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    Cardiac troponin-I as a marker of myocardial dysfunction in children with septic shock
    (SMW supporting association, 2004) Gurkan F.; Alkaya A.; Ece A.; Haspolat K.; Boşnak Mehmet; Bilici M.; Kervancioglu M.
    Objectives: Cardiac depression is well known in severe sepsis and septic shock. Our aim was to investigate the incidence of myocardial ischaemia as shown by cardiac troponin I (cTnI) levels in patients with septic shock and to evaluate the correlation with myocardial dysfunction measured by echocardiography. Methods: The study was performed in the paediatric intensive care unit in Dicle University Hospital, Turkey, between January 2001 and December 2002. Patients in septic shock, with a mean age of 6.4 ± 2.8 months, were simultaneously submitted to a two-dimensional echocardiogram and biochemical investigation on admission. Results: The mean serum cTnI level of the patients was 3.1 ± 2.6 ng/ml (0.01-9.80 ng/ml) and the mean LVEF value was calculated as 48% ± 11%. 21 patients (75%) had a cTnI level ?0.6 ng/ml, and 15 patients (54%) had a LVEF <0.5. For cTnI levels ?0.6 ng/ml, sensitivity and specificity were 93.3% and 46.2%, and positive and negative predictive values were 66.7% and 85.7% respectively. For cTnI values ?2.0 ng/ml, sensitivity and specificity were 86.7% and 76.9%, and positive and negative predictive values were 81.3% and 83.3%, respectively. There was a statistically significant relationship between LV dysfunction and cTnI positivity (r2 = 0.316, p = 0.002). No significant difference was found for the cTnI levels ?0.6 ng/ml between non-survivors and survivors (p <0.05). Conclusion: Myocardial ischaemia and cell injury seem to be common in patients with septic shock and correlate with left ventricular dysfunction. Measurement of cTnI may be an easy and practical tool for monitoring cardiac damage in critically ill septic patients.
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    Correlation of mean platelet volume, neutrophil-to-lymphocyte ratio, and disease activity in children with juvenile ıdiopathic arthritis
    (E-Century Publishing Corporation, 2015) Güneş A.; Ece A.; Şen V.; Uluca Ü.; Aktar F.; Tan İ.; Yel S.
    Juvenile idiopathic arthritis (JIA) is a chronic inflammatory arthritis characterized by periods of remission and relapse. Mean platelet volume (MPV) is an indicator of systemic inflammation. In the present study, we aimed to determine the association between mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), platelet distribution width (PDW) and clinical measures of diseases activity in children with JIA. The study included 115 patients with JIA (64 with active disease and 51 with inactive disease) and 64 age-gender matched healthy control subjects. Routine laboratory methods were used to measure white blood cell count (WBC), platelet count (PLT), neutrophil count, lymphocyte count, hemoglobin (Hb), MPV, PDW, NLR, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in all subjects of both the patient and control groups. Active disease was associated with significantly increased MPV (8.23 ± 1.16 fl) compared with inactive disease (7.00 ± 1. 08 fl) and control subjects (6.77 ± 1.08 fl) P<0.001, P<0.001, P=NS, respectively). NLR was significantly higher in patients with active (2.11 ± 1.19) and inactive (2.03 ± 1.51) disease relative to the control subjects (1.33 ± 0.66) (P<0.001, P=0.017, respectively). Mean PDW was significantly higher in patients with active disease (17.84 ± 1.06) compared with the control group (17.19 ± 0.93) (P=0.01). Our results suggest that MPV may be a useful marker of disease activity in patients with JIA. Regular treatment may decrease platelet activation in JIA patients. However, NLR was not a predictive marker of disease activity in patients with JIA. © 2015, E-Century Publishing Corporation. All rights reserved.
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    The effects of pomegranate and carvacrol on methotrexate-induced bone marrow toxicity in rats
    (The Canadian Society for Clinical Investigation, 2014) Şen V.; Bozkurt M.; Söker S.; Ece A.; Güneş A.; Uluca Ü.; Söker M.
    Purpose: The aim of this study was to evaluate the effects of pomegranate (PMG) extract and carvacrol (CARV) on methotrexate (MTX)-induced oxidative stress and bone marrow toxicity. Methods: Wistar albino rats (32 rats) were divided into four groups (n=8): Group 1 was control; Group 2 was given a single intraperitoneal injection of methotrexate (20 mg/kg); Group 3 was treated with carvacrol (73 mg/kg i.p.) one day before MTX (20 mg/kg i.p.) injection; and, Group 4 received a single dose of MTX (20 mg/kg i.p) while PMG was administered orally for seven days at 225 mg/kg. After animals were euthanized, blood samples were taken to evaluate hematological parameters and oxidative stress. In addition, the femur was cropped and bone marrow was extracted for examination. Results: White blood cell count, hemoglobin, hematocrit and platelet count were found to be decreased in the MTX group, but these changes were prevented in the groups that received CARV and PMG. Furthermore, decreased bone marrow cellularity was found in the groups treated with MTX, whereas the PMG and CARV groups had cellularity similar to controls. Strikingly, oxidative stress increased in the MTX group, but was ultimately decreased in the rats that received the antioxidants PMG and CARV. Conclusion: Carvacrol and PMG were found to be protective against methotrexate induced oxidative bone marrow damage. Use of these antioxidants, in combination with chemotherapeutics, may help to reduce some adverse effects of methotrexate. © 2014 CIM.
