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Kose E, Nakagawa S, Niki K, Hashizume J, Kawazoe T, Suzuki N, Uchida M, Takase H. Pharmacist Interventions for Adverse Drug Reactions in Palliative Care: A Multicentre Pilot Study. Pharmazie 2023; 78:141-149. [PMID: 37592417 DOI: 10.1691/ph.2023.3554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
This study aimed to investigate adverse reactions to medications administered during palliative care and compare the responses of Board-Certified Pharmacists in Palliative Pharmacy (BCPPP) and non-BCPPP professionals. Methods: This multicentre prospective survey included hospital and community pharmacists who are members of the Japanese Society for Pharmaceutical Palliative Care and Sciences. Study participants included patients who experienced new drug reactions during the study period and responded to the requested survey items. The follow-up period for each eligible patient began on the day the pharmacists initiated the intervention and ended at discharge, death, or after one month of intervention. The primary endpoint was the impact of pharmacist intervention on adverse drug reactions. The pharmacists included in the study evaluated the severity of adverse drug reactions to assess the effect of their intervention using an integrated palliative care outcome scale before and after the intervention. Key findings: During the survey period, 79 adverse drug reaction intervention reports from 69 patients were obtained from 54 pharmacists (28 certified and 26 non-certified). The response rate was 1.62% (54/3,343). The management of palliative pharmacotherapy side effects by BCPPP and non-BCPPP significantly improved the patients' activities of daily living (P < 0.001). The BCPPP group intervened for significantly more patients with adverse drug reactions and overall adverse drug reactions than the non-BCPPP group (P < 0.023 and P < 0.013, respectively). Conclusion: BCPPP interventions can improve symptom management.
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Affiliation(s)
- E Kose
- Department of Pharmacy; These authors contributed equally to this work
| | - S Nakagawa
- Department of Clinical Pharmacy; Nippon Medical School Tamanagayama Hospital; Research Promotion Committee; These authors contributed equally to this work; Corresponding author: Sari Nakagawa, Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe-shi, Hyogo 650-8586, Japan,
| | - K Niki
- Faculty of Pharmaceutical Sciences, Kobe Gakuin University; Department of Clinical Pharmacy Research and Education; Nippon Medical School Tamanagayama Hospital; Research Promotion Committee
| | - J Hashizume
- Graduate School of Pharmaceutical Sciences, Osaka University; Department of Hospital Pharmacy
| | - T Kawazoe
- Nagasaki University Hospital; Department of Clinical Pharmacy; Nippon Medical School Tamanagayama Hospital; Research Promotion Committee
| | - N Suzuki
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University; Department of Pharmacy
| | - M Uchida
- National Hospital Organization Sendai Medical Center; Department of Education and Research Center for Pharmacy Practice; Nippon Medical School Tamanagayama Hospital; Research Promotion Committee
| | - H Takase
- Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts; Department of Pharmacy; Nippon Medical School Tamanagayama Hospital; Research Promotion Committee
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Kose E, Yamamoto T, Tate N, Ando A, Enomoto H, Yasuno N. Adverse Drug Event Profile Associated with Anti-dementia Drugs: Analysis of a Spontaneous Reporting Database. Pharmazie 2023; 78:42-46. [PMID: 37189266 DOI: 10.1691/ph.2023.2584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Adverse drug events (ADEs) rates associated with anti-dementia acetylcholinesterase inhibitors are estimated to be 5%-20% and show a wide range of symptoms. No report has examined whether there is a difference in the anti-dementia drugs' ADEs profile. This study aimed to establish whether anti-dementia drugs' ADEs profile differed. Data was based on the Japanese Adverse Drug Event Report (JADER) database. The reporting odds ratios (RORs) was used to analyze data for ADEs from April 2004-October 2021. The target drugs were donepezil, rivastigmine, galantamine, and memantine. The top ten most frequently occurring adverse events were selected. The association between the RORs and antidementia drug ADEs was evaluated, and compared the distribution rate of expression age related to ADEs and each ADEs' timing of onset due to anti-dementia drugs. The primary outcome was RORs. Secondary outcome were expression age and time-to-onset of ADE associated with anti-dementia drugs. A total of 705,294 reports were analyzed. The adverse events incidence differed. Bradycardia, loss of consciousness, falls, and syncope incidence were significantly diverse. The Kaplan-Meier curve results for the cumulative ADEs incidence showed that donepezil had the slowest onset, while galantamine, rivastigmine, and memantine had approximately the same timing of onset.
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Affiliation(s)
- E Kose
- Department of Pharmacy, Teikyo University School of Medicine University Hospital, Teikyo University, Tokyo, Japan;,
| | - T Yamamoto
- Department of Pharmacy, Teikyo University School of Medicine University Hospital, Teikyo University, Tokyo, Japan
| | - N Tate
- Laboratory of Basic Chemistry & Molecular Structure, Faculty of Pharma Sciences, Teikyo University, Tokyo, Japan
| | - A Ando
- Department of Lifelong Education for Pharmacists, Faculty of Pharma Sciences, Teikyo University, Tokyo, Japan
| | - H Enomoto
- Department of Lifelong Education for Pharmacists, Faculty of Pharma Sciences, Teikyo University, Tokyo, Japan
| | - N Yasuno
- Department of Pharmacy, Teikyo University School of Medicine University Hospital, Teikyo University, Tokyo, Japan; Department of Lifelong Education for Pharmacists, Faculty of Pharma Sciences, Teikyo University, Tokyo, Japan; Laboratory of Hospital Pharmacy, Faculty of Pharma Sciences, Teikyo University, Tokyo, Japan
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Doğulu N, Kose E, Tuna Kirsaçlioğlu C, Ezgü FS, Kuloğlu Z, Kansu A, Eminoglu FT. Co-Occurring Atypical Galactosemia and Wilson Disease. Mol Syndromol 2022; 13:454-458. [PMID: 36588756 PMCID: PMC9801321 DOI: 10.1159/000524004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/09/2022] [Indexed: 01/04/2023] Open
Abstract
Introduction Classic galactosemia is a disorder of the galactose metabolism and is inherited as an autosomal recessive disease. It is caused by a complete or severe deficiency of galactose-1-phosphate uridyltransferase (GALT), and in rare cases, atypical galactosemia can manifest at older ages. Wilson disease (WD) is a disorder of the copper metabolism that, like galactosemia, is inherited as an autosomal recessive disease. Hepatic, neurological, or psychiatric symptoms can be seen, independently or in combination, and symptoms vary from family to family. We present here a patient diagnosed with both WD and galactosemia. Case Presentation A 6-year-old girl was referred to our center with elevated transaminase levels and hepatosplenomegaly. The child, birthweight of 2,200 g, was born to first-degree consanguineous parents after a full-term uneventful pregnancy and was hospitalized in the neonatal period due to indirect hyperbilirubinemia, gastrointestinal bleeding, diarrhea lasting 2 weeks, and elevated liver enzymes. Hepatosplenomegaly was evident at the time of admission, a cataract was detected, and a neuropsychiatric evaluation revealed borderline mental capacity, as well as cognitive and speech retardation. Metabolic investigations revealed no specific findings other than trace positivity of reducing substances in the urine. A liver biopsy revealed copper accumulation in hepatocytes and low ceruloplasmin levels. Although WD was suspected in the patient, this diagnosis did not explain the intellectual disability, behavioral disorder, or cataract findings. A genetic analysis revealed homozygous mutations in the ATP7B and GALT genes. The galactose-1-phosphate uridyltransferase enzyme level was found to be low, and the patient was diagnosed with coexisting WD and galactosemia. Conclusion Coexistences of rare genetically transmitted diseases can be seen in countries where consanguineous marriages are common (Saudi Arabia, Iran, Pakistan, etc.), as in our country, Turkey.
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Affiliation(s)
- Neslihan Doğulu
- Department of Pediatric Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey,*Neslihan Doğulu,
| | - Engin Kose
- Department of Pediatric Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ceyda Tuna Kirsaçlioğlu
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Fatih S. Ezgü
- Department of Pediatric Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Zarife Kuloğlu
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Aydan Kansu
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Fatma T. Eminoglu
- Department of Pediatric Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey
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Kose E, Endo H, Hori H, Hosono S, Kawamura C, Kodama Y, Yamazaki T, Yasuno N. Association of Pharmacist-led Deprescribing Intervention with the Functional Recovery in Convalescent Setting. Pharmazie 2022; 77:165-170. [PMID: 35655381 DOI: 10.1691/ph.2022.2323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
So far, no studies investigated the association between pharmacist intervention and rehabilitation outcomes. The aim of study was to establish whether the pharmacist-led deprescribing intervention affects rehabilitation outcomes. This retrospective, observational, single-center, cohort study included consecutive geriatric patients (n = 448) with pharmacist-led intervention between 2017 and 2019. Participants were divided based on pharmacist-led deprescribing and non deprescribing interventions during hospitalization. Demographic data, laboratory data, the Functional Independence Measure were (FIM) analyzed between the groups. Multiple linear regression analysis was performed to analyze the relationship between pharmacist-led deprescribing and FIM total gain. The primary outcome was FIM total gain. The rate of pharmacist intervention during the study period was 92.4%. A multiple linear regression analysis of FMI-T gain, adjusting for confounding factors, revealed that the pharmacist-led deprescribing intervention was independently correlated with FMI-T gain. Particularly, the use of dyslipidemia drugs, antipsychotic drugs, hypnotics, and nonsteroidal anti-inflammatory drugs significantly decreased during hospitalization. The pharmacist-led deprescribing intervention was independently and significantly associated with FIM-T gain. The pharmacist-led deprescribing intervention improved functional recovery in a rehabilitation setting.
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Affiliation(s)
- E Kose
- Department of Pharmacy, Teikyo University School of Medicine University Hospital; Department of Pharmacy, Teikyo University School of Medicine University Hospital, 2-11-1 Kaga, Itabashi-ku, Tokyo 274-8555, Japan;,
| | - H Endo
- Department of Pharmacy, Ogaki Tokushukai Hospital
| | - H Hori
- Department of Pharmacy, Ogaki Tokushukai Hospital
| | - S Hosono
- Department of Pharmacy, Ogaki Tokushukai Hospital
| | - C Kawamura
- Department of Pharmacy, Ogaki Tokushukai Hospital
| | - Y Kodama
- Department of Pharmacy, Ogaki Tokushukai Hospital
| | - T Yamazaki
- Department of Pharmacy, Ogaki Tokushukai Hospital
| | - N Yasuno
- Department of Pharmacy, Teikyo University School of Medicine University Hospital; Laboratory of Hospital Pharmacy, School of Pharmacy, Teikyo University, Tokyo, Japan
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Taş Ö, Kontbay T, Dogan O, Kose E, Berberoglu M, Siklar Z, Tumer L, Eminoglu FT. Correction: Does Metformin Treatment in Pediatric Population Cause Vitamin B12 Deficiency? Klin Padiatr 2022. [PMID: 35226927 DOI: 10.1055/a-1778-8698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Özen Taş
- Ankara University Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Tugba Kontbay
- Ankara University Faculty of Medicine, Pediatric Endocrinology, Ankara, Turkey
| | - Ozlem Dogan
- Ankara University Faculty of Medicine, Biochemistry, Ankara, Turkey
| | - Engin Kose
- Ankara University Faculty of Medicine, Pediatric Metabolism, Ankara, Turkey
| | - Merih Berberoglu
- Ankara University Faculty of Medicine, Pediatric Endocrinology, Ankara, Turkey
| | - Zeynep Siklar
- Ankara University Faculty of Medicine, Pediatric Endocrinology, Ankara, Turkey
| | - Leyla Tumer
- Gazi University Faculty of Medicine, Department of Pediatric Metabolic Diseases, Ankara, Turkey
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Taş Ö, Kontbay T, Dogan O, Kose E, Berberoglu M, Siklar Z, Tumer L, Eminoglu FT. Correction: Does Metformin Treatment in Pediatric Population Cause Vitamin B12 Deficiency? Klin Padiatr 2022. [PMID: 35172352 DOI: 10.1055/a-1766-2824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Özen Taş
- Ankara University Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Tugba Kontbay
- Ankara University Faculty of Medicine, Pediatric Endocrinology, Ankara, Turkey
| | - Ozlem Dogan
- Ankara University Faculty of Medicine, Biochemistry, Ankara, Turkey
| | - Engin Kose
- Gazi University Faculty of Medicine, Department of Pediatric Metabolic Diseases, Ankara, Turkey
| | - Merih Berberoglu
- Ankara University Faculty of Medicine, Pediatric Endocrinology, Ankara, Turkey
| | - Zeynep Siklar
- Ankara University Faculty of Medicine, Pediatric Endocrinology, Ankara, Turkey
| | - Leyla Tumer
- Gazi University Faculty of Medicine, Department of Pediatric Metabolic Diseases, Ankara, Turkey
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Taş Ö, Kontbay T, Dogan O, Kose E, Berberoglu M, Siklar Z, Tumer L, Eminoglu FT. Does Metformin Treatment in Pediatric Population Cause Vitamin B12 Deficiency? Klin Padiatr 2022; 234:221-227. [PMID: 35114702 DOI: 10.1055/a-1702-2614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND/AIM There have been no studies to date examining the effect of metformin treatment on vitamin B12 status in children and adolescents. In this prospective study, the effects of metformin on blood vitamin B12, serum methylmalonic acid (MMA), homocysteine and holo-transcobalamin-II (holo-TC-II) levels were assessed in pediatric age group. MATERIALS AND METHODS This prospective study was conducted at the Pediatric Endocrinology and Adolescent Department between January 2017 and March 2019. Metabolic syndrome and polycystic ovary syndrome diagnosed patients with insulin resistance and/or impaired glucose tolerance, patients with type 2 diabetes mellitus (DM) treated with metformin were enrolled in study. Blood vitamin B12, MMA, homocysteine, holo-TC-II levels and hemogram values were evaluated. RESULTS Twenty-four patients were enrolled in study. Among these, 15 (62.5%) were female. The mean age of patients was 13.7±2.3 (10-19) years. Sixteen patients were diagnosed with metabolic syndrome and 8 patients were type 2 DM. At 6-month follow-up of all patients, there was no statistically significant difference in terms of vitamin B12, homocysteine, MMA and holo-TC-II levels. A 0.6% decline in vitamin B12 levels were revealed. At 12-month follow-up of 11 patients (45.8%) (6 Type 2 DM, 5 metabolic syndrome), no statistically significant difference was determined in vitamin B12, homocysteine, MMA and holo-TC-II levels. There were 6% decline in vitamin B12 levels and 10.9% increase in homocysteine levels, 5.4% decrease was detected in holo-TC-II level. CONCLUSION Although no significant changes in the serum vitamin B12, homocysteine, MMA or holo-TC-II levels with metformin therapy were detected, long-term prospective studies with high-dose metformin treatment in pediatric population are needed to confirm our results.
