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Öğe Çocuk acil servisine zehirlenme nedeni ile başvuran olguların geriye dönük olarak değerlendirilmesi(2017) Yorulmaz, Alaaddin; Akbulut, Hikmet; Yahya, İbaa; Aktaş, Raşit; Emiroğlu, Halil Haldun; Peru, HarunGiriş: Bu çalışmada çocuk acil polikliniğine zehirlenme nedeniyle kabul edilen hastaların demografik ve epidemiyolojik özelliklerini, klinik seyir, laboratuvar sonuçları ve prognozlarını geriye dönük olarak analiz etmeyi amaçladık.Yöntemler: Bu çalışmaya 1 ay-18 yaşları arası zehirlenme nedeni ile başvuran 430 hasta alındı. Hastaların tıbbi verileri geriye dönük olarak dosya bilgilerine göre incelendi. Hastaların yaş, cinsiyet gibi demografik verileri, olayın oluş zamanı, başvuru zamanı, ilacın alınmasından sonra ilk tıbbi müdahaleye kadar geçen süre, zehirlenme nedeni, alınan etken madde, alım şekli, alınan etken madde sayısı, hastaneye başvuru şikayeti incelendi. Bulgular: Çalışma bireyleri tüm çocuk acil servise başvuran hastaların %0,74'ünü oluşturmaktaydı. Hastalarımızın 243'ü (%56,5) kız, 187'si (%43,5) erkek idi. Hastaların yaşları 4 ay ile 220 ay (72,8966,38) arasında değişmekteydi. Hastalarımızın 113'ü (%26,3) yaz, 111'i (%25,8) ilkbahar, 110'u (%25,6) sonbahar ve 96'sı (%22,3) kış ayında başvurdu. 2014 yılında 18, 2015 yılında 193, 2016 yılında 178 ve 2017 yılında 41 zehirlenme hastası acil servisimize başvurdu. Hastalarımızın %12,3'ü 00:00-00:08 saatler, %35,1'i 08:00-16:00 saatler, %52,6'sı 16-24 saatleri arasında hastanemiz acil servisimize başvurdu. Acil servisimize başvuran hastaların 96'sı özkıyım, 334'ü kaza nedeniyle oluşan zehirlenme olduğu belirlendi. Hastalarımızın 142'sinde (%33,02) bulantı, 122'sinde (%28,37) kusma, 102'sinde (%23,72) baş dönmesi şikayetleri mevcuttu. Sonuç: Ülkemiz genelindeki zehirlenmelerin epidemiyolojik özelliklerinin kapsamlı çalışmalar ile belirlenmesinin ve toplumun dikkatinin çekilmesinin çocukluk çağı zehirlenmelerinin önlenmesine önemli katkı sağlayacağı kanısındayız.Öğe Demographic Characteristics of Children Hospitalized with the Diagnosis of Acute Gastroenteritis in Konya(GALENOS YAYINCILIK, 2018) Yorulmaz, Alaaddin; Ozdem, Suna; Yucel, Mehmet; Sert, Sadiye; Karacal, Serife; Istanbullu, Hasan ArifINTRODUCTION: Many studies have been carried out to detect the causative agents in patients admitted to hospital with gastroenteritis. However, there is a limited number of epidemiological studies in patients hospitalized for gastroenteritis. In this study, we aimed to determine the distribution and incidence of the causative agents of acute gastroenteritis in children in Konya and to evaluate the demographic, clinical and laboratory findings. METHODS: This study included 412 patients aged 1 month to 16 years who were hospitalized with a diagnosis of gastroenteritis in the Child Health and Diseases Clinic in our hospital between January 2015 and January 2016. The data of the patients were analyzed retrospectively. The age, sex, seasonal distribution, symptoms, duration of hospitalization, course of the disease, type of acute gastroenteritis, incidence of nosocomial infections and complications were examined. RESULTS: The total number of patients hospitalized for various reasons during the 12-month study period was 3985 and the patients hospitalized for diarrhea constituted 10.33% of it. Two hundred and twenty-seven of the patients were male (55.1%), and 185 (44.9%) were female. There were 57 patients (13.8%) between 0-24 months, 262 patients (63.6%) between 24-60 months and 93 patients (22.6%) over 60 months. When the age groups were compared with the disease groups, there was a statistically significant difference in the incidence of viral gastroenteritis between 24-60 months (p: 0.001). Two hundred and thirty-one (56.1%) patients had acute viral gastroenteritis, 74 (17.9%) patients had amebiasis, and 107 (26.0%) patients had bacterial gastroenteritis. DISCUSSION and CONCLUSION: Viral agents, especially rotavirus, should be kept in mind in childhood acute gastroenteritis. Diagnosis and treatment approaches should be planned considering the incidence of other agents.