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İnce G, Üzüm Ö, Eliaçik K, Kanık A, Emir B, Helvacı M. Mental and Psychosomatic Effects of the Coronavirus Disease 2019 Pandemic on Adolescents: A Validation Study. Turk Arch Pediatr 2024; 59:60-69. [PMID: 38454262 PMCID: PMC10837611 DOI: 10.5152/turkarchpediatr.2024.23110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 09/27/2023] [Indexed: 03/09/2024]
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic has had detrimental impacts on both physical and mental health worldwide. In addition to the behavioral effects, it has caused a range of psychological problems such as depression, anxiety, sleep disorders, and anger. Fear and stress have been particularly prevalent in individuals. This study aims to assess the psychometric properties of the Scale for the Evaluation of Mental and Psychosomatic Effects of the COVID-19 Pandemic (COVID-19 PRPEDS) on adolescents and explore the pandemic's psychosomatic effects. MATERIALS AND METHODS A total of 503 adolescents between the ages of 14 and 18 years who continue their high school education constituted the study population. The COVID-19 PRPEDS comprising 18 items and 2 subscales (Mental Effects, Psychosomatic Effects), was used in adolescents. The forms were delivered to the students via the Internet, and in addition to the scale, the age and sex of the adolescents were recorded. RESULTS A majority of the participants (96.6%, n = 486) had knowledge about COVID-19, 93.8% (n = 472) could differentiate COVID-19 from other diseases, 96.6% (n = 486) were able to explain the transmission ways of COVID-19 and 96% (n = 483) took the necessary precautions to protect themselves from COVID-19. The COVID-19 PRPEDS scores of males were higher than females. The study validation index was above 0.9, which is considered to be acceptable for adolescents. CONCLUSIONS Like in the other pandemics, adolescents experienced serious mental health problems during the COVID-19 pandemic. In addition to its psychosomatic effects, the mental issues related to the pandemic were more common in male adolescents. Cite this article as: İnce G, Üzüm Ö, Eliaçik K, Kanık A, Emir B, Helvacı M. Mental and psychosomatic effects of the coronavirus disease 2019 pandemic on adolescents: A validation study. Turk Arch Pediatr. 2024;59(1):60-69.
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Affiliation(s)
- Gülberat İnce
- Department of Pediatric Diseases, University of Health Sciences, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Özlem Üzüm
- Department of Pediatric Diseases, University of Health Sciences, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Kayı Eliaçik
- Department of Pediatric Diseases, University of Health Sciences, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Ali Kanık
- Department of Pediatric Diseases, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Turkey
| | - Büşra Emir
- Department of Biostatistics, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Turkey
| | - Mehmet Helvacı
- Department of Pediatric Diseases, University of Health Sciences, Tepecik Training and Research Hospital, İzmir, Turkey
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Toprak Kanık E, Yılmaz Ö, Kanık A, Özdoğru EE, Şimşek Y, Alper HH, Yüksel H. Comparative Evaluation of Clinical, Spiro/Oscillometric and Tomographic Parameters as a Global Assessment of Children with Cystic Fibrosis. jpr 2023. [DOI: 10.4274/jpr.galenos.2022.09582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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Muacevic A, Adler JR, Eliaçık K, Kanık A, Elmalı F, Helvacı M. Investigating the Potential Connection Between Cyberchondria and Vaccine Hesitancy in High School Students. Cureus 2023; 15:e34218. [PMID: 36852372 PMCID: PMC9958305 DOI: 10.7759/cureus.34218] [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: 01/25/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Internet use, which provides the opportunity to access information from anywhere, and anytime, is increasing among adolescents and young adults. In studies examining the effect of technology use in adults, it has been observed that there is a relationship between cyberchondria and vaccine hesitancy. This study aimed to uncover the potential relationship between cyberchondria and vaccine hesitancy in adolescents and to obtain data for combating anti-vaccination in this age group. MATERIALS AND METHODS A total of 2.353 high school students were enrolled within the scope of this research. The forms were delivered to the students online and 531 volunteers participated in the survey. The Cyberchondria Severity Scale and Vaccine Hesitancy Scale were used to evaluate the details of the relationship between cyberchondria and vaccine hesitancy levels in adolescents. RESULTS The compulsion subscales of the Cyberchondria Severity Scale in males and vaccine repugnance subscales of the Vaccine Hesitancy Scale in females were statistically significantly higher. Cyberchondria and vaccine hesitancy have a strong relationship with each other except benefits and protective value of vaccines subscale of vaccine hesitancy. CONCLUSION Health policymakers should be aware of this relationship and there is a need to develop novel online intervention programs for combating anti-vaccination, particularly among cyberchondriac adolescents who have relatively high vaccination hesitancy, particularly during the pandemic.