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Affiliation(s)
- Özen Taş
- Ankara University Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Tugba Kontbay
- Ankara University Faculty of Medicine, Pediatric Endocrinology, Ankara, Turkey
| | - Ozlem Dogan
- Ankara University Faculty of Medicine, Biochemistry, Ankara, Turkey
| | - Engin Kose
- Ankara University Faculty of Medicine, Pediatric Metabolism, Ankara, Turkey
| | - Merih Berberoglu
- Ankara University Faculty of Medicine, Pediatric Endocrinology, Ankara, Turkey
| | - Zeynep Siklar
- Ankara University Faculty of Medicine, Pediatric Endocrinology, Ankara, Turkey
| | - Leyla Tumer
- Ankara University Faculty of Medicine, Pediatric Metabolism, Ankara, Turkey
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Surucu Kara I, Oncul U, Kose E, Turan HM, Ceylan AC, Eminoglu FT. Coexistence of Megaconial Congenital Muscular Dystrophy and Cystinuria: Mimicking Hypotonia-Cystinuria Syndrome. Mol Syndromol 2022; 13:240-245. [DOI: 10.1159/000520502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 10/26/2021] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> Hypotonia-cystinuria syndrome is a contiguous gene deletion syndrome that is characterized by hypotonia, developmental delay, and cystinuria type A. We present a male patient who was admitted to our center with clinical findings of hypotonia-cystinuria syndrome and diagnosed with megaconial congenital muscular dystrophy and cystinuria. <b><i>Case Presentation:</i></b> A 16-month-old male patient was admitted with complaints of restlessness and body laxity. It was stated that the patient had hypotonia and growth retardation at the age of 2 months. Physical examination revealed mild hypotonia, growth retardation, and development delay, while laboratory examinations identified elevated serum creatine kinase and elevated dibasic amino acid in urine analysis. Because of the findings of hypotonia, growth retardation, developmental delay, and cystinuria, hypotonia-cystinuria syndrome was considered as a differential diagnosis. However, by chromosomal microarray no contiguous deletion in region 2p21 was found, while a novel homozygous c.225-2A>T pathogenic variant in the <i>CHKB</i> gene and a c.1266_1267delGT heterozygous variant in the <i>SLC7A9</i> gene inherited from the mother were identified with whole-exome sequencing. The co-occurrence of megaconial congenital muscular dystrophy and cystinuria, mimicking hypotonia-cystinuria syndrome, was confirmed. <b><i>Conclusion:</i></b> This case suggests that in countries with a high frequency of consanguineous marriage, even if the molecular genetic analysis results are not compatible with the clinical findings, it should be kept in mind that different genetic diseases may coexist.
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Senol D, Ozbag D, Dedeoglu N, Cevirgen F, Toy S, Ogeturk M, Kose E. Comparison of anthropometric and conic beam computed tomography measurements of patients with and without difficult intubation risk according to modified mallampati score: New markers for difficult intubation. Niger J Clin Pract 2021; 24:1609-1615. [PMID: 34782498 DOI: 10.4103/njcp.njcp_694_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The aim of this study was to compare the anthropometric and cone beam computed tomography (CBCT) measurements taken from risk-free and risky groups by using the modified Mallampati score (MMS). Patients and Methods A total of 176 volunteers between the ages of 18 and 65 in four different MMS classes were included in the study. The patients in classes MMS I and MMS II were accepted as risk-free and the patients in classes MMS III and MMS IV were accepted as risky for intubation. The Mann-Whitney U test was performed on the data to compare the anthropometric and radiological measurements taken from the risk-free and risky groups. A receiver operating characteristic (ROC) analysis was applied to the parameters that had a statistically significant difference. Results According to the analysis results, statistically significant differences were found in the neck circumference (NC), maximum interincisal distance (MID), thyromental distance (TMD) and sternomental distance (SMD) of the anthropometric measurements of men and women between the risk-free and risky groups (P < 0.05). In terms of CBCT measurements, the thickness of the tongue (TT), distance between the uvula and posterior wall of pharynx (U-Ph), distance between posterior nasal spine and nasopharynx (Snp-Nph) and length of the epiglottis (LE) were found to have statistically significant differences between the risk-free and risky groups of men and women (P < 0.05). Conclusion The NC, MID, TMD and SMD anthropometric measurements and TT, U-Ph, Snp-Nph and LE radiologic measurements were found to support MMS, which is one of the most widely used bedside intubation prediction tests. In addition to the inclusion of CBCT for intubation prediction, U-Ph and Snp-Nph radiologic measurements were added as difficult intubation markers.
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Affiliation(s)
- D Senol
- Department of Anatomy, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - D Ozbag
- Department of Anatomy, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - N Dedeoglu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inönü University, Malatya, Turkey
| | - F Cevirgen
- Department of Anatomy, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - S Toy
- Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Turkey
| | - M Ogeturk
- Department of Anatomy, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - E Kose
- Department of Anatomy, Faculty of Medicine, İnönü University, Malatya, Turkey
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Kisa PT, Uzun OU, Gunduz M, Bulbul FS, Kose E, Arslan N. Frequency and status of depression and anxiety in mothers of children with inborn errors of metabolism with restricted diet, with and without risk of metabolic crises. Arch Pediatr 2021; 28:702-706. [PMID: 34620546 DOI: 10.1016/j.arcped.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aimed to investigate the frequency and status of depression and anxiety among mothers of children with inborn errors of metabolism (IEM) who were on a restricted diet and previously experienced metabolic crises. METHODS This cross-sectional multicenter descriptive study included 93 children with IEM who were on restricted diet. The patients were divided into two groups: those who had experienced metabolic crises (n=44, urea cycle defect, organic acidemia, maple syrup urine disease, hereditary fructose intolerance) and those who had not experienced previous metabolic crises (n=49; phenylketonuria, galactosemia, and non-ketotic hyperglycinemia). The control group comprised 37 healthy children. The mothers of the patients and control participants answered a questionnaire about their and their children's demographic and clinical characteristics and completed the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI-S and STAI-T). RESULTS The maternal BDI, STAI-S, and STAI-T scores were 6.3±5.2, 36.1±11.2, and 39.9±8.8, respectively, in the control group. The maternal BDI, STAI-S, and STAI-T scores of the children who had experienced (19.2±9.7; 44.0±12.4; 47.9±10.6) and those who had not experienced (13.9±9.1; 40.7 ±8.6; 45.3±8.3) a crisis were significantly higher than for the controls. The BDI score was significantly higher for the mothers of children who had experienced a crisis (p=0.011), whereas no significant difference was determined between the two patient groups regarding STAI-S and STAI-T scores. The mothers of four children who had experienced metabolic crises were on antidepressant therapy. CONCLUSION Although their children were on a similar restricted diet, the mothers of children who previously experienced or who had the risk of experiencing metabolic crises had higher depression scores as compared with the mothers of children who did not experience a previous crisis. Early supportive therapy may be required for the families of these patients to lower the burden of stress.
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Affiliation(s)
- Pelin Teke Kisa
- Dokuz Eylul University Faculty of Medicine, Department of Pediatric Metabolism and Nutrition, Izmir, Turkey; University of Health Sciences, Dr. Behçet Uz Children's Research and Training Hospital, Department of Pediatric Metabolism and Nutrition, Izmir, Turkey
| | - Ozlem Unal Uzun
- Kocaeli University Faculty of Medicine, Department of Pediatric Metabolism and Nutrition, Kocaeli, Turkey
| | - Mehmet Gunduz
- Ministry of Health Ankara City Hospital, Department of Pediatric Metabolism and Nutrition, Ankara, Turkey
| | - Fatma Selda Bulbul
- Kirikkale University Faculty of Medicine, Department of Pediatric Metabolism and Nutrition, Kirikkale, Turkey
| | - Engin Kose
- Ankara University Faculty of Medicine, Department of Pediatric Metabolism and Nutrition, Ankara, Turkey
| | - Nur Arslan
- Dokuz Eylul University Faculty of Medicine, Department of Pediatric Metabolism and Nutrition, Izmir, Turkey; Izmir Biomedicine and Genome Center, Izmir, Turkey.
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Öncül Ü, Kose E, Eminoğlu FT. ALG1-CDG: A Patient with a Mild Phenotype and Literature Review. Mol Syndromol 2021; 13:69-74. [DOI: 10.1159/000517797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/10/2021] [Indexed: 11/19/2022] Open
Abstract
ALG1-congenital disorder of glycosylation (ALG1-CDG) is an autosomal recessive multisystem disease. We here present a patient with a mild phenotype of ALG1-CDG. A 15-month-old female was referred with hypotonia, failure to thrive, and developmental delay. At 8 months of age, failure to thrive, feeding difficulties and developmental delay became apparent, and an epileptic seizure was observed at 11 months of age. Progressive deterioration and swallowing difficulty were observed. A brain MRI revealed a widening of the cerebrospinal fluid spaces and ventricular system, and decreased protein C, protein S and antithrombin III levels were identified. The isoelectric focusing showed a type 1 pattern. A homozygous c.1076C>T (p.Ser359Leu) variant was found in the <i>ALG1</i> gene. CDG should be taken into consideration in patients presenting with unexplained multisystem involvement.
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Yildirim M, Balasar O, Kose E, Dogan MT. Mild congenital myopathy due to a novel variation in SPEG gene. Intractable Rare Dis Res 2021; 10:220-222. [PMID: 34466346 PMCID: PMC8397816 DOI: 10.5582/irdr.2021.01034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/29/2021] [Accepted: 05/18/2021] [Indexed: 11/05/2022] Open
Abstract
Centronuclear myopathies (CNMs) are a subgroup of congenital myopathies (CMs) characterized by muscle weakness, genetic heterogeneity, and predominant type 1 fibers and increased central nuclei in muscle biopsy. Mutations in CNM-causing genes such as MTM1, DNM2, BIN1, RYR1, CACNA1S, TTN, and extraordinary rarely SPEG (striated muscle preferentially expressed protein kinase) have been identified for about 60-80% of patients. Herein, we report a case of CM due to a novel variation in the SPEG gene, manifested by mild neonatal hypotonia, muscle weakness, delayed motor milestones, and ophthalmoplegia, without dilated cardiomyopathy. We identified a novel variation [c.153C>T (p.Asn51=) in exon 1] in the SPEG gene with whole-exome sequencing and confirmed by Sanger sequencing. Mild intellectual disability has not been associated with SPEG-related CM in the previous reports. We suggest that this report expands the phenotypic spectrum of SPEG-related CM, and further case reports are required to expand the genotype-phenotype correlations.
