Ayhan Gazi Kalayci

Istanbul 29 Mayis University, Ondokuzmayıs, Samsun, Turkey

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Publications (40)64.74 Total impact

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    ABSTRACT: Background: This study was undertaken to evaluate demographics, clinical manifestations, laboratory findings and outcomes of children with inflammatory bowel disease (IBD) in Turkey. Methods: We analyzed the medical records of 127 children diagnosed with IBD (under 18 years old) between January 2004 and January 2012 in 8 pediatric gastroenterology centers. Results: Of the 127 patients, 90 (70.9%) suffered from ulcerative colitis (UC), 29 (22.8%) from Crohn's disease (CD), and 8 (6.3%) from IBD unclassified. The mean age of the 127 patients was 11.6±4.1 years, and 11.8% of the patients were below 5 years old. Of the patients, 49.6% were male, and males were more predominant in patients with CD than in those with UC (72.4% vs. 42.2%, P=0.008; a male/female ratio of 2.62 in CD, P=0.0016). Approximately one fifth of the patients had extra-intestinal manifestations and 13.3% of the patients had associated diseases. Extraintestinal manifestations and associated diseases were more common in early onset disease [P=0.017, odds ratio (OR)=4.02; P=0.03, OR=4.1]. Of the patients, 15% had normal laboratory parameters including anemia, high platelet count, hypoalbuminemia, hypoferritinemia, and high sedimentation rate. Area under receiver operation characteristics was used to predict pancolitis in patients with UC. The values of C-reactive protein, sedimentation rate and pediatric ulcerative colitis activity were 0.61 (P=0.06), 0.66 (P=0.01) and 0.76 (P=0.0001), respectively. Four (4.4%) patients with UC underwent colectomy, and finally two (1.5%, 95% confidence interval: 0-3.7%) patients died from primary disease or complications. Conclusions: IBD is an increasing clinical entity in Turkey. Features of IBD are similar to those in other populations, but prospective multicenter studies are needed to analyze the true incidence of IBD in Turkish children.
    No preview · Article · Oct 2015 · World Journal of Pediatrics
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    ABSTRACT: Background: Progressive familial intrahepatic cholestasis (PFIC) is a cholestatic liver disease of childhood. Pruritus resulting from increased bile salts in serum might not respond to medical treatment, and internal or external biliary drainage methods have been described. In this study, we aimed to evaluate different internal drainage techniques in patients with PFIC. Patients and methods: Between 2009 and 2014, seven children (4 male, 3 female, 3months-5years old), (median 2years of age) with PFIC were evaluated. The patients were reviewed according to age, gender, complaints, surgical technique, laboratory findings and outcome. In each two patients, cholecystoileocolonic anastomosis, cholecystojejunocolonic anastomosis and cholecystocolostomy were performed. Cholecysto-appendico-colonic anastomosis was the technique used in one patient. Results: Jaundice and excessive pruritus were the main complaints. One of the patients with cholecystoileocolonic anastomosis died of comorbid pathologies (cirrhosis, adhesive obstruction and severe sepsis). Temporary rectal bleeding was observed in all the patients postoperatively. Regardless of the surgical technique, pruritus was dramatically decreased in all the patients in the postoperative period. Conclusion: Regardless of the technique, internal biliary diversion methods are beneficial for the relief of pruritus in PFIC patients. Selection of the surgical method might vary depending on the surgeon's preference and the surgical anatomy of the gastrointestinal system of the patient.
    Full-text · Article · Sep 2015 · Journal of Pediatric Surgery
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    Full-text · Article · May 2015
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    O. Yuce · M. Acikgoz · A. Guzel · A. Comba · M. Gunaydin · A. Kalayci

