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Öğe Acquired von Willebrand syndrome in children with aortic and pulmonary stenosis(Clinics Cardive Publ Pty Ltd, 2016) Binnetoglu, Fatih Koksal; Babaoglu, Kadir; Filiz, Sayegan Guven; Zengin, Emine; Altun, Gurkan; Kilic, Suar Caki; Sarper, NazanIntroduction: This prospective study was planned to investigate the frequency and relationship of acquired von Willebrand syndrome (AVWS) with aortic and pulmonary stenosis in patients. Methods: A total of 84 children, ranging from two to 18 years of age, were enrolled in this study. Of these, 28 had isolated aortic stenosis, 32 had isolated pulmonary stenosis and 24 were healthy. Children with aortic and pulmonary stenosis associated with other congenital heart diseases were excluded. Children with hypothyroidism, renal or liver disease, malignancy or autoimmune disease were also excluded. Whole-blood count, blood group, factor VIII level, prothrombin time (PT), activated partial thromboplastin time (aPTT), von Willebrand factor antigen (VWF:Ag), ristocetin co-factor (VWF:RCo), and bleeding time using a platelet-function analyser (PFA-100) were performed in all patients. All of the children in the study underwent a detailed physical examination and echocardiographic evaluation. Results: A history of bleeding was positive in 18% of the aortic stenosis group, 9% of the pulmonary stenosis group, and 4% of the control group. Seven of 60 (12%) patients had laboratory findings that implied a diagnosis of AVWS, and two of these (28%) had a history of bleeding. The frequency of AVWS was 14% in patients with aortic stenosis and 9% in those with pulmonary stenosis. Conclusion: AVWS is not rare in stenotic obstructive cardiac diseases. A detailed history of bleeding should be taken from patients with valvular disease. Even if the history is negative, whole blood count, PT and aPTT should be performed. If necessary, PFA-100 closure time and further tests should be planned for the diagnosis of AVWS.Öğe Association between teething and independent walking in healthy children(Turkish J Pediatrics, 2015) Kaymaz, Nazan; Yildirim, Sule; Cevizci, Sibel; Cimen, Mehmet; Topaloglu, Naci; Binnetoglu, Fatih Koksal; Tekin, MustafaDeveloping teeth provide a reliable indication of maturation and biological age. The objective of this study was to establish whether there is any association between the time of emergence of the first primary tooth and the time when independent walking occurs. A cross-sectional study was conducted with a sample of 206 healthy children (95 girls and 111 boys) aged 12 to 60 (mean: 29.79 +/- 0.66) months who were able to walk independently. The study was conducted using a questionnaire that was filled out by the parents. The first primary tooth emerged at 6.86 +/- 0.14 (min: 3-max: 13) months; the mean independent walking time was 12.58 +/- 2.15 (min: 8.50-max: 24.00) months. There was no correlation between the first teething and independent walking times (r=0.045, p=0.523). Factors such as breastfeeding status, intake of vitamins, walker usage and body mass index were found not to affect the time of either emergence of the first deciduous tooth or independent walking. To the best of our knowledge, this is the first paper in literature to have researched the relationship between the time of emergence of the first deciduous tooth and that of independent walking. It should be explained to parents that there is no relationship between the two in order to resolve anxiety when their child acquires a tooth but does not walk, or vice versa.Öğe Benign Acute Childhood Myositis due to Toxoplasmosis(All India Inst Medical Sciences, 2016) Yildirim, Sule; Battal, Fatih; Aylanc, Hakan; Tekin, Mustafa; Kaymaz, Nazan; Binnetoglu, Fatih Koksal; Topaloglu, Naci[Anstract Not Available]Öğe Comparison of food consumption and nutritional statuses of athletic adolescents(Kamla-Raj Enterprises, 2016) Keser, Alev; Binnetoglu, Fatih Koksal; Asil, Esma; Babaoglu, KadirIn this study, the researchers aimed to assess energy and nutrient consumptions and nutritional statuses of adolescents who participate in different branches of sports. The study group consisted of 138 athletes (108 boys and 30 girls) aged 10-17 years from five different branches of sports. Three-day food intake values and anthropometric measurements were recorded, and body analyses were performed. A high proportion of the athletes had BMIs in