Tıp Fakültesi / Faculty of Medicine

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    Relationship between Helicobacter pylori infection and white matter lesions in patients with migraine
    (2022) Ocal, Serkan; Ocal, Ruhsen; Suna, Nuretdin; 35597897
    Background/aim White matter lesions (WML) are more frequently observed in migraine patients than in the average population. Associations between Helicobacter pylori (H. pylori) infection and different extraintestinal pathologies have been identified. Here, we aimed to investigate the association between H. pylori infection and WML in patients diagnosed with episodic migraine. Materials and methods A retrospective study was conducted with 526 subjects with a diagnosis of episodic migraine. Hyperintensity of WML had been previously evaluated in these patients with brain magnetic resonance imaging (MRI) examinations. Previous endoscopic gastric biopsy histopathological examination of the same patients and reports on H. pylori findings were recorded. The demographic characteristics of the patients, such as age, gender and chronic systemic diseases such as hypertension and diabetes mellitus (DM) were recorded. Statistical evaluation was made. Results Evaluation was made among 526 migraine patients who met the inclusion criteria, comprising 397 (75.5%) females and 129 (24.5%) males with a mean age of 45.57 +/- 13.46 years (range, 18-69 years). WML was detected on brain MRI in 178 (33.8%) patients who were also positive for H. pylori (p < 0.05). Subjects who are H. pylori-positive with migraine, WML were observed at a 2.5-fold higher incidence on brain MRI (odds ratio: 2.562, 95% CI 1.784-3.680). WML was found to be more significant in patients with hypertension and migraine than those without (p < 0.001). Older age was also found to be associated with WML (OR = 1.07, 95% CI: 0.01-0.04, p < 0.001). The age (p < 0.001), H. pylori (p < 0.001), hypertension (p < 0.001), and hypertension + DM (p < 0.05), had significant associations in predicting WML according to the multivariate logistic regression analysis. The presence of hypertension had a higher odds ratio value than the other variables. Conclusion It was concluded that H. pylori infection, as a chronic infection, can be considered a risk factor in developing WML in subjects with migraine.
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    Fecal calprotectin levels in Helicobacter pylori gastritis in children
    (2020) Aksoy, Ozlem Yuksel; Canan, Oguz; Hosnut, Ferda Ozbay; Akcay, EdaYilmaz; Ozcay, Figen; 0000-0003-0614-4497; 0000-0002-5214-516X; 33372437; AAI-9386-2021; ABG-5684-2020
    Background. Fecal calprotectin is an important inflammatory marker in intestinal diseases and is not routinely used in the upper gastrointestinal system disorders. The aim of this study was to show whether there is a relationship between fecal calprotectin levels and Helicobacter pylori (H pylori) gastritis in children and to determine the association of fecal calprotectin levels with gastric biopsy results in terms of chronic inflammation and neutrophil activity. Methods. Patients with the complaints of the upper gastrointestinal system (epigastric pain, heartburn, nausea and vomiting) who were planned to undergo endoscopy were enrolled prospectively. The presence of H pylori was defined according to the gastric antrum biopsy results. Fecal calprotectin level was tested in the stool sample of the patients. The fecal calprotectin levels, upper gastrointestinal endoscopy and gastric biopsy results of 89 patients were evaluated. Results. H pylori was found to be positive in the gastric biopsies of 51 (57.3%) patients. In the H pylori positive group mean fecal calprotectin level was 74.8 +/- 67 mu g/g, and in the H pylori negative group mean fecal calprotectin level was 52.7 +/- 46 mu g/g and the difference was significant (p= 0.039). We also found a significant relationship between fecal calprotectin levels and gastric neutrophil activity grades (p= 0.034). Conclusions. Mean fecal calprotectin levels were found to be higher in H pylori positive subjects in our study. Fecal calprotectin levels were correlated with gastric neutrophil activity grades. Fecal calprotectin represents gastric neutrophilic inflammation. When interpreting a high fecal calprotectin level, H pylori infection should be kept in mind.
