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Öğe Early kidney injury in immunoglobulin A vasculitis: Role of renal biomarkers(Wiley, 2021) Ture, Esra; Yazar, Abdullah; Akin, Fatih; Topcu, Cemile; Aydin, Arif; Balasar, Mehmet; Atas, BulentBackground We aimed to determine whether urine kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) can be used as early noninvasive biomarkers of kidney injury in immunoglobulin A vasculitis. Methods Patients who were diagnosed with immunoglobulin A vasculitis were included in the study. Urine samples were collected for determination of urine KIM-1 and NGAL levels. The control group consisted of age-matched healthy children. Results Sixty-one patients who were diagnosed with immunoglobulin A vasculitis were included in the study; 37.7% of these patients were determined to have renal involvement. Median KIM-1 was found to be significantly higher in the patient group (69.59 pg/mL) than the control group (40.84 pg/mL) (P = 0.001). Median NGAL was determined to be statistically significantly higher in the patient group (59.87 ng/mL) compared with the control group (44.87 ng/mL) (P = 0.013). In 23.6% of the patients without renal involvement at admission renal involvement developed within the following 6 months. When median KIM-1 and NGAL at admission of these patients were compared with the control group, they were determined to be statistically significantly higher (P = 0.001, P = 0.003). Conclusions The fact that our patients with late-term nephropathy had no hematuria and / or proteinuria and that KIM-1 and NGAL levels were determined to be high indicates that these biomarkers might be potentially reliable, noninvasive and early determinants of kidney injury.Öğe The effect of attention deficit/hyperactivity disorder and other psychiatric disorders on the treatment of pediatric diabetes mellitus(Wiley-Hindawi, 2019) Yazar, Abdullah; Akin, Fatih; Akca, Omer F.; Eklioglu, Beray S.; Ture, Esra; Coskun, Fatma; Atabek, Mehmet E.Objective Psychiatric diagnoses of patients with type 1 diabetes mellitus (T1DM), the severity of attention deficit/hyperactivity disorder (ADHD) symptoms of the patients and their primary caregivers, and the effects of these factors on treatment were investigated. Methods Sixty-one patients with T1DM were included in the study along with their parents. Psychiatric diagnoses of the patients were determined using a semistructured psychiatric interview, and their depression and ADHD symptom severities were evaluated with self-report scales. The ADHD symptom severities of the parents were evaluated using self-report scales. The relationships among the psychiatric symptoms and the hemoglobin A1c (HbA1c), fasting blood glucose (FBG), and postprandial blood glucose (PBG) levels of the patients were investigated. Results HbA1c levels were found to correlate with the hyperactivity levels of children and the number of diagnoses they had. FBG and PBG values of patients diagnosed with ADHD were found to be higher than in those who did not have ADHD. HbA1c, FBG, and PBG values of the patients who had any disruptive behavior disorder were found to be higher than in those who did not. ADHD total scores, gender (being female), having diagnoses of ADHD or depression were found to be predictive of HbA1c levels according to the regression analyses. No relationship between the clinical findings of the children and their parents' ADHD levels was found. Conclusions The findings of this study implicate that children with T1DM should be evaluated in terms of ADHD which could have negative effects on the treatment.Öğe How Should We Measure Body Temperature in the Pediatric Emergency Department? Which One Is the Most Accurate?(Georg Thieme Verlag Kg, 2019) Ture, Esra; Yazar, AbdullahThe aim of this study is to evaluate temperature measurement methods in children. Body temperatures of 3 to 18 years old patients were measured with a tympanic infrared thermometer, a noncontact infrared skin thermometer and with a temporal artery thermometer. While the specificity of temporal artery and noncontact thermometers were good in determination of temperatures above 37.5 degrees C, their sensitivities were low. Positive predictive value and negative predictive value for both thermometers were sufficient. Both specificity and sensitivity of both thermometers were determined to be good at temperature values above >= 38 degrees C. It is thought that noncontact and temporal artery thermometers can be used for screening in pediatric emergency departments.