Çocuk Sağlığı ve Hastalıkları/Makale Koleksiyonu

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https://hdl.handle.net/20.500.12395/15659

Listeleniyor 1 - 20 / 192

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, Alaaddin
Aim: 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.
Çocukluk Çağı Karsinoid Tümörleri: Tek Merkez Deneyimi
(Selçuk Üniversitesi, 2019 Aralık) Kara, Buket; Gündüz, Metin; Köksal, Yavuz; Madenci, Hasan
Amaç: Karsinoid tümörler (KT), 15 yaş altı çocuklarda 1-1.4/1.000.000 sıklıkta görülmektedir. Akciğer ve gastrointestinal sistemin diğer bölgelerinde de görülmekle beraber çoğunlukla apendikste görülür. Bu çalışmada kliniğimizde KT tanısı ile izlenen hastaların epidemiyolojik ve klinik özellikleri ile tedavileri retrospektif olarak değerlendirildi. Gereç ve Yöntem: Selçuk Üniversitesi Tıp Fakültesi, Çocuk Onkoloji Kliniği’nde 2010-2017 arasında KT tanısı ile tedavi edilen hastaların dosyaları retrospektif olarak incelendi. Bulgular: Tanı alıp, tedavisi ve izlemi yapılan 10 KT hastası çalışmaya dâhil edildi. Hastaların 7’si kız (% 70) ve 3’ü erkekti (% 30). Hastaların yaşları 10-17 yıl arasında değişiyordu (ortanca yaş:15 yıl). Tümör yerleşimleri apendiks (n: 9, % 90) ve akciğerdi (n: 1, % 10). Apendiks kaynaklı KT hastaların hepsinde başvuru şikâyeti karın ağrısı olup akut apendisit tanısıyla ameliyat edilmişti. Tümör çapları 0,3-2,5cm arasında değişiyordu (ortanca 0,7 cm). Beş hastada tümör apendikste sınırlı iken2 hastada tümör apendiks serozasını aşmıştı. Bu hastalarda tümör çapı 1,7 cm ve 2,5 cm idi. Tümör çapı 2,5 cm olan hastaya sağ hemikolektomi yapıldı. Apendiks kaynaklı KT hastaların hepsi hastalıksız olarak izlemleri devam etmektedir. Akciğer kaynaklı KT hastası, geçmeyen öksürük şikâyeti ile başvurmuş, yapılan bronkoskopide sol akciğer alt lobda KT saptanmıştır. Bu hastaya, lobektomi yapıldı. Bu hasta da halen hastalıksız olarak izlemi devam etmektedir. Hastaların hiçbirinde karsinoid sendrom bulguları yoktu. Sonuç: Çocukluk çağında nadir görülen karsinoid tümörlerin tanısı insidantel olarak konduğu için akut apandisit tanısı ile ameliyatedilen hastaların patolojik incelemelerinin takibi önemlidir.
Glutatyon, Hepatit B Virus Enfeksiyonundan Etkilenir Mi?
(Selçuk Üniversitesi, 2021) Emiroğlu, Halil Haldun
Glutatyon redoks sistemi yaştan etkilenebilir. Bu nedenle serum glutatyon düzeyleri ile ilgili çalışma yapılırken, vaka ve kontrol gruplarına ait yaş ortalamalarının benzer olmasına özen gösterilmelidir.
