Publications by authors named "Tolga Düzenli"

22 Publications

  • Page 1 of 1

A rare cause of abdominal pain: Mesenteric panniculitis.

North Clin Istanb 2021 25;8(2):186. Epub 2021 Feb 25.

Department of Gastroenterology, Hitit University Erol Olcok Training and Research Hospital, Corum, Turkey.

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http://dx.doi.org/10.14744/nci.2020.84704DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8039101PMC
February 2021

Associations between Gilbert's syndrome and personality characteristics.

Trends Psychiatry Psychother 2021 Apr 2. Epub 2021 Apr 2.

Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

Objective: Gilbert's syndrome (GS) is a benign genetic disorder that is characterized by intermittent mild jaundice in which the liver doesn't process bilirubin properly. The aim of this study was to determine whether GS patients have a different personality structure and if there are associations between properties of temperament and character and total bilirubin levels.

Methods: A total of 1665 young male individuals aged from 19 to 30 who were admitted for occupational examinations were included in this study. Careful patient history was taken, a detailed physical examination was conducted, and hematologic and biochemical tests and abdominal ultrasonography were performed. The Turkish version of the Temperament and Character Inventory (TCI) was administered to all participants. 81 patients diagnosed with GS and 150 randomly chosen healthy individuals (control group) were investigated with comparison and correlation analyses.

Results: GS patients had higher scores than healthy controls for disorderliness (NS4) (p = 0.018), sentimentality (RD1) (p = 0.042), and fatigability (HA4) (p = 0.03). Moreover, Gilbert syndrome patients scored lower than controls for empathy (C2) (p = 0.041) and transpersonal identification (ST2) (p = 0.044). Bilirubin levels were positively associated with disorderliness (NS4) (r = 0.141, p = 0.032) and fatigability (HA4) (r = 0.14, p = 0.033).

Conclusions: GS patients may have some different personality characteristics from healthy individuals. This study is an initial exploration of the personality structure of GS patients and the findings should be interpreted with caution. Further prospective studies are needed to identify the relationship between Gilbert disease and personality characteristics.
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http://dx.doi.org/10.47626/2237-6089-2020-0003DOI Listing
April 2021

Endoscopic Retrograde Cholangiopancreatography During the COVID-19 Pandemic: Effects of Enhanced Personal Protective Equipment.

Dig Dis Sci 2021 Mar 23. Epub 2021 Mar 23.

Department of Gastroenterology, Hitit University Erol Olcok Training and Research Hospital, Corum, Turkey.

Background And Aims: Personal protective equipment (PPE) decreases the risk of disease contagion, and because of the COVID-19 pandemic, enhanced PPE (EPPE) is widely used during endoscopic procedures including endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to investigate the effects of EPPE on ERCP success parameters compared to standard PPE (SPPE).

Methods: ERCP procedures were evaluated retrospectively and ERCP outcomes were compared for similar time periods as before and after the COVID-19 pandemic. Primary outcomes were cannulation time, number of cannulation attempts, cannulation success rate, difficult cannulation rate, undesired pancreatic duct cannulation rate, ERCP-related adverse events, and length of hospital stay.

Results: Three hundred and eighty ERCP procedures were examined. One hundred and fifty-nine procedures were excluded due to missing data, previous sphincterotomy or altered anatomy. Of the final eligible sample size of 221 ERCPs, 93 were performed using SPPE and 128 were performed under EPPE. Indications of ERCP and demographic parameters were similar between groups. The majority of the ERCP cases included were for benign biliary obstruction of common bile duct stones (88.7%). No significant differences were detected in overall technical success (91.4% vs 92.2%, p = 0.832), cannulation success rates (94.6% vs 96.8%, p = 0.403), cannulation times (median times of both groups were 3 min, p = 0.824), difficult cannulation rates (37.6% vs 33.6%, p = 0.523), undesired pancreatic duct cannulation rates (29% vs 22.7%, p = 0.593), number of cannulation attempts (2.80 vs 2.71, p = 0.731), ERCP-related adverse events (9.7% vs 10.9%, p = 0.762), and length of hospital stay (6.63 vs 6.92 days, p = 0.768) between SPPE and EPPE groups, respectively.

