Person: DUMAN, DENİZ
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DUMAN
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DENİZ
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Publication Open Access Acid suppression therapy, gastrointestinal bleeding and infection in acute pancreatitis - An international cohort study(ELSEVIER, 2020-10) DUMAN, DENİZ; Demcsak, Alexandra; Soos, Alexandra; Kincses, Lilla; Capunge, Ines; Minkov, Georgi; Kovacheva-Slavova, Mila; Nakov, Radislav; Wu, Dong; Huang, Wei; Xia, Qing; Deng, Lihui; Hollenbach, Marcus; Schneider, Alexander; Hirth, Michael; Ioannidis, Orestis; Vincze, Aron; Bajor, Judit; Sarlos, Patricia; Czako, Laszlo; Illes, Dora; Izbeki, Ferenc; Gajdan, Laszlo; Papp, Maria; Hamvas, Jozsef; Varga, Marta; Kanizsai, Peter; Bona, Erno; Miko, Alexandra; Vancsa, Szilard; Juhasz, Mark Felix; Ocskay, Klementina; Darvasi, Erika; Miklos, Emoke; Eross, Balint; Szentesi, Andrea; Parniczky, Andrea; Casadei, Riccardo; Ricci, Claudio; Ingaldi, Carlo; Mastrangelo, Laura; Jovine, Elio; Cennamo, Vincenzo; Marino, Marco V.; Barauskas, Giedrius; Ignatavicius, Povilas; Pelaez-Luna, Mario; Rios, Andrea Soriano; Turcan, Svetlana; Tcaciuc, Eugen; Malecka-Panas, Ewa; Zatorski, Hubert; Nunes, Vitor; Gomes, Antonio; Goncalves, Tiago Curdia; Freitas, Marta; Constantino, Julio; Sa, Milene; Pereira, Jorge; Mateescu, Bogdan; Constantinescu, Gabriel; Sandru, Vasile; Negoi, Ionut; Ciubotaru, Cezar; Negoita, Valentina; Bunduc, Stefania; Gheorghe, Cristian; Barbu, Sorin; Tantau, Alina; Tantau, Marcel; Dumitru, Eugen; Suceveanu, Andra Iulia; Tocia, Cristina; Gherbon, Adriana; Litvin, Andrey; Shirinskaya, Natalia; Rabotyagova, Yliya; Bezmarevic, Mihailo; Hegyi, Peter Jeno; Han, Jimin; Rodriguez-Oballe, Juan Armando; Salas, Isabel Miguel; Comas, Eva Pijoan; de la Iglesia Garcia, Daniel; Cuadrado, Andrea Jardi; Castineira, Adriano Quiroga; Chang, Yu-Ting; Chang, Ming-Chu; Kchaou, Ali; Tlili, Ahmed; Kacar, Sabite; Gokbulut, Volkan; Duman, Deniz; Kani, Haluk Tarik; Altintas, Engin; Chooklin, Serge; Chuklin, Serhii; Gougol, Amir; Papachristou, George; Hegyi, PeterBackground: Acid suppressing drugs (ASD) are generally used in acute pancreatitis (AP); however, large cohorts are not available to understand their efficiency and safety. Therefore, our aims were to evaluate the association between the administration of ASDs, the outcome of AP, the frequency of gastrointestinal (GI) bleeding and GI infection in patients with AP. Methods: We initiated an international survey and performed retrospective data analysis on AP patients hospitalized between January 2013 and December 2018. Results: Data of 17,422 adult patients with AP were collected from 59 centers of 23 countries. We found that 23.3% of patients received ASDs before and 86.6% during the course of AP. ASDs were prescribed to 57.6% of patients at discharge. ASD administration was associated with more severe AP and higher mortality. GI bleeding was reported in 4.7% of patients, and it was associated with pancreatitis severity, mortality and ASD therapy. Stool culture test was performed in 6.3% of the patients with 28.4% positive results. Clostridium difficile was the cause of GI infection in 60.5% of cases. Among the patients with GI infections, 28.9% received ASDs, whereas 24.1% were without any acid suppression treatment. GI infection was associated with more severe pancreatitis and higher mortality. Conclusions: Although ASD therapy is widely used, it is unlikely to have beneficial effects either on the outcome of AP or on the prevention of GI bleeding during AP. Therefore, ASD therapy should be substantially decreased in the therapeutic management of AP. (C) 2020 IAP and EPC. Published by Elsevier B.V.Publication Open Access Myeloperoxidase and calprotectin; Any role as non-invasive markers for the prediction of inflammation and fibrosis in non-alcoholic steatohepatitis?