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Öğe Demographic and clinical characteristics of patients with serum sickness-like reaction(Springer London Ltd, 2018) Yorulmaz, Alaaddin; Akin, Fatih; Sert, Ahmet; Agir, Mehmet Akif; Yilmaz, Riza; Arslan, SukruIn this study, we aimed to review the demographic, clinical, and laboratory characteristics of patients who were followed up and treated with the diagnosis of serum sickness-like reactions (SSLR) in our pediatric rheumatology clinic retrospectively and emphasize the importance of early diagnosis and treatment. The files of 29 patients who were hospitalized in the pediatric rheumatology clinic between September 2016 and March 2017 with the diagnosis of type 3 hypersensitivity reaction were reviewed retrospectively. Patient records including C-reactive protein, erythrocyte sedimentation rate, serum electrolytes, blood glucose, urea, and liver function were recorded by using the computerized patient database. The gender, age, length of hospital stay, accompanying clinical findings, family history of atopy, preceding infection, and drug usage data were obtained from the files of the patients. Twenty-nine patients with the diagnosis of type 3 hypersensitivity reaction were evaluated. Fifteen (51.7%) of the patients were male and 14 (48.3%) were female. The male to female ratio was 1.07. The age distribution of patients ranged from 18 to 192 months (mean +/- SD 100.66 +/- 53.75 months). The hospitalization duration was 3-16 days (mean +/- SD 5.14 +/- 3.20 days). The use of many drugs, especially antibiotics, has increased even in the treatment of viral upper air way infections. As a result, side effects have also increased. The most important of these is SSLR. However, this disease is not well recognized by clinicians.Öğe Demographic, Clinical and Echocardiographic Characteristics of Children with Chest Wall Deformities(Galenos Yayincilik, 2017) Aslan, Eyup; Sert, Ahmet; Sap, Fatih; Aypar, Ebru; Odabas, DursunIntroduction: To determine the demographic, clinical and echocardiographic characteristics of children with chest wall deformities. Methods: The patients diagnosed with chest wall deformities were investigated retrospectively in the pediatric cardiology unit over a period of three years. The study enrolled 205 children under the age of 18 years diagnosed with chest wall deformities. Results: The mean age of the patients was 7.6 +/- 4.5 years with a median of 8 years. One hundred and sixty four (80 %) patients with chest wall deformities were found to have normal echocardiography results. Incidental echocardiographic diagnoses included 10 (4.87%) atrial septal defects, 8 (3.90%) mitral valve prolapses, 7 (3.41%) mild mitral regurgitations, 5 (2.44%) bicuspid aortic valve without aortic valve stenoses, 4 (1.95%) ventricular septal defects, 2 (0.98%) mild aortic regurgitations, 2 (0.98%) dextrocardia, 2 (0.98%) coarctations of the aorta and 1 (0.49%) complex cardiac defect (pulmonary atresia and VSD). Compression in the right heart was evaluated by echocardiography 15 (7.3%). Discussion and Conclusion: Because chest wall deformities are associated with congenital heart defects in children and may cause compression in the right heart, evaluation by echocardiography can ensure an optimal management of the defects.Öğe Is Asymmetric Dimethylarginine a Useful Biomarker in Children With Carbon Monoxide Poisoning?(Lippincott Williams & Wilkins, 2019) Yazar, Abdullah; Akin, Fatih; Sert, Ahmet; Ture, Esra; Topcu, Cemile; Yorulmaz, Alaaddin; Ercan, FatihObjective Carbon monoxide poisoning (COP) is the leading cause of mortality and morbidity due to poisoning worldwide. Because children are affected more quick and severely from COP, they may require a longer treatment period, even if carboxyhemoglobin (CO-Hb) and/or lactate levels return to normal. Therefore, a new marker that predicts the duration of treatment and the final outcomes of COP is needed. Methods This case control study was conducted on 32 carbon monoxide-poisoned patients younger than 18 years who had been