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    Can the treatment duration be shortened in bismuth-containing therapies for Helicobacter pylori eradication?
    (2019) Etik, Digdem Ozer; Sezer, Semih; Suna, Nuretdin; Oztas, Erkin; Kilic, Zeki Mesut Yalin; 31258136
    Background/Aims: The duration of Helicobacter pylori (H. pylori) eradication therapy as a range (e.g., 10-14 days) is an ignored problem. There is no any particular treatment duration described in current guidelines, and the conditions for when to use 10-day therapy vs. 14-day therapy have not been elucidated. The aim of this study is to determine an effective and reliable H. pylori treatment duration in clinical practice. There were four different treatment modalities administered to groups, and success rates were compared. Materials and Methods: Patients were eligible to participate in the study if they had a biopsy-proven H. pylori infection. Each patient was randomly assigned to one of the four treatment groups according to a predetermined sequence: 14-day or 10-day bismuth-containing quadruple therapy (BQT) groups and 14-day or 10-day moxifloxacin-bismuth-combined treatment (MBCT) groups. Results: A total of 216 patients (54 per group) were enrolled. Two-hundred six patients (95.3%) completed therapy. There was no significant difference in the eradication rates between those patients who received 10- and 14-days BQT regimens (p=0.67). The 14-BQT protocol had the highest eradication rate, the MBCT regimes had the highest compliance, and the 10-MBCT protocol had the poorest results for H. pylori eradication. The posttreatment questionnaire on adverse effects identified nausea/vomiting as the most common side effect (35.7%). Conclusion: Overall, the results of our study suggest that shortening the BQT protocol duration to 10 days does not weaken the H. pylori eradication rate. Moreover, quinolone-containing therapies with the lowest eradication rate among the groups should not be offered as a salvage treatment in case of the BQT failure.
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    Prevention of Helicobacter pylori infection in childhood
    (2014) Yucel, Oya; 25132751
    Helicobacter pylori (H. pylori) infection is one of the most common infections worldwide. Although infection rates are falling in the developed and developing countries, H. pylori is still widespread in the world. This article has reviewed the important publications on H. pylori in childhood with a focus on its evolving transmission route and the source of infection and preventive strategies in childhood, PubMed was searched up to identify eligible studies. Relevant publications were searched using the following. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
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    Helicobacter pylori ve ateroskleroz
    (Başkent Üniversitesi Tıp Fakültesi, 2006) Eren, Serdar; Yılmaz, Uğur
    Helicobacter pylori (H. pylori) ateroskleroz ile ilişkisi hakkında farklı veriler vardır. Bu çalışmada H. pylori ile enfekte ve enfekte olmayan hastalarda serum CRP ve kogülasyon sistem aktivitesini ölçerek H. pylori'nin ateroskleroz üzerine etkisi araştırılmıştır. Kogülasyon system aktivitesi indirek olarak TNF alfa, İL-8 ve P-selektin gibi prokogülan sitokinlerin ve trombin yapım ürünleri olan TAT ve F1-2 serum düzeyleri ölçülerek saptanmıştır. Çalışmaya gastroenteroloji kliniğine dispeptik yakınmalar ile gelen toplam seksen hasta alındı. Hastalar 48 