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Öğe Assessment of parents' knowledge regarding phenylketonuria and its affecting factors: a cross-sectional study(African Field Epidemiology Network-Afenet, 2022) Öztürk, Fatma Üneşi; Bülbül, Selda Fatma; Alpcan, AyşegülIntroduction: the management of phenylketonuria (PKU) is complex. Practical skills and knowledge of individuals taking care of PKU patients are important for treatment compliance. This study investigated parents' knowledge about PKU and its affecting factors. The study group consisted of 62 parents of PKU patients. Methods: data were collected using a ready-made questionnaire on sociodemographic characteristics, PKU and dietary treatment. Total knowledge score (KS) was calculated by giving 5 points for each correct answer. Results: the study included 34 mothers and 28 fathers; 90.3% of patients were diagnosed during the newborn screening program, 6.5% between ages 1 and 2, and 3.2% at age 6 or after. Among all, 38.7% presented to their follow-up appointments with their mothers, 61.3% with both their parents and none with their father alone. Mothers answered all questions more accurately than fathers. Mothers' and fathers' mean KSs were 73.97 +/- 12.72 and 53.04 +/- 22.25, respectively. The highest KS was obtained among parents whose children were 13 years of age or older. Conclusion: the presence of another family member, parents' education level, working status and professional qualifications, previous training on PKU and family's economic status were the affecting factors. Creating a PKU dietary plan requires knowledge and diligence. Patients and their parents should be periodically informed about the disease and dietary treatment in order to increase their level of knowledge.Öğe 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, YaşarHuman 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.Öğe Domestic Lifestyle and Nutritional Status of Children During Covid-19 Pandemics(Galenos Publ House, 2021) Bülbül, Selda; Gülbahçe, Aliye; Göksen, Nil Koç; Ata, Ali Emrecan; Kocagözoğlu, Sevim GoncaObjective: After Covid-19 pandemic was declared, a number of restrictions have been imposed all over the world. We aimed to detect changes in eating habits of children and adults during Covid-19 pandemic when lifestyle changes were inevitable due to these restrictions. Methods: This is a descriptive cross-sectional study. The data collection process was completed by online questionnaire forms sent via mail system. There were questions about demographic characteristics of the participants and their children, lifestyle changes during the pandemic period and awareness of the pandemic. Participants with more than one child were asked to use the information of their youngest children. In statistical analyzes we used Statistical Package for Social Science (SPSS) 20.0 for Windows. Pearson Chi-square test was used for comparisons of categorical variables. The significance level was accepted as p <= 0.05 in all statistical processes. Results: A total of 327 people between 19-65 years of age participated in this study, and 174 of them had children with a mean age of 6.8 years, including 96 (55.7%) boys and 78 (44.3%) girls. Among all children, physical activity decreased in 101 (58%), screen time increased in 87 (50%) and 40 (23%) of them consumed their meals in front of the screen. The snacking habits of 130 (74.8%) children increased, 34 (19.5%) started consuming too much junk food and 12 of them (6.9%) gained weight. We observed that boys consumed more food than girls during their stay at home when compared to usual prerestriction days as they felt anxious and troubled (p=0.02). Conclusion: Pandemics do not affect our lives not only with disease burden but also, have effects on daily lives of families and children. During this period, besides precautions against infection, special interest should be given to feeding, sleeping habits and physical activities that would boost immune system and measures should be taken to prevent harmful habits.