Öğe The Effect of Gene Mutations on Disease Severity Scores in Pediatric Familial Mediterranean Fever Patients(Selçuk Üniversitesi, 2022) Güngören, Vildan; Yorulmaz, Alaaddin; Arslan, ŞükrüObjectives: Familial Mediterranean Fever (FMF) is a self-limiting autoinflammatory disease. In order to better understand the prognosis of diseases, disease severity scores are used. The aim of this study is to determine the effect of genetic mutations on disease severity scores in children with FMF. Methods: Patients aged 0-18 years who were diagnosed with FMF according to Yalçınkaya-Özen diagnostic criteria and whose gene analysis was performed were evaluated retrospectively. Pras et al’s scoring system, Mor et al’s scoring system and International severity score of FMF (ISSF) scoring system were applied to all patients. Genotypes were compared according to disease severity scores. Results: When the patients were divided into 4 groups as M694V homozygous, heterozygous, M694V/ other allele combined heterozygous and other mutations, according to the score of Pras et al., the frequency of mild disease tended to be less in the M694V homozygous group. When the patients divided as homozygous M694V, heterozygous M694V, heterozygous E148Q, heterozygous M694V/ M680I combined mutations, according to the score of Pras et al., mild disease was found to be less common in the homozygous M694V group. When patients were divided into homozygous and heterozygous M694V (combined with other allele or single) groups, the disease was more severe in the homozygous M694V group according to the three scoring systems. In the concordance analysis between scoring systems, while a good agreement was found between Mor et al.’s scoring system and ISSF, the agreement with Pras et al.’s scoring system was weak Conclusions: Based on the scoring system described by Pras et al., the rate of severe disease was higher in patients with homozygous M694V allele, whereas the rate of mild disease was statistically significantly higher in the heterozygous group (combined with other allele or single) compared with homozygous group. From this, we can conclude that the M694V homozygous mutation causes more severe disease than the M694V heterozygous mutation, and even more severe disease than its combination with another pathogenic mutation, one of which is M694VÖğe Evaluation of Electrolyte Imbalance and Blood Gas Parameters in Patients Who Had Rotavirus Gastroenteritis(Selçuk Üniversitesi, 2023 Aralık) Sarı, Bestami; Yorulmaz, AlaaddinAim: In the present study, the cases admitted to the hospital because of acute gastroenteritis and diagnosed with common rotavirus gastroenteritis were evaluated in terms of demographic, epidemiological, clinical and laboratory data. Methods: The clinical and laboratory data of the cases who applied to Pediatric Emergency Clinic of Selçuk University Faculty of Medicine because of acute gastroenteritis aged 0-18 were evaluated retrospectively in the study. Clinical findings, time of admission, place of observation, blood gas and electrolyte levels, electrolyte imbalance, and length of hospital stays of the patients were recorded. Results: Among the acute gastroenteritis patients who were included in the study, 148 (61.2%) were male and 94 (38.8%) were female. The incidence of hypokalemia in patients who had rotavirus (+) gastroenteritis was statistically significant. Statistically significant differences were detected between the groups in terms of creatinine, potassium and albumin values of biochemical parameters. When the blood gas analyzes of the patients with acute gastroenteritis were evaluated; While acidosis was detected in 24 (9.9%) patients, alkalosis was found in 27 (11.2%) patients. The mean pH value of the patients was found as 7.39±0.05. There was a statistical difference between the rotavirus (-) and rotavirus (+) gastroenteritis groups in terms of pH values (p: 0.015). Conclusion: Cases with metabolic acidosis in rotavirus gastroenteritis are hospitalized more frequently, and for this reason, blood gas studies in cases of rotavirus gastroenteritis will guide clinicians.