TR-Dizin İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Which has an Influence on Mean Platelet Volume: Allergic Rhinitis or Asthma?(2022) Senol, Handan Duman; Ozdogru, Emine Ece; Sancakli, Ozlem; Dogru, Mahmut; Tuncel, TubaAim: Bronchial asthma and allergic rhinitis are mediated by similar allergic inflammatory mechanisms. Platelets play a role in allergic reactions which are inflammatory processes. The mean platelet volume (MPV) is a marker of platelet activation. This study aimed to investigate MPV value differences between children with allergic rhinitis during symptomatic or asymptomatic periods to determine whether MPV is a useful indicator of inflammation in allergic rhinitis. Materials and Methods: The records of those patients with allergic rhinitis were analyzed retrospectively. Patients over two years of age who had complete blood count results from both their asymptomatic and the symptomatic periods were included in this study. Clinical characteristics (age, age at diagnosis, symptoms, and comorbid allergic diseases) and laboratory data (thrombocyte count, MPV, white blood cell count, eosinophil count, and percentage, immunoglobulin E level, and skin prick test results) were recorded from the patient files and the hospital registry system. Results: MPV values during the symptomatic periods were statistically significantly higher than those from the asymptomatic period (p<0.001) in all patients. When the patients were grouped according to having asthma or not, MPV was found to be higher in the symptomatic period compared to the asymptomatic period in the group with asthma, but there was no difference between these two periods in the group without asthma (p=0.017, p=0.102 respectively). Additionally, MPV levels were significantly higher in the asthma group during both the symptomatic and the asymptomatic periods (p=0.04, p=0.013, respectively). Conclusion: This study suggests that MPV cannot be used as an inflammation indicator in the symptomatic period for patients with allergic rhinitis. Asthma influences MPV values. It is recommended to conduct more detailed and prospective studies to show MPV inflammation in AR.Item Clinicopathological Evaluation of Childhood Sacrococcygeal Germ Cell Tumors: A Single-Center Experience(2022) Hasbay, Bermal; Canpolat, Tuba; Aktekin, Elif; Ozkan, Hasan; Kekec, Senay Demir; 35781237Objective: We aimed to evaluate the cases of sacrococcygeal germ cell tumors diagnosed in our hospital between 2006 and June 2021. Materials and Methods::We evaluated 38 sacrococcygeal germ cell tumors cases in our series in terms of age, sex, clinical complaints, localization, macroscopy, tumor size, histopathological diagnosis, surgical, postoperative complications, treatment, recurrence, and prognosis. Results: The cases ranged from 1 day to 16 years of age; 14 cases were diagnosed with routine ultrasonographic examination during prenatal period while the rest of the cases most frequently presented with complaints of constipation. In terms of localization, 6 cases were type 1, 11 cases were type 2, 6 cases were type 3, and 15 cases were type 4. In the pathological evaluation, 25 cases were mature teratoma, 8 cases were immature teratoma, and 5 cases were pure yolk-sac tumor. In terms of complications, temporary colostomy was performed as a result of rupture during birth in 2 cases, disseminated intravascular coagulation at birth in 1 case, and colon injury in 2 cases. There was a recurrence in 2 of our cases. Thirty-seven of our cases were alive and 1 died. Alpha-fetoprotein level was high in 28 of our cases. Conclusion: In our series, type 4 cases were observed more frequently, contrary to the literature. We recommend to use a routine ultrasonography to patients who come to the clinic with complaints of constipation and inability to urinate and if a mass is detected, asking for alphafetoprotein for further follow-up. Sacrococcygeal germ cell tumors are ultimately a disease that can be successfully treated with multidisciplinary approach, accurate diagnosis in the antenatal and postnatal period, appropriate surgical intervention, and regular follow-up.Item Prevalence Of Inguinoscrotal Pathologies And Risk Factors In A Cohort Of 388 Children With Spina Bifida(2022) Ozel, S. Kerem; Kucuknane, Mustafa Alper; Ozgenel, Dicle Ozge; Ozer, Vuslat; Canaz, Huseyin; Alatas, Ibrahim; 35899567Background. There is limited information about the prevalence and risk factors of inguinal hernia and undescended testis in patients with spina bifida (SB). The aim of this study was to identify the properties and prevalence of inguinoscrotal diseases in these patients. Methods. A questionnaire was completed by parents of patients