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Şahin A, Kara-Aksay A, Aşcı B, Ekemen-Keleş Y, Üstundağ G, Elvan-Tüz A, Taşar S, Arslan-Maden A, İnce G, Kanık A, Karadağ-Öncel E, Elmalı F, Yılmaz D. Response to `Attitudes of parents with children aged 12-18 to COVID-19 vaccines for themselves and their children: vaccine hesitancy in Türkiye`. Turk J Pediatr 2023; 65:1035-1036. [PMID: 38204319 DOI: 10.24953/turkjped.2023.795] [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] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Affiliation(s)
- Aslıhan Şahin
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Ahu Kara-Aksay
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Bahri Aşcı
- Department of Pediatrics, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Yıldız Ekemen-Keleş
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Gülnihan Üstundağ
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Ayşegül Elvan-Tüz
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Selin Taşar
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Aslıhan Arslan-Maden
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Gülberat İnce
- Department of Pediatrics, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | | | - Eda Karadağ-Öncel
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Ferhan Elmalı
- Department of Biostatistics, Izmir Katip Celebi University Faculty of Medicine, İzmir
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Şahin A, Aksay AK, Aşcı B, Keleş YE, Üstündağ G, Tüz AE, Taşar S, Maden AA, İnce G, Kanık A, Öncel EK, Elmalı F, Yılmaz D. Attitudes of parents with children aged 12-18 to COVID-19 vaccines for themselves and their children. Turk J Pediatr 2023; 65:194-204. [PMID: 37114685 DOI: 10.24953/turkjped.2022.762] [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 The incidence of vaccine hesitancy is increasing in many countries. This study aims to determine parents` attitudes and related factors regarding COVID-19 vaccine acceptance for themselves and their children aged 12-18. METHODS A cross-sectional survey was conducted on parents between 16th November and 31st December 2021, after COVID-19 vaccines were initiated for children in Türkiye. In the survey, the sociodemographic characteristics of the parents, whether they and their children were vaccinated against COVID-19, and if not, the reasons for this were asked. Multivariate binary logistic regression analysis was used to evaluate the factors affecting parents` refusal to vaccinate their children for COVID-19. RESULTS Three hundred and ninety-six mothers and fathers were included in the final analysis. Overall, 41.7% of parents reported vaccine refusal for their children. COVID-19 vaccine refusal was higher in mothers younger than 35 (β = 6.5, p = 0.002, 95% CI: 2.0-23.1), children aged 15 and younger (β = 2.3, p = 0.001, 95% CI: 1.4-3.7). Concerns about the side effects of the COVID-19 vaccine (29.7%) and their children not wanting to be vaccinated (29.0%) were the most common causes of COVID-19 vaccine refusal. CONCLUSIONS In the present study, the rate of children not vaccinated due to COVID-19 vaccine refusal was relatively high. Parents` concerns about vaccine side effects, as well as their children`s unwillingness to be vaccinated, suggest that both parents and adolescents should be informed about the importance of COVID-19 vaccines.
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Affiliation(s)
- Aslıhan Şahin
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Ahu Kara Aksay
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Bahri Aşcı
- Department of Pediatrics, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Yıldız Ekemen Keleş
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Gülnihan Üstündağ
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Ayşegül Elvan Tüz
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Selin Taşar
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Aslıhan Arslan Maden
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Gülberat İnce
- Department of Pediatrics, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | | | - Eda Karadağ Öncel
- Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, İzmir
| | - Ferhan Elmalı
- Department of Biostatistics, İzmir Katip Celebi University Faculty of Medicine, İzmir
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Eyduran E, Kaymaz B, Ince G, Kanık A. A rare cause of hypernatremia in an adolescent girl: Questions. Pediatr Nephrol 2022; 37:2331-2332. [PMID: 35288794 DOI: 10.1007/s00467-022-05490-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Eda Eyduran
- Department of Pediatrics, Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey.
| | - Berkay Kaymaz
- Department of Pediatrics, Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Gülberat Ince
- Department of Pediatrics, Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ali Kanık
- Department of Pediatrics, Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey.,Department of Pediatrics, Izmir Katip Çelebi University, Izmir, Turkey
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Eyduran E, Kaymaz B, Ince G, Kanık A. A rare cause of hypernatremia in an adolescent girl: Answers. Pediatr Nephrol 2022; 37:2333-2335. [PMID: 35288795 DOI: 10.1007/s00467-022-05509-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Eda Eyduran
- Department of Pediatrics, Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey.
