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    A Comparison of Five Different Treatment Regimens as the First-Line Treatment of Helicobacter pylori in Turkey
    (Wiley, 2016) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Gokturk, Huseyin Savas; Karakoca, Aydin; Erinanc, Ozgur Hilal
    BackgroundThe H. pylori eradication success is low in countries with high antibiotic resistance to H. pylori. ObjectiveWe retrospectively assessed the eradication rates achieved by five different regimens and aimed to compare the efficiency of bismuth enhanced sequential therapy and other treatments in a gastroenterology outpatient clinic a university-affiliated hospital. DesignOur study was carried out with a retrospective cohort design. SettingThis study assessed the gastroscopy examinations of patients. PatientsA total of 621 patients were included in the study. There were 122 patients in the quadruple treatment group, 168 patients in the classical sequential treatment group, 130 patients in the bismuth enhanced sequential therapy, 113 patients in the sequential treatment with levofloxacin, and 88 patients in the hybrid treatment. MeasurementsEradication rates of different regimens was analyzed by performing Chi-square and Tukey's honest significant difference test. ResultsEradication rates by ITT and PP analysis achieved by treatment groups were 74.6 and 75.6% in the quadruple treatment; 70.2 and 70.4% in the sequential treatment with clarithromycin, 88.5 and 90.3% in the bismuth enhanced sequential therapy, 77.9 and 78.5% in the sequential treatment with levofloxacin, and 76.1 and 76.2% in the hybrid treatment. LimitationsThe main limitation of our study was its retrospective nature. Different proton pump inhibitors were used in the treatment arms. ConclusionsBismuth-enhanced sequential therapy can be recommended to overcome resistance.
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    A comparison of the parameter estimation methods for bimodal mixture Weibull distribution with complete data
    (Taylor & Francis Ltd, 2015) Karakoca, Aydin; Erisoglu, Ulku; Erisoglu, Murat
    Bimodal mixture Weibull distribution being a special case of mixture Weibull distribution has been used recently as a suitable model for heterogeneous data sets in many practical applications. The bimodal mixture Weibull term represents a mixture of two Weibull distributions. Although many estimation methods have been proposed for the bimodal mixture Weibull distribution, there is not a comprehensive comparison. This paper presents a detailed comparison of five kinds of numerical methods, such as maximum likelihood estimation, least-squares method, method of moments, method of logarithmic moments and percentile method (PM) in terms of several criteria by simulation study. Also parameter estimation methods are applied to real data.
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    Conscious sedation : clues for diagnosing obstructive sleep apnea syndrome
    (Univ Catholique Louvain-Ucl, 2016) Unler, Gulhan Kanat; Gokturk, Huseyin Savas; Dogan, Rusina; Kivanc, Tulay; Karakoca, Aydin
    Background and aims: The use of anesthetic agents for endoscopic sedation has recently increased. However, sedation introduces additional risks in patients with obstructive sleep apnea syndrome (OSAS). The presence of sleep apnea is not often enough questioned in clinical practice. The purpose of this study was to determine whether patients with sedation-induced snoring and decreased arterial oxygen saturation during gastroscopy are more likely to have OSAS. Methods: This study considered 600 consecutive patients undergoing elective outpatient upper gastrointestinal endoscopy under conscious sedation for evaluation of dyspepsia. Ten patients with observed snoring and decreased arterial saturation during the gastroscopy procedure were enrolled in the study. The control group was comprised of 13 patients matched by sex, age, and body mass index (BMI) who did not snore and had a more stable oxygen saturation under conscious sedation during an elective outpatient gastroscopy for the evaluation of dyspepsia and were selected using a computer-generated randomized sequence. Patients were monitored and an overnight polysomnography was performed in the study group. Statistically significant differences between groups were assessed using the nonparametric Wilcoxon and independent-samples t-tests. Results: There was no significant difference in age or BMI between the two groups (p>0,05) Mean minimum oxygen saturation was significantly different between the two groups (p=0.011). In the study group, 7 patients were found to have moderate OSAS necessitating a continuous positive airway pressure device. Conclusion: Patients with hypoxia and snoring, under conscious sedation are more likely to have OSAS. Out-of-operating-room sedoanalgesia is therefore critical.