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Affiliation(s)
- Mirac Yildirim
- Department of Pediatric Neurology, Ankara University Faculty of Medicine, Ankara, Turkey
- Address correspondence to:Mirac Yildirim, Department of Pediatric Neurology, Ankara University Faculty of Medicine, Ankara, RI 06590, Turkey. E-mail:
| | - Ozgur Balasar
- Department of Medical Genetics, Konya Research and Training Hospital, Konya, Turkey
| | - Engin Kose
- Department of Pediatric Metabolism and Nutrition, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Melih Timucin Dogan
- Department of Pediatric Cardiology, Konya Research and Training Hospital, Konya, Turkey
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Oncul U, Kose E, Eminoglu FT. A Mild Phenotype of Mitochondrial DNA Depletion Syndrome Type 13 with a Novel FBXL4 Variant. Mol Syndromol 2021; 12:294-299. [PMID: 34602956 PMCID: PMC8436661 DOI: 10.1159/000515928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/16/2021] [Indexed: 11/19/2022] Open
Abstract
Mitochondrial DNA depletion syndromes (MDDS) are a group of rare genetic disorders caused by defects in multiple genes involved in mitochondrial DNA maintenance. Among these, FBXL4 gene variants result in encephalomyopathic mtDNA depletion syndrome 13 (MTDPS13), which commonly presents as a combination of failure to thrive, neurodevelopmental delays, encephalopathy, hypotonia, a pattern of mild facial dysmorphisms, and persistent lactic acidosis. To date, 53 pathogenic FBXL4 variants and 100 cases have been described in the literature. In the present case report, we report on a 4.5-year-old boy with MTDPS13 and a novel variant. The patient had a history of antenatal hydrocephalus, severe developmental delay and mental motor retardation with psychomotor delay, severe hypotonia, mild left ventricular hypertrophic cardiomyopathy, mild facial dysmorphism, and elevated lactate levels. Symptoms suggested mitochondrial myopathy; subsequently, whole-exome sequencing was performed and a novel homozygous variant FBXL4 (NM_012160.4): c.486T>G (p.Tyr162Ter) was identified. While most of the patients with FBLX4 gene mutation have severe clinical manifestation and die at a very young age, clinical progress of our case was milder than previously reported. MDDS are very rare and can present with many different clinical signs and symptoms. In this report, we identified a novel pathogenic variant in the FBXL4 gene. This report shows that patients with FBLX4 gene mutations may present with a milder clinical phenotype than previously reported.
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Affiliation(s)
- Ummuhan Oncul
- Department of Pediatric Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey
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14
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Kose M, Isik E, Aykut A, Durmaz A, Kose E, Ersoy M, Diniz G, Adebali O, Ünalp A, Yilmaz Ü, Karaoğlu P, Edizer S, Tekin HG, Özdemir TR, Atik T, Onay H, Özkınay F. The utility of next-generation sequencing technologies in diagnosis of Mendelian mitochondrial diseases and reflections on clinical spectrum. J Pediatr Endocrinol Metab 2021; 34:417-430. [PMID: 33629572 DOI: 10.1515/jpem-2020-0410] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 12/10/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Diagnostic process of mitochondrial disorders (MD) is challenging because of the clinical variability and genetic heterogeneity of these conditions. Next-Generation Sequencing (NGS) technology offers a high-throughput platform for nuclear MD. METHODS We included 59 of 72 patients that undergone WES and targeted exome sequencing panel suspected to have potential PMDs. Patients who were included in the analysis considering the possible PMD were reviewed retrospectively and scored according to the Mitochondrial Disease Criteria Scale. RESULTS Sixty-one percent of the patients were diagnosed with whole-exome sequencing (WES) (36/59) and 15% with targeted exome sequencing (TES) (9/59). Patients with MD-related gene defects were included in the mito group, patients without MD-related gene defects were included in the nonmito group, and patients in whom no etiological cause could be identified were included in the unknown etiology group. In 11 out of 36 patients diagnosed with WES, a TES panel was applied prior to WES. In 47 probands in 39 genes (SURF1, SDHAF1, MTO1, FBXL4, SLC25A12, GLRX5, C19oRF12, NDUFAF6, DARS2, BOLA3, SLC19A3, SCO1, HIBCH, PDHA1, PDHAX, PC, ETFA, TRMU, TUFM, NDUFS6, WWOX, UBCD TREX1, ATL1, VAC14, GFAP, PLA2G6, TPRKB, ATP8A2, PEX13, IGHMBP2, LAMB2, LPIN1, GFPT1, CLN5, DOLK) (20 mito group, 19 nonmito group) 59 variants (31 mito group, 18 nonmito group) were detected. Seven novel variants in the mito group (SLC25A12, GLRX5, DARS2, SCO1, PC, ETFA, NDUFS6), nine novel variants in the nonmito group (IVD, GCDH, COG4, VAC14, GFAP, PLA2G6, ATP8A2, PEX13, LPIN1) were detected. CONCLUSIONS We explored the feasibility of identifying pathogenic alleles using WES and TES in MD. Our results show that WES is the primary method of choice in the diagnosis of MD until at least all genes responsible for PMD are found and are highly effective in facilitating the diagnosis process.
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Affiliation(s)
- Melis Kose
- Department of Pediatrics, Division of Inborn Errors of Metabolism, İzmir Katip Çelebi University, Izmir, Turkey.,Department of Pediatrics, Division of Genetics, Ege University, Izmir, Turkey
| | - Esra Isik
- Department of Pediatrics, Division of Genetics, Ege University, Izmir, Turkey
| | - Ayça Aykut
- Department of Medical Genetics, Ege University, Izmir, Turkey
| | - Asude Durmaz
- Department of Medical Genetics, Ege University, Izmir, Turkey
| | - Engin Kose
- Department of Pediatrics, Division of Inborn Errors of Metabolism, Ankara University, Ankara, Turkey
| | - Melike Ersoy
- Department of Pediatrics, Division of Inborn Errors of Metabolism, Health Sciences University, Bakırkoy Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Gulden Diniz
- Department of Pathology, İzmir Democrasy University, Izmir, Turkey
| | - Ogun Adebali
- Adebali Lab, Molecular Biology, Genetics and Bioengineering Program, Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - Aycan Ünalp
- Department of Pediatric Neurology, Health Sciences University Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Ünsal Yilmaz
- Department of Pediatric Neurology, Health Sciences University Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Pakize Karaoğlu
- Department of Pediatric Neurology, Health Sciences University Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Selvinaz Edizer
- Department of Pediatrics, Division of Pediatric Neurology, Kanuni Sultan Suleyman University, Istanbul, Turkey
| | - Hande Gazeteci Tekin
- Department of Pediatrics, Division of Pediatric Neurology, Çiğli Training and Research Hospital, Izmir, Turkey
| | - Taha Reşid Özdemir
- Department of Medical Genetics, Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey
| | - Tahir Atik
- Department of Pediatrics, Division of Genetics, Ege University, Izmir, Turkey
| | - Hüseyin Onay
- Department of Medical Genetics, Ege University, Izmir, Turkey
| | - Ferda Özkınay
- Department of Pediatrics, Division of Genetics, Ege University, Izmir, Turkey
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15
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Kose M, Kose E, Ünalp A, Yılmaz Ü, Edizer S, Tekin HG, Karaoğlu P, Özdemir TR, Er E, Onay H, Yildirim ES. Neuronal ceroid lipofuscinosis: genetic and phenotypic spectrum of 14 patients from Turkey. Neurol Sci 2021; 42:1103-1111. [PMID: 33486620 DOI: 10.1007/s10072-021-05067-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/16/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION AND PURPOSE Neuronal ceroid lipofuscinoses (NCLs) is a group of congenital metabolic diseases where the neurodegenerative process with the accumulation of ceroid and lipofuscin autofluorescent storage materials is at the forefront. According to the age of presentation, NCLs are classified as congenital, infantile (INCL), late infantile (LINCL), juvenile (JNCL), and adult (ANCL) NCLs. In our study, it was aimed to discuss the clinical and molecular characteristics of our patients diagnosed with NCL. MATERIAL AND METHOD This is a descriptive cross-sectional study which was conducted in 14 patients from 10 unrelated families who were diagnosed with different types of NCL based on clinical presentation, neuroimaging, biochemical measurements, and molecular analyses, at the department of pediatric metabolism between June 2015 and June 2020. RESULTS A total of 14 patients were diagnosed with different types of NCL. Of those, 4 patients were diagnosed with NCL7 (4/14; 30%), 3/14 (23%) with NCL1, 3/14 (23%) with NCL2, 2/14 (14.2%) with NCL13, and 1/14 (7.1%) with NCL10. Eleven pathogenic variants were detected, 5 of which are novel (c.721G>T [p.Gly241Ter] and c.301G>C [p.Ala146Pro] in MFDS8 gene; c.316C>T [p.Gln106Ter] in PPT1 gene; c.341C>T [p.Ala114Val] in TPP1 gene; c.686A>T [p.Glu229Val] in CTSD gene) CONCLUSION: This study is one of the pioneer comprehensive researches from Turkey that provides information about disease-causing variants and clinical presentation of different and rare types of NCLs. The identification of novel variants and phenotypic expansion is important for genetic counselling in Turkey and expected to improve understanding of NCLs.
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Affiliation(s)
- Melis Kose
- Department of Pediatrics, Division of Metabolism and Nutrition, Izmir Katip Çelebi University Faculty of Medicine, Ismet Kaptan Street, 35100, Izmir, Turkey.
| | - Engin Kose
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aycan Ünalp
- Pediatric Neurology Department, University of Health Sciences, Behçet Uz Children Training and Research Hospital, Izmir, Turkey
| | - Ünsal Yılmaz
- Pediatric Neurology Department, University of Health Sciences, Behçet Uz Children Training and Research Hospital, Izmir, Turkey
| | - Selvinaz Edizer
- Pediatric Neurology Department, University of Health Sciences, Behçet Uz Children Training and Research Hospital, Izmir, Turkey
| | - Hande Gazeteci Tekin
- Faculty of Medicine, Çiğli Research and Training Hospital, Department of Pediatrics, Division of Neurology, Bakırçay University, Izmir, Turkey
| | - Pakize Karaoğlu
- Pediatric Neurology Department, University of Health Sciences, Behçet Uz Children Training and Research Hospital, Izmir, Turkey
| | - Taha Reşid Özdemir
- Genetics Department, University of Health Sciences Tepecik Training & Research Hospital, Izmir, Turkey
| | - Esra Er
- Department of Pediatrics, Division of Nutrition and Metabolism, Izmir Katip Çelebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Hüseyin Onay
- Department of Medical Genetics, Ege University Faculty of Medicine, Izmir, Turkey
| | - Eser Sozmen Yildirim
- Clinical Chemistry Department, Ege University Faculty of Medicine, İzmir, Turkey
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16
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Kose E, Besci O, Gudeloglu E, Suncak S, Oymak Y, Ozen S, Isguder R. Transcobalamin II deficiency in twins with a novel variant in the TCN2 gene: case report and review of literature. J Pediatr Endocrinol Metab 2020; 33:1487-1499. [PMID: 32841161 DOI: 10.1515/jpem-2020-0096] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 06/08/2020] [Indexed: 11/15/2022]
Abstract
Objectives Transcobalamin II (TC) is an essential plasma protein for the absorption, transportation, and cellular uptake of cobalamin. TC deficiency presents in the first year of life with failure to thrive, hypotonia, lethargy, diarrhea, pallor, mucosal ulceration, anemia, pancytopenia, and agammaglobulinemia. Herein, we present TC deficiency diagnosed in two cases (twin siblings) with a novel variant in the TCN2 gene. Case presentation 4-month-old twins were admitted with fever, respiratory distress, vomiting, diarrhea, and failure to thrive. Physical examination findings revealed developmental delay and hypotonia with no head control, and laboratory findings were severe anemia, neutropenia, and hypogammaglobulinemia. Despite normal vitamin B12 and folate levels, homocysteine and urine methylmalonic acid levels were elevated in both patients. Bone marrow examinations revealed hypocellular bone marrow in both cases. The patients had novel pathogenic homozygous c.241C>T (p.Gln81Ter) variant in the TCN2 gene. In both cases, with intramuscular hydroxycobalamin therapy, laboratory parameters improved, and a successful clinical response was achieved. Conclusions In infants with pancytopenia, growth retardation, gastrointestinal manifestations, and immunodeficiency, the inborn error of cobalamin metabolism should be kept in mind. Early diagnosis and treatment are crucial for better clinical outcomes. What is new? In literature, to date, less than 50 cases with TC deficiency were identified. In this report, we presented twins with TCN2 gene mutation. Both patients emphasized that early and aggressive treatment is crucial for achieving optimal outcomes. In this report, we identified a novel variation in TCN2 gene.
