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Kilic G, Kilic GE, Özkahraman A, Konur S, Dertli R, Kayar Y. Amoxicillin, gemifloxacin and rabeprazole, as first-line Helicobacter pylori therapy in clinical practice: A pilot study. Medicine (Baltimore) 2024; 103:e38012. [PMID: 38701320 PMCID: PMC11062647 DOI: 10.1097/md.0000000000038012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
Success in eradication of H. pylori is decreasing due to increasing resistant strains. In particular, side-effects due to 4-agent treatment multiple drug use are observed and treatment compliance decreases. The aim of this study was to evaluate the efficacy, reliability, and side-effect profile of the combination of amoxicillin and rabeprazole with gemifloxacin, which is a new generation quinolone, in the treatment of H. pylori infection. This study was conducted on 71 naive patients who received H. pylori eradication. All the patients were administered treatment of Amoxicillin (1000 mg twice a day) + Gemifloxacin (320 mg once a day) + rabeprazole (20 mg twice a day) for 7 days. Drug compliance and treatment tolerance were evaluated after finishing the treatment. At 1 month after the end of the treatment, H. pylori eradication was evaluated in all the patients by examining H. pylori antigen in the feces. In the evaluation after treatment, H. pylori eradication was obtained in 63 (88.7%) patients and eradication was not obtained in 8 (11.3%) patients. The treatment was not completed by 2 patients because of side-effects and noncompliance, so after exclusion of these 2 patients, successful H. pylori eradication was obtained in 63 (91.3%) of 69 patients who completed the treatment. Side-effects were seen in a total of 9 (12.7%) patients. Diarrhea, bloating, abdominal pain, and nausea-vomiting were seen in some patients, but no reflux, constipation, skin rash, listlessness-fatigue, headache, dizziness, palpitations, dry mouth, or weight loss was seen in any patient. In regions with high resistance to clarithromycin and metronidazole in particular, the combination of gemifloxacin with amoxicillin and rabeprazole can be considered for use in first-stage treatment as both the efficacy and tolerability are high.
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Affiliation(s)
- Guner Kilic
- Van Training and Research Hospital, Department of Internal Medicine, Division of Gastroenterology, Van, Turkey
| | - Gulce Ecem Kilic
- Van Training and Research Hospital, Department of Internal Medicine, Van, Turkey
| | - Adnan Özkahraman
- Van Training and Research Hospital, Department of Internal Medicine, Van, Turkey
| | - Sevki Konur
- Van Training and Research Hospital, Department of Internal Medicine, Van, Turkey
| | - Ramazan Dertli
- Van Training and Research Hospital, Department of Internal Medicine, Division of Gastroenterology, Van, Turkey
| | - Yusuf Kayar
- Van Training and Research Hospital, Department of Internal Medicine, Division of Gastroenterology, Van, Turkey
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Al Kafee A, Kayar Y. Electrogastrography in patients with gastric motility disorders. Proc Inst Mech Eng H 2024; 238:22-32. [PMID: 37982194 DOI: 10.1177/09544119231212269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Electrogastrography (EGG) is a novel diagnostic modality for assessing the gastrointestinal tract (GI) that generates spontaneous electrical activity and monitors gastric motility. The aim of this study was to compare patients with functional dyspepsia (FD) and diabetic gastroparesis (D-GP) with healthy controls (CT) to use established findings on abnormalities of gastric motility based on EGG characteristics. In this study, 50 patients with FD, 50 D-GP patients, and 50 CT subjects were studied to compare EGG with discrete wavelet transform models (DWT) to extract signal characteristics using a variety of different qualitative and quantitative metrics from pre-prandial and postprandial states. As a result, higher statistically significant (p < 0.05*) were found in the DWT models based on power spectral density (PSD) analysis in both states. We also present that the correlations between EGG metrics and the presence of FD, D-GP, and CT symptoms were inconsistent. This paper represents that EGG assessments of FD and D-GP patients differ from healthy controls in terms of abnormalities of gastric motility. Additionally, we demonstrate that diverse datasets showed adequate gastric motility responses to a meal. We anticipate that our method will provide a comprehensive understanding of gastric motility disorders for better treatment and monitoring in both clinical and research settings. In conclusion, we present potential future opportunities for precise gastrointestinal electrophysiological disorders.
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Affiliation(s)
- Abdullah Al Kafee
- Institute of Biomedical Engineering, Istanbul University, Istanbul, Turkey
| | - Yusuf Kayar
- Division of Gastroenterology, Department of Internal Medicine, Van Education and Research Hospital, Van, Turkey
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Kilic G, Kilic GE, Ozkahraman A, Konur S, Dertli R, Kayar Y. Course of Acute Pancreatitis Patients with Renal Failure According to Balthazar Classification. Niger J Clin Pract 2023; 26:680-685. [PMID: 37470639 DOI: 10.4103/njcp.njcp_728_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Background and Aim There are criteria that include many organ systems to predict the prognosis in acute pancreatitis (AP) patients. In this study, we aimed to show how the course of the disease changes according to the Balthazar classification in AP patients presenting with renal failure. Methods and Materials Our study included 352 patients who were admitted to the Emergency Service of our hospital and were diagnosed and hospitalized with AP. According to the Balthazar score, patients with scores of 0-2, 4-6, and 8-10 were evaluated as mild, moderate, and severe AP, respectively. Demographic data (age, gender) of all patients were documented. The etiology of AP was determined in all patients. Biliary, drug/toxic, alcohol, infections, hyperlipidemia, post-endoscopic retrograde cholangiopancreatography (ERCP), genetics, hypercalcemia, structural anomalies, and malignancy were evaluated as the etiology. Those without any underlying pathology were evaluated as idiopathic AP. The patients were divided into two groups as those with and without renal insufficiency. All patients underwent helical computed tomography (section 64, Aquilion; Toshiba Medical Systems, Tokyo) within the first 12 hours and between days 3 and 7. Pancreas, peripancreatic and extrapancreatic findings, and complications were examined. "The Statistical Package for the Social Sciences 19.0 (SPSS Armonk, NY: IBM Corp.)" was used for all analyses. Kolmogorov-Smirnov test and histograms were used to determine whether there was a normal distribution. The non-parametric data of the groups were compared using the Mann-Whitney U test and the parametric data using the ındependent t test. Chi-square test was used to test categorical data. Cases with P < 0.05 were considered statistically significant. Results : While 22 (6.2%) patients had renal insufficiency, 332 (95.8%) patients did not have renal insufficiency. In the evaluation made in terms of AP severity; according to Balthazar classification at admission, there was no difference in mild and moderate pancreatitis for kidney insufficiency in both groups, but it was significantly higher in the group with severe pancreatitis [2 (9.1%) versus 1 (0.3%), P < 0.001]. In the evaluation made after 72 hours; renal failure was significantly lower in the group with mild pancreatitis [11 (50.0%) versus 245 (73.8%), P: 0.016] and severe renal failure was significantly higher in severe pancreatitis [7 (31.8%) versus 13 (%) 3.9), P < 0.001]. Conclusions Early intensive care unit admission and close follow-up and early treatment in AP patients change the course of the disease. In our study, we showed that serum creatinine level is an important parameter in the course of AP and has a predictive value for the course of the disease.
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Affiliation(s)
- G Kilic
- Department of Internal Medicine, Van Education and Research Hospital, Division of Gastroenterology, Van, Turkey
| | - G E Kilic
- Department of Internal Medicine, Van Education and Research Hospital, Van, Turkey
| | - A Ozkahraman
- Department of Internal Medicine, Van Education and Research Hospital, Van, Turkey
| | - S Konur
- Department of Internal Medicine, Van Education and Research Hospital, Van, Turkey
| | - R Dertli
- Department of Internal Medicine, Van Education and Research Hospital, Division of Gastroenterology, Van, Turkey
| | - Y Kayar
- Department of Internal Medicine, Van Education and Research Hospital, Division of Gastroenterology, Van, Turkey
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Kayar Y, Dertli R, Konür Ş, Ağın M, Kafee AA, Baran B, Örmeci AÇ, Akyüz F, Demir K, Beşışık F, Kaymakoğlu S, Kaymakoglu S. Mucocutaneous Manifestations and Associated Factors in Patients with Crohn's Disease. Turk J Gastroenterol 2022; 33:945-954. [PMID: 36098365 PMCID: PMC9797716 DOI: 10.5152/tjg.2022.21750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND One-third of all extraintestinal manifestations are mucocutaneous findings in patients with Crohn's disease and there is a relationship between some risk factors. Our aim is to evaluate factors associated with mucocutaneous manifestations in our cohort of patients with Crohn's disease with a follow-up duration of up to 25 years. METHODS In the study, 336 patients with Crohn's disease who were followed up between March 1986 and October 2011 were included. The demographic characteristics, Crohn's disease-related data, and accompanying mucocutaneous manifestations were recorded. The cumulative probability of mucocutaneous extraintestinal manifestations and possible risk factors were analyzed. RESULTS Oral and skin involvement were detected in 109 (32%) and 31 (9.2%) patients, respectively. The cumulative probability of developing oral and skin manifestations were 43.2% and 20.3%, respectively. Cox regression analysis showed that female gender (odds ratio: 3.28, 95% CI: 1.51-7.14, P = .003) and corticosteroid use (odds ratio: 7.88, 95% CI: 1.07-57.97, P = .043) are independently associated with the development of skin manifestations, while family history (odds ratio: 3.59, 95% CI: 2.18-5.93, P < .001) and inflammatory-type disease (odds ratio: 1.776, 95% CI: 1.21-2.61, P = .004) were independently associated with the development of oral ulcers. CONCLUSION Mucocutaneous extraintestinal manifestations are associated with female gender, corticosteroid use, family history, and disease type in a large cohort of patients with Crohn's disease. Defining the specific relationships of immune-mediated diseases will help to better understand the pathogenesis of Crohn's disease and associated mucocutaneous manifestations and to use more effective treatments.
