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    A key challenge in gestational diabetes screening: resistance to oral glucose tolerance test screening and implications for neonatal health
    (2021) Tursun, Serkan; Yeral, Mahmut İlkin; Yıldız, Volkan; Ünal, Elif Gökçe; Guzoglu, Nilufer; Aliefendioglu, Didem
    Objective: Gestational diabetes mellitus (GDM) is the most common endocrine disorder in pregnancy, and the number of pregnant women resistant to oral glucose tolerance test (OGTT) has increased significantly in recent years. In this study, we investigated the extent of resistance to OGTT screening among pregnant women followed-up in our hospital and the effects of this situation on the newborn. Materials and Method: We conducted this study with pregnant women and their babies who were regularly followed up in the Obstetrics and Gynecology Department and Pediatrics Department of our hospital between December 1, 2015, and December 31, 2017. While we included those who did not accept an OGTT in the study group (Group 1), and we created the control group with those who accepted the test. Besides, the control group was divided into two groups as those accepted as GDM (Group 2) and normal (Group 3). Ultimately, we scrutinized the relationship between the OGTT and clinicopathological findings. Results: We included a total of 906 pregnant women and their babies in the study. Of women, 374 (41.3%) did not accept the test. The cesarean (C/S) delivery rate was significantly lower in the babies of mothers who did not have an OGTT (p<0.05). In addition, the hospitalization rate of the newborn babies of mothers who had an OGTT but did not have gestational diabetes was significantly lower than the other two groups (p<0.05). Conclusion: Our study revealed that resistance to the OGTT was a far-reaching issue and may lead to an increase in the hospitalization of newborns. Our results suggested that the inability to perform OGTT may have been due to some unidentified problems.
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    Ailelerin Korkusu, Ateş
    (2016) Tursun, Serkan; Alpcan, Ayşegül
    Ateş, çocuk acil servisine en sık başvuru nedenlerinden biridir. Aileler tarafından bir semptom olarak değil de bir hastalık olarak algılandığı için gereksiz endişelere yol açmaktadır. Ateşin ve ateşe yaklaşımın sağlık çalışanları, aileler ve çocuğun bakımını üstlenen kişilerce iyi bilinmesi gereklidir. Bu makalenin amacı ateş hakkında bilgi vererek, ateşli çocuğa nasıl yaklaşılması gerektiğini vurgulamaktır
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    An adolescent case with unexplained ecchymosis: Munchausen syndrome
    (2022) Tursun, Serkan; Çelik, Cansu; Alpcan, Ayşegül; Albayrak, Meryem
    Munchausen syndrome (MS) is a condition in which a patient deliberately mimics signs and symptoms of health problems to gain attention\rfrom their close circle and healthcare professionals. Symptoms can be self-induced or fabricated. The paper aimed to discuss MS detected\rin an adolescent girl who presented with hematological findings and shift the interest to factitious disorders that may be confronted in\rpediatric practice. A thirteen-year-old girl was admitted to the pediatric hematology outpatient clinic with bruises spread throughout the\rbody, predominantly localized on the arms, persisting for three months and disappearing every two weeks. She had complaints of fatigue and\rloss of appetite, emerging simultaneously with the occurrence of bruises. Following elaborative examinations, we discovered that the patient\rwas painting bruises on her skin using an eye shadow. MS needs to be considered in differential diagnoses among patients with long-term,\rinconsistent, and irrational complaints, no underlying causes, and normal laboratory findings. Overall, we presented the case to underline\rthat MS is likely to be confronted in pediatric practice.
