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Yılmaz Aİ, Pekcan S, Eyüboğlu TŞ, Hangül M, Arslan H, Kılınç AA, Çokuğraş H, Arık E, Keskin Ö, Özdemir A, Ersoy M, Ersoy A, Köse M, Özsezen B, Ünal G, Ercan Ö, Girit S, Oksay SC, Gökdemir Y, Karadağ B, Şen V, Çakır E, Yüksel H, Tekin MN, Aslan AT. Comparison of refugee patients with cystic fibrosis and their counterpart children from Turkey during the war. Eur J Pediatr 2024; 183:1831-1838. [PMID: 38265526 PMCID: PMC11001702 DOI: 10.1007/s00431-024-05431-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/25/2024]
Abstract
Since the outbreak of the Syrian civil war in 2011, the population of Arab refugees in Turkey has rapidly increased. While cystic fibrosis (CF) is believed to be rare among Arabs, recent studies suggest it is underdiagnosed. This study aims to present the demographic, clinical, and genetic characteristics of CF patients among Arab refugees in Turkey. Additionally, a comparison is made between the findings in the National CF Registry 2021 in Turkey (NCFRT) and the refugee CF patient group. The study included refugee patients between the ages of 0 and 18 years who were diagnosed with CF and received ongoing care at pediatric pulmonology centers from March 2011 to March 2021. The study examined demographic information, age at diagnosis, age of diagnosis of patients through CF newborn screening (NBS), presenting symptoms, CF transmembrane conductance regulator (CFTR) mutation test results, sputum culture results, weight, height, and body mass index (BMI) z score. Their results were compared with the NCFRT results. The study included 14 pediatric pulmonology centers and 87 patients, consisting of 46 (52.9%) boys and 41 (47.1%) girls. All of the patients were Arab refugees, with 80 (92%) being Syrian. All the patients were diagnosed in Turkey. The median age at diagnosis of patients was 22.33 (interquartile range, 1-258) months. The median age of diagnosis of patients through NBS was 4.2 (interquartile range, 1-12) months. The median age of older patients, who were unable to be included in the NBS program, was 32.3 (interquartile range, 3-258) months. Parental consanguinity was observed in 52 (59.7%) patients. The mutation that was most frequently found was F508del, which accounted for 22.2% of the cases. It was present in 20 patients, constituting 32 out of the total 144 alleles. There was a large number of genetic variations. CFTR genotyping could not be conducted for 12 patients. These patients had high sweat tests, and their genetic mutations could not be determined due to a lack of data. Compared to NCFRT, refugee patients were diagnosed later, and long-term follow-up of refugee CF patients had significantly worse nutritional status and pseudomonas colonization. Conclusion: Although refugee CF patients have equal access to NBS programs and CF medications as well as Turkish patients, the median age at diagnosis of patients, the median age of diagnosis of patients through NBS, their nutritional status, and Pseudomonas colonization were significantly worse than Turkish patients, which may be related to the difficulties of living in another country and poor living conditions. The high genetic heterogeneity and rare mutations detected in the refugee patient group compared to Turkish patients. Well-programmed NBS programs, thorough genetic studies, and the enhancement of living conditions for refugee patients in the countries they relocate to can have several advantages such as early detection and improved prognosis. What is Known: • Children who have chronic diseases are the group that is most affected by wars. • The outcome gets better with early diagnosis and treatment in patients with Cystic Fibrosis (CF). What is New: • Through the implementation of a newborn screening program, which has never been done in Syria previously, refugee patients, the majority of whom are Syrians were diagnosed with cystic fibrosis within a duration of 4 months. • Despite equal access to the newborn screening program and CF medications for both Turkish patients and refugee patients, the challenges of living in a foreign country have an impact on refugees.
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Affiliation(s)
- Aslı İmran Yılmaz
- Department of Pediatric Pulmonology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Sevgi Pekcan
- Department of Pediatric Pulmonology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
| | | | - Melih Hangül
- Pediatric Pulmonology, Adana City Training and Research Hospital, Adana, Turkey
| | - Hüseyin Arslan
- Department of Pediatric Pulmonology, Cerrahpaşa Faculty of Medicine, Istanbul University - Cerrahpasa, Istanbul, Turkey
| | - Ayşe Ayzıt Kılınç
- Department of Pediatric Pulmonology, Cerrahpaşa Faculty of Medicine, Istanbul University - Cerrahpasa, Istanbul, Turkey
| | - Haluk Çokuğraş
- Department of Pediatric Pulmonology, Cerrahpaşa Faculty of Medicine, Istanbul University - Cerrahpasa, Istanbul, Turkey
| | - Elif Arık
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Özlem Keskin
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ali Özdemir
- Department of Pediatric Pulmonology, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Murat Ersoy
- Department of Pediatric Pulmonology, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Ali Ersoy
- Department of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Köse
- Department of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Beste Özsezen
- Department of Pediatric Pulmonology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - Gökçen Ünal
- Department of Pediatric Pulmonology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Ömür Ercan
- Department of Pediatric Pulmonology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Saniye Girit
- Department of Pediatric Pulmonology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Sinem Can Oksay
- Department of Pediatric Pulmonology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Yasemin Gökdemir
- Department of Pediatric Pulmonology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Bülent Karadağ
- Department of Pediatric Pulmonology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Velat Şen
- Department of Pediatric Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Erkan Çakır
- Department of Pediatric Pulmonology, Liv Hospital, Istinye University, Istanbul, Turkey
| | - Hasan Yüksel
- Department of Pediatric Pulmonology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Merve Nur Tekin
- Department of Pediatric Pulmonology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ayşe Tana Aslan
- Department of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Uytun S, Cinel G, Eryılmaz Polat S, Özkan Tabakçı S, Kiper N, Yalçın E, Ademhan Tural D, Özsezen B, Şen V, Selimoğlu Şen H, Ufuk Altıntaş D, Çokuğraş H, Kılınç AA, Başkan AK, Yazan H, Çollak A, Uzuner S, Ünal G, Yılmaz Aİ, Çağlar HT, Damadoğlu E, Irmak İ, Demir E, Kartal Öztürk G, Bingöl A, Başaran E, Sapan N, Canıtez Y, Tana Aslan A, Asfuroğlu P, Harmancı K, Köse M, Hangül M, Özdemir A, Çobanoğlu N, Özcan G, Keskin Ö, Yüksel H, Özdoğan Ş, Topal E, Çaltepe G, Can D, Korkmaz Ekren P, Kılıç M, Emiralioğlu N, Şişmanlar Eyüboğlu T, Pekcan S, Çakır E, Özçelik U, Doğru D. Patients with cystic fibrosis who could not receive the CFTR modulator treatment: What did they lose in 1 year? Pediatr Pulmonol 2023; 58:2505-2512. [PMID: 37278544 DOI: 10.1002/ppul.26535] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 04/29/2023] [Accepted: 05/29/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Cystic fibrosis (CF) is an autosomal recessive disorder caused by CF transmembrane conductance regulator (CFTR) genetic variants. CFTR modulators improve pulmonary function and reduce respiratory infections in CF. This study investigated the clinical and laboratory follow-up parameters over 1 year in patients with CF who could not receive this treatment. METHODS This retrospective cohort study included 2018 and 2019 CF patient data from the CF registry of Turkey. Demographic and clinical characteristics of 294 patients were assessed, who had modulator treatment indications in 2018 but could not reach the treatment. RESULTS In 2019, patients younger than 18 years had significantly lower BMI z-scores than in 2018. During the 1-year follow-up, forced expiratory volumes (FEV1) and FEV1 z-scores a trend toward a decrease. In 2019, chronic Staphylococcus aureus colonization, inhaled antipseudomonal antibiotic use for more than 3 months, oral nutritional supplement requirements, and oxygen support need increased. CONCLUSIONS Patients who had indications for modulator treatments but were unable to obtain them worsened even after a year of follow-up. This study emphasized the importance of using modulator treatments for patients with CF in our country, as well as in many countries worldwide.
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Affiliation(s)
- Salih Uytun
- Division of Pediatric Pulmonology, Ankara City Hospital, Ankara, Turkey
| | - Güzin Cinel
- Division of Pediatric Pulmonology, Ankara City Hospital, Ankara, Turkey
- Division of Pediatric Pulmonology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | | | | | - Nural Kiper
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ebru Yalçın
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Dilber Ademhan Tural
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Beste Özsezen
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Velat Şen
- Division of Pediatric Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Hadice Selimoğlu Şen
- Department of Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Derya Ufuk Altıntaş
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Haluk Çokuğraş
- Division of Pediatric Pulmonology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Ayşe Ayzıt Kılınç
- Division of Pediatric Pulmonology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Azer Kılıç Başkan
- Division of Pediatric Pulmonology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Hakan Yazan
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem Vakıf University, İstanbul, Turkey
| | - Abdulhamit Çollak
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem Vakıf University, İstanbul, Turkey
| | - Selçuk Uzuner
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem Vakıf University, İstanbul, Turkey
| | - Gökçen Ünal
- Division of Pediatric Pulmonology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Aslı İmran Yılmaz
- Division of Pediatric Pulmonology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Hanife Tuğçe Çağlar
- Division of Pediatric Pulmonology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Ebru Damadoğlu
- Department of Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - İlim Irmak
- Department of Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Esen Demir
- Division of Pediatric Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Gökçen Kartal Öztürk
- Division of Pediatric Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Ayşen Bingöl
- Division of Pediatric Pulmonology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Erdem Başaran
- Division of Pediatric Pulmonology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Nihat Sapan
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Yakup Canıtez
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Ayşe Tana Aslan
- Division of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Pelin Asfuroğlu
- Division of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Koray Harmancı
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Mehmet Köse
- Division of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Melih Hangül
- Division of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ali Özdemir
- Division of Pediatric Pulmonology, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Nazan Çobanoğlu
- Division of Pediatric Pulmonology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Gizem Özcan
- Division of Pediatric Pulmonology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Özlem Keskin
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Hasan Yüksel
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Şebnem Özdoğan
- Division of Pediatric Pulmonology, Sarıyer Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Erdem Topal
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Gönül Çaltepe
- Division of Pediatric Gastroenterology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Demet Can
- Division of Pediatric Pulmonology, Faculty of Medicine, Balıkesir University, Balıkesir, Turkey
| | | | - Mehmet Kılıç
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - Nagehan Emiralioğlu
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Sevgi Pekcan
- Division of Pediatric Pulmonology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Erkan Çakır
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem Vakıf University, İstanbul, Turkey
| | - Uğur Özçelik
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Deniz Doğru
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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3
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Onay ZR, Eyüboğlu TŞ, Aslan AT, Gürsoy TR, Yalçın E, Kiper N, Emiralioğlu N, Şen HS, Şen V, Ünal G, Yılmaz Aİ, Kılınç AA, Çokuğraş H, Başkan AK, Yazan H, Çollak A, Uzuner S, Şasihüseyinoğlu AŞ, Özcan D, Altıntaş DU, Öztürk GK, Demir E, Bingöl A, Başaran E, Çekiç Ş, Sapan N, Irmak İ, Damadoğlu E, Tuğcu GD, Polat SE, Özdemir A, Harmancı K, Kılıç G, Hangül M, Köse M, Tamay Z, Yüksel H, Özcan G, Topal E, Can D, Korkmaz P, Çaltepe G, Kılıç M, Özdoğan Ş, Çakır E, Çobanoğlu N, Pekcan S, Cinel G, Özçelik U, Doğru D. Clinical characteristics of patients requiring lung transplantation referral in national cystic fibrosis registry data. Turk J Pediatr 2023; 65:257-268. [PMID: 37114691 DOI: 10.24953/turkjped.2021.4930] [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: 04/29/2023]
Abstract
BACKGROUND We aimed to determine the number of cystic fibrosis (CF) patients recorded in the Cystic Fibrosis Registry of Türkiye (CFRT) who were in need of lung transplantation (LT) referral and examine clinical differences between patients who were LT candidates due to rapid forced expiratory volume in one second (FEV₁) decline and LT candidates without rapid FEV₁ decline in the last year to identify a preventable cause in patients with such rapid FEV₁ decline. METHODS All CF patients recorded in the CFRT in 2018 were evaluated in terms of LT. Patients were divided into those with FEV₁ below 50% and in need of LT due to a decrease of 20% or more in the previous year (Group 1) and those who did not have FEV₁ decline of more than 20% in the previous year but had other indications for LT (Group 2). Demographic and clinical features were compared between the two groups. RESULTS Of 1488 patients registered in CFRT, 58 had a need for LT. Twenty patients were included in Group 1 and others in Group 2. Our findings did not reveal any significant variations in treatment, chronic infection status, or complications between the two groups. The average weight z-score was significantly higher in Group 1. Positive correlations were detected between weight z-score and FEV₁ in 2017 in Group 1 and between FEV₁ values in 2017 and 2018 in Group 2. CONCLUSIONS There appears to be a relationship between the nutritional status and weight z-scores of CF patients and pulmonary function, which may indirectly affect the need for lung transplantation referral.
