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Publication Metadata only Adenovirus, norovirus and rotavirus in etiology of children with acute gastroenteritis applying to Istanbul American Hospital(Antibiyotik ve Kemoterapi Derneği, 2017) Kayıran, Sinan Mahir; Palaoğlu, Erkan; Gürakan, Berkan; Gürsoy, Tuğba; Faculty Member; School of Medicine; 214691The most common etiologic agents of gastroenteritis in children are rotavirus, norovirus, astrovirus and adenovirus. In the light of the opinion of etiological changes in the frequency of etiology after rotavirus vaccination, cases with viral gastroenteritis in our region and country in our hospital were evaluated. The analyses of the fresh stool of the study group (474 patients) revealed rotavirus in 17 (3.6 %), adenovirus in 18 (3.8 %) and, norovirus in 27 (5.7 %) of the patients. Viral antigens were detected in 62 (13 %) of all children tested. The mean age of the cases were 3.2±0.7 years old. There was no significant relation between the frequency of the viral agent, age and gender (p>0.05). As a result, we are observing the most common etiological agent in cases with acute gastroenteritis changing from rotavirus to norovirus. / Öz: Çocuklardaki gastroenterit vakalarının çoğunluğunun etiyolojisinde rotavirus, norovirus, astrovirus ve adenovirus rol almaktadır. Rotavirus aşılaması sonrasında ülkemizde ve bölgemizde değişiklik olduğu düşüncesiyle, çalışmamızda hastanemizde akut gastroenterit vakalarının etiyolojisinde virusların sıklığı değerlendirilmiştir. Çalışmaya alınan 474 hastanın taze dışkısının analizinde 17 hastada rotavirus (% 3.6), 18 hastada adenovirus (% 3.8), 27 hastada norovirus (% 5.7) antijeni pozitif bulunmuştur. Toplamda çocukların % 13’ünde (n=62) viral antijen tespit edilmiştir. Hastaların yaş ortalaması 3.2±0.7 olarak bulunmuştur. Tüm çocuklara rotavirus aşısı yapıldığı tespit edilmiştir. Viral antijenlerin pozitifliğinde yaş gruplarına göre ve cinsiyete göre anlamlı bir farklılık saptanmamıştır (p>0.05). Sonuç olarak akut pediatrik gastroenterit vakalarında etiyolojide en sık etkenin rotavirustan norovirusa değiştiğini gözlemekteyiz.Publication Metadata only Adult-onset treatable leukodystrophy: cerebrotendinous xanthomatosis(AVES Yayıncılık, 2022) Şenel, Gülçin Benbir; Abbaszade, Hikmet; Apaydın, Hülya; Başak, Ayşe Nazlı; Tekgül, Şeyma; Faculty Member; Master Student; School of Medicine; Graduate School of Sciences and Engineering; 1512; 63142Cerebrotendinous xanthomatosis is a leukodystrophy resulting from sterol 27-hydroxylase enzyme deficiency caused by CYP27A1 gene mutations. It is characterized by diarrhea and cataract in children, xan-thomas in adolescents, and progressive neurologic symptoms in adults. This study presented a 39-year-old woman who had progressive difficulty in talking, clumsiness in the hands, and imbalance for 2 years. She was able to walk on her toes but was unable to perform activities of daily living or simple housework. Speech difficulty was present since disease onset. Neurologic examination revealed mild mental retardation, hyperactive deep tendon reflexes, bradykinesia prominent on right, and ataxia. She had bilateral cataract surgery at the age of 15 years. There was no parental consanguinity. Routine biochemical tests, vitamin levels, viral serology, autoimmune antibodies, vasculitis, tumor, and paraneoplastic markers were negative. Brain magnetic resonance imaging showed hyperintensities in cerebellar dentate nuclei in T2-weighted/ Fluid Attenuated Inversion Recovery (FLAIR) images. Patient benefited from early levodopa therapy given for dystonia-Parkinsonism. Genetic analysis demonstrated homozygote 1476+2T>C mutation in CYP27A1 gene. Chenodeoxycholic acid replacement therapy was started gradually twice but discontinued due to side effects. Cerebrotendinous xanthomatosis may present with neurologic symptomatology in adults, but the presence of chronic diarrhea, juvenile cataract, and xanthomas at earlier ages should be kept in mind. Early diagnosis and treatment have beneficial results in preventing the emergence of neurologic symptoms as it is a treatable leukodystrophy. Rarely, intolerance to the drug may occur. Early levodopa therapy in patients having dystonia-Parkinsonism will increase patient’s quality of life.Publication Metadata only An evaluation of depression levels in asthmatic children and their mothers during the course of the disease(Kare Yayıncılık, 2021) Ergüven, Müferet; Karatoprak, Elif Yüksel; Mutlu, Hasan Hüseyin; N/A; Çetiner, Nilüfer; Faculty Member / Doctor; School of Medicine; Koç University Hospital; 181047Objective: Asthma, which has gradually increased in children in recent years, imposes limitations on their development from various perspectives. This study was planned to investigate whether asthma, a chronic illness, causes depression in children and their mothers, and to provide psychological