Papers by ferda harmandar
Non-Hodgkin lenfomalı (NHL) 114 hastamızın klinik özellikleri, histopatolojik tipleri, tedavileri... more Non-Hodgkin lenfomalı (NHL) 114 hastamızın klinik özellikleri, histopatolojik tipleri, tedavileri ve yanıtları, ve sağkalım analizi değerlendirildi. Tanıda Cotswold'a göre %10'u evre I, %14'ü evre II, %30'u evre III ve %46'sı evre IV'tü. Olguların 101'ine (%89) tedavi uygulandı. 57 ...
PubMed, Mar 31, 2009
Cranial neuropathy is an uncommon manifestation of relapsing polychondritis (RPC). Optic neuropat... more Cranial neuropathy is an uncommon manifestation of relapsing polychondritis (RPC). Optic neuropathy is the most common type of cranial nerve involvement in RPC. Until now, trigeminal neuralgia (TN) has been reported with different rheumatic diseases, however, there is no reported case of TN associated with RPC. We here present a case of RPC with TN. A 57 year-old female patient previously diagnosed with rheumatoid arthritis (RA) and RPC presented us with polyarthritis, auricular and nasal chondritis, and TN. Cranial MRI and MRI angiography of the brain did not show any pathology. The patient partially responded to RA therapy; and carbamazepine and etanercept were administered. RA-related joint findings, her chondritis and TN symptoms improved completely with etanercept. We presume that the TN was caused by compression of the trigeminal nerve from inflammation or ischemia secondary to vasculitis.
PubMed, Jan 25, 2018
Hypertriglyceridemia is one of the rare causes of the acute pancreatitis. The prevalance of hyper... more Hypertriglyceridemia is one of the rare causes of the acute pancreatitis. The prevalance of hypertriglyceridemia has increased recently due to the changing eating habits, sedentary lifestyle, alcohol consumption, obesity and concomitant diabetes mellitus. Therefore, the frequency of the acute pancreatitis due to hypertriglyceridemia may increase in coming years. Diagnosis of the acute pancreatitis by hypertriglyceridemia can be overlooked easily and may be very severe if untreated accurately on time. In addition to the standard management of pancreatitis, specific treatment for hypertriglyceridemia that is insulin, heparin and anti-hypertriglyceridemic drugs are used. Therapeutic plasmapheresis is the last treatment option and seems the most effective one in this subject through developing device and membrane technologies when we review the current literature. Not only triglycerides but also proinflammatory cytokines and adhesion molecules that play an active role in pathogenesis are removed by plasmapheresis. So, the effectiveness of treatment appears promising. However, the exact pathophysiology of hypertriglyceridemia-induced pancreatitis could not be fully understood and the majority of published experience comes from the case reports and the benefit of randomized clinical trials is not available. Therefore, there are no data about what are the exact indications and when we start therapeutic plasmapheresis in literature. This manuscript describes our hospital experience with treatment options and analyzes reports published recently about plasmapheresis as a treatment modality for hypertriglyceridemia induced acute pancreatitis.
PubMed, Sep 1, 2006
Aim: To evaluate leptin and resistin levels in patients with various hematologic malignancies. Me... more Aim: To evaluate leptin and resistin levels in patients with various hematologic malignancies. Methods: We included 21 patients with lymphoma, 14 with multiple myeloma (MM), 14 with acute leukemia, 13 with chronic lymphocytic leukemia (CLL), and 25 healthy control subjects into our study. The subjects' body mass indexes (BMI) were calculated; hematological and acute phase response parameters, serum lipid were determined; serum leptin and resistin levels were determined by ELISA. Results: Serum leptin level was significantly increased in CLL and MM groups when compared to the control group (p less, similar 0.01). Resistin level was significantly higher in lymphoma patients than in CLL, acute leukemia and control groups (p less, similar 0.01). In the control group, leptin level was negatively correlated with hemoglobin level (r = -0.44, p = 0.047); and in all patients with hematologic malignancies, leptin level was correlated with BMI (r = 0.32, p = 0.02). Leptin in lymphoma subjects correlated with hemoglobin level (r = 0.64, p = 0.005), resistin level correlated with the platelet count in patients with hematologic malignancies (r = 0.26, p = 0.044). In addition, leptin level had negative correlations with international prognostic score (IPS) in Hodgkin lymphoma (r = -0.9, p = 0.002) and with international prognostic index (IPI) in non-Hodgkin lymphoma (r = -0.77, p = 0.03). In CLL patients, leptin level had a correlation with the poor prognostic marker - CD38 level (r = 0.68, p = 0.03). Conclusion: We found higher leptin levels in MM and CLL patients, and higher resistin levels in lymphoma patients: this fact demonstrates that changes in adipose tissue and metabolism occur in these disease states.
