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Öğe [A clinical presentation of a very rare infection: parenchymal Fasciola hepatica].(2013) Sapmaz, Ferdane; Kalkan, Ismail Hakki; Guliter, Sefa; Nazlio?lu, AdemFascioliasis is primarily an infection of livestock such as cattle and sheep, caused by the flat, brown liver fluke Fasciola hepatica. Humans are accidental hosts. The diagnosis of infection depends on suspicion. Radiologic findings are specific. Usually, Computed Tomography (CT) and other imaging studies show hypodense migratory lesions of the liver. The development of a chronic liver abscess appears to be extremely rare. Here we present our case with hepatic abscess due to F. hepatica, which is a rare clinical presentation.Öğe Accidental ingestion of a pen in an adolescent girl(Edizioni Minerva Medica, 2016) Sapmaz, Ferdane; Aslan, Mustafa Kemal; Guenal, Yasemin Dere; Boybeyi, Oezlem; Kalkan, Ismail Hakki; Guliter, SefaForeign body ingestion is a common problem in pediatric population with a peak incidence between 6 months and 6 years. adolescents, however, are more likely to swallow or insert foreign bodies intentionally as a risk-taking behavior, a bid for attention, or under the influence of drugs or alcohol. in this paper we report the case of an adolescent girl who accidentally ingested a pen, which was successfully removed with endoscopy.Öğe Acute cholecystitis complicated by pylephlebitis(Aves, 2014) Sapmaz, Ferdane; Kalkan, Ismail Hakki; Guliter, Sefa; Bilgili, Yasemin Karadeniz…Öğe Celiac disease prevalence in patients with iron deficiency anemia of obscure origin(Turkish Soc Gastroenterology, 2009) Ucardag, Derya; Guliter, Sefa; Ceneli, Ozcan; Yakaryilmaz, Fahri; Atasoy, Pinar; Caglayan, OsmanBackground/aims: Anemia, especially due to iron deficiency, is a frequent feature in celiac disease. In this study, we aimed to define the prevalence of celiac disease in Turkish patients with iron deficiency anemia of obscure origin. Methods: One thousand four hundred and eighty-six consecutive patients with iron deficiency anemia were evaluated for etiology. Of those, 77 patients were found to have iron deficiency anemia of obscure origin. Sera from 77 patients with iron deficiency anemia of obscure origin and 119 healthy controls were tested for IgA and IgG tissue transglutaminase (tTG) antibodies by ELISA. Endoscopic mucosal biopsies were taken from the second part of the duodenum in these patients. Histopathologic examination results of patients were stratified according to Marsh classification. Results: IgA and IgG class anti-tTG antibodies were found positive in 6 (7.8%) and 3 (3.9%) patients with iron deficiency anemia of obscure origin, respectively. Three patients had only IgA anti-tTG and 3 had both IgA and IgG anti-tTG antibodies. In the control group, 1 subject was positive for both IgA and IgG anti-tTG antibodies (0.7%). Six patients (7.8%) and 1 control subject (0.8%) had histopathologic findings of celiac disease (p=0.02). Conclusions: Patients with iron deficiency anemia of obscure origin had increased prevalance of celiac disease. Our study results suggest that serological screening may be recommended for early detection of celiac disease in patients with iron deficiency anemia of obscure origin.Öğe Cerebral sinus thrombosis in a patient with active ulcerative colitis and double heterozygosity for Factor V Leiden and prothrombin gene mutations(Medknow Publications, 2009) Yakaryılmaz, Fahri; Guliter, Sefa; Değertekin, Bülent; Tuncer, Candan; Ünal, SelahattinInflammatory bowel diseases are associated with increased risk for thrombotic complications, In patients with ulcerative colitis (UC) cerebral sinus venous thrombosis (CSVT) is an extremely rare complication. We report a patient with active UC and CSVT. The patient was heterozygous for Factor V Leiden and G20210A prothrombin gene mutations without other identifiable precipitating factors. This patient highlights the need for investigating the patients with UC with thrombotic complications for other thrombophilic states.