Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Factors Affecting Complication Rates of Percutaneous Nephrolithotomy in Children: Results of a Multi-Institutional Retrospective Analysis by the Turkish Pediatric Urology Society(2014) Onal, Bulent; Dogan, Hasan Serkan; Satar, Nihat; Bilen, Cenk Y.; Gunes, Ali; Ozden, Ender; Ozturk, Ahmet; Demirci, Deniz; Istanbulluoglu, Okan; Gurocak, Serhat; Nazli, Oktay; Tanriverdi, Orhan; Kefi, Aykut; Korgali, Esat; Silay, Mesrur Selcuk; Inci, Kubilay; Izol, Volkan; Altintas, Ramazan; Kilicarslan, Hakan; Sarikaya, Saban; Yalcin, Veli; Aygun, Cem; Gevher, Fetullah; Aridogan, Ibrahim Atilla; Tekgul, Serdar; 24095906Purpose: We assessed factors affecting complication rates of percutaneous nephrolithotomy in children. Materials and Methods: We retrospectively evaluated data on 1,205 renal units in 1,157 children treated with percutaneous nephrolithotomy at 16 Turkish centers between 1991 and 2012. Of the patients 28.3% had a history of urolithiasis. Complications were evaluated according to the Satava classification system and modified Clavien grading system. Univariate and multivariate analyses were done to determine predictive factors affecting complication rates. Results: A total of 515 females and 642 males were studied. Mean +/- SD patient age was 8.8 +/- 4.7 years (range 4 months to 17 years). Mean +/- SD stone size, operative time and postoperative hospital stay were 4.09 +/- 4.06 cm 2, 93.5 +/- 48.6 minutes and 5.1 +/- 3.3 days, respectively. Postoperative stone-free rate was 81.6%. A total of 359 complications occurred in 334 renal units (27.7%). Complications were intraoperative in 118 cases and postoperative in 241. While univariate analysis revealed that stone history, positive urine culture, operative time, length of hospitalization, treatment success, punctured calyx and location of the stone significantly affected the complication rates (p <0.05), operative time, sheath size, mid calyceal puncture and partial staghorn formation were the statistically significant parameters affecting complication rates on multivariate logistic regression analysis. Conclusions: Percutaneous nephrolithotomy is the treatment of choice for most renal calculi in children. The technique is effective and safe in children, with a high success rate and a low rate of major complications. The significant factors identified should be considered by clinicians to decrease associated complication rates.Item Overview of Pediatric Peripheral Facial Nerve Paralysis: Analysis of 40 Patients(2015) Ozkale, Yasemin; Erol, Ilknur; Saygi, Semra; Yilmaz, Ismail; 0000-0002-8522-5078; 0000-0003-3009-336X; 0000-0002-3530-0463; 0000-0002-1694-7608; 24810082; AAB-1203-2021; AAL-6136-2021; AAK-4825-2021; AAJ-2992-2021Peripheral facial nerve paralysis in children might be an alarming sign of serious disease such as malignancy, systemic disease, congenital anomalies, trauma, infection, middle ear surgery, and hypertension. The cases of 40 consecutive children and adolescents who were diagnosed with peripheral facial nerve paralysis at Baskent University Adana Hospital Pediatrics and Pediatric Neurology Unit between January 2010 and January 2013 were retrospectively evaluated. We determined that the most common cause was Bell palsy, followed by infection, tumor lesion, and suspected chemotherapy toxicity. We noted that younger patients had generally poorer outcome than older patients regardless of disease etiology. Peripheral facial nerve paralysis has been reported in many countries in America and Europe; however, knowledge about its clinical features, microbiology, neuroimaging, and treatment in Turkey is incomplete. The present study demonstrated that Bell palsy and infection were the most common etiologies of peripheral facial nerve paralysis.Item Hyperventilation During Routine Electroencephalography: Are Three Minutes Really Necessary?