the 15-85 percentile, and there were body fat percentages of <15th percentile in all groups. Basketball players had significantly higher percentage of body fat and BMI compared to football players. All athletes obtained daily energy intake of 44.8±7.99 percent, 14.6±3.01 percent and 39.1±7.70 percent from carbohydrate, protein and fat respectively. In different sports branches, there were differences between the energy contributions of macro- and micronutrient intake (p<0.05). A high proportion of athletes failed to meet most micronutrient recommendations. Suboptimal nutritional status may negatively affect the athletes’ performance, as well as physiological growth and development. © Kamla-Raj 2016.Öğe Do we really ponder about necessity of intravenous hydration in acute bronchiolitis?(Corporacion Editora Medica Valle, 2016) Yildirim, Sule; Kaymaz, Nazan; Topaloglu, Naci; Binnetoglu, Fatih Koksal; Tekin, Mustafa; Aylanc, Hakan; Battal, FatihObjective: The goal was to establish the role of intravenous hydration therapy on mild bronchiolitis. Methods: This was a retrospective case control study. Infants between 1 month and 2 years of age admitted to our general pediatrics ward between June 2012 and June 2013 with a diagnosis of uncomplicated acute bronchiolitis were enrolled to the study. Hospital medical files were reviewed to get information about children personal history, symptoms of the disease, disease severity scores and their management. Patients were classified into 4 groups according to the management; nebulized short-acting beta 2-agonist (salbutamol) +hydration; nebulized short-acting beta 2-agonist (salbutamol); hydration and neither bronchodilator nor hydration. We examined length of stay in the hospital as an outcome measure. Results: A total of 94 infants were studied. There was no significant difference between groups in terms of length of stay in hospital. Conclusions: IV hydration is not effective on length of stay in hospital in mild acute bronchiolitis patients.Öğe Early detection of myocardial deformation by 2D speckle tracking echocardiography in normotensive obese children and adolescents(Turkish Soc Cardiology, 2015) Binnetoglu, Fatih Koksal; Yildirim, Sule; Topaloglu, Naci; Tekin, Mustafa; Kaymaz, Nazan; Aylanc, Hakan; Karakurt, HasanObjective: To evaluate the left venticular myocardial deformation parameters in normotensive obese children and adolescents by using 2-D speckle tracking echocardiography. Methods: This observational cross-sectional study included 69 children and adolescents (aged between 10-18), 38 were normotensive obese and 31 were normal weighted. All children underwent detailed two-dimentional, Doppler and two-dimentional speckle tracking echocardiography. Student t-test, Mann-Whitney U test, chi-square test and Pearson's correlation were used in statistical analysis. Multiple linear regression analysis was used the determine independent variables on global longitudinal strain (GLS). Results: While in normal limits, diastolic blood pressure was significantly higher in obese group. Left ventricular end-diastolic diameter (LVDd) and end-systolic diameter (LVDs), interventricular septal thickness (IVSd), left ventricular posterior wall thickness (LPWD) and left ventricular mass index (LVM)/height2.7 were significantly higher in obese group compared to healthy peers (p=0.004, p=0.011, p<0.001, p=0.001, p<0.001) respectively. Obese subjects had reduced global longitudinal strain (GLS) values (p=0.001). Multiple linear regression analysis using the stepwise method were performed to assess the independent variables (age, body mass index, insulin resistance, systolic blood pressure, diastolic blood pressure, left ventricular diameters and LVM index (g/m2.7) affecting the dependent variable GLS. GLS was found significantly correlated with body mass index (BMI) (beta:0.440, p:0.001; 95% CI:0.104-0.311). Conclusion: Left ventricular strain parameters obtained by two dimentional speckle tracking echocardiography were diminished in obese children compared to normal subjects indicating that obesity in childhood is linked to decreased myocardial deformation even in the absence of comorbidities in early stages.