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    Parental history of migraine and bronchial asthma in children
    (2000) Gürkan F.; Ece A.; Haspolat K.; Dikici, Bünyamin
    Background: a possible association between migraine and various allergic disorders have been reported. It was aimed in this study to inquire the association between bronchial asthma in children and parental history of migraine. Methods and results: parental history of allergic diseases and migraine were inquired among 140 asthmatic children (91 males, 49 females) and 110 age and sex matched control subjects who had not any allergic or hypersensitivity disorders, followed-up at Pediatric outpatient clinics of Dicle University Hospital. While 13 of 140 asthmatic children (9.3%) had parental history of migraine, 2 of 110 control subjects (1.8%) had parental migraine history. Difference between asthmatic and control subjects was significant (OR: 5.5, 95% Cl: 1.3-25.0). Children who had parental history of migraine also had significantly more frequent parental history of asthma, eczema and particularly allergic rhinitis (p = 0.007). Conclusions: our results suggest that children are at increased risk of asthma if their parents have a history of migraine. Migraine in one generation and asthma in the next lead to the conclusion that the two disorders may have a relationship to a common denominator.
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    Passive smoking and expired carbon monoxide concentrations in healthy and asthmatic children
    (2000) Ece A.; Gürkan F.; Haspolat K.; Derman O.; Kirbaş G.
    Background: Carbon monoxide (CO) in expired air has been reported to be an indirect measurement for the quantity of passive smoking. Since endogen CO is produced in inflammatory processes and inflammation is the main pathogenetic mechanism of asthma, it was aimed to investigate the relationship between the intensity of passive smoking and CO concentration in expired air of healthy and asthmatic children. Methods and Results: the study was performed in the outpatient pediatrics clinics and day care centers. Knowledge about indoor smoking habits were obtained from parents. The exhaled CO concentrations were measured by a portable device in 235 healthy (mean age, 4.4 ± 2.3 years) and 54 asthmatic (mean age, 4.5 ± 1.7 years) children. Children with no smoking parents had the lowest exhaled CO concentrations. Significant relationships were found between the number of smoking cigarettes in the house and exhaled CO concentrations in both healthy (p = 0.003) and asthmatic (p = 0.01) children. Carbon monoxide concentrations were higher in asthmatic children than healthy ones (mean ± SD, 1.32 ± 1.50 ppm and 0.86 ± 1.35 ppm, respectively, p = 0.028) if their parental smoking habits were not taken into account. Asthmatic children of nonsmoking parents had higher CO concentrations than healthy subjects of non-smoking parents (1.05 ± 1.55 ppm vs 0.37 ± 0.53 ppm, p = 0.01). On the other hand, asthmatic children who has no smoking parents and did not receive inhaled steroids had significantly higher CO concentrations (1.75 ± 1.45 ppm) than those who received steroids (0.58 ± 0.65 ppm, p = 0.024). Conclusions: exhaled CO can be used as an indicator of passive smoking in children. Higher expired CO of asthmatic children may reflect inflammation of the lung in asthma.
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    Prevalence of asthma and other allergic disorders among schoolchildren in Diyarbakir, Turkey
    (2001) Ece A.; Ceylan A.; Saraçlar Y.; Saka G.; Gürkan F.; Haspolat K.
    This study was performed to describe the prevalence rates of allergic diseases among children in southeast Anatolia. A questionnaire survey of children six to 15 years old was conducted using a modified version of the Turkish translated ISAAC protocol, with additional questions concerning sociodemographic and environmental characteristics of children that could be potential risk factors for allergic disorders. Questionnaires were distributed to parents of all children aged below 11 years and to children themselves aged over 11 for completion. A total of 3,040 children returned the questionnaires. The lifetime prevalence rates of asthma, wheezing, allergic rhinitis and atopic dermatitis were 14.1%, 22.4%, 12.9%, and 7.8%, respectively. The prevalence of wheezing, rhinitis and chronic rash in the last 12 months were 14.7%, 39.9%, and 11.8%, respectively. The prevalence rates of symptoms and diagnoses of allergic disorders were similar in boys and girls. Passive smoking, pet ownership, number of household and socioeconomic status were not significant risk factors for allergic diseases. Family history of atopy was the most prominent risk factor for all types of allergic diseases. high prevalence rates of asthma, rhinitis and eczema exist among schoolchildren in southeast Anatolia.
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    An unusual cause of acute abdominal pain in children: Biliary ascariasis
    (1999) Dokucu A.I.; Ozturk H.; Bukte Y.; Ece A.; Otcu S.; Yucesan S.
    Ascariasis is one of the most common worldwide helminthic disease that may cause various complications. The presence of this worm in the biliary tree, however, is a rare condition, especially in children. We describe a child with biliary ascariasis who was presenting clinical symptoms mimicking surgical acute abdomen. The diagnosis was made by ultrasound. The child was successfully treated with mebendazole and antispasmolytic. Biliary ascariasis should be added to the differential diagnosis of acute abdominal pain in patients, even in children, from endemic areas.