admitted to pediatric emergency department. The control group included age- and sex-matched 30 healthy children. Blood samples were obtained for analysis of arterial blood gases, CO-Hb percent, methemoglobine, lactate, and asymmetric dimethylarginine (ADMA). Results Asymmetric dimethylarginine levels were significantly increased (P < 0.05) in patients with COP on admission and after the treatment when compared with controls (1.36 [0.89-6.94], 1.69 [0.76-7.81], 1.21 [0.73-3.18] nmol/L, respectively). There was no positive correlation between CO-Hb and ADMA levels on admission and at 6 hours (P = 0.903, r = 0.218, P = 0.231, r = 0.022, respectively). Positive correlation was found between lactate and CO-Hb levels on admission (P = 0.018, r = 0.423). Conclusions This study showed that ADMA levels were still high after 6 hours of 100% oxygen therapy in children with COP, even CO-Hb and/or lactate levels return to normal range. On the basis of these results, we consider that ADMA may be a useful biomarker in patient with COP.Öğe Konya'daki talasemi majörlü hastalarda bozulmuş glukoz toleransı ve diyabet prevalansı(Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, 2007) Sert, Ahmet; Albayrak, Canan UçarKonya'daki Talasemi Majörlü Hastalarda Bozulmuş Glukoz Toleransı ve DiyabetPrevalansıAmaç: Beta-Talasemi majörlü hastalarda yaşam süresi hipertransfüzyon protollerininuygulanmasından sonra belirgin olarak uzamıştır. Bununla birlikte, bu bozulmuş glukoztoleransı ve diyabet gibi endokrin komplikasyonların artmasına yol açmıştır. Diyabetinpankreatik beta hücrelerinde aşırı demir birikiminin yol açtığı hasara bağlı olduğunainanılmaktadır. Bununla birlikte, çeşitli ek kolaylaştırı faktörler görünmektedir. Bu çalışmanınamacı Konya, Selçuk Üniversitesi Meram Tıp Fakültesi Pediatrik Hematoloji Bölümü'ndeizlenen beta-talasemi majörlü hastalardaki, diyabet ve bozulmuş glukoz tolerans sıklığınıdeğerlendirmek ve beta-talasemi majöre eşlik eden şelasyon tedavisine uyum, diyabet için ailehikayesi ve hastaların demografik özelliklerinin diyabet patogenezindeki olası rolünüaraştırmaktı.Materyal ve Metot: Talasemi majör tanısı ile izlenen yaş ortalaması 9.56 ± 5.59 (yıl)olan 51 hasta değerlendirmeye alındı. Hastalara oral glukoz tolerans testi uygulandı. 0., 30.,60., 90. ve 120. dakikalarda alınan kan örneklerinin sonuçları Dünya Sağlık Örgütü tanıkriterlerine göre yorumlandı.Bulgular: Talasemi majörlü hastalar arasında bozulmuş glukoz toleransı sıklığı %10(51 hastanın 5'i), diyabet sıklığı ise %10 (51 hastanın 5'i) olarak bulundu. Ferritin düzeyianormal glukoz toleranslı talasemili hastalarda normal glukoz toleranslı hastalara göre dahayüksekti ancak istatistiksel olarak anlamlı değildi. Anormal glukoz toleranslı hastalarınhiçbirinde diyabet için aile hikayesi yoktu. Anormal glukoz toleranslı talasemik hastalarınbirinde HCV-RNA pozitif bulundu.Sonuç: Bu çalışma merkezimizdeki talasemi majörlü hastalarda bozulmuş glukoztoleransı ve diyabet prevalansının literatürdeki daha önce bildirilen sonuçlara benzer69olduğunu göstermektedir. Talasemik hastalar anormal glukoz toleransı için yakından takipedilmelidir. Talasemi majörlü hastaların tamamı sadece açlık glukozuyla doğrudan tanıalmadığı için talasemik hastalarda anormal glukoz toleransının teşhisi için OGTT yapılmasınıöneriyoruz. Yüksek serum ferritin konsantrasyonunun talasemi majörlü hastalarda anormalglukoz toleransı için bir risk faktörüdür. Yoğun demir şelasyon tedavisi ve hepatit Cinfeksiyonunun önlenmesi ve düzenli taramalarla tespit edilmesi talasemik hastalarda glukozhomeostazının kontrol altına alınmasında önemlidir.