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Öğe A case of IVIG-resistant Kawasaki disease with gallbladder hydrops(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2015) Yildirim, Şule; Binneto?lu, Fatih Köksal; Tekin, Mustafa; Battal, Fatih; Aylanç, Hakan; Aylanç, Nilüfer; Kaymaz, NazanKawasaki Disease is an acute systemic vasculitis of childhood affecting small and medium-sized arteries particularly coronary arteries. Intravenous immunoglobulin therapy decreases the major cardiovascular complication of the disease. Atypical clinical conditions may accompany to the disease and these cases seem to be more prone to intravenous immunoglobulin resistance which is an important problem in the management of the cases. Herein, we presented a case of 4-year-old boy admitted to our emergency department with fever of 5 days duration and diagnosed as Kawasaki disease based on the clinical, laboratory and imaging findings. He was resistant to intravenous immunoglobulin treatment and in the follow up resulting abdominal tenderness was explained by gallbladder hydrops. Copyright © 2015 by Türkiye Klinikleri.Öğe A case of Takayasu arteritis presenting with renovascular hypertension(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2016) Battal, Fatih; Yildirim, Şule; Adam, Gürhan; Aylanç, Nilüfer; Binneto?lu, Fatih Köksal; Kasapçopur, ÖzgürTakayasu arteritis (TA) that affects aorta and large vessels is rare rheumatological disease. In patients with Takayasu arteritis, hypertension is an important symptom which occurs as a result of narrowing of renal arteries and/or aorta. A 14-years-old girl was referred with facial flashing and tenderness on her face. Hypertension was found in upper limbs. Femoral pulses were weak and there was an abdominal murmur. On MR angiography, there was occlusion in aorta and renal arteries. The patient was diagnosed as TA, with increased acute phase reactants. After an antiinflammatory, an antihypertensive and immunsuppresive treatment, patient's clinical complaints and laboratory findings were under control. In this case, we want to emphasize the importance of blood pressure measurement and four limb pulse examination in childhood in routine physical assesment. In differential diagnosis of secondary hypertension, TA should be kept in mind. © Copyright 2016 by Türkiye Klinikleri.Öğe A rare cause of respiratory distress in newborns: Case report of a premature infant with congenital cystic adenomatoid malformations type 3(2014) Reşorlu, Mustafa; Topalo?lu, Naci; Uysal, Fatma; Adam, Gürhan; Karata?, Ozan; Kaymaz, Nazan; Yildirim, ŞuleCongenital cystic adenomatoid malformations (CCAMs) are hamartomatous lesions of pulmonary airway which are characterized by proliferations of terminal brochioles. They are usually infiltrated to one lobe. These patients are during the postnatal period at a level of 80% and adult patients are rare. We report a case of Stocker type 3 CCAM which caused respiratory distress in a premature born infant weighing 1940 g who was delivered by emergency caesarean section. Radiological imaging results revealed CCAM. He subsequently underwent right lobectomy. Pathological examination showed immature airspaces and interstitium, including bronchioles and cartilage as type 3 CCAM. CCAM should be considered in newborns with respiratory distress.Öğe Alternative treatment applications in children with respiratory tract infections in the West of Turkey(Galenos Yayincilik,, 2013) Topalo?lu, Naci; Yildirim, Şule; Tekin, Mustafa; Uluda?, Ayşegül; Özgen, KenanIntroduction: It is known that the trend toward alternative treatments is increasing each day regardless of the differences between communities. We aimed to detect alternative treatments in our region and to determine the thoughts of families about these treatments. Materials and Methods: A total of 214 patients presenting to General Pediatrics Outpatient Clinics of Çanakkale Onsekiz Mart University Teaching and Research Hospital between October 2012 and February 2012 with fever, coughs, sore throat, wheezing and diagnosed as upper or lower respiratory tract infection and their parents are included in the study. Results: A total of 93.7% of parents were using non-drug applications with varying frequencies. Alternative practices are being used prior to drug treatment (62.7%), with drugs (28.7%), when there is no response to drugs (6.7%) or never (1.9%). Most common used applications to reduce cough was to give pure honey (30.6%) and the most common application to lower the fever was to use warm shower (48.1%). Most common source of information for these applications was relatives and family members. It was shown that the most requested resources to get information were doctors, nurses and other health care professionals with 84.5%. There was statistically signifi cant correlation between educational status and frequency of usage of non-drug applications. However, requested source of information did not change according to the educational status. Conclusions: As a result we thought that doctors and nurses dealing with child health and disease should obtain information about alternative treatments and help the parents about logical managements. © The Journal of Current Pediatrics, published by Galenos Publishing.