Öğe Diagnostic Approach in Cystinuria: A Case Report(Galenos Publ House, 2021) Bülbül, Selda; Gülbahçe, Aliye; Kocagözoğlu, Sevim GoncaCystinuria is an, inherited metabolic disorder progressing with recurrent kidney stones due to impaired reabsorption of dibasic amino acids and arises from mutations in the SLC3A1 and SLC7A9 on chromosome 2. Cystine crystals were detected in the urinalysis of a 17 -year -old male patient who was investigated for recurrent kidney stones. Because of demonstration of cystine excretion in the urinary amino acid analysis and having positive family history, we suspected Cystinuria Type B and initiated supportive therapy. However, based on the results of molecular analyses his diagnosis was changed as Cystinuria Type A. In conclusion, our final diagnosis was changed according to the molecular analyses but our treatment approach did not change. Therefore we would like to emphasize that, prominent physical examination findings and supportive laboratory test results will be sufficient for the diagnosis of cystinuria.Öğe Allergic Contact Dermatitis to Temporary Black Henna Tattoo Due to Sensitization to Para-Phenylenediamine(Bilimsel Tip Yayinevi, 2021) Dibek Misirlioglu, Emine; Tanidir, Merve; Büyüktiryaki, Betül; Kanık Yüksek, Saliha; Şahiner, Neriman; Güvenir, Hakan; Azkur, DilekThe fashion for temporary black henna tattoo is becoming increasingly more common among young adults and teens. An adolescent case with itching, erythema, edema, and inflammatory discharge on the right forearm two days after a temporary tattoo application is presented in this report. To determine the contact sensitizer, a patch test was performed one month after the end of the treatment. A bullous strong positive reaction (3+) was observed against para-phenylenediamine at the 48th and 72nd hours of evaluation after the application. Despite the common belief that henna tattoo application is harmless, the ingredients used in henna tattoo especially paraphenylenediamine can lead to allergenic reactions that can even be severe.Öğe 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, Ayşegül; Gül, Serdar; Kandur, YaşarIntroduction: 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.Öğe Factors Affecting Burden of Psychopharmacological Medication in Patients with Autism Spectrum Disorder: The Importance of Early Diagnosis(Kure Iletisim Grubu A S, 2016) Bodur, Şahin; Taşkıran, Candan; Işıldar, Yetiş; Alan, Burcu Ersöz; Çetinkaya, Miray; Kara, Halil; Şahin, MehmetObjective: The aim of the present study is to specify the frequency in psychopharmacological medication use in children with autism spectrum disorder (ASD) and determine their age range at diagnosis. Methods: Five hundred and twenty three children with ASD who applied to Dr. Sami Ulus Maternity and Children Research and Training Hospital between 2010-2015 were reviewed retrospectively. Data has been obtained from computerized hospital information system. Individuals with the diagnosis of Autism (F84.0), Atypical Autism (F84.1) and Pervasive Developmental Disorder Not Other Specified (F84.9) were screened. Results: Psychotropic medication was recommended to 28.5% of the 523 children and adolescents diagnosed with