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Öğe Akut romatizmal karditli çocuklarda plazma NT-pro brain natriüretik peptid düzeylerinin hastalığın tanı ve takibindeki yeri(Selçuk Üniversitesi Tıp Fakültesi, 2009) Çimen, Ömer; Oran, BülentBu çalışmada akut romatizmal karditli çocuklarda plazma NT-pro BNP düzeylerinin hastalığın tanısında ve tedavinin takibindeki yeri araştırıldı. Çalışmaya Aralık 2006 - Eylül 2007 tarihleri arasında Selçuk Üniversitesi Meram Tıp Fakültesi Çocuk Kardiyoloji kliniğinde Akut Romatizmal Kardit tanısı alan 6-17 yaşları arasında 24 hasta ve 23 sağlıklı çocuk alındı. Hastaların tedavi öncesi plazma NT-proBNP düzeyleri, tedavi sonrası ve kontrollerle karşılaştırıldığında anlamlı olarak yüksek bulunurken, tedavi sonrası ile kontrol grubu düzeyleri arasında anlamlı farklılık saptanmadı. Hastaların tanı anındaki mevcut kapak yetmezliği ve artmış sol atriyum hacimlerinin tedaviyle düzelmesine parelel olarak plazma NT-proBNP düzeylerininde gerilediği gözlendi. Ayrıca hastalardaki yüksek akut-faz reaktan düzeylerinin steroid tedavisi ile plazma NT-pro BNP düzeylerine parelel olarak gerilediği ve tedavi sonrası normale döndüğü gözlendi. Bu çalışmada plazma NT-proBNP düzeylerinin akut romatizmal karditli hastalara doğru tanı konulabilmesinde, ayrıca kalpteki inflamasyonun ve/veya hemodinamideki bozukluğun ciddiyetini yansıtması nedeniyle de, hastaların tedavisinin takibinde kulanılabileceği sonucuna varıldı.Öğe CD19 deficiency: A village screening study(AVES, 2009) Reisli, İsmail; Artaç, Hasibe; Pekcan, Sevgi; Kara, Reyhan; Yumlu, Kadir; Karagöl, Cüneyt; Çimen, ÖmerAim: We identified a new CD19 deficient case who was a relative of the first CD19 deficient patient and lived in the same village. These cases suggested that other patients with CD19 deficiency or carriers could be found in this village. The aim of this study was to assess the warning signs of primary immunodeficiency and the CD19 molecule deficiency in this population. Material and Method: The relatives of CD19 deficient patients and controls were examined for the warning signs of primary immunodeficiency using a questionnaire form Blood samples were taken from these subjects CD19 and CD21 expressions (median fluorescent intensity, MFI) were analyzed by flowcytometry in these samples. Results: A total of 208 subjects (59 families, 126 females, 82 males) including 129 children 9.5 +/- 3 7 years and 79 adults (37 13 years) were evaluated. A new case with CD19 deficiency was not detected There was at least one warning sign for immunodeficiency in 67 subjects (57 children and 10 adults) CD19 median expression value was lower than 60 MFI value in 20 subjects, which was known as in the carriers who were detected to have heterozygous mutation Conclusions: Our findings suggested that CD19 median expression might be a diagnostic tool for the subjects who have CD19 heterozygous mutations. Mutation analyses are planned for the confirmation of CD19 heterozygous mutation in these subjects who have low CD19 median expression. (Turk Arch Ped 2009; 44. 127-30)Öğe CD19 molekül eksikliği: Bir köy taraması(2009) Reisli, İsmail; Artaç, Hasibe; Pekcan, Sevgi; Kara, Reyhan; Yümlü, Kadir; Karagöl, Cüneyt; Çimen, ÖmerAmaç: CD19 eksikliğinin ilk kez tanımlandığı bir olgunun köyünde yaşayan ve akrabası olan bir olguda daha CD19 eksikliği tanımlandı. Bu olgular, bu köyde yaşayan başka olguların ve taşıyıcıların da olabileceğini düşündürdü. Bu amaçla köy halkı immün yetersizlik düşündüren klinik bulgular ve CD19 molekül eksikliği yönünden değerlendirildi. Gereç ve Yöntem: CD19 eksikliği olgularının akrabaları ve kontrol grubu, anket formları ile birincil immün yetersizlik hastalıklarının klinik belirtileri için sorgulandı. Olgulardan alınan kan örneklerinde, CD19 ve CD21 molekül varlığı akış sitometri ile incelendi. Bulgular: Toplam 59 aileden 129 çocuk (9,53,7 yıl) ve 79 yetişkin (3713 yıl) olmak üzere 208 olgu (126 kadın, 82 erkek) değerlendirildi. Yeni bir CD19 eksikliği olgusu saptanmadı. Anket formları ile 67 olguda (57 çocuk, 10 yetişkin) en az bir uyarıcı immün yetersizlik bulgusu vardı. CD19 mediyan ekspresyon değeri (MFI) 20 olguda, CD19 yönünden heterozigot taşıyıcı olan bireylerden elde edilen 60 MFI değerinin altındaydı. Çıkarımlar: Bulgularımız CD19 eksikliği heterozigot “taşıyıcılığı” açısından, CD19 taşıyan B lenfosit oranının değil, CD19 mediyan ekspresyon düşüklüğünün yol gösterici olduğunu düşündürmüştür. CD19 mediyan ekspresyon değerine göre taşıyıcı oldukları belirlenen bu olguların, mutasyon tetkiklerinin yapılarak taşıyıcı olduklarının doğrulanması planlanmıştır.