Öğe Left and right ventricular function by echocardiography, tissue Doppler imaging, carotid intima-media thickness, and asymmetric dimethyl arginine levels in obese adolescents with metabolic syndrome(Cambridge Univ Press, 2019) Aslan, Eyup; Sert, Ahmet; Buyukinan, Muammer; Pirgon, Mustafa Ozgur; Kurku, Huseyin; Yilmaz, Hakan; Odabas, DursunPurpose: The aim of our study was to assess left ventricle and right ventricle systolic and diastolic functions in obese adolescents with metabolic syndrome using conventional echocardiography and pulsed-wave tissue Doppler imaging and to investigate carotis intima-media thickness, and asymmetric dimethyl arginine levels. Methods: A total of 198 obese adolescents were enrolled in the study. The obese patients were divided into metabolic syndrome group and non-metabolic syndrome group. All subjects underwent laboratory blood tests, including asymmetric dimethyl arginine, complete two-dimensional, pulsed, and tissue Doppler echocardiography, and measurement of the carotid intima-media thickness. Results: Obese adolescents were characterised by enlarged left end-diastolic, end-systolic and left atrial diameters, thicker left and right ventricular walls compared with non-obese adolescents. The metabolic syndrome group had normal left ventricle systolic function, impaired diastolic function, and altered global systolic and diastolic myocardial performance. In the metabolic syndrome obese group patients, left ventricle mass was found positively correlated with body mass index, waist and hip circumferences, diastolic blood pressure, age, and waist-to-hip circumference ratio. The carotid intima-media thickness was found positively correlated with waist and hip circumferences and total cholesterol levels. Asymmetric dimethyl arginine levels were found positively correlated with systolic blood pressure, waist-to-hip circumference ratio, and diastolic blood pressure. Conclusions: The results of this study demonstrate that metabolic syndrome in adolescence is associated with significant changes in myocardial geometry and function. In addition, it has been associated with a high level of asymmetric dimethyl arginine concentration and thicker carotid intima-media thickness reflecting endothelial dysfunction.Öğe Management of acute mitochondriopathy and encephalopathy syndrome in pediatric intensive care unite: a new clinical entity(Springer Heidelberg, 2020) Arslan, Sukru; Yorulmaz, Alaaddin; Sert, Ahmet; Akin, FatihAcute mitochondriopathy and encephalopathy syndrome(AMES) is described differently by different authors in the literature. As a new clinical entity, we aimed to present the clinical signs and symptoms, diagnosis and treatment algorithm of our patients with AMES. 56 patients aged between 2 months and 18 years who were followed up in pediatric intensive care units of Konya Training and Research Hospital and Selcuk University Medical Faculty Hospital, between January 2010 and June 2017 were included. Patients' data were obtained retrospectively from the intensive care unit patient files. 34 (60.7%) of the patients were male and 22 (39.3%) were female. The median age of our patients was 10.0 months. At the time of admission, 42 (75%) of the patients had fever, 35 (62.5%) vomiting, 27 (48.2%) abnormal behaviour and agitation and 28 (50%) convulsion. The etiological classification of patients with AMES was divided into four groups as infection, metabolic disorder, toxic, and hypoxic-ischemic. 39 (69.6%) patients were found to have infection, 10 (17.9%) patients hypoxia, 7 (12.5%) patients metabolic disorders. AMES occurs rarely, but should be kept in mind in the differential diagnosis of patients with any encephalopathy of unknown origin especially in those with a history of ingestion of drugs, previous viral infection and vomiting. Early recognition and treatment is imperative to reduce morbidity and mortality in children with AMES.Öğe Mean platelet volume in children with hepatitis A(Biomed Central Ltd, 2016) Akin, Fatih; Sert, Ahmet; Arslan, SukruBackground: Mean platelet volume (MPV), which is commonly used as a measure of platelet size, indicates the rate of platelet production and platelet activation. We aimed to evaluate the mean platelet volume in children with hepatitis A. Methods: In this retrospective case-controlled study, the study population consisted of 62 children with hepatitis A and 62 healthy control subjects. Results: MPV values, aspartate transaminase (AST), and alanine transaminase (ALT) levels on admission were significantly increased in patients with hepatitis A when compared to controls whereas white blood cell (WBC) counts were significantly lower. Two weeks after admission, the MPV values showed a significant decrease from 9. 