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Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori enfeksiyonu sıklığı ve demir eksikliği anemisi ile ilişkisi

Yıl 2019, Cilt: 17 Sayı: 2, 209 - 219, 02.08.2019

Öz

GİRİŞ ve AMAÇ: Çalışmanın amacı, Orta Karadeniz bölgesindeki çocuklarda
Helikobakter Pilori (H.Pilori) pozitiflik oranının belirlenmesi; H.Pilori
enfeksiyonunun, demir eksikliği anemisi (DEA) ve ilişkili hematolojik
parametreler ile korelasyonunun değerlendirilmesidir.

YÖNTEM ve GEREÇLER: Çalışmaya gastrointestinal sistem semptomları nedeni ile
C-14 üre nefes testi uygulanan çocuklar dahil edildi. Hemoglobin, hematokrit,
ortalama eritrosit hacmi (n=852); serum demir düzeyi (n=175), demir bağlama
kapasitesi (n=175), ferritin (n=197), transferrin satürasyonu (n=254) ve C-14
üre nefes testi sonuçları (n=1006) retrospektif olarak değerlendirildi.
H.Pilori pozitiflik oranı belirlendi; H.Pilori pozitif ve negatif çocuklarda
hematolojik parametreler karşılaştırıldı. 

BULGULAR: Çalışmaya dahil edilen çocuk hastaların %46,8’ inde H.Pilori pozitif
idi. H.Pilori pozitif hastalarda hemoglobin ve hematokrit düzeylerinin negatif
hastalara kıyasla anlamlı oranda düşük olduğu tespit edildi (hemoglobin için T:
4,014 P: 0,000; hematokrit için T: 3,486 P: 0,001). Ortalama eritrosit hacmi
H.Pilori pozitif hastalarda düşük olmakla birlikte, istatistiksel olarak
anlamlı değildi. Serum demir düzeyi (T: 2,297 P: 0,023), ferritin düzeyi (T:
2,19 P: 0,03) ve transferrin saturasyonu (T: 2,541 P: 0,012) H.Pilori pozitif
hastalarda anlamlı düzeyde düşük saptandı. Demir bağlama kapasitesi açısından
anlamlı fark izlenmedi. Anemik çocuklarda (x²: 23,533 P: 0,000), transferrin
düzeyi düşük olan çocuklarda (x²: 4,948 P: 0,026), ferritin düzeyi düşük olan
çocuklarda (x²: 6,96 P: 0,008) ve ferritin düzeyi düşük olan anemik çocuklarda
(x²: 13,74 P: 0,00) H.Pilori pozitiflik oranının yüksek olduğu tespit edildi.
Kızlarda ve erkeklerde H.Pilori pozitif çocuklarda anemi oranı anlamlı düzeyde
yüksek bulundu (kızlarda x²: 9,033 P: 0,003; erkeklerde x²: 15,016 P:
0,000). 

TARTIŞMA ve SONUÇ: Orta Karadeniz bölgesinde gastrointestinal sistem semptomu
olan çocuklardaki H.Pilori pozitiflik oranının, ülkemizin diğer bölgelerindeki
oranlar ile karşılaştırıldığında ortanca değer düzeylerinde olduğu düşünülmektedir.
Çalışmaya dahil olan geniş pediatrik populasyondan elde edilen sonuçlar,
H.Pilori enfeksiyonu ile DEA arasındaki ilişkiyi desteklemektedir