| | - Berkay Kaymaz
- Department of Pediatrics, Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Gülberat Ince
- Department of Pediatrics, Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ali Kanık
- Department of Pediatrics, Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey.,Department of Pediatrics, Izmir Katip Çelebi University, Izmir, Turkey
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Erinç ZÖ, Eliaçık K, Ince G, Kılıç Öztürk Y, Elmalı F, Emir B, Kanık A, Helvacı M. Understanding Vaccine Hesitancy: Social Isolation in Relation to Social Media Addiction and COVID-19 Anxiety. Cureus 2022; 14:e29705. [PMID: 36320979 PMCID: PMC9616316 DOI: 10.7759/cureus.29705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Despite significant advancements in immunization over the last century, vaccine hesitancy is a major threat to world health. Health-related information available from a variety of sources, including new media such as social media platforms, can encourage vaccine hesitancy. The aim of this study is to determine the level of vaccine hesitation among adults, specifically their belief in the advantages of vaccination and their perceptions of vaccine-related dangers in relation to social media addiction and coronavirus disease 2019 (COVID-19) anxiety. Materials and methods: Between December 2021 and January 2022, 454 adults participated in an online cross-sectional survey consisting of the social media use disorder scale, the vaccine hesitancy scale, and the coronavirus anxiety scale. Results: The results of the study revealed a strong correlation between social media addiction, vaccine hesitation, and COVID-19 anxiety. Conclusion: Given the potential for misinformation to spread through social media, especially in a situation like a pandemic, the conscious use of social media should be emphasized and anti-addiction measures are required. Novel programs including online interventions should be developed to promote vaccination among social media addicts who have relatively high vaccination hesitancy.
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Kanık A, Eliaçık K, Kanık ET, Demirçelik Y, Demir BK. A comparative study for the clinical features in children with PFAPA syndrome who were diagnosed before and after the age of five. Int J Pediatr Otorhinolaryngol 2022; 158:111153. [PMID: 35500396 DOI: 10.1016/j.ijporl.2022.111153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/16/2022] [Accepted: 04/20/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Ali Kanık
- İzmir Katip Çelebi University, Faculty of Medicine, Department of Pediatrics, İzmir, Turkey.
| | - Kayı Eliaçık
- Tepecik Education and Training Hospital, Department of Pediatrics, İzmir, Turkey
| | - Esra Toprak Kanık
- Dr. Behcet Uz Children's Hospital, Department of Pediatric Allergy and Immunology, İzmir, Turkey
| | - Yavuz Demirçelik
- Tepecik Education and Training Hospital, Department of Pediatrics, İzmir, Turkey
| | - Belde Kasap Demir
- İzmir Katip Çelebi University, Faculty of Medicine, Department of Pediatric Rheumatology, İzmir, Turkey
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10
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Üzüm Ö, Karadağ Öncel E, Demirçelik Y, Örsdemir Hortu H, Kanık A, Eliaçık K, Yılmaz Çiftdoğan D, Helvacı M. Characteristics and Results of Hospital Admission Caused by Influenza Virus Infections in Children under 5 Years Old. J Trop Pediatr 2022; 68:6617964. [PMID: 35751686 DOI: 10.1093/tropej/fmac049] [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] [Indexed: 11/12/2022]
Abstract
AIMS The influenza virus is an infectious disease with acute respiratory tract infections, caused secondary bacterial infections and death. In this study, we aimed to determine which predictors were associated with the need for high-flow nasal cannula oxygen therapy (HFNC) and transition to intensive care for influenza virus and also to compare single viral pathogens with multiple ones. METHODS Inpatients under the age of 5 with influenza virus-related respiratory tract infections between November 2015 and March 2019 were included in the study. Demographic features, comorbidities, symptoms, secondary bacterial infection, need for HFNC and pediatric intensive care unit and respiratory support system, length of hospital stay, polymerase chain reaction tests were recorded. RESULTS A total of 93 patients were included in the study. It was determined that 53.8% of the cases were male and 84.9% were under the age of 2. Comorbidities were present in 50.5% of the cases. Secondary bacterial pneumonia developed in 56.9% of the cases. Patients with secondary bacterial pneumonia had higher PICU need, HFNC need and hospital stay (p = 0.014, p ≤ 0.001 and p ≤ 0.001, respectively). Patients with comorbidity had longer hospital stays and a higher need for HFNC (p ≤ 0.001 and p = 0.001, respectively). CONCLUSIONS In this study, it was determined that especially comorbidity and secondary bacterial infection aggravated the clinical treatment of hospitalized patients. Therefore, it was concluded that patients with comorbidity should be followed closely and secondary bacterial pneumonia should be recognized and treated early.
