Person: TUTAR, ENGİN
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TUTAR
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ENGİN
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Publication Open Access Bowel Preparation for Colonoscopy in Children: 1 Day PEG-3350 with Bisacodyl versus 3 Day Sennosides(KARGER, 2019) ERTEM ŞAHİNOĞLU, DENİZ; Tutar, Engin; Bayrak, Nevzat Aykut; Volkan, Burcu; Ertem, DenizBackground and Objectives: Bowel preparation (BP) for colonoscopy is a challenging procedure in children and different regimens have been used for this purpose. Polyethylene glycol (PEG) is the most preferred agent in recent years. The primary aim of this study was to evaluate the efficacy of 1-day PEG-3350 with bisacodyl (PEG-B) and comparing it with 3-day sennosides A+B. Method: In this prospective, randomized, and single-blinded study, children aged 2-18 years were included in the PEG-B group for 1 day or in Senna group for 3 days. The effectiveness of BP was assessed according to the Ottawa and Boston BP scales, compliance and adverse effects were also recorded. Pre- and post-preparation biochemistry were obtained for investigation of safety of both regimens. Results: Successful BP was observed in 88.3% (n = 53/60) of PEG-B and 86% (n = 55/64) of Senna groups according to Boston scale, and it was 85% (n = 51/60) and 84.4% (n = 54/64), respectively, according to Ottawa scale. The cecal intubation rate was 96.7% (n = 58/60) in the PEG-B group and 93.8% (n = 60/64) in the Senna group. Ease of administration and disturbance in regular daily activities was better in the PEG-B group (p < 0.05). There was no major adverse event and biochemical abnormality in both groups. The correlation between Ottawa and Boston scales was found to be excellent (r(2) = -0.954, p < 0.01). Conclusions: The efficacy, safety, and adverse effect profile of 1-day BP with PEG-B regimen was found to be similar to 3-day sennosides regimen, however, the PEG-B regimen had advantages such as short duration, ease of administration, and better patient comfort. Also, high correlation rate between the Boston and Ottawa scales in pediatric patients was remarkable. (c) 2019 S. Karger AG, BaselPublication Metadata only What is the diagnostic utility of endoscopic scoring systems in children?(AVES, 2013) ÇELİKEL, ÇİĞDEM; Tutar, Engin; Kutluk, Gunsel; Bayrak, Nevzat Aykut; Celikel, Cigdem Ataizi; Pehlivanoglu, Ender; Ertem, DenizBackground/aims: The aim of this study was to evaluate the consistency of the Savary-Miller, the Hetzel-Dent and the Los Angeles endoscopic classification systems and to compare them with the esophageal histopathology in children. Material and Methods: Children between the ages of 5-17 years who underwent esophagogastroduodenoscopy were included in the study. The endoscopic reports and the still images of the esophagus were reclassified by the same gastroenterologist according to the Savary-Miller, Hetzel-Dent and Los Angeles scoring systems. The esophageal biopsies were also reevaluated by the same pathologist and the consistency between endoscopic and histopathologic esophagitis was evaluated. Results: A total of 113 out of 192 pediatric patients were included in the study. Seventy-three patients (64.6%) had esophagitis according to the Hetzel-Dent classification, whereas only 20 (17.7%) patients were defined as having esophagitis according to the other two classification systems. The consistency between the Savary-Miller and Los Angeles classifications was excellent (kappa: 0.92) but the agreement between the Hetzel-Dent and Savary-Miller and between the Hetzel-Dent and Los Angeles classifications were poor. A total of 82 patients (72.6%) had histopathological esophagitis, and there was a weak consistency between all 3 endoscopic scoring systems and the histopathology. Conclusions: Since pediatric patients have milder esophagitis than in adults, the use of endoscopic scoring systems developed for adults seems to be inapplicable for children. The inclusion of minimal endoscopic changes in endoscopic scoring systems by using more sensitive and novel endoscopic techniques would increase the sensitivity of these scoring systems in children.Publication Open Access Gastrointestinal Manifestations in Children with Primary Immunodeficiencies: Single Center: 12 Years Experience(KARGER, 2019) ÖZEN, AHMET OĞUZHAN; Akkelle, Bilge S.; Tutar, Engin; Volkan, Burcu; Sengul, Ozlem K.; Ozen, Ahmet; Celikel, Cigdem A.; Ertem, DenizBackground: It has been reported that 5-50% of patients with primary immune deficiencies (PID) may present with or develop gastrointestinal (GI) manifestations. Objective: This study was aimed at analyzing GI and related endoscopic, histopathological findings in children with PID. Methods: Children with PID who were evaluated by endoscopy between 2005 and 2016 were enrolled in this study. Demographic data, growth parameters, signs and symptoms at diagnosis were obtained. Results: Of 425 children with PID, 195 had GI manifestations. Forty-seven of 195 children required endoscopic investigation, 30 (63.8%) were male, and the mean age was 7.7 +/- 5 years. The rate of consanguinity was 61.7%, and the most common symptom was chronic diarrhea (57.4%). Seventy-two percent of the patients were malnourished. Giardia intestinalis was detected in 4, and Helicobacter pylori was confirmed in 8/45 (17.7%) patients. Non-celiac villous flatting was discovered in 15.5% of patients. Twelve patients were diagnosed as having immunodeficiency associated inflammatory bowel disease (IBD)-like colitis. Conclusions: PID may present with GI manifestations or develop during the course of the disease. Investigating immunodeficiency in patients with atypical GI symptoms can provide an appropriate therapeutic option, and an improved quality of life, particularly in populations with a high rate of consanguinity.Publication Metadata only Acute Liver Failure and Hepatic Encephalopathy After Cleft Palate Repair(ALLIANCE COMMUNICATIONS GROUP DIVISION ALLEN PRESS, 2015) TUTAR, ENGİN; Kocaaslan, Nihal Durmus; Tuncer, Fatma Betul; Tutar, Engin; Celebiler, OzhanParacetamol is the most commonly used analgesic after cleft palate repair. It has rarely caused acute hepatic failure at therapeutic or supratherapeutic doses. Only one case of therapeutic paracetamol toxicity after cleft palate repair had been reported previously. Here, we present a similar patient who developed acute liver failure and hepatic encephalopathy after an uncomplicated cleft palate surgery. Lack of large prospective trials in young children due to ethical concerns increases the value of the case reports of acetaminophen toxicity at therapeutic doses. The dosing recommendations of paracetamol may need to be reconsidered after cleft palate surgery.Publication Metadata only Endemi̇k Olmayan Bölgede Vi̇seral Lei̇shmani̇si̇s: Olgu Sunumu.(2013-04-01) KEPENEKLİ KADAYİFCİ, EDA; TUTAR, ENGİN; KOÇ, AHMET; ÇELİKEL, ÇİĞDEM; Karabağ Yılmaz E., Baranoğlu Him N., Kepenekli Kadayifci E., Volkan B., Tutar E., Koç A., Çelikel Ç., Soysal A.