(AVES, 2020-10-30) ÇELİKEL, ÇİĞDEM; Bicakci, Ercan; Demirtas, Coskun Ozer; Celikel, Cigdem; Haklar, Goncagul; Duman, Deniz GuneyBackground/Aims: Specific serum markers reflecting hepatic inflammation and fibrosis are required to tailor the treatment strategies in non-alcoholic steatohepatitis (NASH). We aimed to investigate the roles of myeloperoxidase (MPO) and calprotectin in predicting the hepatic inflammation status and disease severity in NASH. Materials and Methods: A total of 48 patients with biopsy-proven NASH and 25 healthy volunteers with normal weight were prospectively enroiled Serum MPO and calprotectin levels were compared between the NASH and control groups. Hepatic MPO and calprotectin expressions were compared in terms of histologic non-alcoholic fatty liver disease activity scores (NAS) (low NAS [<= 4] vs. high NAS [>5]) and fibrosis stage (insignificant [F0-1]/significant [F2-4]). Results: Serum MPO and calprotectin levels were not significantly different between the NASH and control groups. In the subgroup analysis, hepatic MPG expression was significantly increased in patients with NASH with significant fibrosis than in those with insignificant fibrosis (F2-4: 7.04 +/- 3.61 vs. F0-1: 4.83 +/- 2.42, p=0.01). We found no difference between the groups with low and high NAS with regard to serum MPG and calprotectin levels and hepatic MPG and calprotectin expressions. Conclusion: This study demonstrated that hepatic MPG expression can reflect advanced fibrosis in NASH. However, when serum MPO and calprotectin levels were evaluated as potential serum markers, both did not associate with hepatic inflammation status and fibrosis stage in NASH. Therefore, our study results preclude their use as serum markers for hepatic inflammation in NASH.Publication Metadata only Endoscopic submucosal dissection for colorectal laterally spreading tumors(AVES, 2013) DUMAN, DENİZ; Hulagu, Sadettin; Senturk, Omer; Korkmaz, Ugur; Sirin, Goktug; Duman, Ali Erkan; Dindar, Gokhan; Celebi, Altay; Ogutmen Koc, Deniz; Bozkurt, Neslihan; Yilmaz, Hasan; Gurbuz, Yesim; Duman, Deniz; Tarcin, OrhanBackground/aims: Colorectal laterally spreading tumors are superficial tumors classified into two groups as granular (G-laterally spreading tumor) and non-granular (non-granular-laterally spreading tumor) types. In this study, we aimed to investigate the efficacy and feasibility of endoscopic submucosal dissection in the treatment of laterally spreading tumors. Materials and Methods: Forty-four laterally spreading tumors in 40 patients were treated with endoscopic submucosal dissection at a tertiary referral hospital. Patient data were collected retrospectively. In this study, we evaluated tumor size, macroscopic type, lesion location, histology, curative resection, and complications. Results: Of the 44 laterally spreading tumors excised by endoscopic submucosal dissection, 29 (65.9%) were G-laterally spreading tumor and 15 (34.1%) were non-granular-laterally spreading tumor. Most of the non-granular-laterally spreading tumors were localized in the right colon, while most G-laterally spreading tumors were localized in the left colon (p<0.001). There was also no difference between G-laterally spreading tumors (6/29) and non-granular-laterally spreading tumors (2/15) with regard to exhibiting malignant features (p=0.69). Although median size (40 mm vs. 27.5 mm) and procedure time (115 minutes vs. 60 minutes) for G-laterally spreading tumors were bigger and longer respectively, procedure time