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Affiliation(s)
- Zeynep Reyhan Onay
- Department of Pediatric Pulmonology, Gazi University Faculty of Medicine, Ankara
| | | | - Ayşe Tana Aslan
- Department of Pediatric Pulmonology, Gazi University Faculty of Medicine, Ankara
| | - Tuğba Ramaslı Gürsoy
- Department of Pediatric Pulmonology, Gazi University Faculty of Medicine, Ankara
| | - Ebru Yalçın
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara
| | - Nural Kiper
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara
| | - Nagehan Emiralioğlu
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara
| | | | - Velat Şen
- Department of Pediatric Pulmonology, Dicle University Faculty of Medicine, Diyarbakır
| | - Gökçen Ünal
- Department of Pediatric Pulmonology, Necmettin Erbakan University Meram Faculty of Medicine, Konya
| | - Aslı İmran Yılmaz
- Department of Pediatric Pulmonology, Necmettin Erbakan University Meram Faculty of Medicine, Konya
| | - Ayşe Ayzıt Kılınç
- Department of Pediatric Allergy and Immunology, İstanbul University Cerrahpasa Faculty of Medicine, İstanbul
| | - Haluk Çokuğraş
- Department of Pediatric Allergy and Immunology, İstanbul University Cerrahpasa Faculty of Medicine, İstanbul
| | - Azer Kılıç Başkan
- Department of Pediatric Allergy and Immunology, İstanbul University Cerrahpasa Faculty of Medicine, İstanbul
| | - Hakan Yazan
- Department of Pediatric Pulmonology, Bezmialem Vakıf University Faculty of Medicine, İstanbul
| | - Abdulhamit Çollak
- Department of Pediatric Pulmonology, Bezmialem Vakıf University Faculty of Medicine, İstanbul
| | - Selçuk Uzuner
- Department of Pediatric Pulmonology, Bezmialem Vakıf University Faculty of Medicine, İstanbul
| | | | - Dilek Özcan
- Department of Pediatric Allergy and Immunology, Çukurova University Faculty of Medicine, Adana
| | - Derya Ufuk Altıntaş
- Department of Pediatric Allergy and Immunology, Çukurova University Faculty of Medicine, Adana
| | | | - Esen Demir
- Department of Pediatric Pulmonology, Ege University Faculty of Medicine, İzmir
| | - Ayşen Bingöl
- Department of Pediatric Pulmonology, Akdeniz University Faculty of Medicine, Antalya
| | - Erdem Başaran
- Department of Pediatric Pulmonology, Akdeniz University Faculty of Medicine, Antalya
| | - Şükrü Çekiç
- Department of Pediatric Allergy and Immunology, Bursa Uludağ University Faculty of Medicine, Bursa
| | - Nihat Sapan
- Department of Pediatric Allergy and Immunology, Bursa Uludağ University Faculty of Medicine, Bursa
| | - İlim Irmak
- Department of Chest Diseases, Hacettepe University Faculty of Medicine, Ankara
| | - Ebru Damadoğlu
- Department of Chest Diseases, Hacettepe University Faculty of Medicine, Ankara
| | | | | | - Ali Özdemir
- Division of Pediatric Pulmonology, Mersin City Training and Research Hospital, Mersin
| | - Koray Harmancı
- Department of Pediatric Allergy and Immunology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir
| | - Gonca Kılıç
- Department of Pediatric Allergy and Immunology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir
| | - Melih Hangül
- Department of Pediatric Pulmonology, Erciyes University Faculty of Medicine, Kayseri
| | - Mehmet Köse
- Department of Pediatric Pulmonology, Erciyes University Faculty of Medicine, Kayseri
| | - Zeynep Tamay
- Department of Pediatric Allergy and Immunology, İstanbul University Faculty of Medicine, İstanbul
| | - Hasan Yüksel
- Department of Pediatric Allergy and Immunology, Celal Bayar University Faculty of Medicine, Manisa
| | - Gizem Özcan
- Department of Pediatric Pulmonology, Ankara University Faculty of Medicine, Ankara
| | - Erdem Topal
- Department of Pediatric Allergy and Immunology, İnönü University Faculty of Medicine, Malatya
| | - Demet Can
- Department of Pediatric Pulmonology, Balıkesir University Faculty of Medicine, Balıkesir
| | - Pervin Korkmaz
- Department of Chest Diseases, Ege University Faculty of Medicine, İzmir
| | - Gönül Çaltepe
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Ondokuz Mayıs University Faculty of Medicine, Samsun
| | - Mehmet Kılıç
- Department of Pediatric Allergy and Immunology, Fırat University Faculty of Medicine, Elazığ
| | - Şebnem Özdoğan
- Department of Pediatric Pulmonology, Şişli Hamidiye Etfal Research and Training Hospital, İstanbul, Türkiye
| | - Erkan Çakır
- Department of Pediatric Pulmonology, Bezmialem Vakıf University Faculty of Medicine, İstanbul
| | - Nazan Çobanoğlu
- Department of Pediatric Pulmonology, Ankara University Faculty of Medicine, Ankara
| | - Sevgi Pekcan
- Department of Pediatric Pulmonology, Necmettin Erbakan University Meram Faculty of Medicine, Konya
| | - Güzin Cinel
- Department of Pediatric Pulmonology, Ankara City Hospital, Ankara
| | - Uğur Özçelik
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara
| | - Deniz Doğru
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara
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Muacevic A, Adler JR, Şen V. Evaluation of Clinical, Biochemical, and Demographic Characteristics of Paediatric COVID-19 Patients Admitted to Dicle University Hospital. Cureus 2023; 15:e34171. [PMID: 36843786 PMCID: PMC9950032 DOI: 10.7759/cureus.34171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION AND AIM In this study, we aim to determine how laboratory parameters were related to the clinical courses of patients admitted to the Dicle University Faculty of Medicine Department of Paediatrics and Paediatric Intensive Care Unit with COVID-19 diagnoses from March 2020 to November 2021. MATERIALS AND METHOD Clinical, biochemical and demographic characteristics of 220 patients between 0 and 16 years old with COVID-19 diagnoses at admission were analysed retrospectively. RESULTS We found that 57.3% of patients were male and 42.7% female, with a mean age of 107.8 ± 65.5 (range 1-192) months. Of the cases, 48.6% (n = 107) were asymptomatic, 35.5% (n = 78) were mild, 11.8% (n = 26) were moderately severe and 3.6% (n = 8) were severe. The patients' site of admission, mortality rates, C reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and fibrinogen levels differed significantly (p < 0.001). CONCLUSION It is important to learn about the clinical course of the disease by accurately interpreting the results of blood parameters and appropriate imaging studies.
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Kan A, Türe M, Akın A, Yılmaz K, Sürücü M, Ünal E, Şen V, Üzel VH. The Effect of Vitamin D Levels in Multisystem Inflammatory Syndrome in Children. J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1749372] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract
Objective Multiple factors being overweight, asthmatic, or being of Asian or black ethnic origins have been reported vis-à-vis the “multisystem inflammatory syndrome in children” (MIS-C). There is an association between these conditions and vitamin D deficiency, which explains why MIS-C is more common in these patients. In the present study, we attempted to retrospective evaluate the 25-hydroxy vitamin D levels of patients with MIS-C, its association with acute phase reactants, its treatment, and clinical status.
Methods Patients aged between 1.5 months to 18 years with MIS-C were included in the study. All of the laboratory parameters, treatment, and response to the treatment were evaluated retrospectively. Two groups were formed. Patients had 25‐hydroxycholecalciferol D vitamin < 20 ng/mL in group 1 and ≥ 20 ng/mL in group 2.
Results A total of 52 patients were included in the study. There was no statistical difference between groups in terms of acceptance of the intensive care unit treatment (p = 0.29) and response to the first-line treatment (p = 0.56). A lower median lymphocyte count (p = 0.01) and a higher median C-reactive protein (p = 0.04) and procalcitonin (p = 0.01) with N-terminal pro-B-type natriuretic peptide (p = 0.025) values were found in group 1.
Conclusion Vitamin D deficiency was associated with an increased inflammatory response in children with MIS-C. More studies are required to determine the potential impact of vitamin D deficiency on the clinical outcome of MIS-C.
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Affiliation(s)
- Ahmet Kan
- Department of Pediatric Allergy and Immunology, Dicle University Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Mehmet Türe
- Department of Pediatric Cardiology, Dicle University Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Alper Akın
- Department of Pediatric Cardiology, Dicle University Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Kamil Yılmaz
- Department of Pediatrics, Dicle University Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Mehmet Sürücü
- Department of Pediatrics, Dicle University Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Edip Ünal
- Department of Pediatric Endocrinology, Dicle University Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Velat Şen
- Department of Pediatric Pulmonology, Dicle University Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Veysiye Hülya Üzel
- Department of Pediatric Hematology, Dicle University Faculty of Medicine, Dicle University, Diyarbakır, Turkey
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Çobanogĝlu N, Emiralioglu N, Çakır B, Sertçelik A, Yalçın E, Kiper N, Şen V, Ufuk Altıntasş D, Çokuĝraş H, Sakallı AK, Başkan A, Hepkaya E, Yazan H, Türel Ö, Yılmaz A, Ünal G, Caĝlar T, Damadoglu E, Irmak İ, Demir E, Öztürk G, Bingöl A, Başaran E, Sapan N, Aslan A, Asfuroğlu P, Harmancı K, Köse M, Hangül M, Özdemir A, Tuĝcu G, Polat SE, Özcan G, Gayretli Z, Keskin Ö, Bilgiç S, Yüksel H, Özdoĝan Ş, Topal E, Çaltepe G, Can D, Ekren PK, Kılıç M, Süleyman A, Eyüboĝlu TŞ, Cinel G, Pekcan S, Çakır E, Özcelik U, Doĝru D. P060 Factors associated with pulmonary functions of cystic fibrosis (CF) patients in the National Cystic Fibrosis Patient Registry: a retrospective cohort study. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00393-9] [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: 10/18/2022]
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Kan A, Şen V. The Use of Puzzles in Inhaler Technique Training. J Asthma 2022; 59:2413-2420. [PMID: 35259046 DOI: 10.1080/02770903.2022.2051542] [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: 10/18/2022]
Abstract
Objective: Inhaled drugs are essential for the treatment of several chronic respiratory diseases. However, patient inhaler techniques are frequently suboptimal; here, educational games may enhance patients' understanding of educational interventions. In addition, patients may practice repetitively, learning in a more relaxed and fun environment. In this study we aimed to compare two methods of inhaler technique training: (1) face-to-face training only and (2) face-to-face training and a subsequent puzzle game.Methods: The participants in group 1 were provided only face-to-face training. In group 2, the participants were given a puzzle after receiving the face-to-face training. Subsequently, the inhaler technique scores of both groups were compared. The chi-squared (χ2 ) test was used for categorical variables and the Mann-Whitney U test (non-parametric) or Student's t test (parametric) were employed to compare the numerical variables between the groups.Results: In total, 170 patients with asthma and their parents were included in the study. It was found that the median total scores for the inhaler technique (p < 0.001) and the number of correct users (p < 0.001) were higher in group 2, whereas the inhaler technique error rate in shaking the inhaler tube (p < 0.001) was higher in group 1.Conclusion: The present study revealed that the success rate of correct users and participants' total scores were higher in the puzzle game group. Therefore, a game may help patients to better remember and visualize the steps of the inhaler technique. Our study supports the use of puzzles as real-world applications to teach patients optimal inhaler technique.
