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Öğe The association between electrocardiographic data and obesity in children and adolescents(Edizioni Minerva Medica, 2021) Ture, Mehmet; Akin, Alper; Unal, Edip; Kan, Ahmet; Balik, Hasan; Tas, Funda Feryal; Haspolat, Yusuf KenanBackground: There are not enough studies investigating the relationship between obesity and ECG abnormalities in children and adolescents. This study aims to investigate the relationship between obesity and electrocardiographic data in children and adolescents for early diagnosis to prevent arrhythmia or sudden death in later stages of life.Patients and Methods: A total of 65 children and adolescents with obesity applied to our pediatric endocrinology outpatient clinic with nonspecific complaints and without any known chronic illnesses; 76 healthy children and adolescents were included in the study. Anthropometric and laboratory data, blood pressure measurements, and 12-lead electrocardiography data of all participants were collected.Results: There was a statistically significant difference between the obese and the control group in terms of triglycerides, total cholesterol, high density lipoprotein, low density lipoprotein levels, and systolic blood pressure. According to electrocardiographic findings, there was a statistically significant difference between the two groups in terms of heart rate (p=0.008), PR duration (p<0.001), left ventricular hypertrophy (p=0.02), P maximum (p=0.04), P dispersion (p<0.001), QRS duration (p<0.001), QT minimum (p=0.007), QT maximum (p=0.03), QT dispersion (p=0.024), QTc minimum (p=0.002), QTc dispersion (p=0.003), Tp-e minimum (p=0.007), and Tp-e maximum (p=0.003) variables.Conclusion: There were significant differences between the electrocardiographic evaluation of obese group compared to the control group in our study, which may be associated with risk of cardiac arrhythmia. These differences require monitorization in terms of cardiac arrhythmia and risk of sudden death. Further studies with longer follow-up time are needed to support the potential clinical outcomes of our findings.Öğe The Effect of Vitamin D Levels in Multisystem Inflammatory Syndrome in Children(Georg Thieme Verlag Kg, 2022) Kan, Ahmet; Ture, Mehmet; Akin, Alper; Yilmaz, Kamil; Surucu, Mehmet; Unal, Edip; Sen, VelatObjective Multiple factors being overweight, asthmatic, or being of Asian or black ethnic origins have been reported vis-a-vis the multisystem inflammatory syndrome in children (MIS-C). There is an association between these conditions and vitamin D deficiency, which explains why MIS-C is more common in these patients. In the present study, we attempted to retrospective evaluate the 25-hydroxy vitamin D levels of patients with MIS-C, its association with acute phase reactants, its treatment, and clinical status. Methods Patients aged between 1.5 months to 18 years with MIS-C were included in the study. All of the laboratory parameters, treatment, and response to the treatment were evaluated retrospectively. Two groups were formed. Patients had 25-hydroxycholecalciferol D vitamin < 20 ng/mL in group 1 and >= 20 ng/mL in group 2. Results A total of 52 patients were included in the study. There was no statistical difference between groups in terms of acceptance of the intensive care unit treatment (p = 0.29) and response to the first-line treatment (p = 0.56). A lower median lymphocyte count (p = 0.01) and a higher median C-reactive protein (p = 0.04) and procalcitonin (p = 0.01) with N-terminal pro-B-type natriuretic peptide (p = 0.025) values were found in group 1. Conclusion Vitamin D deficiency was associated with an increased inflammatory response in children with MIS-C. More studies are required to determine the potential impact of vitamin D deficiency on the clinical outcome of MIS-C.Öğe Effects of vitamin D prophylaxis on oral irontreatments of iron deficiency anemia(Edizioni Minerva Medica, 2022) Kan, Ahmet; Sayli, TulinBACKGROUND: Iron deficiency anemia causes a decrease in immune response to infections, physical working capacity and response to metabolic stress. It also causes behavioral, perceptual and cognitive disorders. Therefore, as soon as iron deficiency anemia is diagnosed, it should be treated immediately. In this study, it was investigated retrospectively whether there was a difference in treatment efficacy between the administration of oral ferrous or ferric iron and vitamin D at the same time and at different time. METHODS: A total of sixty patients under 1 year who attended the pediatrics outpatient clinic for pale and diagnosed with iron deficiency anemia. Patients were randomly divided into 4 groups. Anemia was defined as hemoglobin below <2 SD according to age and gender. Iron deficiency was definied with serum iron, iron-binding capacity, ferritin and transferin saturation below the range for age and gender appropriates. All patients were seen at the outpatient clinic for 1st, 3rd month of the treatment. RESULTS: There were statistically significant differences between the groups in terms of increase in Hb values according to time (1st month, 3rd month, 1st and 3rd month). There was no statistically significant difference between the groups in terms of the recovery of anemia after treatment. CONCLUSIONS: It was concluded that iron treatment in babies with iron deficiency anemia is not affected by the administration of vitamin D prophylaxis at the same time or at different times, and therefore both treatments can be administered at the same time to increase drug compliance.