Conclusion: Biliary obstructions of common bile duct stones were the major indication of ERCP in the current study. The use of EPPE had no negative effects on ERCP performance in this patient group. ERCP can be effectively performed under EPPE.
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http://dx.doi.org/10.1007/s10620-021-06940-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7985571PMC
March 2021

A very uncommon clinical entity: Lansoprazole-induced symptomatic hyponatremia in a young woman.

Turk J Gastroenterol 2020 Dec;31(12):957-959

Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

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http://dx.doi.org/10.5152/tjg.2020.19374DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7928252PMC
December 2020

Physician awareness of hepatitis C virus among different departments.

Clin Exp Hepatol 2020 Dec 30;6(4):354-358. Epub 2020 Dec 30.

Department of Gastroenterology, Hitit University Erol Olcok Training and Research Hospital, Merkez/Çorum, Turkey.

Aim Of The Study: To determine the anti-hepatitis C virus (HCV) positivity in our region and to evaluate physician awareness of HCV among different inpatient and outpatient departments in a tertiary reference center in Turkey.

Material And Methods: This retrospective study was conducted between January 2017 and January 2020. The patients tested for anti-HCV for any reason were enrolled from the data of all patients admitted to our hospital, which is the reference center of the region.

Results: A total of 121,492 anti-HCV assays were screened from the computerized database. Total number of patients with a positive anti-HCV result was 891 (0.81%). HCV RNA was positive in 147 (16.5%) of 891 patients and negative in 389 (43.7%) patients. Unfortunately HCV RNA was not tested in 355 (39.8%) patients. The percentages of the untested patients regarding the departments were 65.38% ( = 85/130) in medical inpatient clinics, 61.02% ( = 72/118) in surgical clinics, 16.67% ( = 88/528) medical outpatient departments, 96.8% ( = 91/94) in surgical outpatient departments, and 90.5% ( = 19/21) in the emergency department.

Conclusions: The prevalence of anti-HCV positivity was found to be 0.81% and was stable in Turkey. However, the level of physician awareness for HCV was unsatisfactory, and differed between departments. Because HCV is commonly asymptomatic, positive patients should not be overlooked and adequate treatment should be administered. Awareness of physicians should be increased to prevent delays in the diagnosis of hepatitis C and to reduce the number of untreated patients.
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http://dx.doi.org/10.5114/ceh.2020.102155DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816635PMC
December 2020

Evaluation of serum CXC chemokine ligand 16 (CXCL16) as a novel inflammatory biomarker for Familial Mediterranean Fever disease.

Turk J Med Sci 2020 Dec 11. Epub 2020 Dec 11.

Background/aim: FMF is a disease that is mainly diagnosed with clinical features. Several well-known inflammatory markers increase in FMF. However, there is still a need for diagnostic tests for specifying FMF and monitoring inflammatory activity. CXCL16 is a chemokine produced by inflammatory cells that demonstrate efficacy in the acute phase response. In this study, we aimed to investigate the relationship between CXCL16 levels and FMF disease and to evaluate CXCL16 levels as a novel biomarker for FMF.

Materials And Methods: Fifty-three male patients diagnosed with FMF and sixty healthy individuals were included in this cross-sectional study. Blood samples were taken in the first 24 hours of the attack periods. Serum soluble CXCL16 was evaluated by ELISA method.

