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    Changing trends in the epidemiology of delta virus infection
    (Galenos Publishing House, 2023) Örmeci, Necati; Erdem, Hakan
    Hepatitis delta virus (HDV) infection is an important health and economic problem worldwide. There are approximately 15 million patients with HDV worldwide and effects of 5-10% of all hepatitis B virus (HBV) infections globally. Chronic HDV infection results in 3 times more hepatocellular carcinoma (HCC) and 2 times more hepatic decompensation in cirrhosis patients compared with chronic HBV infection. HDV is associated with a higher economic burden than both HBV and hepatitis C virus (HCV) infection alone. Unlike HBV, HDV infection progresses to liver cirrhosis in 5 years, to HCC in 10 years. Risk factors for HDV infection are hepatitis B surface antigen (HBsAg) positivity, intravenous drug use, multipartner sexual behaviors, anti-human immunodeficiency virus positivity, anti-HCV positivity, men who have sex with men, healthcare workers, immigrant people moving from high HBV infection endemic areas, prisoners, hemophiliacs, poor hygienic conditions, and low economic income. From West to East, HDV prevalence increased in both patients with chronic active hepatitis (CAH) and cirrhosis. However, the prevalence of HDV infection decreased both CAH and cirrhosis after 1995 in Turkey. Amazon basin, Indian population living in Venezuela, and the Santa Marta region of Colombia are areas of the highest HDV prevalence. Due to immigration from high HBV infection endemic areas to industrialized countries, Delta infection continues stably 5-10 % in HBsAg carriers. Each HBsAg-positive patient should be checked for anti-delta antibody to prevent rapid progress of parenchymal liver diseases.
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    Percutaneous treatment of hydatid cysts with the Örmeci technique
    (AVES, 2024) Örmeci, Necati; Asiller, Özgün Ömer; Parmaksız, Ayhan; Kalkan, Çağdaş; Üstüner, Evren; Altınel, Ahmet; Erdem, Hakan
    Background/Aims: The percutaneous route is accepted as the most convenient course in the management of hydatid cysts (HCs). The aim of this study is to analyze the efficacy of the Örmeci technique used in the treatment of hydatid cysts. Materials and Methods: This is a retrospective cohort study. Patients with HCs who presented to the Ankara University Faculty of Medicine, Department of Gastroenterology since 1991 were included. Patients with World Health Organization cystic echinococcosis (WHO-CE) types 1, 2, 3A-3B live cysts who were treated percutaneously at least once and followed up after a minimum of 6 months were analyzed. Results: A total of 1556 cystic lesions in 1035 patients have been presented to our department since 1991. Five hundred forty-four live HCs in 479 patients were treated with the Örmeci technique. The mean follow-up time was 59.29 months for females and 57.18 for males. The overall clinical success rate of all treated cysts with the Örmeci technique was 94.5%. After the treatment, a statistically significant decrease was found in all WHO-CE cyst types in terms of cyst sizes (P < .001 for all). Mortality, abscess and fistula formation, sclerosing cholangitis, and drug toxicities were not detected. Only 2 patients experienced reversible anaphylaxis during the treatment among 544 cysts (0.36%). Conclusion: Hydatid cysts can be treated percutaneously by the Örmeci technique with a high success rate for WHO-CE type 1, 2, and 3B. The Örmeci technique is an economic, simple, cheap, and repeatable outpatient procedure. It can be chosen as the first-line therapeutic modality in suitable patients with HCs.