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    ANALYSIS OF POISONING CASES ADMITTED TO THE PEDIATRIC EMERGENCY DEPARTMENT: 5 YEARS OF CLINICAL EXPERIENCE
    (2021) Şenses, Oğuzhan; Tursun, Serkan; Alpcan, Ayşegül
    Objective: Intoxication is one of the most acute causes of morbidity and mortality in childhood. Analyzing poisoning cases is considered noteworthy in terms of both adopting appropriate clinical practice approaches and taking relevant preventive measures.Material and Methods: We reviewed a total of 674 pediatric intoxication cases admitted to our hospital over a 5-year period (2014-2019). We retrospectively extracted clinical data of all cases from the hospital information system and forensic records.Results: Among all cases, we found the rate of intoxication to be 0.54% and the mean age at presentation to be 8.65±6.0 years. While 51.5% of the cases were girls and 48.5% were boys. The most common cases were seen in children aged 1-5 years mostly boys with accidents and 15-17 years mostly girls with suicide causes. We detected that medical drugs ranked first place in poisoning with a rate of 39.5% and followed by intoxications due to carbon monoxide and chemical corrosive substances, respectively. Nervous system drugs (21.7%) were more common in intoxication, while the most common drugs taken for suicide purposes were anti-depressants (n = 20; 16%). Symptomatic treatment was applied to the majority of the cases (61.7%). The mean length of hospitalization was 1.23±1.22 days and none of our patients were lost.Conclusion: While drug intoxication is seen with a high frequency in all age groups, accidental intake is at the forefront at young ages, while suicide attempts are seen at a high rate in adolescent group and girls.
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    Aseptic meningitis caused by Coronavirus OC43 in a child: A case report
    (Bayrakol Medical Publisher, 2022) Demirbaş, Yasemin; Alpcan, Ayşegül; İnal, Mikail; Güney, Şeyma; Tursun, Serkan; Kandur, Yaşar
    Human coronavirus OC43 (HCoV-OC43) is one of the coronaviruses that cause the mild cold. On the other hand, extra-respiratory manifestations such as cen-tral nervous system infections with HCoV-OC43 are very rarely reported. We present a case of a previously healthy immunocompetent child with acute aseptic meningitis, as a result of HCoV-OC43 who admitted to the emergency department with a complaint of unconsciousness.. Respiratory tract and cerebrospinal fluid culture showed HCoV-OC43 in viral screening. During the follow-up period, the patient was completely asymptomatic, with normalized consciousness. The clinicians should keep in mind that HCoV-OC43 can be the etiological agent in the differential diagnosis of aseptic meningitis in immunocompetent individuals with reversible neurological symptoms.
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    Association between serum ferritin level and thyroid hormones in hypothyroid pediatric patients
    (2021) Alpcan, Ayşegül; Kandur, Yaşar; Tursun, Serkan; Albayrak, Meryem; Ergür, Ayça Törel
    Aim: The present study aimed to investigate the iron store status in patients with hypothyroidism due Hashimoto thyroiditis and subclinical hypothyroidism. Material and Method: We retrospectively reviewed the medical records of patients who were followed up at our university hospital with the diagnosis of hypothyroidism due to Hashimoto thyroiditis and subclinical hypothyroidism between 2010-2021. Results: Nineteen patients with Hashimoto thyroiditis, 17 with subclinical hypothyroidism, and 20 controls were enrolled in this study. There was no significant difference in mean age among three groups (138.3±46.8 months, 116.0±68.1 months, 151.8±50.3 months in groups of Hashimoto thyroiditis, subclinical hypothyroidism and controls respectively p=0.169) . There was a significant female preponderance in HT group (68.5%, p=0.001). There was no significant difference for mean ferritin levels among groups (p=0.440). There was no correlation between TSH and ferritin level (r=-0.132, p=0.410) but we found a positive correlation between ferritin and free T4 level (r=0.340, p=0.030). Conclusion: We found a positive relationship between ferritin and thyroxine hormone that made us think that iron supplementation may be effective in the treatment of hypothyroidism. But this hypothesis warrants further prospective and experimental studies.
