Gastrointestinal System Endoscopy Research Articles

The Effects of Ketamine-Propofol and Remifentanil-Propofol Combinations on Integrated Pulmonary Index During Sedation in Gastrointestinal System Endoscopy.

Different sedo-analgesia and monitoring methods are used during endoscopic procedures. And yet, there is no consensus on optimal sedating agents. In this study, the main aim is to compare ketamine-propofol and remifentanil propofol sedo-analgesia protocols by monitoring integrated pulmonary index (IPI). The study population is divided into two groups: Group ketamine received 0.25 mg/kg ketamine and 0.75 mg/kg propofol at the beginning of anesthesia. 1 mcg/kg of remifentanil and 0.75 mg/kg propofol were administered to group remifentanil patients at the induction of anesthesia. Anesthesia maintenance was provided by titration of drug doses according to the Ramsey sedation scale. Measurements were taken at four different points in time: just before anesthesia was induced, five minutes after sedation was induced, ten minutes later, and five minutes after the treatment was finished. There was no significant difference in respiratory parameters such as respiratory rate, SPO2, and EtCO2 measured in the T1 time period between the groups. In the T2 time period, a significant difference was found between the groups in the integrated pulmonary index (IPI), sPO2, respiratory rate, and systolic pressure parameters were found to be significantly higher in group ketamine. T3 time period results were higher in these three parameters: IPI, sPO2, and respiration rate. In the T2, T3, T4 time periods, there was a difference between the groups in the respiration count parameter and it was found to be higher in group ketamine. Although it causes slight prolongation in recovery, ketamine is a safe and effective drug that can be used during endoscopic procedures.

Evaluation of the frequency of hiatal hernia in patients undergoing upper gastrointestinal system endoscopy

Obesity was identified as an essential and independent risk factor for hiatal hernia. This study focused on the frequency of hiatal hernia detection in patients who underwent upper gastrointestinal system endoscopy in our clinic. The relationship between the frequency of hiatal hernia and demographic data and the patient's height-weight-body mass index was evaluated. This study examined the frequency of Hiatal hernia detection in 303 patients who underwent upper gastrointestinal endoscopy at our institution. The relationship between the frequency of hiatal hernia and demographic data and the patient's height-weight-body mass index was evaluated. Patient data were obtained from the hospital's electronic database. Age, gender, and upper gastrointestinal endoscopy reports were examined. The frequency of Hiatal hernia detection in patients who underwent upper gastrointestinal endoscopy was documented. According to the distribution of demographic and clinical findings of the patients, there was a statistically significant difference between the groups in terms of gender, age, waist circumference, and the occurrence of esophagitis (p<0.05). The incidence of hiatal hernia was higher in men than in women, and the ages of patients with hernia were higher than those without. Waist circumferences and esophagitis rates of patients with hiatal hernias were higher than those without. As a result, obesity and body mass index (BMI) carry risks for hiatus hernia. In obese patients, Hiatal hernia should be included in the differential diagnosis of gastrointestinal complaints. The gold standard in the diagnosis of reflux is clinical and endoscopic examination.

Evaluation of the frequency of colon diverticula with lower gastrointestinal system endoscopy

Evaluation of the frequency of colon diverticula with lower gastrointestinal system endoscopy

Value of integrated pulmonary index monitoring for the detection of adverse respiratory events in patients undergoing sedation for gastrointestinal system endoscopy.