Hematological Parameters and Inflammatory Markers in Children with Multisystem Inflammatory Syndrome
(Selçuk Üniversitesi, 2022) Alkan, Gulsum; Sert, Ahmet; Oz, Sadiye Kubra Tuter; Emiroglu, Melike
Objective: Multisystem inflammatory syndrome in children (MIS-C), is a newly recognised lifethreatening complication of coronavirus disease 2019 (COVID-19). Early determination of clinical severity of the disease is important for early decision of treatment regimens. The aim of this study is to investigate the severity classification value of a number of hematological parameters, inflammatory markers and biochemical tests in patients with MIS-C during the acute stage and after anti-inflammatory treatment. Material and Methods: In this retrospective case-controlled study, 64 children with MIS-C and 95 healthy age and gender matched children were included. Patients were divided into three clinical severity groups; mild, moderate, and severe. Results: Mean platelet volume (MPV), MPV to lymphocyte ratio (MPVLR), d-dimer, ferritin, interleukin 6 (IL6) levels were significantly higher, while albumin levels were lower in the severe MIS-C group compared to all the other groups on admission. Neutrophil-to-lymphocyte ratio (NLR) and derived (d) NLR (d-NLR) levels were significantly higher in the moderate group compared to the mild group. In the pre-treatm ent period of MIS-C patients had higher MPV, platelet distribution width (PDW) values while they had lower white blood cell, lymphocyte, monocyte, haemoglobin, mean corpuscular volume (MCV), red cell distribution width (RDW), plateletcrit and platelet values compared to the posttreatment group. Lymphocyte, platelets, and haemoglobin levels were significantly higher in the control group compared to the pre-treatment group. Acute phase reactants, NLR, NMR, PLR, d-NLR, MPVLR and systemic inflammatory index were significantly higher in all MIS-C patients on admission compared to the control group. Conclusion: Specific routine laboratory test results may be useful in determining disease severity of MIS-C, possibly predicting the prognosis and early initiation of the appropriate treatment.
The Effect of Gene Mutations on Disease Severity Scores in Pediatric Familial Mediterranean Fever Patients
(Selçuk Üniversitesi, 2022) Güngören, Vildan; Yorulmaz, Alaaddin; Arslan, Şükrü
Objectives: 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 M694V
İmmünglobulin A Vasküliti Tanısı Konulmuş Pediyatrik Hastaların Değerlendirilmesi: Tek Merkez Deneyimi
(Selçuk Üniversitesi, 2021) Ağır, Mehmet Akif; Güngörer, Vildan; Yorulmaz, Alaaddin; Arslan, Şükrü
Amaç: 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.
Çocuklarda primer böbrek tümörlerinin klinik özellikleri, tedavi yaklaşımları ve tedavi sonuçları
(Selçuk Üniversitesi, 2021) Kara, Buket; Sarıkaya, Mehmet; Ertan, Kübra; Uğraş, Nevzat Serdar; Çiftci, İlhan; Yavaş, Güler; Köksal, Yavuz
Amaç: Bu çalışmanın amacı, çocuklarda primer malign böbrek tümörlerinin klinik özellikleri, tedavi yaklaşımları ve tedavi sonuçlarının değerlendirilmesidir. Gereç ve Yöntem: 2006 ile 2020 yılları arasında primer malign böbrek tümör tanısı alan ve izlenen çocuk hastaların onkoloji dosyaları geriye yönelik incelendi. Hastaların demografik ve klinik özellikleri ile tedavi yaklaşımları ve izlemleri not edildi. Bulgular: Bu yıllar arasında izlenen 950 malign hastalıklı çocuğun 49’unda(%5,2) primer malign böbrek tümörü vardı. Hastaların yaşı üç gün ile 13 yıl arasında değişiyordu (ortanca, 3 yıl). Erkek kız oranı 25/24’dü. En sık görülen semptom ve bulgu karında kitle idi. İki hastada bilateral hastalık vardı (%4,1). Patolojik tanılar, Wilms tümörü (n = 44, % 89,8), mezoblastik nefroma (n=2, % 4,1), böbreğin clear hücreli sarkomu (n=2, % 4,1) ve böbreğin primer sinovyal sarkomuydu (n=1, %2). Wilms tümörlü hastalardan sadece ikinde diffüz anaplazi vardı. Hastalarımızın risk grupları düşük (n = 4, % 8.3), orta (n = 35, % 72.9) ve yüksek riskli (n = 9, % 18.8) idi. Hastaların takip süreleri iki ay ile 15 yıl (ortanca, 5 yıl) arasında değişiyordu. Primer böbrek tümörlerinde genel ve olaysız sağ kalım oranları sırasıyla % 72,7 ve% 59,7 idi. Wilms tümörlü hastaların genel ve olaysız sağ kalım oranları %79 ve %63’dü. Sonuç: Primer malign böbrek tümörlerinde özellikle de Wilms tümöründe multidisipliner yaklaşımlarla başarı oranları yükselmiştir. Bundan sonra hem tedavi başarısının daha da artırılması hem de tedavi ilişkili yan etkilerin azaltılması üzerinde durulmalıdır.