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    BİR ÜNİVERSİTE HASTANESİ ÇOCUK ACİL SERVİSİNE BAŞVURAN KARBONMONOKSİT ZEHİRLENMELERİNİN GERİYE DÖNÜK İNCELENMESİ
    (2020) Tursun, Serkan; Alpcan, Ayşegül; Karahan, İrfan
    Amaç: Karbonmonoksit zehirlenmeleri ölümcül olabilen vetoplu zehirlenmelere yol açabilen ciddi bir sağlık sorunudur.Bu çalışmada çocukluk çağında olup karbonmonoksitzehirlenmesi ile acil servise başvuran hastaların özellikleri,klinik ve laboratuvar bulgularının araştırılması amaçlanmıştır.Gereç ve Yöntemler: Kırıkkale Üniversitesi Tıp FakültesiÇocuk Acil Servisi’ne 2014-2020 yılları arasındakarbonmonoksit zehirlenmesiyle başvuran 114 olgu geriyedönük incelendi. Hastaların demografik özellikleri,başvurularının dikkati çeken noktaları başvurudaki belirti vebulguları, laboratuvar değerleri irdelendi. Hastalık şiddetinegöre ve hiperbarik oksijen tedavisi alıp almama durumuna göreikili gruplamada temel laboratuvar düzeyleri karşılaştırıldı.Bulgular: Ortanca yaşı 8 olan 56 kız, 58 erkek hastanınbaşvurularının 102’sinde başvuran hasta dışında ailedenbiri/birileri bulunmaktaydı. En sık kaynak soba, en sıkbaşvurulan ay Ocak ayıydı. En sık semptom bulantı vekusmaydı. Hastaların genel olarak laboratuvar tetkiklerininortanca değerleri normal aralıklarda seyretmekle birlikte;karboksihemoglobin, laktat, troponin, INR, kan glukozu,karaciğer hasar testleri gibi düzeylerinde anormal değerleriolan hastalar da mevcuttu. Klinik şiddete göre hafif ve ortaolgular karşılaştırıldığında karboksihemoglobin, laktat ve INRdüzeyleri orta şiddetteki hastalarda daha yüksek saptandı.Sadece iki tane hasta ağır olgu olduğu için karşılaştırmayaalınmadı. Olgular, hiperbarik oksijen tedavisi alan ve almayanşeklinde gruplanıp laboratuvar düzeyleri karşılaştırıldığında;troponin T, laktat ve karboksihemoglobin düzeylerinde anlamlıfarklılık mevcut saptandı.Sonuç: Çocukluk çağında ciddi problemlere yol açabilen vesemptomları nedeniyle tanıda zorluk yaşanabilenkarbonmonoksit zehirlenmeleri için farkındalık arttırılmalı vesık görüldüğü zamanlar için tedbirler alınmalıdır.
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    BİR ÜNİVERSİTE HASTANESİ ÇOCUK ACİL SERVİSİNE BAŞVURAN KARBONMONOKSİT ZEHİRLENMELERİNİN GERİYE DÖNÜK İNCELENMESİ
    (Kırıkkale Üniversitesi, 2020) Tursun, Serkan; Alpcan, Ayşegül; Karahan, İrfan
    Amaç: Karbonmonoksit zehirlenmeleri ölümcül olabilen ve toplu zehirlenmelere yol açabilen ciddi bir sağlık sorunudur. Bu çalışmada çocukluk çağında olup karbonmonoksit zehirlenmesi ile acil servise başvuran hastaların özellikleri, klinik ve laboratuvar bulgularının araştırılması amaçlanmıştır.Gereç ve Yöntemler: Kırıkkale Üniversitesi Tıp Fakültesi Çocuk Acil Servisi’ne 2014-2020 yılları arasında karbonmonoksit zehirlenmesiyle başvuran 114 olgu geriye dönük incelendi. Hastaların demografik özellikleri, başvurularının dikkati çeken noktaları başvurudaki belirti ve bulguları, laboratuvar değerleri irdelendi. Hastalık şiddetine göre