ASD. Antipsychotics were the most common drugs of choice among psychotropic medications. The mean age at diagnosis of patients taking psychotropic medication was significantly higher than that of the patients who were not taking psychotropic medication (t=-3.064; p<0.01). The rate of psychotropic drug usage in female patients was significantly high than male patients (chi(2)=6.675; p=0.01). Conclusion: The results of the present study suggest that the delay of diagnosis can be included as a factor for psychotropic medication need of patients with ASD. Nearly half of the patients have been diagnosed in the first three years of their life. For further benefits of studies in Turkey, evaluating the psychopharmacological drug prescription rate, age of diagnosis and related factors to determine the present situation of psychotropic medication in our country will be necessary.Öğe Differences in Possible Risk Factors, Treatment Strategies, and Outcomes of Neonatal Pneumothorax in Preterm and Term Infants(Aves, 2024) Tandırcıoğlu, Ümit Ayşe; Koral, Umran; Güzoğlu, Nilüfer; Alan, Serdar; Aliefendioğlu, DidemObjective: The study aimed to compare the risk factors, treatment strategies, and early outcomes of symptomatic neonatal pneumothorax (NP) between preterm and term newborns. Materials and Methods: This retrospective cross-sectional study was conducted in a neonatal intensive care unit between 2015 and 2022, consisting of hospitalized neonates with symptomatic NP. The cases were divided into three groups according to their gestational ages: <34(0/7 )(group 1), 34(0/7)-36(6/7) (group 2), and >= 37(0/7) weeks (group 3). Risk factors, treatment strategies, and mortality rates of the study groups were compared using Kruskal-Wallis analysis. Results: Fifty-nine infants with a diagnosis of symptomatic NP were included in the study. The number of participants was as follows: 25 (42.3%) in group 1, 18 (30.5%) in group 2, and 16 (27.1%) in group 3. The need of delivery room (DR) resuscitation was significantly higher in group 1 (40%, P = .003). The surfactant administration rate was significantly higher in group 1 when compared to group 2 and group 3 (68% vs. 22% and 19%, respectively), P < .001. Similarly, the invasive mechanical ventilation percentage was significantly higher in group 1 than group 2 and group 3, P = .014. However, compared to group 3 (63%), the percentage of chest drain insertion (CDI) need was significantly higher in group 1 (96%) and group 2 (89%) (P = .014). Conclusion: Exposure to DR resuscitation and the need for surfactant are the most common risk factors for NP in preterm infants. Although oxygen and/or needle aspiration treatments are less invasive in symptomatic NP, the improvement rate without CDI is very low in preterm infants born before 34 weeks of gestational age.Öğe Common viral respiratory infections in children with cancer during the COVID-19 pandemic: a multicenter study from Türkiye(Turkish J Pediatrics, 2024) Kacar, Dilek; Kebudi, Rejin; Özyörük, Derya; Tuğcu, Deniz; Bahadir, Aysenur; Özdemir, Zeynep Canan; Özgüven, Ali AykanBackground. Microbiologic confirmation of respiratory tract infections gained importance during the coronavirus disease 2019 (COVID-19) pandemic. This study retrospectively evaluated seasonal distribution, clinical presentation, and complications of respiratory viral infections (RVIs) other than COVID-19 in children with cancer during and after the pandemic lockdown. Methods. Two hundred and sixty-five inpatient and outpatient RVI episodes in 219 pediatric cancer patients confirmed by multiplex reverse transcriptase polymerase chain reaction (RT-PCR) panels from 13 centers were enrolled. Results. Eighty-six (32.5%) of the total 265 episodes occurred in 16 months corresponding to the lockdowns in T & uuml;rkiye, and the remaining 67.5% in 10 months thereafter. Human rhinovirus/enterovirus (hRE) (48.3%) was the most common agent detected during and after lockdown. Parainfluenza virus (PIV) (23.0%), influenza virus (9.8%), and respiratory syncytial virus (RSV) (9.1%) were the other common agents. The 28.7% of episodes were lower respiratory tract infections (LRTIs), and complications and mortality were higher than upper respiratory tract infections (URTIs) (25.0% vs 5.3%). Bacteremia was identified in 11.5% of culture-drawn episodes. Treatment delay in one-third and death within four weeks after RVI in 4.9% of episodes were observed. Conclusion. During the pandemic, fewer episodes of RVIs occurred during the lockdown period. Respiratory viruses may cause complications, delays in treatment, and even death in children with cancer. Therefore, increased awareness of RVIs and rapid detection of respiratory viruses will benefit the prevention and, in some cases, abrupt supportive and some antiviral treatment of RVI in children with cancer.Öğe Acute Kidney Injury in Very Preterm Infants: A Cohort Study in a Level III NICU(Galenos Publ House, 2024) Güzoğlu, Nilüfer; Tandircioglu, Ümit Ayşe; Bulut, Aye; Acar, Banu Çelikel; Aliefendioglu, DidemBACKGROUND/AIMS: Acute kidney injury (AKI) is not rare among preterm infants in neonatal intensive care units (NICU). It raises mortality and morbidity in NICUs and also chronic kidney disease in the long term. The aim of this study was to define the incidence of clinical characteristics and the course of AKI in very preterm infants. MATERIALS AND METHODS: A retrospective cohort study was conducted in a level III NICU in a university hospital. All very preterm infants born in the same hospital during the study period were included in this study. Patient data were taken from the medical records. AKI diagnosis was made using the neonatal-modified Kidney Disease Improving Global Outcomes (KDIGO) criteria. RESULTS: AKI was diagnosed in 20 very preterm infants (42%). The median time of AKI diagnosis was 4.5 days of life (between 2-12 days). While there were 8 infants with AKI when the diagnosis was made based on the serum creatinine (Cr) level being over 1.5, the diagnosis of AKI increased to 20 with the use of the KDIGO criteria. Need for resuscitation in the birth room, patent ductus arteriosus, the number of cases of apnea, desaturation episodes, sepsis, hypotension, inotropic support, and sepsis rates were significantly higher in the AKI group. Days hospitalized among survivors were longer and mortality was higher in the AKI group than in the non-AKI group (p=0.042, p<0.0001 respectively). CONCLUSION: The neonatal KDIGO criteria are beneficial and also informative in diagnosing and staging AKI. Close follow-up of urine output and Cr levels especially in the first days is essential in very preterm infants.Öğe The diagnostic value of n-terminal probrain natriuretic peptides to differentiate neonatal pneumoniae and transient tachypnea of the newborn(Tubitak Scientific & Technological Research Council Turkey, 2023) Arslan, Zeynep; Alan, Serdar; Aliefendioglu, DidemBackground/aim: The primary objective of the study was to determine the diagnostic value of serum N-terminal probrain natriuretic peptide (NT-proBNP) levels to differentiate neonatal pneumonia (NP) and transient tachypnea of the newborn (TTN). The secondary objective was to investigate the prognostic role of NT-proBNP levels in neonates with