Browsing by Author "Ozgur, Gulsum Teke"
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Item A Comparison of Five Different Treatment Regimens as the First-Line Treatment of Helicobacter pylori in Turkey(2016) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Gokturk, Huseyin Savas; Karakoca, Aydin; Erinanc, Ozgur Hilal; 0000-0001-6503-3872; 0000-0003-1401-6356; 0000-0003-0182-002X; 26621567; AAF-8985-2020; AAL-1268-2021; AAG-3273-2020BackgroundThe H. pylori eradication success is low in countries with high antibiotic resistance to H. pylori. ObjectiveWe retrospectively assessed the eradication rates achieved by five different regimens and aimed to compare the efficiency of bismuth enhanced sequential therapy and other treatments in a gastroenterology outpatient clinic a university-affiliated hospital. DesignOur study was carried out with a retrospective cohort design. SettingThis study assessed the gastroscopy examinations of patients. PatientsA total of 621 patients were included in the study. There were 122 patients in the quadruple treatment group, 168 patients in the classical sequential treatment group, 130 patients in the bismuth enhanced sequential therapy, 113 patients in the sequential treatment with levofloxacin, and 88 patients in the hybrid treatment. MeasurementsEradication rates of different regimens was analyzed by performing Chi-square and Tukey's honest significant difference test. ResultsEradication rates by ITT and PP analysis achieved by treatment groups were 74.6 and 75.6% in the quadruple treatment; 70.2 and 70.4% in the sequential treatment with clarithromycin, 88.5 and 90.3% in the bismuth enhanced sequential therapy, 77.9 and 78.5% in the sequential treatment with levofloxacin, and 76.1 and 76.2% in the hybrid treatment. LimitationsThe main limitation of our study was its retrospective nature. Different proton pump inhibitors were used in the treatment arms. ConclusionsBismuth-enhanced sequential therapy can be recommended to overcome resistance.Item Does the Urea Breath Test Predict Eradication of Helicobacter Pylori Infection(2016) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Gokturk, Huseyin Savas; Durukan, Elif; Erhamamci, Seval; https://orcid.org/0000-0003-0182-002X; https://orcid.org/0000-0002-8579-5564; 26852756; AAJ-8621-2021Background/Aim : Helicobacter pylori infection is common world-wide and has been linked to development of gastric and duodenal ulcers, gastric adenocarcinoma, and gastric lymphoma. However, antimicrobial resistance has decreased H. pylori eradication rates worldwide. This study aimed to evaluate the effect of-bacterial load on eradication rate. Method : This prospective study included 237 consecutive patients who presented to our institution with dyspeptic symptoms and underwent both upper endoscopy and urea breath tests (UBT). The patients were divided into three equal sized groups according to their UBT values. All subjects received a standard triple eradication regimen, followed by a bismuth-based quadruple eradication regimen if triple eradication was not successful. The three groups were compared with respect to age, endoscopic findings, sex, and eradication rates. Results : Our results were consistent with those of previous studies : higher UBT values were associated with failure of standard 14-day triple treatment (p < 0.05). However, in patients who received a quadruple eradication regimen, differences between groups were not significant (p = 0.434). There was no relationship between UBT values and gastric pathologies (p = 0.751). Age and sex also did not differ significantly between groups (p = 0.061). Conclusions : Our study and others have found that high bacterial loads are negatively associated with achievement of eradication with triple treatment. However, differences between groups were not significant in patients who received a quadruple eradication regimen. Comparisons of treatment results according to bacterial density may be informative. The importance of H. pylori density should be further evaluated with new treatment protocols.Item Gastric Polyps: A Retrospective Analysis of Endoscopic Biopsies: A Single Center Study in Central Anatolia(2019) Erinanc, Hilal; Unler, Gulhan Kanat; Gokturk, Huseyin Savas; Ozgur, Gulsum TekeObjective: Gastric polyps accounts for %6 of gastrointestinal endoscopy. Geographical differences occur in the prevalence of them. We aimed to determine the spectrum of gastric polyps. Matherial and method: Data including demographics, medical history and histological characteristics of polyps and Helicobacter pylori were obtained retrospectively. Results: Of the 24568 endoscopies performed, 184 patients were identified