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Öğe Ağır gastrointestinal sistem kanaması siklofosfamidle tedavi edilen Henoch- Schönlein purpuralı iki çocuk olgu(2013) Yavuz, Sevgi; Uluca, Ünal; Karabel, Duran; Ece, Aydın; Tan, İlhanHenoch-Schönlein purpurası (HSP) çeşitli sistemleri tutan ve farklı klinik seyirler gösteren bir vaskülittir. Purpura tarzında döküntü, karın ağrısı, artrit, böbrek tutulumu ileortaya çıkabilmektedir. Nadiren, deri, gastrointestinal sis tem (GİS) ve böbrek tutulumu ağır seyretmekte ve erken veya geç dönemde çeşitli komplikasyonlara yol açabil mektedir. Bu yazıda yüksek doz intravenöz steroid teda- visine yanıt vermeyen tekrarlayan GİS kanaması intrave-nöz siklofosfamid ile başarılı bir şekilde tedavi edilen ağırGİS tutulumlu iki HSP’li çocuk olgunun sunulması amaç- landı. Hastalarımızdan birinde GİS tutulumuna ilaveten deri grefti gerektirecek kadar ağır nekrotik cilt tutulumu,diğerinde ise nefrotik proteinüri ile seyreden böbrek tu tulumu mevcuttu. HSP’li çocuklarda yüksek doz steroide yanıt alınamayan ağır GİS tutulumunda intravenöz siklofosfamid yararlı olabilir.Öğe Ağır gastrointestinal sistem kanaması siklofosfamidle tedavi edilen HenochSchönlein purpuralı iki çocuk olgu(Dicle Üniversitesi Tıp Fakültesi, 2013) Ece, Aydın; Yavuz, Sevgi; Tan, İlhan; Uluca, Ünal; Karabel, DuranHenoch-Schönlein purpurası (HSP) çeşitli sistemleri tutan ve farklı klinik seyirler gösteren bir vaskülittir. Purpura tarzında döküntü, karın ağrısı, artrit, böbrek tutulumu ile ortaya çıkabilmektedir. Nadiren, deri, gastrointestinal sistem (GİS) ve böbrek tutulumu ağır seyretmekte ve erken veya geç dönemde çeşitli komplikasyonlara yol açabilmektedir. Bu yazıda yüksek doz intravenöz steroid tedavisine yanıt vermeyen tekrarlayan GİS kanaması intravenöz siklofosfamid ile başarılı bir şekilde tedavi edilen ağır GİS tutulumlu iki HSP’li çocuk olgunun sunulması amaçlandı. Hastalarımızdan birinde GİS tutulumuna ilaveten deri grefti gerektirecek kadar ağır nekrotik cilt tutulumu, diğerinde ise nefrotik proteinüri ile seyreden böbrek tutulumu mevcuttu. HSP’li çocuklarda yüksek doz steroide yanıt alınamayan ağır GİS tutulumunda intravenöz siklofosfamid yararlı olabilirÖğe The association between depression and vitamin D and parathyroid hormone levels in adolescents(Mashhad University of Medical Sciences, 2016) Karabel, Müsemma; Şimşek, Şeref; Haspolat, Yusuf Kenan; Kelekçi, Selvi; Karabel, Duran; Tuncel, Tuba; Şen, Velat; Uluca, Ünal; Tan, İlhan; Şahin, CahitBackground: Depression, a challenging disorder, affects 1–6% of adolescents and early onset often predicts more serious manifestations in later life. Elevated Parathyroid hormone (PTH), parathormone levels have reported among adults with depression. In this study, the roles of 25(OH) D (vitamin D) and parathormone during adolescence, in which the frequency of depression is high, were studied. Materials and Methods: Patients who were followed-up jointly at both clinics and whose 25(OH) D and PTH levels were evaluated and questioned "Depression Scale for Children" for depression at the same time, were included in the study. Cases’ socio-demographic data, 25(OH) D and PTH levels and Depression Scale’ scores were recorded. Results: Depression was diagnosed in 35 (25.3%) of the 138 patients. No differences were found between vitamin D and parathormone in terms of age and gender in groups either with or without depression. Negative correlation was found between the vitamin D levels and depression score in the group with depression (r=-0.368; P=0.03). A significant and positive correlation was found between the PTH levels and depression score (r=0.399; P=0.018). A significant and negative correlation was found between 25(OH) D and PTH levels. Conclusion: Even if clinical depression is absent, the frequency of depressive symptoms is increased with decreased vitamin D levels and increased PTH levels, independent of other factors. The prevention of depression, specifically in adolescents, is important to decrease possible suicidal and homicidal thoughts that might arise during adulthood, and substance abuse. Maintaining vitamin D support during adolescence, as with the first year of life, is necessary for both the prevention and treatment of depression.