Öğe Evaluation of hematological parameters in children with FMF(SPRINGER LONDON LTD, 2019) Yorulmaz, Alaaddin; Akbulut, Hikmet; Taş, Suna Adeviye; Tıraş, Merve; Yahya, İbaa; Peru, HarunIn this study, we aimed to investigate whether neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and mean platelet volume (MPV) might be helpful in the diagnosis of subclinical inflammation of familial Mediterranean fever (FMF). Clinical, laboratory, and genetic results of the patients who were followed up with the diagnosis of FMF were obtained retrospectively from the hospital files and recorded to standardized form. Age- and sex-matched healthy subjects were included as the control group. Eighty-three of the 143 patients (58.0%) were male and 60 (42.0%) were female. The mean age of our patients was 164.62 +/- 51.20months and the mean age of the control group was 164.92 +/- 51.10months. The mean diagnosis age of our patients was 98.10 +/- 49.11months. The mean follow-up time of the patients was 66.03 +/- 36.37months. 91.60% of our patients had abdominal pain, 78.32% fever, and 28.67% joint pain. The mean NLR of the patients was significantly higher than the mean levels at attack-free period and the control group. However, no statistically significant difference was found between the mean levels at attack-free period and the control group. MPV levels were statistically significantly high during acute attack when compared with the control group. However, they showed no statistically significant difference between acute attack and attack-free period. NLR is a useful marker to predict inflammation in FMF patients. However, our results did not support the idea that MPV might reflect acute attack and attack-free period.Öğe The Evaluation of Primary School Readiness Levels of the Children Aged 66-72 Months with the Denver II Test(KOWSAR CORP, 2018) Yorulmaz, Alaaddin; Sert, Sadiye; Yilmaz, Fatma Hilal; Kara, Fatih; Cinarlidere, SerifeBackground: Primary school can lead to compatibility problems in children without an early childhood education because they experience separation from their families for the first time. Objectives: In order to detect developmental delays that may arise at the school and to plan the necessary support, it was aimed to determine primary school readiness levels of the children aged 66 -72 months. Methods: This study included 91 children aged 66 - 72 months who were admitted to the Pediatric Outpatient Clinic of Beyhekim State Hospital between June 2016 and August 2016. The Denver Developmental Screening Test II which consists of 134 items was performed. The Test items are divided into four main sections and surveys whether the chilren are ready for the first grade of primary school. The test results were interpreted as normal, suspect and abnormal. Results: 36 (39.6%) of 91 patients were female and 55 (60.4%) were male. There was no statistically significant difference between the test results in terms of gender. When examining the distribution of children according to months, there was no statistically significant difference. Data for the child's age, the mother's age, the father's age, duration of breastfeeding, the age (month) at which the child started talking, walking or completed toilet training was expressed as mean +/- standard deviation. When these values were examined and also the mean values containing normal and abnormal results were compared, there was a statistically significant difference only between the months when the children started talking. When examining the results of the Denver II test, it was found that 64 (70.3%) children had abnormal development and 27 (29.7%) normal development. Conclusion: In the study evaluating primary school readiness levels of the children aged 66 -72 months, the substantial proportion of the children who were admitted to the hospital, had a developmental delay. In light of this study, all pre-school children should be evaluated before admission to primary school.Öğe I?spirto Zehirlenmesi Olan İki Olgunun Başarılı Yönetimi: Olgu Sunumu(Selçuk Üniversitesi, 2016 Aralık) Yorulmaz, Alaaddin; Öztürk, Esma Erdemir; Acar, TarıkMetanol zehirlenmesi, düşük doz alımda dahi morbidite ve mortaliteye yol açan alımı genellikle erişkinlerde kaza ya da intihar amaçlı, çocuklarda ise bilinçsiz bir şekilde alınması ile olabilen klinik durumdur. Özellikle erişkin dönemde ve erkeklerde çok görülen metanol zehirlenmesi çocuklarda nadir olarak bildirilmektedir. Bu yazımızda ispirto alımı sonrasında 30 dakika içinde hastanemiz acil polikliniğine getirilen 5 ve 7 yaşında iki erkek kardeş olgumuzun hızlı tanı ve tedavi ile başarılı tedavi yönetimini sunduk.