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Affiliation(s)
- Ahmet Kan
- Department of Pediatric Allergy and Immunology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Velat Şen
- Department of Pediatric Pulmonology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
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8
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Yılmaz K, Hattapoğlu S, Şen V, Karabel M, Kan A, Yılmaz ED, Selimoglu Sen H, Yılmaz S. Evaluation of children and adolescent with cystic fibrosis by pancreatic elastography. Pediatr Int 2022; 64:e14951. [PMID: 34390069 DOI: 10.1111/ped.14951] [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: 03/13/2021] [Revised: 07/28/2021] [Accepted: 08/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) is an autosomal recessively inherited disease. Clinical findings vary by age of the patient, the organ systems involved, and the severity of the CFTR gene mutation. Pancreatic and liver involvement is prominent and exocrine pancreatic insufficiency is observed in the majority of patients. Point shear wave elastography (pSWE) is a non-invasive method that can quantitatively determine tissue elasticity and stiffness. In this study, the morphological evaluation of the pancreas was performed using the pSWE technique in pediatric patients diagnosed with CF. The effectiveness of this method for the early detection of pancreatic insufficiency was investigated. METHODS Fifty-five patients with CF (24 girls, 31 boys) and 60 healthy children (29 girls, 31 boys) without any chronic diseases and who were suitable for the pSWE examination were included in the study. RESULTS The mean value of pSWE was 1.12 ± 0.16 in the healthy group and 0.97 ± 0.16 in the patients with cystic fibrosis. There was a statistically significant difference between the two groups (P < 0.001). Significant negative correlations were found between pSWE and age (r = -0.319; P = 0.018), height (r = -0.293; P = 0.03), serum glucose (r = -0.346; P = 0.01), HbA1C (r = -0.592; P = 0.02), and duration of the disease (r = -0.806; P < 0.001). CONCLUSIONS Investigating pancreatic elasticity and detecting pancreatic insufficiency using pSWE (a simple, inexpensive, and non-invasive method) in the early period before overt laboratory and clinical symptoms of EPI appear can contribute positively to long-term results in young patients with CF.
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Affiliation(s)
- Kamil Yılmaz
- Department of Pediatric Infectious Diseases, Diyarbakir, Turkey
| | | | - Velat Şen
- Department of Pediatric Pulmonology, Diyarbakir, Turkey
| | | | - Ahmet Kan
- Department of Pediatric Allergy, Diyarbakir, Turkey
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9
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Türe M, Kan A, Akın A, Yılmaz K, Şen V. Multisystem inflammatory syndrome in children: A single-center experience. Pediatr Int 2021; 63:1062-1068. [PMID: 34227711 DOI: 10.1111/ped.14742] [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: 02/15/2021] [Revised: 03/28/2021] [Accepted: 04/09/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND This case series aims to evaluate the presenting symptoms, laboratory data, systemic findings, and response to early treatment in patients who were followed up with the diagnosis of multisystemic inflammatory syndrome associated with novel coronavirus disease 2019 (COVID-19). METHODS The presentation, laboratory findings, and responses to treatment of patients hospitalized and diagnosed with multisystemic inflammatory syndrome were evaluated retrospectively. RESULTS A total of 32 patients were included in the study. The median age was 90 (1.5-204) months and 62.5% of the patients were male; 59.4% of the cases were non-specific disease, 31.2% typical (complete) Kawasaki, and 9.4% had phenotypic characteristics of atypical (incomplete) Kawasaki. Most of the patients were found to have low albumin and elevated C-reactive protein, sedimentation rate, and d-dimer, and all patients had elevated N-terminal pro-B-type natriuretic peptide, and procalcitonin. Lymphopenia was detected in 25 patients (78.1%) and serum ferritin levels were elevated in 25 patients (78.1%). Eleven (34.4%) patients responded well only to intravenous immunoglobulin treatment. Twenty patients (62.5%) received intravenous immunoglobulin and steroid therapy (second-line therapy). Only one patient (3.1%) received third-line therapy (intravenous immunoglobulin + steroid +anakinra + plasmapheresis). None of the patients died. CONCLUSIONS Most patients had mild clinical symptoms and responded well to intravenous immunoglobulin and / or steroid therapies as first- and second-line therapies. Only one of our patients was clinically stabilized after third-line treatment because he did not respond to intravenous immunoglobulin and steroid therapy. We think that all of our patients diagnosed with multisystem inflammatory syndrome in children recovered because we had recommended quickly medical intervention. Treatment should therefore be started immediately in patients diagnosed with multisystem inflammatory syndrome in children. If there is no response after 24 h to the initial treatment, the next treatment protocol should be started.
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Affiliation(s)
- Mehmet Türe
- Department of Pediatric Cardiology, Dicle University Hospital, Diyarbakır, Turkey
| | - Ahmet Kan
- Department of Pediatric allergy and immunology, Dicle University Hospital, Diyarbakır, Turkey
| | - Alper Akın
- Department of Pediatric Cardiology, Dicle University Hospital, Diyarbakır, Turkey
| | - Kamil Yılmaz
- Department of Pediatrics, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Velat Şen
- Department of Pediatrics, Dicle University Medical Faculty, Diyarbakır, Turkey
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10
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Yılmaz K, Şen V, Aktar F, Onder C, Yılmaz ED, Yılmaz Z. Does Covid-19 in children have a milder course than Influenza? Int J Clin Pract 2021; 75:e14466. [PMID: 34107134 PMCID: PMC8237020 DOI: 10.1111/ijcp.14466] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/01/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND In December 2019, a novel type of coronavirus infection emerged in the Wuhan province of China and began to spread rapidly. In this study, we aimed to determine the differences between COVID-19 disease and Influenza. METHODS This retrospective study included 164 children with COVID-19, as well as 46 children with Influenza. The two groups were compared with respect to clinical and laboratory parameters and the rates of intensive care and mechanical ventilation requirement. RESULTS In both groups, the most common admission complaints were fever and cough. As compared to the COVID-19 group, the Influenza group had significantly higher rates of cough (37 [80.4%] and 38 [23.2%]), fever (31 [67.4%] and 34 [20.7%]), muscle pain (34 [73.9%] and 31 [18.9%]), vomiting (13 [28.9%] and 8 [4.9%]) and tachypnea (32 [69.6%] and 3 [1.8%]) (P < .01 for all comparisons). The mean WBC count (7.10 ± 1.08 vs. 10.90 ± 1.82), mean neutrophil count (3.19 ± 0.58 vs. 6.04 ± 0.97), APTT, CRP, procalcitonin, ALT, and LDH levels were significantly lower in the COVID-19 group compared to the Influenza group (P < .05 for all comparisons). There was, however, no significant difference between the mean lymphocyte counts of both groups. The Influenza group had significantly higher rates of intensive care requirement (19 [41.3%] vs. 3 [1.8%]) and mechanical ventilation requirement (16 [34.8%] vs. 2 [1.2%]) as well as a significantly higher mortality rate (7 [15.2%] vs. 2 [1.2%]) than the COVID-19 group (P < .01). CONCLUSION COVID-19 and Influenza may share similar clinical features. According to our findings, however, we believe that COVID-19 disease has a milder clinical and laboratory course than Influenza in children.
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Affiliation(s)
- Kamil Yılmaz
- Department of PediatricsDicle University School of MedicineDiyarbakirTurkey
| | - Velat Şen
- Department of PediatricsDicle University School of MedicineDiyarbakirTurkey
| | - Fesih Aktar
- Department of PediatricsDicle University School of MedicineDiyarbakirTurkey
| | - Cihan Onder
- Department of PediatricsDicle University School of MedicineDiyarbakirTurkey
| | - Engin Deniz Yılmaz
- Department of PediatricsDicle University School of MedicineDiyarbakirTurkey
| | - Zulfikar Yılmaz
- Department of PediatricsDicle University School of MedicineDiyarbakirTurkey
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11
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Üzel VH, Yılmaz K, Şen V, Aktar F, Karabel M, Yolbaş İ, Pirinççioğlu AG, Söker M. Evaluation of Hematological Parameters of Children Diagnosed with COVID-19: Single-Center Experience. Turk Arch Pediatr 2021; 56:463-468. [PMID: 35110115 PMCID: PMC8849318 DOI: 10.5152/turkarchpediatr.2021.21076] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Although many pediatric studies on children infected with coronavirus disease 2019 (COVID-19) have been published, the diagnosis, clinical symptoms, laboratory findings, and treatment of COVID-19 in children are still unclear. MATERIALS AND METHODS This study was conducted with an aim to examine the hematological findings of symptomatic pediatric patients diagnosed with COVID-19 in May 2020 at the Pandemic Hospital in Dicle University. Patient records were evaluated retrospectively. This study involved 59 symptomatic pediatric patients with a definite diagnosis of COVID-19 who had positive SARS-CoV-2 RT-PCR test results on nasopharyngeal swab between March 15, 2020 and May 31, 2020. RESULTS The records of a total of 10 (16.9%) patients under the age of 1; 21 (35.6%) patients aged 1-10 years, and, 28 (47.5%) patients aged 10-18 years, who had been diagnosed with COVID-19 were evaluated. Based on severity, 35 (59.3%) patients were in the mild group (group 1) and 24 (40.7%) patients were in the moderate-severe group (group 2). The blood parameters of WBC, neutrophil, lymphocyte, monocyte, and thrombocyte counts, the hemoglobin (Hgb) level, and NLR, PLR, MPV, fibrinogen, ferritin, and D-dimer levels were compared between groups, the difference was not statistically significant (P > .05). LDH was higher in group 2 (P = .014). CONCLUSION Since children infected with COVID-19 show mild clinical symptoms or are asymptomatic, fewer pediatric patients may be detected than adults. Therefore, it should be known that the laboratory findings typical for adults may not accompany the disease in pediatric cases. More studies are needed to determine the most appropriate COVID-19 treatment approach for children, as hospitalization history and testing rates are less reported among children.
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Akın A, Şen V, Yılmaz K, Aktar F, Türe M, Mermutluoğlu Ç, Gözü Pirinççioğlu A. Electrocardiographic Ventricular Repolarization Variables in Children Diagnosed With COVID-19. Turk Arch Pediatr 2021; 56:394-395. [PMID: 35005737 PMCID: PMC8655970 DOI: 10.5152/turkarchpediatr.2021.21092] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/08/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Alper Akın
- Department of Pediatric Cardiology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Velat Şen
- Department of Pediatrics, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Kamil Yılmaz
- Department of Pediatrics, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Fesih Aktar
- Department of Pediatrics, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Mehmet Türe
- Department of Pediatric Cardiology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Çiğdem Mermutluoğlu
- Department of Infectious Disease and Clinical Microbiology, Dicle University School of Medicine, Diyarbakır, Turkey
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13
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Yılmaz K, Gozupirinççioğlu A, Aktar F, Akın A, Karabel M, Yolbas I, Uzel VH, Şen V. Evaluation of the novel coronavirus disease in Turkish children: Preliminary outcomes. Pediatr Pulmonol 2020; 55:3587-3594. [PMID: 32991038 PMCID: PMC7536995 DOI: 10.1002/ppul.25095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The novel coronavirus disease (Covid-19) can progress with mild to moderate or self-limiting clinical findings in children. The aim of this study was to investigate the disease features of Covid-19 in Turkish children. METHODS Children diagnosed by the method of real-time reverse transcription-polymerase chain reaction for Covid-19 at the Dicle University Department of Pediatric, between April and June 2020, were evaluated. Hospital records were investigated retrospectively. RESULTS One hundred and five patients children with the mean age of 108.64 ± 65.61 months were enrolled in this study. The most common cause of transmission in pediatric patients was in contact with a family member diagnosed with COVID-19 (n = 91, 86.7%). The most common admission complaints were dry cough (n = 17, 16.2%), fever (n = 16, 15.2%), lassitude and fatigue (n = 14, 13.3%) respectively. More than 95% of all children with Covid-19 were asymptomatic, mild, or moderate cases. CRP was identified only independent factor associated with long duration of hospitalization. CONCLUSION The results of this study show the effect of Covid-19 on Turkish children. A clear understanding of the local epidemiology of corona virus infections and identification of risk factors are critical for the successful implementation of the prevention and control program.