PPARG genindeki Pro12Ala polimorfizmi, Türk populasyonunda insülin direnci ve tip 2 diyabet ile ilişkili değildir: Bir vaka-kontrol çalışması
(Selçuk Üniversitesi, 2021) İşçioğlu, Funda; İpekçi, Süleyman Hilmi; Baldane, Süleyman; Kaya, Dudu Erkoç; Arıkoğlu, Hilal
Amaç: Tip 2 diyabet (T2D), diyabetin en sık görülen türüdür ve tüm dünyada olduğu gibi ülkemizde de ciddi bir halk sağlığı sorunu haline gelmiştir. İnsülin sekresyonunun azalması ve/veya insülin direnci (IR) gelişimi, T2D patogenezinde yer alan iki ana bozukluktur. Kromozom 3p25’te yer alan peroksizom proliferatör aktive reseptör gama (PPARG) geni tarafından kodlanan ve esas olarak adipositlerde eksprese edilen PPARG2, glikoz ve lipid metabolizmasının düzenlenmesinde yer alan çok sayıda anahtar geni düzenler. Fonksiyonel önemi dolayısıyla, T2D gelişimi ile ilişkisi ilk rapor edilen aday gen PPARG2 (Pro12Ala varyantı)’dir. Çalışmamızda, PPARG genindeki Pro12Ala’nın IR gelişimi ve T2D riski üzerine etkilerini Konya bölgesinde yaşayan 387 (181 non-obez/ 206 obez) T2D ve 264 (137 non-obez/127 obez) sağlıklı birey olmak üzere toplam 650 kişide değerlendirmeyi amaçladık. Yöntem: Bireylerden alınan kan örneklerinden, T2D ilişkili biyokimyasal parametreler analiz edildi ve sonrasında HOMA-IR (HOMA indeksi) hesaplandı. HOMA-IR indeksi 2.5’ten yüksek olan kişiler insüline dirençli olarak kabul edildi. İzole edilen DNA örneklerinde, Pro12Ala genotiplendirmesi RT-PCR tekniği ile yapıldı. İstatistiksel analiz için SPSS18.0 programı kullanıldı. P<0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Obez hasta grubu dışında diğer hasta ve kontrol grupları Hardy-Weinberg dengesinde değildi (p<0.05). Dominant, resesif ve additif modeller kurularak yapılan ilişkilendirme analizine göre Pro12Ala polimorfizminin T2D riski ve ilişkili biyokimyasal parametreler üzerine bir etkisi bulunmadı (p>0.05). Sonuç: Hastalığın poligenik doğası ve çevresel faktörlerin karmaşıklığı, genlerin T2D patogenezindeki etkisinin anlaşılmasını zorlaştırmaktadır. Bu nedenle, PPARG’nin hastalığın genetik zeminindeki olası rolünü ortaya çıkarmak için daha büyük popülasyonlarda daha fazla çalışmaya ihtiyaç vardır. Çalışma Türk toplumunda PPARG ve T2D ilişkisi bakımından sunulan ilk rapordur.
Increased Fat Graft Survival with Mesenchymal Stem Cell Recruiting Effect of PRP: In Vitro and In Vivo Study of Application Techniques
(Selçuk Üniversitesi, 2022) Yildiran, Gokce; Cicek, Gulsemin; Artac, Hasibe; Ucaryılmaz, Hulya; Duman, Selcuk; Sutcu, Mustafa; Aktan, T. Murad; Tosun, Zekeriya; Akdag, Osman; Celik, Z. Esin
Aim: Adding platelet-rich plasm (PRP) or mesenchymal stem cells are the most accepted methods to increase fat graft’s permanence. However, there is no consensus on timing and whether the effect of stem cells or PRP is observed more in the recipient area or in the donor area. It is aimed to present the application method and localization of PRP to be combined with fat graft to increase the survival. Material and Methods: in vitro part: Fat grafts were kept in a medium containing PRP. Cell output from the fat graft to the Petri dishes was examined every day. The time to recruit the maximum number of stem cells to the medium was determined (day 10). in vivo part: Eight group of rats were received PRP in different concentrations either to recipient or donor areas of fat grafts. After ten days, fat grafts were transferred to the recipient area. Ninety days after the transfer, histopathological examination and immunohistochemical staining were performed. Results: The group which had received the full-dose PRP to the recipient area showed the highest cellular integrity and vascularity (p< 0.05). Vascularity was superior in the half-dose PRP group compared to the control group (p< 0.05); cellular integrity did not increase. Donor site groups did not show increase in cellular integrity. Conclusion: Although PRP starts to increase fat graft permanence by increasing vascularity, it acts by preserving the cellular integrity of the fat cells as the concentrations increase. The PRP injection to the recipient area 10 days before fat grafting may provide higher survival rates.