Öğe İmmünglobulin A Vasküliti Tanısı Konulmuş Pediyatrik Hastaların Değerlendirilmesi: Tek Merkez Deneyimi(Selçuk Üniversitesi, 2021) Ağır, Mehmet Akif; Güngörer, Vildan; Yorulmaz, Alaaddin; Arslan, ŞükrüAmaç: Bu çalışma çocukluk çağında en sık görülen vaskülit olan immünglobulin A vasküliti (IgAV;Henoch-Schönlein purpura) tanısıyla iç Anadolu yöresinde takip edilen çocuk hastaların klinik özelliklerini, laboratuvar değerlerini ve bunlar arasındaki istatistiksel ilişkiyi ortaya koymak amacıyla yapıldı. Gereç ve Yöntem: Bu retrospektif çalışmada Ekim 2016 ile Eylül 2018 tarihleri asında Selçuk Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Çocuk Romatoloji polikliniğine, Çocuk acil servisine, Çocuk Sağlığı polikliniğine ve Çocuk Nefroloji polikliniğine başvurup IgAV tanısı alan hastaların verileri, otomasyon epikriz kayıtları ve poliklinik dosyalarının incelenmesi ile değerlendirildi. Yaşın, anne-baba yaşının, cinsiyetin, tanı aldığı mevsimin, vücut ağırlığının, boyun, laboratuvar değerlerinin sistem tutulumlarının, nüks ve semptomlar üzerine etkileri araştırıldı. Bulgular: Çalışmamıza dâhil edilen hastaların erkek/kız oranı yapılan çalışmalara benzer şekilde 1,34 olarak bulundu. Başvuru mevsimleri incelendiğinde sonbahar ve kış aylarında tanı alan hasta sayılarının ilkbahar ve yaz aylarına göre belirgin fazla olduğu görüldü. Sistem tutulumu açısından dağılım incelendiğinde hastaların tamamında cilt tutulumu, %66’sında kas iskelet sistemi tutulumu, %51’inde gastrointestinal sistem (GİS) tutulumu, %15,5’inde böbrek tutulumu ve %8,7’sinde skrotal tutulum olduğu tespit edildi. İlk altı ay içinde hastaların %18,4’ünde nüks görüldü. Lökosit sayısı ve yaş arttıkça böbrek tutulumunun anlamlı şekilde arttığı bulundu (p<0,05). Sonuç: IgAV’de geçirilen bir enfeksiyonun çoğunlukla tetiği çektiği, sonbahar mevsiminde daha sık görüldüğü, eklem ve cilt tutulumu başta olmak üzere diğer tüm sistemleri de tutabileceği, prognozunun kısa dönemde iyi olduğu ve vakaların çoğunluğunun sekelsiz bir şekilde iyileştiği görülmüştür. Lökositoz ve büyük yaş ile böbrek tutulumu arasında anlamlı bir ilişki bulunmuştur.Öğe The Importance of Biomarkers in the Diagnosis and Follow-Up of Celiac Disease(Selçuk Üniversitesi, 2023 Ekim) Gümüş, Meltem; Yorulmaz, Alaaddin; Kilim, Esra; Kaya, Reyhan; Ergani, Anna Carina; Emiroğlu, Halil HaldunAim: In the present study, the purpose is to investigate the clinical significance, diagnostic capabilities, relationships, and correlations of inflammation-based biomarkers before and after treatment in children with Celiac Disease. Methods: The study was conducted by retrospectively evaluating the files of patients who were diagnosed and followed up in the Department of Pediatric Gastroenterology of Selcuk University between January 2011 and January 2023. The study was completed with 202 Celiac Disease patients who were diagnosed according to the criteria of the European Pediatric Gastroenterology, Hepatology, and Nutrition Community and 160 healthy follow-ups. In case of clinical or laboratory suspicion, serological tests such as positive Tissue Transglutaminase Antibody and Anti-Endomysium values and the histopathological examination of the endoscopic tissue sample findings consistent with Celiac Disease were evaluated. Results: There were 122 (56.7%) girls and 80 (54.4%) boys in the patient group and 93 (43.3%) girls and 67 (45.6%) boys in the control group. The most common intestinal complaint was abdominal pain in 49 (22.3%) patients. Gluten-free diet treatment was started after the diagnosis. The values of the patients at the time of diagnosis, in the 6th month after the diet, and the values of healthy control patients were compared. A weak and positive correlation was found between NLR, RPR, RLR levels, and age, body weight, and height in the correlation analysis. The ROC curve for hematological biomarkers was used to evaluate the level of additional diagnostic support in Celiac Disease patients. Conclusion: After a gluten-free diet, symptoms regress, and the development of more serious celiac-related damage can be prevented. This suggests that NLR, RLR, PLR, SII, HRR, and PNI formulas, which are used in many inflammatory conditions and obtained from routine hemogram parameters, can be used to determine dietary compliance in Celiac Disease patients during their follow-ups.