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Affiliation(s)
- Yusuf Kayar
- Division of Gastroenterology, Department of Internal Medicine, Van Teaching and Research Hospital, Health Sciences University, Van, Turkey,Corresponding author: Yusuf Kayar, e-mail:
| | - Ramazan Dertli
- Division of Gastroenterology, Department of Internal Medicine, Van Teaching and Research Hospital, Health Sciences University, Van, Turkey
| | - Şevki Konür
- Department of Internal Medicine, Van Teaching and Research Hospital, Health Sciences University, Van, Turkey
| | - Mehmet Ağın
- Division of Gastroenterology, Department of Pediatrics, Van Teaching and Research Hospital, Health Sciences University, Van, Turkey
| | - Abdullah Al Kafee
- Department of Biomedical Engineering, İstanbul University, İstanbul, Turkey
| | - Bülent Baran
- Division of Gastroenterology, Department of Internal Medicine, Koç University, İstanbul, Turkey
| | - Aslı Çiftçibaşı Örmeci
- Division of Gastroenterology, Department of Internal Medicine, İstanbul University, İstanbul, Turkey
| | - Filiz Akyüz
- Division of Gastroenterology, Department of Internal Medicine, İstanbul University, İstanbul, Turkey
| | - Kadir Demir
- Division of Gastroenterology, Department of Internal Medicine, İstanbul University, İstanbul, Turkey
| | - Fatih Beşışık
- Division of Gastroenterology, Department of Internal Medicine, İstanbul University, İstanbul, Turkey
| | - Sabahattin Kaymakoğlu
- Division of Gastroenterology, Department of Internal Medicine, İstanbul University, İstanbul, Turkey
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Bilgili MA, Dertli R, Kafee AA, Kılıç G, Kayar Y. Is there a correlation between the initial calcium level and Balthazar classification in patients with acute pancreatitis? ULUS TRAVMA ACIL CER 2022; 28:769-775. [PMID: 35652862 PMCID: PMC10443004 DOI: 10.14744/tjtes.2021.03464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/22/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND While a life-threatening course is observed in 2-3% of patients with acute pancreatitis (AP), mortality can be up to 50% in severe AP. In our study, we research relationship between calcium level and Modified Balthazar (MB) score. METHODS 354 patients who were followed up with a diagnosis of AP between 2013 and 2019 were included in our study. Serum calcium level was measured within the first 24 h. Abdominal computed tomography (CT) was performed in all patients in the first 12 h and between 3 and 7 days. The severity of AP was determined according to the MB classification. The correlation between calcium level and MB classification was examined. RESULTS 206 (58.2%) of the patients were women. Mean age was 54.8±17.9 years (range: 18-100). It was observed that the rate of severe AP was significantly higher in the low calcium group compared to the MB classification in which tomographies taken at ad-mission and 72 h after were evaluated (p<0.05). Furthermore, progression was higher in low calcium group (p<0.05). The cutoff value was 9.35 mg/dl for the ROC analysis performed to distinguish mild pancreatitis from moderate-severe pancreatitis according to the MB classification performed by CT obtained after 72 h based on the Ca values. For the cutoff value of 9.35 mg/dl (AUC: 0.581, p=0.018, 95% Cl: 0.514-0.649), the sensitivity was 57.4% and the specificity was 53.1%. CONCLUSION Since there is a correlation between the initial calcium level and the severity of the disease according to the CT-scan obtained later, the calcium level gives us an idea of the course of the disease.
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Affiliation(s)
| | - Ramazan Dertli
- Department of Internal Medicine, Division of Gastroenterology, Van Training and Research Hospital, Van-Turkey
| | - Abdullah Al Kafee
- Department of Biomedical Engineering, Boğaziçi University Faculty of Engineering, İstanbul-Turkey
| | - Guner Kılıç
- Department of Internal Medicine, Division of Gastroenterology, Van Training and Research Hospital, Van-Turkey
| | - Yusuf Kayar
- Department of Internal Medicine, Division of Gastroenterology, Van Training and Research Hospital, Van-Turkey
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Dertli R, Toka B, Asıl M, Kayar Y, Karakarcayildiz A, Göktepe MH, Biyik M, Konur S, Ataseven H. Can neutrophil-lymphocyte ratio predict mortality in acute non-variceal upper gastrointestinal bleeding? ULUS TRAVMA ACIL CER 2022; 28:626-633. [PMID: 35485469 PMCID: PMC10442992 DOI: 10.14744/tjtes.2021.42900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 01/24/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Acute non-variceal upper gastrointestinal bleeding (NVUGIB) is one of the common gastrointestinal problems and has a high mortality, especially in patients with poor hemodynamics. Therefore, treatment and follow-up should be managed dy-namically. Neutrophil-lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) are fast workable, cheap, and easy to calculate he-matological parameters. We need easily accessible parameters as well as routine classifications such as Rockall score in the treatment and follow-up of NVUGIB patients, whose hemodynamics are unstable and progress with high mortality. In this study, we planned to evaluate NLR and PLR levels in patients with NVUGIB in the treatment follow-up with other scoring systems and their relationship with mortality in these patients. METHODS Two hundred and forty-nine patients who were admitted to our clinic between January 2015 and January 2017 diag-nosed with NVUGIB, and who underwent necessary examinations and follow-ups, were included in the study. The patients' Glasgow Blacthford, Rockall Score, NLR, and PLR levels were calculated at the first admission. RESULTS One hundred and fifty-six of the patients were male (70.6%) and the mean age of all patients was 64.5±18.0 years. After follow-up and treatment, 28 (11.2%) patients died due to bleeding. High NLR and tachycardia at the time of admission and high patient age were found to be independent risk factors affecting the long of hospital stay. High Rockall score, high NLR at admission, and hy-potension at admission were shown to be independent risk factors affecting mortality. CONCLUSION Besides the use of various scoring systems in patients with NVUGIB, we think that the use of simple hematological parameters may be appropriate and the use of these hematological parameters may be useful in the management of patients with unstable hemodynamics.
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Affiliation(s)
- Ramazan Dertli
- Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University Meram Faculty of Medicine, Konya-Turkey
| | - Bilal Toka
- Department of Internal Medicine, Division of Gastroenterology, Sakarya University Faculty of Medicine, Sakarya-Turkey
| | - Mehmet Asıl
- Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University Meram Faculty of Medicine, Konya-Turkey
| | - Yusuf Kayar
- Department of Internal Medicine, Division of Gastroenterology, Van Training and Research Hospital, Van-Turkey
| | - Ahmet Karakarcayildiz
- Department of Internal Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Konya-Turkey
| | - Mevlüt Hakan Göktepe
- Department of Internal Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Konya-Turkey
| | - Murat Biyik
- Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University Meram Faculty of Medicine, Konya-Turkey
| | - Sevki Konur
- Department of Internal Medicine, Division of Gastroenterology, Van Training and Research Hospital, Van-Turkey
| | - Huseyin Ataseven
- Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University Meram Faculty of Medicine, Konya-Turkey
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Yılmaz İnal F, Daşkaya H, Yılmaz Y, Kayar Y. Attitudes and Behaviors of Gastroenterology Specialists Toward Sedation Practices in Endoscopy Units in Turkey: Is Anesthesia Mandatory? Istanbul Med J 2022. [DOI: 10.4274/imj.galenos.2022.88972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Toka B, Köksal AŞ, Dertli R, Şirin G, Fidan S, Ülger Y, Harmandar F, Yıldırım AE, Eminler AT, Asil M, Kayar Y, Bıyık M, Kuran S, Uslan MI, Hülagü S. Hepatitis B Reactivation in Patients Treated with Direct-Acting Antivirals for Hepatitis C. Dig Dis 2022; 40:635-643. [PMID: 35108715 DOI: 10.1159/000521298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 12/01/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION There is limited research about HBV reactivation (HBVr) due to direct-acting antivirals (DAA) for HCV and most are limited by short duration of follow-up, small sample size, and absence of baseline HBV DNA. We aimed to determine the incidence and clinical course of HBVr in HBsAg and/or anti-HBcIgG positive patients treated with DAA for HCV. METHODS Seven centers retrospectively analyzed their database on HCV patients treated with DAA between 2015 and 2019. Patients with HBV coinfection or resolved HBV infection were enrolled. Serum transaminases, HBsAg, HBeAg, and HBV DNA were followed every 4 weeks during DAA treatment and every 12 weeks 1 year after treatment. Entecavir or tenofovir disoproxil fumarate was started in case of HBVr. The development of HBVr, HBV flare, liver failure, and mortality were determined. RESULTS 852 patients received DAA treatment for HCV. Among them, 35 (4.1%) had HBV coinfection and 246 (28.9%) had resolved HBV infection. 257 patients (53.3% male, mean age: 63 ± 9) constituted the study group (29 with coinfection and 228 with resolved infection). Three patients with coinfection were HBV DNA positive. HBVr developed in 10 (34.5%) HBsAg positive patients, either during (n = 3) or 12-48 weeks after finishing DAA treatment. HBV flare and acute liver failure developed in 1 patient (3.4%), each. Two patients with resolved infection developed HBVr (0.87%) and one (0.44%) had HBV flare. Overall, none of the patients died or underwent liver transplantation due to HBVr. CONCLUSION Patients with HBV/HCV coinfection have a high risk of HBVr after DAA treatment and should receive antiviral prophylaxis. Patients with resolved infection have a low risk of HBVr and can be monitored by serial ALT measurements.