support if necessary. Material and Methods: Two hundred and fifty asthmatic children randomly selected from children diagnosed with asthma, aged between 6 and 14 years, and under follow-up for at least 6 months, together with their mothers, were included in the study. One hundred and twenty-five volunteer children from the same age group admitted to the general pediatric clinic, and their mothers, were included in the control group. The Children’s Depression Inventory was applied to the children under the guidance of a specialist psychologist, and the Beck Depression Inventory was administered to the mothers, and the data were then collected. Results: Statistically significant differences were found between the asthmatic children and control group in terms of mean depression scale test for children scores (p=0.01). When asthmatic children were evaluated among themselves, a significant relationship was found between severity of asthma and frequency of depression. A significant relationship was found between length of disease and frequency of depression in asthmatic patients (p=0.01). Depression scores were higher in patients diagnosed with asthma and under follow-up for 4 years or more than the 3–4 years follow-up group. The frequency of depression was higher in the mothers of patients than in the control group mothers (p=0.001). Conclusion: Every clinician involved in the treatment of asthma should be aware of the important role that psychological and social factors can play in children and their mothers. Psychological support should be provided for children and their mothers during the treatment of the disease.Publication Open Access An evaluation of glucagon injection anxiety and its association with the fear of hypoglycemia among the parents of children with type 1 diabetes(Galenos Yayınevi, 2021) Muradoğlu, Serra Küpçüoğlu; Gökçe, Tuğba; Can, Ecem; Yeşiltepe Mutlu, Rahime Gül; Hatun, Şükrü; Faculty Member; School of Medicine; Graduate School of Health Sciences; Koç University Hospital; N/A; N/A; N/A; 153511; 153504Objective: Hypoglycemia is a common acute complication of type 1 diabetes (T1D), which may cause seizure, loss of consciousness, and temporary motor or sensory impairment. Glucagon administration is an effective way of treating severe hypoglycemia, especially in a free-living setting. Nonetheless, families have difficulties in managing severe hypoglycemia due to their anxiety and challenges with current glucagon administration techniques. The aim of the current study was to explore the associations between parental fear of hypoglycemia (FoH) and their general anxiety level, and in particular, their attitudes towards and thoughts on glucagon administration. Methods: Parents of children with T1D completed questionnaires assessing background and clinical information, FoH, generalized anxiety disorder (GAD) and parental anxiety for glucagon administration (PAGA). Results: sixty-eight parents participated. Positive correlations were found between parental GAD-7 score and both FoH and the number of night-time blood glucose measurements and there was a negative correlation with the child's age. Parents mean self-evaluation score of their competence in glucagon administration was 6 (standard deviation +/- 2.9) on a scale of 0 to 10. Unsurprisingly, this score was negatively correlated with the PAGA scores. There was no significant difference between children using continuous glucose monitoring system and self-monitoring of blood glucose in terms of parental FoH, anxiety and misconceptions about glucagon administration. Conclusion: the results showed that parents of children with T1D had anxiety and fear connected with hypoglycemia and glucagon administration. Structured and practical training should be implemented to increase parents' self-confidence including annual refresher training for home glucagon administration.Publication Metadata only Approach to speech and language delay in children from the perspective of pediatrics(Marmara University School of Medicine, 2012) Kayıran, Sinan Mahir; Şahin, Seda Atilla; Department of Psychology; Acer, Sena Cüre; Undergraduate Student; Department of Psychology; College of Social Sciences and Humanities; 223822During well-child visits, as pediatricians generally focus on physical examination, speech and language delay may be ignored. Speech and language delay is associated with genetic, emotional, neuropsychiatric or idiopathic causes. The prevelance in our country has not been established. When speech and language delay is suspected, the pediatrician should discuss this concern with the family and, if required, refer the child to a speech-language therapist. In this review, the issue is discussed from the perspective of pediatrics and what a pediatrician needs to know. (Marmara Medical Journal 2012;25:1-4) / Sağlam çocuk vizitlerinde, genellikle pediatristler fiziksel incelemeye