per cm(2) was not different (8.9 minutes vs. 8.2 minutes) between the two groups. Curative resection rates for laterally spreading tumors were quite high (95.5%), while en bloc resection rates were low (77.3%). The rates of endoscopic submucosal dissection-related complications such as perforation, major and minor bleeding were low (4.5%, 2.3%, 6.8%, respectively). Conclusion: Endoscopic submucosal dissection is an effective and safe therapeutic option with high curative rates for early-stage malignant and pre-malignant laterally spreading tumors not having an absolute indication for surgery, regardless of the lesion type and size.Publication Open Access Advanced endoscopic ultrasound management techniques for preneoplastic pancreatic cystic lesions(BMJ PUBLISHING GROUP, 2017-01) DUMAN, DENİZ; Arshad, Hafiz Muhammad Sharjeel; Bharmal, Sheila; Duman, Deniz Guney; Liangpunsakul, Suthat; Turner, Brian G.Pancreatic cystic lesions can be benign, premalignant or malignant. The recent increase in detection and tremendous clinical variability of pancreatic cysts has presented a significant therapeutic challenge to physicians. Mucinous cystic neoplasms are of particular interest given their known malignant potential. This review article provides a brief but comprehensive review of premalignant pancreatic cystic lesions with advanced endoscopic ultrasound (EUS) management approaches. A comprehensive literature search was performed using PubMed, Cochrane, OVID and EMBASE databases. Preneoplastic pancreatic cystic lesions include mucinous cystadenoma and intraductal papillary mucinous neoplasm. The 2012 International Sendai Guidelines guide physicians in their management of pancreatic cystic lesions. Some of the advanced EUS management techniques include ethanol ablation, chemotherapeutic (paclitaxel) ablation, radiofrequency ablation and cryotherapy. In future, EUS-guided injections of drug-eluting beads and neodymium:yttrium aluminum agent laser ablation is predicted to be an integral part of EUS-guided management techniques. In summary, International Sendai Consensus Guidelines should be used to make a decision regarding management of pancreatic cystic lesions. Advanced EUS techniques are proving extremely beneficial in management, especially in those patients who are at high surgical risk.Publication Open Access Turkish Gastroenterology Association, Pancreas Study Group, Chronic Pancreatitis Committee Consensus Report(AVES, 2020-11-12) DUMAN, DENİZ; Soyturk, Mujde; Bengi, Goksel; Oguz, Dilek; Kalkan, Ismail Hakki; Yalniz, Mehmet; Tahtaci, Mustafa; Demir, Kadir; Kasap, Elmas; Oruc, Nevin; Unal, Nalan Gulsen; Sezgin, Orhan; Ozdogan, Osman; Altintas, Engin; Yaras, Serkan; Parlak, Erkan; Koksal, Aydin Seref; Saruc, Murat; Unal, Hakan; Unsal, Belkis; Gunay, Suleyman; Duman, Deniz; Yurci, Alper; Kacar, Sabite; Filik, LeventPublication Open Access European Guideline on IgG4-related digestive disease - UEG and SGF evidence-based recommendations(SAGE PUBLICATIONS INC, 2020-07) DUMAN, DENİZ; Lohr, J-Matthias; Beuers, Ulrich; Vujasinovic, Miroslav; Alvaro, Domenico; Frokjaer, Jens Brondum; Buttgereit, Frank; Capurso, Gabriele; Culver, Emma L.; De-Madaria, Enrique; Della-Torre, Emanuel; Detlefsen, Sonke; Dominguez-Munoz, Enrique; Czubkowski, Piotr; Ewald, Nils; Frulloni, Luca; Gubergrits, Natalya; Duman, Deniz Guney; Hackert, Thilo; Iglesias-Garcia, Julio; Kartalis, Nikolaos; Laghi, Andrea; Lammert, Frank; Lindgren, Fredrik; Okhlobystin, Alexey; Oracz, Grzegorz; Parniczky, Andrea; Mucelli, Raffaella Maria Pozzi; Rebours, Vinciane; Rosendahl, Jonas; Schleinitz, Nicolas; Schneider, Alexander; van Bommel, Eric F. H.; Verbeke, Caroline Sophie; Vullierme, Marie