TR-Dizin İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Pathology, Classification, Clinical Manifestations and Prognosis of Langerhan's Cell Histiocytosis: A Single Center Experience(2022) Hasbay, Bermal; Kocer, Nazim Emrah; Kayaselcuk, Fazilet; Canpolat, Emine Tuba; Buyukkurt, Nurhilal; Erbay, AyseObjective: The aim of the study is to raise awareness about clinical features, histopathological and radiological analyzes and treatment details of this rare disease. Methods: A total of 55 Langerhans cell histiocytosis patients, diagnosed between the year 2006 and October 2020 in our department were included in the study. The patients were evaluated in terms of age, gender, tumor localization, risk groups, treatment modalities, recurrence, and outcome of the disease. Results: Twenty-three out of 55 patients were children and 32 were adults. The ages of the patients were between 7 months and 72 years. Thirty-seven of the cases were male and 18 were female. The most common clinical complaint in both groups was pain and swelling. The duration between the onset of the patient complaints and admission to the hospital varies between 7 days-12 months in children, and 10 days-23 years in adults. Forty-three of the cases had single organ involvement and 12 had multiorgan involvement. The most frequently affected organ in both groups was bone. Forty of the 55 patients had follow-up data and the treatment modalities are as follows: Nine patients radiotherapy, 8 patients chemotherapy+steroid, 7 patients chemotherapy, 2 patients chemotherapy+radiotherapy+steroid, 1 patient steroid, 2 patients chemotherapy+radiotherapy. Eleven patients were followed up without additional treatment after surgery. Median follow-up from the time of biopsy was 45.9 months in children and 41.9 months in adults. Conclusions: As a result, diagnosis requires a high degree of suspicion and final diagnosis is based on the histological examination of the lesions and biopsies.Item Plasma Exchange in the Treatment of A Child with West Nile Virus Encephalitis: A Case Report(2022) Ozkale, Yasemin; Ozkale, Murat; Ceylan, Ozgur; Erol, IlknurBackground: West Nile virus (WNV) is a member of the Japanese encephalitis antigenic complex of the family Flaviviridae that can cause a wide range of clinical symptoms, from asymptomatic disease to severe meningitis, encephalitis flaccid paralysis, and death. In immunocompetent children, WNV infection is usually benign and self-limiting. However, this virus is also associated with severe neurological disease in some patients, especially those who are older, have a chronic disease, have undergone organ transplantation, or are immunocompromised. Case Report: A 12-year-old boy with selective immunoglobulin A-deficiency (SIgAD) and refractory seizures due to WNV encephalitis (WNE) was successfully treated with therapeutic plasma exchange (TPE) in conjunction with other immunomodulatory therapies. Conclusion: WNV can progress like autoimmune encephalitis. TPE appears to be safe and effective for treating children with WNE. To our knowledge, this report is the first of a child with WNV infection and SIgAD.Item Evaluation of video game playing status in school-age children with various variables(2021) Aydin, Beril; Oflu, Ayse; Yalcin, Sidika Songul; 34286323Objective: Excessive video game playing has several health implications on children. In this study, we evaluate the factors related to video game use in school-aged children. Material and Methods: This cross-sectional descriptive study included 160 children aged 6-8 years who applied to outpatient clinics at the Department of Pediatrics at Baskent University Hospital. Each parent completed a structured questionnaire including demographic information, video game use, average daily screen time, and parental habits and concerns about their children's screen use. Results: The mean age of first video game use was (mean +/- SD) 2.8 +/- 1.1 years. The minimum age for playing video games was 1 year. Male children spent more time playing video games. Both parental age and maternal education level were higher in the group of video gamers compared with non-gamers (p<0.05). Average time spent playing video games was 2.7 +/- 1.6 hours/day. The group of video gamers had a considerably younger age for starting watching television and higher rates for other video gamers at home than non-gamers (p=0.036 and p<0001, respectively). The group of video gamers had significantly higher rates for having a computer, tablet, and game console at home compared with non-gamers (p<0.05). Conclusions: Our study indicates a statistically significant relationship between the age of starting watching television, gender of child, parent's age, maternal education, and the categories of video gaming habits. Developing strategies toward avoiding early screen exposure in children should be taken into consideration, because it is directly related to video gaming habits in children.Item Invasive Fungal Infections in Children with Acute Lymphoblastic Leukemia: Experience from a Reference University Hospital in Cappadocia(2020) Yilmaz, Ebru; Erdogmus, Arda; Ozcan, Alper; Gorkem, Sureyya Burcu; Ceylan, Ozgur; Deniz, Kemal; Unal, Ekrem; Atalay, Mustafa Altay; Karakukcu, Musa; Koc, Ayse Nedret; Patiroglu, Turkan; 0000-0001-6910-7250; AAK-8276-2021Invasive fungal infections (IFI) are an important cause of mortality and morbidity in patients with hematological malignancy. This study aims to investigate the incidence of IFI development, risk factors, the management of the infection in a pediatric patient group followed up with the diagnosis of acute lymphoblastic leukemia (ALL), and to share the experience obtained from a single center. Two hundred forty children monitored with the diagnosis of ALL in the pediatric hematology-oncology department of the Erciyes University Medical Faculty from January 2010 to September 2017 included in the