Öğe Effect of delivery mode on postpartum neonatal body temperatures(Taylor & Francis Ltd, 2016) Topaloglu, Naci; Binnetoglu, Fatih Koksal; Yildirim, Sule; Tekin, Mustafa; Kaymaz, Nazan; Aylanc, Hakan; Battal, FatihObjective: It is known that general and local anesthesia practices disrupt the delicate balance of thermoregulation center which is already sensitive to very tiny differences of temperatures in a normal subject. We aimed to evaluate and compare the rectal temperatures of newborns born with normal vaginal delivery and cesarean section.Methods: We performed a prospective study of 106 term newborn - 40 born with normal vaginal delivery (group 1) and 66 born with cesarean section [51 spinal anesthesia (group 2), 15 general anesthesia (group 3)]. Only term babies were included in the study. Babies of eclamptic, pre-eclamptic and diabetic mothers and babies with chronic systemic diseases were excluded. Pregnants who underwent elective cesarean section were included in the study. Adolescent pregnants, pregnants with increased risks and pregnants with complicated operations were excluded. Mothers' temperatures were measured before and after the interventions. Rectal temperatures of the babies were measured immediately after birth.Results: Environmental temperature was maintained at 22-24 degrees C. Pre-operative mother temperatures were 36.310.30 degrees C in group 1, 36.36 +/- 0.26 degrees C in group 2 and 36.39 +/- 0.19 degrees C in group 3 (p=0.414). Post-operative mother temperatures were 36.39 +/- 0.27 degrees C in group 1, 36.29 +/- 0.31 degrees C in group 2 and 36.25 +/- 0.28 degrees C in group 3 (p=0.215). Rectal temperatures of the babies born with normal vaginal delivery were significantly higher than the others. It was lowest in the general anesthesia group (37.5 +/- 0.6 degrees C, 37.2 +/- 0.2 degrees C and 36.8 +/- 0.4 degrees C in group 1, 2 and 3, respectively). The temperature differences between groups were statistically significant p<0.001).Conclusions: In conclusion, it is worthy to note that temperatures of the newborns can differ according to the delivery mode. Physicians and health professionals that take care of the newborns should be aware of this difference.Öğe Health Related Quality of Life and the Quality of Sleep in School Aged Children with Functional Constipation(Taylor & Francis Inc, 2017) Yildirim, Sule; Kaymaz, Nazan; Tekin, Mustafa; Topaloglu, Naci; Binnetoglu, Fatih Koksal; Altinbas, Kursat; Asik, ZuhalThe aim of the present study was to investigate the sleep quality and health related quality of life in children with functional constipation. Fifty patients (7-13 years) attended to our general pediatric outpatient clinic and diagnosed with functional constipation and 50 healthy controls were enrolled in this case-control study. Health-related quality of life was assessed by using Kid-KINDL inventory and sleep quality was assessed by using PSQI. Children with functional constipation had lower scores of quality of life compared to healthy controls. Although the total score was not statistically significant the physical well-being scores of constipated children was significantly lower than control group. The Pittsburgh Sleep Quality Index score for children with functional constipation was significantly higher than controls (2.5 +/- 2.4 and 0.5 +/- 0.6, respectively; p < 0.05). School-aged children with functional constipation had lower quality of life and quality of sleep compared to their healthy peers. Physical well-being was especially impaired in constipated children affecting daily activities negatively. Assessment of quality of sleep as well as quality of life should be a part of management of functional constipation in childhood.Öğe ISCHEMIA-MODIFIED ALBUMIN AS AN OXIDATIVE STRESS BIOMARKER IN OBESE CHILDREN(Nobel Ilac, 2015) Topaloglu, Naci; Yildirim, Sule; Tekin, Mustafa; Binnetoglu, Fatih Koksal; Cakir, Dilek Ulker; Erdem, Fehime; Cevizci, SibelObjective: Ischemia modified albumin (IMA) is a marker that is considered as an oxidative stress biomarker. In this study we investigated the IMA levels, an oxidative stress marker, in obesity that leads to free radical formation, in children. Material and Method: Fifty obese and fifty normal weighted children as a control were included in the study. Blood samples were collected for biochemical parameters and serum IMA values. Results: Serum IMA levels were significantly higher in obese group than non-obese group (p<0.001). Median and minimum-maximum IMA values of obese and control groups were 930 (min: 673-max 1332) and 864 (min: 496-max: 1068) respectively. Conclusion: IMA may be used as an important marker to show oxidative stress in childhood obesity.