Öğe Investigation of the Non-Traumatic Forensic Cases Admitted to Pediatric Emergency Department, Selcuk University Medical Faculty Hospital(Selçuk Üniversitesi, 2022) Şen, Sevil; Yorulmaz, AlaaddinObjective: The aim of this study is to reveal the demographic epidemiological characteristics of pediatric forensic cases admitted to the emergency department of a medical school hospital, to determine the reasons for admission, admission times, hospitalization and death rates. Material and Method: 1104 pediatric forensic cases who applied to Selcuk University Medical Faculty Hospital Pediatric Emergency Unit between 2016 and 2019 and patients up to 18 years old were analyzed retrospectively. Data on demographic characteristics, including age and gender, reasons for referral, time of presentation, hospitalization period, need for intensive care and mortality rates were determined. Results: Of the patients, 538 (48.7%) were female and 566 (51.3%) were male. While the mean of boy was 57.86 months, the mean age of the girls was 81.43 months. When the mean age according to gender was analyzed statistically, a significant difference was found (p:0.001). The number of patients in the 0-6 age group (n=731, 66.2%) was higher than the others. Summer was the season in which applications were most frequently observed. The most frequently admittance time zone was between 16:00-23:59. The most common reason for admission was poisoning (n=855, 77.1%), followed by foreign body in the digestive tract (n=112, 10.5%). Conclusion: In our study, the majority of forensic cases are forensic cases caused by accident in the 0-6 age group. It has been observed that these cases can be prevented by taking careful measures. Therefore, medicines and cleaning products should be kept out of reach of children. It was thought that giving importance to security measures at home and providing training on this could reduce the frequency of poisoning.Öğe Is Asymmetric Dimethylarginine a Useful Biomarker in Children With Carbon Monoxide Poisoning?(LIPPINCOTT WILLIAMS & WILKINS, 2019) Yazar, Abdullah; Akin, Fatih; Sert, Ahmet; Ture, Esra; Topcu, Cemile; Yorulmaz, Alaaddin; Ercan, FatihObjective Carbon monoxide poisoning (COP) is the leading cause of mortality and morbidity due to poisoning worldwide. Because children are affected more quick and severely from COP, they may require a longer treatment period, even if carboxyhemoglobin (CO-Hb) and/or lactate levels return to normal. Therefore, a new marker that predicts the duration of treatment and the final outcomes of COP is needed. Methods This case control study was conducted on 32 carbon monoxide-poisoned patients younger than 18 years who had been admitted to pediatric emergency department. The control group included age- and sex-matched 30 healthy children. Blood samples were obtained for analysis of arterial blood gases, CO-Hb percent, methemoglobine, lactate, and asymmetric dimethylarginine (ADMA). Results Asymmetric dimethylarginine levels were significantly increased (P < 0.05) in patients with COP on admission and after the treatment when compared with controls (1.36 [0.89-6.94], 1.69 [0.76-7.81], 1.21 [0.73-3.18] nmol/L, respectively). There was no positive correlation between CO-Hb and ADMA levels on admission and at 6 hours (P = 0.903, r = 0.218, P = 0.231, r = 0.022, respectively). Positive correlation was found between lactate and CO-Hb levels on admission (P = 0.018, r = 0.423). Conclusions This study showed that ADMA levels were still high after 6 hours of 100% oxygen therapy in children with COP, even CO-Hb and/or lactate levels return to normal range. On the basis of these results, we consider that ADMA may be a useful biomarker in patient with COP.