Öğe Children with urİnary tract isolated from cultures of microorganisms and antibiotic resistance rates(Anatolian Journal of Clinical Investigation, 2014) Aylanç, Hakan; Topaloğlu, Naci; Battal, Fatih; Yildirim, Şule; Bİnnetoğlu, Fatih Köksal; Tekİn, Mustafa; Tekİn, Satı ZeynepUrinary tract infections (UTI) are one of the most common infections in childhood. Resistance is a major problem due to common use of wide-spectrum antibiotics. In the present study we aimed to identify the pathogens of UTI in our clinic and define the resistance pattern of these pathogens.We scanned the urinary cultures and antibiograms of the children applied to our outpatient clinic between August 2011 and December 2013. Urinary cultures of 217 children were studied. Of the 217 studied children 176 (81.1%) were girls and 4 (18.9%) were boys. Of the 52 patients under one year 38 (73%) were girls and 14 (27%) were boys. The age of the cases were between 0.01 and 17.80 decimal years (mean: 5.6). The pathogens were E. Coli in 64.1%, Klebsiella spp. İn 16.1%, Pseudomonas aeruginosa in 6.5%, Enterococcus spp in 4.6%, Enterobacter spp in 3.2%, Proteus spp in 2.8%, Staphylococcus spp. İn 1.9%, Streptococcus spp in 1%. there was a high resistance against ampicillin, amoxicillin-clavulanate and trimethoprin-sulfamethoxazole. The present study proved the importance of culture and antibiogram. Until antibiogram results oral cephalosporins can be used as a first line empirical treatment. If the antibiogram could not be done regional resistance status should be known for the succesful treatment. © 2014, Anatolian Journal of Clinical Investigation. All rights reserved.Öğe Effect of infant feeding on epicardial fat thickness in normal weighted children(Anatolian Journal of Clinical Investigation, 2015) Yildirim, Şule; Binnetoğlu, Fatih Köksal; Aylanç, Hakan; Battal, Fatih; Tekin, Mustafa; Kaymaz, Nazan; Topaloğlu, NaciEFT is an independent predictor of coronary artery disease and closely associated with increased risk of metabolic syndrome and cardiovascular complications. This study aimed to evaluate the effect of breastfeeding on EFT thickness in normal-weighted children to predict the increased risk of coronary artery disease. This study included 84 normal weighted children (aged between 5-10 years), who admitted to pediatric cardiology department from October 2013 to March 2014. The patients were divided into 3 groups according to the feeding regimen in the first 6 months of year. Group 1 consisted of children who were exclusively breastfed in the first 6 months (n: 45). Group 2 consisted of children who were fed with both breast milk and formula (n: 37) and the Group 3 included children who only fed with formula (n: 2). Transthoracic echocardiography was performed and epicardial fat tissue measured. EFT was statistically lower in Group 1 compared to Group 2. EFT was highest in Group 3. The children who breastfed for longer time had low EFT thickness and this correlation was statistically significant (r= -0,457, p<0,001). In conclusion echocardiographically measured EFT thickness is low in breastfed children compared to formula-fed children. © 2015, Anatolian Journal of Clinical Investigation. All rights reserved.Öğe Infants' non-nutritive sucking habits and childhood obesity(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2016) Kaymaz, Nazan; Yildirim, Şule; Cevizci, Sibel; Erdem, Fehime; Topalo?lu, Naci; Tekin, Mustafa; Binneto?lu, Fatih KöksalObjective:Habits formed in early childhood can affect future life. The aim of this study is to investigate whether prolonged non-nutritive sucking habits (pacifiers and finger sucking) during infancy increases the probability of childhood exogenous obesity causing a habit of high frequency of feeding. Material and Methods: A case-control study was conducted including children with exogenous obesity diagnosis and healthy controls. The study was performed with questionnaires completed by parents. Body mass index above the 95th percentile were evaluated as obese. Cases with endocrine, metabolic, or genetic causes