Öğe Electrocardiographic data of children with type 1 diabetes mellitus(Cambridge Univ Press, 2022) Ture, Mehmet; Akin, Alper; Unal, Edip; Kan, Ahmet; Savas, SuatBackground: Adult patients diagnosed with type 1 diabetes mellitus are at risk for ventricular arrhythmias and sudden cardiac death. Aim: The objective of our study is to evaluate the electrocardiographic data of children diagnosed with type 1 diabetes mellitus and to determine the possibility of arrhythmia in order to prevent sudden death. Methods: Electrocardiographic data of 60 patients diagnosed with type 1 diabetes mellitus and 86 controls, who were compatible with the patient group in terms of age and gender, were compared. Results: The duration of diabetes in our patients with type 1 diabetes mellitus was 5.23 +/- 1.76 years, and the haemoglobin A1c levels were 9.63% +/- 1.75%. The heart rate, QRS, QT maximum, QT dispersion, QTc minimum, QTc maximum, QTc dispersion, Tp-e maximum, Tp-e maximum/QTc maximum and the JTc were significantly higher compared to the control group. There was no significant correlation between the duration of type 1 diabetes mellitus and HbA1c levels and the electrocardiographic data. Conclusion: We attributed the lack of a significant correlation between the duration of type 1 diabetes mellitus and the haemoglobin A1c levels and the electrocardiographic data to the fact that the duration of diabetes was short, since our patients were children. We believe that patients with type 1 diabetes mellitus should be followed up closely in terms of sudden death, as they have electrocardiographic changes that may cause arrhythmias compared to the control group. However, more studies with longer follow-up periods are necessary to support our data.Öğe Evaluation Anxiety Levels of Adult Patients and Parents of Adolescent Patients With Anaphylaxis(Harran Üniversitesi, 2022) Emre, Emre; Kan, AhmetBackground: Anaphylaxis is a sudden onset condition that may progress with severe systemic symptoms and may be accompanied by life-threatening respiratory failure and cardiovascular shock. Exposure to a traumatic event may cause patients and their parents to fear reliving the same event, so they try to avoid risk factors. It was aimed to determine the anxiety and stress levels in adult patients and in parents of adolescent patients diagnosed with anaphylaxis and to compare them with healthy controls. Materials and Methods: A questionnaire-type study was conducted. Control group (group 1), adult pa-tients diagnosed with anaphylaxis (group 2), and parents (a mother or father) of adolescent diagnosed with anaphylaxis (group 3) were included in the study. The anxiety levels of participants were evaluated by State-Trait Anxiety Inventory (STAI).Results: A total of 163 participants were included in the study. Seventy-one participants were in the con-trol group, forty-four were in group 2, thirty-eight were in group 3. STAI-T and STAI-S scores of groups 2 and 3 were significantly higher than controls. No difference was found between groups 2 and 3 for STAI-T scores (p=0.8) and STAI-S scores (p=0.74). Conclusions: Adult patients diagnosed with anaphylaxis and parents of adolescents are more anxious than the normal healthy population. Anxiety and anaphylactic conditions are often comorbid. Psychosocial assessment should be the first step in adult patients with anaphylaxis and their parents. Physicians should prevent the harm that anxiety may cause. For this purpose, education programs, screening programs, support trainings with patient participation should be organized.Öğe Evaluation of Biomarkers in Patients with Sepsis Diagnosis in Pediatric Intensive Care Unit(Kemal Türker ULUTAŞ, 2021) Cengiz, Hamza; Yılmaz, Kamil; Pirinççioğlu, Ayfer Gözü; Kan, AhmetIntroduction: Sepsis is one of the leading causes of mortality and morbidity in intensive care units. In this study, we aimed to investigate the etiological cause, focus of infection, culture sample results, and inflammatory markers among patients treated for sepsis at pediatric intensive care units (PICUs). Materials and Methods: We retrospectively reviewed the medical records of 70 patients aged 1 month to 18 years who were treated for sepsis at PICU between January 2014 and May 2019. Results: The median age of the patients was 37 months. The most common underlying etiology was respiratory failure (70%). The most common site of infection causing sepsis was the respiratory system (n:40, 57%). The most commonly isolated agents were Proteus mirabilis and Acinetobacter baumannii. Whereas C reactive protein (CRP) was normal at the time of the diagnosis of sepsis in 28.5% (n=20) of the patients, procalcitonin (PCT) was elevated in all of them. A comparison of the laboratory parameters in the first 24 hours after the diagnosis of sepsis and at the end of the treatment revealed a significant difference between White blood cell (WBC) count, neutrophil-lymphocyte ratio (NLR), the levels of C reactive protein (CRP) and Procalcitonin (p<0.05). In addition, positive correlations were detected between NLR, CRP and PCT (p=0.036, p=0.012/ r=0.251, r:0.299, respectively). Conclusion: We believe that PCT, CRP, and NLR can be used as biomarkers for monitoring patients with sepsis.