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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 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 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 How effective are APRI, FIB-4, FIB-5 scores in predicting liver fibrosis in chronic hepatitis B patients?(Lippincott Williams & Wilkins, 2022) Sapmaz, Ferdane Pirincci; Buyukturan, Galip; Sakin, Yusuf Serdar; Kalkan, Ismail Hakki; Atasoy, PinarLiver fibrosis is the most important factor in the prognosis and treatment plan of patients with chronic hepatitis B (CHB). Aspartate aminotransferase (AST)-to-platelet ratio index (APRI), fibrosis index based on 4 factors (FIB-4), and fibrosis index based on 5 factors (FIB-5) scores are noninvasive fibrosis markers, and previous comparative studies have shown that they are as effective as liver biopsy in detecting liver fibrosis in different liver diseases. The aim of our study is to investigate whether existing scoring systems are effective in demonstrating fibrosis in CHB patients and to compare the APRI, FIB 4, and FIB 5 scores in differentiating early and advanced fibrosis in 123 patients who underwent liver biopsy for CHB infection. APRI, FIB-4, and FIB-5 scores of patients who underwent liver biopsy due to CHB were calculated by means of calculators and recorded to be compared with liver biopsies in terms of fibrosis scoring. One hundred twenty-three patients who underwent liver biopsy due to chronic hepatitis B were included in the study. APRI (area under the receiver-operating characteristic [ROC] curve 0.728), FIB-4 (area under the ROC curve 0.693) and FIB-5 (area under the ROC curve 0.643) scores were evaluated as significant predictors of advanced fibrosis. The scoring system with the highest positive and negative predictive value was evaluated as FIB-4. APRI, FIB-4, and FIB-5 scoring systems are appropriate scoring systems in the assessment of advanced fibrosis in patients with CHB. Our study is the first to compare APRI, FIB-4, and FIB-5 values in CHB patients, and more comprehensive studies are needed.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 Is Gastric Xanthelasma an Alarming Endoscopic Marker for Advanced Atrophic Gastritis and Intestinal Metaplasia?(Springer, 2016) Koksal, Aydin Seref; Suna, Nuretdin; Kalkan, Ismail Hakki; Eminler, Ahmet Tarik; Sakaogullari, Sukran Ziysan; Turhan, Nesrin; Parlak, ErkanThe clinical significance of gastric xanthelasmas is unknown. We conducted a case-control study in order to evaluate whether gastric xanthelasma is an indicator of advanced atrophic gastritis and intestinal metaplasia. The study was conducted among 1400 patients who underwent elective upper endoscopy. Patients with gastric xanthelasma and atrophy and/or intestinal metaplasia constituted the study group (n = 55). The control group involved patients with only atrophic gastritis and/or intestinal metaplasia (n = 50). Histopathologic findings of the groups including the distribution of atrophic gastritis and/or intestinal metaplasia, operative link on gastritis assessment score, operative link on gastritis intestinal metaplasia assessment (OLGIM) score, and presence of dysplasia and malignancy were compared. Subgroup analysis was performed in order to establish the relation between the characteristics (size, number, and localization) of xanthelasmas, atrophy, and intestinal metaplasia. Multifocal atrophic gastritis was significantly more common in patients with a gastric xanthelasma (41.8 vs. 26.0 %, p = 0.03). Patients with multiple xanthelasmas had a significantly higher rate of intestinal metaplasia (p = 0.02) and a higher OLGIM score (p = 0.02) compared to those with a single xanthelasma. Dysplasia was detected in 8 (14.5 %) patients with a xanthelasma and 4 (8.0 %) patients without a xanthelasma (p = 0.2). Gastric xanthelasma(s) is a warning endoscopic sign for the presence of multifocal atrophic gastritis and advanced intestinal metaplasia.Öğe Ischemic colitis in a young woman following colonoscopy(Springer Wien, 2014) Sapmaz, Ferdane; Kalkan, Ismail Hakki; Gueliter, Sefa; Bilgili, Yasemin Karadeniz…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 RAPIDLY RECURRING GASTRIC POLYP AFTER ENDOSCOPIC POLYPECTOMY(Lippincott Williams & Wilkins, 2015) Koksal, Aydin Seref; Kalkan, Ismail Hakki; Yildiz, Hakan…Öğe Rectal perforation as a result of self-administration of retrograde enema in an elderly dementia patient(Wiley-Blackwell, 2012) Kalkan, Ismail Hakki; Oztas, Erkin; Yildiz, Hakan; Beyazit, Yavuz; Suvak, Burak; Boyabatli, Mustafa…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 A simple method to improve adenoma detection rate during colonoscopy: Altering patient position(Pulsus Group Inc, 2013) Koksal, Aydin Seref; Kalkan, Ismail Hakki; Torun, Serkan; Taskiran, Ismail; Oztas, Erkin; Kayacetin, Ertugrul; Sasmaz, NurgulBACKGROUND: Colonoscopy is currently considered to be the gold standard method for detecting and removing adenomatous polyps. However, tandem colonoscopy studies reveal a pooled polyp miss rate of 22%. OBJECTIVE: A prospective randomized trial was conducted to assess whether alteration of patient position during colonoscopy withdrawal increases the adenoma detection rate (ADR). METHOD: The study group included 120 patients who presented for elective colonoscopic examination. After reaching the cecum, patients were randomly assigned in a 1: 1 ratio to examination in either the left lateral position or other positions (left lateral position for the cecum, ascending colon and hepatic flexure; supine for transverse colon; and supine and right lateral position for splenic flexure, descending and sigmoid colon) first. Examination of the colon was performed segment by segment. The size, morphology and location of all polyps were recorded. Polyps were removed immediately after examination of a colon segment when all positions were completed. ADR and polyp detection rates (PDR) were calculated. RESULTS: A total of 102 patients completed the study. Examination in the left lateral position revealed 66 polyps in 31 patients (PDR 30.3%) and 42 adenomas in 24 patients (ADR 23.5%). PDR increased to 43.1% (81 polyps in 44 patients) and the ADR to 33.3% (53 adenomas in 34 patients) after the colon was examined in the additional positions (P< 0.001 and P= 0.002, respectively). The increase in the number of adenomas detected was statistically significant in the transverse and sigmoid colon. The addition of position changes led to a 9.8% increase in the ADR in the transverse colon, splenic flexure, and descending and sigmoid colon. The frequency of surveillance interval was shortened in nine (8.8%) patients after examination of the colon in dynamic positions. CONCLUSION: Alteration of patient position during colonoscopy withdrawal is a simple and effective method to improve ADR.Öğe Turkish Gastroenterology Association, Pancreas Study Group, Chronic Pancreatitis Committee Consensus Report(AVES, 2020) Soyturk, Mujde; Bengi, Goksel; Oguz, Dilek; Kalkan, Ismail Hakki; Yalniz, Mehmet; Tahtaci, Mustafa; Demir, Kadir[Özet Yok]