severe respiratory distress (RD). Materials and methods: A prospective, observational, single-blinded study involving 58 late preterm and term newborns who were diagnosed with TTN or NP was conducted between June 2020 and June 2021 at a level-3 neonatal intensive care unit in Kirikkale University Faculty of Medicine. TTN and NP groups were compared for serum NT-proBNP levels measured at the 1st and 24th hours of life. Optimal cut-off NT-proBNP value was determined by Youden index to predict the diagnosis of NP. Lung ultrasound was used to support the diagnosis of TTN and NP. In addition, lung ultrasound score (LUS) was used to determine severe RD. Results: The median of NT-proBNP level was significantly higher at the 24th hour of life in the NP group than in the TTN group, respectively 7263.5 pg/mL (1643-35,000) and 3308 pg/mL (69-19,746), p = 0.004. At a cut-off value of 5515.5 pg/mL, NT-proBNP had a sensitivity of 75% and specificity of 73.8% to predict NP [AUC= 0.749 (95% CI: 0.602-0.895; p = 0.004)]. The study population was divided into two groups as high score group (n: 23, LUS >= 7) and low score group (n: 35, LUS < 7) according to the LUS at the 6th hour of life. NT-proBNP values at 24th hour of life were 6320 pg/mL (69-35,000) in high score group and 3500 pg/mL (570-15,948) in low score group, p = 0.044. Duration of oxygen support (p = 0.006), noninvasive ventilation (p = 0.008) and NICU stay (p = 0.004) were higher in high-score group. Conclusion: NT-proBNP values at 24th hour of life can be used as a relatively early predictor in the differentiation between NP and TTN in late preterm and term neonates. In addition, elevated NT-proBNP values are related to the higher LUS which reflects the severity of RD regardless of diagnosis.Öğe Karbonmonoksit zehirlenmesi(2017) Tursun, Serkan; Alpcan, Ayşegül; Şanlı, Cihat; Kabalcı, MehmetTatsız, kokusuz ve renksiz zehirli bir gaz olmasından dolayı "sessiz katil" olarak da tanımlanan karbonmonoksit, ölümcül zehirlenmelerin en sık sebeplerindendir. Tüm dünyada olduğu gibi ülkemizde de ciddi bir tehdittir. ABD'de her yıl karbonmonoksit zehirlenmesinden etkilenen 45 bin /500 milyon kişinin 4 bini ölürken, ülkemizde bu veriler net değildir. Spesifik bir antidot yoktur. En sık uygulanan tedavi yöntemi normobarik ve hiperbarik oksijen tedavisidir. Hiperbarik oksijen tedavisi nörolojik bulguları azaltılmasına da katkı sağlar.Öğe Outcomes of Eltrombopag Treatment and Development of Iron Deficiency in Children with Immune Thrombocytopenia in Turkey(2020) Yozgat, Ayça Koca; Yaralı, Neşe; Özbek, Namık Yaşar; Leblebisatan, Göksel; Şaşmaz, Hatice İlgen; Akbayram, Sinan; Özel, Simge ÇınarObjective: Immune thrombocytopenia (ITP) is a rare autoimmune disease and hematologic disorder characterized by reduced platelet counts that can result in significant symptoms, such as bleeding, bruising, epistaxis, or petechiae. The thrombopoietin receptor agonist eltrombopag (EPAG) is a second-line agent used to treat chronic ITP purpura in adults and children. Materials and Methods: The present retrospective study evaluated the efficacy, safety, and side effects of EPAG treatment in pediatric patients with acute refractory and chronic immune thrombocytopenia, particularly focusing on iron-deficiency anemia. Results: The diagnosis was chronic ITP in 89 patients and acute refractory ITP in 16 patients. The mean age of patients was 9.5±4.5 years (minimum-maximum: 1.2-18 years) at the beginning of EPAG treatment. The overall response rate was 74.3% (n=78). The mean time for platelet count of ?50x109/L was 11.6±8 weeks (range: 1-34 weeks). The treatment was stopped for 27 