Öğe Permanent Junctional Reciprocating Tachycardia-induced Dilated Cardiomyopathy: A Case Report(Galenos Yayincilik, 2017) Yildirim, Fatih Battal Sule; Aylanc, Hakan; Binnetoglu, Fatih Koksal; Kaymaz, Nazan; Akdeniz, CelalWe present a four-year-old girl who was admitted to our hospital with the complaints of dyspnea, tachypnea, cough, excess sweating and fatigue. Electrocardiogram (ECG) in the tachycardic girl showed inverted P waves in leads 2, 3 and aVF along with a P-R interval of 0.16 sec and an R-P interval of 0.28 sec. Transthoracic echocardiography revealed an enlarged and spherical left ventricle with diminished systolic functions. Holter ECG confirmed long R-P tachycardia with a rate of 140-160 beats/minute. She was diagnosed as having permanent junctional reciprocating tachycardia-induced dilated cardiomyopathy and successfully treated with catheter ablation and flecainide.Öğe Poor Appetite in School Children: Is It a False Perception of Parents?(Galenos Yayincilik, 2015) Kaymaz, Nazan; Bulur, Nurcan; Yildirim, Sule; Cevizci, Sibel; Topaloglu, Naci; Tekin, Mustafa; Binnetoglu, Fatih KoksalAim: Poor appetite is a common symptom in childhood that can either be organic or nonorganic. Prolonged poor appetite may affect children's growth negatively. However picking at food or refusing to eat stresses parents out. In this study, we aimed to investigate the relationship between parental perception of the child's body measurements and appetite in school children who were admitted to the outpatient clinic with the complaint of sustained poor appetite. Materials and Methods: A total of 105 school children (6-15 years old) with the complaint of poor appetite who were investigated several times previously with no organic reason were included in the study. The study was conducted with a questionnaire that was filled out by parents recording demographics. Anthropometric measurements including body weight and height were measured by the same researcher. Body mass index was calculated and BMI for-age was determined. Patients with normal BMI percentile values and patients with low BMI percentile values were compared. Results: 105 children (M/F: 51/54) with a mean age of 8.2 +/- 1.9 years were studied. Mean body weight and height of children were 23.8 +/- 5.7 kg and 124.1 +/- 11.6 cm, respectively. Mean BMI of children was 15.2 +/- 1.5. According to BMI percentiles 65.7% (n=69) of children were normal weight, 30.5% (n=32) were underweight, and 3.8% (n=4) were overweight. When compared in terms of BMI percentiles no difference was found between the groups. Conclusion: Perception of the parents of their children's growth is influenced by many factors and usually does not reflect the facts. In our study, we found that the majority of the children with poor appetite were in normal weight range according to BMI percentile. Nevertheless, nearly one third of the children were underweight, a fact that should not be ignored.Öğe Prolonged pacifier usage in infancy does not cause eating behavior problem later(Turkish J Pediatrics, 2015) Kaymaz, Nazan; Yildirim, Sule; Cevizci, Sibel; Bulur, Nurcan; Topaloglu, Naci; Binnetoglu, Fatih Koksal; Tekin, MustafaThe objective of this study conducted in children aged 3-7 years was to determine whether pacifier use during infancy is associated with eating problems in later periods. A total of 85 children (55.2 +/- 12.3 months) admitted to hospital with eating problems and with no organic pathology in scans, and 97 healthy children (52.24 +/- 10.97 months) without eating problems, were assigned to case and control groups, respectively. Eating problems were classified into five groups and investigated via a questionnaire. The presence of eating problems was analyzed for association with pacifier use. There was no significant difference between the two groups in terms of pacifier use (chi-square test: 0.141, p=0.707), and pacifier use is not related to a poor appetite in later periods. Pediatric healthcare providers and parents should be informed with regard to the subject.