    Full-text · Article · May 2014 · Pediatric Critical Care Medicine
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    Ö. Yüce · A.G. Kalayci · A. Okuyucu · G. Caltepe · A. Bedir
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    ABSTRACT: Objective: To investigate the presence of genotoxicity in intestinal epithelial cells and lymphocytes in celiac patients and to assess DNA repair capacity. Material and Method: The study comprised 15 newly diagnosed celiac patients, 14 celiac patients receiving glutenfree diet, and 9 non-celiac patients who had undergone endoscopy for various reasons (control group). Comet assay was performed to detect DNA injury. DNA injury was measured both after being exposed to stress by hydrogen peroxide and 20 minute regeneration period to measure DNA repair capacity. Results: DNA injury in the intestinal epithelial cells was significantly higher in the newly diagnosed celiac patients than that in the controls (Tail DNA%: 25.9±1.5 and 15.7±0.9, respectively, p<0.001). Although DNA injury (Tail DNA%) in the lymphocytes was higher in the newly diagnosed celiac patients (3.7±0.3) than that in the celiac patients on diet (2.9±0.9; p=0.020), it was not different from the controls (4.3±0.3; p=0.100). DNA injury in the lymphocytes after hydrogen peroxide exposure was higher in the newly diagnosed celiac patients than that in the celiac patients on diet and controls (Tail DNA%: 14.2±0.6, 10.7±0.5 and 12.4±0.6, respectively). The remaining DNA injury after regeneration period was also higher in the newly diagnosed celiac patients compared to those in the celiac patients on diet and controls (Tail DNA%: 8.4±0.5, 6.3±0.3 and 6.4±0.4, respectively). Conclusion: Genotoxicity was detected in the intestinal epithelial cells of the newly diagnosed celiac patients. Lymphocytes of these patients were more susceptible against stress and had low DNA repair capacity. Thus, DNA injury in celiac patients may contribute to the development of malignant diseases.
    Full-text · Article · Jan 2014 · Nobel medicus
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    ABSTRACT: Objective: A prospective study was carried out to determine the sensitivity and specificity of reflux symptoms and laryngeal findings to diagnose laryngopharyngeal reflux (LPR) and gastro-esophageal reflux (GER) in children with asthma by comparing the results of double probe pH monitorization and to determine the difference between controlled and uncontrolled asthma in terms of GER and LPR coexistence. Methods: A total of 50 patients (23 girls, mean age 10.8±0.4 years) with mild to moderate persistent asthma were included in this study. The patients were divided in two groups according to the asthma control status as controlled (n=27) vs. uncontrolled asthma (n=23). All patients completed the reflux symptom questionnaire and then they underwent flexible fiberoptic laryngoscopy and 24h double probe (pharyngeal and esophageal) pH monitorization. Laryngopharyngeal and gastroesophageal reflux were defined according to the double probe pH meter results. Results: The prevalences of LPR and GER were 70% and 46% in asthmatic patients, respectively. The reflux symptom score and LPR disease index were not useful to predict LPR or GER. There was no association between asthma control status and LPR and GER. Vocal nodule seems to be a valuable sign to evaluate LPR in asthmatic children. Conclusions: The reflux symptom score and LPR disease index do not seem reliable to diagnose LPR and GER in children with asthma. The frequency of LPR and GER are independent of asthma control, atopy and long acting beta agonist usage.
    No preview · Article · Dec 2012 · International journal of pediatric otorhinolaryngology