Öğe Konya Bölgesindeki Ailevi Akdeniz Ateşli Olguların Değerlendirilmesi: Klinik ve Genetik Çalışma(2008) Peru, Harun; Elmacı, Ahmet Midhat; Yorulmaz, Alaaddin; Altun, Bülent; Kara, FatihAmaç: Bu çalışmanın amacı, Konya bölgesinde yaşayan ailevi Akdeniz ateş (AAA)’li hastalarda sıklıkla rastlandığı bilinen 8 mutasyonun ve ateş, karın ağrısı, eklem ağrısı, göğüs ağrısı gibi klinik bulguların sıklıklarını belirleyerek, bu sonuçların ülkemiz ve diğer ırkların verileri ile karşılaştırılmasını yapmaktır. Yöntem: Bu çalışmada Konya il merkezi ve çevresindeki ilçelerde yaşayan, Selçuk Üniversitesi Meram Tıp Fakültesi Çocuk Nefroloji bölümüne başvurup AAA tanısı alan 142 olgu retrospektif olarak değerlendirildi. MEFV geninde sıklıkla rastlandığı bildirilen 8 mutasyonun (M694V, M680I,E148Q,V726A, A744S, R202Q, R761H, T267I) sıklıkları ve bu mutasyonlar ile klinik yakınmalar arasındaki ilişki araştırıldı. Bulgular: Hastaların 122’sinde (% 85.9) mutasyon tespit edildi, bunların 69’unda (% 48.5) homozigot, 53’ünde (% 37.3) heterozigot mutasyon bulundu. Homozigot mutasyonların 52’sinde (% 36,6) M694V mutasyonu belirlendi. Klinik bulguların mutasyon tipine göre değerlendirilmesinde, M694V alleli taşıyan (heterozigot ya da homozigot) hastalarda diğer tüm mutasyon tiplerine göre eklem şikâyetleri anlamlı olarak daha sık bulundu. Ateş, karın, eklem ve göğüs ağrısı gibi yakınmalarının sıklığı, sırası ile % 94.4, % 96.5, % 44.4 ve % 21.8 olarak bulundu. Sonuç: Bölgemizdeki AAA hastalarında gerek mutasyon gerekse klinik yakınmalarının sıklığı ülkemizdeki çalışmaların sonuçlarına benzerlik göstermektedir.Öğe Management of acute mitochondriopathy and encephalopathy syndrome in pediatric intensive care unite: a new clinical entity(Springer-Verlag Italia s.r.l., 2019) Arslan, Şükrü; Yorulmaz, Alaaddin; Sert, Ahmet; Akın, FatihAcute mitochondriopathy and encephalopathy syndrome (AMES) is described differently by different authors in the literature. As a new clinical entity, we aimed to present the clinical signs and symptoms, diagnosis and treatment algorithm of our patients with AMES. 56 patients aged between 2 months and 18 years who were followed up in pediatric intensive care units of Konya Training and Research Hospital and Selcuk University Medical Faculty Hospital, between January 2010 and June 2017 were included. Patients’ data were obtained retrospectively from the intensive care unit patient files. 34 (60.7%) of the patients were male and 22 (39.3%) were female. The median age of our patients was 10.0 months. At the time of admission, 42 (75%) of the patients had fever, 35 (62.5%) vomiting, 27 (48.2%) abnormal behaviour and agitation and 28 (50%) convulsion. The etiological classification of patients with AMES was divided into four groups as infection, metabolic disorder, toxic, and hypoxic-ischemic. 39 (69.6%) patients were found to have infection, 10 (17.9%) patients hypoxia, 7 (12.5%) patients metabolic disorders. AMES occurs rarely, but should be kept in mind in the differential diagnosis of patients with any encephalopathy of unknown origin especially in those with a history of ingestion of drugs, previous viral infection and vomiting. Early recognition and treatment is imperative to reduce morbidity and mortality in children with AMES. © 2019, Belgian Neurological Society.Öğe Prediction of the development of pulmonary arterial hypertension with Tei Index in congenital heart diseases with left-to-right shunt(Turkish Society of Cardiology, 2019) Yücel, Mehmet; Alp, Hayrullah; Yorulmaz, Alaaddin; Karaarslan, Sevim; Baysal, TamerObjective: The aim of this study was to determine the usefulness of the Tei Index, an echocardiographic parameter, in the early determination of pulmonary artery pressure (PAP) in congenital heart disease (CHD) with a left-to-right shunt. Methods: Right and left ventricular functions were evaluated using Tei Index values determined with tissue Doppler echocardiography. Cardiac catheterization was performed in all cases. The presence of pulmonary arterial hypertension (PAH) was defined as a mean PAP of ?25 mm Hg and a pulmonary vascular resistance index of >3 WU/m2. Patients with a pulmonary/systemic blood flow ratio of ?2 were considered candidates for surgery. Results: The Tei Index values measured from the left ventricular posterior wall and the right ventricular anterior wall were found to be significantly higher in the patients with PAH (0.68±0.18, 0.67±0.16, respectively) compared with the patients without PAH (0.56±0.16, p=0.027; 0.51±0.12 p=0.001). A significant correlation was detected between the Tei Index value measured from the left ventricular posterior wall and the mean PAP (correlation coefficient: 0.491). Conclusion: The right ventricular Tei Index values in children with CHD and a left-to-right shunt can be used as a parameter to follow up on the potential development of PAH, to make a diagnosis in the early period, and to make a timely decision about surgery. © 2019 Turkish Society of Cardiology.