ve hiperbarik oksijen tedavisi alıp almama durumuna göre ikili gruplamada temel laboratuvar düzeyleri karşılaştırıldı.Bulgular: Ortanca yaşı 8 olan 56 kız, 58 erkek hastanın başvurularının 102’sinde başvuran hasta dışında aileden biri/birileri bulunmaktaydı. En sık kaynak soba, en sık başvurulan ay Ocak ayıydı. En sık semptom bulantı ve kusmaydı. Hastaların genel olarak laboratuvar tetkiklerinin ortanca değerleri normal aralıklarda seyretmekle birlikte; karboksihemoglobin, laktat, troponin, INR, kan glukozu, karaciğer hasar testleri gibi düzeylerinde anormal değerleri olan hastalar da mevcuttu. Klinik şiddete göre hafif ve orta olgular karşılaştırıldığında karboksihemoglobin, laktat ve INR düzeyleri orta şiddetteki hastalarda daha yüksek saptandı. Sadece iki tane hasta ağır olgu olduğu için karşılaştırmaya alınmadı. Olgular, hiperbarik oksijen tedavisi alan ve almayan şeklinde gruplanıp laboratuvar düzeyleri karşılaştırıldığında; troponin T, laktat ve karboksihemoglobin düzeylerinde anlamlı farklılık mevcut saptandı.Sonuç: Çocukluk çağında ciddi problemlere yol açabilen ve semptomları nedeniyle tanıda zorluk yaşanabilen karbonmonoksit zehirlenmeleri için farkındalık arttırılmalı ve sık görüldüğü zamanlar için tedbirler alınmalıdır.
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    Bölgesel nöral tüp defektli gebelerin sağlıklı gebelerle karşılaştırılması
    (2018) Sayan, Cemile Dayangan; Sağsöz, Nevin; Özkan, Zehra Sema; Yeral, Mahmut İlkin; Tursun, Serkan
    Amaç: Nöral tüp defektleri (NTD) nöral tüpün bir bölümünün kapanmasında meydana gelen kusur sonucu ortaya çıkan vesık görülen konjenital anomalilerdir. Dünya çapında her yıl yaklaşık 300.000 bebek NTD ile doğmaktadır ve NTD konjenitalanomalilerle ilişkili neonatal ölümlerin yaklaşık olarak %29’undan sorumlu tutulmaktadır. Bu çalışmada Kırıkkale ilinde2014-2017 yılları arasında saptanan NTD’li gebeler ile sağlıklı gebelerin demografik özellikleri ve laboratuar bulgularınıkarşılaştırmayı amaçladık.Gereç ve Yöntemler: Bu retrospektif çalışmaya NTD’i tanısı almış 27 olgu ve 30 sağlıklı gebe dahil edildi. Olgularındemografik verileri ve laboratuvar değerleri kayıtlardan tarandı ve kaydedildi. Bulgular NTD’li ve sağlıklı gebelik gruplarıarasında karşılaştırıldı.Bulgular: NTD’li hastaların 15 tanesi meningomyelosel, 4 tanesi anensefali, 2 tanesi ensefalosel, 2 tanesi eksensefali, 2tanesi anensefali+ensefalosel, 1 tanesi meningomyelosel+ensefalosel ve 1 tanesi de myeloşizis tanılı idi. NTD grubununortalama vücut kitle indeksi kontrol grubuna göre anlamlı olarak yüksekti. Gruplar arasında laboratuvar parametreleriaçısından istatistiksel olarak anlamlı bir fark yoktu.Sonuç: Kırıkkale ilinde NTD’li ve sağlıklı gebeleri karşılaştırdığımız çalışmamızda NTD grubunda VKİ’nin kontrol grubunagöre anlamlı daha yüksek olduğunu tespit ettik. Çok merkezli ve artmış popülasyonla yapılacak yeni çalışmalar, Türktoplumunda NTD risklerini ayrıntılı olarak belirlemek açısından faydalı olacaktır.