Kaynakça

  • 1- Cherian S, Forbes D, Sanfilippo F, Cook A, Burgner D. The epidemiology of helicobacter pylori infection in African refugee children resettled in Australia. MJA 2008; 189:438-41.
  • 2- Kanbay M, Kanbay A, Boyacioglu S. Helicobacter pylori infection as a possible risk factor for respiratory system disease: A review of the literature. Resp Med 2007; 101:203-9.
  • 3- Moon A, Solomon A, Beneck D, Cunningham-Rundles S. Positive association between helicobacter pylori and gastroesophageal reflux disease in children. J Pediatr Gastroenterol Nutr 2009; 49:283-8.
  • 4- Russo-Mancuso G, Branciforte F, Licciardello M, La Spina M. Iron deficiency anemia as the only sign of infection with Helicobacter pylori: a report of 9 pediatric cases. Int J Hematol 2003; 78:429-31.
  • 5- WHO. Iron Deficiency Anaemia: Assessment, Prevention, and Control. A guide for programme managers, 2001.
  • 6- Dallmann, P R, Yip R, Oski FA. Iron deficiency and related nutritional anemias. In: Nathan DG, Oski FA (eds). Hematology of Infancy and Childhood. Philadelphia: W.B. Saunders; 1993. P.413-50.
  • 7- Peach HG, Bath NE, Farish SJ. Helicobacter pylori infection: an added stressor on iron status of women in the community. Med J Aust 1998; 169:188-90.
  • 8- Cardenas VM, Mulla ZD, Ortiz M, Graham DY. Iron deficiency and Helicobacter pylori infection in the United States. Am J Epidemiol 2006; 163:127-34.
  • 9- Parkinson AJ, Gold BD, Bulkow L, Wainwright RB, Swaminathan B, Khanna B, et al. High prevalence of Helicobacter pylori in the Alaska native population and association with low serum ferritin levels in young adults. Clin Diagn Lab Immunol 2000; 7:885-8.
  • 10- Gold BD, Colletti RB, Abbott M, Czinn SJ, Elitsu Y, Hassall E, et al. Helicobacter pylori infection in Children: Recommendations for diagnosis and treatment. J Pediatr Gastroenterol Nutr 2000; 31:490-7.
  • 11- Hino B, Eliakim R, Levine A, Spreche H, Berkowitz D, Hartma C, et al. Comparison of Invasive and Non-Invasive Tests Diagnosis and Monitoring of Helicobacter Pylori Infection in Children. JPGN 2004; 3:519-23.
  • 12- Delvin EE, Brazier JL, Deslandres C, Alvarez F, Russo P, Seidman E. Accuracy of the [13C]-Urea Breath Test in Diagnosing Helicobacter pylori Gastritis in Pediatric Patients. J Pediatr Gastroenterol Nutr 1999; 28:59-62.
  • 13- Kato S, Nakayama K, Minoura T, Konno M, Tajiri H, Matsuhisa T, et al. Comparison between the 13C-14C urea breath test and stool antigen test for the diagnosis of childhood Helicobacter pylori infection. J Gastroenterol 2004; 39:1045-50.
  • 14- Logan RPH Urea breath tests in the management of Helicobacter pylori infection. Gut 1998; 43: 47-50.
  • 15- Özturk E, Yeşilova Z Ilgan S, Arslan N, Erdil A, Celasun B, et al. A new, practical, low-dose 14C- urea breath test for the diagnosis of Helicobacter pylori infection: clinical validation and comparison with the standard method. Eur J Nucl Med Mol Imaging 2003: 30:1457-62.
  • 16- Ahuja V, Bal C, Sharma M. Can the 14C urea breath test replace follow-up endoscopic biopsies in patients treated for Helicobacter Pylori infection? Clin Nucl Med 1998; 23(12): 815-9.
  • 17- Hegedus O, Ryden J, Rehnberg AS, Nilsson S, Hellström PM. Validated accuracy of a novel 14C urea breath test for rapid Helicobacter pylori detection and in-office analysis. Eur J Gastro Hepatol 2002; 14:1-8.
  • 18- Salih BA. Helicobacter pylori infection in developing countries: the burden for how long?. Saudi J Gastroenterol. 2009; 15(3):201-7.
  • 19- Di Xu C, Chen SN, Jiang SH, Xu JY. Seroepidemiology of Helicobacter pylori infection among asymptomatic Chinese children. World J Gastroenterol 2000; 5:759-61.
  • 20- Pradip K B. Epidemiological Features of Helicobacter pylori Infection in Developing Countries. Clin Inf Dis 1997; 25:973-8.
  • 21- Sykora J, Siala K, Varvarovska J, Pazdiora P, Pomahačová R, Huml M. Epidemiology of Helicobacter pylori infection in asymptomatic children: a prospective population-based study from the Czech Republic. Application of a monoclonal-based antigen-instool enzyme immunoassay. Helicobacter 2009; 14:286-97.
  • 22- Baggett HC, Parkinson AJ, Muth PT, Gold BD, Gessner BD. Endemic iron deficiency associated with Helicobacter pylori infection among school-aged children in Alaska. Pediatrics 2006; 117;396-404.
  • 23- Selimoğlu MA, Ertekin V, İnandı T. Seroepidemiology of Helicobacter pylori infection in children living in eastern Turkey. Pediatrics International 2002; 44:666-9.
  • 24- Kaya AD, Gencay E, Ozturk CE, Yavuz T. Seroprevalence of Helicobacter pylori infection in children in northwest region of Turkey: relationship with iron deficiency anemia. J Trop Pediatr 2008; 54:353-4.
  • 25- Kilinc M, Yuregir G, Ekerbicer H. Anemia and iron deficiency anaemia in south-east Anatolia. Eur. J. Haematol. 2002; 69:280-3.
  • 26- Süoglu ED, Gökçe S, Saglam AT , Sökücü S, Saner G. Association of Helicobacter pylori infection with gastroduodenal disease, epidemiologic factors and iron deficiency anemia in Turkish children undergoing endoscopy, and impact on growth. Pediatrics International 2007; 49:858-63.
  • 27- Baysoy G, ErtemD, Ademoğlu E. Gastric Histopathology, Iron Status and Iron Deficiency Anemia in Children with Helicobacter pylori Infection. JPGN 2004: 38;146-51.
  • 28- Sezgin FM, Nar R, Babaoğlu ÜT, İlanbey B. Helicobacter pylori Prevalence in Pediatric Patients in Kırşehir Region. Ahi Evran Med J 2017; 1:14-7.
  • 29- Erbey F, Acar MN, Okur M, Güven A. Van Gölü Havzasında 1-18 Yaş Grubu Çocuklarda Helicobacter pylori Sıklığı. Çocuk Enfeksiyon Dergisi 2010; 4:93-5.
  • 30- Mishra S, Singh V, Rao GR, Dixit VK, Gulati AK, Nath G. Prevalence of Helicobacter pylori in asymptomatic subjects - a nested PCR based study. Infect Genet Evol 2008; 8:815-9.
  • 31- Bhuiyan TR, Qadri F, Saha A, Svennerholm AM. Infection by Helicobacter Pylori in Bangladeshi children from birth to two years relation to blood group, nutritional status, and seasonality. The Pediatric Infectious Disease Journal 2009; 28:79-85.
  • 32- Zhang ZW, Patchett SE, Perrett D, Katelaris PH, Domizio P, Farthing MJG. The relation between gastric vitamin C concentrations, mucosal histology, and CagA seropositivity in the human stomach. Gut 1998; 43:322-6.
  • 33- Sarker SA, Davidsson L, Mahmud H, Walczyk T, Hurrell RF, Gyr N, et al. Helicobacter pylori infection, iron absorption, and gastric acid secretion in Bangladeshi children. Am J Clin Nutr 2004; 80:149-53.
  • 34- Cardamone M, Alex G, Harari MD, Moss WP, Oliver MR. Severe iron-deficiency anaemia in adolescents: Consider Helicobacter pylori infection. J. Paediatr Child Health 2008: 44;647-50.
  • 35- Ciacci C, Sabbatini F, Cavallaro R, Castiglione F, Di Bella S, Lovino P, et al. Helicobacter pylori impairs iron absorption in infected individuals. Dig Liver Dis 2004; 36:455-60.
  • 36- Seo JK, Ko JS, Choi KD. Serum ferritin and Helicobacter pylori infection in children: A sero-epidemiologic study in Korea. J Gastro Hepatol 2002; 17:754-7.
  • 37- Santos IS, Boccio J, Davidsson L, Hernandez-Triana M, Huanca-Sardinas E, Janjetic M, et al. Helicobacter pylori is not associated with anaemia in Latin America: results from Argentina, Brazil, Bolivia, Cuba, Mexico and Venezuela. Public Health Nutr 2009: 12;1862-70.
  • 38- Kurekci AE, Atay AA, Sarici SU. Is There a Relationship Between Childhood Helicobacter Pylori Infection and Iron Deficiency Anemia?. J Trop Ped 2005; 51:166-9.