  • No preview · Article · Aug 2012 · Pediatric Nephrology
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    Full-text · Article · Aug 2012 · Pediatric Nephrology
  • Sule Paksu · Muhammet Sukru Paksu · Ayhan Gazi Kalayci · Recep Sancak
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    ABSTRACT: The combination of idiopathic pulmonary hemosiderosis (IPH) and celiac disease (CD) is rare. The clinical importance of this association is that a significant improvement can be obtained with gluten free diet not only in intestinal but also in pulmonary symptoms. A four and half-years old girl was admitted with complaints of cough, difficulty in breathing and paleness. She had intermittent episodes of abdominal pain and diarrhea. She had dyspnea and tachycardia, and oxygen saturation 88%. The patient was diagnosed with CD and concomitant IPH. With gluten-free diet and corticosteroid treatment, both intestinal and pulmonary symptoms were controlled.
    No preview · Article · Mar 2012 · Indian pediatrics
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    ABSTRACT: Objective: Peutz-Jeghers syndrome is a disease characterized by melanotic macules on the lips and the mucous membranes and polyposis in the gastrointestinal tractus. This condition which is known to be diagnosed around 20 years of age can appear with recurrent abdominal pain and cause more insidious symptoms as refractory iron deficiency anemia in early childhood. In this report, we aimed to share our experiences on the application complaints, diagnosis and therapeutic monitorization of our patients who were followed up with diagnosis of Peutz-Jeghers syndrome in childhood. Material and Methods: Admission complaints, clinical, laboratory, endoscopic and histopathological findings and data of monitorization of five patients with Peutz-Jeghers syndrome were evaluated. Results: Mean age of application to our hospital was 7.3 +/- 3 (2.5-10) years. First application complaints were abdominal pain in all of the patients(100%), acute abdomen in two patients (invagination) (40%) and anemia-pallor in three patients (60%). All of the patients had hyperpigmented maculee on the lips and a positive family history. Hamartomatous polyps were detected in jejunum (100%), stomach (80%), rectum (60%) and duodenum (20%). Conclusion: Questioning of family history in terms of polyposis and suggestion of Peutz-Jeghers Syndrome in differential diagnosis of children with refractory iron deficiency anemia and recurrent abdominal pain would be beneficial for the diagnosis and follow-up of these patients and the other family members with the disease.
    Full-text · Article · Jun 2011 · Turkiye Klinikleri Journal of Medical Sciences
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    ABSTRACT: Gastrointestinal involvement is common in Henoch-Schönlein purpura, whereas life-threatening gastrointestinal bleeding is very rare. A seven-year-old male patient who was diagnosed with Henoch-Schönlein purpura four days before admitted with rectal bleeding and impaired general well-being. Palpable purpuric rash on the lower extremities and a clinical picture of shock were observed during the physical examination. His first hemoglobin value was 17 g/dl. Intravenous fluid, erythrocyte suspension and methylprednisolone were administered. The patient's condition improved and he was discharged to continue follow-up as an outpatient. In the case of gastrointestinal system involvement, early administration of steroid therapy reduces the risk of complications and improves the clinical outcome. It is important to bear in mind that in the early stages of massive bleeding, fluid loss may be more evident than blood loss, so hemoconcentration may be observed; hence, vital findings deserve more attention than laboratory results.
    No preview · Article · Jan 2011 · Cocuk Sagligi ve Hastaliklari Dergisi
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    ABSTRACT: Myopathy is a rare complication of influenza infections. Here, we report on an eight-year-old girl with severe myopathy due to new pandemic influenza A (H1N1). She presented with severe myopathy following generalized tonic-clonic seizure and recovered completely within a few days.
    No preview · Article · Oct 2010 · Tropical Doctor
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    Gönül Dinler · Kenan Bek · Yonca Açikgöz · Ayhan Gazi Kalayci
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    ABSTRACT: Henoch-Schönlein purpura (HSP) is the most common small vessel vasculitis of childhood. It is characterized by nonthrombocytopenic palpable purpura, abdominal pain, arthritis, and glomerulonephritis. Although HSP is typically known to be self-limited, serious complications can occur. Acute pancreatitis rarely presents as a complication of HSP. It is even rarer as an initial presenting feature of HSP, before the occurrence of characteristic palpable purpura. Herein, we report a 12-year-old girl with HSP who atypically presented with acute pancreatitis.
    Preview · Article · Mar 2010 · The Turkish journal of pediatrics
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    Gönül Dinler · Erdal Atalay · Ayhan Gazi Kalayci
