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Öğe Comparison of standard and standard plus vitamin E therapy for Helicobacter pylori eradications in children(Aves, 2014) Tumgor, Gokhan; Baran, Masallah; Cakir, Murat; Yuksekkaya, Hasan Ali; Aydogdu, SemaBackground/Aims: Although various drugs can be used in adults for Helicobacter pylori eradication in adults, treatment options are limited in children. The aim of this study was to compare the effects of the standard lansoprazole, amoxicillin, and clarithromycin (LAC) protocol to those of LAC + vitamin E (LACE) combination for H. pylori eradication. Materials and Methods: The study included 90 children (age range: 10-17 years) who were admitted to four pediatric gastroenterology centers between March 2011 and November 2012 with dyspeptic symptoms and who had tested positive for H. pylori by 14C-urea breath tests. The patients were randomized into two groups. The LAC group [45 patients (pts)] was treated with a standard regimen consisting of lansoprazole (1 mg/kg/day), amoxicillin (50 mg/kg/day), and clarithromycin (14 mg/kg/day), each of which was given in two equally divided doses every 12 h for 14 days; the LACE group (45 pts) was given the standard regimen and vitamin E at 200 IU/day for 14 days. H. pylori eradication was assessed using the 14C-UBT in the 6th week after the cessation of treatment. Results: H. pylori was eradicated in 21 (46.6%) pts in the LAC group, while it was eradicated in 29 (64.4%) pts in the LACE group. There was no statistical difference between the two groups (p=0.13). Conclusion: The eradication rate of H. pylori in children while using the LAC regimen has decreased in the last years. The LACE regimen has been associated with an increased eradication rate but can reach to statistically significance. Further studies with larger cohorts are needed to examine the success of the LACE regimen for H. pylori eradication.Öğe The Effect of Enteral Nutrition Support Rich in TGF-? in the Treatment of Inflammatory Bowel Disease in Childhood(Mdpi, 2019) Agin, Mehmet; Yucel, Aylin; Gumus, Meltem; Yuksekkaya, Hasan Ali; Tumgor, GokhanBackground and Objective: Malnutrition is a major complication of inflammatory bowel disease (IBD). Our aim of the study was to examine the effects of Modulen IBD supplementation, which was administered to IBD patients without limiting their daily diet in addition to medical treatment, on the clinical, laboratory, anthropometric values, and disease activities of these patients. Materials and Methods: Seventy three children with IBD were evaluated retrospectively. The cases were classified as those who had Crohn disease receiving (CD-M; n = 16) or not receiving Modulen IBD (CD; n = 19) and those who had ulcerative colitis receiving (UC-M; n = 13) or not receiving Modulen IBD (UC; n = 25). Disease activities, laboratory values, remission rates, and anthropometric measurements of the groups were compared. In addition to IBD treatment, Modulen IBD in which half of the daily calorie requirement was provided was given for eight weeks. Results: In the third month of treatment, 14 (88%) patients were in remission in CD-M group and eight (42%) patients were in remission in CD group. The height and weight z scores, which were low at the time of diagnosis, improved in the first week in CD-M group. Inflammatory parameters (UC) were significantly lower in the UC-M group compared to the UC group in first and third months. In the third month, eight (62%) patients in the UC-M group and four (16%) in the UC group were remitted clinically and in terms of laboratory values. Conclusions: TGF-beta-rich enteral nutrition support in children with IBD is an easy, effective, and reliable approach. It was shown that TGF-beta-rich enteral nutritional supplementation enabled the disease to enter the remission earlier, and contributed to the early recovery of weight and height scores.Öğe Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey(Frontiers Media Sa, 2023) Misirlioglu, Merve; Yildizdas, Dincer; Ekinci, Faruk; Ozgur Horoz, Ozden; Tumgor, Gokhan; Yontem, Ahmet; Talay, Mehmet NurIntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score.Öğe Inflammatory bowel disease in Turkish children(Zhejiang Univ Sch Medicine, 2015) Cakir, Murat; Unal, Fatih; Dinler, Gonul; Baran, Masallah; Yuksekkaya, Hasan Ali; Tumgor, Gokhan; Kasirga, ErhunThis study was undertaken to evaluate demographics, clinical manifestations, laboratory findings and outcomes of children with inflammatory bowel disease (IBD) in Turkey. 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. 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. 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.Öğe Ursodeoxycholic acid treatment for duodenogastric reflux in childhood(Kuwait Medical Assoc, 2021) Agin, Mehmet; Gumus, Meltem; Yucel, Aylin; Yuksekkaya, Hasan Ali; Aydogdu, Sema; Tumgor, GokhanObjective: The purpose of this study was to determine the clinical and histopathological features of duodenogastric reflux (DGR) in children and the effectiveness of ursodeoxycholic acid (UDCA) therapy. Design: Prospective Setting: Cukurova University Medical Faculty Pediatric Gastroenterology Clinic and Necmettin Erbakan University Medical Faculty Pediatric Gastroenterology Clinic, Adana and Konya, Turkey Subjects: One hundred and four children Intervention: One hundred and four patients with DGR were assessed in terms of their history, physical examination, endoscopy, histopathology and response to UDCA therapy. Main outcome measure: Positive results were obtained by administering UDCA treatment in addition to stomach drugs. Results: Eighty-two (79%) patients had previously used various antacids and proton pump inhibitors for dyspeptic symptoms. Gastritis was detected with upper gastrointestinal system endoscopy in all patients. Symptoms decreased by more than half or resolved completely in 97 patients (93%) at the 3-month follow-up interval. Conclusion: DGR should be considered in the etiology of patients with dyspeptic symptoms who fail to respond to antacid and proton pump inhibitor therapy. The majority of patients with DGR responded well to three months of UDCA therapy.