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Affiliation(s)
- Kamil Yılmaz
- Department of Pediatric Infectious Diseases, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Ayfer Gozupirinççioğlu
- Department of Pediatric Intensive Care, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Fesih Aktar
- Department of Pediatric Intensive Care, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Alper Akın
- Department of Pediatric Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Müsemma Karabel
- Department of Pediatric Pulmonology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Ilyas Yolbas
- Department of Pediatric, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Veysiye Hulya Uzel
- Department of Pediatric Hematology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Velat Şen
- Department of Pediatric Pulmonology, Dicle University School of Medicine, Diyarbakir, Turkey
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Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) is a global health problem that can result in serious complications. The aim of this study was to investigate the prevalence and clinical importance of vitamin D deficiency in children with COVID-19. MATERIAL AND METHODS This study includes 40 patients who were diagnosed to have COVID-19 and hospitalized with the real-time reverse transcription polymerase chain reaction method, 45 healthy matched control subjects with vitamin D levels. The age of admission, clinical and laboratory data, and 25-hydroxycholecalciferol (25-OHD) levels were recorded. Those with vitamin D levels which are below 20 ng/ml were determined as Group 1 and those with ≥20 ng/ml as Group 2. RESULTS Patients with COVID-19 had significantly lower vitamin D levels 13.14 μg/L (4.19-69.28) than did the controls 34.81 (3.8-77.42) μg/L (p < .001). Patients with COVID-19 also had significantly lower serum phosphorus (4.09 ± 0.73 vs. 5.06 ± 0.93 vs. (U/L) (p < .001)) values compared with the controls. The symptom of fever was significantly higher in COVID- 19 patients who had deficient and insufficient vitamin D levels than in patients who had sufficient vitamin D levels (p = .038). There was a negative correlation found between fever symptom and vitamin D level (r = -0.358, p = .023). CONCLUSION This is the first to evaluate vitamin D levels and its relationship with clinical findings in pediatric patients with COVID-19. Our results suggest that vitamin D values may be associated with the occurrence and management of the COVID-19 disease by modulating the immunological mechanism to the virus in the pediatric population.
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Affiliation(s)
- Kamil Yılmaz
- Department of PediatricDicle University School of MedicineDiyarbakirTurkey
| | - Velat Şen
- Department of Pediatric PulmonologyDicle University School of MedicineDiyarbakirTurkey
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15
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Çobanoğlu N, Özçelik U, Çakır E, Şişmanlar Eyüboğlu T, Pekcan S, Cinel G, Yalçın E, Kiper N, Emiralioğlu N, Şen V, Şen HS, Ercan Ö, Çokuğraş H, Kılınç AA, Al Shadfan LM, Yazan H, Altıntaş DU, Karagöz D, Demir E, Kartal Öztürk G, Bingöl A, Başaran AE, Sapan N, Çekiç Ş, Çelebioğlu E, Aslan AT, Gürsoy TR, Tuğcu G, Özdemir A, Harmancı K, Yıldırım GK, Köse M, Hangül M, Tamay Z, Süleyman A, Yüksel H, Yılmaz Ö, Özcan G, Topal E, Can D, Korkmaz Ekren P, Çaltepe G, Kılıç M, Özdoğan Ş, Doğru D. Patients eligible for modulator drugs: Data from cystic fibrosis registry of Turkey. Pediatr Pulmonol 2020; 55:2302-2306. [PMID: 32453906 DOI: 10.1002/ppul.24854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/23/2020] [Revised: 04/22/2020] [Accepted: 05/09/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND A better understanding of cystic fibrosis transmembrane conductance regulator biology has led to the development of modulator drugs such as ivacaftor, lumacaftor-ivacaftor, tezacaftor-ivacaftor, and elexacaftor-tezacaftor-ivacaftor. This cross-sectional study evaluated cystic fibrosis (CF) patients eligible for modulator drugs. METHODS Data for age and genetic mutations from the Cystic Fibrosis Registry of Turkey collected in 2018 were used to find out the number of patients who are eligible for modulator therapy. RESULTS Of registered 1488 CF patients, genetic analysis was done for 1351. The numbers and percentages of patients and names of the drugs, that the patients are eligible for, are as follows: 122 (9.03%) for ivacaftor, 156 (11.54%) for lumacaftor-ivacaftor, 163 (11.23%) for tezacaftor-ivacaftor, and 57 (4.21%) for elexacaftor-tezacaftor-ivacaftor. Among 1351 genotyped patients total of 313 (23.16%) patients are eligible for currently licensed modulator therapies (55 patients were shared by ivacaftor and tezacaftor-ivacaftor, 108 patients were shared by lumacaftor-ivacaftor and tezacaftor-ivacaftor, and 22 patients were shared by tezacaftor-ivacaftor and elexacaftor-tezacaftor-ivacaftor groups). CONCLUSIONS The present study shows that approximately one-fourth of the registered CF patients in Turkey are eligible for modulator drugs. As, frequent mutations that CF patients have in Turkey are different from North American and European CF patients, developing modulator drugs effective for those mutations is necessary. Furthermore, as modulator drugs are very expensive currently, financial support of the government in developing countries like Turkey is noteworthy.
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Affiliation(s)
- Nazan Çobanoğlu
- Division of Pediatric Pulmonology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Uğur Özçelik
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erkan Çakır
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem University, İstanbul, Turkey
| | | | - Sevgi Pekcan
- Division of Pediatric Pulmonology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Güzin Cinel
- Division of Pediatric Pulmonology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Ebru Yalçın
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nural Kiper
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nagehan Emiralioğlu
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Velat Şen
- Division of Pediatric Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Hadice Selimoğlu Şen
- Department of Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Ömür Ercan
- Division of Pediatric Pulmonology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Haluk Çokuğraş
- Division of Pediatric Pulmonology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Ayşe Ayzıt Kılınç
- Division of Pediatric Pulmonology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | | | - Hakan Yazan
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem University, İstanbul, Turkey
| | - Derya Ufuk Altıntaş
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Dilek Karagöz
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Esen Demir
- Division of Pediatric Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Gökçen Kartal Öztürk
- Division of Pediatric Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Ayşen Bingöl
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine Akdeniz University, Antalya, Turkey
| | - Abdurrahman Erdem Başaran
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine Akdeniz University, Antalya, Turkey
| | - Nihat Sapan
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Şükrü Çekiç
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Ebru Çelebioğlu
- Department of Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ayşe Tana Aslan
- Division of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Tuğba Ramaslı Gürsoy
- Division of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Gökçen Tuğcu
- Division of Pediatric Pulmonology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Ali Özdemir
- Division of Pediatric Pulmonology, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Koray Harmancı
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Gonca Kılıç Yıldırım
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Mehmet Köse
- Division of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Melih Hangül
- Division of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Zeynep Tamay
- Division of Pediatric Allergy and Pulmonology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Ayşe Süleyman
- Division of Pediatric Allergy and Pulmonology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Hasan Yüksel
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Özge Yılmaz
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Gizem Özcan
- Division of Pediatric Pulmonology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Erdem Topal
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Demet Can
- Division of Pediatric Pulmonology, Faculty of Medicine, Balıkesir University, Balıkesir, Turkey
| | | | - Gönül Çaltepe
- Division of Pediatric Gastroenterology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Mehmet Kılıç
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - Şebnem Özdoğan
- Division of Pediatric Pulmonology, Sarıyer Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Deniz Doğru
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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16
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Dogru D, Çakır E, Şişmanlar T, Çobanoğlu N, Pekcan S, Cinel G, Yalçın E, Kiper N, Şen V, S Şen H, Ercan Ö, Keskin Ö, B Eltan S, Al Shadfan LM, Yazan H, Altıntaş DU, Şaşihüseyinoğlu Ş, Sapan N, Çekiç Ş, Çokuğraş H, A Kılınç A, R Gürsoy T, Aslan AT, Bingöl A, Başaran AE, Özdemir A, Köse M, Hangül M, Emiralioğlu N, Tuğcu G, Yüksel H, Yılmaz Ö, Orhan F, Gayretli Aydın ZG, Topal E, Tamay Z, Süleyman A, Can D, Bal CM, Çaltepe G, Özçelik U. Cystic fibrosis in Turkey: First data from the national registry. Pediatr Pulmonol 2020; 55:541-548. [PMID: 31710166 DOI: 10.1002/ppul.24561] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 07/19/2019] [Accepted: 10/09/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) care has been implemented in Turkey for a long time; however, there had been no patient registry. For this purpose, the Turkish National CF Registry was established. We present the first results of registry using data collected in 2017. METHODS The data were collected using a data-entry software system, which was accessed from the internet. Demographic and annually recorded data consisted of 15 and 79 variables, respectively. RESULTS There were 1170 patients registered from 23 centers; the estimated coverage rate was 30%. The median age at diagnosis was 1.7 years (median current age: 7.3 years); 51 (4.6%) patients were aged over 18 years. Among 293 patients who were under 3 years of age, 240 patients (81.9%) were diagnosed through newborn screening. Meconium ileus was detected in 65 (5.5%) patients. Genotyping was performed in 978 (87.4%) patients and 246 (25.2%) patients' mutations were unidentified. The most common mutation was deltaF508 with an allelic frequency of 28%, followed by N1303K (4.9%). The median FEV1% predicted was 86. Chronic colonization with Pseudomonas aeruginosa was seen in 245 patients. The most common complication was pseudo-Bartter syndrome in 120 patients. The median age of death was 13.5 years in a total of 15 patients. CONCLUSIONS Low coverage rate, lack of genotyping, unidentified mutations, and missing data of lung functions are some of our greatest challenges. Including data of all centers and reducing missing data will provide more accurate data and help to improve the CF care in Turkey in the future.
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Affiliation(s)
- Deniz Dogru
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erkan Çakır
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
| | - Tuğba Şişmanlar
- Division of Pediatric Pulmonology, Dr Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
| | - Nazan Çobanoğlu
- Division of Pediatric Pulmonology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Sevgi Pekcan
- Division of Pediatric Pulmonology, Meram Medicine Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Güzin Cinel
- Division of Pediatric Pulmonology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Ebru Yalçın
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nural Kiper
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Velat Şen
- Division of Pediatric Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Hadice S Şen
- Department of Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Ömür Ercan
- Division of Pediatric Pulmonology, Meram Medicine Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Özlem Keskin
- Division of Pediatric Allergy, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Sevgi B Eltan
- Division of Pediatric Allergy, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Lina M Al Shadfan
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
| | - Hakan Yazan
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
| | - Derya U Altıntaş
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Şenay Şaşihüseyinoğlu
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Nihat Sapan
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkey
| | - Şükrü Çekiç
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkey
| | - Haluk Çokuğraş
- Division of Pediatric Allergy and Pulmonology, Cerrahpaşa Medicine Faculty, Istanbul University, Istanbul, Turkey
| | - Ayşe A Kılınç
- Division of Pediatric Allergy and Pulmonology, Cerrahpaşa Medicine Faculty, Istanbul University, Istanbul, Turkey
| | - Tuğba R Gürsoy
- Division of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ayşe T Aslan
- Division of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ayşen Bingöl
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Abdurrahman E Başaran
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Ali Özdemir
- Division of Pediatric Pulmonology, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Mehmet Köse
- Division of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Melih Hangül
- Division of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Nagehan Emiralioğlu
- Division of Pediatric Pulmonology, Gaziantep Cengiz Gökçek Maternity and Children Hospital, Gaziantep, Turkey
| | - Gökçen Tuğcu
- Division of Pediatric Pulmonology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Hasan Yüksel
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Özge Yılmaz
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Fazıl Orhan
- Division of Pediatric Allergy, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Zeynep G Gayretli Aydın
- Division of Pediatric Infectious Disease, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Erdem Topal
- Division of Pediatric Allergy, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Zeynep Tamay
- Division of Pediatric Allergy, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ayşe Süleyman
- Division of Pediatric Allergy, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Demet Can
- Division of Pediatric Pulmonology, Faculty of Medicine, Balıkesir University, Balıkesir, Turkey
| | - Cem M Bal
- Division of Pediatric Pulmonology, Atatürk Regional Training and Research Hospital, Erzurum, Turkey
| | - Gönül Çaltepe
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Uğur Özçelik
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Erdem SB, Can D, Girit S, Çatal F, Şen V, Pekcan S, Yüksel H, Bingöl A, Bostancı I, Erge D, Ersu R. Does atopy affect the course of viral pneumonia? Allergol Immunopathol (Madr) 2018. [PMID: 28634031 PMCID: PMC7130674 DOI: 10.1016/j.aller.2017.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background The presence of atopy is considered as a risk factor for severe respiratory symptoms in children. The objective of this study was to examine the effect of atopy on the course of disease in children hospitalised with viral pneumonia. Methods Children between the ages of 1 and 6 years hospitalised due to viral pneumonia between the years of 2013 and 2016 were included to this multicentre study. Patients were classified into two groups as mild–moderate and severe according to the course of pneumonia. Presence of atopy was evaluated with skin prick tests. Groups were compared to evaluate the risk factors associated with severe viral pneumonia. Results A total of 280 patients from nine centres were included in the study. Of these patients, 163 (58.2%) were male. Respiratory syncytial virus (29.7%), Influenza A (20.5%), rhinovirus (18.9%), adenovirus (10%), human metapneumovirus (8%), parainfluenza (5.2%), coronavirus (6%), and bocavirus (1.6%) were isolated from respiratory samples. Eighty-five (30.4%) children had severe pneumonia. Atopic sensitisation was found in 21.4% of the patients. Ever wheezing (RR: 1.6, 95% CI: 1.1–2.4), parental asthma (RR: 1.5, 95% CI: 1.1–2.2), other allergic diseases in the family (RR: 1.8, 95% CI: 1.2–2.9) and environmental tobacco smoke (RR: 1.6, 95% CI: 1.1–3.5) were more common in the severe pneumonia group. Conclusions When patients with mild–moderate pneumonia were compared to patients with severe pneumonia, frequency of atopy was not different between the two groups. However, parental asthma, ever wheezing and environmental tobacco smoke exposure are risk factors for severe viral pneumonia in children.