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    ABSTRACT: Celiac disease presents with a spectrum of clinical disorders. The variety of clinical presentations largely depends on age and extraintestinal findings. This study aimed to determine typical and atypical cases according to presenting symptoms and to evaluate their biochemical and pathological parameters. Eighty-seven patients with celiac disease in our unit between 2000 and 2007 were reviewed. Their diagnosis was made by serological and histological examination. The patients were divided into two groups according to their typical or atypical symptoms. The mean age of the patients at diagnosis was 8.2 years (range, 1-18 years), but patients presenting with typical symptoms were younger than those presenting with atypical symptoms. The patients in the two groups did not differ significantly in sex, weight and height Z scores except age. Diarrhea (96.3%), abdominal distention (65.4%) and failure to thrive (60%) were the most common clinical presentations in the typical group, and short stature (62.5%) and anemia (31.2%) were the most common in the atypical group. Total/subtotal villous atrophy was significantly higher in the typical group than in the atypical group. Many children with celiac disease show an atypical form. The understanding of presentations of celiac disease may prevent delayed diagnosis. Celiac disease should be specially investigated in patients with recurrent iron deficiency anemia, short stature and autoimmune disorders.
    Preview · Article · Nov 2009 · World Journal of Pediatrics
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    Gönül Dinler · Burak Tander · Ayhan Gazi Kalayci · Riza Rizalar
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    ABSTRACT: Plummer-Vinson syndrome presents as a classical triad of dysphagia, iron deficiency anemia and upper esophageal web(s). The syndrome usually occurs in adults, and is rare in childhood. We report a case of this syndrome occurring in a 15-year-old boy. He presented with dysphagia and anemia. Radiological examination showed the presence of webs at the cervical esophagus. The boy was treated with endoscopic balloon dilation and iron supplementation and remains in good general condition six months after the treatment.
    Full-text · Article · Jan 2009 · The Turkish journal of pediatrics
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    Gönül Dinler · Gülnar Sensoy · Deniz Helek · Ayhan Gazi Kalayci
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    ABSTRACT: To present our experience with tuberculous peritonitis treated in our hospital from 2002-2007. We reviewed the medical records of 9 children with tuberculous peritonitis. Nine patients (5 boys, 4 girls) of mean age 14.2 years were diagnosed with peritoneal tuberculosis. All patients presented with abdominal distention. Abdominal pain was seen in 55.5% and fever in 44.4% of the patients. Four cases had coexisting pleural effusion and two had pulmonary tuberculosis with parenchymal consolidation. Ultrasonography found ascites with septation in 7 patients. Two patients had only ascites without septation. Ascitic fluid analysis of 8 patients yielded serum-ascite albumin gradients of less than 1.1 gr/dL. Laparoscopy and laparotomy showed that whitish tuberculi were the most common appearance. Adhesions were also seen in three cases. The diagnosis of peritoneal tuberculosis was confirmed histo-pathologically in 7 patients and microbiologically in two. Two patients had been diagnosed by ascitic fluid diagnostic features and a positive response to antituberculous treatment. All patients completed the antituberculous therapy without any complications. Tuberculous peritonitis has to be clinically suspected in all patients with slowly progressive abdominal distension, particularly when it is accompanied by fever and pain. Laparoscopy and peritoneal biopsy are still the most reliable, quick and safe methods for the diagnosis of tuberculous peritonitis.
    Preview · Article · Jan 2009 · World Journal of Gastroenterology
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    Aysun Avşar · Ayhan Gazi Kalayci
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    ABSTRACT: The aim of this study was to investigate the presence and distribution of developmental enamel defects and caries in children with celiac disease (CD) and compare the results obtained with those of a control group of children without CD. A total of 64 subjects (mean age 8.2 years) selected from patients diagnosed and treated for CD were studied. Sixty-four age/ sex-matched healthy children were enrolled as a control group. Permanent dentition enamel defects were recorded according to Aine's classification. The caries experience of the children was recorded according to the criteria of the World Health Organization (WHO). The prevalence of enamel defect in CD subjects was found to be significantly higher (42.2%) than in healthy subjects (9.4%) (p < 0.001). Grade I type enamel defects were most commonly diagnosed in both groups (20.3% and 6.3%, respectively). The number of caries-free subjects in the control group was higher (38%) than in the CD group (17%). This study clearly showed that children with CD were at an increased risk of dental enamel defects compared with healthy subjects. Enamel defects were associated with an increased caries incidence.
    Preview · Article · Jan 2008 · The Turkish journal of pediatrics
  • Ayhan Kalayci · Burak Tander · Sule Kocak · Riza Rizalar · Ferit Bernay