Öğe Evaluation of children and adolescent with cystic fibrosis by pancreatic elastography(Wiley, 2022) Yilmaz, Kamil; Hattapoglu, Salih; Sen, Velat; Karabel, Musemma; Kan, Ahmet; Yilmaz, Engin Deniz; Sen, Hadice SelimogluBackground Cystic fibrosis (CF) is an autosomal recessively inherited disease. Clinical findings vary by age of the patient, the organ systems involved, and the severity of the CFTR gene mutation. Pancreatic and liver involvement is prominent and exocrine pancreatic insufficiency is observed in the majority of patients. Point shear wave elastography (pSWE) is a non-invasive method that can quantitatively determine tissue elasticity and stiffness. In this study, the morphological evaluation of the pancreas was performed using the pSWE technique in pediatric patients diagnosed with CF. The effectiveness of this method for the early detection of pancreatic insufficiency was investigated. Methods Fifty-five patients with CF (24 girls, 31 boys) and 60 healthy children (29 girls, 31 boys) without any chronic diseases and who were suitable for the pSWE examination were included in the study. Results The mean value of pSWE was 1.12 +/- 0.16 in the healthy group and 0.97 +/- 0.16 in the patients with cystic fibrosis. There was a statistically significant difference between the two groups (P < 0.001). Significant negative correlations were found between pSWE and age (r = -0.319; P = 0.018), height (r = -0.293; P = 0.03), serum glucose (r = -0.346; P = 0.01), HbA1C (r = -0.592; P = 0.02), and duration of the disease (r = -0.806; P < 0.001). Conclusions Investigating pancreatic elasticity and detecting pancreatic insufficiency using pSWE (a simple, inexpensive, and non-invasive method) in the early period before overt laboratory and clinical symptoms of EPI appear can contribute positively to long-term results in young patients with CF.Öğe Factors affecting levels of cyberchondria in mothers of children with food allergies(Yuzuncu Yil University Faculty of Medicine, 2023) Kan, Ahmet; Kartal, Gülşah; Öztürk, MasumCyberchondria is a term used to assess the anxiety-inducing effects of online health-related searches. Most of the mothers were found to have obtained information from the internet , but the influence of the internet on maternal anxiety has not been sufficiently investigated. Therefore, our aim in the present study was to evaluate the relationship between cyberchondria experienced by mothers of children with food allergies and sociod emographic factors. The study was carried out with mothers whose children had been diagnosed with a food allergy and mothers of healthy children. „The Cyberchondria Severity Scale‟ was used to evaluate the anxiety of the mothers. In addition, the sociodemographic status of the participants was evaluated with a questionnaire. The cyberchondria severity scores of 60 mothers with food -allergic children and 60 mothers with healthy children were compared. The most common diagnosis was atopic eczema (51.8%). The cyberchondria severity scores of mothers with food-allergic children (59±23) were significantly higher than those for the healthy group (50±13) (p<0.001). The mean cyberchondria severity scores were significantly higher in working mothers (p=0.01), families whose monthly income was the minimum wage and above (p=0.02), and mothers who searched on the internet to choose a physician (p=0.03). Psychological problems in mothers of children with food allergies th at may be caused by cyberchondria can often be overlooked in outpatient settings. To detect these problems, it is necessary to perform screening tests and to provide support to these mothers in a timely manner.Öğe Maternal anxiety, stress, and depression: The role of food allergy(Bilimsel Tıp Yayınevi, 2022) Kan, Ahmet; Türe, Mehmet; Yılmaz, Kamil; Emre, Emre; Baş, GülnurObjective: The prevalence of food allergy in children continues to rise worldwide. Both proven and suspected food allergy in children may be associated with depression, anxiety, and stress for mothers. In this study, our primary aim was to determine the severity of depression, anxiety, and stress in mothers of food allergic children and compare them with controls. Materials and Methods: A questionnaire that included the sociodemographic features and independent risk factors and the depression, anxiety, stress scale 21 were used. Results: A total of 104 patients, and their mothers were included in the study. Most patients were diagnosed with eczema. Multiple foods or food groups were eliminated by most patients. Moderate to severe depression (p<0.001), anxiety (p<0.001), and stress (p=0.01) were significantly more common in mothers of food allergic children compared with the control group. No association was found between the maternal anxiety, depression, and stress scores and the types of food allergy, income of the family, and the number of foods eliminated from the diet. There was a positive correlation between the maternal depression score and maternal education level (p=0.029, r=0.21). Conclusion: The mother and baby should be considered as an inseparable whole and the mothers should be supported psychosocially. Psychosocial problems in the mothers of food allergic children should be detected in a timely manner by screening programs.