as having gastric polyps. The most frequently encountered were hyperplastic polyps (62%), followed by fundic gland polyps (19,3%) and adenomatous polyps (3, 8%). The corpus (36,4 %) was the most common site and the antrum (25%) was the second. Female patients were more affected than male patients (64,7%). Majority of the polyps (88%) were smaller than 1 cm in diameter. The mean age was 62,10+13,4 (range:30-90) years. Fundic gland polyps were observed at younger age (mean age: 56,58) compared to other gastric polyps. Intestinal metaplasia was more frequently encountered in hyperplastic polyps than in fundic gland polyps. Conclusion: In this study, hyperplastic polyps are the most common in our population however there was no association between the hyperplastic polyps and H. pylori infection. H. pylori infection ratio was similar in both hyperplastic polyps and fundic gland polyps however all of the patient have chronic gastritis. This findings suggest chronic gastritis also play role in hyperplastic polyps development. The study also showed that H. Pylori infection is still common in our country and further studies need to find efficacy of H.pylori treatment.Item Impaired Coronary Microvascular and Left Ventricular Diastolic Function in Patients with Inflammatory Bowel Disease(2015) Caliskan, Zuhal; Gokturk, Huseyin Savas; Caliskan, Mustafa; Gullu, Hakan; Ciftci, Ozgur; Ozgur, Gulsum Teke; Guven, Aytekin; Selcuk, Haldun; 0000-0003-2579-9755; 0000-0002-8445-6413; 0000-0002-6463-6070; 25128749; AAJ-8546-2021; JYO-9455-2024; IXD-5147-2023; AAJ-6976-2021; A-7318-2017Background and aim: Increased incidence of coronary vascular events in patients with inflammatory bowel disease (IBD) is known. However, the association between coronary microvascular function and IBD has not been fully defined. We aimed to investigate whether coronary flow reserve (CFR) and left ventricular diastolic function were impaired in IBD patients. Methods: Seventy-two patients with IBD (36 patients with ulcerative colitis [UC] and 36 Crohn's disease [CD]) were registered. Each subject was evaluated after a minimum 15-day attack-free period. For the control group, 36 age- and sex-matched healthy volunteers were included into the study. IBD clinical disease activity in UC was assessed by the Truelove-Witts Index (TWAS) and in CD by the Crohn's Disease Activity Index (CDAI). In each subject, CFR was measured through transthoracic Doppler echocardiography. Results: Compared to the controls, the CD group and UC group had significantly higher high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate. Baseline diastolic peak flow velocity (DPFV) of the left anterior descending artery (LAD) was significantly higher in the IBD group (24.1 +/- 3.9 vs. 22.4 +/- 2.9, p < 0.05), and hyperemic DPFV (56.1 +/- 12.5 vs. 70.6 +/- 15.3, p < 0.05) and CFR (2.34 +/- 0.44 vs. 3.14 +/- 0.54, p < 0.05) were significantly lower in the IBD group than in the control group. In stepwise linear regression analysis, hs-CRP and lateral Em/Am ratio were independently correlated with CFR. Conclusion: CFR, reflecting coronary microvascular function, is impaired in patients with IBD. CFR and left ventricular diastolic function parameters are well correlated with hs-CRP. (C) 2014 Published by Elsevier Inc.Item Is Activation in Inflammatory Bowel Diseases Associated with Further Impairment of Coronary Microcirculation?(2016) Caliskan, Zuhal; Keles, Nursen; Gokturk, Huseyin Savas; Ozdil, Kamil; Aksu, Feyza; Ozturk, Oguzhan; Kahraman, Resul; Kostek, Osman; Tekin, Ahmet S.; Ozgur, Gulsum Teke; 27541650Background: Inflammatory bowel disease [IBD] includes a number of chronic relapsing diseases. In IBD intestinal microvascular endothelial cells are damaged by an abnormal immune response. Several studies have shown that IBD may cause increment in risk of developing atherosclerosis. IBD in activation was related to enhanced risks of worse cardiovascular [CV] outcome, on the other hand no risk increment was seen in remission comparing to control group in those studies. Coronary FlowReserve [CFR] reflects coronary microvascular circulation. Coronary microvascular dysfunction may be defined as a predictor of CV outcome combined with previous described atherosclerotic risk factors. The present study was purposed to further evaluate whether or not CFR in the left anterior descending artery [LAD] is disturbed in IBD patients with activation in comparison to remission and healthy subjects. Methods: 62 patients with IBD and 39 healthy volunteers were enrolled into the study. Patients' demographics were recorded. CFR evaluation of patients with IBD in both activation and remission period and control group were performed with transthoracic echocardiography. Results: CFR was significantly lowest in the active period of the IBD [2.26 [2.08-2.55] vs. 2.55 [2.18-3.00] and 3.10 [2.85-3.29] p < 0.001]. CFR is negatively correlated with disease activity scores of IBD. Conclusion: This study showed that CFR is more prominently disturbed in patients with IBD in activation. The activation of disease may have a major role in the progression of coronary microcirculatory dysfunction and future cardiovascular events. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Item Is there any association between colonic polyps and gastric intestinal metaplasia?(2016) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Gokturk, Huseyin Savas; Korkmaz, Huseyin; Erinanc, Ozgur Hilal; 27210777Background/Aims: Chronic gastritis progression is a multistep process of atrophy, intestinal metaplasia (IM), and dysplasia, which may lead to invasive carcinoma. In this study, we identified an association of colonic polyps with gastric IM in patients undergoing colonoscopy. Materials and Methods: This retrospective case-control, cross-sectional study was conducted in a tertiary-care institution in Turkey. Pathology and endoscopy reports were reviewed. The study group comprised 400 patients with colonic adenomatous polyps, and the control group comprised 360 patients without colonic adenomatous polyps on colonoscopy. Results: The risk of gastric IM was 1.42-fold higher in the study group (p<0.05). The risk of IM in patients aged >= 50 years with colonic polyps was 3.35-fold higher than in those aged <50 years (p<0.05). The risk of Helicobacter pylori infection in the study group was 1.07-folder higher than that in the control group (p<0.05). H. pylori infection prevalence was higher only in patients with high-grade colonic polyp dysplasia (p<0.05). There were no statistically significant differences in the proportion of incomplete IM between the groups (p<0.05). Conclusion: This study observed increased rates of gastric IM with colonic polyps. An increased risk of gastric IM was associated with higher grades of polyp dysplasia.Item A Rare Cause of Acute Dysphagia: Abscess of the Base of the Tongue(2015) Ozgur, Gulsum Teke; Akdogan, Mehmet Volkan; Unler, Gulhan Kanat; Gokturk, Huseyin Savas; 25802771Dysphagia represents a difficulty in passage of solid or liquid foods from the oral cavity into the stomach and is considered as an alarm symptom of gastrointestinal system. It often indicates an organic disease and needs to be explained. In this paper, a case of 61-year-old manwith posterior tongue abscess is presented.Item A Rare Type of Eosinophilic Gastroenteritis: Eosinophilic Ascites(2015) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Erinanc, Ozgur Hilal; Gokturk, Huseyin SavasEosinophilic gastrointestinal diseases are a group of inflammatory disorders characterized by signs and symptoms associated with eosinophil infiltration of the gastrointestinal tissues with the absence of any secondary cause of eosinophilia such as parasitic infection, vasculitis and malignancy. Eosinophilic gastrointestinal diseases are rare and eosinophilic ascite is probably the least common and least reported form. We reported a case of 24-year old women presented with eosinophilic ascites and we want to point out a rare cause of ascites that can be managed appropriately.Item Should We Remember Adrenal Insufficiency in Acute Gastroenteritis?(2016) Unler, Gulhan Kanat; Gokturk, Huseyin Savas; Ozgur, Gulsum Teke; Togan, Turhan; https://orcid.org/0000-0003-0182-002XIntroduction: Cortisol, which is released from the adrenal cortex, is a steroid hormone with vital functions. Its daily release is regulated by the hypothalamic-hypophyseal-adrenal axis. In healthy people, an adequate amount of endogenous corticosteroids is synthesized in the adrenal gland in response to stressful events, but in patients with adrenal insufficiency, there is a steroid synthesis defect that prevents the patient's requirements from being met. It may be challenging to diagnose corticosteroid deficiency in some circumstances, which can lead to catastrophic consequences, including death. Case presentation: In this article, we report a patient who had been using prednisolone 5mg/day for 10 years for rheumatoid arthritis with acute gastroenteritis whose clinical condition deteriorated despite appropriate therapy for 1 week and who was subsequently diagnosed with secondary adrenal insufficiency. Conclusion: On the basis of this case report, we remind clinicians of the necessity of rearranging steroid therapy during the course of an infectious disease in patients previously treated with prolonged steroid therapy.