Öğe Relation between QT Variables and Left Ventricular Geometry in Athletes and Obese Children(Ordem Medicos, 2016) Yildirim, Sule; Binnetoglu, Fatih Koksal; Battal, Fatih; Aylanc, Hakan; Kaymaz, Nazan; Tekin, Mustafa; Topaloglu, NaciIntroduction: We aimed to evaluate the relation between QT variables and left ventricular geometry in athletes and obese children. Material and Methods: This study included 209 children and adolescents. Thirty-eight of them were obese, 140 were athletes and 31 were normal weighted. Children with history of functional and structural cardiovascular diseases (acquired and congenital), chronic systemic diseases, hypertension, sleep apnea, endocrinological disorders were excluded. All subjects underwent detailed electrocardiographic and echocardiographic examination. Results: QT dispersion was significantly higher in obese children, basketball players, football players and swimmers compared to control group (p < 0.05, p < 0.001, < 0.001 and < 0.01 respectively). Basketball players had the highest QT dispersion. Left ventricular endsystolic diameter (mm/m(2)) was higher in footballers, swimmers, wrestlers and tennis players compared to obese subjects. Interventricular septal thickness at diastole was highest in swimmers compared to control group (p < 0.001) and left ventricular posterior wall thickness was significantly higher in footballers and swimmers compared to healthy subjects (p < 0.01 and p < 0.001 respectively). Left ventricular geometry was normal in 84 patients (47.1%), but 34 patients (19.1%) had concentric remodelling, 20 (22.4%) had concentric hypertrophy and 40 (28.6%) had eccentric hypertrophy. No concentric and eccentric hypertrophy was observed in obese subjects. Left ventricle hypertrophy was prominent in dynamic and combined groups but it was not statistically significant (p = 0.204). QT dispersion was statistically higher in obese, dynamic sports and combined sports compared to control group (p < 0.05, p < 0.001 and p < 0.001 respectively). Discussion: In this study we determined that QT dispersion is elevated in dynamic and combined sports types and obese children. Conclusion: QT dispersion is prolonged in obese and athletes who participate dynamic and combined sports.Öğe Relationship between Abdominal Aortic Intima Media Thickness and Central Obesity in Children(Karger, 2016) Aylanc, Hakan; Aylanc, Nilufer; Yildirim, Sule; Tekin, Mustafa; Battal, Fatih; Kaymaz, Nazan; Binnetoglu, Fatih KoksalBackground: Childhood obesity is one of the important risk factors for early atherosclerosis. We aimed to evaluate the effect of obesity on abdominal aortic intima media thickness (aaIMT) in children. Methods: We consecutively recruited 60 obese and 28 healthy children from the outpatient clinic of pediatrics. In all patients, BMI, waist circumference (WC) and hip circumference (HC) were measured, and fasting serum lipid profile, plasma glucose and plasma insulin were studied. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) was calculated for the obese group. All children underwent ultrasonography to evaluate hepatosteatosis and to measure aaIMT. Results: There was a significant difference between the groups in terms of aaIMT, insulin, glucose, HOMA-IR, total cholesterol, low-density lipoprotein, triglyceride and hepatosteatosis. aaIMT was 1.12 +/- 0.25 and 0.61 +/- 0.18 mm in the obese and nonobese groups, respectively (p < 0.001). In the obese group, there was a positive correlation between aaIMT and WC, WC/height ratio, BMI, HC and hepatosteatosis (p < 0.05 for all), with the highest significance for WC. Conclusions: This study showed that aaIMT was significantly higher in obese children than in nonobese children, and that WC was a strong predictor for aaIMT. Early detection of an increased aaIMT in obese children may guide the follow-up of these patients in terms of developing atherosclerosis and its complications. (C) 2015 S. Karger AG, BaselÖğe Severe digital necrosis in a 4-year-old boy: Primary Raynaud's or jellyfish sting(2013) Binnetoglu, Fatih Koksal; Kizildag, Betul; Topaloglu, Naci; Kasapcopur, OzgurRaynaud's phenomena is a common disorder which may be primary or secondary to some connective tissue disorders such as systemic sclerosis and systemic lupus erythematosus. Jellyfish sting is a rare but lifethreatening cause of Raynaud's phenomena. Digital gangrene is reported in 3% of children with secondary Raynaud's phenomena but does not occur in children with primary Raynaud's phenomena. We report a case of a 4-year-old boy who initially presented with episodes of pain and bluish to blackish discolouration and necrosis affecting the fingers on both hands after a jellyfish sting without any sign of connective tissue disorder. Copyright © 2013 BMJ Publishing Group. All rights reserved.
