Efficacy of a modified sequential therapy including bismuth subcitrate as first-line therapy to eradicate Helicobacter pylori in a Turkish population.

Background: Eradication rates of Helicobacter pylori with standard triple therapy are not satisfactory. Sequential therapy is an alternative method to overcome this problem.

Objectives: The aim of this study was to assess efficacy of a modified sequential therapy with the addition of a bismuth preparation, as first-line treatment in the eradication of H.

Indications, complications and long-term follow-up of patients undergoing percutaneous endoscopic gastrostomy: A retrospective study.

Introduction: Gastroenterology units have faced a major increase in referrals for PEG insertion over the last decade. For this reason we decided to review our PEG insertion procedures with regard to indications, complications and follow-up.

Materials And Methods: The indications, success of procedure, complications, long-term results of PEG in patients of Gulhane Military Medical Academy, Haydarpasa Training Hospital between October 2002 and April 2009 were retrospectively evaluated.

Plasma ghrelin levels in patients with familial Mediterranean fever.

Background: Familial Mediterranean fever (FMF) is an auto-inflammatory disorder characterized by febrile attacks. Increased acute-phase reactants are characteristic during febrile attacks. Ghrelin is a natural G-protein that decreases secretion of pro-inflammatory cytokines and acts as anti-inflammatory agent.

Determination of the frequency of dyssynergic defecation and patient characteristics in patients with functional constipation.

Background/aims: Dyssynergic defecation, a subgroup of functional constipation, is a relatively new definition, diagnostic criteria of which have recently been described. Distribution of subgroups of functional constipation in our population is scarcely known. We aimed to evaluate the demographic characteristics and defecation features of patients as we determined the frequency of dyssynergic defecation in patients with functional constipation in our community.

Benign recurrent intrahepatic cholestasis: late initial diagnosis in adulthood.

Benign recurrent intrahepatic cholestasis (BRIC) is a rare autosomal recessive or sporadic disorder, characterized by recurrent episodes of intense pruritus and jaundice that resolve spontaneously without leaving considerable liver damage. The attacks can start at any age, but the first attack is usually seen before the second decade of life. We report the case of a young adult male patient with BRIC who presented with recurrent cholestatic jaundice and pruritus with negative work up for all possible etiologies and a liver biopsy consistent with intrahepatic cholestasis.

Comparison of the effects of intravenous midazolam alone and in combination with meperidine on hemodynamic and respiratory responses and on patient compliance during upper gastrointestinal endoscopy: a randomized, double-blind trial.

Background/aims: We examined hemodynamic responses during gastroscopy in healthy subjects and compared the changes with midazolam alone versus in combination with meperidine. The aim of this study was to evaluate if either method had any advantages or disadvantages with respect to patient compliance and the commonly seen side effects.

Methods: Thirty patients who were otherwise healthy were included in each group.

Comparison of three different second-line quadruple therapies including bismuth subcitrate in Turkish patients with non-ulcer dyspepsia who failed to eradicate Helicobacter pylori with a 14-day standard first-line therapy.

Background And Aim: Many studies have reported poor results with standard first-line treatment for Helicobacter pylori. Second-line regimens that may overcome bacterial resistance can minimize side-effects and optimize compliance. The aim of this study was to evaluate the efficacy of proton pump inhibitor (PPI) and bismuth subcitrate-based quadruple therapy, after failure of a PPI plus clarithromycin and amoxicillin as first-line therapy.

Urinary glycosaminoglycan levels as a marker of renal amyloidosis in patients with familial Mediterranean fever.

Introduction And Aim: Familial Mediterranean Fever (FMF) is an autosomal recessive disease with a defect in the pyrine gene and is manifested with short attacks of inflammatory serositis, fever, and erysipelas-like skin lesions. Secondary amyloidosis is the most serious complication of the disease, in which extracellular deposits of amyloid (an amorphous and eosinophilic protein) are seen in tissues. Glycosaminoglycans are mucopolysaccharide molecules that take place in amyloid deposits with fibrillar links to amyloid.

A case of dyskeratosis congenita with portal hypertension associated with jugular venous anomaly.

Dyskeratosis congenita is an unusual inherited disease characterized by the triad of abnormal skin pigmentation, nail dystrophy and mucosal leukoplakia. Bone marrow failure and various abnormalities including genitourinary, pulmonary, skeletal, neurological, ophthalmic, dental and gastrointestinal have been reported. Portal hypertension is an extremely rare manifestation.

Elevated carbohydrate antigen 19-9 levels in a patient with choledocholithiasis.