Results: CXCL16 (p<0.001), erythrocyte sedimentation rate (p<0.001), C-reactive protein (p<0.001) and fibrinogen (p=0.005) were significantly higher in FMF group than in control group. Receiver operating characteristic (ROC) curve analysis revealed a cut off value of CXCL16 as 2.68 ng/ml with 83% sensitivity and 68% specificity (p<0.001). Logistic regression analysis indicated that high CXCL16 and erythrocyte sedimentation rate levels were predictive parameters for FMF disease (OR 8.31; 95% CI 2.59-26.62; p <0.001) (OR 1.27; 95% CI 1.12-1.44; p<0.001). There was no correlation between CXCL16 levels and attack frequency and disease duration (p=0.395, p=0.956).

Conclusion: To the best of our knowledge, this is the first study evaluating serum soluble CXCL16 levels as a biomarker for FMF. CXCL16 levels were significantly higher and were predictive for monitoring inflammatory activity in patients with FMF. CXCL16 may be a promising biomarker for FMF diagnosis.
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http://dx.doi.org/10.3906/sag-2010-64DOI Listing
December 2020

Ultrasonographic Assessment of Knee Cartilage Thickness in Patients with Ulcerative Colitis: Decreased Femoral Cartilage Thickness May Be an Indicator of Extraintestinal Manifestation in Patients with Mild Activity Ulcerative Colitis.

Cartilage 2020 Oct 23:1947603520968204. Epub 2020 Oct 23.

Department of Physical Medicine and Rehabilitation, Afyon Emirdağ State Hospital, Afyon, Turkey.

Objectives: Ulcerative colitis is a systemic inflammatory disease which primarily involves the gut but presented by numerous extraintestinal manifestations. The effect of ulcerative colitis on knee cartilage has not been evaluated up to the present. In the current study, we aimed to investigate the possible relationship between the presence of ulcerative colitis and femoral cartilage thickness.

Design: Sixty-two patients with confirmed diagnosis of ulcerative colitis and 70 healthy controls aged 18 to 50 years referred to the gastroenterology outpatient department between January 2018 and January 2019 participated in this cross-sectional study. The measurements were made by ultrasonography with the patient in a supine position and the knees in complete flexion. Demographic, clinical, endoscopic and laboratory data were collected for all the subjects.

Results: The groups of ulcerative colitis and control group were similar with regard to sex, mean age, weight, height, body mass index, extremity dominancy, and existence of knee pain ( > 0.05). Medial femoral condyles, intercondylar areas, and lateral femoral condyles of both right and left knees had thinner cartilage thickness in ulcerative colitis group than control group ( < 0.001).

Conclusion: Knee cartilage was thinner in subjects with mild activity ulcerative colitis than in healthy controls. Decreased knee cartilage thickness may be an indicator of extraintestinal manifestation in patients with mild activity ulcerative colitis. This association between ulcerative colitis and knee cartilage degeneration may be effective in early detection of possible risk factors and potential treatment strategies for both ulcerative colitis and specific subtypes of knee osteoarthritis.
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http://dx.doi.org/10.1177/1947603520968204DOI Listing
October 2020

Predictive role of neutrophil to lymphocyte ratio in patients with intrahepatic cholangiocarcinoma submitted to treatment of 90Y-microspheres.

Nucl Med Commun 2020 07;41(7):714

Department of Gastroenterology, Hitit University Erol Olcok Traning and Research Hospital, Corum, Turkey.

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http://dx.doi.org/10.1097/MNM.0000000000001178DOI Listing
July 2020

NLR and PLR as Novel Prognostic Biomarkers of Mucosal Healing in Ulcerative Colitis Patients Treated with Anti-TNF.

Inflamm Bowel Dis 2020 08;26(9):e103

Department of Gastroenterology, Gazi State Hospital, Samsun, Turkey.

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http://dx.doi.org/10.1093/ibd/izaa153DOI Listing
August 2020

NLR and PLR as potential markers of disease activity in patients with ankylosing spondylitis?

Adv Rheumatol 2020 05 1;60(1):24. Epub 2020 May 1.

Department of Physical Medicine and Rehabilitation, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

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http://dx.doi.org/10.1186/s42358-020-00129-5DOI Listing
May 2020

NLR as a prognostic marker in metastatic gallbladder cancer?