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Affiliation(s)
- Özlem Üzüm
- Department of Pediatric Diseases, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Eda Karadağ Öncel
- Department of Pediatric Infectious Diseases, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Yavuz Demirçelik
- Department of Pediatric Diseases, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Hacer Örsdemir Hortu
- Department of Pediatric Diseases, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Ali Kanık
- Department of Pediatric Diseases, Faculty of Medicine, Katip Çelebi University, Izmir, Turkey
| | - Kayı Eliaçık
- Department of Pediatric Diseases, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Dilek Yılmaz Çiftdoğan
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Katip Çelebi University, Izmir, Turkey
| | - Mehmet Helvacı
- Department of Pediatric Diseases, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
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Demir BK, Kanık A, Köse M, Hişmi BÖ, Baran M. A surprising cause of proteinuria: Answers. Pediatr Nephrol 2022; 37:1033-1039. [PMID: 34999986 DOI: 10.1007/s00467-021-05363-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Belde Kasap Demir
- Department of Pediatrics, Division of Nephrology and Rheumatology, İzmir Katip Çelebi University, İzmir, Turkey. .,Department of Pediatrics, Health Sciences University, Tepecik Training and Research Hospital, İzmir, Turkey.
| | - Ali Kanık
- Department of Pediatrics, Health Sciences University, Tepecik Training and Research Hospital, İzmir, Turkey.,Department of Pediatrics, İzmir Katip Çelebi University, İzmir, Turkey
| | - Melis Köse
- Department of Pediatrics, Health Sciences University, Tepecik Training and Research Hospital, İzmir, Turkey.,Department of Pediatric Metabolism, İzmir Katip Çelebi University, İzmir, Turkey
| | - Burcu Öztürk Hişmi
- Department of Pediatric Metabolism, Marmara University, İstanbul, Turkey
| | - Maşallah Baran
- Department of Pediatrics, Health Sciences University, Tepecik Training and Research Hospital, İzmir, Turkey.,Department of Pediatrics, Division of Pediatric Gastroenterology, İzmir Katip Çelebi University, İzmir, Turkey
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Sancaklı Ö, Tuncel T, Eren Akarcan S, Kanık A, Özyurt G. Evaluation of the Impact of Environmental Changes on Asthma Control in Children, Access to Health Care, and Treatment Adherence in Early COVID-19 Lockdown. Turk Arch Pediatr 2022; 57:228-234. [PMID: 35383020 PMCID: PMC9366234 DOI: 10.5152/turkarchpediatr.2022.21309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: During the coronavirus disease 2019 pandemic, lockdown measures and difficulties in accessing healthcare have impacted asthma management in children. This study aimed to determine the evaluation of the impact of environmental changes on asthma control in children, access to health care, and treatment adherence in early coronavirus disease 2019 lockdown. Materials and Methods: The study included children with asthma aged 6-11 years. A survey form was administered to the patients who visited the pediatric allergy outpatient clinic between June 1 and 30, 2020. The survey acquired demographic information about the children and their families as well as information about their asthma symptoms, how they reached healthcare services, and adherence. The childhood asthma control test was administered. The P values <.05 were considered significant. Results: The study included a total of 123 children (female/male : 48/75) with a mean age of 8.4 ± 1.9 years. According to the mothers’ self-report, it was found that 78% of the patients were not able to follow-up routinely, 19.5% were non-adherence to treatment, and 16.2% were poorly controlled asthma. It was found that, based on childhood asthma control test scores, asthma control was better during the pandemic lockdown period (P = .001). Asthma symptoms were better in 41.5% of the patients compared to the previous months and in 53.7% compared to the same period last year. Conclusion: Our study found that the children’s asthma was controlled although most of them did not have their follow-up visits, and poorly controlled asthma was higher in older children in early coronavirus disease 2019 lockdown.
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Affiliation(s)
- Özlem Sancaklı
- Department of Pediatric Allergy and Immunology, Baskent University, İzmir, Turkey
- Corresponding author:Özlem Sancaklı✉
| | - Tuba Tuncel
- Department of Pediatric Allergy and Immunology, İzmir Katip Celebi University, Faculty of Medicine, İzmir, Turkey
- Department of Pediatric Allergy and Immunology, İzmir Health Sciences University, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Sanem Eren Akarcan
- Department of Pediatric Allergy and Immunology, İzmir Health Sciences University, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Ali Kanık
- Department of Pediatrics, İzmir Katip Celebi University, Faculty of Medicine, İzmir, Turkey
- Department of Pediatrics, İzmir Health Sciences University, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Gonca Özyurt
- Department of Child and Adolescent Psychiatry, İzmir Katip Celebi University, Faculty of Medicine, İzmir, Turkey
- Department of Child and Adolescent Psychiatry, İzmir Health Sciences University, Tepecik Training and Research Hospital, İzmir, Turkey
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Sancakli O, Tuncel T, Eren Akarcan S, Kanık A, Özyurt G, Ozdogru EE. Anxiety Levels and Changes in Health and Hygiene Behaviors in Mothers of Children with Asthma in Early COVID-19 Lockdown in Turkey. Pediatr Allergy Immunol Pulmonol 2022; 35:27-35. [PMID: 35290751 DOI: 10.1089/ped.2021.0113] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: The restrictions imposed by the coronavirus disease 2019 (COVID-19) pandemic have caused significant changes in people's lives. This study aimed to investigate anxiety levels and changes in health and hygiene behaviors in mothers of children with asthma in early COVID-19 lockdown in Turkey. Materials and Methods: This study was a cross-sectional survey conducted on children with asthma, 6 to 11 years of age, between June 1 and 30, 2020, in Turkey. A sociodemographic data form, health and hygiene behavior form, childhood asthma control test, and state-trait anxiety inventory were administered to the mothers of the children. Results: The asthma group included 123 children (Female: 39.0%) and median age, interquartile range (IQR) [minimum-maximum]: 8.0 (6) [6-12] years; the control group included 88 children (Female: 47.7%) median age, IQR [minimum-maximum]: 8.0 (7) [5-12] years. Increased hygiene behaviors and high compliance with social isolation measures were recorded in the early lockdown, with no difference between the groups. Before the pandemic, the most frequently used cleaning products were general-purpose cleaners. During the early lockdown, however, the most frequently used product was disinfectants and was similar in both groups. In both groups, the rate of using nutritional supplements increased during the pandemic period, but the rate was higher in children with asthma both before and during the early lockdown (P < 0.001). The anxiety levels of the mothers in asthma and control groups were similar. Conclusion: This study is the first in Turkey demonstrating that, in mothers of children with asthma, lifestyle changes related to health and hygiene and anxiety levels are similar to those of other children and their mothers during the early lockdown period of COVID-19 pandemic.