Gastroenterology Nursing, Apr 11, 2023
Endoskopi, Jan 2, 2017
kanserlerin yaklaşık %50'sinin kardiya ya da fundus kaynaklı olduğu bildirilmiştir (3). Çalışmala... more kanserlerin yaklaşık %50'sinin kardiya ya da fundus kaynaklı olduğu bildirilmiştir (3). Çalışmalarda PGK'nın distal gastrik kansere (DGK) göre daha kötü prognoza sahip olduğu gösterilmiş ve bu durum PGK'nin farklı klinik ve biyolojik davranış göstermesine bağlanmıştır (4). Özellikle obezitenin (3,5) ve sigara kullanımının (6,7) GİRİŞ Mide kanseri kanser nedenli ölümler arasında ikinci sıradadır. Gelişmiş ülkelerde son yıllarda sıklığı azalma eğilimi gösterse de gelişmekte olan ülkelerde ve mide kanserinin endemik olduğu ülkelerde görülme sıklığı artmaktadır. Son 30 yılda yapılan bir çok çalışmada proksimal gastrik kanser (PGK) insidansında artış olduğu bildirilmiştir (1,2). Amerikan ulusal kanser verileri de bu durumu destekler niteliktedir ve gastrik Background and Aims: Gastric cancer is the second most common cancer-related cause of death throughout the world. It is reported that in recent years, proximal gastric cancer cases have increased, and distal gastric cancer cases have decreased in western countries. We searched for the newly-diagnosed gastric cancer cases between 2010 and 2015 in order to determine the localization, pathology, and age status of the patients. Materials and Methods: Gastric cancer cases diagnosed between 2010 and 2015 in the Antalya Training and Research Hospital and the Ankara Güven Hospital were retrospectively evaluated. A total of 203 patients were included in the study. The patients were divided into two groups according to the year of diagnosis, the first group being diagnosed between 2010 and 2013 and the second one, between 2013 and 2016. These two groups were compared according to the localization and pathology of the tumor and the age of the patients. Results: From the total, 126 (62.1%) patients were male, and 77 (37.9%) were female. There was no statistically significant difference between the mean age of the male and female patients (p > 0.05). A total of 203 patients were studied and 68 (33.5%) were diagnosed as having proximal and 135 (66.5%) as having distal gastric cancer.[Editor1][J2] Proximal gastric cancer cases were more frequent in the second group, but this was not statistically significant. The age and sex showed no difference according to the localization of the gastric cancer (p > 0.05). 154 (75%) adenocancer, 25 (12%) carcinoid tumor, 15 (8%) lymphoma, and 9 (5%) stromal tumor cases were detected. Carcinoid tumor cases were more frequent in the second group, but this was not statistically significant. The age and sex showed no difference according to the pathological type of the gastric cancer (p > 0.05). The rate of stomach cancer under the age of 45 constituted 13.5% of all of the patients. Conclusion: Gastric cancer is mostly seen in the corpus, then in the antrum, and least in the cardia. Our results are inconsistent with the recent studies showing a proximal gastric cancer dominancy, but we showed an upward trend for the proximal gastric cancer. The age limit for an endoscopy in dispeptic patients should be revised because of an increase in the young, even in their 20s, patients with gastric cancer.
American Journal of Medical Case Reports, Apr 27, 2016
Eosinophilic colitis is a rare condition and very uncommonly it presents with acute surgical emer... more Eosinophilic colitis is a rare condition and very uncommonly it presents with acute surgical emergency such as haemorrhage and peritonitis. We describe a rare presentation of eosinophilic colitis with severe haemorrhage and abdominal pain with ischemic bowel.