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Affiliation(s)
- Engin Kose
- Department of Pediatric Metabolism and Nutrition, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ozge Besci
- Department of Pediatrics, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Elif Gudeloglu
- Department of Pediatrics, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Suzan Suncak
- Department of Pediatrics, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Yesim Oymak
- Department of Pediatric Hematology, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Selime Ozen
- Department of Pediatric Immunology and Allergy, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Rana Isguder
- Department of Pediatrics, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
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17
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Kose M, Canda E, Kagnici M, Aykut A, Adebali O, Durmaz A, Bircan A, Diniz G, Eraslan C, Kose E, Ünalp A, Yılmaz Ü, Ozyilmaz B, Özdemir TR, Atik T, Uçar SK, McFarland R, Taylor RW, Brown GK, Çoker M, Özkınay F. SURF1 related Leigh syndrome: Clinical and molecular findings of 16 patients from Turkey. Mol Genet Metab Rep 2020; 25:100657. [PMID: 33134083 PMCID: PMC7586243 DOI: 10.1016/j.ymgmr.2020.100657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/03/2020] [Accepted: 10/03/2020] [Indexed: 01/09/2023] Open
Abstract
Introduction Pathogenic variants in SURF1, a nuclear-encoded gene encoding a mitochondrial chaperone involved in COX assembly, are one of the most common causes of Leigh syndrome (LS). Material-methods Sixteen patients diagnosed to have SURF1-related LS between 2012 and 2020 were included in the study. Their clinical, biochemical and molecular findings were recorded. 10/16 patients were diagnosed using whole-exome sequencing (WES), 4/16 by Sanger sequencing of SURF1, 1/16 via targeted exome sequencing and 1/16 patient with whole-genome sequencing (WGS). The pathogenicity of SURF1 variants was evaluated by phylogenetic studies and modelling on the 3D structure of the SURF1 protein. Results We identified 16 patients from 14 unrelated families who were either homozygous or compound heterozygous for SURF1 pathogenic variants. Nine different SURF1 variants were detected The c.769G > A was the most common variant with an allelic frequency of 42.8% (12/28), c.870dupT [(p.Lys291*); (8/28 28.5%)], c.169delG [(p.Glu57Lysfs*15), (2/24; 7.1%)], c.532 T > A [(p.Tyr178Asn); (2/28, 7.1%)], c.653_654delCT [(p.Pro218Argfs*29); (4/28, 14.2%)] c.595_597delGGA [(p.Gly199del); (1/28, 3.5%)], c.751 + 1G > A (2/28, 4.1%), c.356C > T [(p.Pro119Leu); (2/28, 3.5%)] were the other detected variants. Two pathogenic variants, C.595_597delGGA and c.356C > T, were detected for the first time. The c.769 G > A variant detected in 6 patients from 5 families was evaluated in terms of phenotype-genotype correlation. There was no definite genotype – phenotype correlation. Conclusions To date, more than 120 patients of LS with SURF1 pathogenic variants have been reported. We shared the clinical, molecular data and natural course of 16 new SURF1 defect patients from our country. This study is the first comprehensive research from Turkey that provides information about disease-causing variants in the SURF1 gene. The identification of common variants and phenotype of the SURF1 gene is important for understanding SURF1 related LS. Synopsis SURF1 gene defects are one of the most important causes of LS; patients have a homogeneous clinical and biochemical phenotype.
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Affiliation(s)
- Melis Kose
- Izmir Katip Çelebi University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Izmir, Turkey.,Ege University Faculty of Medicine, Department of Pediatrics, Division of Nutrition and Metabolism, Izmir, Turkey.,Oxford University Hospitals NHS Foundation Trust, The Churchill Hospital, Oxford Medical Genetics Laboratories, Oxford, UK
| | - Ebru Canda
- Ege University Faculty of Medicine, Department of Pediatrics, Division of Nutrition and Metabolism, Izmir, Turkey
| | - Mehtap Kagnici
- University of Health Sciences, Antalya Training and Research Hospital, Department of Pediatrics, Division of Metabolism and Nutrition, Antalya, Turkey
| | - Ayça Aykut
- Ege University Faculty of Medicine, Department of Medical Genetics, Izmir, Turkey
| | - Ogün Adebali
- Sabanci University, Faculty of Engineering and Natural Sciences, Molecular Biology, Genetics and Bioengineering Program, Adebali Lab, Istanbul, Turkey
| | - Asude Durmaz
- Ege University Faculty of Medicine, Department of Medical Genetics, Izmir, Turkey
| | - Aylin Bircan
- Sabanci University, Faculty of Engineering and Natural Sciences, Molecular Biology, Genetics and Bioengineering Program, Adebali Lab, Istanbul, Turkey
| | - Gulden Diniz
- Izmir Democracy University, Faculty of Medicine, Department of Pathology, İzmir, Turkey
| | - Cenk Eraslan
- Ege University Faculty of Medicine, Department of Radiology, Division of Neuroradiology, Izmir, Turkey
| | - Engin Kose
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Metabolism and Nutrition, Ankara, Turkey
| | - Aycan Ünalp
- University of Health Sciences, Behçet Uz Children Training and Research Hospital, Department of Pediatrics, Division of Neurology, Izmir, Turkey
| | - Ünsal Yılmaz
- University of Health Sciences, Behçet Uz Children Training and Research Hospital, Department of Pediatrics, Division of Neurology, Izmir, Turkey
| | - Berk Ozyilmaz
- University of Health Sciences Tepecik Training and Research Hospital, Department of Medical Genetics, Izmir, Turkey
| | - Taha Reşid Özdemir
- University of Health Sciences Tepecik Training and Research Hospital, Department of Medical Genetics, Izmir, Turkey
| | - Tahir Atik
- Ege University Faculty of Medicine, Department of Pediatrics, Division of Nutrition and Metabolism, Izmir, Turkey
| | - Sema Kalkan Uçar
- Ege University Faculty of Medicine, Department of Pediatrics, Division of Nutrition and Metabolism, Izmir, Turkey
| | - Robert McFarland
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Robert W Taylor
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Garry K Brown
- Oxford University Hospitals NHS Foundation Trust, The Churchill Hospital, Oxford Medical Genetics Laboratories, Oxford, UK
| | - Mahmut Çoker
- Ege University Faculty of Medicine, Department of Pediatrics, Division of Nutrition and Metabolism, Izmir, Turkey
| | - Ferda Özkınay
- Ege University Faculty of Medicine, Department of Pediatrics, Division of Nutrition and Metabolism, Izmir, Turkey.,University of Health Sciences, Antalya Training and Research Hospital, Department of Pediatrics, Division of Metabolism and Nutrition, Antalya, Turkey
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18
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Kose E, Kose M, Ozturk SI, Ozcan E, Onay H, Ozkan B. Cascade screening and treatment of children with familial hypercholesterolemia in Turkey. J Pediatr Endocrinol Metab 2020; 33:1251-1256. [PMID: 32829317 DOI: 10.1515/jpem-2020-0234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 07/01/2020] [Indexed: 12/13/2022]
Abstract
Objectives Premature coronary artery disease is the most common preventable cause of death in developed countries, and familial hypercholesterolemia (FH) is the most common monogenetic disorder of lipid metabolism, predisposing for premature coronary artery. FH is the most common preventable cause of death in developed countries. In 2016, the national lipid screening program in school-age children has been started in Turkey. In this study, we aimed to evaluate the efficacy of lipid screening program, lipid-lowering treatments, and the challenges of treatments in children diagnosed with FH. Methods Patients diagnosed with FH in the pediatric metabolism outpatient clinic were retrospectively evaluated. Changes in lipid profile with dietary interventions and statin treatments were assessed. The results of cascade screening were analyzed. Results Fifty-one patients diagnosed with FH were enrolled in the study. Twenty-four (47.1%) were female. The mean age of the patients was 9.8 ± 3.2 years. Heterozygous LDLR gene mutation was detected in all patients. Three novel pathogenic variations were revealed with the genetic investigation. Forty-one (80.4%) patients had high adherence to CHILD-2 dietary recommendations. The mean low-density lipoprotein cholesterol (LDL-C) level decreased by 14.5 ± 7.6% after dietary intervention. Parents refused to start statin treatment in 8 (15.7%) patients. Statin treatment was initiated to 22 (43.1%) patients. Mean LDL-C level decreased from 204.1 ± 19.1 mg/dL to 137.0 ± 13.1 mg/dL. In cascade screening, 7 (13.7%) parents without a diagnosis of FH were diagnosed with FH. After the screening program, statin treatment was initiated for 18 (35.3%) parents and 7 (16.3%) siblings. Conclusions We can conclude that screening for FH in children is crucial for diagnosing FH not only in children but also in their relatives. Although statins are safe and effective in achieving the target LDL-C level, we determined significant resistance for initiating statin treatment in patients.
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Affiliation(s)
- Engin Kose
- Department of Pediatric Metabolism and Nutrition, Katip Celebi University Faculty of Medicine, Izmir, Turkey
| | - Melis Kose
- Department of Pediatric Metabolism and Nutrition, Katip Celebi University Faculty of Medicine, Izmir, Turkey
| | - Sureyya Ipek Ozturk
- Department of Nutrition and Dietetics, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Esra Ozcan
- Department of Medical Genetics, Ege University Faculty of Medicine, Izmir, Turkey
| | - Huseyin Onay
- Department of Pediatric Endocrinology, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Behzat Ozkan
- Department of Pediatric Metabolism and Nutrition, Ankara University Faculty of Medicine, Ankara, Turkey
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19
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Onay H, Bolat H, Kılıç Yıldırım G, Kose E, Kalkan Uçar S, Aşıkovalı S, Özkınay F, Çoker M. Analysis of the alpha galactosidase gene: mutation profile and description of two novel mutations with extensive literature review in Turkish population. J Pediatr Endocrinol Metab 2020; 33:1245-1250. [PMID: 32813676 DOI: 10.1515/jpem-2020-0056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/16/2020] [Indexed: 11/15/2022]
Abstract
Objectives Fabry disease (FD, OMIM #301500) is a rare and progressive X-linked lysosomal storage disorder. FD is caused by mutations in the GLA gene on chromosome Xq22. Methods In this article, we aimed to present the largest sample of GLA mutation spectrum including common and novel variants in Turkish population. GLA gene sequence analysis was performed on the subjects who applied to the department of medical genetics with the preliminary diagnosis of FD between 2013 and 2018. Results We detected 22 different mutations as two novel [(p.F69S(c.206T>C), p.P205A (c.613C>G)] and 20 previously reported GLA mutations in 47 individuals from 22 unrelated families. These mutations included 14 missense mutations, four nonsense mutations, two small deletions, one small deletion/insertion and one small insertion. Major clinical findings of the female case with p.F69S(c.206T>C) mutation were cornea verticillata, acroparesthesia, angiokeratoma, psychiatric and gastrointestinal symptoms. Other novel mutation (p.P205A [c.613C>G]) was carried by a male case presenting gastrointestinal symptoms. Conclusions We described clinical findings of two cases that had novel mutations to provide more insight in genotype-phenotype correlation. We presented the largest mutation spectrum in Turkish population and reviewed previous mutations in this article.
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Affiliation(s)
- Hüseyin Onay
- Department of Medical Genetics, Ege University Faculty of Medicine, Izmir, Turkey
| | - Hilmi Bolat
- Department of Medical Genetics, Balıkesir Atatürk City Hospital, Balikesir, Turkey
| | - Gonca Kılıç Yıldırım
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Engin Kose
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sema Kalkan Uçar
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Ege University Faculty of Medicine, Izmir, Turkey
| | - Semih Aşıkovalı
- Department of Medical Genetics, Ege University Faculty of Medicine, Izmir, Turkey
| | - Ferda Özkınay
- Department of Medical Genetics, Ege University Faculty of Medicine, Izmir, Turkey.,Department of Pediatrics, Division of Pediatric Genetics, Ege University Faculty of Medicine, Izmir, Turkey
| | - Mahmut Çoker
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Ege University Faculty of Medicine, Izmir, Turkey
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20
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Abstract
OBJECTIVES The association between anticholinergic load-based Anticholinergic Risk Scale scores and nutritional status is unclear in Japanese patients. The aim of this study was to establish whether anticholinergic load affects the nutritional status of geriatric patients in convalescent stages. DESIGN Retrospective longitudinal cohort study. SETTING Convalescent rehabilitation wards. PARTICIPANTS Of the 1490 patients aged ≥65 years who were discharged from convalescent rehabilitation wards between July 2010 and October 2018, 908 patients met the eligibility criteria. They were categorized according to the presence or absence of increased anticholinergic load from admission to discharge. MEASUREMENTS Demographic data, laboratory data, the Functional Independence Measure were analyzed between the groups. The primary outcome was Geriatric Nutritional Risk Index (GNRI) at discharge. Multiple linear regression analysis was performed to analyze the relationship between anticholinergic load and GNRI at discharge. RESULTS Multiple linear regression analysis after adjusting for confounding factors revealed that anticholinergic load was independently and negatively correlated with GNRI at discharge. Particularly, the use of chlorpromazine, hydroxyzine, haloperidol, metoclopramide, risperidone, etc. increased significantly from admission to discharge. CONCLUSION Increased anticholinergic load during hospitalization may be a predictor of nutritional status in geriatric patients.