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Affiliation(s)
- S B Erdem
- Dr Behcet Uz Children's Hospital, Department of Pediatric Allergy, Izmir, Turkey.
| | - D Can
- Dr Behcet Uz Children's Hospital, Department of Pediatric Allergy, Izmir, Turkey
| | - S Girit
- Kartal Dr Lütfü Kırdar Training and Research Hospital, Pediatric Pulmonology, Istanbul, Turkey
| | - F Çatal
- Inonu University Faculty of Medicine, Department of Allergy Immunology, Malatya, Turkey
| | - V Şen
- Dicle University Faculty of Medicine, Department of Pediatrics, Diyarbakır, Turkey
| | - S Pekcan
- Necmettin Erbakan University, Meram Medical Faculty, Department of Allergy Immunology, Konya, Turkey
| | - H Yüksel
- Celal Bayar University Medical Faculty, Department of Allergy Immunology, Manisa, Turkey
| | - A Bingöl
- Akdeniz University Faculty of Medicine, Department of Allergy Immunology, Antalya, Turkey
| | - I Bostancı
- Dr. Sami Ulus Obstetrics and Child Health and Diseases Training and Research Hospital, Department of Allergy Immunology, Ankara, Turkey
| | - D Erge
- Adnan Menderes University Medical Faculty, Department of Allergy Immunology, Aydın, Turkey
| | - R Ersu
- Marmara University Faculty of Medicine, Department of Pediatric Pulmonology, Istanbul, Turkey
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Tokgöz Y, Karabel M, Baysoy G, Göya C, Çiçek M, Pirinççioğlu AG, Uluca Ü, Şen V. Fasciola hepatica infestation in Turkish children. Gazz Med Ital - Arch Sci Med 2017. [DOI: 10.23736/s0393-3660.17.03430-1] [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: 11/08/2022]
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Abstract
Congenital tuberculosis is a rare disease with a high mortality rate. Congenital tuberculosis is considered the result of mother-to-child transmission from the placenta to the fetus, through the ingestion of the amniotic fluid, or via transplacental transmission through the umbilical vein. Given the non-specific clinical signs of tuberculosis, it is usually difficult to diagnose it. The case of a 48-day-old male infant hospitalized due to weight loss, fever, cough, hemoptysis, and respiratory distress for the past 20 days, is presented. In this period, he had received broad spectrum antibiotics but with no improvement. A chest x-ray showed the presence of consolidation and a cavitary lesion in the upper and middle left lung fields. Mycobacterium tuberculosis was detected by polymerase chain reaction in a bronchoalveolar lavage specimen. Congenital tuberculosis was diagnosed based on this finding; hence, a tuberculostatic regimen was started accordingly. The patient died 13 days after treatment initiation. Congenital tuberculosis should be considered in infants with weight loss, fever, cough, hemoptysis and respiratory distress.
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Affiliation(s)
- Velat Şen
- Dicle University Medical School, Departmento de Pediatría Pulmonar
| | | | - Fesih Aktar
- Dicle University Medical School, Departmento de Pediatría Pulmonar
| | - Ünal Uluca
- Dicle University Medical School, Departmento de Pediatría Pulmonar
| | - Müsemma Karabel
- Dicle University Medical School, Departmento de Pediatría Pulmonar
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Güneş A, Ece A, Akça H, Aktar F, Mete Ş, Samanci S, Uluca Ü, Şen V, Tan İ, Kaplan İ. Urinary kidney injury molecules in children with febrile seizures. Ren Fail 2016; 38:1377-1382. [DOI: 10.1080/0886022x.2016.1215198] [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: 10/21/2022] Open
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21
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Uyan ZS, Turan I, Ay P, Cakir E, Ozturk E, Gedik AH, Gokdemir Y, Erdem E, Şen V, Karadag B, Karakoc F, Ersu R. Sleep disordered breathing and sleep quality in children with bronchiolitis obliterans. Pediatr Pulmonol 2016; 51:308-15. [PMID: 26129911 DOI: 10.1002/ppul.23246] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 01/14/2015] [Revised: 05/17/2015] [Accepted: 05/28/2015] [Indexed: 01/13/2023]
Abstract
The incidence of sleep-disordered breathing (SDB) increases in chronic lung diseases. Our aim was to evaluate SDB and sleep quality in children with postinfectious bronchiolitis obliterans (BO) and assess associated risk factors. We hypothesized that children with BO are at increased risk for SDB and have impaired sleep quality. We also hypothesized that severity of SDB and impairment of sleep quality is related to the severity of lung disease. Sleep Related Breathing Disorder (SRBD) subscale of the Pediatric Sleep Questionnaire (PSQ) and Pittsburgh Sleep Quality Index (PSQI) questionnaires; spirometry, impulse oscillometry (IOS), and overnight polysomnography (PSG) were performed. Twenty-one patients (14 male, median age: 8.3 years) were enrolled. Five patients (25%) had a PSQ score of >0.33, predictive of a SDB. Ten patients (48%) had poor sleep quality. Four patients (19%) had an OAHI of >1/hr. Nineteen patients (90%) had a high desaturation index. Four patients (19%) had a mean oxygen saturation of <93%. Median central apnea time was 7.5 (IQR: 6.9-9.1) seconds. Central apnea index of the patients correlated positively with R5, R10, R15, R20, Z5, and negatively with X10 and X15 at IOS. There was a positive correlation between the lowest oxygen saturation and FVC, FEV1 , X5, X10, X15, X20 while there was a negative correlation between lowest saturation and the central apnea index at PSG, R5, R10, and Z5 at IOS. Mean oxygen saturation during PSG correlated positively with FVC, FEV1, FEF(25-75), X5, X10, X15, X20 results. The risk of nocturnal hypoxia is increased in patients with BO and correlated to the severity of lung disease determined by pulmonary function tests. Although BO patients have a shorter duration of central apneas, they are more prone to desaturate.
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Affiliation(s)
- Zeynep S Uyan
- Division of Pediatric Pulmonology, Kocaeli University, Kocaeli, Turkey
| | - Ihsan Turan
- Department of Pediatrics, Marmara University, Istanbul, Turkey
| | - Pinar Ay
- Department of Public Health, Marmara University, Istanbul, Turkey
| | - Erkan Cakir
- Division of Pediatric Pulmonology, Bezmi Alem Vakif University, Istanbul, Turkey
| | - Ersin Ozturk
- Department of Pediatrics, Kocaeli University, Kocaeli, Turkey
| | - Ahmet H Gedik
- Division of Pediatric Pulmonology, Bezmi Alem Vakif University, Istanbul, Turkey
| | - Yasemin Gokdemir
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey
| | - Ela Erdem
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey
| | - Velat Şen
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey
| | - Bulent Karadag
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey
| | - Fazilet Karakoc
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey
| | - Refika Ersu
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey
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22
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Haspolat YK, Karabel M, Karabel D, Kelekci S, Tuncel T, Şen V, Uluca Ü, Tan İ. The Assessment of Children’s Socio-Demographic Features at the Adolescent Outpatient Clinic. Dicle Med J 2016. [DOI: 10.5798/diclemedj.0921.2016.01.0639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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23
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Güneş A, Ece A, Aktar F, Tan İ, Söker M, Karabel D, Balık H, Uluca Ü, Şen V, Yolbaş İ. Urinary Kidney Injury Molecules in Children with Iron-Deficiency Anemia. Med Sci Monit 2015; 21:4023-9. [PMID: 26697893 PMCID: PMC4694706 DOI: 10.12659/msm.896794] [Citation(s) in RCA: 4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 12/08/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the urine levels of human kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-β-D-glucosaminidase (NAG), and liver-type fatty acid-binding protein (L-FABP) in children with iron-deficiency anemia (IDA). MATERIAL AND METHODS Thirty-five children with IDA and 32 matched healthy controls were recruited. We assessed complete blood count, serum iron, iron-binding capacity, ferritin, serum levels of urea, creatinine (Cr), sodium (Na), potassium (K), calcium (Ca), and glucose levels. Estimated glomerular filtration rate (eGFR) was calculated. Urinary NAG, NGAL, KIM-1, and L-FABP were measured and divided by urine creatinine for comparisons. RESULTS There were no significant differences in serum urea, Cr, or eGFR between the IDA group and the control group (p>0.05, for all). IDA patients had significantly higher urine NGAL/Cr, L-FABP/Cr, KIM-1/Cr, and NAG/Cr compared with the control group (p<0.05). There were significant negative correlations between hemoglobin, hematocrit, red blood cell count, and urine NGAL/Cr, NAG/Cr, L-FABP/Cr, KIM-1/Cr levels (p<0.05). CONCLUSIONS Higher urinary kidney injury molecule levels in IDA patients suggest a possible subclinical renal injury in pediatric IDA patients whose renal functions and serum electrolytes were normal.
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Affiliation(s)
- Ali Güneş
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - Aydın Ece
- Department of Pediatric Nephrology, Medical School, Dicle University, Diyarbakir, Turkey
| | - Fesih Aktar
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - İlhan Tan
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - Murat Söker
- Department of Pediatric Hematology, Medical School, Dicle University, Diyarbakir, Turkey
| | - Duran Karabel
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - Hasan Balık
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - Ünal Uluca
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - Velat Şen
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - İlyas Yolbaş
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
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Güneş A, Uluca Ü, Aktar F, Konca Ç, Şen V, Ece A, Hoşoğlu S, Taş MA, Gürkan F. Clinical, radiological and laboratory findings in 185 children with tuberculous meningitis at a single centre and relationship with the stage of the disease. Ital J Pediatr 2015; 41:75. [PMID: 26467304 PMCID: PMC4606503 DOI: 10.1186/s13052-015-0186-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 10/06/2015] [Indexed: 08/30/2023] Open
Abstract
Background A delay in the diagnosis and treatment of tuberculosis meningitis (TBM) may lead to increased mortality and morbidity. The aim of this study was to describe the clinical, radiological and laboratory findings of TBM on a cohort of 185 pediatric patients at a single centre over a 10 year period and to investigate relationship between the stage of the disease. Methods The hospital records of 185 TBM children that presented to the Pediatric Clinics of Dicle University Hospital were retrospectively evaluated. The age, gender, family history of tuberculosis, result of Mantoux skin test, status of BCG vaccination, stage of TBM at hospitalization, and clinical, laboratory and radiological features were recorded. Clinical staging of TBM was defined as follows: Stage I, no focal neurological findings and Glasgow Coma Scale (GCS) score 15; Stage II, GCS 15 presenting with focal neurological deficit or all the patients with GCS 10–14; Stage III, all the patients with GCS < 10. Relationships between results and stages of TBM were investigated. Results The mean age of the patients was 53.5 ± 44.9 months (4 months–18 years). 121 (65.4 %) of the patients were male and 64 (34.6 %) female. Family history of tuberculosis was defined in 62 (33.5 %) patients. Forty five (24.3 %) children had BCG vaccination scar. Mantoux skin test was interpreted as positive in 35 (18.9 %) patients. Sixty-eight (36.8 %) children were at stage I TBM, 57 (30.8 %) at stage II and 60 (32.4 %) were at stage III on admission. Mean duration of hospitalization was 23.9 ± 14.1 days. Totally, 90 patients (48.6 %) had abnormal chest X-ray findings (parenchymal infiltration in 46 (24.9 %), mediastinal lymphadenopathy in 36 (19.5 %), miliary opacities in 25 (13.5 %), pleural effusion in 2 (1.1 %), and atelectasis in 2 (1.1 %) patients). One hundred sixty seven (90.3 %) patients had hydrocephalus in cranial computerized tomography. There were 24 (13.0 %) patients with positive culture for Mycobacterium tuberculosis and 3 (1.6 %) patients with positive acid-fast bacilli in cerebrospinal fluid. Overall mortality rate was 24 (13.0 %). Among the findings; patients at Stage III had less frequent positive chest X-ray abnormality, miliary opacities and BCG vaccination scar when compared with patients at Stage I and II (p = 0,005; p = 0,007, p = 0.020, respectively). Conclusions Children with TBM and positive chest X-ray findings at hospital admission were more frequently diagnosed at Stage I, and BCG vaccination might be protective from the Stage III of the disease.