HPB (Oxford) 2020 05 29;22(5):793. Epub 2020 Mar 29.

Hitit University Erol Olcok Training and Research Hospital, Department of Gastroenterology, Corum, Turkey.

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http://dx.doi.org/10.1016/j.hpb.2020.03.012DOI Listing
May 2020

treatment in Turkey: Current status and rational treatment options.

North Clin Istanb 2020 11;7(1):87-94. Epub 2019 Jul 11.

Department of Gastroenterology, Acibadem University, Istanbul, Turkey.

According to the TURHEP study, the prevalence of in Turkey is 82.5%. After FDA approval in 1995, many countries have used standard triple therapy (proton pump inhibitor 40 mg b.i.d clarithromycin 500 mg b.i.d and amoxicillin 1 gr b.i.d) for treatment. In the beginning, eradication rates were above 90% in many countries; however, current studies have demonstrated a prominent decrease in successful treatment rates, even down to 60%. This unfavorable reduction stimulated searches for new treatment protocols. Treatment protocols differ according to country, prevalence, cost-effectiveness, antibiotic resistance, CYP2C19 polymorphism and eradication rates. Thus, each country/region needs to revise its own therapeutic results and the efficacy of various eradication regimens in the treatment of . This report aims to review the current status of treatment in Turkey and to provide recommendations for rational therapeutic considerations for the eradication of the bacterium.
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http://dx.doi.org/10.14744/nci.2019.62558DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103748PMC
July 2019

Presepsin:albumin ratio and C-reactive protein:albumin ratio as novel sepsis-based prognostic scores : A retrospective study.

Wien Klin Wochenschr 2020 Apr 14;132(7-8):182-187. Epub 2020 Feb 14.

Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

Objective: To investigate the prognostic value of the presepsin:albumin ratio and C‑reactive protein:albumin ratio in patients with sepsis in the intensive care unit (ICU).

Methods: A total of 228 (129 males and 99 females) patients with newly diagnosed sepsis were included in the study. The relationship between the C‑reactive protein:albumin ratio, presepsin:albumin ratio, clinicopathologic parameters, and overall survival were investigated. The associations between C‑reactive protein:albumin ratio and presepsin:albumin ratio were evaluated alongside other inflammation-based prognostic scores such as quick Sepsis Related Organ Failure Assessment (qSOFA).

Results: The presepsin:albumin ratio was significantly higher in non-survivors (p < 0.01). Patients with a high presepsin:albumin ratio had worse overall survival compared with patients with high C‑reactive protein:albumin ratio levels (p < 0.001).

Conclusion: Presepsin and presepsin:albumin ratio are markers of adverse prognosis in patients with sepsis and are superior to C‑reactive protein and C‑reactive protein:albumin ratio for this purpose. Presepsin:albumin ratio may be a novel marker of poor prognosis in patients with sepsis in intensive care units.
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http://dx.doi.org/10.1007/s00508-020-01618-9DOI Listing
April 2020

Drug-induced Liver Injury Caused by Phenprobamate: Strong Probability Due to Repeated Toxicity.

Euroasian J Hepatogastroenterol 2019 Jan-Jun;9(1):49-51

Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

Drug-induced liver injury (DILI) is an important cause of morbidity and mortality. DILI can even cause acute liver failure and the need for liver transplantation. Identifying DILI may be particularly difficult because it is actually an exclusion diagnosis and individuals are usually exposed to several drugs during a lifetime. Causality assessment methods are needed for objective diagnosis. The most common methods are; updated Roussel Uclaf causality assessment method (RUCAM), Narenjo adverse drug reaction probability scale and Maria and Victorino (M&V) causality assessment scale. Phenprobamate is a widely used muscle relaxant. Herein we report a rare case of repeated DILI caused by phenprobamate and review the objective diagnostic process for hepatotoxicities. Physicians should be aware of the potential adverse effects of this drug, including hepatotoxicity. Duzenli T, Tanoglu A, Drug-induced Liver Injury Caused by Phenprobamate: Strong Probability Due to Repeated Toxicity. Euroasian J Hepatogastroenterol 2019;9(1) :49-51.
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http://dx.doi.org/10.5005/jp-journals-10018-1295DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969320PMC
January 2020

Pentoxifylline has favorable preventive effects on experimental chronic pancreatitis model.