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Affiliation(s)
- Ozlem Sancakli
- Department of Pediatric Allergy Immunology, Başkent University, Izmir, Turkey
| | - Tuba Tuncel
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Izmir University of Health Sciences Izmir Tepecik Training and Research Hospital, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Sanem Eren Akarcan
- Department of Pediatric Allergy and Immunology, Izmir University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ali Kanık
- Department of Pediatrics, Izmir University of Health Sciences Izmir Tepecik Training and Research Hospital, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Gonca Özyurt
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Emine Ece Ozdogru
- Department of Pediatric Allergy and Immunology, Izmir University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
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Toprak Kanık E, Yilmaz O, Ozdogru E, Alper H, Ulman C, Kanık A, Simsek Y, Yuksel H. Relevance between clinical status and exhaled molecules related to neutrophilic inflammation in pediatric cystic fibrosis. J Breath Res 2020; 14:046007. [PMID: 31896101 DOI: 10.1088/1752-7163/ab670d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Cystic fibrosis (CF) is characterized with chronic inflammation with neutrophil and related cytokines in airway secretions. We aimed to measure the levels of neutrophil related inflammatory markers as nitric oxide, IL-8, IL-17, leukotriene B4 and neutrophil elastase as well as e-cadherin in exhaled breath condensate (EBC), and to determine their relation with clinical findings. METHODS We consecutively enrolled cystic fibrosis patients into our clinics between the age of six and eighteen years who could cooperate for exhaled breath condensate to this case-control study (n = 30). The age and sex matched control group (n = 26) was enrolled. Spirometry was performed during the stable period and EBC samples were obtained for measurement of the markers. RESULTS The mean age of the subjects enrolled was 12.1(4.2) years and 40% were positive for P.Aeruginosa in sputum. Subjects who had P.Aeruginosa in sputum cultures had significantly lower FEV1, FVC and FEF 25/75 values compared to the ones without P.Aeruginosa (p = 0.002, p = 0.002 and p = 0.005 respectively). EBC neutrophil elastase levels were significantly higher in the CF patients compared to non-CF controls (3.11 ± 4.71 versus 0.90 ± 2.68, p = 0.04). Nitric oxide, IL-17, IL-8, e-cadherin, neutrophil elastase or leukotriene B4 levels in EBC of CF patients were not related to P.Aeruginosa s infection, FEV1 levels or hospital admission in the last year. CONCLUSION In our study, neutrophil elastase levels in EBC are higher in CF patients compared to non-CF controls. This is independent of acute infection and is evidence to the persistence of neutrophilic lung injury. However, EBC NO, IL-8, IL-17, e-cadherin, neutrophil elastase and leukotriene B4 levels as inflammatory markers, are not correlated with disease progression or clinical findings.
