Background: Dynapenia and non-alcoholic fatty liver disease (NAFLD) are common, especially in the middle and advanced-age diabetic male population. We aimed to examine the clinical features, NAFLD severity, and parameters associated with the presence of dynapenia in type 2 diabetes mellitus (T2DM) cases. Material and Methods: One hundred thirty-five male patients diagnosed with T2DM between 45 and 65 years of age were included. Patients were staged by ultrasonography according to NAFLD status. Results: There were significant differences in muscle strength, upper arm circumference, calf circumference, and up-and-go test scores between the mild-moderate-severe and non-NAFLD groups (p < 0.001 for all). The frequency of dynapenia was lower, and arm and calf circumferences were higher in patients without NAFLD. The muscle strength, upper arm circumference, calf circumference, and up-and-go test scores were significantly lower in the dynapenic group compared to the non-dynapenic group (p < 0.005 for all). The prevalence of dynapenia increased along with the increase in NAFLD stages (p < 0.001). Conclusions: We detected a significant association between NAFLD and dynapenia in middle-aged men with T2DM. As muscle strength decreases, the amount of fat in the liver increases, and as the fat in the liver increases, muscle strength decreases.

Peritonitis is the most frequent complication of peritoneal dialysis. Diagnosis of peritonitis includes symptoms and signs of peritonitis with a cloudy aspirate of more than 100 WBC/ml, as well as positive cultures. Although sterile peritonitis has been reported in the literature, to the best of our knowledge this is the first report of an unusual presentation of peritonitis without any white blood cells in the peritoneal aspirate despite multiple positive peritoneal cultures.An 82-year-old Caucasian man who had been on continuous cycling peritoneal dialysis for 12 years was admitted to our hospital with general malaise, loss of appetite, weight loss and somnolence. He did not describe abdominal pain or fever. Even though his peritoneal fluid was consistently negative for leukocytes and clear, he had peritonitis with different organisms consecutively.Our case report shows that any patient on peritoneal dialysis presenting with evidence of infection (fever, peripheral leukocytosis) without an obvious cause should have aspirate cultures done even if the aspirate is clear and abdominal pain is absent. Our case report may change the initial work-up and management of these patients. We believe this report is of interest to general medicine and emergency room physicians as well as nephrologists.

OBJECTIVE: In our study, we aimed to evaluate the endoscopic features such as prevalence and localization of polypoid lesions determined by us using esophagogastroduodenoscopy and histopathological characteristics of biopsy specimens taken in detail. METHODS: The data of 19,560 patients undergoing upper gastrointestinal endoscopy for any reason between 2009 and 2015 in our endoscopy unit were screened retrospectively and endoscopic and histopathological findings were analyzed in detail. RESULTS: In our study, the polypoid lesion was detected in 1.60% (n=313) of 19,560 patients. The most common localization of the polypoid lesions was determined to be gastric localization (n=301, 96.2%) and antrum with a rate of 33.5% (n=105). When 272 patients in whom biopsy specimen could be taken was investigated, the most frequently seen lesion was polyp (n=115, 43.4%). Hyperplastic polyps (n=81, 29.8%) were the most frequently seen type among all polyps. In histopathological evaluation of the lesions, the prevalence rates of intestinal metaplasia (IM), surrounding tissue IM, atrophy, dysplasia, and neoplasia (adenocarcinoma, squamous cell carcinoma, gastrointestinal stromal tumor, neuroendocrine tumor, and metastatic tumor) among premalignant lesions were determined to be 16.9%, 11.2%, 4.1%, 1.1%, and 3.7%, respectively. CONCLUSION: Polypoid lesions can be seen in endoscopic investigations. In histopathological investigations, while the vast majority of these lesions are benign polyps, some of them are diagnosed as premalignant or malignant lesions. In our study, we determined malignant lesions higher than the similar studies in the literature. This condition shows how effective endoscopic procedure and histopathological evaluation are of vital importance.

Giriş ve Amaç: Kolorektal kanserler dünyada ve ülkemizde en sık görülen kanserlerdendir ve çok büyük oranda kolorektal poliplerinden gelişirler. Biz bu denli önem arz eden poliplerin ünitemizdeki prevalansını, endoskopik ve histolojik özelliklerini ortaya koymayı amaçladık. Gereç ve Yöntem: 2016-2019 yılları arasında gastroenteroloji ünitesi endoskopi laboratuvarımızda erişkin hastalara, herhangi bir nedenle yapılmış olan kolonoskopik incelemeler etik kurul onayı alınarak retrsopektif olarak tarandı. Kolonoskopik işlemlerde rastlanıp snare ya da forseps yardımı ile polipektomi uygulanan ya da biyopsi alınan polipler ayrılarak , bu poliplerin endoskopik (lokalizasyonu, boyutu, sayısı) ve histolojik (histopatolojik tanı, displazi, kanser) özellikleri incelendi. Elde edilen veriler IBM SPSS 22.0 istatistik programında analiz edildi. Bulgular: Çalışmamızda 2068 hastaya ait işlemlerin 362’sinde (%17.50) polip ya da poliplere rastlanılmıştı. Polip saptanan hastaların yaş ortalaması 59.86±11 (19-92) yıl, erkeklerin yaş ortalaması 60.36 yıl, kadınların yaş ortalaması 59.16 yıldı. Vakaların 236’sı (%65) erkek, 126’sı (%35) kadındı. Çalışmamızda poliplerin boyutlarına göre dağılımı; 298 (%66.81) diminutif polip, 117 (%26.23) küçük polip, 31 (%6.95) büyük polip olarak saptandı. En fazla sayıda polip görülen lokalizasyon sigmoid kolon (n=158, %35.42), en az sayıda polip görülen lokalizasyon ise çekumdu (n=11, %2.46). Çalışmamızda histolojik olarak polipler neoplastik (n=270, %60.54) ve non neoplastik (n=179, %39.46) olarak iki ana grupta incelendi. En sık görülen histolojik tanı neoplastik polipler grubundan adenomlardı (n=254, %56.95), adenomlar içinde en sık tübüler adenomlar (n=222, %87.40) görülmekteydi. Adenomlardan sonra en sık görülen tanı ise hiperplastik poliplerdi (n=131, %29.4). Poliplerin displazi/kanser özellikleri gözden geçirildiğinde 246 (%55.16) polipte düşük dereceli displazi, 6 (%1.35) polipte yüksek dereceli displazi, 1 (%0.22) polipte intramukozal adenokarsinom saptandı. Proksimal kolona doğru gidildikçe poliplerin neoplastik özellikleri artmaktaydı. Sonuç: Çalışmamız yakın zamanda yapılmış güncel kolon polip prevalans çalışmaları ile karşılaştırılarak yapıldı. Çalışmamızda ülkemiz oranlarına yakın kolorektal polip prevalansının yanısıra benzer çalışmalara göre displastik özellikler içeren polip sıklığımızın fazla oluşu dikkat çekiciydi. Bu durum kolonoskopik tarama ve takip programlarına verilmesi gereken önemi ve özeni bir kez daha göstermekteydi.