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Öğe Benign Rheumatoid Nodules – Reply(AMER MEDICAL ASSOC, 1994) Yavuz, Haluk; Özel, Ahmet; Erkul, İbrahimWe think that our article1 has been misunderstood. The word "swelling" was used to describe the nodule by parents. The patient had only nodules and limited motion of the arms in the morning. Pain orjoint swelling were not present either in the history or on physical examination. Morning stiffness alone cannot be regarded as a criterion of objective arthritis in the diagnosis of JRA.2 The negative test resultfor rheumatoidfactor does not exclude the diagnosis of benign rheumatoid nodules as well as JRA.3 We think that the criteriafulfilling the diagnosis of JRA have not developed in our patient.Öğe Çocuk Hekimlerinin Menenjit Tedavisine Yaklaşımları(2000) Yavuz, Haluk; Çakır, Münire; İstanbullu, Hasan ArifAMAÇ: Ülkemizde çocuk hekimlerinin menenjit tedavisine yaklaşımlarını öğrenmek. GEREÇ VE YÖNTEM: Araştırma Van 'da düzenlenen XL1. Milli Pediatri Kongresine katılan çocuk sağlığı ve hastalıkları ile uğraşan hekimlerle konuşularak yapılmıştır. BULGULAR: Başlangıç için en çok tercih edilen ilaçlar 2 aylık hastada ampisilin sefotaksim, 1 ve 5 yaşındakinde penisilin kloramfenikoldür. En çok tercih edilen ortalama tedavi süresi 11-14 gün, etken Gram (-) bakteri ise 20 gün ve üzeri, S. pnömonia ve H. influenza tip B ise 11-14 gün, N. Meningitis ise 7-10 gündür. Çoğunluk (%65) dekzametazonun kullanılabileceğini belirtmiştir. Tedaviyi sonlandırmak için en çok istenen özellik (%60), yeterli süre ilaç tedavisi klinik iyileşme beyin omurilik sıvısı (BOS) bulgularının tamamen normale gelmiş olmasıdır. Hekimlerin %35 'i bunun için en az iki kere lumbal ponksiyon gerekeceğini söylemiştir. Hekimlerin %41 'i BOS kültür, % 69 'u protein ve şeker sonuçlarına güvendiğini bildirmiştir. SONUÇ: Ülkemizde menenjit tedavisinde fikir birliği sağlanmalı, laboratuvar tetkiklerine güven artırılmalı, tedavinin sonlandırılması ile ilgili eğitim yapılmalıdır.Öğe Çocuk Sağlığı ve Hastalıkları Uzmanları ile Pratisyen Hekimlerin Ateşli Havale Hakkındaki Görüş ve Uygulamaları(2006) Keleş, Sevgi; Yavuz, Haluk; Bodur, SaidAmaç: Ateşli havale (AH), çocukluk çağının sık görülen, iyi huylu ve ateşle ortaya çıkan bir havale türüdür. AH’si olan bir çocuk değişik hekimlik dallarına mensup hekimler tarafından görülebilir. Çalışmada AH ile sık karşılaşan çocuk sağlığı ve hastalıkları uzmanları ile pratisyenlerin hastalık hakkındaki görüş ve uygulamalarının değerlendirilmesi amaçlandı. Yöntem: Çoğunluğu Konya’dan olmakla birlikte muhtelif illerden 100 çocuk sağlığı ve hastalıkları uzmanı ile 100 pratisyen çalışmaya dahil edildi. Uzman ve pratisyenler için ayrı anket hazırlandı. Anketler yüz yüze görüşülerek hekimlerce dolduruldu. Bulgular: Uzmanların % 62.1’i ve pratisyenlerin % 51.6’sı AH denilebilmesi için ateşin en az 38.0 C olması gerektiğini belirtti. Uzmanların çoğu ateşli havalede üst yaş sınırını 6, pratisyenlerin çoğunluğu ise 5 yaş olarak kabul etmekteydi. Uzmanların % 60.0’ının biyokimya, EEG, görüntüleme çalışması gibi tetkikler istediği ve sadece % 13.0’ünün LP gerekçelerini tam olarak bildiği tespit edildi. Pratisyenlerin çoğunluğu AH’yi sevk ettiğini ve % 41.1’i AH’de BOS incelemesinin gerekli olduğunu belirtti. Sonuç: Hem çocuk sağlığı ve hastalıkları uzmanları hem de pratisyenlerin AH ile ilgili bilgilerinde güncellenmesi gereken hususlar vardır. Hizmet içi ve sürekli eğitim bu konuda yararlı olabilir.Öğe Corticosteroid-Therapy and Severe Chickenpox(MOSBY-ELSEVIER, 1994) Yavuz, Haluk; Özel, Ahmet; Erkul, İbrahimTo the Editor." We read with interest the article by Abzug and Cotton. 1 Although some reports indicate that varicella infections may have a more severe clinical course in patients receiving corticosteroids, there are studies suggesting the opposite. 2 A metaanalysis on the corticosteroid-infection association revealed that use of prednisone may increase the risk of infectious complications when the dose exceeds 10 mg daily or 700 mg cumulatively)Öğe The diagnostic criteria of benign monomelic amyotrophy(TURKISH J PEDIATRICS, 2012) Yavuz, Haluk[Abstract not Available]Öğe Differences in Immunoglobulin Preparations and Outcome of Kawasaki Disease(MOSBY-ELSEVIER, 1996) Yavuz, Haluk; Özel, AhmetIt is known that morbidity and mortality rates for Kawasaki disease (KD) vary from one community to another. Cardiac involvement and sequelae were greater and mortality rates were higher in the British Isles than in Japan.