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    ABSTRACT: In our country, safety pin ingestion by infants is commonplace. When swallowed, open safety pins are mostly found within the esophagus or stomach, and they cannot be easily removed by rigid esophagogastroscopy. Our aim was to evaluate the removal of safety pins using flexible endoscopy in infants. We evaluated the cases of 7 infants who had ingested open safety pins between 2001 and 2004. In all the patients, the primary diagnostic tool was a direct x-ray of the neck, chest, and abdomen. In all cases, the safety pins were removed by flexible esophagogastroduo-denoscopy. Clinical records for the cases were reviewed. Four of the open safety pins were lodged in the esophagus, two in the stomach, and one in the duodenum. One infant had a safety pin lodged in the esophagus with the pin's open end pointed caudally; the pin was held with the endoscopic forceps by its tail end and removed. Three safety pins in the esophagus had their open ends pointing cephalad; these were held by their tail ends using the endoscopic forceps and pushed into the stomach. Then they were rotated in the stomach and removed tail end first. The safety pins located in the stomach or duodenum were also removed similarly. All safety pins were successfully removed, and there were no operative complications. Open surgery or other invasive removal methods are not necessary in infants with open safety pin ingestions. In our opinion, the best way to extract an open safety pin from the esophagus, stomach, or duodenum is by using a flexible endoscopic device.
    No preview · Article · May 2007 · Journal of Laparoendoscopic & Advanced Surgical Techniques
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    ABSTRACT: To evaluate the efficacy of two regimens of combined interferon-alpha2a (IFN-alpha2a) and lamivudine (3TC) therapy in childhood chronic hepatitis B. A total of 177 patients received IFN-alpha2a, 9 million units (MU)/m2 for 6 months. In group I (112 patients, 8.7 +/- 3.5 years), 3TC (4 mg/kg/day, max 100 mg) was started simultaneously with IFN-alpha2a, in group II (65 patients, 9.6 +/- 3.8 years) 3TC was started 2 months prior to IFN-alpha2a. 3TC was continued for 6 months after antiHBe seroconversion or stopped at 24 months in nonresponders. Baseline alanine aminotransferase (ALT) was 134.2 +/- 34.1 and 147.0 +/- 45.3; histological activity index (HAI) was 7.4 +/- 2.7 and 7.1 +/- 2.3; and HBV DNA levels were above 2,000 pg/ml in 76% and 66% of patients in groups I and II, respectively (P > 0.005). Complete response was 55.3% and 27.6% in groups I and II, respectively (P < 0.01). AntiHBe seroconversion was higher and earlier, and HBV DNA clearance was earlier in group I (P < 0.05). HBsAg clearance was 12.5% and 4.6% and antiHBs seroconversion was 9.8% and 6.2% in groups I and II, respectively (P > 0.05). Breakthrough occurred in 17.9% and 24.6%; breakthrough times were 15.9 +/- 4.6 and 14.1 +/- 5.1 months; and relapse rates were 6.8% and none in groups I and II, respectively (P > 0.05, P > 0.05, P > 0.05). Responders had higher HAI (HAI > 6) and higher pre-treatment ALT than non-responders. Simultaneous 3TC+IFN-alpha2a yields a higher response and earlier antiHBe seroconversion and viral clearance than consecutive combined therapy. Relapse rate is low. Predictors of response are high basal ALT and high HAI scores. 3TC can be administered for 24 months without any side effect and breakthrough rate is comparable with previous studies.
    Full-text · Article · Feb 2006 · Antiviral therapy
  • Ayhan Gazi Kalayci · Yilmaz Kanber · Asuman Birinci · Levent Yildiz · Davut Albayrak
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    ABSTRACT: Iron deficiency anaemia is a frequent finding seen in coeliac disease, which can be diagnosed alone or with other findings. In this study, our aim was to determine the prevalence of coeliac disease in children with iron deficiency anaemia without significant gastrointestinal symptoms. There were 135 children with iron deficiency anaemia in the patient group (group 1), and 223 healthy children without iron deficiency anaemia in the control group (group 2) in this study. Antiendomysial antibody (EMA) IgA test was given to both groups. Antiendomysial antibody-positive patients underwent small intestine biopsy. The mean age was 7.2+/-4.6 (2-16) y in the patient group (group 1) and 8.2+/-3.8 (2-16) y in the control group (group 2), and no significant difference between the two groups was detected. In terms of gender, there was a significant difference between groups 1 and 2 (M/F: 74/61 and 98/125, respectively) ( p<0.05). EMA was positive in six cases in group 1 (4.4%), and villous atrophy and/or inflammation in the lamina propria with increased intraepithelial lymphocytes was seen on small intestine biopsy in these patients. In the control group, EMA was negative in all children. In detailed histories of patients with coeliac disease diagnosis, recurrent iron deficiency anaemia/pica was found in four patients (66.7%) and occasionally foul-smelling or watery stool attacks were seen in four patients (66.7%). Three of these six patients (50%) had short stature. The prevalence of coeliac disease was high in patients with iron deficiency anaemia; therefore, gastrointestinal findings should be further examined for coeliac disease, and the possibility of coeliac disease should be investigated in patients with recurrent iron deficiency anaemia and short stature.
    No preview · Article · Jun 2005 · Acta Paediatrica

Publication Stats

309 Citations
64.74 Total Impact Points

Institutions

  • 2015
    • Istanbul 29 Mayis University
      Ondokuzmayıs, Samsun, Turkey
  • 2009
    • Ondokuz Mayıs Üniversitesi
      Djanik, Samsun, Turkey
  • 2000
    • Ankara University
      • Department of Pediatric Gastroenterology
      Engüri, Ankara, Turkey