Öğe Prevalence and distribution of children with congenital heart diseases in the central Anatolian region, Turkey(TURKISH J PEDIATRICS, 2006) Baspinar, Osman; Karaaslan, Sevim; Oran, Buelent; Baysal, Tamer; Elmaci, A. Midhat; Yorulmaz, AlaaddinCongenital heart diseases (CHD) are the most frequent malformation at birth. The aims of this study were to assess the prevalence of congenital heart disease, their different types, and the detection rate among children in the central Anatolian region in Turkey. The study was conducted during an eight-year period (March 1995-December 2002). The prevalence of CHD in a large tertiary care hospital in the central Anatolian region in Turkey was studied. The diagnosis of a structural defect was based on echocardiographic study. The following age groups were considered: neonates, infants and toddlers, preschool children, schoolchildren, and adolescents. In the study period, 1,693 children were found to have CHD; 1,253 patients were neonates and infants. Total prevalence of CHD over the study period was 7.77 per 1,000 live-born. The prevalence increased from 6.35 to 9.65 per 1,000 live births between 1995 and 2002 (p<0.05). The average age at diagnosis was 2.2+/-3.64 years (I day to 18 years, median 5 months). There were 863 (51%) boys and 830 (49%) girls, with a male/female ratio of 1:1. Isolated ventricular septal defect (32.6%) was the most frequent acyanotic anomaly, and tetralogy of Fallot (5.8%) was the most frequent cyanotic anomaly. The commonest non-cardiac anomalies with CHD were musculoskeletal. anomalies. Down syndrome was determined in 83 patients (78.3%) from all syndromic CHD cases. Congenital heart disease is a very significant health problem. It requires urgent measures in terms of organization of early diagnosis and proper management. The prevalence rate is comparable to that of similar developed countries. Increasing incidence of CHD might be attributed to more diagnoses with new technologic development or it may indicate a real increase in the defects.Öğe Primer immün yetmezlik tanısı ile takip edilen hastaların retrospektif olarak değerlendirilmesi(Selçuk Üniversitesi Tıp Fakültesi, 2007) Yorulmaz, Alaaddin; Reisli, İsmailPrimer immün yetmezlikler, primer ya da doğumsal immün yetmezlik bozuklukları sonucunda gelişen kronik ve/veya yineleyen bakteriyel, viral, fungal ve protozoal enfeksiyonlarla seyreden hastalıklar grubudur. Çocuk Sağlığı ve Hastalıkları mmünoloji ve Allerji bilim dalında takip edilen 1054 hastanın klinik, laboratuar ve demografik özellikleri değerlendirildi. Hastalarımızın 647'si (%61,4) erkek, 407'si (%38,6) kız idi. Hastaların tanı yaşı ortalama 55,5 ay olup, 2 ay ile 552 ay arasında değişiyordu. Hastalarımızdan 2 olgu hariç diğerleri pediatrik yaş grubundaydı. Hastalarımızın %92,8'ini (n:978) antikor eksikliğine bağlı immün yetmezlikler oluşturmaktaydı. Diğerleri arasında ağır kombine immün yetersizlikler %2,4 (n:25), diğer iyi tanımlanmış immün yetmezlik sendromları %1,7 (n:18), immün sistemin regülasyon bozuklukları %0,9 (n:9), fagositik sistem bozuklukları %0,4 (n:4), kompleman eksiklikleri %0,1 (n:1), doğal immün sistemde eksiklikle seyreden hastalıklar %1,4 (n:15) ve diğer immün yetersizlikler %0,4 (n:4) oranındaydı. Hastaların başvuru anında saptanan klinik bulgular; tekrarlayan ÜSYE %54,4, ASYE %47,4, sinüzit %38,9, otitis media %25,3, astım bulguları %15,9, alerji deri bulguları %15,0, gastroenterit %9,2, moniliazis %5,6, YE %4,0, sepsis %1,7, menenjit %1,1, tekrarlayan cilt enfeksiyonu %0,9 oranında saptandı. ÜSYE, ASYE ve sinüzit diğer eşlik eden semptomlara göre anlamlı olarak yüksekdi (p<0,05). Hastalarımızın ebeveynleri arasında %37,5 oranında akraba evliliği olduğu saptandı. Akraba evliliği oranı, SCID'de %84, fagositer işlev bozukluğunda %75, CVID'de %73,3 oranında tespit edildi. SCID, diğer iyi tanımlanmış immün yetersizlikler ve immün sistemin regülasyon bozukluğuna bağlı hastalıklarda 1. derece akraba evliliği, diğer P Y'lere göre anlamlı olarak yüksek saptandı (p<0,05). Tekrarlayan enfeksiyonlar nedeniyle 379 (%36) hastaya trimetoprim-kotrimaksazol profilaksisi başlandı. 