Öğe CD19 Molekül Eksikliği: Bir Köy Taraması(Kare Publishing, 2009) Reisli, İsmail; Artaç, Hasibe; Pekcan, Sevgi; Kara, Reyhan; Yümlü, Kadir; Karagöl, Cüneyt; Çimen, Ömer; Şen, Metin; Artaç, MehmetAim: We identified a new CD19 deficient case who was a relative of the first CD19 deficient patient and lived in the same village. These cases suggested that other patients with CD19 deficiency or carriers could be found in this village. The aim of this study was to assess the warning signs of primary immunodeficiency and the CD19 molecule deficiency in this population. Material and Method: The relatives of CD19 deficient patients and controls were examined for the warning signs of primary immunode- ficiency using a questionnaire form. Blood samples were taken from these subjects. CD19 and CD21 expressions (median fluorescent intensity, MFI) were analyzed by flowcytometry in these samples. Results: A total of 208 subjects (59 families, 126 females, 82 males) including 129 children 9.5±3.7 years and 79 adults (37±13 years) were evaluated. A new case with CD19 deficiency was not detected. There was at least one warning sign for immunodeficiency in 67 subjects (57 children and 10 adults). CD19 median expression value was lower than 60 MFI value in 20 subjects, which was known as in the carriers who were detected to have heterozygous mutation. Conclusions: Our findings suggested that CD19 median expression might be a diagnostic tool for the subjects who have CD19 heterozygous mutations. Mutation analyses are planned for the confirmation of CD19 heterozygous mutation in these subjects who have low CD19 median expression.Öğe Release of N-Terminal Pro-Brain Natriuretic Peptide in Children With Acute Rheumatic Carditis(Cambridge Univ Press, 2010) Çimen, Ömer; Oran, Bülent; Çimen, Derya; Baysal, Tamer; Karaaslan, Sevim; Ünal, Ekrem; Başarılı, Kemal; Büyükbaş, SadıkBackground: Acute rheumatic carditis is still an important cause of cardiac failure in developing countries. B-type natriuretic peptides, especially N-terminal segment of its prohormone are now recognised as essential parrs of cardiologic evaluation. Increased plasma concentrations of B-type natriuretic peptide and its prohormone are markers of cardiac failure and hypoxia in adults. Aim: To measure the prohormone levels in children with acute rheumatic carchtis and to determine whether its concentrations correlate with clinical and laboratory findings. Methods: A total of 24 children with acute rheumatic carchtis and 23 age and sex-matched healthy subjects were entered in the study. Transthoracic echocardiography was performed in all patients to assess the severity of the valve insufficiency and cardiac dysfunction. The prohormone plasma levels were tested for correlation with cardiac dysfunction and other biochemical markers, such as C-reactive protein, erythrocyte sedimentation rate, and anti-streptolysin-O titter. Results: The prohormone plasma concentrations were significantly higher in children with acute rheumatic carditis than in control subjects at the rime of diagnosis. A significant decrease of the plasma level was detected among patients after treatments (6-8 weeks). Conclusion: We found increased plasma prohormone levels in children with acute rheumatic carditis in the acute stage of illness compared with healthy subjects. Another result is increased plasma prohormone levels as acute rheumatic carditis are reversible.Öğe Serratia Marcescens Sepsis Outbreak in a Neonatal Intensive Care Unit(Wiley, 2010) Arslan, Uğur; Erayman, İbrahim; Kırdar, Sevin; Yüksekkaya, Şerife; Çimen, Ömer; Tuncer, İnci; Bozdoğan, BülentBackground: Contaminated parenteral nutrition (PN) is an important source of infection in neonates. Many organisms have been reported to cause contamination resulting in outbreaks in intensive care units. The aim of the present study was to investigate an outbreak caused by Serratia marcescens in a neonatal intensive care unit (NICU). Methods: This was a descriptive study of an outbreak of sepsis in an NICU of a university teaching hospital. The outbreak was detected in seven patients from 10 to 12 December 2005 following the administration of PN. Extensive environmental samplings for culture were performed. The clonal relationship among isolates was tested using pulsed-field gel electrophoresis, random amplification of polymorphic DNA-polymerase chain reaction and plasmid DNA typing. Results: Serratia marcescens was found in blood cultures from infected newborns and from in-use PN solutions. Gestational age of the seven babies ranged from 28 to 34 weeks (median, 32 weeks), birthweight ranged from 1000 g to 2190 g (median, 1469 g), and postnatal age ranged from 8 to 22 days. The mortality rate was 14.3%. All these strains of S. marcescens had the same antibiotic susceptibility pattern and the same genomic DNA profile. Plasmid typing, as well as RAPD-PCR showed that all isolates had the same profile. Conclusion: The source of the nosocomial sepsis in seven neonates was the PN solution. Contamination may occur during storage or repeated handling during PN preparation.