Pediatric Helicobacter Pylori infection prevalence and iron deficiency anemia coincidence among children in North Central Turkey

Yıl 2019, Cilt: 17 Sayı: 2, 209 - 219, 02.08.2019

Öz

INTRODUCTION: To estimate Helicobacter Pylori (H.Pylori) prevalence,
coincidence of iron deficiency anemia (IDA) and related hematological
parameters in children of North Central Turkey. 

METHODS: Hemoglobin, hematocrit, mean corpuscular volume (n=852); serum iron
level (n=175), iron binding capacity (n=175), ferritin (n=197), transferrin
saturation (n=254) and 14C urea breath test results (n=1006) were reviewed in
children with nonspecific gastrointestinal symptoms. H.Pylori prevalence was
determined; hematological parameters were compared in H.Pylori positive and
negative patients. 

RESULTS: Overall H.Pylori prevalence was 46,8%. Hemoglobin and hematocrit
values were significantly lower in H. Pylori positive patients (T: 4,014 P:
0,000 for hemoglobin; T: 3,486 P: 0,001 for hematocrit). Although MCV values
were lower in H. Pylori positive patients, the difference was not statistically
significant.Serum iron levels (T: 2,297 P: 0,023), ferritin levels (T: 2,19 P:
0,03) and transferrin saturations (T: 2,541 P: 0,012) were significantly lower
in H.Pylori positive patients. Iron binding capacity was higher in H.Pylori
positive patients but this was also not significant. H.Pylori positivity is
significantly higher in anemic patients (x²: 23,533 P: 0,000), in patients with
low transferrin (x²: 4,948 P: 0,026), low ferritin (x²: 6,96 P: 0,008) and in
patients with low ferritin and anemia together (x²: 13,74 P: 0,00). In females
and males, anemia was significantly higher in H.Pylori positive patients (x²:
9,033 P: 0,003 and x²: 15,016 P: 0,000 in females and males respectively).

DISCUSSION AND CONCLUSION: H.Pylori positivity rate in the pediatric population
of North Central Turkey seems to be a median value within the range of yet
reported Turkish prevalence. There is an association between H.Pylori and IDA
according to the results of a large pediatric population