patients (25.7%) at an average of 6.8±9 months (range: 1-38 months). The reason for discontinuation was lack of response in 18 patients, nonadherence in 4 patients, and hepatotoxicity in 2 patients. Response to treatment continued for an average of 4 months after cessation of EPAG in 3 patients.Conclusion: Results of the current study imply that EPAG is an effective therapeutic option in pediatric patients with acute refractory and chronic ITP. However, patients must be closely monitored for response and side effects during treatment, and especially for iron deficiency.Öğe Intracranial hemorrhage due to vitamin K deficiency in ınfancy: Clinical and radiological findings(2009) Mısırlıoğlu, Emine Dibek; Aliefendioğlu, Didem; Bademci, Gülşah; Baydar, Zekiye; Köse, Gülşen; Çakmak, Fatma NurBu çalışmada; K vitamini eksikliğine bağlı intrakraniyal kanaması olan 25 infantın klinik, radyolojik bulguları ve risk faktörleri geriye dönük olarak değerlendirildi. 25 olgunun 2 (%8)'si klasik tip ve 23'ü geç başlangıçlı tipte idi. 18 (%72)'i erkek ve 7 (%28)'si kız idi. Olguların 24 (%96)'ü sadece anne sütü ile beslenmekteydi. Olguların 18'ine doğumdan sonra K vitamini uygulanmıştı. En fazla görülen semptom kusma (%44) ve konvülsiyon (%40) idi. En fazla saptanan muayene bulgusu fontanel bombeliği (%40) ve solukluk (%40) idi. Onbir (%44) hastada intrakraniyal kanama birden fazla bölgede vardı ve kanama en fazla (%68) intraparankimal alana olmuştu. 12 olgu izleminde normal mental-motor gelişim gösterirken, mortalite oranı %8 bulundu. İntrakraniyal kanama özellikle geç tipin bulgusu olup en fazla intraparankimal alanda olmaktadır. Anne sütü ile beslenen bebeklerde doğumdan sonra K vitaminin yapılmamış olması en önemli risk faktörüdür.Öğe Pertussis; Still a clinical diagnosis(2006) Koçak, Ülker; Şanlı, Cihat; Albayrak, Meryem; Bulduk, Erol Reyhan; Saygı, SemraBoğmaca, öksürük nöbetleriyle karakterize akut, bulaşıcı bir solunum yolu enfeksiyonudur. Bebeklerde en önemli ve ciddi komplikasyonu pnömoniye bağlı solunum yetmezliğidir. Nöbetlerle boğulur tarzda öksürük ve siyanoz ile başvuran, hiç aşı olmamış, yatışının ikinci gününde pnömoni, altıncı gününde lökomoid reaksiyon geliştiren üç aylık bebek sunulmuştur. Özellikle bebeklerde pnömoninin mortalite ile ilişkisi ve lö¬komoid reaksiyonun prognostik önemi vurgulanmıştır.Öğe Bebek Beslenmesinde Kullanılan Mamalar(2017) Bülbül, Selda FatmaBebek beslenmesinde kullanılan her besin maddesinin güvenli bir temele oturtulması ve bebeğin sağlığına hiçbir şekilde zarar vermeyecek nitelikte olması gerekir. Anne sütünün verilemediği nadir bazı durumlarda, çoğunlukla anne sütü ile adapte edilmiş endüstriyel formül sütler (mamalar) kullanılmaktadır. Bu ürünlerde optimum standartları sağlamak ve besin eksikliklerini önlemek amacıyla üretim aşamaları ve piyasaya verilişleri Codex Alimentarius'a göre standardize edilmiştir. Ayrıca, Dünya Sağlık Örgütü ve Birleşmiş Milletler Çocuk Fonu (UNICEF) 1981 yılında, emzirmenin korunması ve yaygınlaştırılması yoluyla ve gerekli olduğunda anne sütü muadillerinin yeterli bilgi ve uygun pazarlama ve dağıtıma dayanan uygun kullanımını sağlayarak, bebeklerin güvenli ve yeterli besin almalarına katkıda bulunmak amacıyla "Mama Kodu" olarak bilinen yasayı ortaya koymuştur. Bu yazıda doğal olmayan bebek beslenmesinde mamaların yeri, mama çeşitleri ve kullanım standartları tartışılmıştır.