Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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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 Ability of ESWL nomograms to predict stone-free rate in children(2021) Ceyhan, Erman; Ozer, Cevahir; Ozturk, Bulent; Tekin, Mehmet Ilteris; Aygun, Yuksel Cem; 0000-0001-8223-6399; 0000-0002-6232-4313; 0000-0002-7850-6912; 33867289; ABI-2513-2020; AAM-3015-2021; AAM-2222-2020Introduction We aimed to evaluate whether the pediatric extracorporeal shock wave lithotripsy (ESWL) nomograms can predict stone-free status in children effectively and whether they are applicable to our series. We hypothesize that two current nomograms predicting successful treatment with ESWL in pediatric patients are valid. Study design We evaluated 415 renal units (children <18 years) with eligible data who received ESWL treatment for upper urinary tract stones. Children's age, gender, stone size, stone surface area, stone location and history of previous intervention were recorded. Children with no residual fragments after ESWL treatment were designated as stone-free. The nomograms described by Dogan and Onal were implemented to our series for the prediction of stone-free status. Results Mean age of children was 64.7 +/- 57.2 months. Male to female ratio was 219:196.78.8% (327) of children had single stone. Mean stone size was 10.0 +/- 3.7 mm and mean stone surface area was 380.0 +/- 72.2 mm(2). Our stone-free rate after single ESWL session was 52.5% (218/415). Mean residual stone size and stone surface area after single session was 6.4 +/- 3.3 mm and 36.0 +/- 44.2 mm(2) respectively. There were no significant difference between stone-free children and children with residual fragments regarding gender, age and history of previous intervention. Mean stone size and stone surface area in stone-free children were lower and lower pole stones had the lowest stone-free rate (p < 0.05). Area under curve for Dogan and Onal nomogram were 0.628 and 0.580 respectively in ROC analysis (0.05). The agreement between Dogan and Onal score was moderate in our series. In multivariate analysis only stone surface area and Dogan score found to be independent predictors of stone-free status (p < 0.05). Discussion Only one study has assessed both nomograms in the literature. Both nomograms are reported to be independent predictors of stone free status. ROC analysis in our study revealed fair accuracy for both nomograms with higher area under curve for Dogan nomogram. Higher accuracy for both nomograms were reported by other authors. These nomograms offer practical data but more effective tools are needed to be developed for the prediction of stone-free status in pediatric ESWL. Conclusions Stone size and stone surface area are associated with stone clearance. Dogan and Onal nomograms can be useful in prediction of stone-free status in children. Dogan nomogram is superior to Onal nomogram. [GRAPHICS]Item Our experience on management of failed pediatric pyeloplasty(2020) Ceyhan, Erman; Dogan, Hasan Serkan; Tekgul, Serdar; 0000-0001-8223-6399; 32542506; ABI-2513-2020Purpose The purpose of the study was to assess the outcomes of salvage procedures after failed pediatric pyeloplasty. Recurrent ureteropelvic junction obstruction treatment is a difficult course. The salvage surgery is more challenging in the pediatric population. We aimed to assess the outcomes of salvage procedures after failed pediatric pyeloplasty to determine the most efficient surgical intervention. Methods 40 children with 41 renal units who have been treated for recurrent ureteropelvic junction obstruction after pyeloplasty were analyzed retrospectively. The outcomes of all initial and sequent interventions were assessed including redo pyeloplasty, endopyelotomy and balloon dilatation. Results Children's mean age at initial intervention for failed pyeloplasty was 45.9 (+/- 46.4) months. Our mean follow-up time after the initial intervention was 46.9 (+/- 46.6) months. The success rate of our initial treatment methods was 48.7% (20/41). Although redo pyeloplasty was the most successful intervention (83.3%) than DJS placement (45.5%), endopyelotomy (50%) and balloon dilatation (30.8%), the statistical difference was not significant in the initial operations. The overall success rates of redo pyeloplasty, double-J stent placement, endopyelotomy and balloon dilatation were 78.9%, 46.1%, 38.8% and 29.4%, respectively (p < 0.05). Conclusions Redo pyeloplasty provides the best improvement in recurrent ureteropelvic junction obstruction in children. In selected patients, minimal invasive methods such as endopyelotomy and balloon dilatation offer alternative treatment.Item Effect of adherence to carbohydrate counting on metabolic control in children and adolescents with type 1 diabetes mellitus(2020) Bayram, Sinem; Kiziltan, Gul; Akin, Onur; 0000-0003-1569-7747; 32871653Purpose: Carbohydrate counting provides better glycemic control and flexibility than other food planning methods. Consistent adherence to such a complex method is difficult, especially for youth. However, studies that determine adherence to this method and whether it alters metabolic control are limited. The aim of the current study was to determine adherence to this method and investigate its effect on metabolic control, anthropometric measurements, insulin dose, and energy intake. Methods: In this prospective cross-sectional study, 53 children and adolescents with type 1 diabetes mellitus aged 2 to18 years and receiving intensive insulin therapy were trained and followed for 6 months. Demographics, anthropometrics, insulin requirements, hemoglobin A1c (HbA1c), fasting lipids, and food records at baseline and study conclusion were evaluated. At the end of the study patients were divided into adherer and nonadherer groups according to carbohydrate estimate deviations from standardized daily sample menus and calculations for accurate insulin doses. More than 10-g variation in daily consumed carbohydrate amount or failure to decide bolus insulin dose was defined as a nonadherer. Results: The mean HbA1c, low-density lipoprotein cholesterol, and body mass index standard deviation score changed after the carbohydrate counting training while the mean HbA1c between groups was significant (P<0.05). Total daily insulin doses increased, and the mean high-density lipoprotein cholesterol levels decreased in both groups. There were significant correlations between HbA1c and carbohydrate deviation scores as well as HbA1c and caregiver's education level. Conclusion: Since adherence to carbohydrate counting may affect metabolic control, health professionals should evaluate and monitor carbohydrate counting skills of caregivers and patients in order to improve efficiency.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 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.