To determine if the integrated pulmonary index detects changes in ventilation status early in patients undergoing gastrointestinal endoscopy under sedation, and to determine the risk factors affecting hypoxia. The retrospective study was conducted at the endoscopy unit of a tertiary university hospital in Turkey and comprised data between October 2018 and December 2019 related to patients of either gender aged >18 years who were assessed as American Society of Anaesthesiologists grade I-III and underwent elective lower and upper gastrointestinal endoscopy. Monitoring was done with capnography in addition to standard procedures. Data was analysed using SPSS 23. Of the 154 patients, 94(%) were females and 60(%) were males. The overall mean age was 50.88±11.8 years (range: 20-70 years). Mean time under anaesthesia was 23.58±4.91 minutes and mean endoscopy time was 21.73±5.06 minutes. During the procedure, hypoxia was observed in 42(27.3%) patients, severe hypoxia in 23(14.9%) and apnoea in 70(45.5%). Mean time between apnoea and hypoxia was 12.59±7.99 seconds, between apnoea and serious hypoxia 21.07±17.64 seconds, between integrated pulmonary index score 1 and hypoxia 12.91±8.17 sec, between integrated pulmonary index score 1 and serious hypoxia 21.59±14.13 seconds, between integrated pulmonary index score <7 and hypoxia 19.63±8.89 seconds, between integrated pulmonary index score <7 and serious hypoxia 28.39±12.66 seconds, between end-tidal carbon dioxide and hypoxia 12.95±8.33 seconds, and between end-tidal carbon dioxide and serious hypoxia 21.29±7.55 seconds. With integrated pulmonary index score 1, sensitivity value for predicting hypoxia and severe hypoxia was 88.1% and 95.7%, respectively, and specificity was 67% and 60.3%, respectively. With integrated pulmonary index score <7, the corresponding values were 100%, 100%, 42% and 64.1%, respectively. Capnographic monitoring, especially the follow-up integrated pulmonary index score, was found to be valuable and reliable in terms of finding both time and accuracy of the risk factor in the diagnosis of respiratory events.

Investigation of Gastric Intestinal Metaplasia in Children According to the Current Sidney System: Single Centre Experience

Aim: The purpose of this investigation was to examine the occurrence of intestinal metaplasia in pediatric patients who underwent upper gastrointestinal endoscopy and its clinical implications. Methods: A retrospective evaluation was conducted on the endoscopy and pathology reports of 1280 patients who underwent upper gastrointestinal system endoscopy for various indications at the Pediatric Gastroenterology Clinic of XX University Faculty of Medicine Hospital from January 2019 to December 2022. The study included 66 cases that were diagnosed with intestinal metaplasia based on the histopathological examination of biopsy samples.&#x0D; Results: Among the patients, 37 (56.1%) were female and 29 (43.9%) were male. The mean age for females was 12.92±4.297 years (ranging from 1 to 17 years), while for males it was 12.07±4.765 years (ranging from 2 to 17 years). The average number of endoscopies performed was 1.66 times (ranging from 1 to 5 times). The top three indications for endoscopy included abdominal pain, growth retardation, and suspicion of celiac disease. Detection of H. Pilori positivity was observed in 67.1% of cases.&#x0D; Conclusion: While Gastric Intestinal Metaplasia is uncommon in childhood, it should not be disregarded due to its associated risk. It is important to remember that endoscopic biopsies may not provide sufficient diagnostic information in cases involving patchy involvement or diseases affecting the submucosa or deeper layers.

EFFICACY AND SAFETY OF GEMIFLOXACIN CONTAINING TREATMENT REGIMEN IN FIRST-LINE TREATMENT OF HELICOBACTER PYLORI.

•In eradication treatment of H. pylori gemifloxacin containing triple treatment regimen was as effective as bismuth containing quadruple treatment. •Drug adverse effects were fewer and milder in the gemifloxacin group. •Since treatment period was shorter and pills to be taken were fewer compared to quadruple treatment, patient compliance was significantly higher in the gemifloxacin group. Background - After eradication of Helicobacter pylori (H. pylori) chronic gastritis will resolve, complications due to H. pylori infection and recurrence of infection will be prevented. Objective - To determine efficacy and safety of gemifloxacin containing treatment regimen in first line treatment of H. pylori with comparison to bismuth containing quadruple therapy. Methods - This retrospective study was conducted in a tertiary care university hospital between January 2018 and January 2021 with 410 participants who were diagnosed to have H. pylori infection with biopsies obtained during upper gastrointestinal system endoscopy. Patients were distributed into two groups according to their first-line treatment regimens. First group patients were treated with amoxicillin, gemifloxacin and pantoprazole and second group patients were treated with amoxicillin, metronidazole, bismuth subcitrate and pantoprazole for seven days. Results - Intention to treat and per protocol ratios for gemifloxacin containing regimen were 90.0% and 91.2%, while quadruple treatment has these ratios as 91.7% and 93.8% respectively. Treatment success rate in both regimens were similar. But adverse effects were lower and patient compliance were better in patients who had gemifloxacin containing treatment (P<0.001). Conclusion - Gemifloxacin containing treatment regimen is as effective as bismuth containing quadruple treatment regimen for H. pylori infection and patient compliance is better in this group. Gemifloxacin containing treatment regimens may be novel and effective alternatives for eradication of H. pylori infection.