Öğe Yenidoğan yoğun bakım ünitemizdeki erken ve geç trombositopeni nedenlerinin değerlendirilmesi(2015) Güzoğlua, Nilüfer; Kara, Nagihan Akıcı; Aliefendioğlu, DidemAmaç: Trombositopeni yenidoğan döneminde sık görülen hematolojik sorunlardan biridir. Bu çalışmanın amacı yenidoğan yoğun bakım ünitemizde (YYBÜ) yatan hastalarda trombositopeni sıklığı ve nedenlerini belirlemektir.Gereç ve Yöntemler: Ocak 2011- Mayıs 2014 tarihleri arasında YYBÜ'de yatan hastalar dosya kayıtlarından geriye yönelik olarak incelendi. Postnatal ilk 72 saatte gözlenen trombositopeni erken, 72 saatten sonra görülenler ise geç trombositopeni olarak tanımlandı. Hastaların demografik ve klinik özellikleri ve laboratuar bulguları kaydedildi. Bulgular: Çalışma süresince YYBÜ' de trombositopeni sıklığı %11 idi. Erken trombositopeni gözlenen hastaların trombositopeni nedenleri plasental yetmezlik (n=14), 1 hastada aynı zamanda kromozom anomalisi, sepsis (n=14), maternal trombositopeni (n=7), perinatal asfiksi (n=6), hemofagositoz (n=1) idi. İki hastada yalancı trombositopeni, 4 hastada tanısal değerlendirme yapılamamakla birlikte, neonatal alloimmün trombositopeni düşünüldü. Geç trombositopeni gözlenen hastaların trombositopeni nedenleri kültür pozitif sepsis (n=15), klinik sepsis (n=10), NEK (n=7), TAR Sendromu (n=1), CMV enfeksiyonu (n=1) ve yalancı trombositopeni (n=5) idi.Sonuçlar: Çalışmamızda ilk 72 saat içinde tanı alan hastalarda trombositopeni genellikle gebelik veya doğum komplikasyonlarına bağlı iken, 72 saatten sonra tanı alan hastalar sıklıkla edinilmiş enfeksiyon veya nekrotizan enterokolitle ilişkilidir. Sonuç olarak, trombositopeninin erken veya geç olması etiyolojik açıdan önemlidirÖğe Traditıonal child care procedures in an anatolian city(2009) Aliefendioğlu, Didem; Hızel, Selda; Mısırlıoğlu, Emine Dibek; Şanlı, Cihat; Albayrak, Meryem; Oktay, AylaAmaç: İnsanlık tarihi kadar eski olan geleneksel uygulamalar, günümüzde modernle- şen tıp tekniklerine karşın güncelliğini korumaktadır. Toplumsal ve kültürel özellik- ler, bebek bakımı ile ilgili davranışları da etkilemekte ve bunların bazıları bebek için yararlı iken bazıları bebek için zararlı olabilmektedır. Bu çalışma ile Anadolu’nun orta bölgesinde yer alan ve yoğun göç alarak kurulan Kırıkkale ilinde bebek bakımı ile ilgili geleneksel uygulamaların araştırılması amaçlanmıştır. Metod: Randomizasyon yöntemi ile seçilen evlerde annelere önceden hazırlanmış anket formları doldurtularak, annelerin sosyodemografik özellikleri ve geleneksel uygulamalar açısından pratikleri araştırıldı.Karşılaştırmalarda ki kare testi kullanıl- dı. Lojistik regresyon modelinde geleneksel uygulamaların evlenme yaşı ve eğitim düzeyi ile etkileşimi araştırıldı. Bulgular: Yaşları 18-60 arasında değişen toplam 974 anne ile görüşüldü. Annelerin 201 (% 43)’i 30 yaş altında idi. Yüzde yirmidokuzunun evlenme yaşı 17 veya altı iken, ilk gebeliği 17 yaş veya altında olanların oranı % 16 olarak bulundu. Tüm anne- lerin % 48’inin bebek bakımında en az bir geleneksel uygulamaya başvurduğu ve en sık uygulamanın kundaklama (% 27,2) olduğu görüldü. Eğitim düzeyi 8 yılın altında olanlarda, evlenme yaşı 17 yaş veya altında olanlarda ve son gebeliği üzerinden 10 yıldan uzun zaman geçmiş olanlarda bu uygulamalar daha fazla oranda idi (p<0,05). Sonuç: Günümüzde halen bebek bakımı ile ilgili geleneksel uygulamaların devam ettiği görülmektedir. Ancak, bebeğe zarar verebilme olasılığı da bulunan bu uygu- lamaların daha genç ve eğitimli anneler tarafından daha az yapılıyor olması, anne eğitiminin önemli olduğunu ve yıllar içinde toplumsal yapının az da olsa değiştiği izlenimini vermektedir.