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 Mean Platelet Volume and Neutrophil-to-Lymphocyte Ratio May Be Used as Predictors in Febrile Seizures(Georg Thieme Verlag Kg, 2018) Yazar, Abdullah; Akin, Fatih; Ture, Esra; Caksen, Huseyin; Odabas, DursunFebrile seizure (FS) is the most frequent seizure disorder in childhood, associated with rapid onset of high fever. Our study aims are (1) to determine if the levels of mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR) are risk factors for FS and to (2) assess the usefulness of these markers as predictors to distinguish the subgroups of FS. This prospective study includes children with FS, acute febrile illness (AFI) without seizure, and control group. Complete blood count was performed on all participants. The following data were obtained: white blood cell count (WBC), platelet count, MPV, hemoglobin (Hb), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), and NLR. MPV, WBC, ANC, and NLR were significantly increased in patients with AFI and FS compared with controls (p < 0.05). When patients with FS and AFI were compared, only WBC was increased significantly in patients with FS (p < 0.05). WBC, ANC, and NLR were significantly increased in patients with complex FS compared with simple (p < 0.05). Our findings showed that WBC, MPV, ANC, and NLR were higher in children with FS than in the control group. Additionally WBC, ANC, and NLR were found to be higher in children with CFS than in those with simple febrile seizure. Based on the study results, we suggest that only WBC may be used as predictors in children with FS.Öğe Retrospective Evaluation of Return Visits to the Paediatric Emergency Department(Emergency Medicine Physicians Assoc Turkey, 2020) Ture, Esra; Yazar, AbdullahAim: This study aimed to establish regional data using the results obtained via determination of clinical and demographic characteristics of patients who revisited the paediatric emergency department of a university hospital within 5 days. Materials and Methods: Patients who revisited the paediatric emergency department within the first 5 days were included. Patient age and sex, complaints at admission, admission sessions and timeframes and whether the patients were admitted during or outside of working hours were recorded. Results: The emergency department was revisited by 654 (1.32%) patients. When patient distribution by age group was examined, 415 patients were found to be aged <5 years. When patient distribution based on working hours was examined, 302 patients were found to be admitted outside of working hours and on holidays, whereas 291 patients were usually admitted during the evenings. Conclusion: Clinicians informing parents at the first visit of the details about their child's disease, the disease course and when to revisit the hospital after discharge may be an effective way to not only prevent unnecessary return visits but also alleviate the anxiety of parents and reduce medical errors and negative patient outcomes.Öğe Simulation Based Endotracheal Intubation Education for Residents of Pediatrics(Emergency Medicine Physicians Assoc Turkey, 2021) Kilic, Ahmet Osman; Ture, Esra; Yazar, Abdullah; Akin, Fatih; Reisli, IsmailAim: Endotracheal intubation is an important element of cardiopulmonary resuscitation. Gaining adequate experience with endotracheal intubation during pediatric residency is important. Our clinic initiated a simulation-based endotracheal intubation training for pediatric residents. This study aimed to evaluate the success of our endotracheal intubation training. Materials and Methods: Residents received two programs of the simulation-based endotracheal intubation training at 1 year apart. Success rates were compared in terms of endotracheal intubation performance. Results: Intubation success rates after the first and second programs were 80% (28/35) and 100% (35/35), respectively, and the difference was significant (chi(2)=7.667, p=0.006). The mean durations of successful endotracheal intubation in both programs were 14.14 +/- 4.16 sec and 8.22 +/- 3.58 sec, respectively. Intubation durations in the second program were significantly lower than those of the first (p<0.01). Conclusion: In this study, the simulation based-endotracheal intubation training, which was performed 1 year apart using high-fidelity manikins, increased the success rate of endotracheal intubation attempts and shorten the intubation time.