with the diagnosis of SB in our center. Together with demographic data, presence an of inguinal hernia, side, operation history, presence of ventriculoperitoneal (VP) shunt, type of SB aperta or occulta, recurrence and presence of undescended testis were questioned. Patients were grouped into 2 as SB aperta and occulta. The prevalence of these pathologies and their clinical properties were evaluated. Results. In this study, 388 patients were evaluated. Of these, 238 patients had SB aperta and 150, SB occulta. There was no significance in comparison of gender. The prevalence of inguinal hernia was 12.6% in general. A hernia was noted in 37 SB aperta patients (15.6%) whereas this was seen in 12 of the SB occulta patients (8%) (p=0.029). When there was a VP shunt, hernia prevalence was 21.5% and when there was no shunt, this ratio was 7.1% (p=0.0001). Prevalence of inguinal hernia was 21.8% in males and 3.2% in females (p=0.0001). When there was a VP shunt with SB aperta the prevalence was 21.9% and when a VP shunt was present with SB occulta, this number was found to be 13.3% (p=0.006). The prevalence of undescended testis was 17.7% and there was no difference between SB aperta and occulta patients. Conclusions. Inguinal hernia and undescended testis are more frequent in SB patients when compared to the normal population. VP shunts and male gender may be risk factors for inguinal hernia in these children. These findings may imply neurological factors in the etiology of inguinal hernia and undescended testis.Item Rituximab Treatment In Children With Difficult-To-Treat Nephrotic Syndrome(2022) Parmaksiz, GonulPurpose: Rituximab (RTX) has been offered as rescue therapy for patients with difficult-to-treat nephrotic syndrome (frequent relapsing, steroid-dependent and steroid resistant). We aimed to assess the efficacy and long-term outcomes of RTX treatment in children with difficult nephrotic syndrome and shared our experiences Materials and Methods: Medical records of children with difficult nephrotic syndrome who were treated with RTX were retrospectively evaluated. The relapse-free survival rate at 12 month and monitoring of B-cell depletion were assessed. Results: In the study included 20 children of which 8 had steroid-dependent (SDNS), 6 had frequent relapsing (FRNS), and 6 had steroid-resistant nephrotic syndrome (SRNS). The median number of relapses at 1 year before and after treatment in FRNS/SDNS patients receiving RTX treatment were compared. The median number of relapses decreased from 2 (1-4) to 0 (0-1) times/year. The mean duration of the follow-up period after RTX treatment was 23 (12-59) months, and 8 patients developed relapse. Repeated doses of RTX were administered to 5 patients who relapsed after RTX treatment. In these patients, CD19+B cells re-emerged during remission, while depletion of memory B-cells remained. Conclusion: The RTX treatment prolonged the remission time in FRNS/SDNS patients, but it was ineffective in SRNS patients. It was determined that the RTX doses can be repeated to maintain remission in these patients, and the best memory B-cell counts can help in timing the repeat doses.Item Evaluation of the Impact of Environmental Changes on Asthma Control in Children, Access to Health Care, and Treatment Adherence in Early COVID-19 Lockdown(2022) Sancakli, Ozlem; Tuncel, Tuba; Akarcan, Sanem Eren; Kanik, Ali; Ozyurt, Gonca; 35383020Objective: During the coronavirus disease 2019 pandemic, lockdown measures and difficulties in accessing healthcare have impacted asthma management in children. This study aimed to determine the evaluation of the impact of environmental changes on asthma control in children, access to health care, and treatment adherence in early coronavirus disease 2019 lockdown. Materials and Methods: The study included children with asthma aged 6-11 years. A survey form was administered to the patients who visited the pediatric allergy outpatient clinic between June 1 and 30, 2020. The survey acquired demographic information about the children and their families as well as information about their asthma symptoms, how they reached healthcare services, and adherence. The childhood asthma control test was administered. The P values < .05 were considered significant. Results: The study included a total of 123 children (female/male : 48/75) with a mean age of 8.4 +/- 1.9 years. According to the mothers' self-report, it was found that 78% of the patients were not able to follow-up routinely, 19.5% were non-adherence to treatment, and 16.2% were poorly controlled asthma. It was found that, based on childhood asthma control test scores, asthma control was better during the pandemic lockdown period (P = .001). Asthma symptoms were better in 41.5% of the patients compared to the previous months and in 53.7% compared to the same period last year. Conclusion: Our study found that the children's asthma was controlled although most of them did not have their follow-up visits, and poorly controlled asthma was higher in older children in early coronavirus disease 2019 lockdown.Item Effect of Inhaled Corticosteroid Treatment on Body Composition Parameters in Children with Asthma(2021) Koksal, Burcu Tahire; Yilmaz Ozbek, OzlemObjective: Prolonged treatment with low doses of inhaled corticosteroids may affect the growth rate; however, limited data are currently available for body composition parameters in children with asthma. We examined whether treatment with inhaled corticosteroids has an effect on body mass index, basal metabolic rate, percentage body fat, obesity degree, fat mass, and muscle mass in children with mild asthma. Materials and Methods: The study was performed in 45 children with mild persistent asthma being treated with inhaled corticosteroids and 45 healthy controls. Body composition parameters; body mass index, percentage body fat, obesity degree, basal metabolic rate, body fat mass, muscle mass, and waist-hip circumferences were measured. Written questionnaires including duration of television/computer viewing, frequency of fast food consumption, and weekly physical activity were completed. Results: There was no difference in body composition parameters and waist-hip circumference measurements between the groups. A positive correlation was demonstrated between the duration of inhaled corticosteroid treatment and the percentage of body fat, muscle mass, fat mass, and hip circumference. When compared with healthy controls, a significant increase in the duration of television/ computer viewing and frequency of fast food consumption and a significant decrease in weekly physical activity were observed in children with asthma. Conclusion: Body composition parameters seem not to be affected in the inhaled steroid-using children with asthma. However, as the duration of inhaled corticosteroid treatment increased, the percentage of body fat, body fat mass, and hip circumference also increased. Children with asthma should be encouraged to increase physical activity and be recommended to decrease the duration of television/computer viewing.Item Uncoupling protein gene UCP1-3826A/G, UCP2 Ins/Del and UCP3-55C/T polymorphisms in obese Turkish children(2020) Verdi, Hasibe; Kinik, Sibel Tulgar; Cebi, H. Pinar Baysan; Yalcin, Yaprak Yilmaz; Guvercin, Ayse Canan Yazici; Aydin, Beril; Tutunc, Neslihan Bascil; Atac, F. Belgin; 0000-0002-9141-9987; 0000-0002-9337-9106; 0000-0002-1816-3903; 33372430; AAH-2620-2021; ABB-4078-2020; ABG-5027-2020Background. Mitochondrial uncoupling proteins (UCP) 1, 2 and 3 are members of the anion carrier protein family located in the inner mitochondrial membrane. There are various controversial reports on UCP genotypes and obesity in adults and children. This study aims to investigate the link between mostly studied UCP polymorphisms (UCP1-3826A/G, UCP2 Insertion/Deletion ans/Del) polymorphism of exon 8, and UCP3-55C/T Polymorphisms) and obesity in Turkish children. Furthermore, the relationships of UCP polymorphisms are also analyzed within the scope of metabolic parameters of obese children. Methods. Molecular screening of the UCP2, UCP2, and UCP3 gene polymorphisms was carried out in 189 children aged 6 to 18 years, 102 of who had exogenous obesity (54 girls) and 87 of whom were healthy controls (48 girls). In the obese group, fasting lipids, glucose and insulin levels were measured. In 60 obese children, an oral glucose tolerance test (OGTT) was performed with 0, 30, 60, 90 and 120 minutes of sampling for plasma glucose and insulin levels. Results. The frequency of UCP polymorphisms was similar in obese and non-obese children. In obese children, fasting lipids, glucose and insulin levels were not different among the UCP1, 2 and 3 genotypes. While no relationship was found between the UCP1 and 3 genotypes and glucose/insulin levels during OGTT, carriers of the Insertion allele with UCP2 Ins/Del polymorphism had significantly higher 30-minute insulin levels (p=0.018). Conclusions. Polymorphisms of the UCP1-3826A/G, UCP2 Ins/Del, and UCP3-55C/T are not associated with obesity and related pathologies in Turkish children. However, the presence of the Ins allele of the UCP2 gene has been found to have an unfavorable influence on early insulin excursion after glucose loading.Item Comparison of Cross Reactions Between Cow's Milk and Other Mammals' Milk Using Skin Prick Test and Atopy Patch Test in Children with Atopic