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    The basic needs of children on haemodialysis in Turkey
    (2008) Ensari, Cüneyt
    Background. Haemodialysis treatment can be very tiring and unpleasant, particularly for paediatric patients, families and also for the treatment team. In this study, the basic needs of children on haemodialysis were determined in order to improve the conditions of their therapy environment. Methods. The requirements of 20 children and 40 adults, who were on haemodialysis therapy for a minimum of five sessions, were recorded by means of a questionnaire. Results. The majority of children and adults preferred to be treated in separate units. All children and adults stated that they needed a constant transportation facility to be provided by the dialysis unit. All children wanted their parents/relatives to be with them during the dialysis sessions while only a minority of adults required an accompanying relative. The majority of both paediatric and adult patients preferred daytime sessions. The majority of children preferred to have the same nurse to needle their fistula and supervise their therapy session. Conclusions. The health authority should recognize the role of the therapy team, including a paediatric nephrologist, in providing the basic needs and fulfilling the expectations of paediatric haemodialysis patients in order to increase the efficiency of the treatment. © The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
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    The prevalance of enuresis nocturna among 6-10 year-old primary school children in Kırıkkale
    (Logos Medical Publishing, 2011) Soyer, Tutku ; Boybeyi, Özlem; Aslan, Mustafa Kemal; Durmuş, Gül; Çakmak, Zeynep Aytül; Ensari, Cüneyt
    Objective: A cross-sectional study was performed to evaluate the prevalence of enuresis nocturna (EN) among 6-10 year-old primary school children in Kırıkkale. Material and Method: Children (n:1500) aged between 6-10 years were included in the study. Questionnaires were answered by the parents to evaluate the demographic and voiding characteristics, time of toilet training, dysfunctional voiding (DV) symptoms, prevalence of EN, methods and results of EN treatment. DV score (DVS) validated for Turkish children were surveyed and scores greater than 8.5 were considered significant. Results: Children (n:1372) who completed the questionnaire were included in the study. The mean age of students was 8.27 years (M: F: 707:659). EN was noted in 11.4 % (n:157, group 1) of children. EN history was noted in 37.5 % (n:515, group 2) of children, and 51.1 % (n:700, group 3) of them had never EN. Toilet training was completed after 5 years of age in 5.2 % of the students with EN and 1.3 % of the children without EN (p<0.05). The mean DVS was 8.8 (1-28), 3 (1-16) and 2 (1-16) in Groups 1,2, and 3, respectively. DVSs greater than 8.5 were noted in 45.2 %, 4.5 % and 1.6 % in these 2 groups (p<0.05), respectively. In Group 2, 42.9 % EN cases were cured spontaneously whereas 57.1 % of them were cured with treatment. Supportive treatment was recommended for 80.2 % of the children, while 19.1 % of the children had medical treatment. Desmopressin (30 %), oxybutinin (26.6 %) and imipramine (20 %) were used in 3.82 % of the children. The 24.4 % of the parents found supportive treatment effective. Parents found medical and alarm treatment effective in 20 % and 16.6 % of the cases, respectively. Conclusion: The prevalence of enuresis was 11.4 % among 6-10 year-old primary school children in our province. DV symptoms were more frequent in children with EN. Nearly half of the children with EN had been never consulted to a physician. No standard mode of follow-up and treatment was noted for these children. © 2011 Logos Medical Publishing. All right reserved.
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    The spectrum of FMF mutations and genotypes in the referrals to molecular genetic laboratory at KÄaut +/- rÄaut +/- kkale University in Turkey
    (Springer, 2009) Günel-Özcan, Ayşen; Sayin, Derya Beyza; Mısırlıoğlu, Emine Dibek; Guliter, Sefa; Yakaryilmaz, Fahri; Ensari, Cüneyt
    Familial Mediterranean Fever (FMF) is an autosomal recessive genetic disorder characterised by recurrent and self-limited abdominal pain, synovitis and pleuritis. MEFV gene mutations are responsible from the disease and its protein product, pyrin or marenostrin, plays an essential role in the regulation of the inflammatory reactions. MEFV gene contains 10 exons and most of the mutations have been found on the last exon. Up to date, 152 mutations and polymorpisms have been reported inwhere V726A, M694V, M694I, M680I and E148Q are the most common mutations. In this study, MEFV allele frequencies of 136 individuals (60 from Pediatry, 76 from Internal Medicine) have been evaluated, and compared with each other. Asymptomatic individuals with FMF family history (4 from Pediatry, 6 from Internal Medicine) were excluded from the analysis. The prominent mutations indicated in the Pediatry group are V726A, M694V and M680I (G/C) and with the allele frequency of 0.06, 0.05 and 0.04 respectively while they were E148Q, M694V, M680I (G/C) in the Internal Medicine group with the allele frequency of 0.12, 0.08 and 0.04. The E148Q mutation is significantly overrepresented in the adult referrals (P = 0.02). Mutation on both alleles was observed in only 12% of cases. Overall mutation frequency was low, seen in 26.2% (66/252). However, when only diagnosed patients were analyzed it is 72.7% (16/22). It is also interesting that 63% of individuals are female that there may be sex influence on FMF phenotype.