(2015) Watemberg, Nathan; Farkash, Michael; Har-Gil, Miki; Sezer, Toner; Goldberg-Stern, Hadassah; Alehan, Fusun; 0000-0002-2278-1827; 25661285; AAJ-5931-2021OBJECTIVE: Hyperventilation induces absence seizures in children with absence epilepsy, and routine electroencephalography studies include three minutes of hyperventilation. We studied the duration of hyperventilation required to provoke a first absence seizure to determine whether three minutes of the procedure are indeed necessary. METHODS: Electroencephalography records of children who experienced absence seizures during hyperventilation were reviewed. The time from hyperventilation onset to a first and further seizure(s) was measured, and the occurrence of absences during the posthyperventilation phase was also noted. RESULTS: Sixty-two studies were evaluated. Mean time from hyperventilation onset to a first absence was 52 seconds (median 32 seconds). The vast majority (85.5%) had an absence within 90 seconds. Most (68%) children sustained a single event. All eight children with posthyperventilation seizures had experienced at least one event during hyperventilation. CONCLUSIONS: Our findings suggest that current guidelines for routine pediatric electroencephalography recording requiring three minutes of hyperventilation may not be clinically necessary. We found that the vast majority of children referred for suspected absence seizures experience a seizure less than 90 seconds after hyperventilation onset, and even more so by 120 seconds. Hence, a larger prospective study is warranted to establish more accurate hyperventilation duration parameters. We also suggest that once an absence seizure has been recorded at any time during hyperventilation, this procedure could be stopped, thus reducing the amount of discomfort for the child.Item Solid Variant of Aneurysmal Bone Cyst of The Rib Presenting As A Left Intrathoracic Mass Without Radiological Bone Destruction(2014) Gezer, Hasan Ozkan; Oguzkurt, Pelin; Temiz, Abdulkerim; Demir, Senay; Hicsonmez, Akgun; https://orcid.org/0000-0002-4635-2613; https://orcid.org/0000-0001-8789-6003; https://orcid.org/0000-0002-4209-9075; 25341605; J-3197-2013; A-4719-2018; AAK-9310-2021An aneurysmal bone cyst (ABC) is a benign but often rapidly expanding osteolytic multi-cystic osseous lesion that occurs as a primary, secondary, intra-osseous, extra-osseous, solid, or conventional lesion. A 15-year-old boy presented with a left-sided intrathoracic mass displacing the lung without bone destruction. The mass was totally resected without rib resection, and the pathological diagnosis was ABC. The clinical manifestations, etiology, management, and pathology are discussed, with a brief discussion regarding the difficulty in the preoperative differential diagnosis.Item Efficacy of Topical 0.05% Cyclosporine Treatment in Children with Severe Vernal Keratoconjunctivitis(2014) Coban-Karatas, Muge; Ozkale, Yasemin; Altan-Yaycioglu, Rana; Sizmaz, Selcuk; Pelit, Aysel; Metindogan, Sevda; Canturk-Ugurbas, Silay; Aydin-Akova, Yonca; https://orcid.org/0000-0003-3009-336X; https://orcid.org/0000-0002-9139-8848; https://orcid.org/0000-0002-0662-2033; 25818961; AAL-6136-2021; AAL-4440-2020; F-2809-2015We aimed to determine the efficacy of topical cyclosporine in children with vernal keratoconjunctivitis refractory to topical mast cell stabilizer and antihistamine therapy. Thirty-one patients, 24 boys and 7 girls younger than 16 years of age, were included in the study. All patients were scored on a four-point scale from 0 to 3 for symptoms and signs. Each patient received topical cyclosporine 0.05% emulsion (Restasis, Allergan Inc., Irvine, CA, USA) four times daily in addition to preservative-free artificial tears and was followed for 6 months. The data was recorded before the initiation of treatment (day 0) and at the 1st, 3rd, and 6th months following treatment. After six months of treatment, severity of all symptoms and signs showed a statistically significant decrease (p<0.05). Patients did not report any serious adverse effects. Topical cyclosporine 0.05% emulsion treatment is a safe and effective treatment option for controlling the symptoms and signs of vernal keratoconjunctivitis in children.Item Posterior Reversible Encephalopathy Syndrome in Childhood Hematological/Oncological Diseases: Multicenter Results(2021) Bilir, Ozlem A.; Dikme, Gurcan; Malbora, Baris; Evim, Melike S.; Sivis, Zuhal