Turkiye Klinikleri Gastroenterohepatology - Special Topics, 2012
Nigerian Journal of Clinical Practice, 2017
Background and Aim: Most of the studies about sequential therapy that have been reported from Tur... more Background and Aim: Most of the studies about sequential therapy that have been reported from Turkey were levofloxacin based. We aimed to compare the Helicobacter pylori (H. pylori) eradication rates of standard triple, sequential and quadruple therapies including claritromycin regimes in this study. Materials and Methods: A total of 160 patients with dyspeptic symptoms were enrolled to the study. The patients were randomized to four groups of treatment protocols. And 40 patients received standard triple therapy for 2 weeks, 40 patients received bismuth containing quadruple therapy for 2 weeks, 40 patients received 5 + 5 clarithromycin-based sequential therapy, and 40 patients received 7 + 7 clarithromycin-based sequential therapy. H. pylori eradication was assessed by C 14 urea breath test 4 weeks after therapy. Results: Out of 160 patients with H. pylori infection, 131 (81.9%) were eradicated successfully and 29 (18.1%) failed to eradicate H. pylori infection. H. pylori eradication was achieved in 28 of 40 patients receiving standard triple therapy (70%), in 33 of 40 patients receiving quadruple therapy (82.5%), in 37 of 40 patients receiving 5 + 5 sequential therapy (92.5%), and in 33 of 40 patients receiving 7 + 7 sequential therapy (82. 5%). Statistics revealed that 5 + 5 sequential therapy led to significantly higher H. pylori eradication rates compared with that of standard triple therapy (P = 0.019). There was no statically difference between 5 + 5 sequential therapy and the other therapy groups' eradication rates, but it was higher than all of the protocols. H. pylori eradication rate with sequential therapy in our patients with nonulcer dyspepsia was higher than those of patients with standard therapy (93% versus 82%, respectively, P>0.05). Conclusion: 5 + 5 sequential therapy was associated with significantly higher eradication rate of H. pylori compared with standard triple therapy in our study cohort.
PubMed, Jan 16, 2019
Objective: To evaluate the utility of B-mode gray-scale histogram analysis in the management of p... more Objective: To evaluate the utility of B-mode gray-scale histogram analysis in the management of patients with infected cirrhotic ascites. Methods: A total of 97 patients (mean(SD) age : 66.8(14.2) years, 50.5% were males) diagnosed with cirrhotic ascites were included in this non-interventional study. Paracentesis for ascitic fluid analysis [culture tests, white blood cell count, albumin and protein levels, serum ascites albumin gradient (SAAG)] and gray-scale histogram analysis for ascites/subcutaneous echogenicity ratio (ASER) were performed at baseline in each patient and on Day 2 and Day 5 of treatment in patients with infected ascites. Receiver operating characteristics (ROC) curve was plotted to determine performance of ASER in identification of antibiotic resistance with calculation of area under curve (AUC) and ideal cut-off value of % change in ASER to detect antibiotic resistance. Results: Treatment was associated with a significant decrease in median (min-max) ASER [from 0.005(0.0002-0.02) at baseline to 0.003(0.0001-0.01) on Day 2 and 0.0005(0.0001-0.009) on Day 5] and ascitic fluid polymorphonuclear leukocyte (PMNL) count [from 600(300-2200) at baseline to 350(50-1250) on Day 2 and 100(50-1100) on Day 5] (p<0.001 for each). ROC analysis revealed that less than 38% reduction in ASER [AUC: 0.923, 95% CI (0.797-0.982), p<0.001] was a potential marker of antibiotic resistance with a sensitivity of 90.9% and a specificity of 95.0%. Conclusions: In conclusion, our findings emphasize potential utility of gray-scale histogram based quantitative analysis of ascitic fluid echogenicity as an adjunct non-invasive method in the assessment of treatment response and early recognition of treatment failure in patients with infected ascites.
Digestive Diseases, 2022
Introduction: There is limited research about HBV reactivation (HBVr) due to direct-acting antivi... more 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....