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Affiliation(s)
- Bilal Toka
- Department of Gastroenterology, Health Sciences University Konya Training and Research Hospital, Konya, Turkey
| | - Aydın Şeref Köksal
- Department of Gastroenterology, Sakarya University Faculty of Medicine, Adapazarı, Turkey
| | - Ramazan Dertli
- Department of Gastroenterology, Malatya Education and Research Hospital, Malatya, Turkey
| | - Göktuğ Şirin
- Department of Gastroenterology, Kocaeli University School of Medicine, İzmit, Turkey
| | - Sami Fidan
- Department of Gastroenterology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Yakup Ülger
- Department of Gastroenterology, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Ferda Harmandar
- Department of Gastroenterology, Health Sciences University Antalya Training and Research Hospital, Antalya, Turkey
| | - Abdullah Emre Yıldırım
- Department of Gastroenterology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Ahmet Tarik Eminler
- Department of Gastroenterology, Sakarya University Faculty of Medicine, Adapazarı, Turkey
| | - Mehmet Asil
- Department of Gastroenterology, Konya Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Yusuf Kayar
- Department of Gastroenterology, University of Health Sciences, Van Education and Research Hospital, Van, Turkey
| | - Murat Bıyık
- Department of Gastroenterology, Konya Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Sedef Kuran
- Department of Gastroenterology, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Mustafa Ihsan Uslan
- Department of Gastroenterology, Sakarya University Faculty of Medicine, Adapazarı, Turkey
| | - Sadettin Hülagü
- Department of Gastroenterology, Kocaeli University School of Medicine, İzmit, Turkey
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Kafee AA, Cilacı T, Kayar Y, Akan A. Electrogastrography in Patients with Functional Dyspepsia, Joint Hypermobility, and Diabetic Gastroparesis. Turk J Gastroenterol 2022; 33:182-189. [DOI: 10.5152/tjg.2021.20853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Dertli R, Asil M, Bıyık M, Karakarcayıldız A, Keskin M, Kayar Y, Başdemirci M, Ataseven H. Are Pattern Recognition Receptors Associated with Hepatocellular Carcinoma? Turk J Gastroenterol 2021; 32:593-599. [PMID: 34464323 DOI: 10.5152/tjg.2021.20657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is one of the important causes of mortality due to malignancy. Toll-like receptors (TLRs) are very important in liver pathophysiology in terms of their roles in the innate immune system, such as the regulation of inflammation, wound healing, stimulation of adaptive immune responses, promotion of epithelial regeneration, and carcinogenesis. In this study, we planned to examine the role of TLR1 (rs4833095, rs5743551) and nucleotide-binding oligomerization domain (NOD2) (rs2066844, rs2066845, rs2066847) polymorphisms in the development of HCC and their effects on the clinical presentation of HCC patients. METHODS Our study was designed prospectively. Cirrhotic and HCC patients who were followed up in our clinic between January 2015 and September 2018 were included in the study. Sex, age, cirrhosis etiology, Child-Pugh class, and MELD scores were recorded. TLR1 and NOD2 polymorphisms were studied by the PCR method. RESULTS HCC developed in 88 (31.4%) of the 280 patients who were followed up, either during the recruitment phase of our study or during the follow-up. The mean follow-up time of our patient group was 17.04 ± 11.72 months, and the mean follow-up time of HCC patients was 12.09 ± 10.26 months. TLR1 (rs5743551) polymorphism was associated with HCC development (P = .003). TLR1 (rs5743551) and NOD2 (rs2066844) polymorphisms were associated with the development of spontaneous bacterial peritonitis (SBP) in the HCC patient group (P = .013 and P = .021, respectively). CONCLUSION We think that increased bacterial translocation in cirrhotic patients may contribute to HCC development by causing chronic inflammation, especially in patients with TLR 1 (rs5743551) polymorphism.
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Affiliation(s)
- Ramazan Dertli
- Division of Gastroenterology, Department of Internal Medicine, Necmettin Erbakan University, Meram School of Medicine, Meram, Konya, Turkey
| | - Mehmet Asil
- Division of Gastroenterology, Department of Internal Medicine, Necmettin Erbakan University, Meram School of Medicine, Meram, Konya, Turkey
| | - Murat Bıyık
- Division of Gastroenterology, Department of Internal Medicine, Necmettin Erbakan University, Meram School of Medicine, Meram, Konya, Turkey
| | - Ahmet Karakarcayıldız
- Division of Gastroenterology, Department of Internal Medicine, Necmettin Erbakan University, Meram School of Medicine, Meram, Konya, Turkey
| | - Muharrem Keskin
- Division of Gastroenterology, Department of Internal Medicine, Necmettin Erbakan University, Meram School of Medicine, Meram, Konya, Turkey
| | - Yusuf Kayar
- Division of Gastroenterology, Department of Internal Medicine, Van Training and Research Hospital, Van, Turkey
| | - Müşerref Başdemirci
- Department of Medical Genetics, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Hüseyin Ataseven
- Division of Gastroenterology, Department of Internal Medicine, Necmettin Erbakan University, Meram School of Medicine, Meram, Konya, Turkey
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Dertli R, Biyik M, Yolacan R, Karakarcayildiz A, Keskin M, Kayar Y, Asil M. May Neutrophil Gelatinase-Associated Lipocalin (NGAL) Level Predict Mortality in Patients with Hepatocellular Carcinoma (HCC)? J Gastrointest Cancer 2021; 51:932-938. [PMID: 31729643 DOI: 10.1007/s12029-019-00323-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Hepatocellular carcinoma (HCC) ranks fifth among the common cancers worldwide. Hepatocarcinogenesis is a multiple-phases process, which involves changes in cellular genomes including high cell proliferation.In this study, we aimed to evaluate the relationship of NGAL level at the time of diagnosis with mortality in patients diagnosed with HCC. MATERIAL AND METHODS A total of 35 patients who developed HCC on the ground of HBV(+) and 30 healthy subjects were included in the study. Barcelona Clinic Liver Cancer (BCLC), Okuda staging system, and Milan criteria were used for staging of the patients with HCC. RESULTS The mean age of all patients was 59.54 ± 11.57 years. Seventeen (48.6%) HCC patients died during 1-year follow-up. Survival of the patients who met the Milan criteria was longer (log-rank (Mantel-Cox) test, χ2 = 5.353, p = 0.021). Kaplan-Meier curve was drawn for NGAL cut-off value, mortality was found to be higher in patients with a NGAL level higher than 217.50 (log-rank (Mantel-Cox) test, χ2 = 15.540, p < 0.001). CONCLUSION In this study, we found that high levels of NGAL at the time of diagnosis were associated with poor prognosis in HCC patients.
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Affiliation(s)
- Ramazan Dertli
- Department of Internal Medicine, Division of Gastroenterology, Van Education and Research Hospital, Van, Turkey.
| | - Murat Biyik
- Meram School of Medicine, Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University, Meram, Konya, Turkey
| | - Ramazan Yolacan
- Meram School of Medicine, Department of Internal Medicine, Necmettin Erbakan University, Meram, Konya, Turkey
| | - Ahmet Karakarcayildiz
- Meram School of Medicine, Department of Internal Medicine, Necmettin Erbakan University, Meram, Konya, Turkey
| | - Muharrem Keskin
- Meram School of Medicine, Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University, Meram, Konya, Turkey
| | - Yusuf Kayar
- Department of Internal Medicine, Division of Gastroenterology, Van Education and Research Hospital, Van, Turkey
| | - Mehmet Asil
- Meram School of Medicine, Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University, Meram, Konya, Turkey
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12
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Dertli R, Bıyık M, Yolacan R, Keskin M, Karakarcayıldız A, Kayar Y, Ataseven H, Polat H, Demir A, Asıl M. A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I. Istanbul Med J 2021. [DOI: 10.4274/imj.galenos.2020.45403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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13
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Abstract
Introduction Celiac disease (CD) is a chronic autoimmune systemic disease caused by the T cell-driven immune mechanism, which is triggered by gluten in cereals such as wheat, barley, and rye in individuals who have a genetic predisposition. The purpose of the present study was to investigate the frequency of gallstones in children with CD. Methods A total of 120 patients who were diagnosed with CD and who were followed-up by the pediatric gastroenterology clinic of the hospital and 100 healthy children were included in the study. The age, gender, hemogram, biochemistry, and abdominal ultrasonography images of the patients were compared. Cases that had gallstones were evaluated in terms of fasting serum lipids, glucose-6-P dehydrogenase, and pyruvate kinase, osmotic fragility, hemoglobin electrophoresis, and peripheral smears. Cases diagnosed with a hematological or metabolic disease were excluded from the study. Celiac serology was examined in terms of CD diagnosis in cases who had gallstones for the first time. Results The median age of the patients with CD who were included in the study was eight years (5-12), and the median age of the control group was 10 years (6-13). A total of 48% of the Control Group was female, and 52% were male. No significant differences were detected between the age and gender distribution of the cases. There were no differences between hemogram and biochemical parameters. Gallstones were detected in six (5%) of CD-diagnosed cases, and in three (3%) of the cases in the control group. Two (2/160; 1.3%) of the patients who were referred to our clinic with the diagnosis of gallstones were diagnosed with CD. Conclusions: Early diagnosis and treatment of CD is important to avoid gallstone development because a gluten-free diet corrects enteropathy significantly in CD. CD must be considered in cases with gallstones.
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Affiliation(s)
- Mehmet Agin
- Pediatric Gastroenterology, Van Education and Research Hospital, Van, TUR
| | - Yusuf Kayar
- Gastroenterology, Van Education and Research Hospital, Van, TUR
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14
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Agin M, Kayar Y. Demographic, Laboratory, and Clinical Comparison of Pediatric Brucella Cases With and Without Liver Involvement. Cureus 2020; 12:e10862. [PMID: 33178515 PMCID: PMC7652021 DOI: 10.7759/cureus.10862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction In this study, the purpose was to compare the demographic, clinical, and laboratory results of pediatric Brucella cases with and without liver involvement. Methods The data of 248 patients between 2 and 18 years of age at diagnosis with Brucellosis between July 2017 and August 2018 were analyzed retrospectively. Liver involvement was defined as elevated transaminase enzymes when compared to levels of the control group. Transaminases enzyme levels were taken as the control group. The two groups were compared in age, gender, complaints at admission, duration of symptoms, physical examination findings, laboratory values, blood culture reproduction, and relapse rates. Results There was no significant relationship between age and sex between groups with liver involvement (n = 92) and without liver involvement (n = 156). Loss of appetite, nausea, and sensitive stomach were higher in the patients who had hepatic involvement. In the patients who had hepatic involvement, the hemoglobin and platelet values were lower, and the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and blood culture growth were higher (p < 0.05). The relapse rates were lower in patients who had liver involvement (p < 0.05). Conclusions The correlation detected between blood culture positivity and elevated liver enzymes, CRP and ESR levels, low hemoglobin and platelet levels were considered to be consistent with the fact that brucellosis is a pathogen that involves the reticuloendothelial system.