O.; Tufekci, Ozlem; Bahadir, Aysenur; Karaman, Serap; Vural, Sema; Bayhan, Turan; Yarali, Husniye N.; Celkan, Tiraje; Ozbek, Namik Y.; 33060391The aim of the study was to analyze the characteristics of posterior reversible encephalopathy syndrome (PRES) cases treated at 10 different institutions in our country. Fifty-eight patients diagnosed with PRES were included in this study. The data of PRES cases from 10 departments of pediatric hematology/oncology were analyzed. The mean age of the patients at the time of diagnosis of PRES was 8.95 +/- 3.66 years. Most patients (80.4%) had a primary diagnosis of acute leukemia. Patients received chemotherapy (71.4%) and/or used steroids within 14 days before the diagnosis of PRES (85.7%). Hypertension was found in 83.9% of the patients. Twenty-six patients had infections and 22 of them had febrile neutropenia. The most common electrolyte disorders were hypocalcemia, hypomagnesemia, and hypopotassemia. Six patients had tumor lysis syndrome and 4 had inappropriate antidiuretic hormone syndrome. Magnetic resonance imaging was used for diagnosis in all patients. The most commonly involved regions by magnetic resonance imaging were occipital (58%), parietal (51%), and frontal lobes (45%), respectively. Twenty-five patients required intensive care and 7 patients were intubated. In conclusion, PRES may develop during the follow-up and treatment of hematological diseases. In addition to steroid and intense combined chemotherapies, immunosuppressive agents and hypertension are also factors that may be responsible for PRES.Item Treatment of young patients with pilonidal sinus disease with the original (unmodified) Limberg flap standardized for the first time(2020) Gezer, Hasan Ozkan; Ezer, Semire Serin; Ince, Emine; Temiz, Abdulkerim; 0000-0002-9597-3264; 0000-0001-8789-6003; 0000-0002-4635-2613; 32353919; A-4719-2018; J-3197-2013; AAJ-9529-2021Background Pilonidal sinus disease (PSD) is commonly seen in young adults but may also affect adolescents. Our goal was to present results from operated patients, with a focus on the original Limberg flap, which we standardized for the first time. Methods This study was a retrospective review of 60 teenage patients who underwent surgery in a single pediatric surgery center over approximately 15 years. Results Of the 60 patients, 33 (55%) were male and the mean age was 14.20 +/- 1.31 (9-17) years. After pilonidal sinus excision, primary repair and Limberg flap were performed in 45 (75%) and 15 (25%) patients respectively. There were no complications in the patients who underwent the Limberg flap technique, whereas 49% of the patients who underwent primary repair exhibited complications. The mean follow-up was 6.7 +/- 4.8 years. Conclusion We standardized the Limberg flap for the first time in children with measurements and consider that it meets expectations: it is not difficult to perform, it has low complication and recurrence rates, it requires an acceptable period to return to normal activities, and gives satisfactory cosmetic results. We did not identify any complications in patients treated with the Limberg flap excision and post-operative epilation. We consider that findings achieved by the treatment of original, standardized Limberg flap excision is comparable with all of the treatment methods reported in the literature related with children.Item Visual Hallucinations Induced by Clarithromycin in a Child: A Case Report and Literature Review(2019) Gokturk, Bahar; Erden, Semih; 31232747Objective Our aim was to present a child with visual hallucinations possibly associated with oral clarithromycin administration. Case report A 4-year-old child was admitted to our hospital with an onset of visual hallucinations after taking the second dose of clarithromycin by mouth. The symptoms gradually disappeared in a week once the clarithromycin therapy had been discontinued. She was observed for a month without any symptoms or further treatment. She was suspected of having Hoigne syndrome (also called as antibiomania) induced by clarithromycin syndrome. Conclusion This report highlights neuropsychological adverse effects due to therapeutic doses of clarithromycin therapy as a possible adverse effect in children.