Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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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 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 Relationship between Helicobacter pylori infection and white matter lesions in patients with migraine(2022) Ocal, Serkan; Ocal, Ruhsen; Suna, Nuretdin; 35597897Background/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.Item 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-5684-2020Background. 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.Item Interactions between Helicobacter pylori and gastroesophageal reflux disease(2019) Yucel, Oya; 0000-0001-5752-7493; 30151653; AAU-1657-2020Interactions between Helicobacter Pylori (HP) and gastroesophageal reflux disease (GERD) are a complex issue. Several pathophysiological factors influence the development and the course of GERD, HP infection might be only one of these. Many studies emphasize the co-existence of these diseases. HP infection could contribute to GERD through both a protective and an aggressive role. Gastric acid secretion is a key factor in the pathophysiology of reflux esophagitis. Depending on the type of gastritis related to HP, acid secretion may either increase or decrease. Gastritis in corpus leads to hypoacidity, while antrum gastritis leads to hyperacidity. In cases of antral gastritis and duodenal ulcers which have hyperacidity, the expectation is an improvement in pre-existing reflux esophagitis after eradication of HP. In adults, HP infection is often associated with atrophic gastritis in the corpus. Atrophic gastritis may protect against GERD. Pangastritis which leads to gastric atrophy is commonly associated with CagA strains of HP and it causes more severe gastric inflammation. In case of HP-positive corpus gastritis in the stomach, pangastritis, and atrophic gastritis, reflux esophagitis occurs frequently after eradication of HP. Nonetheless, as a predisposing disease of gastric cancer, HP should be treated. In conclusion, as the determinative factors affecting GERD involving in HP, detailed data on the location of gastric inflammation and CagA positivity should be obtained by the studies at future.Item 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; 31258136Background/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.Item Is Human Papillomavirus and Helicobacter pylori Related in Gastric Lesions?(2019) Bozdayi, GUlendam; Dinc, Bedia; Avcikucuk, Havva; Turhan, Nesrin; Altay-Kocak, Aylin; Ozkan, Secil; Ozin, Yasemin; Bostanci, Birol; 31625359Background: Human papillomavirus (HPV), the causative agent of cervical cancer, is also suggested as a risk factor for gastric adenocarcinoma. Many infectious agents besides Helicobacter pylori have been associated with gastritis. The aim of this study was to investigate HPV DNA and genotyping HPV type 16 DNA in gastric adenocarcinoma and Helicobacter pylori gastritis cases. Methods: A hundred and six gastric adenocarcinoma and Helicobacter pylori gastritis samples and 26 controls were included. After deparaffinization by xylene, DNA extraction was performed by the phenol-chloroform-isoamyl alcohol method and 106 samples were studied with a G6PDH control kit (Eurogentec, Seraing, Belgium). Fifty-three adenocarcinoma and 43 Helicobacter pylori samples were thought to have enough tissue and were studied for HPV DNA. HPV types other than 16 and HPV type 16 DNA were detected by Real Time PCR using the L1 region. Amplifications of MY09/11 products were done by GP5+/GP6+ primers and Cyanine-5 labeled HPV DNA and HPV 16 DNA specific probe in Light Cycler 2.0 (Roche Diagnostics, Germany) device. Results: Among gastric adenocarcinoma and Helicobacter pylori gastritis samples, 20/53 (38%) and 18/43 (41.8%) were HPV DNA positive, respectively. Five (19.2%) of 26 controls were HPV DNA positive. Conclusions: Our 38% positive result in the gastric carcinoma group is in concordance with previous reports. This is the first study revealing the HPV-H. pylori relationship in gastritis cases and we concluded that with regard to the nearly three-fold higher HPV DNA (41.8%) in gastritis cases compared to controls, Helicobacter pylori positive cases should also be evaluated in favor of HPV in the gastritis group.Item Prevention of Helicobacter pylori infection in childhood(2014) Yucel, Oya; 25132751Helicobacter 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.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 Helicobacter pylori ve ateroskleroz(Başkent Üniversitesi Tıp Fakültesi, 2006) Eren, Serdar; Yılmaz, UğurHelicobacter 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.