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Affiliation(s)
- Mehmet Agin
- Pediatric Gastroenterology, Van Education and Research Hospital, Van, TUR
| | - Yusuf Kayar
- Gastroenterology, Van Education and Research Hospital, Van, TUR
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15
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Kayar Y, Dertli R, Konur S. Clinical outcomes of acute pancreatitis in elderly patients: An experience of single tertiary center. Pancreatology 2020; 20:1296-1301. [PMID: 32900631 DOI: 10.1016/j.pan.2020.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/03/2020] [Accepted: 06/10/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although well understanding the course of diseases in geriatric population is of paramount importance in order to provide the optimal treatment, there is only a few studies with controversial results that have been conducted about the course and outcomes of acute pancreatitis (AP) in elderly. We aimed to compare clinical outcomes of AP disease in geriatric age group and to evaluate the risk factors affecting outcomes. METHODS A total of 336 patients diagnosed with AP, hospitalized and followed-up in our hospital between July/2013-February/2019 were included in this study. Patients aged 65 years and over were assessed as elderly population. Patients' demographic data, comorbidities, duration of hospitalization, local systemic complications, and mortality rates were documented. RESULTS 196(58.3%) of the patients were female with a mean age of 54.1 ± 17.9 years. The number of patients was 114(33.9%) in the elderly group and 222(66.1%) in the non-elderly group. Although there was no significant difference between both groups in terms of abscess, pseudocyst and necrosis, pancreatic necrosis and systemic complications were higher in the elderly group (p < 0.05). The durations of oral intake and hospitalization were longer, the mortality rate and severity of AP according to the Ranson and Atlanta criteria were significantly higher in the geriatric population (p < 0.05). In addition, age and severity of AP were found to be independent predictive factors of developing complications. CONCLUSIONS Early recognition of AP is important in the geriatric population. Clinical and laboratory investigations, and early diagnosis in severe patients will be largely helpful in providing close follow-up and the optimal treatment.
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Affiliation(s)
- Yusuf Kayar
- Saglik Bilimleri University, Van Education and Research Hospital, Department of Internal Medicine, Clinic of Gastroenterology and Hepatology, Van, Turkey.
| | - Ramazan Dertli
- Saglik Bilimleri University, Van Education and Research Hospital, Department of Internal Medicine, Clinic of Gastroenterology and Hepatology, Van, Turkey
| | - Sevki Konur
- Saglik Bilimleri University, Van Education and Research Hospital, Department of Internal Medicine, Van, Turkey
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16
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Agin M, Kayar Y, Dertli R. Diagnosis and Treatment of Fasciola Hepatica With Endoscopic Retrograde Cholangiopancreatography in a Child Patient: Case Report. Cureus 2020; 12:e10486. [PMID: 33083186 PMCID: PMC7567306 DOI: 10.7759/cureus.10486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Fasciola hepatica (FH) is a parasite that causes fever, hepatomegaly, abdominal pain, weight loss, anemia, and eosinophilia in the acute period, and jaundice, pancreatitis, and cholangitis in the chronic period by settling in the bile ducts. A 13-year-old girl admitted with abdominal pain, nausea, and jaundice. In her hemogram, the patient had leukocytosis and eosinophilia. The transaminase, bilirubin, amylase, and lipase values were high in the biochemistry of the patient. Abdominal ultrasonography revealed dilatation, and moving and hyperechogenic tubular structures in the intra- and extrahepatic bile ducts. Endoscopic retrograde cholangiopancreatography (ERCP) was performed on the patient, and live parasites were detected in brown color spilling from the choledoch to the duodenum during the procedure. The clinical findings of the patient improved, and the laboratory values returned to normal approximately one week after the procedure. ERCP provides important benefits in the diagnosis and treatment of FH in the pediatric patient group.
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Affiliation(s)
- Mehmet Agin
- Pediatric Gastroenterology, Van Education and Research Hospital, Van, TUR
| | - Yusuf Kayar
- Department of Gastroenterology, Van Education and Research Hospital, Van, TUR
| | - Ramazan Dertli
- Department of Gastroenterology, Van Education and Research Hospital, Van, TUR
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Konur S, Ozkahraman A, Surmeli N, Gunduz I, Iliklerden UH, Dertli R, Kayar Y. The Severity of Acute Pancreatitis According to Modified Balthazar Classification in Patients With Pancreatic Cancer. Tumori 2020; 106:356-361. [PMID: 32811352 DOI: 10.1177/0300891620948961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Although acute pancreatitis (AP) is a self-limited disease under supportive and medical treatment, it can have life-threatening potential in some patients. Results of studies reporting outcomes of AP-associated pancreatic malignancy are controversial. The aim of this study was to evaluate the severity and prognosis of pancreatic cancer (PC)-related AP by modified Balthazar score. METHODS A total of 354 patients hospitalized and followed up in our clinic between 2013 and 2019 were included in the study. Demographic data of all patients were recorded. The etiology of all cases was determined. According to the etiology, the cases were divided into 2 groups: AP related to pancreatic malignancy and AP due to nonmalignant causes. The patients underwent computed tomography of the abdomen within the first 12 hours of admission and after 3 to 7 days. Patients were evaluated and classified by modified Balthazar classification. RESULTS Malignancy-related AP was detected in 18 (5.1%) patients. A total of 336 cases (94.9%) were related to nonmalignant causes. There was no statistically significant difference in the severity of AP in both groups at admission and after 3 days (p > 0.05). The changes (regression, progression, or no change) in the disease severity at the first and the subsequent imaging were examined. There was no significant relationship between the 2 groups (p > 0.05). CONCLUSION AP may be the clinical manifestation of PC or PC may induce AP in various ways. It was shown that the underlying malignancy did not adversely affect the severity and course of AP.
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Affiliation(s)
- Sevki Konur
- Department of Internal Medicine, Van Education and Research Hospital, Van, Turkey
| | - Adnan Ozkahraman
- Department of Internal Medicine, Van Education and Research Hospital, Van, Turkey
| | - Neslihan Surmeli
- Nutrition and Diets Unit, Health High School, Van Yüzüncü Yıl University, Van, Turkey
| | - Ihsan Gunduz
- Department of Surgery of Gastroenterology, Van Education and Research Hospital, Van, Turkey
| | | | - Ramazan Dertli
- Department of Gastroenterology, Van Education and Research Hospital, Van, Turkey
| | - Yusuf Kayar
- Department of Gastroenterology, Van Education and Research Hospital, Van, Turkey
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18
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Kayar Y, Dertli R, Konur S, Agin M, Baran B, Ormeci AC, Akyuz F, Demir K, Besisik F, Kaymakoglu S. The development of extraintestinal manifestation and related risk factors in Crohn's patients. Ir J Med Sci 2020; 190:597-604. [PMID: 32748219 DOI: 10.1007/s11845-020-02326-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/23/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Crohn's disease (CD) primarily involves gastrointestinal tract; however, it can present with extraintestinal manifestations (EIMs), which leads to significant morbidity. Frequency of EIMs and associated risk factors vary due to genetic and environmental differences in studies. AIM To examine the frequency and risk factors associated with EIMs in CD. METHOD Patients with CD under follow-up from March 1986 to October 2011 were included in this study. Demographics, type of EIMs, autoimmune diseases, and clinical features of CD were recorded. Frequency of EIMs and associated risk factors were analyzed. RESULTS Three hundred thirty-six patients with CD were included in the study (mean follow-up duration 7.54 years). 55.4% (n: 186) were male and the mean age at diagnosis of CD was 30.6 years (range, 10.3-68.2 years). At least one EIM was detected in 47.3% and multiple EIMs in 22.9% of the cohort. Oral, joint, and skin involvements (32.4%, 24.7%, 9.2%, respectively) were the most common EIMs. Female gender (OR: 2.19, 95% CI: 1.34-3.58, p = 0.001), corticosteroid usage (OR: 2.32, 95% CI: 1.28-4.22, p = 0.007), and positive family history (OR: 5.61, 95% CI: 1.95-3.58, p = 0.001) were independent risk factors for EIM development. Colonic involvement (OR: 3.93, 95% CI: 1.59-9.68, p = 0.003), no surgical operation (OR: 2.31, 95% CI: 1.14-4.68, p = 0.020), and corticosteroid usage (OR: 2.85, 95% CI: 1.07-7.61, p = 0.037) were independent risk factors for multiple EIM development. CONCLUSION Although the immunological and clinical associations between EIMs and CD cannot be fully elucidated, identifying specific relationships of immune-mediated diseases will help to better understand CD pathogenesis.
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Affiliation(s)
- Yusuf Kayar
- Department of Internal Medicine, Division of Gastroenterology, Van Education and Research Hospital, Saglik Bilimleri University, 65100, Van, Turkey.