Carbohydrate antigen 19-9 (CA19-9) has been used as a tumor marker in the diagnosis and differentiation of pancreatic cancers. However, significantly high levels of CA 19-9 in the absence of pancreatic malignancy have also been reported. We present a 50-year-old woman with a common bile duct stone and cholangitis, whose CA 19-9 level of 1.

Does eradication of Helicobacter pylori infection reduce hypergastrinema during long term therapy with proton pump inhibitors?

Background/aims: Proton pump inhibitors and Helicobacter pylori infection are the major cause of hypergastrinemia. In this study the effect of eradication therapy on blood gastrin levels in patients using long term proton pump inhibitors was evaluated.

Methods: Twenty-seven Helicobacter pylori (positive) patients were included in the study, of whom 20 were given eradication treatment for seven days consisting of ranitidine bismuth citrate, clarithromycin and amoxicillin (eradication therapy group) and seven were given symptomatic therapy (symptomatic therapy group).

Effect of N-acetyl cysteine on Helicobacter pylori.

Background: Use of mucolytic agents that result in reduced mucous viscosity of the gastric mucous has been suggested to have an additive effect in curing Helicobacter pylori infection.

Methods: Seventy Hpylori-positive patients were given either eradication treatment consisting of 500 mg clarithromycin bid and 30 mg lansoprazole bid for 10 days plus 10 mL (400 mg) N-acetyl cysteine (NAC) liquid tid (AC group) or eradication treatment only (control group). The results were compared 1 month after the completion of the treatment.

Leptin levels in the acute stage of ulcerative colitis.

Background And Aims: Leptin, a recently discovered protein, acts as a hormonal feedback signal in regulating adipose tissue mass via hypothalamic mechanisms. Inflammatory bowel disease is often associated with anorexia and weight loss. The aim of the present study was to investigate serum leptin levels during the time course of the acute phase of ulcerative colitis (UC) and to evaluate whether leptin leads to anorexia and bodyweight loss in these patients.

Gallbladder and gastric motility in patients with idiopathic slow-transit constipation.

Objective: Idiopathic slow-transit constipation (STC) has been suggested to be a pangastrointestinal motility disorder. We investigated scintigraphically whether motility in the gallbladder and stomach was impaired in slow-transit constipation.

Methods: Twenty-four patients with STC were studied.

Is hyperbilirubinemia a component or just a coincidence of familial mediterranean fever: a case report and review of the literature.

Familial Mediterranean fever is a multisystem disorder, usually seen in subjects of Mediterranean and Middle Eastern origin, characterized by recurrent bouts of fever and pain due to inflammation of the peritoneum, synovia, or pleura. In this article we report a case of Familial Mediterranean fever with recurrent abdominal pain and hyperbilirubinemia, review the literature and discuss whether the hyperbilirubinemia is co-existant or a feature of the disease.

Value of regional cerebral blood flow in the evaluation of chronic liver disease and subclinical hepatic encephalopathy.

Aims: Regional changes in cerebral blood flow in patients with chronic hepatitis, cirrhosis and subclinical hepatic encephalopathy were investigated in the present study using single photon emission computed tomography (SPECT).

Methods: Twenty patients with cirrhosis, 11 patients with chronic hepatitis, and nine healthy controls were included in the study. Cerebral SPECT were obtained for all patients.

Does N-acetyl cystein affect the sensitivity and specificity of Helicobacter pylori stool antigen test?

Background: N-acetyl cystein, a mucolytic agent, might make Helicobacter pylori antigens shed more easily to stool, and might therefore contribute to the diagnostic accuracy of the Helicobacter pylori stool antigen test. The aim of this study is to investigate if N-acetyl cystein contributes to the diagnostic accuracy of the Helicobacter pylori stool antigen test by increasing the sensitivity and specificity of the test.

Materials And Methods: 107 patients were separated into treatment and placebo groups.

Oral colonization of Helicobacter pylori: risk factors and response to eradication therapy.

Background: Dental plaque is considered by some to be a secondary reservoir for Helicobacter pylori and thus responsible for gastric reinfection. The aim of this study was to investigate whether testing dental plaque using a rapid urease test (CLOtest) can be used to determine gastric H. pylori status.

Impact of imprint cytology in detecting short segment Barrett's esophagus.

Background: Short-segment Barrett's esophagus (SSBE) is defined by the presence of columnar-appearing mucosa in distal esophagus (involving less than 2 to 3 cm), with intestinal metaplasia on biopsy. Its potential to develop dysplasia and cancer may require a surveillance program with better diagnostic tools to detect intestinal metaplasia.

Goals: To investigate the role of imprint cytology as a diagnostic tool either alone or combined with histology in SSBE.