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Affiliation(s)
- E Kose
- Eiji Kose, Department of Pharmacy, Teikyo University School of Medicine University Hospital, 2-11-1 Kaga, Itabashi-ku, Tokyo 274-8555, Japan, Phone No: +81-3-3964-1211; Fax No: +81-3-3964-9426, E-mail address:
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21
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Teke Kisa P, Kose M, Unal O, Er E, Hismi BO, Bulbul FS, Kose E, Gunduz M, Canda E, Kucukcongar A, Arslan N. Clinical and molecular characteristics and time of diagnosis of patients with classical galactosemia in an unscreened population in Turkey. J Pediatr Endocrinol Metab 2019; 32:675-681. [PMID: 31194682 DOI: 10.1515/jpem-2018-0457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 03/30/2019] [Indexed: 12/23/2022]
Abstract
Classical galactosemia is an autosomal recessive inborn error of metabolism caused by biallelic pathogenic variants in the GALT gene. With the benefit of early diagnosis by newborn screening, the acute presentation of galactosemia can be prevented. In this study, we describe the clinical phenotypes, time of diagnosis and GALT genotypes of 76 galactosemia patients from Turkey, where the disease is not yet included in the newborn screening program. The median age at first symptom was 10 days (range 5-20), while the median age at diagnosis was 30 days (range 17-53). Nearly half of the patients (36 patients, 47.4%) were diagnosed later than age 1 month. Fifty-eight individuals were found to have 18 different pathogenic variants in their 116 mutant alleles. In our sample, Q188R variant has the highest frequency with 53%, the other half of the allele frequency of the patients showed 17 different genotypes. Despite presenting with typical clinical manifestations, classical galactosemia patients are diagnosed late in Turkey. Due to the geographical location of our country, different pathogenic GALT variants may be seen in Turkish patients. In the present study, a clear genotype-phenotype correlation could not be established in patients.
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Affiliation(s)
- Pelin Teke Kisa
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Melis Kose
- Division of Pediatric Metabolism and Nutrition, Dr. Behcet Uz Children's Training and Research Hospital, Izmir, Turkey
| | - Ozlem Unal
- Division of Pediatric Metabolism and Nutrition, Ankara Children's Training and Research Hospital, Ankara, Turkey
| | - Esra Er
- Division of Pediatric Metabolism and Nutrition, Ege University Faculty of Medicine, Izmir, Turkey
| | - Burcu Ozturk Hismi
- Division of Pediatric Metabolism and Nutrition, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Fatma Selda Bulbul
- Division of Pediatric Metabolism and Nutrition, Kirikkale University, Kirikkale, Turkey
| | - Engin Kose
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Mehmet Gunduz
- Division of Pediatric Metabolism and Nutrition, Ankara Children's Training and Research Hospital, Ankara, Turkey
| | - Ebru Canda
- Division of Pediatric Metabolism and Nutrition, Ege University Faculty of Medicine, Izmir, Turkey
| | - Aynur Kucukcongar
- Division of Pediatric Metabolism and Nutrition, Ankara Children's Training and Research Hospital, Ankara, Turkey
| | - Nur Arslan
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
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Abstract
Non-ketotic hyperglycinemia (NKH) is a rare inborn error of metabolism and is caused by a glycine cleavage system deficiency. Eighty-five percent of patients present with the neonatal type of NKH, the infants initially develop lethargy, seizures, and episodes of apnea, and most often death. Between 60-90% of cases are caused by mutations in the glycine decarboxylase (GLDC). We believed that more mutation reports especially for rare disease as NKH help to evaluate the genotype-phenotype relationship in patients with GLDC. In this study, we describe a case of a neonate admitted to intensive care unit with hypotonia, respiratory failure, lethargy, poor feeding. Due to the history of 2 non-ketotic hyperglycinemia diagnosed male siblings, molecular prenatal diagnosis in patient was performed and a novel c.2963G>A (Arg998Gln) homozygous mutation within the GLDC gene has been detected. We aimed to contribute to mutation knowledge pool of GLDC gene with a novel mutation.
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Affiliation(s)
| | | | | | - Nur Arslan
- Division of Pediatric Metabolism and Nutrition, Department of Pediatrics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Affiliation(s)
- Jason Hsu
- Jason Hsu is chairman and CIO at Rayliant Global Advisors, Hong Kong
| | - Vitali Kalesnik
- Vitali Kalesnik is a partner and the director of research for Europe at
Research Affiliates Global Advisors (Europe), Limited, in London
| | - Engin Kose
- Engin Kose is vice president and senior analyst at Allianz Global Investors,
San Diego
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Kose E, Arslan N. Vitamin/mineral and micronutrient status in patients with classical phenylketonuria. Clin Nutr 2019; 38:197-203. [PMID: 29433755 DOI: 10.1016/j.clnu.2018.01.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/21/2017] [Accepted: 01/28/2018] [Indexed: 11/27/2022]
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Kose E, An T, Kikkawa A. Assessment of oral anticoagulation control at pharmacist-managed clinics: A retrospective cohort study. Pharmazie 2018; 73:356-360. [PMID: 29880089 DOI: 10.1691/ph.2018.8322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
In chronic kidney disease (CKD) patients, the ratio of warfarin enantiomers is changed and becomes unstable due to a reduction of cytochrome P450 (CYP) 2C9 activity of, which contributes to the development of hemorrhagic complications. The aim of this study was to investigate the influence of interventions by clinical pharmacists in addition to guidance by physicians on time in therapeutic range (TTR) control of warfarin therapy for CKD patients with non-valvular atrial fibrillation (NVAF). This retrospective cohort study included NVAF patients with CKD admitted and discharged from a cardiovascular internal medicine ward between March 2011 and July 2013 in Yokosuka Kyousai Hospital. Participants were classified into two groups according to the instructions by clinical pharmacists and physicians (intervention group) and by physicians only (usual care group). The primary outcome was TTR. Secondary outcomes were major bleeding and minor bleeding. In total, 39 participants (28 males, 11 females; mean age: 72.1 years) were classified into the intervention (n = 16) and usual care (n = 23) groups. TTR in the intervention group was significantly higher than in the usual care group. Major bleeding and minor bleeding were not significantly different between the two groups. The intervention of clinical pharmacists with anticoagulation therapy can lead to a proper use of warfarin prescribed by physicians.
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Kose E, Armagan C, Teke Kısa P, Onay H, Arslan N. Severe hyperchylomicronemia in two infants with novel APOC2 gene mutation. J Pediatr Endocrinol Metab 2018; 31:1289-1293. [PMID: 30307897 DOI: 10.1515/jpem-2018-0280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/11/2018] [Indexed: 12/17/2022]
Abstract
Background Familial apo C-II deficiency is a rare hereditary disorder frequently caused by lipoprotein lipase (LPL) and APOC2 gene mutations. To date, less than 30 patients with familial apo C-II deficiency with 24 different mutations have been identified in the literature. Here, we describe two familial chylomicronemia syndrome cases in infants with two novel mutations of the APOC2 gene. Case presentation Case 1, a 46-day-old female, was admitted to our hospital for evaluation due to the lipemic appearance of the blood sample. A clinical examination revealed hepatomegaly and lipemia retinalis. Triglyceride level of 6295 mg/dL was decreased with a strict low-fat diet, medium-chain triglycerides (MCT) oil-rich formula and omega-3 fatty acid supplementation. Due to low adherence to the diet, TG elevation was detected and fresh frozen plasma (10 mL/kg/day) was administered for 2 days. A novel homozygous p.Q25X (c.73C>T) mutation in the APOC2 gene was detected. Case 2, a 10-month-old female patient, referred to our center for the differential diagnosis of hyperlipidemia as her blood sample could not be assessed due to its lipemic appearance. Laboratory examinations showed a TG level of 4520 mg/dL which was reduced with a low-fat diet, MCT oil-rich formula and omega-3 fatty acid supplementation. Hepatosteatosis and splenomegaly were determined using abdominal sonography. A novel homozygous IVS2+6T>G (c.55+6T>G) mutation in the APOC2 gene was identified. Conclusions We describe two novel homozygous mutations (p.Q25X [c.73C>T] and IVS2+6T>G [c.55+6T>G]) in the APOC2 gene in infants with hyperchylomicronemia. To the best of our knowledge, Case 1 is the youngest patient with familial apo C-II deficiency in the literature to date.
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Affiliation(s)
- Engin Kose
- Dokuz Eylul University, Department of Pediatrics, Izmir, Turkey
| | - Coskun Armagan
- Dokuz Eylul University, Department of Pediatrics, Izmir, Turkey
| | - Pelin Teke Kısa
- Dokuz Eylul University, Department of Pediatric Metabolism and Nutrition, Izmir, Turkey
| | - Huseyin Onay
- Ege University, Department of Medical Genetics, Izmir, Turkey
| | - Nur Arslan
- Dokuz Eylul University, Department of Pediatric Metabolism and Nutrition, Izmir, Turkey
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Kose E, Hirai T, Seki T, Hidaka S, Hamamoto T. Anticholinergic load negatively correlates with recovery of cognitive activities of daily living for geriatric patients after stroke in the convalescent stage. J Clin Pharm Ther 2018; 43:799-806. [DOI: 10.1111/jcpt.12706] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 04/10/2018] [Indexed: 01/09/2023]
Affiliation(s)
- E. Kose
- Department of Pharmacotherapy; School of Pharmacy; Nihon University; Funabashi-shi Japan
| | - T. Hirai
- Department of Pharmacy; Hitachinaka General Hospital; Hitachinaka Japan
| | - T. Seki
- Department of Pharmacy; Hitachinaka General Hospital; Hitachinaka Japan
| | - S. Hidaka
- Laboratory of Pharmaceutical Regulatory Science; School of Pharmacy; Nihon University; Funabashi-shi Japan
| | - T. Hamamoto
- Laboratory of Applied Therapeutics; Center for Education & Research on Clinical Pharmacy Showa Pharmaceutical University; Machida Japan
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Kose E, An T, Kikkawa A, Matsumoto Y, Hayashi H. The association between the increase in pulse pressure and renal function in chronic kidney disease patients with dyslipidemia. Pharmazie 2018; 71:510-513. [PMID: 29441846 DOI: 10.1691/ph.2016.6589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
In recent years, an association between chronic kidney disease (CKD) and arteriosclerosis has been identified. Pulse pressure (PP) is used as an index of arteriosclerosis. However, there have been few studies of the relationship between PP and renal dysfunction in patients with CKD. Therefore, we examined the association of increased PP on renal function in patients with CKD and dyslipidemia. This study included 104 patients with CKD who were diagnosed with dyslipidemia and commenced on drug treatment. In the present study, patients with PP ≥65 mmHg were included in the High PP group, and patients with PP <65 mmHg were included in the Low PP group. We compared the High PP group with the Low PP group about background patient characteristics, laboratory data and antihypertensive medications and type. Mutiple logistic regression analysis identified estimated glomerular filtration rate (eGFR) as a significant predictor of PP ≥65 mmHg. In addition, values of BUN, Ccr, and eGFR baseline and 12 months later were compared. In the High PP group, compared with baseline, BUN increased significantly and Ccr and eGFR decreased significantly after 12 months later. We consider that PP may be an auxiliary indicator of generalized arterial sclerosis and renal function.
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Kose E, Aksoy B, Kuyum P, Tuncer N, Arslan N, Ozturk Y. The Effects of Breastfeeding in Infants With Phenylketonuria. J Pediatr Nurs 2018; 38:27-32. [PMID: 29167077 DOI: 10.1016/j.pedn.2017.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 10/12/2017] [Accepted: 10/13/2017] [Indexed: 11/17/2022]
Abstract
PURPOSE In the early years of phenylketonuria (PKU) treatment, mothers and healthcare professionals often decide to discontinue breastfeeding after the diagnosis of PKU in infants. It was believed to be the only effective way to monitor the infant's intake and allow for precise titration and measurement of the intake of phenylalanine (Phe). In the early 1980s, with the determination of low concentration of Phe in breast milk, breast milk supplemented with Phe-free formula has become an acceptable dietary treatment for infants with PKU. Today, breastfeeding is encouraged and well established in PKU patients. The aim of the present study is to investigate the prevalence and duration of breastfeeding, the effect of breastfeeding on serum Phe levels, and weight gain in infants with PKU. DESIGN AND METHODS Data were collected from chart reviews. Medical records of 142 children with PKU diagnosed via the national neonatal screening program were analyzed retrospectively. RESULTS Of the 41 infants with complete medical records, 40 (97.6%) were breastfed following delivery whereas only one (2.4%) was bottle fed. After the diagnosis, breastfeeding was continued in 25 (61%) infants with phenylalanine-free amino acid based protein substitute. The mean duration of breastfeeding was 7.4±4.0 (1-15) months. Serum Phe concentration of breastfed infants (280±163 μmol/L) was significantly lower than non-breastfed infants (490±199 μmol/L) (p<0.001). Mean monthly weight gain in the first year of life was significantly higher in breastfed patients (493±159 g/month) compared to non-breastfed patients (399±116 g/month) (p=0.046). CONCLUSION In the first year of life, weight gain and serum Phe levels were more favorable in breastfed infants with PKU compared to non-breastfed infants with PKU.
