[show abstract][hide abstract] ABSTRACT: Aim. Colonic polyps and thyroid nodules are common diseases and their frequency increases with age. In the literature, there is no study investigating the coexistence of colonic polyps and thyroid nodules. Therefore, this study was designed to investigate thyroid nodule prevalence in patients with colonic polyps. Material and Methods. Sixty-six patients with colonic polyps and 146 patients without colonic polyps enrolled into the study. Age and sex matched control group was composed from patients without colonic polyps. Colonoscopic examinations, thyroid ultrasonographies were performed in all patients, and TSH were measured. Results. Male/female ratio in polyp and control groups were 40/26 versus 68/78, respectively (P = 0.058). Mean ages were similar in both groups (53.3 ± 11.4 versus, 51.8 ± 11.4, P = 0.373). Thyroid nodule was detected in 44 (66.7%) patients with polyps and in 61 (41.8%) controls (P = 0.001). Patients with adenomatous polyps had 5 or more thyroid nodules compared to patients with hyperplastic polyps (P = 0.03). Thyroid nodules were more prevalent among patients aged 50 or older compared to 50 years or less (P = 0.023). Conclusion. Thyroid nodules were detected more common in patients with colonic polyps. Further studies are needed to clarify this coexistence.
Gastroenterology Research and Practice 01/2012; 2012:178570. · 1.62 Impact Factor
[show abstract][hide abstract] ABSTRACT: Antimicrobial resistance has decreased eradication rates for Helicobacter pylori infection, and recent reports from different countries report eradication rates lower than 80% with triple therapy. The aim of this pilot study was to investigate the efficacy of standard triple eradication regimen in long-term aspirin users.
The study population consisted of 77 aspirin using patients with dyspeptic symptoms and 79 age- and sex-matched dyspeptic patients without aspirin use as a control group. Both the study group and control patients were given lansoprazole (30 mg twice a day), clarithromycin (500 mg twice a day) and amoxicillin (1 g twice a day) (LCA) for 14 days as the eradication regimen. Patients on the study group were allowed to take aspirin during the eradication regimen (LCAAsp). Eradication was defined as the absence of H pylori as assessed with the C-urea breath test and H pylori stool antigen test 8 weeks after the end of the antimicrobial therapy.
The H pylori eradication rate in the LCAAsp group was 64/77 [83%, 95% confidence interval (CI): 79%-94%] with intention-to-treat (ITT) analysis and 64/75 (85%, 95% CI: 82%-96%) with per protocol (PP) analysis, and the H pylori eradication rate in the LCA group was 42/79 (53%, 95% CI: 43%-65%) with ITT analysis and 42/75 (56%, 95% CI: 46%-68%) with PP analysis. The difference between the groups both with ITT analysis and with PP analysis was statistically significant (P < 0.05).
These data suggest that H pylori eradication rate with standard triple eradication regimen is significantly higher among long-term aspirin users than in controls.
The American Journal of the Medical Sciences 07/2011; 342(1):15-9. · 1.33 Impact Factor
[show abstract][hide abstract] ABSTRACT: Although Helicobacter pylori infection has been reported to be more frequent in patients with dyspepsia, whether it should be treated in dyspepsia remains controversial. This study was carried out to compare the histopathological changes in Helicobacter pylori-positive and -negative dyspepsia patients.
A total of 461 patients with Helicobacter pylori-positive dyspepsia seen in our institution were enrolled in the study. The control group was formed from 100 Helicobacter pylori-negative dyspepsia patients. Subjects underwent an upper gastrointestinal endoscopy, and biopsy specimens were taken from the gastric antrum and corpus. All of the cases were evaluated according to the Sydney classification, and the relation of Helicobacter pylori with chronic inflammation, atrophy, intestinal metaplasia, and activity was investigated by two pathologists.
Activity, inflammation and intestinal metaplasia were found in 10 (10%), 70 (70%) and 10 (10%) of Helicobacter pylori (-) patients, respectively, and the numbers increased with increasing Helicobacter pylori intensity when compared with Helicobacter pylori (+) patients (p<0.01, p<0.01 and p<0.05, respectively). Atrophy was found in 27 (5.5%) of all cases (in 10 Helicobacter pylori (-) patients and in 17 Helicobacter pylori (+) patients), but no significant relation was found with increasing Helicobacter pylori intensity (p>0.05). There was no significant difference between corpus alone or antrum alone Helicobacter pylori (+) and both corpus/antrum (+) patients in regards to the presence of activity, inflammation, intestinal metaplasia, and atrophy (p>0.05).
Determination of the degree of morphological changes accompanying Helicobacter pylori infection in dyspepsia is important in the follow-up and treatment of patients. As activity, inflammation and intestinal metaplasia increase with increasing Helicobacter pylori intensity in dyspepsia patients, Helicobacter pylori eradication treatment can be recommended in these patients.
