Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Comparison of Clinical Features and Laboratory Findings of Coronavirus Disease 2019 and Influenza A and B Infections in Children: A Single-Center Study(2021) Siddiqui, Meraj; Gultekingil, Ayse; Bakirci, Oguz; Uslu, Nihal; Baskin, Esra; https://orcid.org/0000-0002-5739-6590; https://orcid.org/0000-0001-7955-5735; 34015895; ABF-7609-2022; AAR-9945-2020Background: As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is crucially important for pediatricians to be aware of the differences in demographic and clinical features between COVID-19 and influenza A and B infections. Purpose: This study analyzed and compared the clinical features and laboratory findings of COVID-19 and influenza A and B infections in children. Methods: This retrospective study evaluated the medical data of 206 pediatric COVID-19 and 411 pediatric seasonal influenza A or B patients. Results: COVID-19 patients were older than seasonal influenza patients (median [interquartile range], 7.75 [2-14] years vs. 4 [2-6] years). The frequency of fever and cough in COVID-19 patients was lower than that of seasonal influenza patients (80.6% vs. 94.4%, P<0.001 and 22.8 % vs. 71.5%, P<0.001, respectively). Ageusia (4.9%) and anosmia (3.4%) were present in only COVID-19 patients. Leukopenia, lymphopenia, and thrombocytopenia were encountered more frequently in influenza patients than in COVID-19 patients (22.1% vs. 8.5%, P=0.029; 17.6% vs. 5.6%, P=0.013; and 13.2% vs. 5.6%, P=0.048, respectively). Both groups showed significantly elevated monocyte levels in the complete blood count (70.4% vs. 69.9%, P=0.511). Major chest x-ray findings in COVID-19 patients included mild diffuse ground-glass opacity and right lower lobe infiltrates. There were no statistically significant intergroup differences in hospitalization or mortality rates; however, the intensive care unit admission rate was higher among COVID-19 patients (2.4% vs. 0.5%, P=0.045). Conclusion: In this study, pediatric COVID-19 patients showed a wide range of clinical presentations ranging from asymptomatic/mild to severe illness. We found no intergroup differences in hospitalization rates, oxygen requirements, or hospital length of stay; however, the intensive care unit admission rate was higher among COVID-19 patients.Item Psikososyal Stres Faktorleriyle Tetiklenen Erken Baslangicli Konversiyon Bozuklugu Olarak Astazi-Abazi Olgusu 2(2022) Guler Aksu, Gulen; KAYAR, Ozan; TAN, Muhammet Emin; KUTUK, Meryem ozlem; BOZLU, Gulcin; TOROS, FevziyeConversion disorder is defined as the loss or change of motor, sensory, and autonomic nervous system-related functions that cannot be explained completely with organic causes. The etiology of the disease may be explained by psychoanalytic theory, learning theory, sociocultural factors, and some traumatic life events besides genetic and neurobiological factors. The onset is usually between late childhood and early adulthood. The disorder occurs after a high rate of psychosocial stressors and the symptoms can vary. While astasia, as one of the possible complaints in conversion disorder, is defined as not being able to stand due to loss of motor power or sensory loss; abasia is identified as patients having no apparent motor problem but not being able to walk properly. Both conditions can be of organic as well as the psychogenic origin. In this paper, the clinical signs of a seven-year-old boy who was admitted to emergency service of Mersin University Faculty of Medicine with the complaints of astasia and abasia but was found to have conversion disorder is presented. The results of the medical examinations and the possible psychosocial stress factors behind these symptoms, as well as the treatment process of the case, were shared. With this report, we is aimed to draw attention to the importance of early diagnosis of the disorder, the necessity of an interdisciplinary approach in the treatment process, and the handling of psychosocial factors leading to somatic symptoms.Item The Relationship between Daily Fructose Consumption and Oxidized Low-Density Lipoprotein and Low-Density Lipoprotein Particle Size in Children with Obesity(2021) Gungor, Ali; Balamtekin, Necati; Özkececi, Coskun Firat; Aydin, Halil İbrahim; 0000-0001-7994-4394; 34557400; AHD-1839-2022Purpose: Obesity has become a very significant health problem in childhood. Fructose taken in an uncontrolled manner and consumed in excessive amounts is rapidly metabolized in the body and gets converted into fatty acids. This single center prospective case-control study aims to investigate the relationship between fructose consumption and obesity and the role of fructose consumption in development of atherosclerotic diseases. Methods: A total of 40 obese and 40 healthy children who were of similar ages (between 8 and 18 years) and sexes were included in the study. In the patient and control groups, the urine fructose levels, as well