Öğe Familiar Drugs for the Treatment of Hypercalcemia(MOSBY-ELSEVIER, 1998) Yavuz, HalukThe rare appearance of hypercalcemia in childhood has resulted in few articles written about it. So I read with interest the case report presented by Kutluk et al. 1 I thought that it would be useful to mention another drug, ketoconazole, for hypercalcemia.Öğe Henoch-Schonlein Purpura-Related Intestinal Perforation: a Steroid Complication?(Blackwell Publishing Asia, 2001) Yavuz, Haluk; Arslan, AhmetHenoch–Schönlein purpura (HSP) is predominantly a childhood disease with a good prognosis. Two-thirds of the patients with HSP have abdominal manifestations. The most common intestinal complaint is colicky abdominal pain, which is often associated with vomiting, followed by intestinal hemorrhage, hematemesis, melena and hematochesia. The influence of HSP on the gastrointestinal system sometimes leads to serious complications, such as intussusception, massive hemorrhage and intestinal perforation. Early corticosteroid treatment for these intestinal complications is recommended.1 In this report we describe two cases with HSP-related intestinal perforation developed after corticosteroid treatment.Öğe Honey Poisoning in Turkey(LANCET LTD, 1991) Yavuz, Haluk; Özel, Ahmet; Akkuş, İdris; Erkul, İbrahimSIR,- Food poisoning associated with honey is not uncommon in the Black Sea region of Turkey. Nectar from some plants in the area is toxic. This form of poisoning is mentioned in Xenophon's Anabasis but published reports are very rare. We describe here a large series.Öğe I?drarı Siyahlaştıran Hastalık: Alkaptonüri(2010) Aslan, Eyüp; Yavuz, HalukGiriş: Alkaptonüri, tirozin metabolizmasıyla ilgili, karaciğerde bulunan bir enzim olan, homogentisat 1-2 dioksigenazın eksikliği sonucunda ortaya çıkan bir hastalıktır. Eksikliğin sebebi homogentisik asit oksidaz geninde değişiklik (mutasyon) olmasıdır. Oldukça nadir görülen, otozomal çekinik kalıtım gösteren bir hastalıktır. Çocukluk çağında en sık rastlanan özelliği, idrarın beklemekle siyahlaşmasıdır. Hastalık daha çok 30 yaşından sonra, özellikle eklemlerde yozlaşma, sklera ve kulak derisinde siyahlaşma ve kalp kapaklarında sertleşme ile kendini gösterir. Henüz tam olarak tedavisi olmamakla birlikte nitisinon, etkisi kanıtlanmış tek tedavi seçeneğidir. Ancak tedavinin en uygun başlanma yaşı, ne kadar devam edilmesi gerektiği ve olası yan etkileri henüz tam olarak bilinmemektedir. Olgu Sunumu: Bu yazıda iç çamaşırında beneklenme ve idrarın siyahlaşması sebebiyle getirilen ve alkaptonüri teşhisi konan 4 yaşında bir kız hasta bildirilmektedir. Tartışma: Bu vaka, ilerleyen yaşlarda ciddi etkiler oluşturabilecek hastalığın çocukluk çağında en sık başvuru şikâyeti olan idrarda siyahlaşmaya dikkati çekmek için bildirilmiştir.Öğe Intestinal Involvement in Metachromatic Leukodystrophy(SAGE PUBLICATIONS INC, 2011) Yavuz, Haluk; Yuksekkaya, Hasan AliMetachromatic leukodystrophy is a lysosomal storage disease caused by the deficiency of the enzyme arylsulfatase A. If arylsulfatase A is deficient, sulfatide accumulates. Functionally, this accumulation results in progressive neurological deterioration. The reports about the extra nervous system manifestations of metachromatic leukodystrophy are related to the gallbladder involvement such as polyposis. Unexplained vomiting began in a 51/2-year-old girl with late infantile metachromatic leukodystrophy. Endoscopy showed multiple polypoid masses in the pylor of the stomach and duodenum. Severe gastrointestinal bleedings occurred during nasogastric feeding. Intestinal intussusception developed later. To the authors' knowledge, intestinal polypoid masses and obstruction with meta-chromatic leukodystrophy have not previously been reported. The persistent vomiting may be a symptom of intestinal obstruction due to intestinal polypoid masses with metachromatic leukodystrophy. There may be a trend for the development of polypoid masses in intestine as well as in the gallbladder in metachromatic leukodystrophy.Öğe Is Acute Hemorrhagic Edema of Infancy a Complement Deficiency State?