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    Cafeteria diet can cause systemic inflammation and oxidative damage in the various tissues
    (Ios Press, 2024) Tursun, Serkan; Şahin, Yaşar; Alcigir, Mehmet Eray; Çınar, Miyase; Karahan, İrfan
    BACKGROUND: Cafeteria diet (CAF) is a succesful tool for establishing animal obesity model. This study purposed to show immunoexpression and oxidant-antioxidant status in the various organ tissues of Wistar rats fed CAF. METHODS: Two groups (six rats per group) of Wistar albino rats were fed CAF and standard chow (control) diets for eight weeks. After experimental procedure, the animals were sacrificed. Intestine, stomach, liver, kidney, spleen, heart, lung, and pancreas tissues were sent to Pathology Department and inducible nitric oxide synthase (iNOS), nuclear factor-kappa B (NF-kappa B) and cannabinoid receptor-1 (CB-1) immunoexpressions were assessed. Also, plasma liver function tests and lipid levels were measured total oxidant capacity (TOC) and total antioxidant capacity (TAC) were evaluated in both plasma and liver tissue. RESULTS: The immunoexpressions of NF-kappa B, iNOS and CB-1 were higher in the experiment group for all tissues. TOC was significantly higher in the experiment group, for both plasma and liver tissue (p < 0.001 and p = 0.02). TAC was higher in the experiment group's plasma measurement (p = 0.02), while there was no difference in the liver tissue between experiment and control groups (p = 0.11). CONCLUSION: CAF-induced obesity may be related to increased immunoexpression and oxidative damage in the various organs. Systemic problems should be considered and these phenomenon should be studied more comprehensively.
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    Clinical characteristics of children with multisystemic inflammatory syndrome associated with COVID-19
    (Bayrakol Medical Publisher, 2022) Alpcan, Aysegul; Tursun, Serkan; Kandur, Yasar
    Aim: Coronavirus disease 2019 (COVID-19) has become a public health threat to people all over the world in 2020 and 2021. The Centers for Disease Control and Prevention (CDC) and WHO (World Health Organization) have named a novel disease multisystem inflammatory syndrome in children (MIS-C). Herein we aimed to present a group of pediatric patients with MIS-C, who were followed up in our clinic. Material and Methods: We retrospectively reviewed the medical records of patients who were followed up at our University Hospital with the diagnosis of MIS-C between January 2021 and May 2021. Results: The mean age of 9 patients was 87.4 +/- 17.8 years (range 6-161 months); six of the patients were male. All patients had fever at admission. The duration of the fever was between 3 and 7 days. Four patients (44.4%) had terminal ileitis on ultrasonic examination. The laboratory tests of the patients revealed leukocytosis in 4 (44.4%) patients, anemia in 5 (55.5%) patients, thrombocytopenia in 1 (11.1%) patient, and a high CRP level in 8 (88.8%) patients. All patients had high sedimentation rates and procalcitonin levels. One (11.1%) patient was operated on for terminal ileitis. All patients were treated with steroids (1-2 mg/kg prednisolone) and IVIG (2gr/kg). Patients who needed ICU admission were also treated with vasoactive drug infusion (intravenous dopamine). Discussion: There is a need for increased awareness among pediatricians that MIS-C should come to mind, especially in patients with long-lasting fever and signs and symptoms that resemble Kawasaki disease.