47 +/- 1.62 to 8.84 +/- 1.48 fL in patients with hepatitis A, but these values were still significantly higher than the controls. There was a significant difference in terms of MPV, WBC, AST, and ALT values between the controls and the patient group 2 weeks after admission. Conclusions: This study is the first to evaluate the MPV levels in children with hepatitis A. MPV values were found to be increased in children hospitalized with hepatitis A.Öğe Mean platelet volume in children with hepatitis A(Biomed Central Ltd, 2016) Akin, Fatih; Sert, Ahmet; Arslan, SukruBackground: Mean platelet volume (MPV), which is commonly used as a measure of platelet size, indicates the rate of platelet production and platelet activation. We aimed to evaluate the mean platelet volume in children with hepatitis A. Methods: In this retrospective case-controlled study, the study population consisted of 62 children with hepatitis A and 62 healthy control subjects. Results: MPV values, aspartate transaminase (AST), and alanine transaminase (ALT) levels on admission were significantly increased in patients with hepatitis A when compared to controls whereas white blood cell (WBC) counts were significantly lower. Two weeks after admission, the MPV values showed a significant decrease from 9. 47 +/- 1.62 to 8.84 +/- 1.48 fL in patients with hepatitis A, but these values were still significantly higher than the controls. There was a significant difference in terms of MPV, WBC, AST, and ALT values between the controls and the patient group 2 weeks after admission. Conclusions: This study is the first to evaluate the MPV levels in children with hepatitis A. MPV values were found to be increased in children hospitalized with hepatitis A.Öğe Pulmonary Hypertension in Children with Lower Respiratory Tract Infections in the Konya Province of Turkey(Georg Thieme Verlag Kg, 2020) Duzenli Kar, Yeter; Akin, Fatih; Sert, Ahmet; Arslan, SukruObjective Lower respiratory tract infections (LRTI) are one of the most important causes of morbidity and mortality in childhood. Hypoxemia, pulmonary hypertension (PH) due to pulmonary vasoconstriction, and heart failure due to various causes are the most important risk factors for mortality in LRTI. The aim of this study was to investigate characteristics of the patients with LRTI and the frequency of PH that developed secondary to LRTI. Materials and Methods The study included 70 patients who were diagnosed as having LRTI clinically and radiologically between January 2012 and March 2013 at Department of Pediatrics, Konya Training and Research Hospital. Age, sex, risk factors for LRTI, symptoms and physical examination findings, laboratory tests, and Doppler echocardiography findings of the patients were retrospectively reviewed. Results Of the patients, 44 (62.9%) were male and 26 (37.1%) were female. Thirty-seven (52.9%) patients were younger than 1 year, and the mean age was 2.5 +/- 3.11 years. The most common symptoms of the patients were cough and fever. Rhonchus, retraction, and crackles were found to be the most common findings in physical examinations. Heart failure was found in 10% of patients and PH was detected in 8.6% through Doppler echocardiography. Development of heart failure and the presence of bilateral patch infiltration on posteroanterior chest X-rays were significantly more frequent in patients with PH. Some 42.9% of patients had at least one viral agent in their nasopharyngeal swabs. The most common viral agents were respiratory syncytial virus and rhinoviruses. Conclusion PH may develop during the course of LRTI in children. Given that the development of PH can cause life-threatening complications such as heart failure, affected patients should be kept under close follow-up. It should be remembered that PH is more likely to develop in patients with bilateral patch infiltration on chest X-ray.