Öğe Comparison of Helicobacter pylori eradication rates of standard 14-day quadruple treatment and novel modified 10-day, 12-day and 14-day sequential treatments(Elsevier, 2014) Sapmaz, Ferdane; Kalkan, Ismail Hakki; Guliter, Sefa; Atasoy, PinarBackground & aim: This study aimed to compare the efficacy and safety of bismuth-included standard regimen and modified sequential treatments in Turkey, where the success rate of standard triple therapy is very low. Methods: One-hundred and sixty patients with dyspeptic complaints and naive Helicobacter pylori infection were randomized into four groups: 41 patients received standard 14-day quadruple treatment (STD) (Rabeprazole 20 mg-bid, bismuth subcitrate (120 mg-qid), Tetracycline 500 mg-qid, Metronidazole 500 mg-tid) for 2 weeks. The modified sequential therapy groups received 20 mg rabeprazole and 1 g amoxicillin, twice daily for the first 5 days, followed by Rabeprazole 20 mg-bid, bismuth subcitrate (120 mg-qid), Tetracycline 500 mg-qid, Metronidazole 500 mg-tid for the remaining 5 (10 day sequential therapy group-10S) (42 patients), 7 (12 day sequential therapy group-12S) (42 patients) and 9 (14 day sequential therapy group-14S) (41 patients) days. Results: The overall compliance and H. pylori eradication rate among the 160 patients who completed the H. pylori eradication regimens were 86.9% (139/160) and 78.1% (125/160), respectively. The results were not statistically different between groups in the eradication rates. Per-protocol eradication rates were 76.5% in STD, 71.4% in 10S, 82.4% in 12S and 83.3% in 14S groups (p = 0.7). Intention-to-treatment rates were 77.5% in STD, 72.5% in 10S, 82.5% in 12S and 80.0% in 14S groups (p = 0.5). Conclusion: The eradication rates of standard 14-day and different sequential quadruple treatment regimens are comparable and much more higher than with standard 14-day triple H. pylori eradication treatment that has been reported previously in Turkey. (C) 2013 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved.Öğe Delayed presentation of post-traumatic diaphragmatic hernia with gastric volvulus: a case report(Turkish Assoc Trauma Emergency Surgery, 2010) Yakaryilmaz, Fahri; Banli, Oktay; Altun, Hasan; Guliter, SefaPost-traumatic diaphragmatic hernia complicated by gastric volvulus may manifest immediately or several years after the incident. Delayed presentation of traumatic diaphragmatic hernia with gastric volvulus is relatively unusual. We report a 28-year-old male patient who admitted with gastric volvulus due to traumatic diaphragmatic hernia after sustaining a knife wound to the left lower chest one year before presentation. The patient has been followed without any symptom for two years since the diaphragmatic hernia was repaired by primary suture plication.Öğe Evaluation of gallbladder motility in patients with irritable bowel syndrome(E M H Swiss Medical Publishers Ltd, 2005) Guliter, Sefa; Yılmaz, Sevda; Yakaryılmaz, Fahri; Keleş, HaticeBackground: Abnormalities involving smooth muscle function in different systems of the body have been reported in irritable bowel syndrome (IBS). There are a few studies on gallbladder function in this disorder with conflicting results. Objectives: To investigate the motility of gallbladder in patients with IBS. Patients and methods: Forty-eight patients (15 male and 3 3 female) with IBS and 48 healthy volunteers (15 male and 3 3 female) were included into the study. Thirty-four patients (70.8%) had constipation predominant and 14 patients (29.2%) had diarrhoea predominant type of IBS. Fasting and postprandial gallbladder volumes were studied using real time ultrasonography and ejection fraction (EF) of gallbladder was calculated. Results: While fasting gallbladder volume (FGV) was similar between IBS and control groups (18.0 +/- 4.0 ml vs. 17.8 +/- 4.9 ml, p > 0.05), postprandial gallbladder volume (PGV) was lower in IBS group than in the control group (5.5 +/- 1.4 ml vs. 6.2 +/- 1.9 ml, p = 0.03). Accordingly, the mean EF of gallbladders was found to be higher in IBS group than in the control group (69.1% vs. 64.1%, p = 0.0001). There were no difference in FGV, PGV and EF of gallbladders between constipation predominant and diarrhoea predominant IBS patients (P > 0.05). Conclusion: The results of this study indicated that IBS patients have increased emptying of gallbladder compared to healthy subjects.