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Affiliation(s)
- Engin Kose
- Dokuz Eylul University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Metabolism, Izmir, Turkey.
| | - Betul Aksoy
- Dokuz Eylul University Faculty of Medicine, Department of Pediatric Gastroenterology, Izmir, Turkey
| | - Pinar Kuyum
- Dokuz Eylul University Faculty of Medicine, Department of Pediatric Gastroenterology, Izmir, Turkey
| | - Nilhan Tuncer
- Dokuz Eylul University Faculty of Medicine, Department of Nutrition and Dietetics, Izmir, Turkey
| | - Nur Arslan
- Dokuz Eylul University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Metabolism, Izmir, Turkey
| | - Yesim Ozturk
- Dokuz Eylul University Faculty of Medicine, Department of Pediatric Gastroenterology, Izmir, Turkey
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Kose E, Guzel O, Arslan N. Analysis of hematological parameters in patients treated with ketogenic diet due to drug-resistant epilepsy. Neurol Sci 2017; 39:85-89. [PMID: 29038947 DOI: 10.1007/s10072-017-3152-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 10/09/2017] [Indexed: 11/28/2022]
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Teke Kisa P, Kose E, Oren N, Arslan N. The Effect of Large Neutral Amino Acids on Blood Phenylalanine Levels in Patients with Classical Phenylketonuria. J Basic Clin Health Sci 2017. [DOI: 10.5152/jbachs.2017.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Kose E, Kuyum P, Aksoy B, Häberle J, Arslan N, Ozturk Y. First report of carglumic acid in a patient with citrullinemia type 1 (argininosuccinate synthetase deficiency). J Clin Pharm Ther 2017; 43:124-128. [PMID: 28741715 DOI: 10.1111/jcpt.12593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 06/20/2017] [Indexed: 12/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Carglumic acid is a structural analogue of human N-acetylglutamate, which has become an alternative therapeutic option for hyperammonaemia in organic acidaemias such as isovaleric acidaemia, methylmalonic acidaemia and propionic acidaemia, and it has been suggested in other urea cycle disorders such as ornithine transcarbamylase deficiency and carbamoyl phosphate synthetase 1 deficiency. CASE DESCRIPTION A male newborn was diagnosed with citrullinemia after serum amino acid analyses revealed markedly elevated citrulline concentration together with homozygous p.Gly390Arg mutation in ASS1 gene. The ammonia concentration decreased and blood gas analysis normalized after peritoneal dialysis was performed for three days. Also, sodium benzoate, L-arginine and parenteral nutrition with glucose and lipid therapy were initiated. Until 1 year of age, low adherence to sodium benzoate therapy due to unpleasant taste caused hyperammonaemic episodes and obligated us to initiate carglumic acid (100 mg/kg/day) therapy. During treatment with carglumic acid, the median ammonia level was 45.6 µmol/L. The patient's treatment was switched from carglumic acid to sodium phenylbutyrate when he was 4.5 years old. Currently, the patient is 6.5 years old and remains under follow-up with sodium phenylbutyrate, L-arginine and protein-restricted diet. Plasma ornithine level was found to be significantly lower during the carglumic acid treatment compared to other treatments (P=.039). Also, glutamic acid was found to be higher during the sodium benzoate treatment period compared to other treatment periods (P=.024). WHAT IS NEW AND CONCLUSION To the best of our knowledge, this is the first report describing the long-term use of carglumic acid in a patient with argininosuccinate synthetase deficiency.
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Affiliation(s)
- E Kose
- Division of Pediatric Metabolism and Nutrition, Dokuz Eylul University, Izmir, Turkey
| | - P Kuyum
- Division of Pediatric Gastroenterology, Dokuz Eylul University, Izmir, Turkey
| | - B Aksoy
- Division of Pediatric Gastroenterology, Dokuz Eylul University, Izmir, Turkey
| | - J Häberle
- Division of Metabolism and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - N Arslan
- Division of Pediatric Metabolism and Nutrition, Dokuz Eylul University, Izmir, Turkey
| | - Y Ozturk
- Division of Pediatric Gastroenterology, Dokuz Eylul University, Izmir, Turkey
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Abstract
The aim of the present study was to evaluate serum selenium levels in children receiving olive oil-based ketogenic diet (KD) for intractable seizures for at least 1 year. Out of 320 patients who were initiated on KD, patients who continued receiving KD for at least 12 months were enrolled. Sixteen patients who had selenium deficiency at the time of starting KD were excluded. Finally, a total of 110 patients (mean age 7.3 ± 4.2 years) were included. Serum selenium levels were measured at baseline and at 3, 6, and 12 months after treatment initiation by using atomic absorption spectroscopy. Selenium deficiency was defined as a serum selenium level <48 μg/L at each visit. Repeated measure ANOVA with post hoc Bonferroni correction was used for data analysis. Mean duration of KD was 15.3 ± 4.3 months. Mean serum selenium levels were significantly lower at 6 and 12 months of KD treatment (66.2 ± 23.3 and 57.2 ± 16.2 μg/L, respectively) compared to pre-treatment levels (79.3 ± 25.7 μg/L) (p = 0.001). On the other hand, selenium levels did not show any significant difference at 3 months of KD treatment (70.0 ± 21.2 μg/L) compared to baseline levels (p = 0.076). A total of 54 patients (49.1%) were diagnosed with selenium deficiency, and oral selenium medication was initiated for these patients. No relevant clinical findings were detected, and echocardiographic findings were normal in all patients. The decline of the serum selenium concentrations after 6 and 12 months of ketogenic diet suggests that patients on this highly prescriptive dietary treatment need close monitoring of this trace element.
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Affiliation(s)
- Nur Arslan
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Izmir Biomedicine and Genome Center (iBG-izmir), Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
- Izmir Biomedicine and Genome Center, Dokuz Eylul University, Izmir, Turkey.
| | - Engin Kose
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Izmir Biomedicine and Genome Center (iBG-izmir), Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Orkide Guzel
- Division of Pediatric Neurology, Behçet Uz Children Hospital, Izmir, Turkey
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Kose E, Guzel O, Demir K, Arslan N. Changes of thyroid hormonal status in patients receiving ketogenic diet due to intractable epilepsy. J Pediatr Endocrinol Metab 2017; 30:411-416. [PMID: 28076316 DOI: 10.1515/jpem-2016-0281] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 11/03/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ketogenic diet (KD), which is high in fat and low in carbohydrates, mimics the metabolic state of starvation and is used therapeutically for pharmacoresistant epilepsy. It is known that generation of triiodothyronine (T3) from thyroxine (T4) decreases during fasting periods. The aim of this study was to evaluate the thyroid function of children receiving KD for at least 1 year due to drug-resistant epilepsy. METHODS A total of 120 patients [63 males, 52.5%; mean age 7.3±4.3 years, median interquartile range (IQR): 7.0 (4-10 years)] treated with KD for at least 1 year were enrolled. Seizure control, side effects, and compliance with the diet were recorded, and free T3, free T4, and thyroid-stimulating hormone (TSH) levels were measured at baseline and at post-treatment months 1, 3, 6, and 12. The Mann-Whitney U-test, repeated measures analysis of variance (ANOVA) with post-hoc Bonferroni correction, and logistic regression analysis were used for data analysis. RESULTS Hypothyroidism was diagnosed and L-thyroxine medication was initiated for eight, seven and five patients (20 patients in total, 16.7%) at 1, 3, and 6 months of KD therapy, respectively. Logistic regression analysis showed that baseline TSH elevation [odds ratio (OR): 26.91, 95% confidence interval (CI) 6.48-111.76, p<0.001] and female gender (OR: 3.69, 95% CI 1.05-12.97, p=0.042) were independent risk factors for development of hypothyroidism during KD treatment in epileptic children. CONCLUSIONS KD causes thyroid malfunction and L-thyroxine treatment may be required. This is the first report documenting the effect of KD treatment on thyroid function. Thyroid function should be monitored regularly in epileptic patients treated with KD.
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Affiliation(s)
- Engin Kose
- Dokuz Eylul University, Division of Pediatric Metabolism and Nutrition, Izmir
| | - Orkide Guzel
- Behçet Uz Children Hospital, Division of Pediatric Neurology, Izmir
| | - Korcan Demir
- Dokuz Eylul University, Division of Pediatric Endocrinology, Izmir
| | - Nur Arslan
- Dokuz Eylul University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Izmir
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Kose E, Unal O, Bulbul S, Gunduz M, Häberle J, Arslan N. Identification of three novel mutations in fourteen patients with citrullinemia type 1. Clin Biochem 2017; 50:686-689. [PMID: 28132756 DOI: 10.1016/j.clinbiochem.2017.01.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 01/15/2017] [Accepted: 01/24/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Citrullinemia type 1 (CTLN1) is an autosomal recessive genetic disorder caused by mutations in the argininosuccinate synthetase 1 (ASS1) gene, which encodes for the argininosuccinate synthetase enzyme. Here, we report genetic and clinical characterizations of 14 patients with citrullinemia type 1. DESIGN & METHODS The study group consisted of 14 patients (4 females, 10 males) diagnosed with citrullinemia type 1 from three centers in Turkey. Age of onset, clinical presentation, initial citrulline and ammonia levels, family history and molecular genetic analysis were retrospectively evaluated. RESULTS The mean age of the cohort and the mean age at the time of diagnosis were 48.3±36.5months (min: 12days, max: 10years) and 11.6±26.2months (min: 3days, max: 8years), respectively. In four patients, a homozygous p.Gly390Arg pathogenic variant was detected. All patients homozygous for p.Gly390Arg were diagnosed during the newborn period with the clinical presentation of classical citrullinemia. In each two patients, homozygous p.Arg86His, c.773+49C>T and p.Gly362Val pathogenic variants were detected. Clinical presentation was compatible with the mild form of the disease in patients homozygous for c.773+49C>T and for Gly362Val. Novel compound heterozygous genotypes (p.Ala164Pro/p.Gly390Arg; p.Leu290Pro/p.Gly390Arg; p.Thr389Pro/p.Gly390Arg) were identified in five patients. Of these, three siblings with CTLN1 were diagnosed with the compound heterozygous genotype p.Ala164Pro/p.Gly390Arg at the age of 4days, 5days and 2years, respectively. The other two patients with novel compound heterozygous genotypes (p.Leu290Pro/p.Gly390Arg; p.Thr389Pro/p.Gly390Arg) were identified in the first month of life as neonatal onset form and were born to non-consanguineous parents. CONCLUSION In our study, consistent with the literature, a correlation was found between homozygous p.Gly390Arg mutation and the classic neonatal onset form. Mild citrullinemia was detected in patients with c.773+49C>T or p.Gly362Val pathogenic variants. This study adds to our understanding of the molecular genetic background of patients with CTLN1, and allows to infer on the correlation between the genotype and phenotype of the disease.
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Affiliation(s)
- Engin Kose
- Dokuz Eylul University, Division of Pediatric Metabolism and Nutrition, Izmir, Turkey
| | - Ozlem Unal
- Ankara Children's Education and Research Hospital, Division of Pediatric Metabolism and Nutrition, Ankara, Turkey
| | - Selda Bulbul
- Kırıkkale University, Division of Pediatric Metabolism and Nutrition, Kırıkkale, Turkey
| | - Mehmet Gunduz
- Ankara Children's Education and Research Hospital, Division of Pediatric Metabolism and Nutrition, Ankara, Turkey
| | - Johannes Häberle
- University Children's Hospital Zurich, Division of Metabolism and Children's Research Center, Zurich, Switzerland
| | - Nur Arslan
- Dokuz Eylul University, Division of Pediatric Metabolism and Nutrition, Izmir, Turkey; Dokuz Eylul University, Izmir Biomedicine and Genome Center, Izmir, Turkey.
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Arslan N, Guzel O, Kose E, Yılmaz U, Kuyum P, Aksoy B, Çalık T. Is ketogenic diet treatment hepatotoxic for children with intractable epilepsy? Seizure 2016; 43:32-38. [PMID: 27866088 DOI: 10.1016/j.seizure.2016.10.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/23/2016] [Accepted: 10/27/2016] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Long-term ketogenic diet (KD) treatment has been shown to induce liver steatosis and gallstone formation in some in vivo and clinical studies. The aim of this retrospective study was to evaluate the hepatic side effects of KD in epileptic children. METHOD A total of 141 patients (mean age: 7.1±4.1years [2-18 years], 45.4% girls), receiving KD at least one year for intractable epilepsy due to different diagnoses (congenital brain defects, GLUT-1 deficiency, West syndrome, tuberous sclerosis, hypoxic brain injury, etc.) were included in the study. Serum triglyceride, cholesterol, aminotransferase, bilirubin, protein and albumin levels and abdominal ultrasonography were recorded before and at 1, 3, 6, and 12 months following after diet initiation. RESULTS The mean duration of KD was 15.9±4.3months. At one month of therapy, three patients had elevated alanine and aspartate aminotransferase levels. These patients were receiving ketogenic diet for Doose syndrome, idiopathic epilepsy and GLUT-1 deficiency. Hepatosteatosis was detected in three patients at 6 months of treatment. Two of these patients were treated with KD for the primary diagnosis of tuberous sclerosis and one for Landau Kleffner syndrome. Cholelithiasis was detected in two patients at 12 months of treatment. They were receiving treatment for West syndrome and hypoxic brain injury sequelae. CONCLUSION Long-term ketogenic diet treatment stimulates liver parenchymal injury, hepatic steatosis and gallstone formation. Patients should be monitored by screening liver enzymes and abdominal ultrasonography in order to detect these side effects.