H. pylori pozitif ve 32 H. pylori negatif hasta olmak üzere iki gruba ayrıldı.Tüm hastalara üst endoskopi yaplıdı. Histopatolojik inceleme için endoskopi sırasında antrumdan ve korpusdan en az üçer adet biyopsi alındı. Serum CRP, TNF alfa, p-selektin, TAT, ve F1-2 düzeyleri belirlendi.Serum CRP, prokagülan sitokinlerin, trombin yapım ürünlerinin düzeyleri H. pylor'inin varlığı ile karşılaştırıldı. H. pylori varlığı ile serum CRP (3,20+- 2,20 vs. 4,13+- 3,35 mg/dl), TNF alfa (6,51+- 4,83 vs. 6,9+- 4,98 pg/ml), IL-8 (16,83+- 10,39 vs. 19,03+- 16,286 pg/ml), p-selectin (13,25+- 6,06 vs. 11,24+- 7,20 ng/ml), TAT (41,09+- 69,40 vs. 30,82+- 56,81 ug/l), F1-2 (2,46+- 3,51 vs. 3,07+- 4,26 nmol/l) (sırasıyla p.0.13, p. 0.46, p.0.55, p. 0.18, p.0.49, p.0.48) düzeyleri arasında anlamlı ilişki bulunamadı.Kronik antral inflamasyon H. pylori pozitif hastalarda daha belirgindi. İnflamasyonun derecesi ile serum CRP, TNF alfa, IL-8, p-selectin, TAT, F1-2 düzeyleri ile arasında ilişki saptanmadı (p.0.250, p.0.84, p.0,31, p.0.83, p.0.75, p.0.19). Aynı şekilde korpusta atrofinin derecesiyle serum CRP, TNF alfa, IL-8, TAT, F1-2 düzeyleri arsında ilişki bulunamadı (p.0.13, p.0.21, p.0.30, p.0.23, p.0.93). Helicobacter pylori, neden olduğu inflamasyon ve atrofinin ateroskleroz patogenezinde rol oynayan prokogülan sitokinler, trombin yapım ürünleri ve serum CRP düzeyi üzerine etkili olmadığı saptandı. There are conflicting reports about the relation between H. pylori and atherosclerosis. The aim of the present study was to highlight the affect of H. pylori on atherosclerosis, by investigating the plasma level of CRP and the activity of coagulation system in H. pylori infected and noninfected patients. The activity of coagulation cascade was measured indirectly by measuring plasma levels of procoagulan cytokines such as TNF alfa, IL-8, p- selectin and thrombin generation markers; TAT and F1-2. Eighty patient, applied to gastroenterology clinic with a complain of dyspepsia, were enrolled in our study. Two groups of patients were defined: 48 H. pylori positive and 32 H. pylori negative. Each patient was submitted to upper gastrointestinal endoscopy with at least three biopsy both from antrum and corpus. Plasma levels of CRP, TNF alfa, IL-8, p-selectin, TAT ant F1-2 were assayed. Plasma levels of procoagulan cytokines, thrombin generation markers and CRP were not related to the presence of H. pylori: The levels of CRP (3,20+- 2,20 vs. 4,13+- 3,35 mg/dl), TNF alfa (6,51+- 4,83 vs. 6,9+- 4,98 pg/ml), IL-8 (16,83+- 10,39 vs. 19,03+- 16,286 pg/ml), p-selectin (13,25+- 6,06 vs. 11,24+- 7,20 ng/ml), TAT (41,09+- 69,40 vs. 30,82+- 56,81 ug/l), F1-2 (2,46+- 3,51 vs. 3,07+- 4,26 nmol/l) were comparable in both group (respectively p.0.13, p. 0.46, p.0.55, p. 0.18, p.0.49, p.0.48)Chronic antral inflammation was significantly higher in H. pylori positive than H. pylori negative group (p.0.00). The grade of inflammation was found to be uncorrelated to the plasma levels of CRP, TNF alfa, IL-8, p-selectin, TAT, F1-2 (respectively p.0.250, p.0.84, p.0,31, p.0.83, p.0.75, p.0.19). Similarly the degree of atrophy in corpus was unrelated to the plasma levels of CRP, TNF alfa, IL-8, TAT, F1-2 (respectively, p.0.13, p.0.21, p.0.30, p.0.23, p.0.93)The infection of H. pylori and its resulting inflammation and atrophy were found to be ineffective on the plasma level of procoagulan cytokines, thrombin generation markers and CRP which all were included in the pathogenesis of atherosclerosis.