Öğe The frequency of A91V in the perforin gene and the effect of tumor necrosis factor-α promoter polymorphism on acquired hemophagocytic lymphohistiocytosis(2011) Okur, Hamza; Ünal, Şule; Balta, Günay; Efendioğlu, Didem; Çimen, Eren; Çetin, Mualla; Gürgey, AytemizAmaç: Edinsel hemofagositik lenfohistiositozun (EHL) gelişmesinde enfeksiyonlar, habis hastalıklar, kollajen doku hastalıkları gibi çok çeşitli etmen rol oynamaktadır. Aynı tetikleyici faktörü bulunan hastaların tümünde EHL’un gelişmemesi EHL’ye yatkınlık yapan ek genetik ve çevresel faktörlerin varlığına işaret etmektedir. Yöntem ve Gereçler: Perforin geninde A91V yanlış anlam değişikliği (perforin geninde ekzon 2, pozisyon 272’de C>T değişikliği) ve tumor nekrozis faktör (TNF)-? geninin promoter bölgesinde –1031T>C nükleotid değişikliği inflamatuvar yanıtı değiştirebilen ve bu nedenle EHL’ye yatkınlığa neden olabilen iki potansiyel adaydır. Çalışmamızda EHL’li hastalar ve kontrollerde bu değişiklikler incelenmiştir. Bulgular: 159 sağlıklı Türk popülasyonunda A91V değişikliği 7 (%4.4) kişide saptanmıştır. 44 EHL olgusunun beşinde (%11.3) bu değişiklik saptanmış olup, fark dikkat çekici olmakla birlikte istatistik- sel anlamlılık göstermemiştir (p=0.09); odds oranı 2.8 olarak hesaplanmıştır. A91V pozitif olan hastaların tümünde enfeksiyon altta yatan etiolojik nedendi. TNF-? -1031T>C polimorfizmi 164 sağlıklı birey ve 40 EHL’li hastada çalışıldı. Kontrollerin 7’sinde (%4.3) ve EHL bulunan hastaların 1’inde (%2.5) riski artıran CC genotipi saptandı. C ve T allel frekansları sırasıyla EHL’de 18 (%22.5) ve 62 (%77.5), kontrollerde 72 (%22) ve 259 (%78) olarak bulundu. Allel frekansları açısından gruplar arasında fark saptanmadı (p>0.05). Sonuçlar: Çalışmamızın sonuçları edinsel HLH’li hastalarda sağlıklı kontrollara göre A91V sıklığının 2.8 kat odds oranına göre daha sık olduğunu, A91V’nin sağlıklı Türk populasyonunda nadir olmadığını ve özellikle enfeksiyonu olanlarda EHL’ye yatkınlık yapabileceğini göstermektedir.Öğe Prevalence of metabolic syndrome in obese prepubertal and pubertal children(2015) Ergür, Ayça TörelAmaç: Çocukluk çağında Metabolik Sendrom (MS), ilişkili obezite glukoz intoleransı, insülin direnci, tip 2 diabet, dislipidemi ve diğer hormonal bozukluklarla karakterizedir. Ne yazık ki Maalesef bu olgular koruyucu önlemler alınmadığı taktirde erişkin yaşamda obez hale gelecektirler. Pediatrik yaşta MS prevelansı ülkemizde halen iyi bilinmemektedir. Bu amaçla çalışmamızda prepubertal ve pubertal çocuklarda MS ve diğer metabolik özelliklere ait prevelansın değerlendirilmesi amaçlandı.Gereç ve Yöntemler: 70 obez çocuk çalışmaya alındı. Antropometrik ölçümleri içeren detaylı muayenesi yapılan herbir çocuğa, kan biyokimyası; kan şekeri, renal ve hepatik fonksiyon testleri, lipidler, elektrolitler, hormonal değerlendirme için fT3, fT4, TSH tiroid otoantikorları, açlık insülin seviyeleri ve OGTT uygulandı. Metabolik sendrom kriterleri modifiye WHO kriterlerine göre tanımlandı. "Homeostasis model assessment of insulin resistance" (HOMA-IR) parametresi insülin rezistans indeksi olarak kullanıldı.Bulgular: Tüm olgularda MS prevalansı %18,8 olarak saptandı. MS prepubertal gruba göre pubertal grupta anlamlı derecede yüksekti (P > 0,05). Glukoz homeostazına ilişkin bulgular, prepubertal grupta açlık hiperinsülinemisi, bozulmuş glukoz toleransı olup sırasıyla %33,3 ve %5,5 idi. Aynı bulgular pubertal grupta sırasıyla %64,7 ve %23,5 idi. Hipertansiyon 4 (%11,7) pubertal vakada gözlendi. Prepubertal ve pubertal grupta dislipidemi sırasıyla %41,6 ve %41,1 olarak saptandı. Bu yönü ile anlamlı farklılık yoktu (P < 0,05).Sonuçlar: Obez pediatrik yaş grubunda özellikle anormal glukoz homeostazını içeren MS prevelansı belirgin yüksek saptandı. Sonuç olarak bu olgularda erken tanı, düzenli izlem ve gerekirse tedaviyle, beta hücre yıkımının ve tip 2 diabet gelişiminin önlenebileceği düşünülebilir