| | - Ramazan Dertli
- Department of Internal Medicine, Division of Gastroenterology, Van Education and Research Hospital, Saglik Bilimleri University, 65100, Van, Turkey
| | - Sevki Konur
- Department of Internal Medicine, Van Education and Research Hospital, Saglik Bilimleri University, Van, Turkey
| | - Mehmet Agin
- Department of Pediatry, Division of Gastroenterology, Van Education and Research Hospital, Saglik Bilimleri University, Van, Turkey
| | - Bulent Baran
- Department of Internal Medicine, Division of Gastroenterology, Koç University, Istanbul, Turkey
| | - Asli Ciftcibasi Ormeci
- Department of Internal Medicine, Division of Gastroenterology, Istanbul University, Istanbul, Turkey
| | - Filiz Akyuz
- Department of Internal Medicine, Division of Gastroenterology, Istanbul University, Istanbul, Turkey
| | - Kadir Demir
- Department of Internal Medicine, Division of Gastroenterology, Istanbul University, Istanbul, Turkey
| | - Fatih Besisik
- Department of Internal Medicine, Division of Gastroenterology, Istanbul University, Istanbul, Turkey
| | - Sabahattin Kaymakoglu
- Department of Internal Medicine, Division of Gastroenterology, Istanbul University, Istanbul, Turkey
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Kayar Y, Agin M, Dertli R, Kurtulmus A, Boyraz RK, Onur NS, Kirpinar I. Eating disorders in patients with irritable bowel syndrome. Gastroenterol Hepatol 2020; 43:607-613. [PMID: 32718838 DOI: 10.1016/j.gastrohep.2020.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 02/07/2020] [Accepted: 03/04/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Eating disorders (ED) constitute an important group of conditions that commonly occur in adolescents. Gastrointestinal complaints are frequently reported in ED patients. Few studies assessed the association of irritable bowel syndrome (IBS) with ED. The aim of the current study is to determine the prevalence of ED in a group of IBS patients and compare it with a healthy control group and assess the relationship of IBS sub-types, it's duration and severity with ED. PATIENTS AND METHODS 100 IBS patients diagnosed according to the Rome-IV criteria and a control group consisting of 100 healthy adults, between 18 and 65 years old, were enrolled in this study. Sub-type, duration and severity of IBS were determined. All participants were requested to fill questionnaires to screen for ED. RESULTS 200 subjects participated in the study. 118(59%) were female and 92(41%) were male. The Eating Attitudes Test (EAT) score was significantly higher in the IBS group (Odds ratio: 5.3 CI 95%:4.3-9.3; p<0.001). The number of subjects with EAT score >30 was significantly higher in the IBS group (p<0.001). EAT scores were significantly higher in female IBS patients and in younger patients (p=0.013 and p=0.043; respectively). No significant association between the IBS sub-type and EAT score was found (p>0.05). However, IBS severity and duration positively correlated with EAT scores. DISCUSSION ED should be considered in the management of IBS patients. Since many psychological factors can exacerbate IBS symptoms a multidisciplinary approach consisting of medical and behavioral therapeutic modalities should be employed for a better management of these patients.
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Affiliation(s)
- Yusuf Kayar
- Department of Internal Medicine, Division of Gastroenterology, Van Education and Research Hospital, Van, Turkey.
| | - Mehmet Agin
- Department of Pediatry, Van Education and Research Hospital, Van, Turkey
| | - Ramazan Dertli
- Department of Internal Medicine, Division of Gastroenterology, Van Education and Research Hospital, Van, Turkey
| | - Ayse Kurtulmus
- Department of Psychiatry, BezmialemVakıf University, Istanbul, Turkey
| | | | | | - Ismet Kirpinar
- Department of Psychiatry, BezmialemVakıf University, Istanbul, Turkey
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Kayar Y, Dertli R. Association of autoimmune diseases with celiac disease and its risk factors. Pak J Med Sci 2019; 35:1548-1553. [PMID: 31777491 PMCID: PMC6861470 DOI: 10.12669/pjms.35.6.821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 08/31/2019] [Accepted: 09/11/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Autoimmune Diseases (AIDs) are detected in celiac patients. Our purpose was to determine the AIDs that are associated with celiac disease and related risk factors in the Turkish population. METHODS The study included 230 celiac patients who were diagnosed and followed-up in our clinics between 2015-2019. All AIDs that accompanied the celiac disease were recorded, and their association with risk factors was analyzed. RESULTS The mean age of the patients was 35.6±10.6 years (age range:18-72). A total of 58(25.2%) patients were male and the mean age at onset of disease was 29.1±6.5 years. The duration of disease follow-up was 6.5±4.6 years. One hundred and twenty two (53%) patients were on a strict diet, and 72(31.3%) patients had accompanying AID. Hashimoto thyroiditis was found in 39(17%) patients, asthma in 16(7%) patients as the most common comorbidities. There was a significant relation between AID and female gender, age of diagnosis being <40 years, duration of disease, non-GIS symptoms at the time of admission, and non-employment status. CONCLUSION Screening other AIDs in celiac patients are important, especially in individuals who have risk factors. Considering that many AIDs may develop in the future despite dietary compliance, patients should be followed with a multidisciplinary approach.
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Affiliation(s)
- Yusuf Kayar
- Yusuf Kayar, Department of Internal Diseases, Division of Gastroenterology, Van Education and Research Hospital, Van, Turkey
| | - Ramazan Dertli
- Ramazan Dertli, Department of Internal Diseases, Division of Gastroenterology, Van Education and Research Hospital, Van, Turkey
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Kayar Y, Senturk H, Tozlu M, Baysal B, Atay M, Ince AT. Prediction of Self-Limited Acute Pancreatitis Cases at Admission to Emergency Unit. GE Port J Gastroenterol 2019; 26:251-259. [PMID: 31328139 DOI: 10.1159/000493762] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/14/2018] [Indexed: 12/15/2022]
Abstract
Background While acute pancreatitis (AP) resolves spontaneously with supportive treatment in most patients, it may be life-threatening. Predicting the disease severity at onset dictates the management strategy. We aimed to define the patients with mild pancreatitis who may be considered for outpatient management with significant cost-savings. Materials and Methods This prospective observational study included 180 patients with mild AP according to the harmless acute pancreatitis score (HAPS) and Imrie score. The relationships of biochemical parameters with the changes in the Balthazar score and clinical course were examined. Results The study included 180 patients (111 females, 69 males; mean age: 53.9 ± 17.2 years; range: 17-92 years). The etiology was biliary in 118 (65%) patients and remained undetermined in 38 (21.1%) patients. Computed tomography (CT) performed within the first 12 h revealed mild and moderate AP in 159 (88.3%) and 21 (11.7%) patients, respectively. CT repeated at 72 h revealed mild, moderate, and severe AP in 155 (86.1%), 24 (13.3%), and 1 (0.6%) patients, respectively. Comparisons between stages A + B + C and D + E showed significant differences in the amylase levels on day 1 and 3, and in C-reactive protein on day 3. Also, in stage D and E disease, narcotic analgesic intake, oral intake onset time, and pain were significantly higher. Conclusion There were no significant changes in the CT findings of patients with mild AP at 12 and 72 h. Most patients (n = 179; 99.4%) recovered uneventfully. Patients with mild pancreatitis according to the HAPS and Imrie scores can be considered for outpatient management. The recovery is longer in stage D and E disease.
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Affiliation(s)
- Yusuf Kayar
- Department of Internal Medicine, Division of Gastroenterology, Bezmialem Vakıf University, Istanbul, Turkey
| | - Hakan Senturk
- Department of Internal Medicine, Division of Gastroenterology, Bezmialem Vakıf University, Istanbul, Turkey
| | - Mukaddes Tozlu
- Department of Internal Medicine, Division of Gastroenterology, Bezmialem Vakıf University, Istanbul, Turkey
| | - Birol Baysal
- Department of Internal Medicine, Division of Gastroenterology, Bezmialem Vakıf University, Istanbul, Turkey
| | - Musa Atay
- Department of Radiology, Bezmialem Vakıf University, Istanbul, Turkey
| | - Ali Tuzun Ince
- Department of Internal Medicine, Division of Gastroenterology, Bezmialem Vakıf University, Istanbul, Turkey
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Tozlu M, Kayar Y, İnce AT, Baysal B, Şentürk H. Low molecular weight heparin treatment of acute moderate and severe pancreatitis: A randomized, controlled,open-label study. Turk J Gastroenterol 2019; 30:81-87. [PMID: 30289392 DOI: 10.5152/tjg.2018.18583] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND/AIMS Acute pancreatitis (AP) runs a moderately severe and severe course in 20%-30% of cases. The purpose of the present study was to determine the effect of low molecular weight heparin (LMWH) for the prevention of pancreatic necrosis (PN) in moderately severe and severe AP (MSAP). MATERIALS AND METHODS A total of 100 patients with MSAP were randomized to receive either standard care (SC) or SC plus LMWH. LMWH was administered at 1 mg/kg via subcutaneous injection twice a day between days 1 and 7. The revised Atlanta criteria were used in the diagnosis of MSAP. Patients with a Harmless AP Score of >1 and a Balthazar computed tomography (CT) score of D and E were included in the study. RESULTS The mean age±SD of the patients (46 male and 54 female) was 52±19 years (range, 17-100). There were 50 patients in each group. On admission, clinical and laboratory parameters and Balthazar CT scores were similar between the groups. Initially, PN was present in one patient in the LMWH group and two in the SC group. Over the course, PN developed in 3 (6.1%) patients in the LMWH group and 11 (22.9%) in the SC group (p<0.05). Local and systemic complications were significantly lower in the LMWH group (p<0.05). No hemorrhagic complication occurred. Mortality was not significantly different between the groups (p=0.056). CONCLUSION Low molecular weight heparin treatment is safe and provides better prognosis in MSAP.
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Affiliation(s)
- Mukaddes Tozlu
- Department of Gastroenterology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Yusuf Kayar
- Department of Gastroenterology, Bezmialem Vakif University School of Medicine, İstanbul, Turkey
| | - Ali Tüzün İnce
- Department of Gastroenterology, Bezmialem Vakif University School of Medicine, İstanbul, Turkey
| | - Birol Baysal
- Department of Gastroenterology, Bezmialem Vakif University School of Medicine, İstanbul, Turkey
| | - Hakan Şentürk
- Department of Gastroenterology, Bezmialem Vakif University School of Medicine, İstanbul, Turkey
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Kayar Y, Çetin H, Ağın M. Tip 2 diyabetes mellitus hastalarında sigara içiciliği ve miktarı ile diyabetik komplikasyonlar arasındaki ilişkisi. Cukurova Medical Journal 2019. [DOI: 10.17826/cumj.412649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Özpolat T, Kayar Y, Sahutoglu T. Acute renal infarction: a presentation of essential thrombocytosis. Kidney Int 2018; 92:1292. [PMID: 29055434 DOI: 10.1016/j.kint.2017.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 06/19/2017] [Accepted: 06/21/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Tahsin Özpolat
- Bloodworks Northwest Research Institute, Seattle, Washington, USA.