as the levels of oxidized low-density lipoprotein (LDL), small dense LDL, Apolipoprotein A and Apolipoprotein B values, which have been shown to play a role in development of atherosclerotic diseases, were measured. Results: The levels of oxidized LDL and small dense LDL and the ratio of Apolipoprotein A/Apolipoprotein B were found to be significantly higher in the patient group. Conclusion: We found that urinary fructose levels were higher in the obese children than the healthy children. Our results suggest that overconsumption of fructose in children triggers atherogenic diseases by increasing the levels of small dense LDL and oxidized LDL and the ratio of Apolipoprotein B/Apolipoprotein A.Item Cochlear Implant Failure in the Pediatric Population(2021) Ozer, Fulya; Yavuz, Haluk; Yilmaz, Ismail; Ozluoglu, Levent N.; 0000-0003-3320-204X; 34551468; F-6315-2015Background and Objectives: In cochlear implant (CI) surgery, the results and causes of revision and reimplantation may guide surgeons in establishing surgical protocols for revision surgery with safe audiological outcomes. The aim of this study was to review our experience in terms of etiology, surgical strategy, and hearing outcomes in pediatric patients who underwent CI removal and reimplantation. Subjects and Methods: All patients received implants of the same brand. Pre and postoperative Categories of Auditory Performance score and aided free-field pure tone audiometry thresholds were noted. In vivo integrity tests were performed for each patient and the results of ex vivo tests of each implant were obtained from manufacturer. Results: A total of 149 CIs were placed in 121 patients aged <18 years. The revision rate in children was 6.7% (10/121 children). Six patients had a history of head injury leading to a hard failure. The causes of reimplantation in others were soft failure (n=1), electrode migration (n=1), infection (n=1), and other (n=1). All patients showed better or similar postreimplantation audiological performance compared with pre-reimplantation results. Conclusions: It is very important to provide a safe school and home environment and educate the family for reducing reimplantation due to trauma. Especially for active children, psychiatric consultation should be continued postoperatively.Item Demographic, epidemiologic and clinical characteristics of poisoning cases followed in pediatric intensive care unit(2020) Ozkale, Murat; Ozkale, Yasemin; 0000-0003-3009-336X; 0000-0003-0625-1057; AAL-6136-2021; A-7806-2016Purpose: This study was planned with the aim of retrospectively reviewing the demographic, epidemiologic and clinical characteristics of poisoning cases who treated in the pediatric intensive care unit and compare them with literature. Materials and Methods: The records of 581 patients admitted to the pediatric intensive care unit due to acute poisoning between 2015 and 2019 were retrospectively evaluated. Results: Five hundred and eightyone cases were enrolled in this study. The poisoned patients were aged between 3 months-18years and the female to male ratio was 1.6. Most poisonings occurred via the oral route (97.8%). It was noted that 57.1% of poisoning cases were accidental, whereas 39.1% were suicidal and 3.8% were a result of a therapeutic error. Eighty point nine percent of the cases were drug related while 19.1% were non-drug-related. Central nervous system drugs (%40.6) were the most common agent in drug-related poisoning, however rat poisons were the most common in non drug-related poisoning. The overall mortality rate in this study was 0.1%. Conclusion: Drug poisoning is the most common cause of poisoning in our region, which requires hospitalization, indicates that the society primarily should be raised more in this regard. In addition, we believe that our study will guide the physicians working in childhood poisoning patients who require hospitalization in our province and it ssurroundings, reflecting the epidemiological and clinical features and our results will contribute to updating the regional poisoning data.Item Peripheral Lymphadenopathy in Childhood: Single Center Study(2015) Ozkale, Yasemin; Ozkale, Murat; Sipahi, TansuPurpose: Lymphadenopathy is defined as an abnormality in the size and/or character of lymph node. In this study we aimed to describe the clinical and laboratory findings of benign and malignant causes of peripheral lymphadenopathy in childhood. Material and Methods: Two hundred and twenty four patients who were admitted to the clinic with peripheral LAP were evaluated. Age, gender, laboratory and radiologic findings, final diagnoses, and duration, localization, size, consistency, spread, and accompanying local and systemic symptoms of LAP were determined. Benign and malignant causes of peripheral lymphadenopathy were compared. Results: One hundred twenty-six patients (56.0%) were male and 98 patients (44.0%) were female. After the first evaluation the patients were divided