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Öğe Assesment of Paediatric Varicella Pneumonia(Univ West Indies Faculty Medical Sciences, 2016) Aktar, F.; Tekin, R.; Bektas, M. S.; Kostu, M.; Aktar, S.; Gunes, A.; Uluca, U.Background: The objective of the study was to determine the clinical presentation, diagnosis, treatment, and respiratory complications of varicella zoster pneumonia (VZP) in children. Material and methods: Relevant data, age, gender, month of admission, demographic data, past medical and family histories, physical findings during admission, laboratory findings, treatments given, and outcome of these treatments with diagnosis of varicella pneumonia were collected retrospectively. Results: In a two-year period, 15 cases were identified and their data were analysed. Eight patients were male (53%) and seven were female (43%). The mean age was 4.7 +/- 3.7 months. Twelve cases (80%) were under six months of age and nine patients (60%) had household contact with persons with chicken pox infection. After onset of the chicken pox rash, the mean time for development of respiratory symptoms was 3.5 +/- 1.0 days. The mean hospital stay was 13 +/- 1.8 days and ranged from 9-17 days. The persisting fever, fatigue, and cough episodes were major presenting symptoms upon admission in almost all the patients. All patients received acyclovir and non-specific pneumonia treatment and all recovered. None of the children were previously immunized against varicella. Conclusions: Varicella zoster pneumonia should be considered in patients with prolonged fever and accompanying cough in patients with chicken pox. Probably the best approach would be a trial of high dose acyclovir treatment in children who develop VZP.Öğe Community-acquired urinary tract infections in children: pathogens, antibiotic susceptibility and seasonal changes(Verduci Publisher, 2013) Yolbas, I.; Tekin, R.; Kelekci, S.; Tekin, A.; Okur, M. H.; Ece, A.; Gunes, A.AIM: Urinary tract infections (UTIs) are common infections affecting children. The aim of our study is to determine microorganisms that cause community-acquired urinary tract infections and their antibiotic susceptibility in children. MATERIALS AND METHODS: Our investigation includes 150 cases which has positive urine culture. The cases are detected at Pediatric Polyclinics of Dicle University between June 2010 and June 2011. RESULTS: The study included 118 (78.7%) female and 32 (21.3%) male children. Urinary tract infections were seen in autumn 10.7% (n = 16), summer 35.3% (n = 53), winter 30.7% (n = 46) and spring 23.3% (n = 35). The culture results indicated 75.3% (n = 113) Escherichia coli; 20.7% (n = 31) Klebsiella; 2.7% (n = 4) Proteus and % 1.3 (n = 2) Pseudomonas. The antibiotic resistance against Escherichia coli was found out is amikacin (3%), ertapenem (7%), imipenem (0%), meropenem (0%), nitrofurantoin (9%), trimethoprim/sulfamethoxazole (58%), piperacillin (83%), amoxicillin/clavulanate (50%), ampicillin/sulbactam (65%), cefazolin (54%), cefotaxime (51%), cefuroxime sodium (51%) and tetracycline (68%). The resistance ratios of Klebsiella are amikacin (0%), imipenem (0%), levofloxacin (0%), meropenem (0%), amoxicillin/clavulanate (57%), ampicillin/sulbactam (79%), ceftriaxone (68%), cefuroxime sodium (74%) and trimethoprim/sulfamethoxazole (61%). CONCLUSIONS: The results represent the increasing antibiotic resistance against microorganisms among the community-acquired UTI patients in a developing country such as Turkey. So, the physicians should consider resistance status of the infectious agent and choose effective antibiotics which are nitrofurantoin and cefoxitin for their empirical antibiotic treatment. Furthermore, they should be trained about selection of more effective antibiotics and check the regional studies regularly.