| | - Yusuf Kayar
- Bezmi Alem School of Medicine, Department of Gastroenterology, Istanbul, Turkey
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Kayar Y, Unver N, Coban G, Gucin Z, Ekinci I, Emegil S, Bayram Kayar N, Baysal B, Sait Bugdaci M, Senturk H. Evaluation of solid pseudopapillary tumor of the pancreas: one tertiary center experience. Biomed Res 2018. [DOI: 10.4066/biomedicalresearch.29-16-833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kayar Y, Danalıoğlu A, Kafee AA, Okkesim Ş, Şentürk H. Gastric myoelectrical activity abnormalities of electrogastrography in patients with functional dyspepsia. Turk J Gastroenterol 2017; 27:415-420. [PMID: 27782888 DOI: 10.5152/tjg.2016.16281] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS Pathogenesis of functional dyspepsia (FD) is unclear and not well documented. Some gastric motility abnormalities have been reported to be important factors. Transcutaneous electrogastrography (EGG) is an experimental method that is used to assess FD. We aimed to compare FD patients with control subjects in terms of motility abnormalities according to the EGG results. MATERIALS AND METHODS Thirty patients with FD and thirty control subjects were included. EGG was preprandially and postprandially performed. The recordings were analyzed and compared between the two groups. RESULTS Mean ages of the cases and controls were 31.4±9.3 and 32.58±7.6 years, respectively. Female subjects constituted 80% of the FD group and 76.67% of the control group. In terms of the preprandial dominant frequency (DF), the FD group demonstrated lower incidence of normal subjects than the control group [13 (43.3%) and 22 (73.3%), respectively] and a higher incidence of bradygastria than the control group [17 (56.7%) and 8 (26.6%), respectively]. In the FD group, the rate of cases with normal postprandial DF was lower than that in the control group [10 (33.3%) and 23 (76.7%), respectively], whereas the rates of bradygastria [18 (60%) and 7 (23.3%), respectively] and tachygastria [2 (6.7%) and 0 (0%), respectively] were higher in the FD group (p<0.05). Preprandial and postprandial DF values were statistically significant in both groups. CONCLUSION A high incidence of gastric motility and myoelectrical activity abnormalities was observed in patients with FD. EGG is an effective, reliable, and non-invasive method in differentiating the subgroups. After standardization of some parameters, EGG may be an essential and irreplaceable test to diagnose and follow-up FD patients with motor dysfunction.
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Affiliation(s)
- Yusuf Kayar
- Department of Internal Medicine, Division of Gastroenterology, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey.
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Kayar Y, Kayar NÃB, ÅžahutoÄŸlu T, Gangarapu V. Spontaneous pneumomediastinum following pneumonia in a 23-year-old male patient. Monaldi Arch Chest Dis 2016; 83:769. [DOI: 10.4081/monaldi.2016.769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 08/31/2016] [Indexed: 11/23/2022] Open
Abstract
Spontaneous pneumomediastinum (SPM) is defined as the presence of interstitial air in the mediastinum without any apparent precipitating factor. We present a case of 23 year old male patient, who has been referred to our outpatient clinic with the complaints of sudden chest pain, dyspnea followed by pneumonia and was diagnosed as SPM. The patient was treated with ampicillin sulbactam (4 gr/day) and methylprednisolon (20 mg/day) for 4 days. and oral intake was stopped during treatment. Post treatment, it was observed that the crepitations were disappeared thoroughly and vesicular sounds were heard by oscultation. The control values of arterial blood gas was as following: pH:7,39 pO2:95 mmHg, pCO2:37 mmHg, SaO2: %97. In the 5th day his oral intake was started and he was discharged.Â
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Ozcelik H, Kayar Y, Danalioglu A, Arabaci E, Uysal O, Yakar F, Kart L. Does CPAP treatment lead to gastroesophageal reflux in patients with moderate and severe OSA? Eur Arch Otorhinolaryngol 2016; 274:1223-1229. [PMID: 27334527 DOI: 10.1007/s00405-016-4116-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/24/2016] [Indexed: 01/10/2023]
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Ekinci İ, Kayar Y, Dae SA, Dur A. Anaphylaxis after the First Dose of Lansoprazole: A Case Report. meandros 2016. [DOI: 10.4274/meandros.2550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kayar Y, Danalioglu A, Kocaman O, Baysal B, Senturk H. Eltrombopag: How secure in triple therapy of HCV? Acta Gastroenterol Belg 2015; 78:445-446. [PMID: 26712061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Triple therapy of hepatitis C usually leads to some hematological and dermatological side effects. Thrombocytopenia is one of the most common side effects that are encountered during triple therapy. Eltrombopag was approved for the treatment of patients with chronic hepatitis C and thrombocytopenia to allow the initiation and maintenance of interferon based therapies. During eltrombopag therapy, some side effects like headache, abdominal pain, and some complications such as portal vein thrombosis, deep vein thrombosis and arterial thrombosis were observed more frequently than placebo. We described here a patient who developing thrombosis secondary to eltrombopag in receiving triple therapy.
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Yıldız K, İnce AT, Gangarapu V, Buğdacı MS, Baysal B, Kayar Y, Sarbay Kemik A, Şentürk H. Evaluation of concentrations of pro/anti-inflammatory cytokines after complication-free ECRP in cholangiocarcinoma. Turk J Gastroenterol 2015; 25 Suppl 1:133-7. [PMID: 25910291 DOI: 10.5152/tjg.2014.6762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS Variations in pro and anti-inflammatory cytokine levels occur commonly after ERCP procedure complications, such as in post-ERCP pancreatitis. Besides, the relationship between increased cytokine levels and multidrug resistance has been shown in cholangiocarcinoma patients. Our aim was to investigate the impact of cytokine level changes on treatment strategy after uncomplicated ERCP procedures in cholangiocarcinoma patients. MATERIALS AND METHODS Of 75 patients enrolled in this study, 25 were cholangiocarcinoma, and 50 were choledocholithiasis patients. Levels of serum IL-1β, IL-6, IL-8, IL-10, and TNF-α were evaluated 2 hours before and 12 hours after complication-free ERCP, and statistical analysis of the results was obtained; if p value<0.05, it was accepted as statistically significant. RESULTS There was no statistically significant difference in the distribution of age (23-87 years; range: 59.8±16.6), gender (37 males vs 38 females), and levels of pre- and post-ERCP serum IL-1β, IL-6, IL-8, IL-10, and TNF-α in both patient groups, despite the presence of some change in test means (p:0.179, 0.445, 0.522, 0.937, and 0.065, respectively). However, significantly decreased levels of TNF-α were observed in the benign group, when comparing pre- and post-ERCP period (p<0.05). CONCLUSION Serum concentrations of IL-1β, IL-6, IL-8, IL-10, and TNF-α evaluated after complication-free ERCP performed in patients with cholangiocarcinoma do not cause any change in treatment planning that would affect multidrug resistance.
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Affiliation(s)
- Kemal Yıldız
- Department of Gastroenterology, Bezmialem Vakif University, İstanbul, Turkey.
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Baysal B, Şentürk H, Masri O, Tozlu M, Kayar Y, Arabacı E, Uysal Ö, Buğdacı MS, İnce AT. Effect of pantoprazole and Helicobacter pylori therapy on uninvestigated dyspeptic patients. Turk J Gastroenterol 2015; 26:6-14. [PMID: 25698264 DOI: 10.5152/tjg.2015.0010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS This study aimed to test the efficacy of empirical proton pump inhibitor use and Helicobacter pylori therapy for uninvestigated dyspepsia in a population with a high prevalence of H. pylori. MATERIAL AND METHODS The study had a two-stage design. In the first stage, the efficacy of 4-week pantoprazole treatment was compared with placebo in patients with uninvestigated dyspepsia. In the second stage, the efficacies of 2-week treatment with pantoprazole in H. pylori-negative patients and H. pylori eradication therapy (pantoprazole + amoxicillin + clarithromycin) in H. pylori-positive patients were compared. The primary endpoint was sufficient overall symptom relief (Global Overall Symptom score ≤2; no or minimal symptoms) at the end of treatment. RESULTS In the first stage, sufficient overall symptom relief was achieved by 25.2% of patients in the pantoprazole group and 15.5% of patients in the placebo group, a difference that was not statistically significant (p=0.06). In the second stage, the rate of sufficient overall symptom relief was higher in the H. pylori therapy group than in the pantoprazole group (37.1% vs. 23.4%; p=0.02). After untreated follow-up, sufficient overall symptom relief remained significantly higher in the H. pylori therapy group than in the pantoprazole group (39.7% vs. 18%; p<0.001). Almost all patients receiving pantoprazole experienced symptom relapse after treatment. CONCLUSIONS This study validated the use of a test-and-treat strategy against H. pylori in uninvestigated dyspepsia, which may be an advisable treatment approach for uninvestigated dyspeptic patients in countries with a high prevalence of H. pylori.
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Affiliation(s)
- Birol Baysal
- Department of Gastroenterology, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey.
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Kayar Y, Ekinci I, Turkdogan FT, Atay M, Soytas RB, Kayar NB. A rare case of isolated macronodular hepatic tuberculosis (Tuberculous) in an immunocompetent patient. J PAK MED ASSOC 2015; 65:1235-1236. [PMID: 26564302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Tuberculosis is one of the most common and well described infectious diseases, with a world wide distribution and a vast spectrum of clinical manifestations. There are three forms of hepatic tuberculosis. Diffuse hepatic involvement with pulmonary or miliary tuberculosis, diffuse hepatic infiltration without recognizable pulmonary involvement is the second form and the third very rare form presents as a focal/local tuberculoma or abscess. In this case report we describe an unusual appearance of macronodular tuberculomas of the liver.
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Affiliation(s)
- Yusuf Kayar
- Department of Internal Medicine, Bezmialem Vakif University, Turkey
| | - Iskender Ekinci
- Department of Internal Medicine, Bezmialem Vakif University, Turkey
| | | | - Musa Atay
- Department of Radiology, Bayrampasa State Hospital, Turkey
| | - Rabia Bag Soytas
- Department of Internal Medicine, Bezmialem Vakif University, Turkey
| | - Nuket Bayram Kayar
- Department of Family Medicine, Bagcilar Education and Research Hospital, Istanbul, Turkey
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Kayar Y, Turkdogan KA, Baysal B, Gultekin N, Danalioglu A, Ince AT, Senturk H. Concurrent acute pancreatitis and pericardial effusion. Pan Afr Med J 2015; 21:122. [PMID: 26327959 PMCID: PMC4546713 DOI: 10.11604/pamj.2015.21.122.6988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 05/28/2015] [Indexed: 12/04/2022] Open
Abstract
While pleural effusion and ascites secondary to acute pancreatitis are common, clinically relevant pericardial effusion and cardiac tamponade are observed rarely. In a study by Pezzilli et al., pleural effusion was noted in 7 of the 21 patients with acute pancreatitis whereas the authors detected pericardial effusion development in only three. The authors asserted that pleural effusion was associated with severe acute pancreatitis, while pericardial effusion and the severity of acute pancreatitis were not significantly related.
