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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 A Clinical Presentation of a Very Rare Infection: Parenchymal Fasciola Hepatica(2013) Sapmaz, Ferdane; Güliter, Sefa; Kalkan, İsmail Hakkı; Nazlıoğlu, AdemFascioliazis düz, kahverengi bir karaciğer paraziti olan Fasciola hepaticaun sebep olduğu, öncelikle sığır, koyun gibi çiftlik hayvanlarında görülen bir enfeksiyon hastalığıdır. Enfeksiyonun tanısı hastalıktan şüphe etmekle mümkündür. Radyolojik bulgular oldukça spesifiktir. Genellikle Bilgisayarlı Tomografi (BT) ve diğer görüntüleme yöntemleri karaciğerde hipodens, hareketli lezyonlar göstermektedir. Parankimal F. hepatica çok nadir izlenmektedir. Biz burada F. Hepaticanın çok nadir bir klinik prezentasyonu olan parankimal F. hepaticalı bir vakayı sunmayı amaçladık. (Turkiye Parazitol Derg 2013; 37: 305-6)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 Gastrik preneoplastik bulguların kolon polibi ile ilişkisi(2013) Kalkan, İsmail Hakkı; Sapmaz, Ferdane; Güliter, Sefa; Atasoy, PınarGiriş ve Amaç: Helicobacter pylori enfeksiyonu ile kolon polibi gelişimi arasındaki ilişkiye yönelik çalışmalarda çelişkili sonuçlar elde edilmiştir. Mide için preneoplastik olduğu bilinen atrofi ve intestinal metaplazi ile kolon polibi gelişimi arasındaki ilişki ise henüz yeterince irdelenmemiş- tir. İki merkezde yürütmüş olduğumuz çalışmada, gastrik preneoplas- tik bulgu varlığı ile kolon polibi arasındaki ilişkiyi araştırmayı amaçla- dık. Gereç ve Yöntem: Kırıkkale Üniversitesi Tıp Fakültesi ve Kırıkkale Yüksek İhtisas Hastanesi Gastroenteroloji polikliniklerine 01.01.2012 ile 01.09.2012 tarihleri arasında başvuraran hastalardan özofagogastrodu - odenoskopi yapılarak Helicobacter pylori için biyopsi örneği alınan ve eş zamanlı kolonoskopi işlemi yapılan olgular çalışmaya dahil edildi. Olgu - ların demografik özellikleri, polip saptanan olgularda polip karakteristik- leri (büyüklük, sayı, histoloji) ve özofagogastroduodenoskopik biyopsi sonucuna göre gastrik atrofi-intestinal metaplazi ve Helicobacter pylori pozitifliği Sydney klasifikasyonuna göre kaydedildi. Bulgular: Çalışma- ya yaş ortalaması 57,413,3 olan toplam 150 (93 erkek, %62,0) olgu dahil edildi. Olguların 51inde (%34,0) en az 1 kolon polibi mevcuttu. Kolon polibi ve adenoma varlığı için atrofi [(Sırasıyla; OR:3,1 (p0,01) ve OR:3,2 (p0,02)] bağımsız risk faktörü idi. Toplam adenomatöz po- lip çapı atrofinin derecesi (p0,04) ve intestinal metaplazinin derecesi (p0,01) ile, toplam adenom sayısı ise atrofinin derecesi (p0,01), intes- tinal metaplazinin derecesi (p0,001) ile korele idi. Sonuç: Çalışmamız- da; gastrik atrofi kolon polibi/adenom gelişimi için bağımsız risk faktörü olarak bulundu. Helicobacter pylori pozitifliğinin kolon polibi varlığı ile ilişkisi saptanmadı. Gastrik preneoplastik lezyonlar ile kolon neoplazisi arasındaki ilişkinin konfirme edilebilmesi için geniş ölçekli, popülasyon tabanlı çalışmalara ihtiyaç bulunmaktadır.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 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 İskemik kolitin nadir bir nedeni: Buerger's hastalığı(2013) Sapmaz, Ferdane; Kalkan, İsmail Hakkı; Güliter, Sefa; Atasoy, PınarBuerger's hastalığı ya da diğer adıyla tromboanjitis obliterans etkilenen da- marlarda tromboz ve rekanalizasyonlarla giden bir hastalık olup, arter ve süperfisyal venlerde segmental okluzif ve multipl inflamatuvar lezyonlarla karakterizedir. Kolonik etkilenme çok nadir görülmektedir. Burada daha önce Buerger's hastalığı tanısı ile takip edilmekte olan hastada gelişen iske- mik kolit tablosunu tartışmayı amaçladık.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 A patient with ileocecal Crohn's disease who has intermittent umbilical and left lower abdominal quadrant pain(Springer Wien, 2015) Sapmaz, Ferdane; Kalkan, ismail Hakki; Güliter, Sefa; Yılmaz, Sevda…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 Spontaneous abdominal esophageal perforation in a patient with mitochondrial neurogastrointestinal encephalomyopathy(Maney Publishing, 2015) Kalkan, İsmail Hakkı; Köksal, Aydın Şeref; Evcimen, Serap; Sapmaz, Ferdane; Öztaş, Erkin; Önder, Fatih O.; Guliter, SefaMitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is an autosomal recessive multisystem disorder caused by thymidine phosphorylase deficiency. Severe denutrition is almost constant during the course of the disease which leads to severe malnutrition and requires long-term parenteral nutrition in most cases. Patients with MNGIE syndrome and chronic intestinal pseudo-obstruction have a particularly poor prognosis and they usually die around 40 years of age. Gastrointestinal perforation associated with MNGIE is extremely rare. Herein we present our unique case with MNGIE associated abdominal esophageal perforation.Öğe A very rare cause of markedly elevated CA 19.9: Autoimmune hepatitis(Taylor & Francis Ltd, 2016) Sapmaz, Ferdane; Kalkan, Ismail H.; Kisa, Ucler; Guliter, SefaCarbohydrate antigen 19.9 (CA 19.9) is a specific tumour marker of the biliary, pancreatic and gastrointestinal tracts. Autoimmune hepatitis is a chronic immune-mediated liver disorder characterised by female predominance. We report a case of approximately 30-fold increased serum CA 19.9 in a 57-year-old woman who was diagnosed with autoimmune hepatitis. She had no evidence of any malignant disease in pancreatobiliary or gastrointestinal tracts. CA 19.9 levels decreased to normal levels with immunosuppressive treatment. Markedly elevated serum CA 19.9 levels might be encountered with benign liver diseases such as autoimmune hepatitis.