Öğe An evaluation of cases of pneumonia that occurred secondary to hydrocarbon exposure in children(Verduci Publisher, 2013) Sen, V.; Kelekci, S.; Sen, H. Selimoglu; Yolbas, I.; Gunes, A.; Abakay, O.; Gurkan, M. FuatOBJECTIVE: Hydrocarbon pneumonia is distinct among the types of childhood pneumonia in that it has a different pathogenesis and treatment and is preventable. In this study, the cases of 54 children with hydrocarbon pneumonia admitted to the Dicle University Medical Faculty Pediatric Chest Diseases Unit between the years 2006 and 2010 were analyzed retrospectively. PATIENTS AND METHODS: The medical records of 54 patients diagnosed with pneumonia after ingesting/inhaling hydrocarbons were analyzed retrospectively. Age, sex, presenting symptoms, clinical status, radiological and laboratory findings and response to treatment and prognosis were noted. RESULTS: 35 (64.8%) of the patients were male, 19 (35.2%) were female and the ages of the patients ranged from 1 to 5 with an average of 2.49 +/- 0.80. The etiologies of the pneumonia were thinner (33%), naphta (3.7%) and kerosene. In 49 of the patients (90.7%), the symptoms started to occur the day the patient was exposed to hydrocarbons. The average length of hospital stay was 4.0 +/- 2.3 days. Six patients were treated in the intensive care unit (ICU), and one patient with hydrocarbon pneumonia due to kerosene ingestion died. Inhaled corticosteroids were administered to 18 patients who were progressively deteriorating and inhaled salbutamol was given to 16 patients with bronchospasm. Patients with radiological findings on their chest X-rays and auscultatory findings were found to have longer hospital stays (p < 0.05). CONCLUSIONS: To prevent chemical pneumonia, precautions must be taken to stop children under 5 years of age from using/abusing chemical substances. Although some cases of chemical pneumonia lead to death, with diligent care and treatment, the outcomes are promising. The patients in this study group responded well to treatment with inhaled corticosteroids and salbutamol.Öğe The frequency of MEFV gene mutation in patients admitted to hospital with preliminary diagnosis of familian mediterranean fever who undergone a prior appendectomy(Verduci Publisher, 2012) Yolbas, I.; Ozen, F.; Kocak, N.; Kelekci, S.; Gunes, A.; Yel, S.OBJECTIVES, Familial mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent and self-limiting fever, peritonitis, arthritis, synovitis, pleuritis, carditis, and erysipelas-like lesions. The aim of this study was to investigate the frequency of the MEFV gene mutation in patients who admitted to hospital with preliminary diagnosis FMF and who had undergone a prior appendectomy. PATIENTS AND METHODS, We retrospectively reviewed the files of 52 patients between the ages of 7-18 who admitted to hospital with preliminary diagnosis of FMF and who had undergone a prior appendectomy. Age, gender and the MEFV gene mutations were included in the data. The 12 known, common MEFV gene mutations [E148Q, P369S, F479L, M680I (G/C), M680I (G/A), I692del, M694V, M694I, K695R, V726A, A744S, R761H] were investigated in the patients. RESULTS, Of these 52 cases, 29 (55.8%) were female and 23 (44.2%) were male. Their mean age was 12.1 +/- 3.1 years (range 7-18 yr). MEFV gene mutation was detected in 31/52 cases (59.6%). In this study was found an high frequency of the MEFV gene mutation in patients admitted to hospital with a preliminary diagnosis FMF who had undergone a prior appendectomy. MEFV gene mutations were M694V 16/41 (39%), E148Q 13/41 (31%), M680I 6/41 (15%), V726A 4/41 (10%) and R761H 2/41 (5%). Other genes mutations were F479L, M680I (G/A), I692del, M694I, K695R and A744S. CONCLUSION, There are too much indications of unnecessary appendectomy in MEFV gene mutation carriers. In MEFV gene mutation carriers the frequency of appendicitis can be higher than the normal population. A more detailed and extensive study should be done about it.Öğe URINARY EARLY KIDNEY INJURY MOLECULES IN CHILDREN WITH BETA-THALASSEMIA MAJOR(Pergamon-Elsevier Science Ltd, 2014) Sen, V.; Ece, A.; Uluca, I.; Soker, M.; Gunes, A.; Kaplan, O.; Tan, I.[Abstract Not Available]