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Affiliation(s)
- Yusuf Kayar
- Bezmialem Vakif University, Department of Internal Medicine, Division of Gastroenterology, Istanbul, Turkey
| | | | - Birol Baysal
- Bezmialem Vakif University, Department of Internal Medicine, Division of Gastroenterology, Istanbul, Turkey
| | - Nigar Gultekin
- Bezmialem Vakif University, Department of Internal Medicine, Division of Gastroenterology, Istanbul, Turkey
| | - Ahmet Danalioglu
- Bezmialem Vakif University, Department of Internal Medicine, Division of Gastroenterology, Istanbul, Turkey
| | - Ali Tuzun Ince
- Bezmialem Vakif University, Department of Internal Medicine, Division of Gastroenterology, Istanbul, Turkey
| | - Hakan Senturk
- Bezmialem Vakif University, Department of Internal Medicine, Division of Gastroenterology, Istanbul, Turkey
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Baysal B, Kayar Y, Ince AT, Arici S, Türkmen I, Şentürk H. Primary pancreatic lymphoma: A rare cause of pancreatic mass. Oncol Lett 2015; 10:1701-1703. [PMID: 26622735 DOI: 10.3892/ol.2015.3412] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 06/05/2015] [Indexed: 11/06/2022] Open
Abstract
Primary pancreatic lymphoma (PPL) is a rare entity, most likely to be clinically misdiagnosed as pancreatic cancer. The cure rate of PPL is higher compared with that of pancreatic adenocarcinoma. This is the case report of a 57-year-old male patient who was hospitalized with complaints of abdominal pain, weight loss and jaundice. The radiological evaluation revealed a pancreatic head mass and, following endoscopic ultrasound-guided fine-needle aspiration biopsy, the tumor was diagnosed as diffuse large B-cell lymphoma. The final diagnosis was PPL, and the patient went into remission after receiving three cycles of treatment with rituximab, doxorubicin, cyclophosphamide, vincristine and prednisolone (R-CHOP regimen). Therefore, PPL should be considered in the differential diagnosis of pancreatic masses and its management differs from that of other types of pancreatic tumor.
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Affiliation(s)
- Birol Baysal
- Department of Gastroenterology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey
| | - Yusuf Kayar
- Department of Gastroenterology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey
| | - Ali Tüzün Ince
- Department of Gastroenterology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey
| | - Sema Arici
- Department of Pathology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey
| | - Ihsan Türkmen
- Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey
| | - Hakan Şentürk
- Department of Gastroenterology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey
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Kayar Y, Turkdogan KA, Baysal B, Unver N, Danalioglu A, Senturk H. EUS-guided FNA of a portal vein thrombus in hepatocellular carcinoma. Pan Afr Med J 2015; 21:86. [PMID: 26491529 PMCID: PMC4594969 DOI: 10.11604/pamj.2015.21.86.6991] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 05/26/2015] [Indexed: 12/15/2022] Open
Abstract
Portal vein thrombosis is a relatively rare but well-known complication of cirrhosis that has a prevalence of between 1% and 5.7%. On the contrary, in case of hepatocellular carcinoma (HCC), it is a much more frequent complication. In this paper, we presented three cases that had liver cirrhosis, mass and portal vein thrombosis in liver. We were not able to diagnose the cases through imaging methods, laboratory results or histopathologically, however, they were diagnosed with endoscopic ultrasonography- fine needle aspiration EUS-FNA from portal vein thrombus.
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Affiliation(s)
- Yusuf Kayar
- Bezmialem Vakif University, Department of Internal Medicine, Division of Gastroenterology, Istanbul, Turkey
| | | | - Birol Baysal
- Bezmialem Vakif University, Department of Internal Medicine, Division of Gastroenterology, Istanbul, Turkey
| | - Nurcan Unver
- Bezmialem Vakif University, Department of Pathology, Istanbul, Turkey
| | - Ahmet Danalioglu
- Bezmialem Vakif University, Department of Internal Medicine, Division of Gastroenterology, Istanbul, Turkey
| | - Hakan Senturk
- Bezmialem Vakif University, Department of Internal Medicine, Division of Gastroenterology, Istanbul, Turkey
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Baysal B, Kayar Y, Özmen A, ElShobaky M, Mahdi N, İnce AT, Danalıoğlu A, Şentürk H. Olanzapine-induced acute pancreatitis. Turk J Gastroenterol 2015; 26:289-290. [PMID: 26006214 DOI: 10.5152/tjg.2015.0216] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Birol Baysal
- Department of Gastroenterology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey.
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Baysal B, Kayar Y, Danalioglu A, Ozkan T, Bayram Kayar N, Unver N, Bozkurt S, Ince AT. The importance of upper gastrointestinal endoscopy in morbidly obese patients. Turk J Gastroenterol 2015; 26:228-31. [DOI: 10.5152/tjg.2015.0083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Kayar Y, Kayar NB, Gangarapu V. Thrombotic thrombocytopenic purpura and focal segmental glomerulosclerosis associated with the use of ecstasy. Indian J Crit Care Med 2015; 19:230-2. [PMID: 25878432 PMCID: PMC4397631 DOI: 10.4103/0972-5229.154561] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ecstasy is a drug, which causes serious side effects and sometimes it can be lethal. These effects are due to idiosyncratic reactions as a result of various stimulations in adrenergic receptors. Here we present a case of a 36-year-old male patient who was diagnosed with thrombotic thrombocytopenic purpura associated with the use of ecstasy. Plasmapheresis along with methylprednisolone treatment restores patient condition to normal.
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Affiliation(s)
- Yusuf Kayar
- Department of Internal Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Nuket Bayram Kayar
- Department of Family Medicine, Bagcilar Education and Research Hospital, Istanbul, Turkey
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Çelik S, Kayar Y, Önem Akçakaya R, Türkyılmaz Uyar E, Kalkan K, Yazısız V, Aydın Ç, Yücel B. Correlation of binge eating disorder with level of depression and glycemic control in type 2 diabetes mellitus patients. Gen Hosp Psychiatry 2015; 37:116-9. [PMID: 25670634 DOI: 10.1016/j.genhosppsych.2014.11.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 11/25/2014] [Accepted: 11/27/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVE It is reported that eating disorders and depression are more common in patients with type 2 diabetes mellitus (T2DM). In this study, we aimed to determine the prevalence of binge eating disorder (BED) in T2DM patients and examine the correlation of BED with level of depression and glycemic control. METHOD One hundred fifty-two T2DM patients aged between 18 and 75 years (81 females, 71 males) were evaluated via a Structured Clinical Interview for DSM-IV Axis I Disorder, Clinical Version in terms of eating disorders. Disordered eating attitudes were determined using the Eating Attitudes Test (EAT) and level of depression was determined using the Beck Depression Scale. Patients who have BED and patients who do not were compared in terms of age, gender, body mass index, glycosylated hemoglobin (HbA1c) levels, depression and EAT scores. RESULTS Eight of the patients included in the study (5.26%) were diagnosed with BED. In patients diagnosed with BED, depression and EAT scores were significantly high (P<.05). A positive correlation was found between EAT scores and depression scores (r = +0.196, P<.05). No significant difference was found in HbA1c levels between patients with BED and those without (P<.05). CONCLUSIONS T2DM patients should be examined in terms of the presence of BED and disordered eating attitudes. Psychiatric treatments should be organized for patients diagnosed with BED by taking into consideration comorbid depression.
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Affiliation(s)
- Selime Çelik
- Sisli Etfal Research and Training Hospital Psychiatry Unıt, Sisli-İstanbul, Turkey.
| | - Yusuf Kayar
- Sisli Etfal Research and Training Hospital Internal Medicine Unıt, Sisli-İstanbul, Turkey
| | | | - Ece Türkyılmaz Uyar
- Sisli Etfal Research and Training Hospital Psychiatry Unıt, Sisli-İstanbul, Turkey
| | - Kübra Kalkan
- Sisli Etfal Research and Training Hospital Internal Medicine Unıt, Sisli-İstanbul, Turkey
| | - Veli Yazısız
- Akdeniz University Department of Internal Medicine, Antalya, Turkey
| | - Çiğdem Aydın
- Sisli Etfal Research and Training Hospital Psychiatry Unıt, Sisli-İstanbul, Turkey
| | - Başak Yücel
- Istanbul University Medical School Psychiatry Unıt, Istanbul, Turkey
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İnce AT, Yıldız K, Gangarapu V, Kayar Y, Baysal B, Karatepe O, Kemik AS, Şentürk H. Serum and biliary MMP-9 and TIMP-1 concentrations in the diagnosis of cholangiocarcinoma. Int J Clin Exp Med 2015; 8:2734-2740. [PMID: 25932227 PMCID: PMC4402874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 01/29/2015] [Indexed: 06/04/2023]
Abstract
AIM Cholangiocarcinoma is generally detected late in the course of disease, and current diagnostic techniques often fail to differentiate benign from malignant disease. Ongoing biomarker studies for early diagnosis of cholangiocarcinoma are still continues. By this study, we analyzed the roles of serum and biliary MMP-9 and TIMP-1 concentrations in the diagnosis of cholangiocarcinoma. MATERIALS AND METHODS The 113 patients (55 males, 58 females) were included; 33 diagnosed with cholangiocarcinoma (malignant group) and 80 diagnosed with choledocholithiasis (benign group). MMP-9 and TIMP-1 concentrations were analyzed in serum and bile and compared in the malignant and benign groups. Results were evaluated statistically. RESULTS Biliary MMP-9 concentrations were significantly higher (576 ± 209 vs. 403 ± 140 ng/ml, p < 0.01) and biliary TIMP-1 concentrations were significantly lower (22.4 ± 4.9 vs. 29.4 ± 6.1 ng/ml, p < 0.01) in the malignant than in the benign group. In contrast, serum MMP-9 and TIMP-1 concentrations were similar in the two groups. Receiver operating curve analysis revealed that the areas under the curve of bile MMP-9 and TIMP-1 were significantly higher than 0.5 (p < 0.001). The sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios and accuracy were 0.94, 0.32, 0.36, 0.93, 1.40, 0.19 and 0.5 for biliary MMP-9, respectively, and 0.97, 0.36, 0.39, 0.97, 1.5, 0.08 and 0.54 for biliary TIMP-1, respectively. CONCLUSION Serum and biliary MMP-9 and TIMP-1 tests do not appear to be useful in the diagnosis of cholangiocarcinoma.