Helikobakter Pilori Enfeksiyonu ile Nötrofil-Lenfosit Oranı, Trombosit-Lenfosit Oranı Ve Nötrofil-Monosit Oranları Arasındaki İlişki

Aim: In our study, we aimed to show the relationship between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, neutrophil-monocyte ratio and mean platelet volume, and Helicobacter pylori positivity and severity. Material and Methods: In this study, we included 596 patients without active and/or chronic disease who underwent upper gastrointestinal system endoscopy due to dyspeptic complaints in a state hospital between July 2021 and July 2022. Demographic and laboratory data were obtained retrospectively from electronic patient records. The patients were divided into two groups as positive and negative for Helicobacter pylori according to the pathology report. Helicobacter pylori presence was defined as none, mild, moderate and severe. Hemogram parameters were compared between the groups. Results: Mean age of the patients (n=596) was 41.8±13.57 years, 374 (62.8%) were female, and 331 (55.5%) were Helicobacter pylori positive. There was no statistically significant difference between Helicobacter pylori positive and negative patient groups in terms of age, gender, leukocytes, lymphocytes, monocytes, platelets, hemoglobin, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, neutrophil-monocyte ratio and mean platelet volume values. When the hemogram parameters were evaluated according to the severity of Helicobacter pylori, a statistically significant difference was found between the groups only in terms of lymphocyte levels (p=0.028). However, this difference was not considered clinically significant. Conclusion: Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, neutrophil-monocyte ratio and mean platelet volume are thought to be popular recently and easy, accessible and inexpensive parameters for diagnosis and degree of inflammation in many systemic diseases, but in our study, no statistically significant relationship was found between Helicobacter pylori positivity and severity and hemogram parameters. Prospective studies with larger numbers of cases are needed to accept these parameters as predictors for Helicobacter pylori infection.

Effectiveness of Combination of Pharmacological Treatment and Endoscopic Band Ligation in Active Esophageale Varicos Bleeding

Acute gastrointestinal system bleeding in cirrhotic patients is one of the emergencies of gastroenterology that requires rapid and careful intervention. For this reason, patients who are thought to have esophageal variceal bleeding should be referred to a center that is adequately equipped for follow-up and treatment. There are studies supporting that current approaches to the treatment of esophageal variceal bleeding have a positive effect on life expectancy. Volume replacement is an important condition in the general approach to esophageal variceal bleeding. It is recommended to maintain hemodynamic stability and keep the hemoglobin level at approximately 8 g/dL. Additionally, it is thought that prophylactic antibiotic usage in gastrointestinal system bleeding of cirrhotic patients reduces the risk of bacterial infection and has a positive effect on life expectancy. In addition to these approaches, there are also specific measures for the control of esophageal variceal bleeding and the prevention of early recurrence of these bleedings. Pharmacological treatment for esophageal variceal bleeding can be started as soon as variceal bleeding is considered, even before upper gastrointestinal system endoscopy. Similar efficacy was demonstrated in a meta-analysis of 15 studies comparing emergency sclerotherapy and pharmacological therapy (vasopressin±nitroglycerin, terlipressin, somatostatin, octreotide). In the treatment of esophageal variceal bleeding, the combination of pharmacological and endoscopic treatment seems to be the most appropriate option. A meta-analysis of 8 studies compared the combination of endoscopic treatment [(sclerotherapy or endoscopic band ligation (EBL)] with endoscopic, pharmacological treatment) for acute variceal bleeding. Combination of endoscopic and pharmacological treatment was found superior in terms of bleeding control and risk of recurrence. In this study, we evaluated the efficacy of combination of pharmacological and endoscopic band ligation in patients who admitted to the hospital with esophageal variceal bleeding.

