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Öğe Comparison of clinical outcomes and FOXP3, IL-17A responses in Helicobacter pylori infection in children versus adults(Wiley, 2021) Yorguc, Eda; Gulerman, Hacer Fulya; Kalkan, Ismail Hakki; Guven, Burcu; Balci, Mahi; Yorguc, Mustafa caglarBackground The purpose of this study was to compare the clinical symptoms and pathological consequences of Helicobacter pylori (H. pylori) infection between children and adults and determine the levels of expression of FOX3P and IL-17A to examine the Th17/Treg balance. Methods Forty pediatric and 40 adult patients who were followed up at the Pediatric Gastroenterology and Internal Medicine Gastroenterology Departments were enrolled in the study. In our case-control study, gastric tissue specimens were evaluated using the updated Sydney system, and the number of cells expressing FOXP3/IL-17A (T-reg and Th17 cell markers) was analyzed immunohistochemically. In addition, each case was evaluated using a clinical follow-up questionnaire. Results Clinical signs and symptoms of children and adults were similar. IL-17A and FOXP3 levels were significantly higher in children and adults with H. pylori (+) than in those without H. pylori (-) (p < .001). In patients with H. pylori (+), the mean FOXP3 level was significantly higher, whereas the mean IL-17A level was significantly lower in children than in adults (p < 0001 for both groups). In children with H. pylori (+), bacterial density was negatively correlated with IL-17A level and positively correlated with FOXP3 level. In adults with H. pylori (+), there was a statistically significant, highly positive correlation between bacterial density and levels of IL-17A and FOXP3. Conclusions T-reg cells are suggested to more predominant in children than in adults, IL-17A levels decrease as H. pylori bacterial density increases. In conclusion, immune responses incline toward T-reg, which increases the susceptibility to persistent infections.Öğe Importance of Delta Over Baseline Values in Predicting the Severity of Helicobacter pylori Infection in Children(Bursa Uludag Univ, 2021) Guven, Burcu; Gulerman, Hacer Fulya; Kacmaz, BirgulIntroduction:Although severe forms of the disease are seen in adults, the Helicobacter pylori (H. pylori) infection is usually acquired during childhood. Therefore, prompt diagnosis of H. pylori infection in childhood is of prime importance. In the present study, we aimed to identify the sensitivity and specificity of 13C urea breath test (UBT) in the diagnosis of H. pylori infection and to assess the severity of the disease with delta over baseline (DOB) values. Materials and Methods: UBT was administered to 200 children who presented with epigastric pain and/or nausea. Esophagogastroduodenoscopy (EGD) was performed in patients. UBT results were compared with histopathological findings. In the Area Under the ROC Curve analysis, a cutoff DOB value was found for the severity of H. pylori infection. Results: 193 children with a mean age of 13.50 +/- 2.98 years were included in the analysis. Of these, 71 (36.8%) patients had a positive UBT and 122 (63.2%) had a negative UBT. EGD was performed in 60 out of 71 patients with positive UBT and in 30 out of 122 patients with negative UBT. The sensitivity and specificity of UBT were 85.1% and 100%. DOB was found to be a significant predictor of moderate/marked H. pylori density at a cutoff value of 6%. Conclusions: The positive correlation detected between the level of DOB values and the density of H. pylori and inflammatory activity can be an advantage for detecting the severity of diseaseÖğe Investigation of Thiol/Disulfide Balance in Obese Rats with Non-Alcoholic Fatty Liver Disease(Korean Soc Pediatric Gastroenterology & Nutrition, 2021) Tursun, Serkan; Gulerman, Hacer Fulya; Gazyagci, Serkal; Sahin, Yasar; Erel, Ozcan; Neselioglu, SalimPurpose: Due to the increasing prevalence of obesity worldwide, non-alcoholic fatty liver disease (NAFLD) has reached epidemic dimensions over time. NAFLD is the most common cause of childhood chronic liver disease. There is a relationship between NAFLD and oxidative stress. This study aims to investigate the changes in thiol/disulfide homeostasis parameters to determine the oxidant/antioxidant balance in obese rats with diet-induced NAFLD and healthy rats. Methods: Twelve Wistar albino rats were used in this study. Experimentally produced NAFLD obese rats (n=6) and healthy rats were compared. Experimental NAFLD model was created with a special fatty liver diet (Altromin (R) C1063, Fatty Liver Diet, Exclusivet, Lage, Germany). The biochemical and histopathological features of the groups, as well as serum thiol/disulfide homeostasis parameters, were analyzed and compared. Results: In the experimentally induced NAFLD rat model, they gained more weight than the control group. Steatosis (at least grade 2) occurred in all rats fed with special fatty liver diet for 12 weeks. Histopathologically, no high-grade inflammation was observed in rats with experimental NAFLD after feeding a diet for 12 weeks. Results revealed that aspartate transaminase and alanine transaminase levels were high, albumin levels were low, oxidant stress parameters increased, and antioxidant thiol groups decreased. Conclusion: Experimental NAFLD is characterized by increased oxidant stress accompanying fatty tissue in the liver. Analysis of thiol/disulfide homeostasis parameters in NAFLD can be used in further studies to develop effective treatment options.Öğe Life-threatening massive upper gastrointestinal bleeding in a term and healthy baby(Taylor and Francis Ltd., 2023) Alan, Serdar; Vural, Sevde Nur; Gulerman, Hacer Fulya; Albayrak, Meryem; Aliefendioglu, DidemUpper gastrointestinal (UGI) bleeding due to gastric ulcer and gastritis can be seen in severely ill or premature infants but is rarely reported in healthy term newborns. UGI endoscopy is crucial for the etiological evaluation and appropriate treatment of UGI hemorrhages. This report discusses the differential diagnosis and treatment approach in a previously healthy infant who was admitted to the neonatal intensive care unit due to life-threatening severe UGI bleeding causing hemodynamic instability. © Copyright © 2022 Baylor University Medical Center.Öğe Nutrition Support in Pediatric Patients with Malnutrition(Springer, 2019) Alpcan, Aysegul; Tursun, Serkan; Gulerman, Hacer Fulya…