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Affiliation(s)
- Ali Tüzün İnce
- Department of Gastroenterology, Bezmialem Vakıf UniversityIstanbul 34093, Turkey
| | - Kemal Yıldız
- Department of Gastroenterology, Bezmialem Vakıf UniversityIstanbul 34093, Turkey
| | | | - Yusuf Kayar
- Department of Gastroenterology, Bezmialem Vakıf UniversityIstanbul 34093, Turkey
| | - Birol Baysal
- Department of Gastroenterology, Bezmialem Vakıf UniversityIstanbul 34093, Turkey
| | - Oğuzhan Karatepe
- Department of General Surgery, Bezmialem Vakıf UniversityIstanbul 34093, Turkey
| | - Ahu Sarbay Kemik
- Biochemistry Division, Cerrahpaşa Medical School, Istanbul UniversityIstanbul, Turkey
| | - Hakan Şentürk
- Department of Gastroenterology, Bezmialem Vakıf UniversityIstanbul 34093, Turkey
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Kayar Y, ElShobaky M, Danalioglu A, Türkdogan MK, Hasbahceci M, Baysal B, Senturk H. Wernicke encephalopathy in a patient with severe acute pancreatitis. Acta Gastroenterol Belg 2015; 78:58-59. [PMID: 26118580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Kayar Y, Kayar NB. Tumor flare reaction in a patient with mantle cell lymphoma. Blood Res 2014; 49:279-80. [PMID: 25548764 PMCID: PMC4278012 DOI: 10.5045/br.2014.49.4.279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 11/14/2014] [Accepted: 11/19/2014] [Indexed: 11/21/2022] Open
Affiliation(s)
- Yusuf Kayar
- Bezmialem Vakif University, Department of Internal Medicine, Istanbul, Turkey
| | - Nuket Bayram Kayar
- Bagcilar Education & Research Hospital, Department of Family Medicine, Istanbul, Turkey
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İnce AT, Baysal B, Kayar Y, Arabacı E, Bilgin M, Hamdard J, Yay A, Şentürk H. Comparison of tomographic and colonoscopic diagnoses in the presence of colonic wall thickening. Int J Clin Exp Med 2014; 7:4413-4419. [PMID: 25550962 PMCID: PMC4276220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 10/23/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION AND OBJECTIVE Colonic wall thickening is a common condition in a number of benignant and malignant diseases. This study investigated the accuracy of radiological diagnoses in patients diagnosed with colonic wall thickening using multislice CT (MDCT). MATERIALS AND METHOD Files of patients with colonic wall thickening diagnosed with 64-slice MDCT were reviewed retrospectively. The colonoscopy results of these patients were grouped under neoplastic process (cancer and adenomatous polyp), inflammatory bowel disease (IBD), diverticulitis and other etiology (nonspecific events, ischemic colitis, solitary rectal ulcer, external compression, secondary to volvulus and radiotherapy), and the results were statistically evaluated. p values < 0.05 were considered statistically significant. RESULTS The study was performed on 505 files (290 males [57.4%], 215 females [42.6%], mean age: 49.15 ± 18.4 years). CT and colonoscopic diagnoses were reviewed and the following CT to colonoscopy ratios was observed: neoplastic process: 44.4% vs. 40.2%; IBD: 42.4% vs. 42.4%; diverticulitis: 4% vs. 4.2%; other etiology: 9.3% vs. 3.2%. Colonoscopy failed to identify pathology in 9.9% of the patients. The sensitivity, specificity, PPV, NPV and accuracy of CT were 95.6%, 90.4%, 87.1%, 96.8% and 92.4%, respectively, in detecting neoplastic processes; 97.2%, 97.9%, 97.2%, 97.9% and 97.6%, respectively, in detecting IBD; 90.5%, 99.8%, 95%, 99.6% and 99.4%, respectively, in detecting diverticulitis, and 50%, 96,7%, 62.5%, 94.6% and 92%, respectively, in detecting other etiology. CONCLUSION While, accuracy of 64 slice-CT in diagnosing colonic wall thickenings secondary especially to neoplastic processes, IBD and diverticulitis was significantly higher, but differential diagnosis is challenging in pathologies due to other etiologies.
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Affiliation(s)
- Ali Tüzün İnce
- Gastroenterology Clinic of Bezmialem Vakıf Universityİstanbul 34093, Turkey
| | - Birol Baysal
- Gastroenterology Clinic of Bezmialem Vakıf Universityİstanbul 34093, Turkey
| | - Yusuf Kayar
- Gastroenterology Clinic of Bezmialem Vakıf Universityİstanbul 34093, Turkey
| | - Elif Arabacı
- Gastroenterology Clinic of Bezmialem Vakıf Universityİstanbul 34093, Turkey
| | - Mehmet Bilgin
- Department of Radiology, Bezmialem Vakıf Universityİstanbul 34093, Turkey
| | - Jamshid Hamdard
- Gastroenterology Clinic of Bezmialem Vakıf Universityİstanbul 34093, Turkey
| | - Adnan Yay
- Gastroenterology Clinic of Bezmialem Vakıf Universityİstanbul 34093, Turkey
| | - Hakan Şentürk
- Gastroenterology Clinic of Bezmialem Vakıf Universityİstanbul 34093, Turkey
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Kayar Y, Eroglu H, Pamukcu O, Cetin H, Kocas O, Atci M. Cannabinoid-induced acute pancreatitis. Turk J Gastroenterol 2014; 25:335-336. [DOI: 10.5152/tjg.2014.4902] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Tozlu M, Kocaman O, Baysal B, Ince A, Danalioglu A, Kayar Y, Senturk H. Metallic stent in the endoscopic treatment of pancreatic fluid collections. Endosc Ultrasound 2014; 3:S10. [PMID: 26425505 PMCID: PMC4569903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND AIMS The endoscopic treatment of pancreatic fluid collections (PFCs) has become the preferred first-line approach. Fully covered self-expandable metal stents (FCSEMS) were considered as an alternative to multiple double pigtail stents. The aim of this study was to evaluate the results of the endosonography guided drainage (EUS-GD) of PFCs with FCEMS. MATERIALS AND METHODS A total of 33 consecutive patients were included. Cystogastrostomy and cystoduodenostomy were created with a linear echoendoscope under endosonographic and fluoroscopic control. Procedures were performed in a standard way of, puncture with a 19 gauge needle, bougie dilation and insertion of FCSEMS. RESULTS A total of 33 patients (mean age 52 years, 21 men, range: 18-77 years), were included. PFCs were 22 non-infected symptomatic pseudocyst and 11 walled-off necrosis or abscess. EUS-GD was successful in 30 (90.9%) patients. Stent insertion failed in one patient. Two patients needed surgery. Complications were observed in 8 (25%) patients (stent dislocation in 3, perforation in 2, bleeding in 2 and pneumoperitoneum in 1 patient). Procedure related mortality was not seen. The mean cyst size was 11.3 cm (5-22). FCSEMS were successful in the treatment of pseudocysts (after 1 month mean cyst size is 6.2 cm, range: 0-15 cm, with 54.8% decrement rate). During a mean follow-up of 15 months complete resolution was 66.6% (20 patients) and recurrence due to stent malfunction was 10%. All these cases were submitted to a new session of endoscopic drainage. CONCLUSIONS EUS-GD, FCSEMS insertion provides an effective, minimally invasive, and safe approach in the management of PFCs.
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Affiliation(s)
- M. Tozlu
- Bezmailem Vakif University, Istanbul, Turkey
| | - O. Kocaman
- Bezmailem Vakif University, Istanbul, Turkey
| | - B. Baysal
- Bezmailem Vakif University, Istanbul, Turkey
| | - A. Ince
- Bezmailem Vakif University, Istanbul, Turkey
| | | | - Y. Kayar
- Bezmailem Vakif University, Istanbul, Turkey
| | - H. Senturk
- Bezmailem Vakif University, Istanbul, Turkey
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Kayar NB, Doğan FG, Özdemir T, Dalkıran SB, Gül F, Gözütok V, Kayar Y, Kafadar D, Dinçkal MH. Awareness and Knowledge of Patients with Acute Coronary Syndromes About Coronary Artery Disease. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Yonal I, Kayar Y, Nazligul E, Yenerel MN, Kalayoglu-Besisik S. Leukemic ascites as an initial presentation of acute myelomonocytic leukemia with inversion of chromosome 16. Ann Saudi Med 2013; 33:197-8. [PMID: 23563011 PMCID: PMC6078620 DOI: 10.5144/0256-4947.2013.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ipek Yonal
- Department of Internal Medicine, Division of Hematolgy, Istanbul, Turkey
- Correspondence: Dr. Ipek Yonal Department of Internal Medicine, Division of Hematolgy, Istanbul Universitesi Istanbul Tip Fakultesi, Ic Hastaliktari ABD, Hematolji BD Istanbul 34104 Turkey
| | - Yusuf Kayar
- Department of Internal Medicine, Division of Hematolgy, Istanbul, Turkey
| | - Esra Nazligul
- Department of Internal Medicine, Division of Hematolgy, Istanbul, Turkey
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Atay K, Tufan F, Kayar Y, Sahutoglu T, Saka B, Kucukkaya R, Erelel M, Tascioglu C. Resolution of respiratory failure with radiotherapy in myelofibrosis. Respiration 2010; 80:353-4. [PMID: 20639619 DOI: 10.1159/000319014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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