Akromegali hastalarında üst gastrointestinal system endoskopi taramasının değerlendirilmesi: tek merkez deneyimi

Purpose: The prevalence of precancerous or cancerous lesions in the upper gastrointestinal tract in acromegalic patients is not well known. The aim of this study is to evaluate the endoscopic findings of the upper gastrointestinal system (GIS) of patients with acromegaly and to assess whether the pathological findings are related to the disease and the use of somatostatin analogs.&#x0D; Materials and Methods: Between January 2010 and October 2021, patients diagnosed with acromegaly were identified by retrospective medical record scanning. This study included 49 patients with acromegaly who underwent upper GIS endoscopy. The acromegaly patients were divided into two groups: those who were taking somatostatin analogs at the time of endoscopy and those who were not. It was investigated whether there was a difference between these two groups in terms of lesion development. The patients with acromegaly and the control group were compared in terms of endoscopic findings and biopsy results.&#x0D; Results: Of these patients, 53% (n=26) were male and 46.9% (n=23) were female. The incidence of Helicobacter pylori (HP) was significantly higher in the acromegaly patients than in the control subjects. In the acromegaly group, 62.5% (n=15) of the 24 patients with antral and pangastritis were taking somatostatin analogs. There was no significant difference between the use of somatostatin analogs and the development of gastritis. The development of esophagitis was statistically higher in patients with acromegaly taking somatostatin analogs.&#x0D; Conclusion: The incidence of HP was higher in patients with acromegaly than in the normal population. No clear results were found regarding the development of gastritis. The incidence of esophagitis was high in acromegalic patients taking somatostatin analogs. Large-scale studies are needed to uncover the relationship between the etiology of the disease and the drugs taken.

Cronkhite-Canada Syndrome Presenting with life-threatening protein-losing enteropathy: a case report

Background: Cronkhite Canada Syndrome (CCS) is a rare gastrointestinal polyposis syndrome. The diagnosis of CCS is made by clinical, endoscopic and histopathological findings. Chronic diarrhea, malnutrition, alopecia, skin hyperpigmentation, onychodystrophy, hypogeusia, protein loss due to chronic inflammatory changes in the intestinal mucosa are common findings.Nutritional support, high protein diet, antibiotics, correction of electrolyte imbalance, and corticosteroids are frequently used in CCS treatment. Aim of the study: Here we present a newly diagnosed Cronkhite Canada Syndrome patient who has suffered life-threatening protein loss. Material and methods: Medical documentation was used. Case report: A 62-year-old male patient presented with bloodless diarrhea, happening 8-10 times a day for 4 months, and general condition disorder. On admission, arterial blood pressure was 80/50 mm/hg, pulse was 110 per minute and body temperature was 38.8°C. In laboratory tests, total protein: 38 mg/dl and albumin: 20 g/L.Upper and lower gastrointestinal system (GIS) endoscopy revealed 2-20 mm polyps in the stomach, duodenum, colon, and a small amount in the distal esophagus. Pathological examination of polypectomy materials revealed edematous and inflamed lamina propria consisting of plasma cells, neutrophils and eosinophils.The patient benefited from total parenteral nutrition, high protein dietary supplementation, antibiotic therapy and was followed with upper and lower GIS endoscopy. Conclusions: CCS is a rare disease that can cause life-threatening hypoalbuminemia and requires close follow-up.

