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    Comparison of first-line eradication therapy protocols for Helicobacter pylori in regions with high clarithromycin resistance
    (2019) Bozkurt, Hilmi; Sert, Ozlem Zeliha; Kaplan, Esin; Aray, Emre; Olmez, Tolga; Uzun, Orhan; Koksal, Rabia; Polat, Erdal; Duman, Mustafa
    Aim: First-line eradication therapy protocols for Helicobacter pylori infection and their success rates still prove to be matter of interest for researchers. The aim of this study was to examine retrospectively eradication therapy protocols used in patients infected with H. pylori in our region with high resistance to clarithromycin, compare success rates and determine the factors affecting success rates. Material and Methods: Eradication therapies for dyspeptic patients who were found to be Helicobacter pylori positive as revealed by upper gastrointestinal endoscopy and biopsy results and success rates attained in the microscopic examination of stool in the 4th week after the therapy were analyzed. Group 1 (legacy triple therapy): clarithromycin 500 mg film-coated tablet 2x1, lansoprazole 30 mg capsule 2x1, amoxicillin 1000 mg tablet 2x1, 14-day therapy period; Group 2 (bismuth-free quadruple therapy): clarithromycin 500 mg film tablet 2x1, rabeprazole 20 mg tablet 2*1, amoxicillin 1000 mg tablet 2x1, metronidazole 500mg 2x1 tablet, 14-day therapy period; Group 3 (bismuthal quadruple therapy): bismuth subsalicylate 262 mg tablet 2x2, metronidazole 500 mg tablet 3x1, tetracycline 500 mg capsule 3x1, pantoprazole 40mg tablet 2x1, 10-day therapy period.Results: Data of 168 patients were analyzed. The patients were divided into Group 1 (classical therapy) with 80 patients, Group 2 (bismuth-free quadruple therapy) with 46 patients and Group 3 (bismuthal quadruple therapy) with 42 patients. Eradication success rates were as follows: Group 1 (80%), Group 2 (80.4%) and Group 3 (83.3%).Conclusion: Antibiotic resistance is the sole reason for the low success rate in eradication therapy for Helicobacter pylori. In regions with high clarithromycin resistance bismuth-free quadruple therapy can be employed as an alternative. In regions with metronidazole resistance in addition to clarithromycin resistance bismuthal therapy protocols can be employed. Keywords: Helicobacter pylori; eradication therapy; clarithromycin resistance.
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    Retrospective analysis of inpatients in a recently established palliative care center
    (2019) Bozkurt, Hilmi; Dost, Burhan
    Aim: The present study makes a retrospective analysis of the records of patients admitted to a recently established district state hospital palliative care center for treatment.Material and Methods: The records of the first 252 patients treated as inpatients in a recently established palliative care center between November 2015 and April 2017 were reviewed retrospectively.Results: The study included 252 patients who were treated between the specified dates following the date of establishment. The mean age of the patients was 74 (18–103) years; 56.8% were male and 43.2% were female. The mean length of hospital stay was 15.2 days. Of the total, 134 (53.1%) patients required analgesics; 219 (86.6%) received dietician support; 73 (28.9%) received psychologist support; and 205 (81%) received physiotherapist support. Of the patients, 75.4% were discharged with full recovery, 15.4% were transferred to the intensive care unit and 9.2% died. Conclusion: Palliative care has recently gained importance as a multidisciplinary approach. The authors believe that the establishment of such centers in district hospitals will reduce overcrowding in the larger centers, and will allow patients to access this service closer to their place of residence.
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    Risk of port site hernia after laparoscopic sleeve gastrectomy
    (2020) Ozdas, Sabri; Bozkurt, Hilmi
    Aim: Recently, one of the most preferred options in the surgical treatment of obesity is laparoscopic sleeve gastrectomy The purpose of this study is to investigate the incidence of port site hernia formation and the factors affecting the fascia defect in the group with and without closure after LSG.Material and Methods: The data of patients who were operated due to morbid obesity in a single center between March 2014 and June 2018 was reviewed and analyzed retrospectively. The patients were divided into two groups, being those in whom the fascial defect at the 12-mm trocar insertion site from which the gastric remnant was removed during surgery was closed, and those in whom the fascial defect was not closed. The incidence of port site hernia and the factors affecting the development of port site hernia were evaluated with physical and ultrasound examinations 1year after surgery.Results: The study was completed with a total of 207 patients, of which 112 fascias was not closed and 95 fascia was closed. The rate of hernia formation was significantly lower in the fascial closure group than in the non-fascial closure group (p:0,036). Aside from this parameter, no significant difference was identified in the other parameters of the two groups. Age was significantly higher in patients that developed hernias following surgery than in those who did not develop hernias.Conclusion: This study determined that the closure of the fascial defect is a protective factor against the development of port site hernia when compared to non-fascial closure.