The Effect of the Education about the Practices Supporting Oral Feeding in Preterm Infants on the Knowledge Levels of Health Professionals
(Selçuk Üniversitesi, 2022) Çelen, Raziye; Soylu, Hanifi; Arslan, Fatma Taş
Aim: The study was conducted to investigate the effect of an education program about evidencebased interventions for oral feeding supporting practices in preterm infants on the knowledge levels of neonatal nurses and physicians. Materials and Methods: The study is a single group study with a pretest-posttest pre-experimental design. It was conducted on 44 healthcare professionals (nurses and physicians) at a medical faculty hospital in Turkey. Data were collected using the Demographic Characteristics Form and the Preterm Infant Feeding Knowledge Form. The participants were divided into groups of 8 to 10 and each education was completed in a single session lasting for about 45 minutes, in a total of five days. The participants completed the pretest prior to the education program. The posttest was administered two weeks after the completion of the education. The data were analyzed using the McNemar test and the paired t test. Results: The average age of the participants is 26.14±4.81. Of the 44 participants, 86.4% are nurses, 13.6% are physicians, and 88.6% are female. While 63.6% of the healthcare professionals had a Neonatal Resuscitation Program certificate, 70.5% did not have the neonatal intensive care nursing certificate. It was found that 40.9% of the participants did not receive education about preterm infant feeding, while those who received training before were found to have breast milk training in the context of in-service training. The mean pretest rate of correct answers was 58.69%, while the mean posttest rate of correct answers was 78% (p<0.001) Conclusion: It has been revealed that the education on oral feeding supporting practices in preterm infants improves the knowledge levels of the healthcare professionals.
Investigation of the Non-Traumatic Forensic Cases Admitted to Pediatric Emergency Department, Selcuk University Medical Faculty Hospital
(Selçuk Üniversitesi, 2022) Şen, Sevil; Yorulmaz, Alaaddin
Objective: 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.
Malnutrition Despite Adequate Nutrient Intake: A Clue For Diencephalic Syndrome
(Selçuk Üniversitesi, 2022)
Diencephalic syndrome is characterized by excessive weight loss and subcutaneous fatty tissue loss, hyperactivity, euphoria, and hypervigilance observed in early childhood. It usually accompanies space-occupying neoplastic lesions of the hypothalamic–optochiasmatic region. There is an inverse relationship between mass size and weight gain. In this case report, a patient aged 1 year and 2 months with hypothalamic–optochiasmatic glioma was presented. We aimed to draw attention to diencephalic syndrome, which is a rare cause of weight gain and vomiting.
Evaluation of Hematologic Parameters in Children with Down Syndrome
(Selçuk Üniversitesi, 2022) Özdemir, Hülya; Artaç, Hasibe
Objective: Congenital hematological disorders are frequently observed in patients with Down syndrome (DS). In this study, we aimed to investigate peripheral blood-derived inflammation biomarkers such as neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and eosinophilmonocyte ratio in patients with Down syndrome. Material and Methods: Ninety-eight patients with karyotypically ascertained DS and 103 healthy controls were included. All subjects were divided into three age groups: 0-2 years (34 patients, 34 controls), 2-6 years (32 patients, 33 controls), and >6 years (32 patients, 36 controls). Demographic, clinical, and laboratory data of patients with DS who were admitted between June 2010 and December 2021 were reviewed from the file records from the pediatric allergy and immunology department. Results: Lymphocyte, eosinophil, and eosinophil-monocyte ratio were found to be significantly lower in children with DS compared to controls in group 2 (2-6 years) and group 3 (>6 years). Platelet-lymphocyte ratio was found to be higher in children with DS in group 2 and group 3. There was no statistically significant difference between DS and controls in group 1 (<2 years) in terms of all parameters. In group 2 (2-6 years) and group 3 (>6 years), there was a statistically significant difference between DS and controls in terms of lymphocyte, eosinophil, platelet-lymphocyte ratio, and eosinophilmonocyte ratio variables (P>0.05). Conclusion: We found significant differences among lymphocyte, eosinophil, platelet-lymphocyte ratio, and eosinophil-monocyte ratio in patients with DS. As a result, these parameters should be evaluated carefully for clinical outcomes.