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Affiliation(s)
- E Toprak Kanık
- Celal Bayar University Medical Faculty, Pediatric Allergy and Pulmonology, Manisa, Turkey
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Demircan E, Kasap-Demir B, Şahin H, Bayram A, Kanık A. Pantoea agglomerans as a Cause of Foreign Body Related Septic Arthritis in a Child: Case Report and Review of the Literature. J PEDIAT INF DIS-GER 2020. [DOI: 10.1055/s-0040-1709701] [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: 10/24/2022]
Abstract
AbstractA previously healthy 7-year-old female patient was admitted with pain and swelling in her left knee and fever. She had injured her left knee 2 weeks ago. Her mother had noticed a protrusion on her knee that she had thought to be associated with a fracture. After being examined by an orthopaedist, fracture was ruled out and the protrusion disappeared. On her admission with fever and painful swollen knee, Pantoea agglomerans was identified in the synovial fluid. On the basis of the close association of P. agglomerans infections with penetrating trauma, the patient and her mother were asked about a history of penetration during the fall, but they denied any possible penetration of a vegetative element since she had fallen on a concrete floor. Although she was treated with antibiotics reported to be sensitive in the antibiogram, she had recurrent septic arthritis. Repeated magnetic resonance imaging (MRI) interpretations revealed a foreign body in the medial aspect of the left knee. The patient underwent arthrotomy and a plant thorn was removed. The postoperative course was uneventful. We reported this case to emphasize that a vegetative foreign body should be kept in mind in septic arthritis caused by P. agglomerans and/or in those resistant to antibiotics. In addition, we reviewed the literature including children having joint and/or bone infections caused by P. agglomerans.
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Affiliation(s)
- Eda Demircan
- Department of Pediatrics, Health Sciences University İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Belde Kasap-Demir
- Department of Pediatrics, Health Sciences University İzmir Tepecik Training and Research Hospital, İzmir, Turkey
- Division of Pediatric Nephrology and Rheumatology, Department of Pediatrics, İzmir Katip Çelebi University, İzmir, Turkey
| | - Hilal Şahin
- Department of Radiology, Health Sciences University İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Arzu Bayram
- Medical Microbiology Laboratory, Health Sciences University İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Ali Kanık
- Department of Pediatrics, İzmir Katip Çelebi University, İzmir, Turkey
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Çavdar S, Sümer EÇ, Eliaçık K, Arslan A, Koyun B, Korkmaz N, Kanık A, Erginöz E, Ercan O, Alikaşifoğlu M. Health behaviors in high school students in İzmir, Turkey. Turk Arch Pediatr 2016; 51:22-34. [PMID: 27103861 DOI: 10.5152/turkpediatriars.2016.3389] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 11/13/2015] [Indexed: 11/22/2022]
Abstract
AIM The aim of this cross-sectional study was to determine the prevalence of the self reported health behaviors and differences in these behaviors by gender and grades in high school adolescents in İzmir, Turkey. MATERIAL AND METHODS A stratified cluster sampling procedure was used for this cross-sectional study. The study sample included 2 296 students attending 22 high schools in Izmir. As a data collection instrument, some questions from the Health Behavior in School-aged Children Study 2009/2010 questionnnaire and questions which were developed by the researchers to understand behaviors of internet use in adolescents were used. Chi-square tests and Cramer's V statistics were used for statistical analyses. RESULTS Among the high school students, 33.8% experimented smoking, 26.3% smoked cigarette during the 30 days before the survey, 14.9% smoked cigarette regularly during the 30 days before the survey, 54.1% experimented drinking alcohol, 38.4% drunk alcohol during the 30 days before the survey, 31.6% got drunk, 10.9% were adequately physically active, 59.9% watched TV for a long period of time, 72.8% used internet for a long period of time, 48.1% ate breakfast regularly, 36.2% ate adequate amount of fruit, 14.1% ate adequate amount of vegetable, 31.3% ate candies and chocolate very often, 18% drunk soft drink very often, 30.3% were bullied, 29.9% bullied others and 41% involved in a physical fight. CONCLUSIONS These results showed that "Adolescent friendly health services" should be generalized all over Turkey, physicians should evaluate each adolescent for his/her health behaviors in each visit and implementation of prevention programs which adopt a health promotion perspective is necessary begining from the elementary school.