Kaynakça

  • 1- Cherian S, Forbes D, Sanfilippo F, Cook A, Burgner D. The epidemiology of helicobacter pylori infection in African refugee children resettled in Australia. MJA 2008; 189:438-41.
  • 2- Kanbay M, Kanbay A, Boyacioglu S. Helicobacter pylori infection as a possible risk factor for respiratory system disease: A review of the literature. Resp Med 2007; 101:203-9.
  • 3- Moon A, Solomon A, Beneck D, Cunningham-Rundles S. Positive association between helicobacter pylori and gastroesophageal reflux disease in children. J Pediatr Gastroenterol Nutr 2009; 49:283-8.
  • 4- Russo-Mancuso G, Branciforte F, Licciardello M, La Spina M. Iron deficiency anemia as the only sign of infection with Helicobacter pylori: a report of 9 pediatric cases. Int J Hematol 2003; 78:429-31.
  • 5- WHO. Iron Deficiency Anaemia: Assessment, Prevention, and Control. A guide for programme managers, 2001.
  • 6- Dallmann, P R, Yip R, Oski FA. Iron deficiency and related nutritional anemias. In: Nathan DG, Oski FA (eds). Hematology of Infancy and Childhood. Philadelphia: W.B. Saunders; 1993. P.413-50.
  • 7- Peach HG, Bath NE, Farish SJ. Helicobacter pylori infection: an added stressor on iron status of women in the community. Med J Aust 1998; 169:188-90.
  • 8- Cardenas VM, Mulla ZD, Ortiz M, Graham DY. Iron deficiency and Helicobacter pylori infection in the United States. Am J Epidemiol 2006; 163:127-34.
  • 9- Parkinson AJ, Gold BD, Bulkow L, Wainwright RB, Swaminathan B, Khanna B, et al. High prevalence of Helicobacter pylori in the Alaska native population and association with low serum ferritin levels in young adults. Clin Diagn Lab Immunol 2000; 7:885-8.
  • 10- Gold BD, Colletti RB, Abbott M, Czinn SJ, Elitsu Y, Hassall E, et al. Helicobacter pylori infection in Children: Recommendations for diagnosis and treatment. J Pediatr Gastroenterol Nutr 2000; 31:490-7.
  • 11- Hino B, Eliakim R, Levine A, Spreche H, Berkowitz D, Hartma C, et al. Comparison of Invasive and Non-Invasive Tests Diagnosis and Monitoring of Helicobacter Pylori Infection in Children. JPGN 2004; 3:519-23.
  • 12- Delvin EE, Brazier JL, Deslandres C, Alvarez F, Russo P, Seidman E. Accuracy of the [13C]-Urea Breath Test in Diagnosing Helicobacter pylori Gastritis in Pediatric Patients. J Pediatr Gastroenterol Nutr 1999; 28:59-62.
  • 13- Kato S, Nakayama K, Minoura T, Konno M, Tajiri H, Matsuhisa T, et al. Comparison between the 13C-14C urea breath test and stool antigen test for the diagnosis of childhood Helicobacter pylori infection. J Gastroenterol 2004; 39:1045-50.
  • 14- Logan RPH Urea breath tests in the management of Helicobacter pylori infection. Gut 1998; 43: 47-50.
  • 15- Özturk E, Yeşilova Z Ilgan S, Arslan N, Erdil A, Celasun B, et al. A new, practical, low-dose 14C- urea breath test for the diagnosis of Helicobacter pylori infection: clinical validation and comparison with the standard method. Eur J Nucl Med Mol Imaging 2003: 30:1457-62.
  • 16- Ahuja V, Bal C, Sharma M. Can the 14C urea breath test replace follow-up endoscopic biopsies in patients treated for Helicobacter Pylori infection? Clin Nucl Med 1998; 23(12): 815-9.
  • 17- Hegedus O, Ryden J, Rehnberg AS, Nilsson S, Hellström PM. Validated accuracy of a novel 14C urea breath test for rapid Helicobacter pylori detection and in-office analysis. Eur J Gastro Hepatol 2002; 14:1-8.
  • 18- Salih BA. Helicobacter pylori infection in developing countries: the burden for how long?. Saudi J Gastroenterol. 2009; 15(3):201-7.
  • 19- Di Xu C, Chen SN, Jiang SH, Xu JY. Seroepidemiology of Helicobacter pylori infection among asymptomatic Chinese children. World J Gastroenterol 2000; 5:759-61.
  • 20- Pradip K B. Epidemiological Features of Helicobacter pylori Infection in Developing Countries. Clin Inf Dis 1997; 25:973-8.