Öğe The impact of Helicobacter pylori eradication on serum hepcidin-25 level and iron parameters in patients with iron deficiency anemia(Springer Wien, 2016) Sapmaz, Ferdane; Basyigit, Sebahat; Kalkan, Ismail Hakki; Kisa, Ucler; Kavak, Engin Eren; Guliter, SefaThe aim of this study was to evaluate the efficacy of bismuth-based quadruple regiment as a first-line treatment for Helicobacter pylori (H. pylori) eradication in patients with unexplained iron deficiency anemia (IDA). The serum hepcidin-25, iron, ferritin levels and total iron-binding capacity were evaluated at baseline and after H. pylori eradication in order to assess whether H. pylori eradication plays a role in IDA related to H. pylori infection. The study included 80 patients with unexplained IDA and H. pylori infection. All patients received pantoprazole (40 mg b.i.d.), bismuth subcitrate (120 mg q.i.d.), tetracycline (500 mg q.i.d.) and metronidazole (500 mg t.i.d.) over 14 days as H. pylori eradication regimen. In all patients, blood samples were drawn at baseline and 1 month after eradication therapy. In all patients, serum hepcidin-25 levels were determined by using commercially available enzyme-linked immunosorbent assay kits. There was an improvement in hemoglobin, iron, total iron-binding capacity and ferritin values after H. pylori eradication in all subjects. Serum hepcidin-25 levels significantly decreased after H. pylori eradication (p < 0.001). Gastric H. pylori infection is a common cause of IDA of unknown origin in adult patients. Our results provide evidence indicating that hepcidin level decreases after successful H. pylori eradication with improvement in IDA.Öğe Increased serum neopterin levels in Familial Mediterranean Fever(Blackwell Publishing, 2006) Kısa, Üçler; Guliter, Sefa; Kısa, Özgül; Musabak, Uğur; Tüzün, A.…Öğe Irritable bowel syndrome in young and elderly patients with stable asthma(Elsevier Science Inc, 2005) Ekici, Arif; Guliter, Sefa; Ekici, Mücahit; Kalpaklıoğlu, Füsun; Kara, Tuba; Keleş, Hatice; Koçyiğit, PelinBackground. It has been speculated that asthma and irritable bowel syndrome may share common pathophysiological processes. Aim. To estimate the prevalence of irritable bowel syndrome in young and elderly patients with stable asthma. Patients and methods. Sixty-five young (age < 60 years) and 66 elderly (age >= 60 years) stable asthmatics, and 119 age-matched healthy volunteers were enrolled. In all participants, presence of irritable bowel syndrome, quality of life and psychological status were evaluated. Results. The prevalence of irritable bowel syndrome in asthmatic group was higher than that in the control group (27.5% versus 16.8%; odds ratio, 1.8 [1.0 - 3.4]; p = 0.04). The prevalence of irritable bowel syndrome was significantly higher in young asthmatics than in age-matched healthy controls (36.9% versus 20.3%; odds ratio, 2.2 [1.0 - 5.1]; p = 0.04) and than in elderly asthmatics (36.9% versus 18.2%; odds ratio, 0.3 [0.1 - 0.8]; p = 0.01). Logistic regression analysis identified the younger age (odds ratio, 2.1 [1.1 - 3.8]; p = 0.01), and the presence of asthma (odds ratio, 1.9 [1.0 - 3.5]; p = 0.03) as independent risk factors for irritable bowel syndrome in all participants after adjusting for gender. We also found impaired quality of life to be associated with the presence of irritable bowel syndrome and asthma in all participants after adjusting for age and gender. Conclusion. The prevalence of irritable bowel syndrome appears to be significantly higher in young asthmatics, but not in elderly asthmatics, compared to age-matched healthy counterparts. Potential pathogenic mechanisms of higher irritable bowel syndrome prevalence in young asthmatics need to be explained by further studies. (c) 2005 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.Öğe Ischemic proctitis in a diabetic patient(Univ Catholique Louvain-Ucl, 2013) Sapmaz, Ferdane; Kalkan, Ismail Hakki; Guliter, Sefa; Atasoy, Pinar…Öğe A juxtapapillary windsock diverticulum connected with the third portion of the duodenum via a natural orifice(Aves, 2014) Sapmaz, Ferdane; Kalkan, Ismail Hakki; Bilgili, Yasemin Karadeniz; Guliter, Sefa…Öğe Lower plasma pantoprazole level predicts Helicobacter pylori treatment failure in patients with type 2 diabetes mellitus(Wiley, 2015) Sapmaz, Ferdane; Kalkan, Ismail H.; Suslu, Incilay; Demirci, Huseyin; Atasoy, Pinar; Guliter, SefaObjectiveWe aimed to compare the plasma pantoprazole level (PPL) between patients with type 2 diabetes mellitus and non-diabetic patients during Helicobacter pylori (H. pylori) eradication treatment and to explore the role of PPL in predicting the treatment success rates. MethodsThis study included 40 diabetic and 40 non-diabetic treatment-naive H.pylori-infected patients. Bismuth-based standard quadruple treatment for H.pylori eradication was used for 14 days in both groups. PPL was measured using the square-wave voltammetry method. ResultsH.pylori eradication rate (60.0% vs 87.5%, P=0.005) and PPL (0.25 0.03 g/mL vs 0.34 +/- 0.03 g/mL, P < 0.001) was significantly lower in the diabetic group compared with the controls. Patients with treatment failure had lower PPL than those with successful treatment (P<0.001). The receiver operating characteristics curve demonstrated that PPL had a significant predictive value for the outcome of H.pylori eradication. ConclusionType 2 diabetic patients had lower PPL than the non-diabetic controls, which led to their lower H. pylori eradication rates.