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Affiliation(s)
- Sabanur Çavdar
- Department of Public Health, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Esin Çetinkaya Sümer
- Department of Public Health, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Kayı Eliaçık
- Clinic of Pediatrics, İzmir Tepecik Training and Research Hospital, İstanbul, Turkey
| | - Aslıhan Arslan
- Clinic of Pediatrics, İzmir Tepecik Training and Research Hospital, İstanbul, Turkey
| | - Begüm Koyun
- Clinic of Pediatrics, İzmir Tepecik Training and Research Hospital, İstanbul, Turkey
| | - Nurhan Korkmaz
- Clinic of Pediatrics, İzmir Tepecik Training and Research Hospital, İstanbul, Turkey
| | - Ali Kanık
- Clinic of Pediatrics, İzmir Tepecik Training and Research Hospital, İstanbul, Turkey
| | - Ethem Erginöz
- Clinic of Pediatrics, İzmir Tepecik Training and Research Hospital, İstanbul, Turkey
| | - Oya Ercan
- Department of Pediatrics, Division of Adolescent Health, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Müjgan Alikaşifoğlu
- Department of Pediatrics, Division of Adolescent Health, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
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Karadaş U, Eliaçık K, Baran M, Kanık A, Özdemir N, İnce OT, Bakiler AR. The subclinical effect of celiac disease on the heart and the effect of gluten-free diet on cardiac functions. Turk J Pediatr 2016; 58:241-245. [PMID: 28266187 DOI: 10.24953/turkjped.2016.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study aimed to investigate the effects of celiac disease (CD) on cardiac function in children by using conventional transthoracic echocardiography (TTE) and tissue Doppler echocardiography (TDE). Forty-nine patients diagnosed with CD were enrolled into the study. Group 1 consisted of 26 (53%) patients who had recently been diagnosed and had not been on gluten-free diet whereas Group 2 consisted of 23 (47%) patients who had been on regular gluten-free diet for at least 10 months. 20 healthy children were enrolled into the study as the control group. The deceleration time (DT) and the left ventricle (LV) isovolumetric relaxation time (IVRT) were significantly shorter in Group 1 compared to Group 2 and the control group (p=0.002, p=0.015). Mitral valve E/E' ratio was significantly lower in Group 1 and 2 when compared to the control group (p < 0.001). The study demonstrated that evaluation of these parameters by using TDE could be beneficial in the early diagnosis of cardiac involvement in children with CD.
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Affiliation(s)
- Ulaş Karadaş
- Division of Pediatric Cardiology, İzmir Tepecik Research and Training Hospital; Izmir, Turkey
| | - Kayı Eliaçık
- Departmant of Pediatrics, İzmir Tepecik Research and Training Hospital; Izmir, Turkey
| | - Maşallah Baran
- Departmant of Pediatrics, İzmir Tepecik Research and Training Hospital; Izmir, Turkey
| | - Ali Kanık
- Departmant of Pediatrics, İzmir Tepecik Research and Training Hospital; Izmir, Turkey
| | - Nihal Özdemir
- Department of Pediatrics, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Osman Tolga İnce
- Departmant of Pediatrics, İzmir Tepecik Research and Training Hospital; Izmir, Turkey
| | - Ali Rahmi Bakiler
- Division of Pediatric Cardiology, İzmir Tepecik Research and Training Hospital; Izmir, Turkey
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Abstract
Abusive head trauma is a serious form of child abuse and mostly seen in infants below the age of two years as a result of a strong shaking by the caregiver who aims to stop the infant's crying. Characteristic symptoms include subdural hematomas, encephalopathy, retinal hemorrhages and fractures of the long bones. When physically examined, there are generally no externally visible signs. For this reason, it can be underdiagnosed, if it is not considered in the differential diagnosis. When the information provided from the parents is inconsistent and contradictory with the clinical picture of the patient, this form of abuse must be suspected and retinal hemorrhages should be searched. In this article, two patients who were admitted to our emergency department and diagnosed with physical child abuse are reported. One of these patients had a history of minor head trauma after falling down from the sofa and the other one had a history of breathlessness and loss of consciousness as a result of excessive crying.
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Affiliation(s)
- Ali Kanık
- Clinic of Pediatrics, The Ministry of Health İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Osman Tolga İnce
- Clinic of Pediatrics, The Ministry of Health İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Şehriban Yeşiloğlu
- Clinic of Pediatrics, The Ministry of Health İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Kayı Eliaçık
- Clinic of Pediatrics, The Ministry of Health İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Ali Rahmi Bakiler
- Clinic of Pediatrics, The Ministry of Health İzmir Tepecik Training and Research Hospital, İzmir, Turkey
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Koçyiğit C, Eliaçık K, Kanık A, Atabay B, Türker M. Frequency of red cell allo- and autoimmunization in patients with transfusion-dependent beta thalassemia and affecting factors. Turk J Pediatr 2014; 56:487-492. [PMID: 26022583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In this study, we aimed to determine the frequency of red cell allo- and autoimmunization and analyze the factors responsible for the development of antibodies in patients with transfusion-dependent thalassemia. This crosssectional study was conducted on 139 patients with thalassemia major and intermedia who received leukodepleted RBC transfusions on a regular basis. Patients with a positive antibody screen were further tested for antibody identification by a gel method. Red cell alloantibodies were found in 9 (6.4%) patients, and autoantibodies were found in 17 (12.2%) patients. The most common alloantibodies detected were those against Rh and Kell antigen systems. The alloantibody development rate was higher in thalassemia intermedia patients, in Rh(-) patients, in patients with an initial transfusion age >2 years and in patients with a transfusion interval >3 weeks (p<0.05). The autoantibody development rate was found to be higher in adult and splenectomized patients (p<0.05). Data from this study demonstrate that the RBC antibody development rate is high in our region. RBC antigen phenotyping and crossmatching with Kell and Rh subgroups may reduce alloimmunization in chronically transfused beta-thalassemia patients.