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Affiliation(s)
- Nur Arslan
- Dokuz Eylul University, Division of Pediatric Metabolism and Nutrition, Izmir, Turkey; Dokuz Eylul University, Izmir Biomedicine and Genome Center, Izmir, Turkey.
| | - Orkide Guzel
- Behçet Uz Children Hospital, Division of Pediatric Neurology, Izmir, Turkey
| | - Engin Kose
- Dokuz Eylul University, Division of Pediatric Metabolism and Nutrition, Izmir, Turkey
| | - Unsal Yılmaz
- Behçet Uz Children Hospital, Division of Pediatric Neurology, Izmir, Turkey
| | - Pınar Kuyum
- Dokuz Eylul University, Division of Pediatric Gastroenterology, Izmir, Turkey
| | - Betül Aksoy
- Dokuz Eylul University, Division of Pediatric Gastroenterology, Izmir, Turkey
| | - Tansel Çalık
- Behçet Uz Children Hospital, Division of Pediatric Neurology, Izmir, Turkey
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Bardak F, Karaca C, Bilgili S, Atac A, Mavis T, Asiri AM, Karabacak M, Kose E. Conformational, electronic, and spectroscopic characterization of isophthalic acid (monomer and dimer structures) experimentally and by DFT. Spectrochim Acta A Mol Biomol Spectrosc 2016; 165:33-46. [PMID: 27107533 DOI: 10.1016/j.saa.2016.03.050] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 03/28/2016] [Accepted: 03/30/2016] [Indexed: 06/05/2023]
Abstract
Isophthalic acid (C6H4(CO2H)2) is a noteworthy organic compound widely used in coating and synthesis of resins and the production of commercially important polymers such as drink plastic bottles. The effects of isophthalic acid (IPA) on human health, toxicology, and biodegradability are the main focus of many researchers. Because structural and spectroscopic investigation of molecules provides a deep understanding of interactional behaviors of compounds, this study stands for exploring those features. Therefore, the spectroscopic, structural, electronic, and thermodynamical properties of IPA were thoroughly studied in this work experimentally using UV-Vis, (1)H and (13)C NMR, FT-IR, FT-Raman and theoretically via DFT and TD-DFT calculations. The UV-Vis absorption spectrum in water was taken in the region 200-400nm. The NMR chemical shifts ((1)H and (13)C) were recorded in DMSO solution. The infrared and Raman spectra of the solid IPA were recorded in the range of 4000-400cm(-1) and 3500-50cm(-1), respectively. DFT and TD-DFT calculations were performed at the level of B3LYP/6-311++G(d,p) in determination of geometrical structure, electronic structure analysis and normal mode. The (13)C and (1)H nuclear magnetic resonance (NMR) spectra were estimated by using the gauge-invariant atomic orbital (GIAO) method. The scaled quantum mechanics (SQM) method was used to determine the total energy distribution (TED) to assign the vibrational modes accurately. Weak interactions such as hydrogen bonding and Van der Walls were analyzed via reduced density gradient (RDG) analysis in monomeric and dimeric forms. Furthermore, the excitation energies, density of state (DOS) diagram, thermodynamical properties, molecular electro-static potential (MEP), and nonlinear optical (NLO) properties were obtained.
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Affiliation(s)
- F Bardak
- Department of Physics, Celal Bayar University, Manisa, Turkey
| | - C Karaca
- Experimental Science Applications and Research Center, Celal Bayar University, Manisa, Turkey
| | - S Bilgili
- Department of Physics, Celal Bayar University, Manisa, Turkey
| | - A Atac
- Department of Physics, Celal Bayar University, Manisa, Turkey
| | - T Mavis
- Department of Physics, Celal Bayar University, Manisa, Turkey
| | - A M Asiri
- Department of Chemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia; Center of Excellence for Advanced Materials Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - M Karabacak
- Departmant of Mechatronics Engineering, H.F.T. Technology Faculty, Celal Bayar University, Turgutlu, Manisa, Turkey
| | - E Kose
- Department of Physics, Celal Bayar University, Manisa, Turkey
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Kose E, Sirin Kose S, Akca D, Yildiz K, Elmas C, Baris M, Anil M. The Effect of Rapid Antigen Detection Test on Antibiotic Prescription Decision of Clinicians and Reducing Antibiotic Costs in Children with Acute Pharyngitis. J Trop Pediatr 2016; 62:308-15. [PMID: 26999012 DOI: 10.1093/tropej/fmw014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We aimed to investigate the effect of rapid antigen detection test (RADT) in the diagnosis of streptococcal pharyngitis, its impact on antibiotic prescription decision of pediatricians and influence on reduction of antibiotic treatment costs in children with pharyngitis. The study group consisted of 223 patients who were diagnosed with pharyngitis by pediatricians. The sensitivity and specificity of RADT were 92.1% (95% Cl: 78.6-98.3%) and 97.3% (95% Cl: 93.8-99.1%), respectively. In the first assessment, before performing RADT, pediatricians decided to prescribe antibiotics for 178 (79.8%) patients with pharyngitis. After learning RADT results, pediatricians finally decided to prescribe antibiotics for 83 (37.2%) patients with pharyngitis, and antibiotic prescription decreased by 42.6%. Antibiotic costs in non-Group A streptococcus pharyngitis, Group A streptococcus pharyngitis and all subjects groups decreased by 80.8%, 48%, and 76.4%, respectively. Performing RADT in children with pharyngitis has an important impact on treatment decision of clinicians, reduction of unnecessary antibiotic prescriptions and antibiotic costs.
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Affiliation(s)
- Engin Kose
- Metabolism Unit, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, 35340 Izmir, Turkey
| | - Seda Sirin Kose
- Department of Pediatric Allergy and Immunology, Dokuz Eylul University Faculty of Medicine, 35340 Izmir, Turkey
| | - Deniz Akca
- Department of Pediatrics, Tepecik Training and Research Hospital, 35120 Izmir, Turkey
| | - Kerem Yildiz
- Department of Pediatrics, Tepecik Training and Research Hospital, 35120 Izmir, Turkey
| | - Cengizhan Elmas
- Department of Pediatrics, Tepecik Training and Research Hospital, 35120 Izmir, Turkey
| | - Mustafa Baris
- Department of Pediatrics, Tepecik Training and Research Hospital, 35120 Izmir, Turkey
| | - Murat Anil
- Department of Pediatric Emergency Service, Tepecik Training and Research Hospital, 35120 Izmir, Turkey
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Kucuk Bicer B, Ozcebe H, Kose E, Ahmad F, Kose O. Corporal punishment: similarities and differences from Eastern cultured countries. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckv176.292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wadhawan R, Gupta M, Laharwal A, Tsai C, Tang S, Hu J, Tan WB, Clara ES, Prakash P, Shabbir A, Lomanto D, Takahashi M, Matsuya H, Nishinari N, Szura M, Pasternak A, Kibil W, Solecki R, Matyja A, Porter A, Berney C, Niebuhr H, Mayer F, Köckerling F, Lal D, Klobusicky P, Feyerherd P, Ates M, Kinaci E, Kose E, Soyer V, Sarici B, Cuglan S, Korkmaz F, Dirican A, Gómez-Menchero J, Jurado PJ, Luque JB, Moreno JG, Grau JMS, Jurado JFG, Giubileo M, Federico L, De Nigris S, Ventura P, García-Pastor P, Carbonell-Tatay F, Torregrosa-Gallud A, Forgione U, Feleshtynsky Y, Vatamanyuk VF, Svyrydovsky SA, Kokhanevych AV, Curado-Soriano A, Infantes-Ormad M, Valera-Sanchez Z, Dominguez-Amodeo A, Naranjo-Fernandez JR, Ruiz Zafra A, Navarrete-Carcer E, Oliva-Mompean F, Padillo-Ruiz J, Brochado J, Farah F, Nicastro RG, Condi GA, De Marco M, Samaan R, Radtke MC, Ji Z, Li J. Topic: Inguinal Hernia - Fixation. Hernia 2015; 19 Suppl 1:S254-60. [PMID: 26518818 DOI: 10.1007/bf03355366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R Wadhawan
- Fortis Hospital, Vasant Kunj, New Delhi, India
| | - M Gupta
- Fortis Hospital, Vasant Kunj, New Delhi, India
| | - A Laharwal
- Fortis Hospital, Vasant Kunj, New Delhi, India
| | - C Tsai
- Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - S Tang
- Minimally Invasive Surgical Centre, Department of Surgery, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - J Hu
- Minimally Invasive Surgical Centre, Department of Surgery, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - W B Tan
- Minimally Invasive Surgical Centre, Department of Surgery, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - E Sta Clara
- Minimally Invasive Surgical Centre, Department of Surgery, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - P Prakash
- Minimally Invasive Surgical Centre, Department of Surgery, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - A Shabbir
- Minimally Invasive Surgical Centre, Department of Surgery, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - D Lomanto
- Minimally Invasive Surgical Centre, Department of Surgery, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | | | - H Matsuya
- Morioka Yuai Hospital, Morioka, Japan
| | | | - M Szura
- I Department of General Surgery, Jagiellonian University, Krakow, Poland
| | - A Pasternak
- I Department of General Surgery, Jagiellonian University, Krakow, Poland.,Department of Anatomy, Jagiellonian University, Krakow, Poland
| | - W Kibil
- I Department of General Surgery, Jagiellonian University, Krakow, Poland
| | - R Solecki
- I Department of General Surgery, Jagiellonian University, Krakow, Poland
| | - A Matyja
- I Department of General Surgery, Jagiellonian University, Krakow, Poland
| | - A Porter
- Bankstown-Lidcombe Hospital, University of New South Wales, Sydney, Australia
| | - C Berney
- Bankstown-Lidcombe Hospital, University of New South Wales, Sydney, Australia
| | - H Niebuhr
- Hanse-Hernienzentrum Hamburg, Hamburg, Germany
| | - F Mayer
- Landeskrankenhaus Salzburg Uniklinikum, Salzburg, Austria
| | | | - D Lal
- National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - P Klobusicky
- Helios St. Elisabeth Hospital, Bad Kissingen, Germany
| | | | - M Ates
- Faculty of Medicine, Department of General Surgery and Liver Transplantation Institute, Inonu University, Malatya, Turkey.,Faculty of Medicine, Department of Anatomy, Inonu University, Malatya, Turkey
| | - E Kinaci
- Faculty of Medicine, Department of General Surgery and Liver Transplantation Institute, Inonu University, Malatya, Turkey.,Department of General Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - E Kose
- Faculty of Medicine, Department of Anatomy, Inonu University, Malatya, Turkey
| | - V Soyer
- Faculty of Medicine, Department of General Surgery and Liver Transplantation Institute, Inonu University, Malatya, Turkey
| | - B Sarici
- Faculty of Medicine, Department of General Surgery and Liver Transplantation Institute, Inonu University, Malatya, Turkey
| | - S Cuglan
- Faculty of Medicine, Department of Anatomy, Inonu University, Malatya, Turkey
| | - F Korkmaz
- Faculty of Medicine, Department of Anatomy, Inonu University, Malatya, Turkey
| | - A Dirican
- Faculty of Medicine, Department of General Surgery and Liver Transplantation Institute, Inonu University, Malatya, Turkey
| | | | - P J Jurado
- Hospital General Básico de Riotinto, Huelva, Spain
| | | | | | | | | | - M Giubileo
- Ospedale San Carlo Borromeo, Milano, Italy.
| | - L Federico
- Ospedale San Carlo Borromeo, Milano, Italy
| | | | - P Ventura
- Ospedale San Carlo Borromeo, Milano, Italy
| | | | | | | | | | - Y Feleshtynsky
- Optimization of Transabdominal Pre-Peritoneal Alloplasty of Inguinal Hernias, Kyiv, Ukraine
| | | | | | | | | | | | | | | | | | - A Ruiz Zafra
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | | | | | - J Brochado
- Hospital Servidor Publico Estadual, São Paulo, Brazil
| | - F Farah
- Hospital Servidor Publico Estadual, São Paulo, Brazil
| | - R G Nicastro
- Hospital Servidor Publico Estadual, São Paulo, Brazil
| | - G A Condi
- Hospital Servidor Publico Estadual, São Paulo, Brazil
| | - M De Marco
- Hospital Servidor Publico Estadual, São Paulo, Brazil
| | - R Samaan
- Hospital Servidor Publico Estadual, São Paulo, Brazil
| | - M C Radtke
- Hospital Servidor Publico Estadual, São Paulo, Brazil
| | - Z Ji
- Department of General Surgery, Zhongda Hospital, Southeast University, Nanjing, China
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Kose E, Sato R, An T, Kikkawa A, Matsumoto Y, Kawakubo T, Hayashi H. Analysis of factors for poor activated partial thromboplastin time control after dabigatran administration. Pharmazie 2015; 70:716-719. [PMID: 26790187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In this study, we compared patients whose activated partial thromboplastin time (APTT) was prolonged excessively with those whose APTT was controlled within the normal range after dabigatran administration. We analyzed the factors for the APTT prolongation. We divided the patients into two groups: those whose APTTs prolonged to more than 65 s and those whose APTTs were less than 65 s after dabigatran administration. There were 130 patients from March 2011 to July 2013, and we analyzed the background features and laboratory data of these patients. Results showed that there were no significant differences in the patients' background and laboratory data except for the high-density lipoprotein cholesterol (HDL-C) level. However, details of the relationship between the APTT prolongation and the HDL-C level are currently unknown. We hypothesize that the reason for the APTT prolongation is the variability in such parameters as the time of blood drawing, internal time of dabigatran, individual variability, and blood concentration. Therefore, we consider that these parameters need to be carefully evaluated even if APTT does not show prolongation.