Scand J Gastroenterol 2020 Feb 16;55(2):236-241. Epub 2020 Jan 16.

Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

To investigate the protective efficacy of pentoxifylline through biochemical parameters and histopathological scores in a caerulein- and alcohol-induced experimental model of chronic pancreatitis in rats. A model of chronic pancreatitis with caerulein and alcohol was created in female rats of the genus Sprague Dawley. Pentoxifylline was administered in doses of 25 mg/kg (low dose) and 50 mg/kg (high dose) as a protective agent. Each group contained 8 animals. The groups were: group 1 (control group); caerulein + alcohol, group 2 (low-dose pentoxifylline group); caerulein + alcohol + pentoxifylline 25 mg/kg, group 3 (high-dose pentoxifylline group); caerulein + alcohol + pentoxifylline 50 mg/kg, group 4 (placebo); caerulein + alcohol + saline, group 5 (sham group); only saline injection.Rats were sacrificed 12 h after the last injection, and TNF-α, TGF-β, MDA, and GPx concentrations were measured in blood samples. The histopathologic examination was conducted by a pathologist who was unaware of the groups. The biochemical results of the treatment groups (group 2 and group 3) were statistically significantly lower compared with the control group (group 1) ( < .05). The difference between the low-dose treatment group (group 2) and high-dose treatment group (group 3) was significant in terms of biochemical parameters ( < .05). The difference between group 2 and the control group was not significant in terms of histopathologic scores ( > .05), whereas the difference between the group 3 and the control group was statistically significant ( < .05). As a result, pentoxifylline, which has anti-inflammatory and antioxidant properties, was shown to have protective efficacy in an experimentally generated model of chronic pancreatitis.
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http://dx.doi.org/10.1080/00365521.2020.1712471DOI Listing
February 2020

Midkine level may be used as a noninvasive biomarker in Crohn’s disease

Turk J Med Sci 2020 04 9;50(2):324-329. Epub 2020 Apr 9.

Department of Gastroenterology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey

Background/aim: Crohn’s disease (CD) is a kind of inflammatory bowel disease. Midkine (MDK) is an endogenous inflammatory marker. We aimed to investigate the relationship between MDK levels and inflammation and hence determine whether MDK can be used as a noninvasive biomarker in active CD.

Materials And Methods: Sixty-five consecutive patients over the age of 18 with CD and 36 healthy controls were included in this study. CD patients’ venous blood samples were taken before treatment. Serum MDK levels were determined in human plasma samples by enzyme-linked immunosorbent assay (ELISA) method.

Results: The mean age of the study patients was 44.8 ± 12.5 years, 35 patients were female, and 30 were male. Of these 65 patients, 37 had active CD and 28 were in the remission phase. MDK levels were significantly higher in active and remission CD than in healthy controls (P = 0.01, P = 0.038, respectively).

Conclusion: e report that there is an association between MDK levels and CD activation, and therefore with enhanced inflammation. MDK levels were significantly correlated with inflammatory indices. In line with our findings, we suggest the theory that MDK inhibitors may be useful in treating Crohn’s disease.
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http://dx.doi.org/10.3906/sag-1904-167DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164751PMC
April 2020

Clinicopathological profile of gastrointestinal tuberculosis: a multinational ID-IRI study.

Eur J Clin Microbiol Infect Dis 2020 Mar 22;39(3):493-500. Epub 2019 Nov 22.

Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.