The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 04/2011; 22(2):122-7. · 0.48 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of the study was to compare 3 stool antigen tests for diagnosis of Helicobacter pylori infection in adult patients with dyspeptic complaints before eradication therapy. We compared 2 enzyme immunoassays (EIAs: Premier Platinum Helicobacter pylori Stool Antigen [HpSA] Plus and Helicobacter pylori Antigen [Hp Ag]) and one immunochromatographic assay (H. pylori fecal antigen test-lateral-flow chromatography) in detecting H. pylori. All the investigated stool antigen tests were made of monoclonal antibodies. We evaluated 168 adult patients with H. pylori infection by using 2 criterion standard methods (histological and rapid urease tests) together. The sensitivity and specificity were 90% and 91%, respectively, for the Premier Platinum HpSA Plus, 77% and 91%, respectively, for the Hp Ag, and 81% and 92%, respectively, for the H. pylori fecal antigen test, respectively. The best agreement between the criterion standard tests and the stool antigen tests used in the study was with the Premier Platinum HpSA Plus. Immunochromatographic assay-based stool antigen test (H. pylori fecal antigen test) was found to be more sensitive than the EIA-based test (Hp Ag). One of the 2 important conclusions obtained from the study was that the Premier Platinum HpSA Plus was found to be the most accurate test for the diagnosis of H. pylori infection in adult dyspeptic patients before eradication therapy, and the other was that monoclonal and high-quality, reliable immunochromatographic assay tests are a good option especially for small hospital laboratories that do not have appropriate equipment for performing the EIA and working on few samples.
Journal of Investigative Medicine 12/2010; 58(8):982-6. · 1.75 Impact Factor
[show abstract][hide abstract] ABSTRACT: Invasive and non-invasive tests can be used to evaluate the activity of inflammatory bowel diseases.
The aim of the present study was to investigate the role of fecal calprotectin in evaluating inflammatory bowel disease activity and the correlation of fecal calprotectin with the erythrocyte sedimentation rate and C reactive protein values in inflammatory bowel disease.
Sixty-five patients affected with inflammatory bowel disease were enrolled. Twenty outpatients diagnosed with inflammatory bowel disease comprised the control group.
In the present study, all patients in the control group had an fecal calprotectin value lower than the cut-off point (50 mg/kg).
In conclusion, fecal calprotectin was found to be strongly associated with colorectal inflammation indicating organic disease. Fecal calprotectin is a simple and non-invasive method for assessing excretion of macrophages into the gut lumen. Fecal calprotectin values can be used to evaluate the response to treatment, to screen asymptomatic patients, and to predict inflammatory bowel disease relapses.
Clinics (São Paulo, Brazil) 11/2009; 64(5):421-5. · 1.59 Impact Factor
[show abstract][hide abstract] ABSTRACT: Eosinophilia associated with tumors is extremely rare. The exact underlying pathogenetic mechanisms are not well understood; limited data have been reported about granulocyte colony-stimulating factor and interleukin-5 in the development of eosinophilia. We report a patient with marked eosinophilia, leukocytosis, and eosinophilic colitis presenting with bloody stool. The subsequent diagnosis was advanced high-grade transitional cell carcinoma of the bladder. Leukocyte count, eosinophil count, and colonoscopic findings returned to normal after surgical removal of the tumor. To our knowledge, eosinophilic colonic infiltration as a manifestation of transitional cell bladder carcinoma has not been previously reported.
The American Journal of the Medical Sciences 08/2008; 336(1):81-3. · 1.33 Impact Factor
[show abstract][hide abstract] ABSTRACT: The relation between Helicobacter pylori and Migraine and usefulness of the eradication treatment on headache is controversial. The aim of this study was to determine whether Helicobacter pylori infection is a risk factor for migraine and whether the eradication of the bacterium can reduce frequency, duration and severity of clinical attacks of the disease.
A total 70 consecutive patients with migraine with aura and without aura who came to Gastroenterology polyclinic with various complaints were enrolled in the study and compared with a group of 60 matched controls. Helicobacter pylori infection was diagnosed by histopathological biopsies, which was taken by endoscopy (Olympus-GIFXQ240 endoscope). The diagnosis and classification of migraine was made according to the International Headache Society (IHS) criteria. We assessed the frequency, duration and severity of clinical attacks of migraine before and after eradication treatment. The eradication control of Helicobacter pylori was made by Helicobacter pylori fecal antigen test by PCR after 2 months.
Helicobacter pylori positiveness is more relevant in the migranous patients compared with controls. 84.6% of patients with eradication treatment and 75% of classically treated patients informed to get benefit from the treatment.
Helicobacter pylori should be examined in migranous patients and eradication of the infection may be helpful for the treatment of the disease.
[show abstract][hide abstract] ABSTRACT: The effect of interferon alpha in chronic viral hepatitis and common side effects are well known, but axonal polyneuropathy and hearing loss have been rarely reported. A 58-year-old woman was administered interferon alpha-2a (9 MU/3 times a week) and lamividin (100 mg daily) with the diagnosis of chronic hepatitis B. At the fifth month of the treatment gait disturbance and tinnitus developed. In her neurological examination tandem gait was ataxic on the right side. Cerebral magnetic resonance imaging performed to elucidate a probable cerebral pathology revealed nonspecific millimetric hyperintense lesions thought to be related with her hypertension anamnesis. Electroneuromyography demonstrated mild axonal polyneuropathy. The finding of pure-tone audiometry was sensorineural hearing loss in her left ear. Our diagnosis was axonal polyneuropathy and sensorineural type hearing loss as a side effect of interferon. In conclusion, the development of polyneuropathy and sensorineural hearing loss in the same patient may suggest autoimmunity as the cause of these side effects.
The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 07/2004; 15(2):97-9. · 0.48 Impact Factor