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Affiliation(s)
- Ali Güneş
- Medical School Department of Pediatrics, Dicle University, Diyarbakir, Turkey.
| | - Ünal Uluca
- Medical School Department of Pediatrics, Dicle University, Diyarbakir, Turkey.
| | - Fesih Aktar
- Medical School Department of Pediatrics, Dicle University, Diyarbakir, Turkey.
| | - Çapan Konca
- Medical School Department of Pediatrics, Adiyaman University, Adiyaman, Turkey.
| | - Velat Şen
- Medical School Department of Pediatrics, Dicle University, Diyarbakir, Turkey.
| | - Aydın Ece
- Medical School Department of Pediatrics, Dicle University, Diyarbakir, Turkey.
| | - Salih Hoşoğlu
- Medical School Department of Infectious Diseases, Dicle University, Diyarbakir, Turkey.
| | - Mehmet Ali Taş
- Medical School Department of Pediatrics, Dicle University, Diyarbakir, Turkey.
| | - Fuat Gürkan
- Medical School Department of Pediatric Pulmonology, Dicle University, Diyarbakir, Turkey.
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25
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Güneş A, Ece A, Şen V, Uluca Ü, Aktar F, Tan İ, Yel S, Yolbaş İ. Correlation of mean platelet volume, neutrophil-to-lymphocyte ratio, and disease activity in children with juvenile ıdiopathic arthritis. Int J Clin Exp Med 2015; 8:11337-11341. [PMID: 26379946 PMCID: PMC4565329] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 06/23/2015] [Indexed: 06/05/2023]
Abstract
Juvenile idiopathic arthritis (JIA) is a chronic inflammatory arthritis characterized by periods of remission and relapse. Mean platelet volume (MPV) is an indicator of systemic inflammation. In the present study, we aimed to determine the association between mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), platelet distribution width (PDW) and clinical measures of diseases activity in children with JIA. The study included 115 patients with JIA (64 with active disease and 51 with inactive disease) and 64 age-gender matched healthy control subjects. Routine laboratory methods were used to measure white blood cell count (WBC), platelet count (PLT), neutrophil count, lymphocyte count, hemoglobin (Hb), MPV, PDW, NLR, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in all subjects of both the patient and control groups. Active disease was associated with significantly increased MPV (8.23 ± 1.16 fl) compared with inactive disease (7.00 ± 1. 08 fl) and control subjects (6.77 ± 1.08 fl) P<0.001, P<0.001, P=NS, respectively). NLR was significantly higher in patients with active (2.11 ± 1.19) and inactive (2.03 ± 1.51) disease relative to the control subjects (1.33 ± 0.66) (P<0.001, P=0.017, respectively). Mean PDW was significantly higher in patients with active disease (17.84 ± 1.06) compared with the control group (17.19 ± 0.93) (P=0.01). Our results suggest that MPV may be a useful marker of disease activity in patients with JIA. Regular treatment may decrease platelet activation in JIA patients. However, NLR was not a predictive marker of disease activity in patients with JIA.
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Affiliation(s)
- Ali Güneş
- Department of Medical School Pediatrics, Dicle UniversityDiyarbakir, Turkey
| | - Aydın Ece
- Department of Medical School Pediatric Nephrology, Dicle UniversityDiyarbakir, Turkey
| | - Velat Şen
- Department of Medical School Pediatrics, Dicle UniversityDiyarbakir, Turkey
| | - Ünal Uluca
- Department of Medical School Pediatrics, Dicle UniversityDiyarbakir, Turkey
| | - Fesih Aktar
- Department of Medical School Pediatrics, Dicle UniversityDiyarbakir, Turkey
| | - İlhan Tan
- Department of Medical School Pediatrics, Dicle UniversityDiyarbakir, Turkey
| | - Servet Yel
- Department of Medical School Pediatrics, Dicle UniversityDiyarbakir, Turkey
| | - İlyas Yolbaş
- Department of Medical School Pediatrics, Dicle UniversityDiyarbakir, Turkey
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Uluca Ü, Ece A, Şen V, Yel S, Tan İ, Karabel D. Management of intestinal bleeding with single-dose cyclophosphamide in Henoch-Schönlein purpura. Pediatr Int 2015; 57:498-500. [PMID: 26113318 DOI: 10.1111/ped.12670] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 09/13/2014] [Revised: 12/28/2014] [Accepted: 02/13/2015] [Indexed: 11/29/2022]
Abstract
In these case series, we report on six children (3 girls, 3 boys) aged 5-13 years with Henoch-Schönlein purpura (HSP) who developed severe gastrointestinal (GI) bleeding resistant to both 2 mg/kg or pulse (10-30 mg/kg) i.v. methylprednisolone. All patients responded to single-dose (500 mg/m(2) ) i.v. cyclophosphamide (CPA) and none of them developed new GI bleeding after CPA treatment. No patients required surgical intervention. Single high-dose CPA may be beneficial in HSP with severe GI involvement, in which bleeding is non-responsive to high-dose steroids.
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Affiliation(s)
| | - Aydın Ece
- Departments of Pediatric Rheumatology, Dicley University Medical School, Diyarbakir, Turkey
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Uluca Ü, Şen V, Ece A, Tan İ, Karabel D, Aktar F, Karabel M, Balık H, Güneş A. Serum galectin-3 levels in children with chronic hepatitis B infection and inactive hepatitis B carriers. Med Sci Monit 2015; 21:1376-80. [PMID: 25968249 PMCID: PMC4548702 DOI: 10.12659/msm.894035] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 04/27/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Chronic hepatitis B virus (HBV) infection is common worldwide. Follow-up of patients by the use of non-invasive techniques may be valuable in clinical practice. The aim of this study was to investigate serum galectin-3 (GAL-3) levels for monitoring disease status in children with chronic HBV infection. MATERIAL/METHODS Thirty-two patients with chronic hepatitis B (CHB), 30 inactive HBV carrier patients, and 30 matched healthy controls were enrolled in the study. We performed basic laboratory tests: serum glucose, albumin, alanine aminotransferase (ALT), aspartate aminotransferase, gamma-glutamyl transferase (GGT), total bilirubin, prothrombin time, and activated partial thromboplastin time. In addition, serum GAL-3 levels were measured by ELISA technique. RESULTS Significantly higher serum GAL-3 levels (16.5±3.6, 1.1±0.3, 0.7±0.5 ng/ml, respectively, p<0.001) and ALT levels (80.2±30.6, 26.8±12.6, 28.1±4.4 IU/L, respectively, p<0.001) were found in the CHB group compared with the inactive carriers and the control groups. There were no significant differences in ALT levels and GAL-3 levels or between inactive HBV carriers and the control groups (p>0.05, for each). Significantly higher GGT levels were found in the CHB group (51.3±27.5 IU/L) compared with the inactive HBV carriers (35.7±10.1 IU/L) and the control group (31.3±9.5 IU/L) (p<0.001, and p=0.004, respectively). A significant correlation was found between GAL-3 and ALT levels in the CHB group (r=0.82, p<0.001). CONCLUSIONS Our results suggest that serum GAL-3 level may be a beneficial indicator of chronicity in hepatitis B infection in children.
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Affiliation(s)
- Ünal Uluca
- Corresponding Author: Ünal Uluca, e-mail:
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Uluca Ü, Ece A, Şen V, Coşkun S, Güneş A, Yel S, Tan İ, Karabel M, Şahin C. High frequency of E148Q sequence variation in children with familial Mediterranean fever in southeast Turkey. ARCH ARGENT PEDIATR 2015. [PMID: 25727825 DOI: 10.5546/aap.2015.133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the spectrum of Mediterranean fever (MEFV) gene mutations and genotype-phenotype correlation in children with familial Mediterranean fever (FMF) in southeast Turkey. METHODS A total of 507 children (274 females) with FMF and MEFV gene mutation(s) were included. A 15-year retrospective evaluation was conducted; parameters analyzed were: age, sex, age at symptoms onset, age at FMF diagnosis, delay between symptoms onset and diagnosis, FMF attack symptoms, and response to colchicine. Disease severity scores were calculated and MEFV mutation analysis was performed via real-time PCR for the 6 most frequent mutations. Children with comorbid diseases or tested negative for MEFV gene mutations were excluded to provide homogeneity. RESULTS A family history of FMF was found in 60.2% (n=305) of patients. The most common symptoms reported for FMF attacks were abdominal pain (98.0%), fever (93.9%) and arthralgia (47.3%); 75.0% of patients (n=380) were heterozygous, 14.2% were homozygous (n=72) and 10.8% were compound heterozygous (n=55).The following MEFV gene mutation alleles were identified: E148Q (40.1%), M694V (25.9%), V726A (15.8%), R761H (7.4%), M680I (6.8%), and P369S (4.1%). The M694V subgroup had the lowest mean age of disease onset and the highest mean disease severity score, whereas the E148Q group had later mean disease onset and the lowest mean disease severity score (p<0.05). CONCLUSION The highest E148Q mutation frequency and milder disease in the course of FMF in our study population may be due to geographic and ethnic background dissimilarities of southeast Turkey.
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Affiliation(s)
- Ünal Uluca
- Departamento de Pediatría, Facultad de Medicina, Universidad de Dicle
| | - Aydın Ece
- Departamento de Reumatología Pediátrica, Facultad de Medicina, Universidad de Dicle
| | - Velat Şen
- Departamento de Pediatría, Facultad de Medicina, Universidad de Dicle
| | - Salih Coşkun
- Departamento de Genética Clínica, Facultad de Medicina, Universidad de Dicle, Diyarbakir, Turquía
| | - Ali Güneş
- Departamento de Pediatría, Facultad de Medicina, Universidad de Dicle
| | - Servet Yel
- Departamento de Pediatría, Facultad de Medicina, Universidad de Dicle
| | - İlhan Tan
- Departamento de Pediatría, Facultad de Medicina, Universidad de Dicle
| | - Müsemma Karabel
- Departamento de Pediatría, Facultad de Medicina, Universidad de Dicle
| | - Cahit Şahin
- Departamento de Pediatría, Facultad de Medicina, Universidad de Dicle
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Uluca Ü, Demir F, Ece A, Şen V, Güneş A, Aktar F, Tan İ, Karabel D, Yazgan Ü, Sabaz MN. Assessment of epicardial adipose tissue thickness and the mean platelet volume in children with familial Mediterranean fever. Ital J Pediatr 2015; 41:15. [PMID: 25887962 PMCID: PMC4348162 DOI: 10.1186/s13052-015-0120-z] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 02/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Familial Mediterranean fever (FMF) is an inflammatory disease, which is suggested to be associated with increased risk of atherosclerosis. Epicardial adipose tissue (EAT) thickness and the mean platelet volume (MPV) are parameters used in prediction of atherosclerotic risk in various conditions. These parameters were evaluated in children with FMF and compared with healthy controls. METHODS Forty-five patients with FMF and 54 age- and gender-matched healthy controls were assessed. Duration of symptoms, age at diagnosis, duration of delay in diagnosis, frequency and duration of FMF attacks, disease severity scores, response to colchicine therapy, MEditerraneanFeVer (MEFV) gene mutations, and MPV values were recorded. EAT thicknesses were measured by echocardiography. RESULTS Epicardial adipose tissue thicknesses of the children with FMF were found to be significantly greater than that of controls (5.1 ± 1.4 vs. 4.5 ± 0.9 mm, p=0.036). FMF patients had significantly higher MPV values compared with the controls (7.8 ± 1.1 vs. 7.3 ± 1.4 fl, p=0.044). Age at diagnosis, duration of delay in diagnosis, and MPV values were found to be correlated with EAT thickness in the patient group (r=0.49, p=0.001 for the former parameters and r=0.32, p=0.04 for MPV). CONCLUSION Epicardial adipose tissue thickness and MPV values seem to be increased in children with FMF. These findings may indicate an increased risk of atherosclerosis in FMF patients.