Dermatitis and Cow's Milk Allergy(2019) Sancakli, Ozlem; Yenigun, Ayse; Tuncel, TubaObjective: The use of other mammals' milk as an alternative treatment of cow's milk allergy is controversial due to their similar protein structures. In the present study, we aimed to investigate cross reactions with sheep's, goat, and camel's milks using skin prick test and atopy patch test in children with cow's milk allergy. Materials and Methods: Our study group was composed of patients with atopic dermatitis who were diagnosed with cow's milk allergy in our former study where we investigated the sensitivity of different diagnostic tests commonly used to determine cow's milk allergy. In all patients, cow's milk, sheep's milk, goat's milk and camel's milk were used for skin prick test and atopy patch test. The study data were analyzed with SPSS 20.0 for Windows. Results: Among the patients with cow's milk allergy, 15 (63%) had early-onset and 9 (37%) late-onset reactions with provocation tests. Seven (70%) of 10 children who were found skin prick test positive with cow's milk were shown to have a cross reaction against goat's and sheep's milk with skin prick test; 8 (88.8%) of 9 children who were found to be atopy patch test positive with cow's milk had a cross reaction against goat's milk, and 7 (66.6%) against sheep's milk. No patient with cow's milk allergy had a cross reaction with camel's milk with either skin prick test or atopy patch test. Conclusion: Our study demonstrated that a cross reaction occurs at a quite high rate between cow's milk, sheep's milk and goat's milk as revealed by both skin prick testing and atopy patch test, whereas there was no demonstrable cross reaction between cow's milk and camel's milk by either method.Item Percutaneous endoscopic gastrostomy experience in children and family satisfaction(2019) Canan, OguzPurpose: The aim of this study was to evaluate the demographic data, complication rates of children who underwent percutaneous endoscopic gastrostomy (PEG) and to question family satisfaction. Materials and Methods: Demographic information, underlying diseases, anthropometric measurements before and after PEG and z scores advanced complications due to processing and follow-up periods were obtained from patient files. Results: In three years, 21 patients underwent PEG procedures. The median age of the patients was 74 months. The majority of the cases consisted of children with neurological, oncological and metabolic diseases (71.4%, 14.3% and 14.3%, respectively). There was a statistically significant increase between baseline and 6th month and between baseline and 12th month of the all antropometric measures z scores. But no significant difference was observed between 6th month and 12th month of the median weight and height z scores. Parents' opinions about PEG were positive. After the procedure, one patient had ostomy leakage and three patients had local stoma infection. Conclusion: Percutaneous endoscopic gastrostomy is a very successful and reliable method in children and adolescents as well as in infants. Families' opinions on PEG after the procedure were positive.Item beta-3AR W64R Polymorphism and 30-Minute Post-Challenge Plasma Glucose Levels in Obese Children(2015) Verdi, Hasibe; Kinik, Sibel Tulgar; Yalcin, Yaprak Yilmaz; Sahin, Nursel Muratoglu; Yazici, Ayse Canan; Atac, F.Belgin; 25800470Objective: In this study, we aimed to investigate the association of W64R polymorphism of the beta 3-adrenergic receptor gene (beta-3AR) with childhood obesity and related pathologies. Methods: beta-3AR gene W64R genotyping was carried out in 251 children aged 6-18 years. Of these subjects, 130 were obese (62 boys) and 121 were normal-weight (53 boys). In the obese group, fasting lipids, glucose and insulin levels were measured. Oral glucose tolerance test (OGTT) was performed in 75 of the obese patients. Results: The frequency of W64R genotype was similar in obese and nonobese children. In obese children, relative body mass index, waist-to-hip ratio, serum lipid, glucose and insulin levels, as well as homeostasis model assessment of insulin resistance (HOMA-IR) scores were not different between Arg allele carriers (W64R and R64R) and noncarriers (W64W). In 75 obese children, OGTT results showed that Arg allele carriers had significantly higher 30-minute glucose levels (p=0.027). Conclusion: W64R polymorphism of the beta-3AR gene is not associated with obesity and waist-to-hip ratio in Turkish children. Although there were no relationships between the genotypes and lipid, glucose/insulin levels or HOMA-IR, the presence of W64R variant seemed to have an unfavorable influence on early glucose excursion after glucose loading.