Rapunzel Syndrome in a Patient with Autism
(Selçuk Üniversitesi, 2022)
Trichobezoar should be considered in the differential diagnosis in pediatric patients who present with complaints of abdominal pain, feeding problems, and vomiting as well as psychiatric problems. Rapunzel syndrome is a rare form of trichobezoar that can extend from the stomach to the small intestine and even to the colon. In this case report, a 9-year-old girl with autism accompanied by trichotillomania and trichophagia and diagnosed with Rapunzel syndrome is presented.
Biochemical and hematological profiles of wistar rats at the Selcuk University experimental medicine research and application center
(Selçuk Üniversitesi Veterinerlik Fakültesi, 2021)
Amaç: Yetiştiriciler, belirli popülasyonlar için bir dizi referans değeri sağlar, ancak yerel deneysel hayvan araştırma merkezlerinde üretilen sıçanlar fizyolojik ve genetik değişikliklere uğramış olabilir. Bu çalışmadaki amacımız, Konya, Türkiye, Selçuk Üniversitesi Deneysel Tıp Araştırma ve Uygulama Merkezi'nde (SUDAM) standart yerel koşullarda yetiştirilen Wistar ratların biyokimyasal ve hematolojik profillerini araştırarak gelecekteki çalışmalara katkıda bulunmaktır. Gereç ve Yöntem: Çalışmaya SUDAM Hayvan Evinde normal hayatlarını sürdüren 1 (erkek = 15, dişi = 15), 3 (erkek = 15, dişi = 15), 6 (erkek = 15, dişi = 15) ve 12 (erkek = 15, dişi = 15) aylık Wistar ratlar dahil edildi. Seçilen biyokimyasal ve hematolojik parametreler sırasıyla Beckman AU 5800 ve Beckman Coulter LH-780 analizörleriyle ölçüldü. Bulgular: Üre, kreatinin, ALT, albümin, globulin, RBC, hemoglobin, hematokrit ve MCH düzeyleri arasında aylara göre istatiksel olarak anlamlı bir farklılık vardı (p<0.05). Seçilen biyokimyasal ve hematolojik parametreler cinsiyete göre karşılaştırıldığında glikoz, üre, ALP, amilaz, albümin, total protein, CK, kolesterol, trigliserit, sodyum, potasyum, RBC, hematokrit, MCH, trombosit, WBC, nötrofil, monosit, eozinofil, bazofil düzeyleri arasında istatistiksel olarak anlamlı bir farklılık vardı (p<0.05). Öneri: Bu çalışma, Wistar ratların biyokimyasal ve hematolojik parametrelerinin yaş, cinsiyet, çevre ve beslenme gibi faktörlerle değişebileceğini kanıtlamıştır.
Tricuspid valve infective endocarditis associated with aseptic meningitis: A rare presentation in a child [Endocarditis infecciosa de la válvula tricúspide asociada con meningitis aséptica: Presentación infrecuente en una niña]
(Sociedad Argentina de Pediatria, 2020) Alkan, Gülsüm; Emiroğlu, Melike; Sert, Ahmet; Kartal, Ayşe; Öc, Mehmet
La endocarditis infecciosa es infrecuente pero potencialmente mortal. Las presentaciones atípicas retrasan el diagnóstico. El compromiso neurológico es habitual en la endocarditis de la válvula mitral, aunque infrecuente en la endocarditis de la válvula tricúspide. Si bien se han informado algunos casos e el del lado derecho con síntomas neurológicos en adultos, en la bibliografía no se ha descripto en niños. Se presenta una niña de 9 años con comunicación interventricular (CIV) congénita con fiebre, cefalea y rigidez de nuca. Sus síntomas clínicos y los hallazgos en el líquido cefalorraquídeo respaldaron el diagnóstico de meningitis aséptica. El día 3 del tratamiento con ceftriaxona, se resolvieron los síntomas; tras nueve días, reingresó con fiebre y rigidez de nuca. Un ecocardiograma mostró endocarditis de la válvula tricúspide. Recibió tratamiento antibiótico durante 6 semanas. Se realizó una cirugía cardíaca para la CIV y la insuficiencia de la válvula tricúspide.