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Affiliation(s)
- Ünal Uluca
- Department of Pediatrics, Dicle University Medical School, Diyarbakir, Turkey.
| | - Fikri Demir
- Department of Pediatric Cardiology, Dicle University Medical School, Diyarbakir, Turkey.
| | - Aydın Ece
- Department of Pediatric Rheumatology, Dicle University Medical School, Diyarbakir, Turkey.
| | - Velat Şen
- Department of Pediatrics, Dicle University Medical School, Diyarbakir, Turkey.
| | - Ali Güneş
- Department of Pediatrics, Dicle University Medical School, Diyarbakir, Turkey.
| | - Fesih Aktar
- Department of Pediatrics, Dicle University Medical School, Diyarbakir, Turkey.
| | - İlhan Tan
- Department of Pediatrics, Dicle University Medical School, Diyarbakir, Turkey.
| | - Duran Karabel
- Department of Pediatrics, Dicle University Medical School, Diyarbakir, Turkey.
| | - Ümitcan Yazgan
- Department of Physiology, Dicle University Medical School, Diyarbakir, Turkey.
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Şen V, Ece A, Uluca Ü, Söker M, Güneş A, Kaplan İ, Tan İ, Yel S, Mete N, Sahin C. Urinary early kidney injury molecules in children with beta-thalassemia major. Ren Fail 2015; 37:607-13. [PMID: 25656833 DOI: 10.3109/0886022x.2015.1007871] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 01/19/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate novel urinary biomarkers including N-acetyl-β-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and liver-type fatty acid binding protein (L-FABP) in children with β-thalassemia major (β-TM). MATERIALS AND METHODS Totally, 52 patients (29 boys, 23 girls) with β-TM and 29 healthy controls (3-17 years) were included. Various demographic characteristics and blood transfusions/year, disease duration, and chelation therapy were recorded. Serum urea, creatinine, electrolytes, and ferritin and urinary creatinine, protein, calcium, phosphorus, sodium, potassium, and uric acid in first morning urine samples were measured and estimated glomerular filtration rate (eGFR) was calculated. Routine serum and urinary biochemical variables, urinary NAG to Creatinine (U(NAG/Cr)), U(NGAL/Cr), U(KIM-1/Cr), and U(L-FABP/Cr) ratios were determined. RESULTS Patients had similar mean serum urea, creatinine and eGFR levels compared with controls (p > 0.05 for all). The mean urinary protein to creatinine (U(Protein/Cr)) ratio was significantly higher in patients compared to the healthy subjects (0.13 ± 0.09 mg/mg and 0.07 ± 0.04 mg/mg, respectively; p < 0.001). Significantly increased U(NAG/Cr) (0.48 ± 0.58 vs. 0.23 ± 0.16, p = 0.026) and U(NGAL/Cr) (22.1 ± 18.5 vs. 11.5 ± 6.17, p = 0.01) ratios were found in β-TM patients compared with healthy controls. However, no differences were found in serum and urinary electrolytes or U(KIM-1/Cr) and U(L-FABP/Cr) ratios between patients and controls (p > 0.05). Significant correlations were found between urinary biomarkers and urinary electrolytes (p < 0.05). CONCLUSIONS Our results suggest that urinary NAG and NGAL may be considered to be reliable markers to monitor renal injury in β-TM patients.
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Affiliation(s)
- Velat Şen
- Dicle University Medical School Department of Pediatrics , Diyarbakir , Turkey
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Şen V, Ece A, Uluca Ü, Güneş A, Yel S, Tan I, Karabel D, Yıldırım B, Haspolat K. Evaluation of children with juvenile idiopathic arthritis in southeastern Turkey: a single center experience. Hippokratia 2015; 19:63-68. [PMID: 26435650 PMCID: PMC4574590] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND The aim of this study was to investigate the disease characteristics of children with juvenile idiopathic arthritis (JIA) in southeast Turkey. METHODS The International League of Associations for Rheumatology (ILAR) criteria were used to diagnose JIA. Hospital records of the Pediatric Rheumatology Unit, of the Dicle University Hospital, were reviewed retrospectively and demographic, clinical and laboratory data were recorded. RESULTS Totally 213 children (103 boys, 110 girls), with an age range of 1.6-18 years were enrolled. The mean age of the disease onset was 8.1 years. Polyarticular type was the most common (42.3%) presentation. The frequencies of other JIA subtypes were as follows: oligoarticular 37.1%, systemic 8.9%, enthesitis-related arthritis (ERA) 10.8% and psoriatic arthritis 0.9%. The knees (74.2%) and ankles (54.0%) were the most commonly affected joints. Uveitis was found in 4.2% of patients. Anti-nuclear antibodies were positive in 11.7% and HLA-B27 in 2.8% of patients. Active disease was seen in 57 (26.7%) patients at the last visit. CONCLUSION In the present study, polyarticular JIA was the predominant subtype and there were fewer patients with positive ANA or uveitis compared to previous studies. Hippokratia 2015, 19 (1): 63-68.
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Affiliation(s)
| | - A Ece
- Pediatric Rheumatology Department, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
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Şen V, Uluca Ü, Ece A, Kaplan İ, Bozkurt F, Aktar F, Bağlı S, Tekin R. Serum prolidase activity and oxidant-antioxidant status in children with chronic hepatitis B virus infection. Ital J Pediatr 2014; 40:95. [PMID: 25425101 PMCID: PMC4247636 DOI: 10.1186/s13052-014-0095-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 11/15/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Chronic hepatitis B (CHB) is a global health problem that can result in serious complications associated with collagen degradation. Prolidase is a specific imidodipeptidase that plays an important role in the breakdown of collagen. The aim of this study was to investigate prolidase activity and oxidant-antioxidant status in children with CHB. METHODS This prospective case control study includes 38 patients with CHB, 31 patients with inactive hepatitis B (IHB), and 29 healthy matched control subjects. Serum prolidase enzyme activity (SPEA), total antioxidant capacity (TAC), total oxidative activity (TOA), and malondialdehyde (MDA) level were measured and oxidative stress index (OSI) was calculated for each group. RESULTS Patients with CHB had significantly higher SPEA levels (207.82 ± 186.80 IU/L) than did the controls (58.6 ± 38.1 IU/L) and IHB patients (67.1 ± 39.9) (p < 0.001). CHB patients also had significantly higher TOA (45.0 ± 19.9 vs. 29.4 ± 11.7 (μmolH2O2 Eq./L), p = 0.005), OSI (33.1 ± 21.4 vs. 17.5 ± 10.2, p = 0.002) and MDA (13.4 ± 4.0 vs. 7.8 ± 2.6 μm/L, p < 0.001) values compared with the controls. TOA (32.0 ± 10.0) and OSI (15.4 ± 11.0) values of IHB patients were significantly lower than those of CHB patients (p < 0.05). SPEA had significant correlations with HBV- DNA and ALT values (r =0.514 and r =0.454, p < 0.001). CONCLUSION Our results suggest that prolidase activity can be considered as a reliable marker for CHB and increased oxidative stress appears to be related to chronicity of the disease.
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Affiliation(s)
- Velat Şen
- Department of Pediatrics, Dicle University Medical School, Diyarbakir, Turkey.
| | - Ünal Uluca
- Department of Pediatrics, Dicle University Medical School, Diyarbakir, Turkey.
| | - Aydın Ece
- Department of Pediatrics, Dicle University Medical School, Diyarbakir, Turkey.
| | - İbrahim Kaplan
- Department of Biochemistry, Dicle University Medical School, Diyarbakir, Turkey.
| | - Fatma Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Medical School, Diyarbakir, Turkey.
| | - Fesih Aktar
- Department of Pediatrics, Dicle University Medical School, Diyarbakir, Turkey.
| | - Sedat Bağlı
- Department of Pediatrics, Dicle University Medical School, Diyarbakir, Turkey.
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Medical School, Diyarbakir, Turkey.
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Selimoğlu Şen H, Şen V, Bozkurt M, Türkçü G, Güzel A, Sezgi C, Abakay Ö, Kaplan I. Carvacrol and pomegranate extract in treating methotrexate-induced lung oxidative injury in rats. Med Sci Monit 2014; 20:1983-90. [PMID: 25326861 PMCID: PMC4211419 DOI: 10.12659/msm.890972] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background This study was designed to evaluate the effects of carvacrol (CRV) and pomegranate extract (PE) on methotrexate (MTX)-induced lung injury in rats. Material/Methods A total of 32 male rats were subdivided into 4 groups: control (group I), MTX treated (group II), MTX+CRV treated (group III), and MTX+PE treated (group IV). A single dose of 73 mg/kg CRV was administered intraperitoneally to rats in group III on Day 1 of the investigation. To group IV, a dose of 225 mg/kg of PE was administered via orogastric gavage once daily over 7 days. A single dose of 20 mg/kg of MTX was given intraperitoneally to groups II, III, and IV on Day 2. The total duration of experiment was 8 days. Malondialdehyde (MDA), total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI) were measured from rat lung tissues and cardiac blood samples. Results Serum and lung specimen analyses demonstrated that MDA, TOS, and OSI levels were significantly greater in group II relative to controls. Conversely, the TAC level was significantly reduced in group II when compared to the control group. Pre-administering either CRV or PE was associated with decreased MDA, TOS, and OSI levels and increased TAC levels compared to rats treated with MTX alone. Histopathological examination revealed that lung injury was less severe in group III and IV relative to group II. Conclusions MTX treatment results in rat lung oxidative damage that is partially counteracted by pretreatment with either CRV or PE.
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Affiliation(s)
| | - Velat Şen
- Department of Pediatric Pulmonology, Dicle University Medical Faculty, Diyarbakir, Turkey
| | - Mehtap Bozkurt
- Department of Physical Therapy and Rehabilitation, Dicle University Medical Faculty, Diyarbakir, Turkey
| | - Gül Türkçü
- Department of Pathology, Dicle University Medical Faculty, Diyarbakir, Turkey
| | - Abdulmenap Güzel
- Department of Anesthesiology, Dicle University Medical Faculty, Diyarbakir, Turkey
| | - Cengizhan Sezgi
- Department of Pulmonology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Özlem Abakay
- Department of Pulmonology, Dicle University Medical Faculty, Diyarbakir, Turkey
| | - Ibrahim Kaplan
- Department of Biochemistry, Dicle University Medical Faculty, Diyarbakir, Turkey
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Şen V, Ece A, Uluca Ü, Güneş A, Tan İ, Tuncel T, Aktar F, Yıldırım B. Evaluation of the Mean Platelet Volume in Children with Juvenile Idiopathic Arthritis. Electron J Gen Med 2014. [DOI: 10.15197/sabad.1.11.83] [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: 11/05/2022]
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Kaplan İ, Sancaktar E, Ece A, Şen V, Tekkeşin N, Basarali MK, Kelekci S, Evliyaoglu O. Gene polymorphisms of adducin GLY460TRP, ACE I/D, AND AGT M235T in pediatric hypertension patients. Med Sci Monit 2014; 20:1745-50. [PMID: 25262176 PMCID: PMC4188538 DOI: 10.12659/msm.892140] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Hypertension is a major global public health problem that affects both pediatric and adult populations. ACE I/D, AGT M235T, and ADD Gly460Trp polymorphisms are thought to be associated with primary hypertension. In the present study, we examined the frequency of these polymorphisms in a pediatric population with secondary hypertension. MATERIAL AND METHODS Included in the study were 58 hypertensive and 58 normotensive pediatric patients. ACE I/D and AGT M235T polymorphisms are determined by conventional PCR; ADD Gly460Trp polymorphism was investigated using PCR amplification of genomic DNA. RESULTS There were significant differences between the control group and pediatric hypertensive group in terms of ACE I/D (P<0.05) and AGT M235T (P<0.05) polymorphisms, but there were no differences in ADD Gly460Trp (P>0.05) polymorphism. CONCLUSIONS We suggest that RAS gene polymorphisms (ACE-I/D, AGT M235T) are significantly associated with susceptibility to diseases that lead to secondary hypertension.