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Kucuk Bicer B, Ozcebe H, Kose E, Kose O, Unlu H. Corporal Punishment Perceptions and Practices of Turkish Families, Ankara. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv172.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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43
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Kose E, Arai S, An T, Kikkawa A, Aoyama T, Matsumoto Y, Hayashi H. Analysis of factors affecting time in therapeutic range control after warfarin administration. Pharmazie 2015; 70:494-498. [PMID: 26373212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The protective efficacy of warfarin for cardiogenic cerebral embolism has been established. However, warfarin is generally administered to only approximately 35% of the atrial fibrillation patients who required warfarin therapy. It has been reported that international normalized ratio (INR) control was carried out appropriately in < 50% of such patients. Therefore, from the viewpoint of prevention of the onset and recurrence of embolism, the maintenance of a stable anticoagulant level is necessary. In warfarin therapy, in addition to INR control, time in therapeutic range (TTR) also markedly affects the efficacy of warfarin therapy. Therefore, we classified patients into two groups on the basis of the cutoff TTR ≥ 65% at which the inhibitory effect of warfarin on stroke has been observed. We aimed to examine the association between INR and TTR with the correction of the therapeutic efficacy of warfarin by analyzing the factors leading to poor TTR control. The most valuable finding of this study is that marked fluctuations of brain natriuretic peptide levels in patients with complication of heart failure was a risk factor for poor TTR control. Identification of the factors leading to the poor TTR control is useful for making the decision to switch to other anticoagulants, such as dabigatran or apixaban, or to continue warfarin by correcting risk factors in atrial fibrillation patients receiving long-term warfarin therapy.
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Kose E, Toyoshima M, Tachi T, Teramachi H, Kawakubo T, Hayashi H. Effects of antidiabetes drugs on functional independence measure on a subacute rehabilitation ward for stroke patients. Pharmazie 2015; 70:489-493. [PMID: 26373211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
It has been reported that the improvement of activities of daily living (ADL) by rehabilitation affects glycemic control. However, there are no reports about antidiabetes drugs as factors affecting the outcomes of rehabilitation. Therefore, we investigated the effects of antidiabetes drugs on functional independence measure (FIM) [total (T), motor (M), and cognition (C) items] in stroke patients with diabetes who were discharged from the subacute rehabilitation ward. We chose the frequently used antidiabetes drugs [sulfonylurea (SU), dipeptidyl peptidase-IV inhibitors (DPP-IVIs), and α-glycosidase inhibitors (α-GIs)] as the basis for categorizing the patients. We compared the patients' background features and laboratory data among the three groups. As a result, when SU was used in stroke patients with diabetes, it is difficult to obtain significant FIM-M gain, FIM-C gain, FIM-M efficiency, and FIM-C efficiency compared with of-GIs. As a reason for this, we hypothesize the possibility of the involvement of insulin resistance. Therefore, we consider that insulin resistance should be determined early and that it is important to reduce insulin resistance comprehensively by involving experts.
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Sas EB, Kose E, Kurt M, Karabacak M. FT-IR, FT-Raman, NMR and UV-Vis spectra and DFT calculations of 5-bromo-2-ethoxyphenylboronic acid (monomer and dimer structures). Spectrochim Acta A Mol Biomol Spectrosc 2015; 137:1315-1333. [PMID: 25305625 DOI: 10.1016/j.saa.2014.08.049] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 08/19/2014] [Accepted: 08/24/2014] [Indexed: 06/04/2023]
Abstract
In this study, the Fourier Transform Infrared (FT-IR) and Fourier Transform Raman (FT-Raman) spectra of 5-bromo-2-ethoxyphenylboronic acid (5Br2EPBA) are recorded in the solid phase in the region 4000-400 cm(-1) and 3500-10 cm(-1), respectively. The (1)H, (13)C and DEPT nuclear magnetic resonance (NMR) spectra are recorded in DMSO solution. The UV-Vis absorption spectrum of 5Br2EPBA is saved in the range of 200-400 nm in ethanol and water. The following theoretical calculations for monomeric and dimeric structures are supported by experimental results. The molecular geometry and vibrational frequencies in the ground state are calculated by using DFT methods with 6-31G(d,p) and 6-311G(d,p) basis sets. There are four conformers for the present molecule. The computational results diagnose the most stable conformer of 5Br2EPBA as Trans-Cis (TC) form. The complete assignments are performed on the basis of the total energy distribution (TED) of vibrational modes, calculated with scaled quantum mechanics (SQM) method in parallel quantum solutions (PQS) program. The (1)H and (13)C NMR chemical shifts of 5Br2EPBA molecule are calculated by using the Gauge Invariant Atomic Orbital (GIAO) method in DMSO and gas phase for monomer and dimer structures of the most stable conformer. Moreover, electronic properties, such as the HOMO and LUMO energies (by TD-DFT and CIS methods) and molecular electrostatic potential surface (MEPs) are investigated. Stability of the molecule arising from hyper-conjugative interactions, charge delocalization is analyzed using natural bond orbital (NBO) analysis. Nonlinear optical (NLO) properties and thermodynamic features are presented. All calculated results are compared with the experimental data of the title molecule. The correlation of theoretical and experimental results provides a detailed description of the structural and physicochemical properties of the title molecule.
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Affiliation(s)
- E B Sas
- Department of Physics, Ahi Evran University, Kırsehir, Turkey
| | - E Kose
- Department of Physics, Celal Bayar University, Manisa, Turkey
| | - M Kurt
- Department of Physics, Ahi Evran University, Kırsehir, Turkey.
| | - M Karabacak
- Department of Mechatronics Engineering, H.F.T. Technology Faculty, Celal Bayar University, Turgutlu, Manisa, Turkey
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Karabacak M, Kose E, Sas EB, Kurt M, Asiri AM, Atac A. DFT calculations and experimental FT-IR, FT-Raman, NMR, UV-Vis spectral studies of 3-fluorophenylboronic acid. Spectrochim Acta A Mol Biomol Spectrosc 2015; 136 Pt B:306-320. [PMID: 25448934 DOI: 10.1016/j.saa.2014.08.141] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 08/11/2014] [Accepted: 08/31/2014] [Indexed: 06/04/2023]
Abstract
The spectroscopic (FT-IR, FT-Raman, (1)H and (13)C NMR, UV-Vis), structural, electronic and thermodynamical properties of 3-fluorophenylboronic acid (C6H4FB(OH)2), 3FPBA) were submitted by using both experimental techniques and theoretical methods (quantum chemical calculations) in this work. The experimental infrared and Raman spectra were obtained in the region 4000-400 cm(-1) and 3500-10 cm(-1), respectively. The equilibrium geometry and vibrational spectra were calculated by using DFT (B3LYP) with 6-311++G(d,p) basis set. The vibrational wavenumbers were also corrected with scale factor to take better results for the calculated data. The total energy distributions (TED) of the vibrational modes were performed for the assignments of the title molecule by using scaled quantum mechanics (SQM) method. The NMR chemical shifts ((1)H and (13)C) were recorded in DMSO solution. The (1)H and (13)C NMR spectra were computed by using the gauge-invariant atomic orbital (GIAO) method, showing a good agreement with the experimental ones. The last one UV-Vis absorption spectra were analyzed in two solvents (ethanol and water), saved in the range of 200-400 nm. In addition these, HOMO and LUMO energies, the excitation energies, density of states (DOS) diagrams, thermodynamical properties and molecular electrostatic potential surface (MEPs) were presented. Nonlinear optical (NLO) properties and thermodynamic features were performed. The experimental results are combined with the theoretical calculations using DFT calculations to fortification of the paper. At the end of this work, the results were proved our paper had been indispensable for the literature backing.
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Affiliation(s)
- M Karabacak
- Department of Mechatronics Engineering, H.F.T. Technology Faculty, Celal Bayar University, Turgutlu, Manisa, Turkey
| | - E Kose
- Department of Physics, Celal Bayar University, Manisa, Turkey.
| | - E B Sas
- Department of Physics, Ahi Evran University, Kırsehir, Turkey
| | - M Kurt
- Department of Physics, Ahi Evran University, Kırsehir, Turkey
| | - A M Asiri
- Department of Chemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia; Center of Excellence for Advanced Materials Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - A Atac
- Department of Physics, Celal Bayar University, Manisa, Turkey
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Abstract
AIM This study evaluated the clinical and economic outcomes of ventriculoperitoneal shunt infections. MATERIAL AND METHODS Patients diagnosed with ventriculoperitoneal shunt infections for the first time between 1 January 2007 and 31 December 2011 were included in this study. Demographic, clinical, and economic data were analyzed retrospectively. A cost coefficient (total cost/follow-up period) and hospitalization coefficient (duration of hospitalization/follow-up period) were calculated for each patient. RESULTS In total, 132 shunt infections (mean follow-up, 734 ± 367 days) were evaluated in 51 patients (mean age, 16.6 ± 9.22 months; median age, 3 months; range, 1-88 months; 28 females, 21 males). In 23 patients (45%), shunt infections were seen in the first 2 months following shunt placement. Seven patients died during the follow-up. There was a negative correlation between the age at diagnosis and the hospitalization duration (p = 0.005, r = -0.381). The average cost of hospitalization per patient was 6397 ± 4338 TL. There was a negative correlation between the cost index and the age at diagnosis (p = 0.04, r = -0.292). CONCLUSION Ventriculoperitoneal shunt infections have significant medical and economic impacts. Younger the diagnosis of patients, the hospitalization duration and treatment cost were higher.
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Affiliation(s)
- Ali Kanik
- Tepecik Education and Research Hospital, Department of Pediatrics, Izmir, Turkey
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Kanik A, Kose E, Baran M, Kose SS, Eliacik K, Sayan A, Helvaci M, Aksu N. Henoch-Schönlein purpura in two pediatric patients presenting as terminal ileitis. Dig Dis Sci 2015; 60:269-71. [PMID: 25052148 DOI: 10.1007/s10620-014-3273-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 06/26/2014] [Indexed: 12/09/2022]
Affiliation(s)
- Ali Kanik
- Department of Pediatrics, Izmir Tepecik Training and Research Hospital, Izmir, Turkey,
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Karabacak M, Kose E, Atac A, Sas E, Asiri A, Kurt M. Experimental (FT-IR, FT-Raman, UV–Vis, 1H and 13CNMR) and computational (density functional theory) studies on 3-bromophenylboronic acid. J Mol Struct 2014. [DOI: 10.1016/j.molstruc.2014.07.058] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Sarioglu B, Kose SS, Saritas S, Kose E, Kanik A, Helvaci M. Severe acute disseminated encephalomyelitis with clinical findings of transverse myelitis after herpes simplex virus infection. J Child Neurol 2014; 29:1519-23. [PMID: 24525997 DOI: 10.1177/0883073813513334] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND ADEM is a central nervous disease that leads to myelin damage as a result of autoimmune response that develops after infections or vaccination. Herpes Simplex Virus (HSV) infection rarely leads to ADEM. PATIENT 25-month-old male due to urinary retention, paradoxical respiration and muscle weakness after herpetic gingivostomatitis diagnosed as transverse myelitis. In follow-up with cranial and spinal magnetic resonance imaging multiple lesions were demonstrated. Electroneuromyography findings were compatible with acute sensorimotor neuropathy, serum anti-GM2 antibodies and Herpes Simplex Virus (HSV) Type 1/2 IgM / IgG detected negative and positivite, respectively. With these findings he was diagnosed acute disseminated encephalomyelitis (ADEM) following HSV infection. Although acyclovir, intravenous immunoglobulin, methylprednisolone and plasmapheresis therapies, he is still in intensive physical therapy program with heavy sequel. RESULTS In our case, ADEM demonstrated transverse myelitis clinic after HSV infection which is rarely seen in literature. As well as clinic and spinal imaging findings, cranial imaging findings helped establishment of ADEM diagnosis. CONCLUSION To our best knowledge, HSV is a rare etiological and probably the poor prognostic factor of ADEM.
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Affiliation(s)
- Berrak Sarioglu
- Department of Pediatric Neurology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Seda Sirin Kose
- Department of Pediatrics, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Serdar Saritas
- Department of Pediatrics, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Engin Kose
- Department of Pediatrics, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ali Kanik
- Department of Pediatrics, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Mehmet Helvaci
- Department of Pediatrics, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
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