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    Clinical Patterns and Seasonal Distribution of Urinary Tract Infection Caused by Extended-spectrum Beta-lactamase-producing Bacteria in Children
    (Bilimsel Tip Yayinevi, 2021) Tursun, Serkan; Arslan, Zeynep; Alpcan, Aysegul; Gul, Serdar; Kandur, Yasar
    Introduction: Extended-spectrum beta-lactamase-producing Escherichia coli or Klebsiella pneumoniae infections in the pediatric age group are mostly nosocomial infections. This study aimed to investigate the clinical pattern of extended-spectrum beta-lactamase positive urinary tract infection and its seasonal distribution. Materials and Methods: We retrospectively reviewed the medical records of pediatric patients with extended-spectrum beta-lactamases-positive UTI, who were followed-up in our clinic between lune 2015 and lune 2020. Results: One hundred-and-ten patients with ESBL-positive UTI and 231 with non-ESBL UTI were enrolled in this study. The rate of male sex in the ESBL group was significantly lower than that in the non-ESBL group (10.9% vs 27.2%, p= 0.001). The patients with ESBL were older than those in the non-ESBL group (81.3 +/- 49.0 months vs 56.0 +/- 47.2 months, p= 0.001). E. coli was the most iso- lated bacteria in both groups (68% and 70.5%, respectively). The rate of Klebsiella isolation in urine culture was significantly greater in the ESBL group than in the non-ESBL group (p= 0.04). The seasonal distribution of ESBL-positive patients was as follows: spring (18/16.4%), summer (25/22.7%), autumn (25/22.7%), and winter (42/38.2%). Conclusion: There is a substantially high rate of antibiotic resistance among patients with urinary tract infection in developing countries like Turkey. Moreover, we should be aware of the risk of ESBL-positive UTIs, especially in winter.
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    Clinical significance of MEFV gene variation R202Q
    (Springer London Ltd, 2022) Kandur, Yasar; Kocakap, Derya Beyza Sayin; Alpcan, Aysegul; Tursun, Serkan
    Background The aim of this study was to evaluate the phenotypic features and the clinical significance of the R202Q mutation of the MEFV gene. Methods We retrospectively reviewed the medical records of Familial Mediterranean Fever patients with M694V/- and M694V/R202Q mutations. We compared the patients regarding disease severity, symptoms, age at the onset of symptoms, gender, consanguinity, and family history. Results Twenty-one patients (9 males, 12 females) had compound heterozygote mutation (M694V/R202Q), and 37 patients (23 males, 14 females) had M694V/- mutation. The mean age of the patients at the time of diagnosis was 7.3 +/- 4.3 and 9.2 +/- 3.7 years. The rate of arthritis was significantly higher in patients with M694V/R202Q heterozygote mutation than those with M694V/- heterozygote mutation (76.2% vs 32.4%; p= < 0.001). The mean severity score was higher in M694V/R202Q heterozygote group although it did not reach statistical significance (8.43 +/- 1.69 vs 7.49 +/- 1.50; p= 0.082). However, the rate of having a high severity score was significantly higher in the M694V/R202Q mutation group than in the other group (47.6% vs 21.6%, respectively; p= 0.039). The rate of arthritis was significantly higher in patients with M694V/R202Q heterozygote mutation than those with M694V/- heterozygote mutation (76.2% vs 32.4%; p= < 0.001). Conclusion Our finding supports the possibility that R202Q may be pathogenic rather than a variation. We found that the R202Q mutation is associated with the inflammatory phenotype of FMF; hence, the typical clinical findings of FMF especially arthritis can be observed in patients with compound mutation including R202Q.
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    Çocuklarda Fentanil Bant Kullanımı; Bilinçsiz Kullanım Ölümcül Olabilir
    (2020) Alpcan, Ayşegül; Tursun, Serkan; Ürem, Ozan; Tandırcıoğlu, Ayşe Ümit; Aydın, Gülçin; Aliefendioğlu, Didem
    Transdermal fentanil kullanımı özellikle süreğen ağrılı hastalarda son yıllarda artmıştır. Ancak uygun olmayan kullanımı ciddi sonuçlar doğurabilir. Burada acil servise solunum arresti ile başvuran ve uygunsuz fentanil kullanımına maruz kalan, 10 yaşındaki bir erkek hasta sunulmuştur.