  • 21- Sykora J, Siala K, Varvarovska J, Pazdiora P, Pomahačová R, Huml M. Epidemiology of Helicobacter pylori infection in asymptomatic children: a prospective population-based study from the Czech Republic. Application of a monoclonal-based antigen-instool enzyme immunoassay. Helicobacter 2009; 14:286-97.
  • 22- Baggett HC, Parkinson AJ, Muth PT, Gold BD, Gessner BD. Endemic iron deficiency associated with Helicobacter pylori infection among school-aged children in Alaska. Pediatrics 2006; 117;396-404.
  • 23- Selimoğlu MA, Ertekin V, İnandı T. Seroepidemiology of Helicobacter pylori infection in children living in eastern Turkey. Pediatrics International 2002; 44:666-9.
  • 24- Kaya AD, Gencay E, Ozturk CE, Yavuz T. Seroprevalence of Helicobacter pylori infection in children in northwest region of Turkey: relationship with iron deficiency anemia. J Trop Pediatr 2008; 54:353-4.
  • 25- Kilinc M, Yuregir G, Ekerbicer H. Anemia and iron deficiency anaemia in south-east Anatolia. Eur. J. Haematol. 2002; 69:280-3.
  • 26- Süoglu ED, Gökçe S, Saglam AT , Sökücü S, Saner G. Association of Helicobacter pylori infection with gastroduodenal disease, epidemiologic factors and iron deficiency anemia in Turkish children undergoing endoscopy, and impact on growth. Pediatrics International 2007; 49:858-63.
  • 27- Baysoy G, ErtemD, Ademoğlu E. Gastric Histopathology, Iron Status and Iron Deficiency Anemia in Children with Helicobacter pylori Infection. JPGN 2004: 38;146-51.
  • 28- Sezgin FM, Nar R, Babaoğlu ÜT, İlanbey B. Helicobacter pylori Prevalence in Pediatric Patients in Kırşehir Region. Ahi Evran Med J 2017; 1:14-7.
  • 29- Erbey F, Acar MN, Okur M, Güven A. Van Gölü Havzasında 1-18 Yaş Grubu Çocuklarda Helicobacter pylori Sıklığı. Çocuk Enfeksiyon Dergisi 2010; 4:93-5.
  • 30- Mishra S, Singh V, Rao GR, Dixit VK, Gulati AK, Nath G. Prevalence of Helicobacter pylori in asymptomatic subjects - a nested PCR based study. Infect Genet Evol 2008; 8:815-9.
  • 31- Bhuiyan TR, Qadri F, Saha A, Svennerholm AM. Infection by Helicobacter Pylori in Bangladeshi children from birth to two years relation to blood group, nutritional status, and seasonality. The Pediatric Infectious Disease Journal 2009; 28:79-85.
  • 32- Zhang ZW, Patchett SE, Perrett D, Katelaris PH, Domizio P, Farthing MJG. The relation between gastric vitamin C concentrations, mucosal histology, and CagA seropositivity in the human stomach. Gut 1998; 43:322-6.
  • 33- Sarker SA, Davidsson L, Mahmud H, Walczyk T, Hurrell RF, Gyr N, et al. Helicobacter pylori infection, iron absorption, and gastric acid secretion in Bangladeshi children. Am J Clin Nutr 2004; 80:149-53.
  • 34- Cardamone M, Alex G, Harari MD, Moss WP, Oliver MR. Severe iron-deficiency anaemia in adolescents: Consider Helicobacter pylori infection. J. Paediatr Child Health 2008: 44;647-50.
  • 35- Ciacci C, Sabbatini F, Cavallaro R, Castiglione F, Di Bella S, Lovino P, et al. Helicobacter pylori impairs iron absorption in infected individuals. Dig Liver Dis 2004; 36:455-60.
  • 36- Seo JK, Ko JS, Choi KD. Serum ferritin and Helicobacter pylori infection in children: A sero-epidemiologic study in Korea. J Gastro Hepatol 2002; 17:754-7.
  • 37- Santos IS, Boccio J, Davidsson L, Hernandez-Triana M, Huanca-Sardinas E, Janjetic M, et al. Helicobacter pylori is not associated with anaemia in Latin America: results from Argentina, Brazil, Bolivia, Cuba, Mexico and Venezuela. Public Health Nutr 2009: 12;1862-70.
  • 38- Kurekci AE, Atay AA, Sarici SU. Is There a Relationship Between Childhood Helicobacter Pylori Infection and Iron Deficiency Anemia?. J Trop Ped 2005; 51:166-9.
Toplam 38 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma
Yazarlar