Data are relatively scarce on gastro-intestinal tuberculosis (GITB). Most studies are old and from single centers, or did not include immunosuppressed patients. Thus, we aimed to determine the clinical, radiological, and laboratory profiles of GITB. We included adults with proven GITB treated between 2000 and 2018. Patients were enrolled from 21 referral centers in 8 countries (Belgium, Egypt, France, Italy, Kazakhstan, Saudi Arabia, UK, and Turkey). One hundred four patients were included. Terminal ileum (n = 46, 44.2%), small intestines except terminal ileum (n = 36, 34.6%), colon (n = 29, 27.8%), stomach (n = 6, 5.7%), and perianal (one patient) were the sites of GITB. One-third of all patients were immunosuppressed. Sixteen patients had diabetes, 8 had chronic renal failure, 5 were HIV positive, 4 had liver cirrhosis, and 3 had malignancies. Intestinal biopsy samples were cultured in 75 cases (78.1%) and TB was isolated in 65 patients (86.6%). PCR were performed to 37 (35.6%) biopsy samples and of these, 35 (94.6%) were positive. Ascites samples were cultured in 19 patients and M. tuberculosis was isolated in 11 (57.9%). Upper gastrointestinal endoscopy was performed to 40 patients (38.5%) and colonoscopy in 74 (71.1%). Surgical interventions were frequently the source of diagnostic samples (25 laparoscopy/20 laparotomy, n = 45, 43.3%). Patients were treated with standard and second-line anti-TB medications. Ultimately, 4 (3.8%) patients died and 2 (1.9%) cases relapsed. There was a high incidence of underlying immunosuppression in GITB patients. A high degree of clinical suspicion is necessary to initiate appropriate and timely diagnostic procedures; many patients are first diagnosed at surgery.
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http://dx.doi.org/10.1007/s10096-019-03749-yDOI Listing
March 2020

Neutrophil-to-lymphocyte ratio alone may not be a true indicator of the severity of acute pancreatitis.

Turk J Gastroenterol 2019 10;30(10):937

Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey.

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http://dx.doi.org/10.5152/tjg.2019.18856DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812943PMC
October 2019

SEVERE ISCHEMIC COLITIS PROBABLY RELATED TO DICLOFENAC.

Authors:
Tolga Duzenli

Gastroenterol Nurs 2019 May/Jun;42(3):297-298

Tolga Duzenli, MD, Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

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http://dx.doi.org/10.1097/SGA.0000000000000445DOI Listing
March 2020

Lansoprazole as an uncommon cause of anaphylaxis: What to give next?

North Clin Istanb 2019 8;6(3):315-316. Epub 2018 Aug 8.

Department of Emergency Medicine, Gulhane Training and Research Hospital, Ankara, Turkey.

Proton pump inhibitors (PPIs) are one of the most prescribed drugs worldwide. Anaphylactic reactions of PPIs are rare; however, several cases have been reported. Here, we report a rare case of anaphylaxis that occurred immediately following lansoprazole intake. Following the successful management in the emergency department, skin prick and oral controlled challenge tests were performed to evaluate cross-reactivity. Thereafter, lansoprazole was switched to pantoprazole, which was well tolerated. Skin prick and oral controlled challenge tests can be performed for determining the cross-reactivity of PPIs to prevent adverse reactions.
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http://dx.doi.org/10.14744/nci.2018.36539DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6790933PMC
August 2018

An unusual method to diagnose a rare disease: Upper gastrointestinal endoscopy.

Turk J Gastroenterol 2017 11 19;28(6):522-523. Epub 2017 Sep 19.

Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey.

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http://dx.doi.org/10.5152/tjg.2017.17224DOI Listing
November 2017

Pregabaline as a Rare Cause of Hepatotoxicity.

Pain Med 2017 07;18(7):1407-1408

Physical and Rehabilitation Medicine, GATA, Haydarpasa Training Hospital, Istanbul, Turkey.

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http://dx.doi.org/10.1093/pm/pnw332DOI Listing
July 2017