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    Çocuklarda idrar yolları enfeksiyonları
    (2018) Alpcan, Ayşegül; Tursun, Serkan; Çelikel, Banu Acar
    İdrar yolu enfeksiyonları çocuklarda oldukça sık görülmektedir. En sık izole edilen ajan EscherichiaColi’dir. İnsidansı kızçocuklarda % 4-8 iken erkeklerde %1-2’dir. Çocuklarda ürosepsis, renal hasar, hipertansiyon, kronik renal yetmezlik ileilişkili olması sebebiyle endişe vericidir. Bu derlemede çocukluk çağı akut ve kronik idrar yolu enfeksiyonunun tedavisi veizleminin anlatılması amaçlanmıştır.
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    Çocuklarda üriner sistem taş hastalıkları
    (2017) Tursun, Serkan; Çelik, Cansu; Acar, Banu Çelikel
    son yıllarda çok daha fazla tanı almaya başlamıştır. Erken tanı, ortaya çıkabilecek ciddi morbiditeleri önlemek açısından önem taşır. Çocuklarda taş oluşumu altta yatan anatomik veya metabolik bir bozukluktan kaynaklanabilir. Klinik bulgular, çocuğun yaşı, taşın lokalizasyonu ve büyüklüğü ve altta yatan hastalığa bağlı olarak değişmektedir. Tedavide altta yatan nedenin ortadan kaldırılması önemlidir. Tedavi sonrasında yeni taş oluşumunun önlenmesi için yeterli sıvı alımının sağlanması, diyet ve yaşam tarzının düzenlenmesi gereklidir
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    Çocukluk çağının gizli tehlikesi; subklinik hipotiroidi
    (2017) Alpcan, Ayşegül; Ergür, Ayça Törel; Tursun, Serkan
    Tiroid hormonları; santral sinir sistemi gelişimi, büyüme, gelişme, vücut ısısı regülasyonu, lipit, karbonhidrat ve enerji metabolizması, iskelet sistemi üzerinde önemli role sahiptir. Diğer yönden çocukluk çağında santral sinir sistemi myelinizasyonunda görevli olduğu için önemi farklıdır. Subklinik hipotiroidi, serum tiroid stimulan hormon seviyesinin orta düzeyde artması ile birlikte serum tiroid hormon seviyelerinin normal referans laboratuvar aralığında olmasıdır. Çocuklarda %2 oranında görülmektedir. Etiyolojisinin büyük bir kısmını otoimmün tiroidit ve iyot eksikliği oluşturmaktadır. Asemptomatik olguların zamanında tanımlanması ve tedavisi önemlidir. Olgularda guatr, büyüme-gelişme geriliği veya duraksaması, ders başarısında azalma, negativizm, depresyon, obezite, demir eksikliği anemisi, dislipidemi, kemik yaşı geriliğinde levotiroksin tedavisi başlanması uygundur.
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    Comparison of the Effectiveness of Topical and Oral Beta Blockers in the Treatment of Childhood Hemangiomas
    (2023) Yüksel, Kerim Faruk; Kandur, Yaşar; Alpcan, Ayşegül; Tursun, Serkan; Vural, Sevde Nur; Albayrak, Meryem
    Purpose: Hemangiomas are the most common vascular tumors in childhood, and the treatment options have undergone profound changes in recent years. In this study, we aimed to compare the efficacy and safety of beta-blockers on hemangiomas, both topi-cal and oral, with non-pharmacological treatment in the pediatric age group. Material and Methods: We retrospectively reviewed the medical records of pediatric patients with hemangiomas. Results: Fifty-three patients (F/M=40/13) were enrolled in this study. Superficial hemangiomas were detected in 14 (26.4%) patients, and deep hemangiomas were detected in 39 (73.6%) patients. Seventeen patients were followed without medication, 19 were treated with a topical beta blocker, and 17 were treated with an oral beta blocker. Twelve patients with superficial hemangi-omas were followed without medication, while two received topical timolol treatment. A comparison of lesion progression in patients with superficial hemangiomas in the non-pharmacological treatment and topical treatment groups showed that the mean scores of success, in terms of mean fading and reduction in lesion depth, were significantly higher at the first month (7.0 vs. 1.66; p=0.049; 6.0 vs. 1.5; p=0.045). Among patients with deep hemangiomas, a comparison of mean fading scores showed no difference between the oral and topical treatment groups in the first and fourth months (p=0.551, p=0.551). Conclusion: We believe that oral beta-blockers can be used instead of topical treatment in the future, and they will be preferred more by clinicians and families due to less side effects.
