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    Clinical and Demographic Features of Children Diagnosed with Cystic Fibrosis after Sweat Test Screening for Failure to Thrive, Chronic Diarrhea or Recurrent Pulmonary Infections
    (Galenos Yayincilik, 2013) Konca, Capan; Gunes, Ali; Sen, Velat; Yel, Servet; Yolbas, Ilyas; Ece, Aydin; Gurkan, Mehmet Fuat
    Introduction: The aim of this study was to investigate the incidence of cystic fibrosis (CF) in patients with recurrent pulmonary infection, chronic diarrhea and failure to thrive having no specific diagnosis and also to investigate the demographic features, and clinic and laboratory findings of such patients. Materials and Methods: The diagnosis of CF has been established through measuring the sweat conductivity in children presenting with one or more characteristic phenotypic features of CF. A chloride concentration lower than 59 mmol/l was interpreted as negative; 60-79 as borderline and over 80 as positive. A borderline sweat test result supported with genetic mutation, nasal potential difference or elastase activity was diagnosed as atypical CF. Results: A total of 356 patients fulfilled the study criteria. Twenty (5.6%) patients were diagnosed as CF. The mean age of the patients was 19.3 +/- 18.1 months and 234 (65.7%) of them were boys. Of the patients suffered from recurrent pulmonary infection, chronic diarrhea and failure to thrive; 15.5%, 10.1%, and 7% were diagnosed as CF, respectively. Major presenting complaints were fever, respiratory tract diseases, failure to thrive, and chronic diarrhea in patients with CF. A total of 430 sweat tests were applied to 356 patients and 20 of the 33 patients with a test resulting over 60 mmol/L were diagnosed as CF. Conclusions: CF should be considered for the differential diagnosis of the patients presented with chronic diarrhea, recurrent pulmonary infection, and failure to thrive. While the incidence of CF in white people is approximately 1 in 3000 individuals, we found a higher rate of 5.6% in our study group.
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    Congenital tuberculosis: presentation of a rare case
    (Soc Argentina Pediatria, 2015) Sen, Velat; Sen, Hadice Selimoglu; Aktar, Fesih; Uluca, Unal; Karabel, Musemma; Gurkan, Mehmet Fuat
    Congenital tuberculosis is a rare disease with a high mortality rate. Congenital tuberculosis is considered the result of mother-to-child transmission from the placenta to the fetus, through the ingestion of the amniotic fluid, or via transplacental transmission through the umbilical vein. Given the non-specific clinical signs of tuberculosis, it is usually difficult to diagnose it. The case of a 48-day-old male infant hospitalized due to weight loss, fever, cough, hemoptysis, and respiratory distress for the past 20 days, is presented. In this period, he had received broad spectrum antibiotics but with no improvement. A chest x-ray showed the presence of consolidation and a cavitary lesion in the upper and middle left lung fields. Mycobacterium tuberculosis was detected by polymerase chain reaction in a bronchoalveolar lavage specimen. Congenital tuberculosis was diagnosed based on this finding; hence, a tuberculostatic regimen was started accordingly. The patient died 13 days after treatment initiation. Congenital tuberculosis should be considered in infants with weight loss, fever, cough, hemoptysis and respiratory distress.
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    The evaluation of children with prolonged cough accompanied by American College of Chest Physicians guidelines
    (Wiley, 2014) Karabel, Musemma; Kelekci, Selvi; Karabel, Duran; Gurkan, Mehmet Fuat
    Introduction In children, coughs lasting longer than 4 weeks are considered to be chronic, with etiological factors varying widely. Objective This study included children with chronic cough who were followed for 1 year. All cases were evaluated with the guidance of the American College of Chest Physicians (ACCP), and etiological factors were analyzed. Methods The study included 270 children between the ages of 2 months and 14 years. Their presenting symptoms, physical examination findings and laboratory data were recorded. All patients underwent laboratory tests including direct chest X-ray and spirometric measurements. Several patients required additional advanced examinations such as a sweat test, determination of immunoglobulin levels and bronchoscopy. Patients were reevaluated according to ACCP recommendations, and etiological factors were investigated. Results The total of 270 patients were included in the study included 43.3% (n = 153) females with a mean age of 6.5 +/- 2.3 years (7 months to 17 years). After a 1-year follow-up of patients, we determined that the most common etiologic factors were asthma (27%), asthma-like syndrome (15.5%) and gastroesophageal reflux (10%). Other etiological factors included upper airway cough syndrome and protracted bronchitis, respectively. Conclusion The use of a standardized clinical approach such as the ACCP increases the possibility for fast and accurate diagnosis during the treatment of children with chronic cough, and the use of these guidelines should be required.