Analysis of Lower Gastrointestinal System Endoscopy Results in Yozgat Region

Amaç: Bu çalışmanın amacı, Yozgat yöresinde kolonoskopi yapılan hastalarda kolonoskopi ve patoloji sonuçlarının retrospektif olarak analiz edilmesi ve kolonoskopi raporlarındaki kolorektal hastalıkları ve biyopsi sonuçlarını belirleyip sonuçların literatürdeki verilerle karşılaştırılmasının yapılmasıdır. Gereç ve Yöntemler: 01/01/2019-31/12/2019 tarihleri arasında polikliniğimize herhangi bir nedenle başvuran hastalardan alt gastrointestinal sistem endoskopisi yapılan 326 hasta çalışmaya alındı ve kolonoskopi raporları, patoloji raporları ve diğer verileri retrospektif olarak incelendi. Bulgular: Hastaların ortalama yaşı 53.78±15.04 (19–91) yıl olarak saptandı. %44.2 (n=144)’si kadın; %55.8 (n=182)’i erkek cinsiyet idi. Kolonoskopik tanılar değerlendirildiğinde normal alt gastrointestinal endoskopi olarak raporlanan hasta oranı %19.3 (n=63) olarak saptandı. En sık raporlanan tanının ise %32.8 (n=107)’lik oranla Hemoroid olduğu görüldü. İnternal hemoroid oranı %27.9 (n=91); eksternal hemoroid oranı %13.2 (n=43) idi. Kolonda malignite düşündüren kitlesel lezyon oranı ise %2.4 (n=8) idi. Kolonda polip %22.4 (n=73) olarak raporlandı. Patolojik tanılara baktığımızda kolon adenokarsinomu %1.5 (n=5) oranında saptandı. Bunun %0.9’u (n=3) rektum adenokarsinomdu. Total adenoma ise %22 (n=72)olarak saptandı. Bunlardan tübülovillöz adenom %3.7 (n=12) oranında saptanırken villöz adenom %0.3 (n=1) oranında saptandı. Sonuç: Bu çalışmada Yozgat yöresine ait kolonoskopi veriler sunulmuştur. Kolorektal kanserlerin erken tanısı hayat kurtarıcı öneme sahiptir. Kolorektal kanserlerin erken tanısında kolonoskopi altın standarttır. Kolorektal kanserler, kanser nedeniyle ölümlerin en sık ikinci nedenini oluşturduğu göz önünde bulundurulursa kolonoskopi endikasyonu olan tüm bireylere kolonoskopi önerilmeli ve yapılmalıdır.

Clinical presentation and endoscopic findings in adult patients with eosinophilic esophagitis

Background/Aim: The frequency of eosinophilic esophagitis has been rising over the last decades. It is diagnosed primarily based on symptoms and endoscopic and histopathological examination findings. Although eosinophilic esophagitis is not associated with malignancy, it remains an important condition affecting both children and adults, as it is associated with morbidity such as dysphagia, food impaction, and esophageal strictures. This study aimed to define clinical and endoscopic characteristics of adult patients diagnosed with eosinophilic esophagitis based on recently recommended histopathological criteria. Methods: This retrospective cross-sectional descriptive study included 54 adult patients (mean age: 33.6 yr, range: 16–61 yr) who underwent upper gastrointestinal system endoscopy for dyspeptic complaints (epigastric pain, reflux, dysphagia, or food impaction) and diagnosed with eosinophilic esophagitis based on the latest histopathological criteria (≥15 eosinophils per high-power field). Patients with a history of malignancy were excluded. Patients’ clinical, endoscopic, and histopathological data were examined. Results: In patients diagnosed with eosinophilic esophagitis, the most common presenting complaint was dysphagia (61.1%), followed by dyspepsia (24.0%), regurgitation (16.6%), chest pain (16.6%), epigastric pain (12.9%), food impaction (11.1%), and halitosis (3.7%), without any age predilection for the complaints. White papules and linear furrow were the most frequent findings on endoscopic examination (35.1% each), followed by circular rings (24.0%), paleness (22.2%), normal endoscopic finding (20.3%), and small-caliber esophagus (11.1%). Conclusion: The diagnosis of eosinophilic esophagitis remains challenging due to considerable variations in definitions and in the relative frequencies of endoscopic findings. Therefore, we recommend combining clinical, endoscopic, and histologic criteria to establish diagnosis. The identification of standards for diagnosis in future studies is warranted.