odaklandığından, konuşma ve dil gecikmesi ihmal edilebilmektedir. Konuşma ve dil gecikmesi genetik, emosyonel, nöropsikiyatrik nedenlerle ya da idiopatik olabilir. Ülkemizdeki prevelans bilimsel çalışmalarla ortaya konulmamıştır. Konuşma ve dil gecikmesinden şüphelenildiğinde, pediatrist bu durumu aile ile tartışmalı ve gerekli gördüğünde bir konuşma terapistine yönlendirmelidir. Bu derlemede, konu pediatri perspektifinden, bir pediatristin bilmesi gerekenler yönüyle tartışılmıştır. (Marmara Üniversitesi Tıp Fakültesi Dergisi 2012;25:1-4)Publication Metadata only Approaches of pediatric nephrologists to hypertensive patients in Turkey (Turkish pediatric hypertension working group study)(Springer, 2018) Demir, Belde Kasap; Hacıhamdioğlu, Duygu Övüç; Girişgen, İlknur; Dursun, Hasan; Çivilibal, Mahmut; Benzer, Meryem; Bıyıklı, Neşe Karaaslan; Özkayın, Neşe; Sönmez, Ferah; Taşdemir, Mehmet; Faculty Member; School of Medicine; 175867Objective: We aimed to evaluate the approaches of pediatric nephrologists in our country to the management of childhood hypertension. Methods: The pediatric nephrologists in our country were invited to fill out an online questionnaire including 24 questions. The answers were compared between those working in the field for <= 10 years (Group 1, n =74) and >10 years (Group 2, n = 62). Results: of 136 participants (M/F = 101/35), 52% were following a single guideline [31% Fourth Report of 2004, 17% European Society of Hypertension in 2016, and 52% American Academy of Pediatrics in 2017], which is more common in Group 1 (P =.035). The most commonly used guideline was American Academy of Pediatrics of 2017 and Group 2 used Fourth Report of 2004 more commonly (P =.042). The most common choice to diagnose hypertension was office + home + ambulatory blood pressure monitoring (59%). The frequency of screening for end-organ damage at first evaluation was 96%. The time to wait for the effect of lifestyle modifications was 3 months in 52%. The first choice medication was angiotensin-converting enzyme inhibitors (49%) or calcium-channel blockers (48%) in non-obese and angiotensin-converting enzyme inhibitors (74%) in obese children. Calcium-channel blockers were more commonly prescribed as the first choice in non-obese children in Group 1 (P =.035). The most accessible emergency drug was esmolol. Conclusion: Despite following recent guidelines, the time spent in the proficiency would change the practices.Publication Open Access Being a pediatrician and living in the world of children(Aves, 2022) Hatun, Şükrü; Faculty Member; School of Medicine; 153504Publication Open Access Birth weight reference percentiles by gestational age for Turkish twin neonates(Aves, 2021) İmamoğlu, Ebru Yalın; Hayran, Mutlu; Kayıran, Sinan Mahir; Zeybek, Gözde; Özumut, Sibel Sevuk; Karatekin, GÜner; Ovalı, Fahri; Gürsoy, Tuğba; Faculty Member; School of Medicine; 214691Aims: in clinical practice, birth weight reference percentiles for singletons are used to evaluate twin births. The utilization of singleton reference percentiles for twins is not appropriate as they experience different growth trajectories. However, Turkey still lacks such references. Our aim was to create gestational age-specific birth weight references for female and male Turkish twins. Materials and methods: this is a hospital-based, multi-centered, retrospective study. In total, 2544 live-born twins between 2010 and 2019 were included in the study. Gestational age, birth weight, mode of delivery, gender, birth order, chorionicity, maternal age, pregnancy resulting from assisted reproduction techniques, APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) score at 5 minutes, admission to the neonatal intensive care unit (NICU), length of stay in NICU, and death during the NICU stay were recorded. Results: smoothed reference curves for birth weight by gestational age and separate tables for female and male twin neonates for the 3rd, 10th, 50th, 90th, and 97th percentiles from 26 to 39 weeks of gestational age were constructed. Overall neonatal and infant mortality rates during NICU stay in our twin cohort were 12/1000 and 16/1000, respectively. Conclusion: twin-specific birth weight nomograms could be helpful as a reference for clinicians to identify high-risk neonates and fetuses who need specialized care. However, further studies with larger series are urgently needed for validation and use of these nomograms in clinical practice.Publication Open Access Comparison of intraoperative and postoperative analgesic properties of ilioinguinal/iliohypogastric and sacral epidural block in pediatric unilateral inguinal hernia operations(Kare Yayıncılık, 2022) Mahli, A.; Coşarcan, Sami Kaan; Doctor; Koç University HospitalObjectives: Central blocks such as caudal, spinal, and sacral epidural are frequently used in pediatric inguinal surgeries. Furthermore, peripheral blocks have been used and successful results have been obtained in pediatric inguinal surgeries. In this study, we aimed to compare the intraoperative and postoperative analgesic efficacy of the ilioinguinal/iliohypogastric (IL/IH) block under general anesthesia with the sacral epidural block. Methods: This study was carried out in Gazi University Faculty of Medicine, Department of Anesthesiology and Reanimation, after obtaining permission from the Ethics Committee of Gazi University Faculty of Medicine and the Central Ethics Committee of the General Directorate of Pharmaceuticals and Pharmacy of the Turkish Ministry of Health, numbered B.10.0.