Turkiye Klinikleri Journal of Gastroenterohepatology Special Topics, 2012
World Journal of Gastroenterology, 2013
Even experienced endoscopists have 90% success in achieving deep biliary cannulation with standar... more Even experienced endoscopists have 90% success in achieving deep biliary cannulation with standard methods. Biliary cannulation may become difficult in 10%-15% of patients with biliary obstruction and precut (access) sphincterotomy is frequently chosen as a rescue treatment in these cases. Generally, precut sphincterotomy ensures a rate of 90%-100% successful deep biliary cannulation. The precut technique has been performed as either a fistulotomy with a needle knife sphincterotome or as a transpapillary septotomy with a standard sphincterotome. Both methods have similar efficacy and complication rates when administered to the proper patient. Although precut sphincterotomy ensures over 90% success of biliary cannulation, it has been characterized as an independent risk factor for pancreatitis. The complications of the precut technique are not limited to pancreatitis. Two more important ones, bleeding and perforation, are also reported in some publications as being observed more commonly than during standard sphincterotomy. It is also reported that precut sphincterotomy increases morbidity when performed in patients without dilatation of their biliary tract. Nevertheless, precut sphincterotomy is a good alternative as a rescue method in the setting of a failed standard cannulation method. This paper discusses the technical details, timing, efficacy and potential complications of precut sphincterotomy.
Oncology Research and Treatment, 2006
In testicular germ cell tumors (GCT), bone metastases are usually seen late in the disease progre... more In testicular germ cell tumors (GCT), bone metastases are usually seen late in the disease progress and are almost always associated with involvement of other sites. However, isolated bone metastasis is an extremely rare finding in these patients. A 43- year-old man was admitted to the neurosurgery department of our hospital suffering from dysarthria, ataxia, headaches and a progressive swelling above the parietooccipital region of the skull. Radiological, biochemical and pathologic tests showed that the lesion of the skull was an isolated skull metastasis as an initial manifestation of nonseminomatous GCT of the testis. When a young patient presents with bone pain or painless swelling, even if it is an unusual site and isolated, testicular GCT should be considered as a differential diagnosis, as these lesions could be the first evidence of metastatic GCT.
Endoscopy, 2014
An 81-year-old man who had had a percutaneous endoscopic gastrostomy (PEG) tube for 8 years was r... more An 81-year-old man who had had a percutaneous endoscopic gastrostomy (PEG) tube for 8 years was referred with buried bumper syndrome (BBS) (• " Fig. 1). His main complaint was of tube occlusion and his physical examination was normal. The internal orifice of the gastrocutaneous fistula was initially unidentifiable.
Mediators of Inflammation, 2010
Introduction. Microbial pathogens, one of them isHelicobacter pylori(H. pylori), have frequently ... more Introduction. Microbial pathogens, one of them isHelicobacter pylori(H. pylori), have frequently been implicated in the atherogenesis. Endothelium-derived nitric oxide (NO) is synthesized from L-arginine by nitric oxide synthase (NOS) and plays a pivotal role in the regulation of vascular tone. Asymmetric dimethylarginine (ADMA) is the most potent endogenous NOS inhibitor. Elevated levels of ADMA have been reported in many circumstances associated with a high cardiovascular risk. The aim of the present study was to investigate whether the eradication ofH. pyloriinfection affects serum ADMA levels.Materials and Methods. Forty-twoH. pylori-positive patients were enrolled in the study. Triple therapy for 14 days were given to all patients. Serum ADMA levels were measured at baseline and 2 months after therapy.Results. Eradication was achieved in 34 (81%) patients. The mean serum ADMA levels before and after therapy were and ng/mL in the group withH. pylorieradicated and and ng/mL in ...
DergiPark (Istanbul University), Dec 1, 2010
Peptik ülser ve kronik atrofik gastritin en önemli nedeni olan Helikobakter pilori (H. pilori) in... more Peptik ülser ve kronik atrofik gastritin en önemli nedeni olan Helikobakter pilori (H. pilori) infeksiyonunun, bunla-r›n d›fl›nda fonksiyonel gastrointestinal sistem hastal›kla-r›na hatta di¤er sistemlere ait hastal›klara da yol açabile-ce¤i ileri sürülmektedir. Yap›lan bir çok çal›flmada infeksiyon s›kl›¤› non-ülser dispepsili olgularda kontrol gruplar›na göre daha s›k olarak rapor edilmesine ra¤men bakterinin fonksiyonel dispepsideki rolü hala aç›klanamam›flt›r (1). Nitekim bu olgularda uygulanan eradikasyon tedavisi ile sadece %9'unda dispepsi flikayetlerinin geriledi¤i belirtilmektedir (2-4).
The Turkish journal of gastroenterology, Dec 12, 2019
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Papers by ferda harmandar