63 (%6,0) hastada bilgisayarlı tomografi (BT) ve/veya HRCT ile kronik akciğer hastalığı tespit edildi. Hastalarımızdan 401'ine (%38,0) astım tanısı konuldu. Sonuç olarak tekrarlayan enfeksiyonları olan ve antibiyotik tedavisine dirençli hastalarda mutlaka primer immün yetersizlik düşünülmelidir. Komplikasyonların azaltılabilmesi için erken tanı ve tedavinin önemli olduğunu düşünüyoruz.Öğe Retrospective Evaluation of Serum Zinc Levels in Patients with Protein-Energy Malnutrition(Selçuk Üniversitesi, 2023 Haziran) Özen, Hasan; Emiroğlu, Halil Haldun; Emiroğlu, Melike; Akdam, Neriman; Yorulmaz, AlaaddinAim: In this study, we aimed to investigate the frequency of serum zinc deficiency in children with protein-energy malnutrition and to show the relationship between the degree of malnutrition and serum zinc level. Methods: Methods: This retrospective study was conducted at the Pediatric Gastroenterology, Hepatology, and Nutrition clinic in Selçuk University Hospital, and included 506 patients aged between 1 and 18 years who were diagnosed with protein-energy malnutrition according to the Waterlow classification. Results: The prevalence of serum zinc deficiency was 61.1% in patients with protein-energy malnutrition. The mean serum zinc levels of patients aged 1-5 were significantly lower than those of patients aged 5-12 and 12-18. There was no difference between malnutrition degrees calculated according to Waterlow criteria and mean serum zinc levels. Although the relationship between the degree of malnutrition calculated according to the BGA scale and the mean serum zinc level was not statistically significant, the mean decrease in serum zinc levels was remarkable in contrast to the increase in the level of malnutrition. Conclusion: It is important to routinely measure serum zinc levels in patients with PEM and to provide zinc supplementation if deficiency is detected.Öğe Short-term results of patients with neural tube defects followed-up in the Konya region, Turkey(WILEY, 2019) Yorulmaz, Alaaddin; Konak, MuratBackground Additional congenital anomalies have often been found in patients with neural tube defect (NTD). We aimed to find out the clinical features, short term prognosis, treatment approaches, and systemic anomalies of NTD patients in the Konya region. Method A total of 186 newborn babies with NTD were retrospectively included in the study and all were assessed in detail for congenital anomalies and clinical features. Results When the application month of the patients was examined, it was seen that the most frequent month was July. Of 186 babies, 101(54.3%) had meningomyelocele, 53 (28.5%) had meningocele, 13 (7.0%) had encephalocele, 16 (8.6%) had spina bifida occulta, and 4 (2.1%) had anencephaly. Of these patients, 97 (52.2%) were male and 89 (47.8%) were female. Hydrocephalus was an almost constant finding and was found in 140 (75.3%) patients. 51 (27.4%) patients had congenital heart disease (CHD). The most common CHD was atrial septal defect 22.3%. Orthopedic anomaly was detected in 51 (27.4%) patients, nephrological anomaly was found in 47 (25.3%) of the cases, congenital hypothyroidism was diagnosed in 14 (7.5%) patients with NTD. The mortality rate of patients diagnosed with NTD was 7.5%. The rates of premature delivery and consanguinity between parents were higher in patients with NTD. Conclusions Our results indicate that at least one congenital anomaly is also present in about two-thirds of newborn babies with NTD, and these anomalies significantly increase their morbidity and mortality. All newborn babies with NTD should be screened for additional congenital anomalies and evaluated with more organized, multidisciplinary methods.
