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Öğe A Rare Case of Cystinosis Presenting with Alkalosis(Taylor & Francis Ltd, 2013) Topaloglu, Naci; Tekin, Mustafa; Yildirim, Sule; Gencer, BaranA 14-month-old girl was admitted to our clinic due to failure to thrive. Her weight and height were below the third percentile for age. Laboratory examination showed signs of alkalosis, hypokalemia, and hypochloremia. However, her urinalysis was consistent with renal tubular acidosis. Radiologic examination showed signs of active rickets. Based on clinical and laboratory findings, we focused on the probable diagnosis of cystinosis. Slit-lamp examination of the cornea confirmed our diagnosis. We should note that the presence of alkalosis does not exclude the possibility of diagnosis of cystinosis and we should be aware that if any slight doubt of cystinosis exists, patients should be carefully and completely evaluated for diagnosis.Öğe Ailevi Akdeniz Ateşi gen mutasyonu olan çocuklarda makula ve koroid kalınlıkları(Yusuf Haydar ERTEKİN, 2018) Battal, Fatih; Aylanc, Hakan; Yildirim, Sule; Ekim, Yeliz; Silan, Fatma; Ozdemir, OzturkGiriş: Bu çalışmanın amacı, MEFV gen mutasyonlu çocuklarda maküla ve koroid kalınlıklarının değerlendirilmesidir.Yöntem: MEFV gen mutasyonlu 35 çocuk ve kontrol grubu olarak 40 sağlıklı çocuk çalışmaya alındı. MEFV gen profilleri Pyrosequencing ve direct Sanger sequencing sekanslama teknikleri ile genotiplendirildi. Her bir hastanın sağ göz maküla ve koroid kalınlıkları spektral-alan optik koherens tomografi kullanılarak ölçüldü.Bulgular: Ortalama arteriolar ve venüler çaplar sırasıyla MEFV gen mutasyonu olan çocuklarda 95,75±11,98 µm ve 127,61±10,44 µm, kontrol grupta 110,19±11,10 µm ve 138,54±10,04 µm idi. MEFV gen mutasyonu olan çocuklarda sağlıklı kontrollere göre ortalama arteryol çapları (p<0,001), ortalama venüler çapları (p<0,001) daha ince idi ayrıca maküler kalınlık (p=0,016) ve koroid kalınlık (p=0,014) azalmıştı. Sonuç: MEFV gen mutasyonları olan çocuklarda retinal arteriyollerin, retinal venüllerin ve maküler ve koroidal incelmenin olduğu görüldü. Gelecekteki çalışmalar, Ailesel Akdeniz Ateşi olan çocuklarda endotel disfonksiyonunu invazif olmayan ve etkili yöntemlerle araştırmayı amaçlamalıdırÖğe 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 Comment on the Article When Breast Milk Alone Is Not Enough: Barriers to Breastfeeding Continuation among Overweight and Obese Mothers(Sage Publications Inc, 2016) Kaymaz, Nazan; Yildirim, Sule[Anstract Not Available]Öğe Comment on the interaction of personality profile and lactation differs between mothers of late preterm and term neonates(Taylor & Francis Ltd, 2017) Kaymaz, Nazan; Yildirim, Sule[Anstract Not Available]Öğe Correlation of ischemia-modified albumin levels and histopathologic findings in experimental ovarian torsion(Kare Publ, 2016) Yildirim, Ahmet; Yildirim, Sule; Topaloglu, Naci; Tekin, Mustafa; Kucuk, Adem; Erdem, Havva; Erbas, MesutObjectives: Ischemia modified albumin (IMA) levels significantly increased and may be used as a diagnostic marker in ovarian torsion. The aim of this study is to investigate whether there was any correlation between IMA levels and histopathologic changes in experimental ovarian torsion. Material and methods: Fourteen Sprague-Dawley rats, each weighing 220-250 g were divided randomly into 2 groups; in Group 1, the control group (n = 7), only laparotomy was performed and in Group 2, the experimental group (n = 7), ovarian torsion was performed. Ischemia was performed for 3 h; following the ischemia period, the torsion was relieved by detwisting the adnexa and then the ovarian I/R protocol was applied for 3 h. Blood samples were taken from all of the rats to measure the IMA levels and the ovaries were surgically removed for histologic examination. A blinded pathologist examined and scored the samples. Results: The median (minimum-maximum) IMA values were 921.00 (870.00-966.00) ABSUs in the ovarian torsion group and 853.00 (782.00-869.00) ABSUs in the control group. The difference was statistically significant. In the correlation analysis, a significant and strong correlationwas found between IMA levels and histopathologic changes (Spearman's rho = vertical bar 0.987, p < 0.001). Conclusion: Positive correlation was found between the IMA levels and the histopathologic severity of the disease. This finding is important for both diagnosis of the disease and patient follow-up. As a new marker in ovarian torsion, IMA may also indicate the severity of the ovarian histopathology. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner.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 Doctors Need Different Doctors to Treat Their Relatives: A Subject That Does Not Receive Enough Attention in Medical Education(Galenos Publ House, 2022) Kaymaz, Nazan; Yildirim, Sule; Battal, Fatih; Aylanc, HakanDue to having medical knowledge, sometimes doctors may not need to refer to other doctors in case of illness of themselves or their relatives. Therefore, the correct diagnosis may be delayed. This paper discussed this issue from the perspective of a daughter whose father, a doctor, caused the diagnosis of her diseases to be delayed. However, delay in diagnosis is difficult to measure, reasons for the delay can originate from the system or can be caused by the course of the disease, by the patient, and sometimes by physicians, as in our patient.Öğe Does intrauterine tobacco exposure increase the pain perception of newborns?(Dove Medical Press Ltd, 2016) Tekin, Mustafa; Yildirim, Sule; Aylanc, Hakan; Kaymaz, Nazan; Battal, Fatih; Topaloglu, Naci; Baser, EsraBackground: This study aimed to assess whether there was a difference in the pain-perception levels of newborns born to mothers who smoked during pregnancy and newborns born to mothers who were not exposed to active or passive smoking during pregnancy. Materials and methods: A total of 60 newborns born by normal spontaneous vaginal birth between June 2013 and June 2014 were included in the study: 30 born to mothers who smoked during pregnancy, and 30 born to mothers not exposed to smoking. Mothers or newborns who had taken analgesics or sedative medications in the previous 24 hours, newborns not born at term, and sick newborns were not included in the study. During the routine hepatitis B-vaccination injection given at postnatal 48 hours, the newborns' behavior was monitored and recorded by video camera. The data obtained from the recordings were evaluated according to the Neonatal Pain, Agitation, and Sedation Scale and analyzed with SPSS 20. Results: The median pain score of the group exposed to tobacco smoke in utero was 8.5, while the median pain score of the unexposed group was 6 (P<0.001). Conclusion: Exposure to tobacco smoke in utero may increase the pain-perception levels of newborns.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 Glucagon-like peptide-2 exhibits protective effect on hepatic ischemia-reperfusion injury in rats(Springer, 2015) Topaloglu, Naci; Kucuk, Adem; Yildirim, Sule; Tekin, Mustafa; Erdem, Havva; Deniz, MustafaGlucagon-like peptide-2 (GLP-2) has potent anti-inflammatory effects and protects against experimental ischemia/reperfusion (I/R) injury in pulmonary, intestinal, and myocardial tissue. However, its protective abilities against I/R injury in the liver are unknown. We investigated the potential role of GLP-2 pretreatment on hepatic I/R injury in rats. A total of 24 rats were randomly divided into three groups (n = 8). The first group was the control group; the second group was the vehicle-treated hepatic ischemia/reperfusion (HIR, vehicle saline-treated) group; and the third group was the GLP-2 pretreated I/R (GLP2-IR) group. Each rat in the third group was intraperitoneally administered 5 mu g GLP-2 for 5 d before the procedure. A portal triad was created to induce ischemia with a vascular atraumatic clamp. After 40 min, the clamp was released to initiate hepatic reperfusion for 6 h. Blood samples and tissue specimens from the liver were obtained. Alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels significantly increased in the saline-treated HIR group (P < 0.001), whereas GLP-2 pretreatment significantly decreased their levels (P < 0.01). Our data suggested that GLP-2 pretreatment may have a protective effect on liver I/R injury. However, dose-response studies are necessary to determine the most effective dose.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 Herbal remedies for perceived inadequate milk supply are perhaps not as safe as women think: A brief case report(Elsevier Science Bv, 2016) Sahin, Basak; Kaymaz, Nazan; Yildirim, Sule[Anstract Not Available]Öğe Importance of Rectal Urgency in Childhood Irritable Bowel Syndrome(Korean Soc Neurogastroenterology & Motility, 2014) Topaloglu, Naci; Akbal, Erdem; Yildirim, Sule[Anstract Not Available]Öğe Investigation of Blood Betatrophin Levels in Obese Children with Non-Alcoholic Fatty Liver Disease(Korean Soc Pediatric Gastroenterology & Nutrition, 2018) Battal, Fatih; Turkon, Hakan; Aylanc, Nilufer; Aylanc, Hakan; Yildirim, Sule; Kaymaz, Nazan; Uysal, SemaPurpose: The prevalence of obesity has significantly increased among children and adolescents worldwide and is becoming an important health care problem in parallel with the increased prevalence of obesity pediatric non-alcoholic fatty liver disease. Betatrophin is a newly define hormone that is commonly