of obesity, children with chronic illness other than obesity and children with obese family members were excluded. Results: 108 children (46 boys, 62 girls) with a mean age of 9.97 years and who met the criteria were assigned to the case group and 116 healthy children (55 boys, 61 girls) with a mean age of 10.02 years were assigned to the control group. In both case and control groups there was no statistically significant difference in mean body mass index levels on both duration of pacifier usage (Independent samples t test, p=0.496 and p=0.368, respectively) and finger sucking habit (Independent samples t test, p=0.319 and p=0.377, respectively). However, the number of the children finger sucking in the case group (n=50) was higher than in the control group (n=33) (46.3% vs. 28.4%, p=0.006). Conclusion: There was no association between pacifier usage in infancy with exogenous obesity in childhood but children who suck fingers are more likely to be obese in later life. © Copyright 2016 by Türkiye Klinikleri.Öğe Influence of body mass index on mindfulness awareness and coping methods for stress in adolescents(Walter de Gruyter GmbH, 2018) Kaymaz, Nazan; Düzçeker, Yasemin; Uzun, Mehmet Erdem; Aylanç, Hakan; Baştürk, Meryem; Yildirim, ŞuleObjective: Psychological state may affect the body weight through the hypothalamus and vice versa. The goal of this study is to investigate whether body mass index affect mindfulness awareness (MA) levels and type of coping with stress. Methods: Healthy adolescents were included in the study. The mindfulness attention awareness scale (MAAS), indicating the ways of coping checklist inventory was performed and body mass index (BMI) (kg/m2) of adolescents were calculated. The influence of BMI on MA and ways of coping with stress was tested. According to BMI percentiles the study population was grouped as obese (including overweight), normal-weighted and underweight. Results: A total of 270 adolescents (mean age: 13.63±2.07 years; 165 female/105 male) participated in the study. No significant correlation was found between BMI and MA scores (r //-0.085; p -0.161) and coping strategies were not different between the groups. When MA scores are compared with stress coping methods, it appeares that participants with high awareness levels chose positive coping styles. Conclusion: BMI is not effective on MA levels and choice of stress coping methods. But the higher MA levels are associated with positive coping styles. © 2018 Walter de Gruyter GmbH, Berlin/Boston.Öğe Left ventrİcular noncompaction and ventricular tachycardia diagnosed at preparticipatİon screening(Anatolian Journal of Clinical Investigation, 2015) Binnetoğlu, Fatih Köksal; Yildirim, Şule; Karadeniz, Cem; Topaloğlu, Naci; Tuzcu, Volkan; Kaymaz, NazanLeft ventricular noncompaction is a rare genetic cardiomyopathy which is characterized by excessive trabeculated and spongioform left ventricule. Heart failure, thromboembolism including stroke, ventricular arrhythmia and Wolf Parkinson White Syndrome are the main complications. In this study we present a patient with arrhythmia diagnosed during preparticipation screening and succesfully treated with radiofrequency ablation and flecainide. © 2015, Anatolian Journal of Clinical Investigation. All rights reserved.Öğe Protective role of Proanthocyanidin in experimental ovarian torsion(Tehran University of Medical Sciences, 2015) Yildirim, Şule; Topaloğlu, Naci; Tekin, Mustafa; Küçük, Adem; Erdem, Havva; Erbaş, Mesut; Yildirim, AhmetBackground: Proanthocyanidin is a potent bioactive antioxidant naturally occurring in grape seed and acts as reactive oxygen species (ROS) scavenger. The aim of this study was to investigate the effects of proanthocyanidinin in experimental ovarian torsion injury. Methods: Twenty four rats were randomly divided into three groups (n=8). Group 1: the laparotomy group, group 2: ovarian torsion group, and group 3: intervention group administered proanthocyanidinin of 50 mg/kg before bilateral ovarian ischemia and reperfusion. Histologic examination and scoring was done at the end of the experiment. Statistical analyses were performed using the SPSS v. 19. Results: Ovarian histopathologic findings of all three groups were significantly different in terms of hemorrhage (p<0.001), edema (p=0.001) and vascular dilatation (p<0.001). Pathologic changes induced by I/R were reduced in ovaries of rats administered proanthocyanidin, in particular, hemorrhage, edema and vascular dilatation. Conclusion: Proanthocyanidin, known as free radical scavenger and antioxidant, is protective against tissue damage induced by ischemia and/or ischemia/reperfusion in rat ovaries.