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    Diagnostic Value of Plasma Soluble Triggering Receptor Expressed on Myeloid Cells-1 in Children with Urinary Tract Infections
    (Georg Thieme Verlag Kg, 2021) Tursun, Serkan; Alpcan, Aysegul; Ozsoy, Metin; Badem, Nermin Dindar; Kandur, Yasar; Acar, Banu Celikel
    Objective The aim of the present study was to evaluate the diagnostic value of soluble triggering receptor on myeloid cells-1 as a novel marker for diagnosis of childhood urinary tract infections (UTI). Methods This study enrolled 30 pediatric patients diagnosed with acute febrile UTIs; 30 healthy children were included as the control group. The blood samples from the patients and healthy controls were collected for a soluble triggering receptor on myeloid cells-1 (sTREM-1) test. Results The study group was composed of 9 males and 21 females, and the mean age of the study population was 6.63.2 (range=1-14) years. sTREM-1 levels were significantly higher in UTI patients than in the controls (592 +/- 323 vs. 490 +/- 299 pg/mL, p=0.04). The receiver operating curve analysis revealed a cut-off value of soluble triggering receptor expressed on myeloid cells-1 of 514 ng/mL (area under the curve=0.562). When the cut-off value was taken 514 pg/mL, soluble triggering receptor expressed on myeloid cells-1 had a sensitivity of 57% and a specificity of 50% for the diagnosis of UTI. Conclusion The present study revealed that plasma sTREM-1 level may be elevated in UTI and may therefore serve as a useful predictive tool for the diagnosis of UTI.
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    Does Subclinical Hypothyroidism Affect Dynamic Thiol/Disulfide Homeostasis and ischemia-modified Albumin Levels in Children?
    (COLL PHYSICIANS & SURGEONS PAKISTAN, 2020) Tursun, Serkan; Alpcan, Aysegul; Ergur, Ayca Torel; Karahan, Irfan; Neselioglu, Salim; Erel, Ozcan
    Objective: To determine the effects of subclinical hypothyroidism on oxidative stress in children. Study Design: A cross-sectional study. Place and Duration of Study: Department of Paediatrics, Paediatric Endocrinology, and General Outpatient Clinics, Kirikkale University, School of Medicine, from May 2017 to October 2018. Methodology: This study included 92 subjects aged between 2 and 18 years. The subjects were divided into two groups. Forty-seven children with subclinical hypothyroidism and 45 healthy controls were evaluated. In order to evaluate oxidative damage, native thiol, total thiol, disulfides, their ratios, and ischemia-modified albumin (IMA) levels were compared between the two groups. The relationship between TSH and IMA levels was assessed. Results: Age and gender were not significantly different in the two groups. Native thiol, total thiol, disulfides and their ratios were similar in the two groups. lschemia-modified albumin levels were significantly higher in the patient group than the controls (p<0.001). There was no correlation between TSH and IMA levels in the patient group (r=0.069 p=0.645). Conclusion: Subclinical hypothyroidism may be related to the impairment of IMA, and have a neutral effect on thiol/disulfide balance. Further research is needed to explain the effects of oxidative stress in subclinical hypothyroidism.