Sibel Uçak Semirgin

Yayımlanma Tarihi 2 Ağustos 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 17 Sayı: 2

Kaynak Göster

APA Uçak Semirgin, S. (2019). Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori enfeksiyonu sıklığı ve demir eksikliği anemisi ile ilişkisi. Güncel Pediatri, 17(2), 209-219. https://doi.org/10.32941/pediatri.600322
AMA Uçak Semirgin S. Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori enfeksiyonu sıklığı ve demir eksikliği anemisi ile ilişkisi. Güncel Pediatri. Ağustos 2019;17(2):209-219. doi:10.32941/pediatri.600322
Chicago Uçak Semirgin, Sibel. “Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori Enfeksiyonu sıklığı Ve Demir eksikliği Anemisi Ile ilişkisi”. Güncel Pediatri 17, sy. 2 (Ağustos 2019): 209-19. https://doi.org/10.32941/pediatri.600322.
EndNote Uçak Semirgin S (01 Ağustos 2019) Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori enfeksiyonu sıklığı ve demir eksikliği anemisi ile ilişkisi. Güncel Pediatri 17 2 209–219.
IEEE S. Uçak Semirgin, “Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori enfeksiyonu sıklığı ve demir eksikliği anemisi ile ilişkisi”, Güncel Pediatri, c. 17, sy. 2, ss. 209–219, 2019, doi: 10.32941/pediatri.600322.
ISNAD Uçak Semirgin, Sibel. “Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori Enfeksiyonu sıklığı Ve Demir eksikliği Anemisi Ile ilişkisi”. Güncel Pediatri 17/2 (Ağustos 2019), 209-219. https://doi.org/10.32941/pediatri.600322.
JAMA Uçak Semirgin S. Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori enfeksiyonu sıklığı ve demir eksikliği anemisi ile ilişkisi. Güncel Pediatri. 2019;17:209–219.
MLA Uçak Semirgin, Sibel. “Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori Enfeksiyonu sıklığı Ve Demir eksikliği Anemisi Ile ilişkisi”. Güncel Pediatri, c. 17, sy. 2, 2019, ss. 209-1, doi:10.32941/pediatri.600322.
Vancouver Uçak Semirgin S. Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori enfeksiyonu sıklığı ve demir eksikliği anemisi ile ilişkisi. Güncel Pediatri. 2019;17(2):209-1.