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Affiliation(s)
- Cemil Koçyiğit
- Department of Pediatrics, Tepecik Training and Research Hospital, İzmir, Turkey.
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Kanık A, Baran M, Çayan Ö, Eliaçık K, Özdemir T, Helvacı M, Çeçen E. Vasoactive intestinal peptide releasing tumor which caused to chronic watery diarrhea and hypokalemia. Turk Arch Pediatr 2014; 49:160-2. [PMID: 26078654 DOI: 10.5152/tpa.2014.1054] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 09/10/2012] [Indexed: 12/27/2022]
Abstract
Watery diarrhea, hypokalemia and achlorhydria syndrome is a rare cause of chronic secretory diarrhea arising from a vasoactive intestinal peptide releasing tumor. In this article, a 15-month old female patient with watery diarrhea and abdominal distension which lasting four months is presented. In different centers no diagnosis could be made although investigations. The patient was diagnosed with vasoactive intestinal peptide releasing ganglioneuroblastoma localized in the right surrenal gland.
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Affiliation(s)
- Ali Kanık
- Clinic of Pediatrics, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Maşallah Baran
- Clinic of Pediatrics, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Özlem Çayan
- Clinic of Pediatrics, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Kayı Eliaçık
- Clinic of Pediatrics, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Tunç Özdemir
- Clinic of Pediatric Surgery, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Mehmet Helvacı
- Clinic of Pediatrics, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Emre Çeçen
- Division of Pediatric Oncology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
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Baran M, Eliaçık K, Kurt I, Kanık A, Zengin N, Bakiler AR. Bullous skin lesions in a jaundiced infant after phototherapy: a case of congenital erythropoietic porphyria. Turk J Pediatr 2013; 55:218-221. [PMID: 24192686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Congenital erythropoietic porphyria is a rare autosomal recessive disorder of porphyrin metabolism in which the genetic defect is the deficiency of uroporphyrinogen III cosynthase (UIIIC). Deficiency of this enzyme results in an accumulation of high amounts of uroporphyrin I in all tissues, leading to hemolytic anemia, splenomegaly, erythrodontia, bone fragility, exquisite photosensitivity, and mutilating skin lesions. We discuss a female infantile case who was admitted for jaundice; bullous lesions appeared on her trunk during phototherapy in the neonatal period. The skin biopsy findings were consistent with epidermolysis bullosa. Due to persistent hepatosplenomegaly and cholestasis, metabolic tests and liver biopsy were performed. During the follow-up, hemolytic anemia and red urine were detected. The levels of porphyrin metabolites were determined at high concentrations in plasma, stool and urine analysis, which were suggestive of congenital erythropoietic porphyria.
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Affiliation(s)
- Maşallah Baran
- Clinic of Pediatrics, Tepecik Training and Research Hospital, İzmir, Turkey.
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Kanık A, Kasap-Demir B, Ateşli R, Eliaçık K, Yavaşcan O, Helvacı M. A novel OCRL1 gene mutation in a Turkish child with Lowe syndrome. Turk J Pediatr 2013; 55:82-85. [PMID: 23692838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Oculocerebrorenal syndrome, also known as Lowe syndrome, is an X-linked recessive disorder that predominantly affects males and is characterized by growth and mental retardation, congenital cataract and renal Fanconi syndrome. OCRL1 is the gene responsible for Lowe syndrome and encodes an inositol polyphosphate-5-phosphatase. We present an 11-year-old boy with Lowe syndrome, who had a de novo frameshift mutation in exon 22 that resulted in amino acid substitution and premature codon termination at position 788. This is a new mutation involving the OCRL1 gene in a patient with Lowe syndrome of Turkish origin and expands the mutation spectrum in this disorder.
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Affiliation(s)
- Ali Kanık
- Clinics of Pediatrics, Tepecik Training and Research Hospital, İzmir, Turkey.
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Arun Özer E, Sivaslı Gül Ö, Men G, Talay E, Sütçüoğlu S, Kanık A, Türkoğlu E, Kahramaner Z, Coşar H, Erdemir A, Yaprak I. Retinopathy of Prematurity in Very Low Birth Weight Infants: Effects of Serum Vitamin A and Clinical Parameters. Turk J Ophthalmol 2011. [DOI: 10.4274/tjo.41.060780] [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: 12/01/2022] Open
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Arun Özer E, Yaprak I, Türkoğlu E, Ballı T, Sütçüoğlu S, Erdemir A, Coşar H, Kahramaner Z, Kanık A, Men G. Yardımcı üreme teknikleri ile sağlanan gebeliklerden doğan bebeklerde yenidoğan ölüm oranı ve kısa dönemdeki seyri. Turk Arch Pediatr 2011. [DOI: 10.4274/tpa.46.07] [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: 12/01/2022]
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