Tricuspid valve infective endocarditis associated with aseptic meningitis: A rare presentation in a child
(SOC ARGENTINA PEDIATRIA, 2020) Alkan, Gülsüm.; Emiroğlu, Melike.; Sert, Ahmet.; Kartal, Ayşe.; Öc, Mehmet.
Infective endocarditis (IE) is a rare but a potentially life-threatening infectious disease. Atypical presentations cause delays in the diagnosis. Neurological involvement such as meningitis or meningismus, are especially common in mitral valve endocarditis, but unusual in tricuspid valve endocarditis. Although few cases of right-sided IE have been reported with neurological symptoms in adults, children have not been described in literature. A nine-year-old girl with congenital ventricular septal defect (VSD) was admitted with fever, headache and neck stiffness. Her clinical symptoms and cerebrospinal fluid findings supported the aseptic meningitis. On ceftriaxone therapy day 3, her complaints were resolved; nine days later she was admitted with fever and neck stiffness again. Further investigation for fever source with echocardiogram revealed a tricuspid valve endocarditis. Antibiotic therapy was completed after 6 weeks. Cardiac surgery was performed for VSD and tricuspid valvular insufficiency.
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, Tamer
Objective: 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.
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, Fatih
Acute 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.
ILC3 deficiency and generalized ILC abnormalities in DOCK8-deficient patients
(Blackwell Publishing Ltd, 2019) Eken A.; Cansever M.; Okus F.Z.; Erdem S.; Nain E.; Azizoglu Z.B.; Haliloglu Y.; Karakukçu M.; Ozcan A.; Devecioğlu O.; Aksu G.; Ayyildiz Z.A.; Topal E.; Aydiner E.K.; Kiykim A.; Metin A.; Cipe F.; Kaya A.; Artac H.; Reisli I.; Guner S.N.; Uygun V.; Karasu G.; Altuntas H.D.; Canatan H.; Oukka M.; Ozen A.; Chatila T.A.; Keles S.; Baris S.; Unal E.; Patiroglu T.
Background: Dedicator of cytokinesis 8 (DOCK8) deficiency is the main cause of the autosomal recessive hyper-IgE syndrome (HIES). We previously reported the selective loss of group 3 innate lymphoid cell (ILC) number and function in a Dock8-deficient mouse model. In this study, we sought to test whether DOCK8 is required for the function and maintenance of ILC subsets in humans. Methods: Peripheral blood ILC1-3 subsets of 16 DOCK8-deficient patients recruited at the pretransplant stage, and seven patients with autosomal dominant (AD) HIES due to STAT3 mutations, were compared with those of healthy controls or post-transplant DOCK8-deficient patients (n = 12) by flow cytometry and real-time qPCR. Sorted total ILCs from DOCK8- or STAT3-mutant patients and healthy controls were assayed for survival, apoptosis, proliferation, and activation by IL-7, IL-23, and IL-12 by cell culture, flow cytometry, and phospho-flow assays. Results: DOCK8-deficient but not STAT3-mutant patients exhibited a profound depletion of ILC3s, and to a lesser extent ILC2s, in their peripheral blood. DOCK8-deficient ILC1-3 subsets had defective proliferation, expressed lower levels of IL-7R, responded less to IL-7, IL-12, or IL-23 cytokines, and were more prone to apoptosis compared with those of healthy controls. Conclusion: DOCK8 regulates human ILC3 expansion and survival, and more globally ILC cytokine signaling and proliferation. DOCK8 deficiency leads to loss of ILC3 from peripheral blood. ILC3 deficiency may contribute to the susceptibility of DOCK8-deficient patients to infections. © 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

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