secreted by liver and plays role in glucose tolerance. This study aimed to investigate the relationship between serum betatrophin levels and non-alcoholic fatty liver disease in obese children. Methods: The study included 40 obese children with a body mass index (BMI) above 95th centile, and 35 non-obese subjects with a BMI 3-85th centile, whose age and gender were similar to those of the patient group. For the evaluation of metabolic parameters fasting serum glucose, insulin, alanine aminotransferase, aspartate aminotransferase, lipid profile and serum betatrophin levels were measured. Total cholesterol: high-density lipoprotein cholesterol and low-density lipoprotein cholesterol: high-density lipoprotein cholesterol ratios were calculated as atherogenic indices. Results: Serum betatrophin levels of the obese subjects were similar to that of non-obese subjects (p=0.90). Betatrophin levels were not correlated with the metabolic parameters. Conclusion: In the present study, levels of betatrophin are not different between obese and insulin resistant children and non-obese subjects, and they are not correlated with atherogenic indices. To elucidate the exact role of betatrophin in obesity, further studies are required to identify the betatrophin receptor and/or other possible cofactors.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 Mean Platelet Volume and Ischemia Modified Albumin Levels in Cord Blood of Infants of Diabetic Mothers(Elsevier Taiwan, 2014) Topaloglu, Naci; Yildirim, Sule; Tekin, Mustafa; Kaymaz, Nazan; Tutunculer, Funda; Ozdemir, Cem; Cosar, EmineBackground: Gestational diabetes mellitus (GDM) is a risk for the health of both the pregnant women and her infant. Its unfavorable effects start in utero and continue after birth. It is known that GDM increases oxidative stress and decreases antioxidant enzyme activities. In this study we aimed to investigate cord blood mean platelet volume (MPV) and ischemia-modified albumin (IMA) levels of infants of diabetic mothers (IDM). Methods: Twenty-nine pregnant women with GDM between 37 and 41 gestational weeks who gave birth by spontaneous vaginal delivery were enrolled as study participants together with 20 healthy pregnant women as a control group. Weight, length, and head circumference of babies were measured by the same standard tape immediately after birth. Five milliliters of umbilical venous blood were obtained to study MPV and IMA levels. Results: There was statistically significant difference in levels of MPV (p = 0.037) and IMA < 0.001) between groups. They increased in IDM compared with their healthy peers. Conclusion: Evaluation of MPV and IMA together is useful for representing the potential oxidative stress of IDM. Copyright (C) 2014, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.Öğe Mean platelet volume, red cell distribution width and ischemia modified albumin as a marker of oxidative damage and inflammation in obese children(Kuwait Medical Association, 2015) Aylanc, Hakan; Battal, Fatih; Yildirim, Sule; Kaymaz, Nazan; Tekin, Mustafa; Turkon, HakanObjectives: Childhood obesity is an important risk factor for adulthood obesity. The objective of this study was to evaluate the relationship between red cell distribution widths (RDW), ischemia modified albumin (IMA), mean platelet volume (MPV) and childhood obesity. Design: Prospective case-control study Setting: General pediatric outpatient clinics of the Department of Pediatrics, Canakkale Onsekiz Mart University Hospital, Turkey Subjects: One hundred and seven (57 obese and 50 normal weight) children and adolescents (aged 5-18 years) Interventions: Age, gender, body mass index (BMI) were recorded. The serum IMA and complete blood count level of the subjects were measured. RDW, MPV, hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), red blood cell (RBC), platelet count and white blood cell (WBC) count were measured as part of the automated complete blood count. Main Outcome Measures: The RDW and IMA were found significantly higher in obese children and adolescents than normal weighted ones (p < 0.001). MPV values were minimally increased in obese subjects as compared to normal weighted peers (p = 0.05). Results: Hb, MCV, platelet and WBC counts were similar between normal and obese subjects. The Hct and RBC count were significantly higher in obese subjects. Conclusions: In the present study we demonstrated that IMA and RDW levels are significantly higher in obese children and adolescents as compared to those with normal weight. The IMA and RDW had positive correlation with BMI. These results support that oxidative and inflammatory processes of obesity begin in childhood. © 2015, The Kuwait Medical Journal. All Rights Reserved.