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Affiliation(s)
- İbrahim Kaplan
- Department of Medical Biochemistry, Dicle University, Diyarbakir, Turkey
| | - Enver Sancaktar
- Department of Medical Biochemistry, Cumhuriyet University, Sivas, Turkey
| | - Aydın Ece
- Department of Pediatry, Dicle University, Diyarbakır, Turkey
| | - Velat Şen
- Department of Pediatry, Dicle University, Diyarbakır, Turkey
| | - Nilgün Tekkeşin
- Central Biochemistry Laboratory, Memorial Hospital Şişli, İstanbul, Turkey
| | | | - Selvi Kelekci
- Department of Pediatry, Dicle University, Diyarbakır, Turkey
| | - Osman Evliyaoglu
- Department of Medical Biochemistry, Dicle University, Diyarbakır, Turkey
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Şen V, Uluca Ü, Ece A, Güneş A, Zeytun H, Arslan S, Kaplan İ, Türkçü G, Tekin R. Role of Ankaferd on bacterial translocation and inflammatory response in an experimental rat model of intestinal obstruction. Int J Clin Exp Med 2014; 7:2677-2686. [PMID: 25356125 PMCID: PMC4211775] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 08/04/2014] [Indexed: 06/04/2023]
Abstract
Intestinal obstruction (IO) is an important risk factor for the development of bacteria translocation (BT), a serious condition associated with sepsis and potential mortality. Ankaferd is an herbal extract that is reported to exert anti-hemorrhagic, anti-oxidant, anti-microbial, and anti-inflammatory, effects in the intestine. In this study, we employed an animal model of intestinal obstruction to evaluate the effects of Ankaferd in the prevention of bacterial translocation and the suppression of the inflammatory response. Thirty male Wistar Albino rats were allocated randomly to three groups: Group 1 (sham) underwent ileal manipulation alone; Group 2 (intestinal obstruction, IO) underwent complete ileal ligation; Group 3 (intestinal obstruction + Ankaferd blood stopper, ABS) underwent complete ileal ligation and intraperitoneal Ankaferd injection. All rats were euthanized after 24 hours. Blood samples were collected for the measurement of serum oxidative stress parameters and cytokine expression. In addition, liver, mesenteric lymph node (MLN), spleen, and ileal specimens were obtained for microbiological culture to determine the rate of bacterial translocation. Liver and ileal tissues were collected for histopathological examination. A reduction in oxidative damage, inflammatory cytokine expression and bacterial translocation was observed in the ABS treatment group relative to the IO group (p<0.05). Furthermore, histopathological examination demonstrated a reduction in obstruction-induced mucosal injury in Ankaferd-treated rats. Data derived from this study provided the first evidence that Ankaferd treatment limits bacterial translocation and enhances intestinal barrier function in mice undergoing intestinal obstruction. Ankaferd may be useful in the prevention of BT associated with IO.
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Affiliation(s)
- Velat Şen
- Department of Pediatrics, Dicle University Medical SchoolDiyarbakir, Turkey
| | - Ünal Uluca
- Department of Pediatrics, Dicle University Medical SchoolDiyarbakir, Turkey
| | - Aydın Ece
- Department of Pediatrics, Dicle University Medical SchoolDiyarbakir, Turkey
| | - Ali Güneş
- Department of Pediatrics, Dicle University Medical SchoolDiyarbakir, Turkey
| | - Hikmet Zeytun
- Department of Pediatric Surgery, Dicle University Medical SchoolDiyarbakir, Turkey
| | - Serkan Arslan
- Department of Pediatric Surgery, Dicle University Medical SchoolDiyarbakir, Turkey
| | - İbrahim Kaplan
- Department of Biochemistry, Dicle University Medical SchoolDiyarbakir, Turkey
| | - Gül Türkçü
- Department of Pathology, Dicle University Medical SchoolDiyarbakir, Turkey
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Medical SchoolDiyarbakir, Turkey
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Uluca Ü, Ece A, Şen V, Karabel D, Yel S, Güneş A, Tan I, Sabas M. Usefulness of mean platelet volume and neutrophil-to-lymphocyte ratio for evaluation of children with Familial Mediterranean fever. Med Sci Monit 2014; 20:1578-82. [PMID: 25189760 PMCID: PMC4165509 DOI: 10.12659/msm.892139] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent attacks of serositis, fever, and rash. Clinical and subclinical inflammatory processes may contribute to atherosclerosis in FMF patients, with mean platelet volume (MPV) as a potential indicator for atherosclerosis risk and neutrophil-to-lymphocyte ratio (NLR) as a marker for subclinical inflammation in these patients. In this study, we investigated whether MPV can be used as an indicator for atherosclerosis risk and if NLR is a marker for subclinical inflammation in FMF patients. Material/Methods The study consisted of 75 FMF patients in attack, 157 attack-free patients, and 77 healthy controls. White blood cell count neutrophil-to-lymphocyte ratio, platelet count, MPV, PDW C-reactive protein levels, and erythrocyte sedimentation rate were recorded. Results There were no significant differences between attack, attack-free, and control groups in terms of mean MPV and PDW value. NLR value was higher in the attack group. NLR value was similar in attack-free and control groups. Conclusions We found that MPV and PDW values are similar in FMF patients and healthy controls. NLR was higher in FMF patients in the attack period. Therefore, our results suggest that MPV and PDW values do not predict atherosclerosis risk in pediatric FMF patients, and NLR may be an indicator for attack period but not attack-free period.
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Affiliation(s)
- Ünal Uluca
- Department of Pediatrics, Dicle University, Medical School, Diyarbakır, Turkey
| | - Aydın Ece
- Department of Pediatric Rheumatology, Dicle University, Medical School, Diyarbakır, Turkey
| | - Velat Şen
- Department of Pediatrics, Dicle University, Medical School, Diyarbakır, Turkey
| | - Duran Karabel
- Department of Pediatrics, Dicle University, Medical School, Diyarbakır, Turkey
| | - Servet Yel
- Department of Pediatrics, Dicle University, Medical School, Diyarbakır, Turkey
| | - Ali Güneş
- Department of Pediatrics, Dicle University, Medical School, Diyarbakır, Turkey
| | - Ilhan Tan
- Department of Pediatrics, Dicle University, Medical School, Diyarbakır, Turkey
| | - Muhammed Sabas
- Department of Pediatrics, Dicle University, Medical School, Diyarbakır, Turkey
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Tuncel T, Şen V, Kelekçi S, Karabel M, Şahin C, Uluca Ü, Karabel D, Haspolat YK. Use of complementary and alternative medicine in children who have no chronic disease. Turk Arch Pediatr 2014; 49:148-53. [PMID: 26078651 DOI: 10.5152/tpa.2014.1498] [Citation(s) in RCA: 15] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 01/24/2014] [Indexed: 11/22/2022]
Abstract
AIM In this study, we aimed to evaluate complementary and alternative methods of medicine, determine the frequencies of usage of these methods and investigate the factors which have an impact on their usage. MATERIAL AND METHODS The study was conducted between October, the 15(th) and November, the 15(th) 2012. Approval was obtained from the local ethics committee (08.10.2012/732). The study form prepared was applied to the mothers of the children who presented to our general outpatient clinic and had no chronic disease. The data were recorded in SPSS for Windows v.16 program. Descriptive statistics, chi-square, Mann-Whitney U and logistic regression analyses were applied. A p value of <0.05 was considered significant. RESULTS Two hundred and six children were included in the study. Complementary and alternative medicine was used in 83% of the patients. Wearing an evil eye (45%) bead and prayer (35%) to protect from the evil eye were the most commonly used methods. The most common medical conditions which caused to use of complementary and alternative medicine included anemia, diarrhea, constipation and cough. Belief-based application were being used in 73% of the patients and herbal methods were being used in 57%. In 18% of the patients, interventional methods including cutting had been performed. No difference was found between the patients in whom these methods were used and not used in terms of familial income, education levels of the parents, family type and residence (p>0.05). CONCLUSIONS Complementary and alternative methods of medicine are applied substantially frequently in children. Physicians should have information about these methods in terms of their effects and side effects and warn families and especially mothers about potential risks.
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Affiliation(s)
- Tuba Tuncel
- Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Velat Şen
- Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Selvi Kelekçi
- Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Müsemma Karabel
- Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Cahit Şahin
- Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Ünal Uluca
- Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Duran Karabel
- Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Yusuf Kenan Haspolat
- Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakır, Turkey
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Şen V, Bozkurt M, Söker S, Ece A, Güneş A, Uluca Ü, Söker M, Yel S, Kaplan İ. The Effects of Pomegranate and Carvacrol on Methotrexate-Induced Bone Marrow Toxicity in Rats. ACTA ACUST UNITED AC 2014; 37:E93-E101. [DOI: 10.25011/cim.v37i2.21091] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Indexed: 11/03/2022]
Abstract
Purpose: The aim of this study was to evaluate the effects of pomegranate (PMG) extract and carvacrol (CARV) on methotrexate (MTX)-induced oxidative stress and bone marrow toxicity.
Methods: Wistar albino rats (32 rats) were divided into four groups (n=8): Group 1 was control; Group 2 was given a single intraperitoneal injection of methotrexate (20 mg/kg); Group 3 was treated with carvacrol (73 mg/kg i.p.) one day before MTX (20 mg/kg i.p.) injection; and, Group 4 received a single dose of MTX (20 mg/kg i.p) while PMG was administered orally for seven days at 225 mg/kg. After animals were euthanized, blood samples were taken to evaluate hematological parameters and oxidative stress. In addition, the femur was cropped and bone marrow was extracted for examination.
Results: White blood cell count, hemoglobin, hematocrit and platelet count were found to be decreased in the MTX group, but these changes were prevented in the groups that received CARV and PMG. Furthermore, decreased bone marrow cellularity was found in the groups treated with MTX, whereas the PMG and CARV groups had cellularity similar to controls. Strikingly, oxidative stress increased in the MTX group, but was ultimately decreased in the rats that received the antioxidants PMG and CARV.
Conclusion: Carvacrol and PMG were found to be protective against methotrexate-induced oxidative bone marrow damage. Use of these antioxidants, in combination with chemotherapeutics, may help to reduce some adverse effects of methotrexate.
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Yolbaş İ, Şen V, Boşnak M, Yel S, Güneş A, Kelekçi S. The relationship between blood lactate levels and mortality in pediatric intensive care patients. J Clin Exp Invest 2013. [DOI: 10.5799/ahinjs.01.2013.03.0282] [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: 11/23/2022] Open
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Yolbaş İ, Tekin R, Güneş A, Kelekçi S, Şen V, Tan İ, Uluca Ü. Antibiotic susceptibility of Acinetobacter baumannii strains in a university hospital. J Clin Exp Invest 2013. [DOI: 10.5799/ahinjs.01.2013.03.0292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Karabel M, Karabel D, Okur MH, Tan İ, Kelekçi S, Şen V, Uluca Ü. The evaluation of cases with pneumothorax in the neonatal intensive care unit. J Clin Exp Invest 2013. [DOI: 10.5799/ahinjs.01.2013.03.0286] [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: 11/23/2022] Open
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Karabel M, Kelekçi S, Tuncel T, Şen V, Karabel D, Uluca Ü, Tan İ, Gürkan MF. Evaluation of risk factors in wheezy infants. J Clin Exp Invest 2013. [DOI: 10.5799/ahinjs.01.2013.03.0299] [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: 11/23/2022] Open
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Ece A, Şen V, Yel S, Güneş A, Uluca Ü, Tan İ, Karabel D, Yıldırım B, Şahin C. Clinical and Laboratory Characteristics and Follow Up Results of 121 Children with Juvenile Idiopathic Arthritis. Electron J Gen Med 2013. [DOI: 10.29333/ejgm/82241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ece A, Çakmak E, Kelekçi S, Yolbaş İ, Güneş A, Şen V. Comparison of acute phase response during attack and attack-free period in children with Familial Mediterranean Fever. J Clin Exp Invest 2013. [DOI: 10.5799/ahinjs.01.2013.02.0268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Ece A, Şen V, Yavuz S, Güneş A, Uluca Ü, Şahin C. A Rare Vasculitis of Childhood, Takayasu Arteritis. Electron J Gen Med 2013. [DOI: 10.29333/ejgm/82349] [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: 11/21/2022]
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Güneş A, Ece A, Yel S, Yolbaş İ, Uluca Ü, Tan İ, Şen V. Çocuklarda akut glomerülonefrit: Üçüncü basamak sağlık merkezinde yedi yıllık deneyim [Acute glomerulonephritis in children: A seven-year experience in a tertiary health center]. J Clin Exp Invest 2012. [DOI: 10.5799/ahinjs.01.2012.03.0178] [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: 11/23/2022] Open
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Ece A, Boşnak M, Kelekçi S, Yel S, Koçyiğit Y, Şen V. Oxidative Stress in Marasmic Children:
Relationships with Leptin. Electron J Gen Med 2010. [DOI: 10.29333/ejgm/82786] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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