Pierre; Witt, Heiko; Besselink, Marc G.; Bruno, Marco J.; Czako, Laszlo; del Chiaro, Marco; Filippova, Oleksandra; Fukuda, Akihisa; Gaujoux, Sebastien; Hart, Phil A.; Hegyi, Peter; Jonas, Eduard; Kahraman, Alisan; Kleger, Alexander; Kuryata, Olexander; Laukkarinen, Johanna; Lerch, Markus M.; Marchegiani, Giovanni; Marschal, Hanns-Ulrich; Matos, Celso; Molad, Yair; Oguz, Dilek; Pukitis, Aldis; Satoi, Sohei; Stone, John H.; Verheij, Joanne; de Vries, NiekThe overall objective of these guidelines is to provide evidence-based recommendations for the diagnosis and management of immunoglobulin G4 (IgG4)-related digestive disease in adults and children. IgG4-related digestive disease can be diagnosed only with a comprehensive work-up that includes histology, organ morphology at imaging, serology, search for other organ involvement, and response to glucocorticoid treatment. Indications for treatment are symptomatic patients with obstructive jaundice, abdominal pain, posterior pancreatic pain, and involvement of extra-pancreatic digestive organs, including IgG4-related cholangitis. Treatment with glucocorticoids should be weight-based and initiated at a dose of 0.6-0.8 mg/kg body weight/day orally (typical starting dose 30-40 mg/day prednisone equivalent) for 1 month to induce remission and then be tapered within two additional months. Response to initial treatment should be assessed at week 2-4 with clinical, biochemical and morphological markers. Maintenance treatment with glucocorticoids should be considered in multi-organ disease or history of relapse. If there is no change in disease activity and burden within 3 months, the diagnosis should be reconsidered. If the disease relapsed during the 3 months of treatment, immunosuppressive drugs should be added.Publication Metadata only Microalbuminuria in nondiabetic patients with nonalcoholic fatty liver disease: association with liver fibrosis(W B SAUNDERS CO-ELSEVIER INC, 2010) ÇELİKEL, ÇİĞDEM; Yilmaz, Yusuf; Alanhdab, Yesim Ozen; Yonal, Oya; Kurt, Ramazan; Kedrah, Alla Eldeen; Celikel, Cigdem Ataizi; Ozdogan, Osman; Duman, Deniz; Imeryuz, Nese; Avsar, Erol; Kalayci, CemRecent evidence has suggested an association between microalbuminuria and ultrasound-diagnosed nonalcoholic fatty liver disease (NAFLD) in patients with diabetes and prediabetes However, few data are available on the occurrence of microalbuminuria in nondiabetic subjects with histologically proven NAFLD We thus evaluated the relationships between microalbuminuria and liver histology in a hospital-based sample of 87 adults with biopsy-proven NAFLD from Turkey An albumin excretion rate less than 30 mg/d was considered within the reference range, whereas an albumin excretion rate from 30 to 300 mg/d was considered to indicate microalbuminuria Compared with those without microalbuminuria (n = 73), NAFLD patients with microalbuminuria (n = 14) had significantly higher homeostasis model assessment of insulin resistance values (3 9 +/- 1 3 vs 5 8 +/- 3 7, P < 001) There were no differences in the prevalence of microalbuminuria in patients with definite nonalcoholic steatohepatitis, borderline nonalcoholic steatohepatitis, and simple fatty liver In the entire study cohort, mean fibrosis scores were significantly higher in patients with microalbuminuria than in those without (1 27 +/- 0.26 vs 0 80 +/- 0 11, P < 05) This difference persisted after adjustment for potential confounders These results indicate the presence of a significant association between the seventy of insulin resistance and microalbuminuria in patients with NAFLD In addition, microalbuminuria may identify NAFLD patients with higher fibrosis scores (C) 2010 Elsevier Inc. All rights reservedPublication