İEG.011.00.01. Sixty patients in the American Society of Anesthesiologists I-II group between the ages of 1 and 8 years who will undergo elective unilateral inguinal hernia operation under general anesthesia were randomly divided into two groups. Group S (n=30) sacral epidural block and group I (n=30) IL/IH nerve block were planned. Results: Hemodynamic values were found to be statistically significantly lower than control values in both groups. The minimum alveolar concentration values for sevoflurane were statistically significantly lower values in both groups at all surgery periods. In terms of additional analgesic requirement, the group I was found to be statistically significantly lower than the group s at the 8th-12th h. When the first analgesic intake hours were examined, no significant difference was found between the two groups. Conclusion: In our study, group I and group S analgesic efficacy was found to be similar. / Amaç: pediatrik inguinal girişimlerde kaudal, spinal ve sakral epidural gibi santral bloklar sıklıkla kullanılmaktadır. Bu girişimlerde periferik bloklar da kullanılmakta ve başarılı sonuçlar alınmaktadır. Bu çalışmada, genel anestezi altında ilioinguinal/ iliohipogastrik bloğunun intraoperatif ve postoperatif analjezik etkinliğini sakral epidural blok ile karşılaştırmayı amaçladık. Gereç ve yöntem: bu çalışma, Gazi Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı’nda, Gazi Üniversitesi Tıp Fakültesi Etik Kurulu’ndan ve Sağlık Bakanlığı İlaç ve Eczacılık Genel Müdürlüğü Merkez Etik Kurulu’ndan B.10.0.İEG.011.00.01 numaralı izin alındıktan sonra gerçekleştirilmiştir. ASA I - II grubunda olup genel anestezi altında elektif tek taraflı inguinal herni ameliyatı olacak, yaşları 1-8 arasında olan 60 hasta randomize olarak iki gruba ayrıldı: Grup S (n=30) sakral epidural blok grubu ve Grup I (n=30) ilioinguinal / iliohipogastrik sinir bloğu grubu. Bulgular: hemodinamik değerler her iki grupta da kontrol değerlerinden istatistiksel olarak anlamlı derecede düşük bulundu. Sevofluran için MAC değerleri, tüm cerrahi periyotlarda her iki grupta da istatistiksel olarak anlamlı derecede düşüktü. Ek analjezik gereksiniminin Grup I’da, 8. ve 12. saatlerde Grup S’ye göre istatistiksel olarak anlamlı derecede düşük olduğu gözlendi. İlk analjezik alım saatleri açısından iki grup arasında anlamlı fark bulunmadı. Sonuç: çalışmamızda Grup I ve Grup S’de analjezik etkinlikleri benzer bulundu.Publication Metadata only Comparison of the adolescent pregnancy outcomes between refugees and Turkish citizens(Turkish National Pediatric Society, 2024) Arslan, Oğuz; Tuğ, Niyazi; N/A; Giray, Burak; School of MedicineBackground. Adolescent pregnant women have significant risk factors in terms of preterm birth, low birth weight, gestational and neonatal complications, and neonatal and infant deaths. In many countries, living as a refugee differs from living as a local citizen regarding education level, access to health services, and lifestyle. We aimed to compare the obstetric, perinatal, and neonatal outcomes of Turkish and refugee adolescent pregnant women admitted to a tertiary maternity center. Methods. The study was planned as a retrospective cross-sectional. We included adolescent pregnant women who delivered between February 2018 and August 2023. Adolescent pregnant women were divided into two groups, the Turkish group and the Syrian refugee group, and compared with each other. Results. One thousand and fifty-one Turkish and 742 refugee adolescent pregnant women were included in the study. Adolescent pregnancy rates are higher in refugees than in the Turkish group (p < 0.001). We found that maternal age (p < 0.001), preeclampsia rates (p=0.029), gestational age at delivery (p < 0.001), and cesarean delivery rates (p=0.02) were lower in refugee adolescent pregnant women. Furthermore, we found that the anemia rates (p < 0.001) and low birth weight newborn rates (p = 0.011) were higher in refugee adolescent pregnant women. Conclusions. Enhancing the outcomes of adolescent pregnancies among refugees necessitates a heightened focus on education regarding sexual reproduction, increased prenatal follow-ups, and enhanced training in family planning. © 2024, Turkish National Pediatric Society. All rights reserved.