Öğe A Non-Inferiority Study: Modified Dual Therapy Consisting Higher Doses of Rabeprazole Is as Successful as Standard Quadruple Therapy in Eradication of Helicobacter pylori(Lippincott Williams & Wilkins, 2017) Sapmaz, Ferdane; Kalkan, İsmail H.; Atasoy, Pınar; Başyiğit, Sebahat; Guliter, SefaThe aim is to compare high-dose rabeprazole and amoxicillin containing modified dual therapy (MDT) with bismuth subcitrate containing standard quadruple therapy (SQT) as the first-line Helicobacter pylori eradication treatment in terms of efficacy, safety, and adherence to treatment. A total of 200 consecutive patients diagnosed endoscopically with nonulcer dyspepsia with H. pylori infection were randomly assigned into 2 groups, 1 treated with amoxicillin 750 mg thrice daily plus rabeprazole 20 mg thrice daily (MDT group) or rabeprazole 20 mg b.i.d., bismuth subcitrate 120 mg q.i.d., tetracycline 500 mg q.i.d., metronidazole 500 mg t.i.d. (SQT group). Overall, 196 patients (98 in the MDT group and 98 in the SQT group) completed the study. H. pylori eradication was achieved in 84.7% of patients in the MDT group by intention to treat analysis and 84.9% by per-protocol analysis, which were comparable with SQT group (87.8% and 88.8%, respectively). Adverse events including nausea (P = 0.03), dysgeusia (P < 0.001), diarrhea (P = 0.001), black colored stool (P < 0.001), headache (P = 0.01), and abdominal pain (P = 0.05) were significantly higher in SQT group. The MDT is an efficient and safe treatment choice that could be recommended in the first-line eradication treatment of H. pylori.Öğe Prevalence of occult hepatitis B and hepatitis C virus infections in Turkish hemodialysis patients(Taylor & Francis Inc, 2006) Yakaryılmaz, Fahri; Gürbüz, Oğuz Alp; Guliter, Sefa; Mert, Ali; Songur, Yildiran; Karakan, Tarkan; Keles, HaticeBackground and Objective. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are important causes of morbidity and mortality in maintenance hemodialysis patients. Although their exact prevalence is not known, HBV and HCV viral infections and occult viral hepatitis are frequent in these patients. This study aimed to determine the prevalence of occult HBV and HCV infections in maintenance hemodialysis patients. Materials and Methods. One hundred and eighty-eight end-stage renal disease patients on maintenance hemodialysis (100 male, mean age 49 29 [16-80] years, and mean duration of hemodialysis 98 66 [12-228] months) were enrolled in this study. Scrological markers for HBV and HCV were determined with immunoenzymatic assay (ELISA) by using commercial diagnostic kits (Access and BioRad, Beckman-Coulter). HCV-RNA (Cobas Amplicor HCV kit) and HBV-DNA (Artus GmbH HBV kit) were determined quantitatively by polymerase chain reaction. Results. Among the patients screened, 25 (13.3%) had HBV infection alone and 38 (20.2%) had HCV infection alone, while seven (3.7%) had dual infection of both viruses. Serological markers for occult hepatitis B and occult hepatitis C were positive in five (2.7%) and nine (4.8%) of the patients, respectively. Isolated anti-HBc was positive in 12 (6.4%) of all patients, three (7.9%) of the patients with anti-HCV and two (40%) of the patients with occult hepatitis B. Isolated anti-HBc positivity was more frequent in patients with occult hepatitis B than in those without (40% [2/5] vs. 5.5% [10/183], p=0.002). None of the patients with HCV had occult hepatitis B. Conclusions. Both occult and non-occult forms of HCV infection are more prevalent than HBV infection in hemodialysis patients. Especially the patients with isolated anti-HBc positivity should be tested for probable occult hepatitis B infection.