Gastrik Intestinal Metaplazi Sıklığı ve Helikobakter Pilori ile İlişkisinin Belirlenmesi

Aim: Gastric intestinal metaplasia (IM) is a precancerous lesion in the pathway to gastric cancer. Helicobacter pylori (HP) is a bacterium that has been associated with an increase in the development of non-cardia gastric cancer and is involved in the development of gastric IM and atrophic gastritis. In this study, we aimed to determine the frequency of IM and its relationship with HP in patients undergoing endoscopic examination with the indication of dyspepsia.&#x0D; Material and Method: The study included 2530 patients who underwent upper gastrointestinal system endoscopy and had gastric biopsy at the Karadeniz Technical University Farabi Hospital Gastroenterology Clinic due to dyspepsia between January 2019 and January 2020. Demographic characteristics of the patients such as age and gender, biopsy findings (presence of IM, HP, atrophy, dysplasia) were evaluated retrospectively.&#x0D; Results: A total of 2530 cases, 1344 (53.1%) women and 1186 (46.9%) men, with a median age of 53 (18-93) years were included in the study. HP was detected in 27.8% of the cases and IM was detected in 26.8%. The median age of 677 patients with positive IM was 59 (19-92) years, and 29.7% (n=352) were male. While no significant difference was found between the sexes in terms of median age within the IM positive and negative groups (p=0.584, p=0.642, respectively), the median age and male sex ratio were higher in patients with IM positive than those with IM negative (p

Evaluation of the Relationship Between Alarm Symptoms and Pathological Findings in Upper Gastrointestinal System Endoscopy

Evaluation of the Relationship Between Alarm Symptoms and Pathological Findings in Upper Gastrointestinal System Endoscopy

Comparison of gastrointestinal symptoms and findings in renal replacement therapy modalities

ObjectiveChronic kidney disease (CKD) affects gastrointestinal system (GIS) and causes histological, functional and mucosal changes. There are scarce data investigating GIS symptoms and findings in patients with CKD stage III-V, receiving hemodialysis (HD) and peritoneal dialysis (PD). In this study, we aimed to evaluate the frequency of gastrointestinal symptoms and findings and compare between renal replacement therapies.MethodA total of 290 patients (97 in CKD stage III-V, 92 PD, 101 HD) were included in this study. Gastrointestinal complaints, diseases, background characteristics of patients and drugs they used were questioned by interviews, forms were filled and examinations of patients were performed. Results of upper GIS endoscopy, colonoscopy, abdominal ultrasonography and tomography of patients were evaluated.ResultsThe most common signs were dyspepsia (50%), nausea (45%) and epigastric pain (44%) among all patients, generally. Gastrointestinal disorders like gastritis (62%) and gastroesophageal reflux (39%) were frequent in patients. Prevalence of patients with weight loss was 20% in predialysis and 8% in PD and the ratio was higher in predialysis group statistically significantly (p = 0,016). The prevalence of gastritis was 70% in PD, 55% in HD and the prevalence of hemorrhoids was 24% in PD and 12% in HD. The prevalence of gastritis and hemorrhoids was higher in the PD group than in the HD group statistically significantly (p = 0.043, p = 0.028), otherwise, there wasn’t a difference between the PD and predialysis groups, statistically significantly.ConclusionThis study showed that; gastrointestinal symptoms and disorders were very common in CKD, besides this; while gastritis and hemorrhoids were more frequent in the PD, esophagitis and hiatal hernia were more frequent in the HD.