study. A total of 30 (14 females and 14 males) IR attacks were diagnosed (12.5%) in the included patients with ALL, two of them having the attacks twice. Candida species were the dominant cause of infection (n= 17) and the rest (n= 8) had invasive Aspergillosis. Nineteen IFI attacks were assessed as proven, 6 as probable, and 5 as possible IFI. The most fungal infection was detected in blood culture (43.3%) followed by pulmonary involvement (40%). The most frequently used diagnostic methods were direct microscopic examination, histological examination, and cultures (66.6%). IFI-related mortality was 20%. IFI continues to be an important problem in pediatric patients with hematologic malignity. The 7 of the observed invasive Aspergillosis developed in non hepafiltered room. Treatment of neutropenic children in hepafiltered rooms decrease the risk of IFI. With careful assessment of the patients bearing risk factors for IFI development, early diagnosis and treatment will reduce morbidity and mortalItem Ophthalmologic Findings in Children with Leukemia: A Single-Center Study(2016) Orhan, Betul; Malbora, Baris; Bayar, Sezin Akca; Avci, Zekai; Alioglu, Bulent; Ozbek, Namik; 27800262Objectives: Ophthalmologic disease in patients with acute leukemia occurs due to primary leukemic infiltration (involvement), or secondary to the disease and its treatment. In recent years the life expectancy of acute leukemia patients has increased with the advent of modern therapies. The present study aimed to determine the incidence of ocular manifestations in children with acute leukemia. Materials and Methods: The study included 120 patients diagnosed with acute leukemia at Baskent University Hospital, Pediatric Hematology Department between 1995 and 2010. All the patients were examined by an ophthalmologist via direct and indirect ophthalmoscopy. Results: Among the patients, 83 (69.2%) were diagnosed with acute lymphoblastic leukemia, 35 (29.1%) with acute myeloblastic leukemia, and 2 (1.7%) with mixed-lineage leukemia. In all, 58 ophthalmic manifestations were noted in 41 patients (34.2%). In our patients, 12 ophthalmologic involvements were present at admission and 46 ocular findings occurred during follow-up. The incidence of these manifestations increased with age. Conclusion: Ophthalmologic manifestations were not correlated with gender, hematological parameters at disease onset, type of leukemia, or the frequency of relapse and survival. To more clearly determine the effect of ophthalmologic manifestations on the prognosis of leukemia, larger scale and multi-center studies are needed.Item Prevalence of Proteinuria in School-Aged Turkish Children, and Its Association with Obesity and Hypertension(2017) Kazanci, Nafia Ozlem; Gul, Ali; Ozer, Samet; Yilmaz, Resul; Sonmezgoz, Ergun; Kasap, Tuba; Takci, Sahin; Unuvar, Seyma; Onder, Yalcin; Citil, RizaAim: In kidney diseases, renal damage may be mild and initially asymptomatic. Proteinuria, a marker of kidney injury, directly contributes to chronic tubulointerstitial damage. We investigated the prevalence of proteinuria (POP) in school-aged children in Turkey. Materials and Methods: The cluster sampling method was used to calculate the required size of the study group for this cross-sectional study. Urine samples were randomly obtained to determine urinary protein/creatinine ratio (Upr/Ucr) from 1374 children aged 6 to 18 years. POP was also specifically assessed in hypertensive and obese children. Results: The mean age of the subjects was 11.68 +/- 3.43 years. The children were from rural (23.9%) and urban (76.1%) regions of Tokat, Turkey. Upr/Ucr >= 0.20 was detected in 92 children, corresponding to a POP rate of 6.7%, without any statistically significant difference between girls and boys. Among 141 obese children, 16 (11.3%) and 76 of 1233 non-obese children (6.2%) had proteinuria (p<0.05). Children with hypertension had a POP of 7.5% compared to the 6.7% of those without hypertension (p>0.05). Conclusion: Among school-aged Turkish children POP was 6.7%. POP was higher in obese than in non-obese children. But there was no association between POP and hypertension. While screening programs allow the early detection of renal disease, further cohort studies are required to be able to suggest urinary screening programs.Item Oxidant and Antioxidant Balance in Patients with Childhood Non-Cystic Fibrosis-Related Bronchiectasis(2018) Gokturk, Bahar; Pekcan, Sevgi; Kose Karatas, Seda; Kurban, Sevil; Guner, Sukru NailObjective: To evaluate the role of the oxidant and antioxidant balance in the pathogenesis and prognosis of non-cystic fibrosis bronchiectasis (non-CF BE) in children. Materials and Methods: Twenty-nine children with non-CF BE were enrolled between June 2009 and October 2010. Thirty healthy children were enrolled as controls. Paraoxonase 1 (PON1), total oxidant status (TOS), and total antioxidant status (TAS) serum levels were measured in controls and in patients when stable and at acute exacerbation. Results: PON1 and TAS levels were lower in patients at acute exacerbation than in controls (P=0.05 and P=0.01, respectively). TOS levels indicative of oxidative stress were higher, and TAS/TOS levels were lower, in immune-deficient patients than control group (P=0.008 and P=0.01, respectively). TAS levels and PON1/TOS ratio were significantly lower in patients with moderate-severe bronchiectasis than in patients with mild bronchiectasis (P=0.043 and P=0.03, respectively). Conclusion: Oxidative stress was increased and antioxidant capacity decreased in patients with non-CF BE during the exacerbation period. Antioxidant treatment in patients with non-CF BE, especially in patients with immunodeficiency and/or with moderate-severe bronchiectasis, could be helpful to reduce the frequency and severity of the attacks by reducing oxidative stress-induced damage, ultimately contributing to a better prognosis.