into two groups. The first group included 186 patients with benign causes and the second group included 38 patients with malignant causes. One hundred and sixty four of 224 patients (73.2 %) had localized peripheral lymphadenopathy. The most frequent cause of localized lymphadenopathy in the benign group was acute lymphadenitis (34.8%). The most common cause of localized lymphadenopathy in the malignant group was Hodgkin's lymphoma (4.3%). Sixty of 224 (26.8%) patients had generalized peripheral lymphadenopathy. The most significant cause of generalized lymphadenopathy in the benign lymphadenopathy group was Epstein-Barr virus (10.0%), whereas Hodgkin's lymphoma (23.3%) was the most common cause in malign lymphadenopathy group. Localized and generalized lymph node enlargement was most frequently found in cervical region. The most frequent site of involvement among benign and malignant cases was the cervical area. The results revealed that findings such as chronic course, generalized LAP, supraclavicular, cervical and inguinal location, organomegaly, hilier LAP, abdominal LAP, and abnormal laboratory findings (thrombocytopenia and blasts on the peripheral blood smear) were associated with malignant diseases. Conclusion: Infections are the most common cause of peripheral LAP. The risk of malignany increases with the age of child and the duration of LAP. Older children with chronic LAP, generalized LAP associated with organomegaly, abnormal laboratory findings should be considered as malignant LAP.Item A novel mutation c.2010delG of CLCN5 gene associated with Dent disease-1 in an 11-year-old male with nephrolithiasis and nephrocalcinosis(2018) Kulu, B.; Sancakli, O.; Sakallioglu, O.Dent's disease-1 (CLCN5 gene) is a rare X-linked recessive tubulopathy characterized by low molecular weight proteinuria, hypercalciuria, nephrolcalcinosis or nephrolithiasis, proximal tubular dysfunction and renal failure in adulthood. Females are carriers and usually mildly affected. We present an 11-year-old child with nephrocalcinosis and nephrolithiasis with c.2010delG (or p.Asp671fs) mutation in CLCN5 gene which had not previously been reported in the Dent's disease-1. © 2018 National Academy of Pediatric Science and Innovation. All rights reserved.Item Sadfly fever: two case reports(2016) Ozkale, Yasemin; Ozkale, Murat; Kiper, Pinar; Cetinkaya, Bilin; Erol, Ilknur; 0000-0002-3530-0463; 0000-0003-0866-7339; 0000-0003-3009-336X; 0000-0003-0625-1057; 27489469; AAK-4825-2021; AAF-1346-2021; AAL-6136-2021; A-7806-2016Sandfly fever, also known as 'three-day fever' or 'pappataci fever' or 'Phlebotomus fever' is a viral infection that causes self-limited influenza-like symptoms and characterized by a rapid onset. The disease occurs commonly in endemic areas in summer months and especially in August during which sandflies are active. In this article, two siblings who presented with high fever, redness in the eyes, headache, weakness, malaise and inability to walk, who were found to have increased liver function tests and creatine kinase levels and who were diagnosed with sadfly fever with positive sadfly IgM and IgG antibodies are reported because of the rarity of this disease.Item Narcolepsy and cataplexy: a pediatric case report(2016) Erol, Ilknur; Savas, Tulin; Saygi, Semra; Habesoglu, Mehmet Ali; 0000-0002-3530-0463; 0000-0002-8522-5078; 0000-0001-9136-355X; 28123336; AAK-4825-2021; Q-2338-2019; AAB-1203-2021Narcolepsy is characterized by excessive sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis during the rapid eye movement period of sleep. Herein, we present a boy aged eight years who was diagnosed as having narcolepsy and cataplexy about thirteen months after his first presentation. He was admitted with symptoms of daytime sleepiness. In the follow-up, cataplexy in the form of head dropping attacks developed seven months after the first admission. The patient was investigated for different prediagnoses and was eventually diagnosed as having narcolepsy and cataplexy through polysomnography and multiple sleep latency tests thirteen months after the first presentation. He is being followed up and is under drug therapy; his symptoms have improved substantially.Item Post-traumatic Delayed Peripheral Facial Palsy(2018) Kansu, LeylaPeripheral facial palsy in children is very rare in comparison to adults. The most common cause is idiopathic. Another rare cause of peripheral facial palsy in children is trauma. It occurs after head trauma, mostly due to temporal bone fracture as an early onset paralysis after trauma. Early onset facial palsy is usually due to direct damage to the facial nerve whereas there is some controversy about the etiology of late onset facial palsy. In this article, a child patient whose peripheral facial palsy developed six days after a head injury is presented, and the etiopathogenesis and the treatment of delayed traumatic facial palsy after temporal bone fracture is discussed.