Gastric Polyps: Retrospective Analysis of a 10-Years Endoscopic Procedure

Objective: Gastric polyps are gastric mucosal protrusions that are usually asymptomatic and detected incidentally during upper gastrointestinal system endoscopy. In this study, the incidence, location and general characteristics of gastric polyps were evaluated.&#x0D; Material and Methods: Upper gastrointestinal system endoscopies performed in a tertiary hospital for a period of ten years were evaluated retrospectively. Demographic characteristics of the patients, gastroscopy indications, morphological and histological characteristics of polyps were recorded.&#x0D; Results: Gastric polyps were found in 347 (1.4%) of a total of 25230 gastroscopy patients. The mean age of the patients was 61.04±15.05. One hundred and twenty four (35.7%) of the patients were male and 223 (64.3%) were female. The most common endoscopic indication (74.1%) of the patients with polyps&#x0D; was dyspepsia. Most of the polyps (55.3%) were smaller than 5 mm and the most common site was the antrum. Hyperplastic polyp (44.4%) was detected the most. 42.9% of the patients with polyps were positive for Helicobacter Pylori. In addition, 58% of adenomatous polyps were accompanied by dysplasia.&#x0D; Conclusion: Hyperplastic polyps were the most common polyp type in our population. Full excision of polyps over 5 mm (especially adenomatous polyps) is recommended instead of biopsy, as they may contain dysplasia foci. In addition, it was thought that taking polyps smaller than 5 mm into endoscopic follow-up without excision was more cost-effective.

Evaluation of Children Undergoing Endoscopic Procedures During the Normalization of the Coronavirus Disease 2019 Pandemic.

Given that procedures involving gastrointestinal tract lumens are high-risk and aerosol forming, the functioning of endos- copy units has been reorganized during the coronavirus disease 2019 pandemic. Guidelines recommend that all personnel should carry out procedures in a negative-pressure room with personal protective equipment; in the absence of a negative-pressure room, an ade- quately ventilated room should be used. During the normalization of the coronavirus disease 2019 pandemic, this study aimed to evalu- ate children who were treated in our endoscopy unit without a negative-pressure chamber in terms of coronavirus disease 2019 after procedures. Patients were questioned and evaluated prospectively for symptoms and contact with coronavirus disease 2019 patients on before and 7th and 14th days after the procedure. Seventy-eight procedures were performed on 69 patients over a 3-month period. The mean age of patients was 12.0 ± 5.1 years. Among all the procedures performed, 54 (69.2%) involved upper gastrointestinal system (GIS) endoscopy and 24 (30.8%) involved colo- noscopy. Furthermore, 72 (91.3%) of the procedures were performed in the pediatric endoscopy unit, and 6 (7.7%) were performed in the operating room. No coronavirus disease 2019 symptoms or presence was detected in the patients. The ideal setting for an endoscopic procedure is in a negative-pressure chamber. However, this study has shown that endoscopic procedures can be performed in units without negative-pressure rooms but with appropriate protective equipment and evaluation of patients for coronavirus disease 2019 symptoms.

Evaluation of gastric polyps: a single-center study conducted in Turkey's Southeast Anatolia Region

Background: Gastric polyps are often detected incidentally during endoscopic procedures performed for different reasons and may sometimes manifest by gastric bleeding, pyloric stenosis, iron deficiency anemia and abdominal pain. Our study aimed to investigate the demographic data of the cases found to have gastric polyps at the gastroenterology endoscopy unit, histologic type of the polyps, their localization and size, and their relationship with Helicobacter pylori.&#x0D; Material and Methods: Between September 2016 - September 2019, gastric polyps were detected in 255 of 9,771 cases who underwent upper gastrointestinal system endoscopy at the Gastroenterology Endoscopy Unit of our hospital. Demographic data, endoscopy reports and pathology results of these patients were retrospectively reviewed from the hospital registry system.&#x0D; Results: Of 255 cases included in the study, 160 (62.7%) were female, and 95 (37.3%) were male, with a mean age of 56.9 (min: 19, max: 95). A total of 336 polyps were detected in 255 cases, with 1.3 polyps per case. 36 (10.7%) of gastric polyps were found to be fundic gland polyps, 32 (9.5%) were found to be foveolar hyperplasia, 137 (40.8%) were found to be hyperplastic polyps, 5 (1.5%) were found to be xanthomas, and 6 (1.8%) were found to be neuroendocrine tumors.&#x0D; Conclusions: According to this study, 90% of gastric polyps detected endoscopically in southeast Turkey are smaller than 5 mm and located most commonly in the corpus; the most common histologic subtype is hyperplastic polyps.