Öğe Retrobulbar Neuritis as the Initial Sign of Interferon-Alpha-Associated Multiple Sclerosis in a Chronic Hepatitis B Patient: Case Report(Ortadogu Ad Pres & Publ Co, 2011) Örnek, Kemal; Onaran, Zafer; Yılmazbaş, Pelin; Guliter, SefaInterferon-alpha (IFN-alpha) is a therapeutic agent which plays an important role in the management of viral and malignant disorders. However, it has several side effects on eye and visual pathway. A 43-year-old man was admitted with sudden loss of vision. He had been on IFN-alpha treatment for chronic hepatitis B which was stopped 9 months earlier. The diagnosis of retrobulbar optic neuritis was made. Six months later, he admitted to us with decreased vision in the same eye. Magnetic resonance imaging of the brain revealed white matter lesions. Further neurological investigations confirmed the diagnosis of multiple sclerosis. Multiple sclerosis should be considered in differential diagnosis of hepatitis B patients with a history of IFN-alpha treatment who present with visual symptoms.Öğe Sandfly fever virus as a rare cause of acute viral hepatitis(Elsevier Sci Ltd, 2014) Ayaslioglu, Ergin; Guliter, Sefa; Karabicak, Cigdem; Ecemis, Kenan; Gulhan, Muhammet; Edis, Cigdem Torun…Öğe Severe gastritis decreases success rate of Helicobacter pylori eradication(Springer Wien, 2016) Kalkan, Ismail Hakki; Sapmaz, Ferdane; Guliter, Sefa; Atasoy, PinarIn several studies, different risk factors other than antibiotic resistance have been documented with Helicobacter pylori eradication failure. We aimed in this study to investigate the relationship of gastric density of H. pylori, the occurrence/degree of gastric atrophy, and intestinal metaplasia (IM) with success rate of H. pylori eradication. Two hundred consecutive treatment naive patients who received bismuth containing standart quadruple treatment due to H. pylori infection documented by histopathological examination of two antral or two corpal biopsies entered this retrospective study. The updated Sydney system was used to grade the activity of gastritis, density of H. pylori colonization, atrophy, and IM. Stages III and IV of operative link for gastritis assessment (OLGA) or the operative link on gastric intestinal metaplasia assessment (OLGIM) stages was considered as severe gastritis. H. pylori eradication was determined via stool H. pylori antigen test performed 4 weeks after the end of therapy. The presence of gastric atrophy and IM was significantly higher in patients with eradication failure (p = 0.001 and 0.01, respectively). Severe gastritis (OLGA III-IV and OLGIM III-IV) rates were higher in eradication failure group. A multiple linear regression analysis showed that OLGA and OLGIM stages were to be independent risk factors for eradication failure (p = 0.03 and 0.01, respectively). Our results suggested that histopathologically severe gastritis may cause H. pylori eradication failure. In addition, we found that H. pylori density was not a risk factor for treatment failure in patients who receive quadruple treatment.Öğe The spectrum of FMF mutations and genotypes in the referrals to molecular genetic laboratory at KÄaut +/- rÄaut +/- kkale University in Turkey(Springer, 2009) Günel-Özcan, Ayşen; Sayin, Derya Beyza; Mısırlıoğlu, Emine Dibek; Guliter, Sefa; Yakaryilmaz, Fahri; Ensari, CüneytFamilial Mediterranean Fever (FMF) is an autosomal recessive genetic disorder characterised by recurrent and self-limited abdominal pain, synovitis and pleuritis. MEFV gene mutations are responsible from the disease and its protein product, pyrin or marenostrin, plays an essential role in the regulation of the inflammatory reactions. MEFV gene contains 10 exons and most of the mutations have been found on the last exon. Up to date, 152 mutations and polymorpisms have been reported inwhere V726A, M694V, M694I, M680I and E148Q are the most common mutations. In this study, MEFV allele frequencies of 136 individuals (60 from Pediatry, 76 from Internal Medicine) have been evaluated, and compared with each other. Asymptomatic individuals with FMF family history (4 from Pediatry, 6 from Internal Medicine) were excluded from the analysis. The prominent mutations indicated in the Pediatry group are V726A, M694V and M680I (G/C) and with the allele frequency of 0.06, 0.05 and 0.04 respectively while they were E148Q, M694V, M680I (G/C) in the Internal Medicine group with the allele frequency of 0.12, 0.08 and 0.04. The E148Q mutation is significantly overrepresented in the adult referrals (P = 0.02). Mutation on both alleles was observed in only 12% of cases. Overall mutation frequency was low, seen in 26.2% (66/252). However, when only diagnosed patients were analyzed it is 72.7% (16/22). It is also interesting that 63% of individuals are female that there may be sex influence on FMF phenotype.