Metadata only Synchronous appearance of gastrointestinal stromal tumor and neuroendocrine tumor in stomach: Review of the literature and management strategies(AVES, 2012) DUMAN, DENİZ; Duman, Deniz Guney; Eren, Funda; Yegin, Ender Gunes; Ikinci, Aygun; Yegen, CumhurGastrointestinal stromal tumors represent the most common mesenchymal tumor of the digestive tract. Although the stomach is the most common location for gastrointestinal stromal tumor with the co-primary tumors, the synchronous appearance of a neuroendocrine tumor and gastrointestinal stromal tumor in the stomach is rare. We present here the case of a 48-year-old male with gastric well-differentiated neuroendocrine tumor and gastrointestinal stromal tumor discovered incidentally during surgical treatment of the neuroendocrine tumor. We discuss the current guidelines for the management of small gastrointestinal stromal tumors (<2 cm in diameter) and the gastric carcinoids. We also review the literature for the co-occurrence of gastrointestinal stromal tumor and neuroendocrine tumor in a gastric location.Publication Metadata only Nonalcoholic Fatty Liver Disease is Associated With Erectile Dysfunction: A Prospective Pilot Study(ELSEVIER SCI LTD, 2016) ÇELİKEL, ÇİĞDEM; Duman, Deniz Guney; Bicakci, Ercan; Celikel, Cigdem Ataizi; Akbal, CemIntroduction: Nonalcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome (MetS). Although the link between MetS and erectile dysfunction (ED) is well known, clinical studies investigating the association between NAFLD and ED are scant. Aim: To evaluate the relationship between NAFLD and ED. Methods: Male patients with biopsy-proven NAFLD were prospectively asked to fill the five-item International Index of Erectile Function (IIEF-5) questionnaire. Their clinical and histologic variables were compared with the IEFF scores. Main Outcome Measures: IIEF scores; proportions of NAFLD patients who demonstrated ED and/or MetS; association between the severity of histological hepatic damage and ED. Results: Forty male patients having an age range of 33 (24-57) and a mean age of 40.13 +/- 10.22 years with biopsy-proven NAFLD had a median IIEF-5 score of 16 (9-25) and MetS was present in 23 (57.5%). ED severity distributions as moderate, mild, and no ED were 11 (27.5%), 16 (40%), and 13 (32.5 %), respectively. Histological NAFLD score was significantly higher in patients having ED compared with patients with no ED (5.63 +/- 1.39 vs 4.15 +/- 1.46; P = .006). MetS diagnosis was significantly more common in patients having ED, compared with those without ED [19 (70.4%) vs 4 (30.8%), respectively, P = .018)]. When patients with and without ED were compared, gamma glutamyl transferase was significantly lower in ED, whereas components of MetS did not correlate with ED. After multivariate analysis, NAFLD score has remained the only significant outcome associated with ED [P = .03; OR (95% CI): 2.38 (1.079-5.238)]. Conclusion: The current clinical study demonstrates a significant association between nonalcoholic steatohepatitis and ED for the first time. Our findings suggest liver damage may play role in the pathogenesis of ED in patients with NAFLD. Future studies are needed to expand the underlying common mechanisms responsible for this novel hypothesis. Copyright (C) 2016, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.Publication Metadata only High prevalence of amebiasis in ulcerative colitis patients compared to Crohn’s disease;ten year follow-up results from a university hospital, Turkey(2006-03-24) DUMAN, DENİZ; İLKİ, ZEYNEP ARZU; HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; Duman D., İlki Z. A., Hasdemir Gökboğa M. U., İmeryüz N., Tüzün N., Hamzaoğlu H.