The Role of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratios in Predicting H Pylori Positivity And Severity in Patients with Chronic Gastritis

Objective: Chronic gastritis is one of the most common diseases in the World. It is estimated that more than half of the World's population will have chronic gastritis at any time in life. H pylori are the most common cause of chronic gastritis. In the previous studies, WBC, neutrophil, lymphocyte, PLT, and mean platelet volume (MPV) values and their ratios are used as inflammatory indicators. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) is among the most critical indicators. This study aimed to show whether there is a relationship between H pylori positivity and severity and these parameters in patients who underwent Upper Gastrointestinal system endoscopy. Method: The files of 1689 patients who underwent upper gastrointestinal endoscopy were scanned for this study. According to laboratory results and pathology reports, the patients were divided into H pylori positivity and non-H pylori positivity. The hemogram results of the patients in both groups were examined, and neutrophil, lymphocyte, thrombocyte values were recorded. NLR and PLR were calculated. Results: 722 (42.7%) of the patients were male, and 967 (57.3%) were female. While H pylori were positive in 838 (49.6%) patients, 851 (50.4%) patients did not have H pylori positivity. Among H pylori-positive patients, 407 patients (48%) had mild, 280 (33%) moderate H pylori positivity, and 151 patients (19%) had severe H pylori positivity. When the patients were divided into mild, moderate, and severe groups according to H pylori positivity, NLR and PLR were statistically significantly lower as H pylori severity increased. On the other hand, when both groups were compared according to H pylori positivity, no statistically significant difference was found between the two groups in terms of age, albumin, AST, ALT, WBC, Neutrophil, PLT, NLR, PLR values. Conclusions: Our study found that NLR and PLR values were statistically significantly lower as H pylori severity increased. Therefore, when we evaluate our results in light of the literature, we assume that it is more appropriate to use PLR and NLR values together rather than separately as inflammatory markers regarding H pylori severity.

Esophagogastroduodenoscopy in Patients Aged 75 Years and Older: A Single-Center Study.

Introduction: Esophagogastroduodenoscopy is frequently used for the elderly population. Older patients are more fragile than younger patients because of multiple age-related chronic diseases and the common use of polypharmacy. There is no adequate data in the existing literature regarding the application of upper gastrointestinal system endoscopy in the elderly population. Therefore, in this article, we evaluated esophagogastroduodenoscopy procedures that were performed on patients aged 75 years or older in the secondary care hospital.Methods: We performed a retrospective observational study of patients aged 75 years or older who underwent esophagogastroduodenoscopy between January 2016 and January 2021 at the Istanbul Sultanbeyli State Hospital Endoscopy Unit. Indications of endoscopy, ages, genders, endoscopic diagnoses, polyp/tumor/biopsy localizations, histopathological examination of biopsies, and complications of esophagogastroduodenoscopy were analyzed.Results: A total of 202 patients were analyzed. The most common indication was dyspepsia (25%), followed by gastrointestinal bleeding, reflux, anemia, and screening/surveillance. For patients aged 75-79 years and patients aged ≥80 years, endoscopic diagnoses of esophageal and gastric malignancies were observed as 6.4% and 18%, respectively. Very relevant findings of endoscopy (esophageal and gastric malignancies; gastric and duodenal ulcers) were detected in 39 (19.3%) of all included patients. No complications due to endoscopic procedures were observed, but complications due to sedation (hypotension and hypoxemia) were observed in 5.0%.Conclusion: After pre-procedural evaluation, we must be careful while doing endoscopic procedures in the elderly because of multiple age-related chronic diseases and the common use of polypharmacy. This present study showed that esophagogastroduodenoscopy is a safe procedure with a high diagnostic yield in patients aged 75 years and older.