Öğe Multisystem inflammatory syndrome in children: A single-center experience(Wiley, 2021) Türe, Mehmet; Kan, Ahmet; Akın, Alper; Yılmaz, Kamil; Şen, VelatBackground This case series aims to evaluate the presenting symptoms, laboratory data, systemic findings, and response to early treatment in patients who were followed up with the diagnosis of multisystemic inflammatory syndrome associated with novel coronavirus disease 2019 (COVID-19). Methods The presentation, laboratory findings, and responses to treatment of patients hospitalized and diagnosed with multisystemic inflammatory syndrome were evaluated retrospectively. Results A total of 32 patients were included in the study. The median age was 90 (1.5-204) months and 62.5% of the patients were male; 59.4% of the cases were non-specific disease, 31.2% typical (complete) Kawasaki, and 9.4% had phenotypic characteristics of atypical (incomplete) Kawasaki. Most of the patients were found to have low albumin and elevated C-reactive protein, sedimentation rate, and d-dimer, and all patients had elevated N-terminal pro-B-type natriuretic peptide, and procalcitonin. Lymphopenia was detected in 25 patients (78.1%) and serum ferritin levels were elevated in 25 patients (78.1%). Eleven (34.4%) patients responded well only to intravenous immunoglobulin treatment. Twenty patients (62.5%) received intravenous immunoglobulin and steroid therapy (second-line therapy). Only one patient (3.1%) received third-line therapy (intravenous immunoglobulin + steroid +anakinra + plasmapheresis). None of the patients died. Conclusions Most patients had mild clinical symptoms and responded well to intravenous immunoglobulin and / or steroid therapies as first- and second-line therapies. Only one of our patients was clinically stabilized after third-line treatment because he did not respond to intravenous immunoglobulin and steroid therapy. We think that all of our patients diagnosed with multisystem inflammatory syndrome in children recovered because we had recommended quickly medical intervention. Treatment should therefore be started immediately in patients diagnosed with multisystem inflammatory syndrome in children. If there is no response after 24 h to the initial treatment, the next treatment protocol should be started.Öğe Nasadîna Pirtûkan(Osman ASLANOĞLU, 2021) Kan, AhmetDanasînek li ser pirtûka bi navê Medyaya Kurdî û Medyaya Nû.Öğe Relationship between pituitary siderosis and endocrinological disorders in pediatric patients with beta-thalassemia(Cureus Inc., 2021) Yılmaz, Kamil; Kan, Ahmet; Çetinçakmak, Mehmet Guli; Uzel, V. Hülya; Yılmaz, Deniz; Deniz, Muhammed Akif; Hattapoğlu, SalihIntroduction Excess iron accumulation occurs mainly in organs such as reticuloendothelial cells, the pituitary gland, and the pancreas in beta-thalassemia because of blood transfusions. In the present study, it was aimed to investigate the relationship between T2* values on magnetic resonance imaging (MRI) and clinically diagnosed pituitary endocrinological disorders in children with thalassemia major. Methods This study enrolled patients diagnosed with beta-thalassemia at pediatric hematology outpatient clinics. In the study, in addition to the medical history of the patients, routinely performed tests, including hemoglobin electrophoresis, routine biochemical tests, and tests for pubertal development (follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, etc.), as well as iron deposition measured by hepatic MRI T2* (STAR) sequence, were retrospectively assessed. A total of 29 patients were enrolled. Results Hypothyroidism was detected in 34.6% (9/26) of patients, short stature in 37% (10/27), and pubertal retardation in 50% (14/28) of the patients. There was no significant correlation between hypothyroidism and pituitary MRI T2* values. No significant correlation was found between laboratory parameters and pituitary MRI examination. Although the sensitivity of T2* levels could rise above 80%, their specificity remained low. This is one of the major limitations of the pituitary MR T2* study for the prediction of short stature. The best lower cut-off level of MR T2* to predict short stature was found 14.6 ms. Conclusion The diagnostic specificity pituitary MR examination levels for short stature were detected as low. Thus, the clinical standardization and validation of pituitary MR T2* values examination are needed before clinical follow-up and multifaceted studies are needed.