(Lippincott Williams & Wilkins, 2000) Yavuz, HalukFew studies on immunologic changes in patients with adenovirus infection have been reported. Mistchenko et al.6 reported immunologic abnormalities in patients with adenoviral diseases. They reported that serum values of IL-6, IL-8 and tumor necrosis factor alpha were associated with severity of adenovirus infection. We found increases in CD81 T cells, HLA-DR1CD81 T cells and CD161 NK cells in patients with adenovirus infection during the acute stage. The increases in CD81 T cells and HLA-DR1CD81 T cells were remarkable in the child with severe adenovirus type 7 pneumonia. Moreover this patient had increased serum IFNgamma levels and peripheral blood IFN-gamma-producing CD31 T cells during the acute stage. Recently a method for intracellular cytokine staining has been developed that enables the detection of cytokine-producing cells by single laser flow cytometry.5 To our knowledge no other report has focused on cytokine-producing T cells in patients with adenovirus infection. IFN-gamma is produced by CD4 and CD81 T cells as well as by NK cells. IFN-gamma has been documented as an antiviral that inhibits viral replication, antiprotozoal activities and immunomodulatory activities.7–9 CD81 T cells might produce IFN-gamma in our patient with adenovirus type 7 pneumonia, because there was a marked increase in activated CD81 T cells.Öğe Melkersson-Rosenthal Sendromu: Bir Çocuk Olgunun Sunumu(2009) Alp, Hayrullah; Yavuz, Haluk; Alp, EsmaMelkersson-Rosenthal syndrome (MRS) includes the triad of oro-facial edema, facial nerve palsy and furrowed tongue. The exact etiology is unknown. However, genetic and acquired factors have been implicated. It is rare in children. In this study, we report a ten year old boy who was diagnosed with MRS with recurrent facial nerve paralysis and facial edema.Öğe Melkersson-Rosenthal sendromu: Bir çocuk olgunun sunumu(2009) Alp, Hayrullah; Yavuz, Haluk; Alp, EsmaMelkersson-Rosenthal sendromu (MRS); yüzde ödem, yedinci sinir felci ve yarık dil ile kendini gösteren bir sendromdur. Kesin nedeni belli değildir. Kalıtımsal veya sonradan olan etkenlerin yol açabileceği düşünülmektedir. Çocuklarda nadir olarak görülür. Bu yazıda 10 yaşında, tekrarlayan yüz felci ve yüzde ödem ile MRS tanısı konan bir erkek olgu sunuldu.Öğe Nesidioblastosisli iki yenidoğan olgusu(1999) Koç, Hasan; Reisli, İsmail; Dilsiz, Alaeddin; Avunduk, Mustafa Cihat; Hazır, İsmail; Yavuz, Haluk; Kaymakçı, AytekinYenidoğan döneminin ilk 3 günü içinde dirençli hipoglisemi ve hiperinsülinizmi tespit edilen, tıbbi tedavilere (% 13,5 lik IV glukoz infüzyonu, steroid, glukagon ve diazoksil tedavisi) rağmen kan şekeri yükseltilemeyen, hipoglisemik dönemlerinde hiperinsülinemileri tespit edilen ve pankreas patolojisi düşünülerek subtotal pankreatektomi yapılan iki olgu sunuldu. Patolojik inceleme sonrasında her ikisinin de nesidioblastosis olduğu saptandı. Nadir görülen ve yenidoğan hipoglisemilerinin ayırıcı tanısında düşünülmesi gereken iki farklı nesidioblastosis olgusu literatür ışığında tartışıldı.Öğe Plasmapheresis as an Adjunct Treatment in Severe Botulism(SPRINGER-VERLAG, 2002) Atabek, M. Emre; Yavuz, Haluk; Oran, Bülent; Karaaslan, Sevim; Erkul, İbrahimAn 11-year-old boy, previously healthy, had consumed a packet of commercially canned food, and lassitude or fatigue and headache had developed. The next day he was transferred to our unit. He was unable to talk and had developed ptosis, impairment of ocular movements and mild symmetrical limb weakness. He was afebrile and orientated. His pupils were fixed and dilated bilaterally.Öğe Short-Term, High-Dose Corticosteroid-Therapy in Childhood Acute Immune Thrombocytopenic Purpura(Mosby-Elsevier, 1995) Yavuz, Haluk; Özel, Ahmet; Erkul, İbrahimWe read with interest the article by Blanchette et al. 1 A therapeutic regimen that increases the platelet count above a safe level for preventing intracranial hemorrhage by use of orally administered corticosteroids in relatively low doses would be the preferred form of therapy, but we think that the continuation of this therapy for 3 weeks is disadvantageous because of the development of untoward effects and the prolongation of therapy. Side effects may occur with the continued daily use of corticosteroids, and the hy pothalamus-pituitary-adrenal system would be suppressed if steroids were administered for periods