases. However, a few studies have investigated the association between acute pancreatitis and MPV. We aimed to investigate whether there is a difference of MPV and coagulation parameters in patients with active and remission in acute pancreatitis. We included 24 consecutive patients with biliary acute pancreatitis and 24 consecutive healthy age-matched and sex-matched controls. Full blood counts and other laboratory tests were collected at onset and remission. The MPV was significantly higher in patients with acute pancreatitis at admission 8.6±1.4 fl than controls 7.6±0.7 fl (P=0.005). We detected positive correlation between, aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, amylase, lipase, and glucose, BMI, D-dimer and MPV. However, there was negative correlation between progression, thrombocyte counts, hemoglobin and MPV. As a result higher MPV levels in acute pancreatitis may reflect hypercoagulation associated with pancreatitis.
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