Öğe The significance of immunoglobulins in cystic fibrosis: Normal or high?(Galenos Yayıncılık, 2022) Kan, Ahmet; Savaş, Suat; Şen, Velat; Türe, MehmetAim: Cystic fibrosis (CF) is characterized by local and chronic inflammation accompanied by increased neutrophil and macrophage counts, high elastase levels, and inflammatory cytokines due to impaired haemostasis. Changes in immunoglobulin (Ig) levels may occur due to recurrent chronic infections and may be associated with the deterioration of respiratory functions. In this study, we aimed to evaluate the interaction of high Ig levels with respiratory functions and chronic infections in CF. Materials and Methods: The diagnosis of the patients CF was made in accordance with the “National CF Diagnosis and Treatment Guidelines”. The socio-demographic characteristics, Ig values, and the pulmonary function tests were evaluated according to age group. Results: A total of 107 patients were included in this study. The patients’ median age was 65 (6-200) months. It was found that those patients with high IgG (p=0.01) and IgA (p<0.001) values had more moderate-to-severe respiratory function than those with normal values. Also, there was no statistically significant difference when the patients were compared for P. aeruginosa colonization using IgG levels (p=0.51), IgA levels (p=0.16) and IgM levels (p=0.34). Conclusion: Elevated IgG and IgA levels in patients with CF may be an indirect indicator of deterioration in pulmonary function tests. There was no significant difference in IgG, IgA, and IgM levels for P. aeruginosa colonization. We recommend that the results of our study be supported by cohort studies.Öğe The use of puzzles in inhaler technique training(Taylor & Francis Ltd, 2022) Kan, Ahmet; Sen, VelatObjective Inhaled drugs are essential for the treatment of several chronic respiratory diseases. However, patient inhaler techniques are frequently suboptimal; here, educational games may enhance patients' understanding of educational interventions. In addition, patients may practice repetitively, learning in a more relaxed and fun environment. In this study we aimed to compare two methods of inhaler technique training: (1) face-to-face training only and (2) face-to-face training and a subsequent puzzle game. Methods The participants in group 1 were provided only face-to-face training. In group 2, the participants were given a puzzle after receiving the face-to-face training. Subsequently, the inhaler technique scores of both groups were compared. The chi-squared (chi(2)) test was used for categorical variables and the Mann-Whitney U test (non-parametric) or Student's t test (parametric) were employed to compare the numerical variables between the groups. Results In total, 170 patients with asthma and their parents were included in the study. It was found that the median total scores for the inhaler technique (p < 0.001) and the number of correct users (p < 0.001) were higher in group 2, whereas the inhaler technique error rate in shaking the inhaler tube (p < 0.001) was higher in group 1. Conclusions The present study revealed that the success rate of correct users and participants' total scores were higher in the puzzle game group. Therefore, a game may help patients to better remember and visualize the steps of the inhaler technique. Our study supports the use of puzzles as real-world applications to teach patients optimal inhaler technique.Öğe Vaccine hesitation in parents of children with food allergy(Dicle Üniversitesi Tıp Fakültesi, 2022) Kan, Ahmet; Türe, Mehmet; Yılmaz, Kamil; Akın, Alper; Kartal, Gülşah; Şen, VelatObjective: The term vaccine hesitation means “rejection or delay of vaccines despite the availability of vaccine services”. Parents may delay the vaccination of their children when their children have a history of food allergies. The present study aims to evaluate the factors about vaccine hesitancy of parents with food allergic children. Methods: A cross-sectional survey research, created by the researchers, was conducted to the parents of children who were already followed up with food allergy by the pediatric allergy department. Results: The parents of 190 children with a median age of 24 (2-60) months who were followed up for food allergy were included in the study. The median follow-up period of the patients was 15.5 (4–160). Forty-four (23.1%) participants had delayed at least one vaccination of their children due to food allergy in the past. The most common vaccine hesitancy was toward the measles-mumps-rubella vaccine. The study also found that there were more delays in vaccination in children with egg allergy (100%) than in those without egg allergy (75.3%) (p = 0.01). As a result of our study, it was determined that the most frequent information about vaccination was obtained from doctors (89.5%) Conclusions: It was understood that a substantial proportion of parents with food allergic children had vaccine hesitancy in the past. Families obtaining complete and accurate information about food allergy and vaccine interactions, especially from the health system, will prevent unnecessary delay due to vaccine hesitations.