longer than 15 days. 2 Moreover, effective treatment without any side effects have been reported in studies in which methylprednisolone was used in very high doses orally for 1 week. 3 We are still investigating'the effect of orally administered methylprednisolone, 10 mg/kg per day, for 5 days in the treatment of acute immune thrombocytopenic purpura in children. The preliminary data for 10 patients revealed mild elevation of the blood glucose concentration in two patients on day 3 and in the occult blood in the stool in one patient on day 7, which were transient. The mean platelet count increased from 21 X 109/L, to 47 × 109/L on the third day of therapy. The platelet count decreased below 20 x 109/L in only one patient during follow-up.Öğe Sydenham's chorea: A clinical follow-up of 65 patients(SAGE PUBLICATIONS INC, 2007) Demiroren, Kaan; Yavuz, Haluk; Cam, Lokman; Oran, Bulent; Karaaslan, Sevim; Demiroren, SaadetSydenham's chorea, the neurological manifestation of rheumatic fever, is the most common acquired chorea of childhood. In this retrospective study, the authors aim to present the clinical and laboratory findings of 65 Sydenham's chorea patients, followed up in a clinic over less than 7 years. The mean age at the onset of the symptoms was 11.7 +/- 2.6 years (range, 6-17 years). Of the patients, 63% were female and 37% were male (male/female: 1.7/1). Chorea was generalized in 78.5% of the patients, right hemichorea in 12.3%, and left hemichorea 9.2%. There was a history of rheumatic fever in 30.8% of the patients. Echocardiographic study showed cardiac valve involvement in 70.5% of 61 patients. Brain magnetic resonance imaging, which was performed on only 18 patients, was evaluated as normal in all. Electroencephalography was also performed on only 18 patients and showed abnormal waves in 50% of them. Pimozide was mostly the first choice of drug therapy. Nevertheless, drug therapy was not needed in 18.5% of the patients. The recovery period of the first attack of the chorea was I to 6 months in 51.7% of the patients. The recurrence rate was 37.9%. In conclusion, Sydenham's chorea is still an important health problem in Turkey with respect to its morbidity.Öğe Transverse Myelopathy: an Initial Presentation of Acute Leukemia(ELSEVIER SCIENCE INC, 2001) Yavuz, Haluk; Çakir, MünireAn 8-year-old female with a history of back pain and loss of the ability to walk is presented. Transverse myelopathy was considered clinically after assessing magnetic resonance imaging results of the thoracic spine. Acute lymphoblastic leukemia was diagnosed approximately 5 months after the beginning of symptoms. Reviewing the related literature suggests that transverse myelopathy is not uncommon in neoplastic diseases. Children with a disorder of the spinal cord, especially if accompanied with fatigue and anemia, might have transverse myelopathy-associated malignant disease. Transverse myelopathy can be the initial presentation of acute lymphoblastic leukemia. (C) 2001 by Elsevier Science Inc. All rights reserved.Öğe Treatment of mitochondrial neurogastrointestinal encephalomyopathy with dialysis(AMER MEDICAL ASSOC, 2007) Yavuz, Haluk; Ozel, Ahmet; Christensen, Mette; Christensen, Ernst; Schwartz, Marianne; Elmaci, Mithat; Vissing, JohnObjective: To study the effect of continuous ambulatory peritoneal dialysis on nucleoside levels and clinical course in a patient with mitochondrial neurogastrointestinal encephalomyopathy (MNGIE). Patient: We studied a patient with genetically verified MNGIE, who prior to treatment had lost weight progressively, developed amenorrhea, vomited multiple times daily, and had abdominal pain. Intervention: The patient was treated with peritoneal dialysis for 3 years, and the effect on symptoms and plasma concentrations of thymidine and deoxyuridine were monitored. Results: Dialysis stopped vomiting and reduced abdominal pain, and the patient gained 5 kg in weight and started to menstruate again. Symptoms returned if dialysis was paused. Dialysis did not affect plasma nucleoside levels. Conclusions: This study shows an unambiguous clinical benefit of peritoneal dialysis on gastrointestinal symptoms in MNGIE. Dialysis did not affect nucleoside levels, indicating elevated thymidine and deoxyuridine levels are not solely responsible for the pathogenesis of MNGIE.