Öğe Bacillus Calmette-Guerin is a preventive factor in mortality of childhood tuberculous meningitis(Elsevier Sci Ltd, 2014) Kelekci, Selvi; Karabel, Musemma; Karabel, Duran; Hamidi, Cihat; Hosoglu, Salih; Gurkan, M. Fuat; Tas, M. AliObjectives: Studies have been done that have focused on the efficacy of bacillus Calmette-Guerin (BCG) vaccination in the prevention of cases of childhood tuberculous meningitis (TBM). However the efficacy of the vaccination in the prevention of mortality has not been sufficiently evaluated. This study aimed to determine the main features of TBM cases in childhood and to evaluate the factors related to mortality, proving the protective effect of BCG vaccination in childhood TBM. Methods: In a retrospective approach, all consecutive cases of TBM in children that occurred between 1997 and 2005, at Dicle University Hospital, were studied. The following data were evaluated: demographic aspects, admission symptoms, radiology and laboratory findings, BCG vaccination status, tuberculin skin test (TST) positivity, and mortality rates. Results: In total, 172 cases of childhood TBM were evaluated (mean age 53.3 +/- 55.7 months; 109 boys (63.4%)). The majority of these cases (70.4%) had typical TBM symptoms on admission. BCG vaccination data were available for 152 (88.4%) cases and 29 of them (19.1%) were positive. The TST was performed for 143 patients (83.1%) and 28 (19.6%) were found positive. Hydrocephalus was identified in 118 patients (68.6%) on computed tomography examination. A shunt was placed in 79 cases (45.9%). In total, 24 patients (14.0%) died in the hospital. TST negativity was a significant factor for mortality (p = 0.012). BCG positivity was found to be a preventive factor from mortality (p = 0.05). Conclusions: BCG vaccination is effective in the prevention of TBM-associated mortality in childhood. TST negativity may be a sign of a poor prognosis in TBM cases. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.Öğe BDNF and NGF gene polymorphisms and urine BDNF–NGF levels in children with primary monosymptomatic nocturnal enuresis(Elsevier Ltd, 2019) Ece, Aydın; Coşkun, Salih; Şahin, Cahit; Tan, İlhan; Karabel, Duran; Çim, AbdullahIntroduction: The pathophysiology and genetic influences in nocturnal enuresis have not been fully elucidated. Delayed neuronal maturation has been suggested as a pathogenetic mechanism in primary monosymptomatic nocturnal enuresis (PMNE). Brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) are neurotrophins affecting maturation of the nervous system. Objective: The aim of this preliminary study was to investigate BDNF and NGF gene polymorphisms and urine levels of BDNF and NGF in children with PMNE as a first time. Study design: The single-nucleotide polymorphisms of BDNF (rs6265:G > A:Val66Met; rs8192466:C > T:Thr2Ile) and NGF (rs6330:C > T:Ala35Val, rs11466112:C > T:Arg221Trp) were investigated by comparing 104 children with PMNE and 140 healthy control subjects. Children with non-PMNE were excluded. DNA isolation and detection of polymorphisms were performed by real-time polymerase chain reaction. In addition, urine BDNF and NGF levels of 47 PMNE and 29 healthy children were measured by enzyme-linked immunosorbent assay method and normalized to urine creatinine (Cr) concentration for comparisons. Results: There were no differences in genotype and allele frequencies of BDNF rs6265 and NGF rs6330 polymorphisms between patients with PMNE and the control group (P > 0.05). No mutant alleles were found in BDNF rs8192466 and NGF rs11466112 polymorphisms in either group. Children with PMNE had higher urine BDNF/Cr (0.020 ± 0.010 vs 0.010 ± 0.002; P = 0.008) and NGF/Cr ratio (3.01 ± 1.87 pg/mg vs 1.77 ± 0.26 pg/mg; P = 0.002) compared with the control subjects. However, no significant differences were found in BDNF/Cr and NGF/Cr values between GG, GA, and AA genotypes of BDNF rs6265 polymorphism and CC and CT genotypes of NGF rs6330 polymorphism (P > 0.05). Discussion: In this study, no association of BDNF and NGF gene polymorphisms with PMNE was found, and urine neurotrophin concentrations were not directly influenced by investigated polymorphisms. Although, previously increased urine neurotrophin secretion has been found in detrusor overactivity, bladder inflammation, and dysfunctional voiding, this preliminary results also showed an increase in neurotrophins in PMNE. Higher urine neurotrophin levels may be related to delayed and continued neuronal maturation or increased production of neurotrophins in the bladder. The increased urine neurotrophins in PMNE may be an indicator of increased sensory nerve excitability of the bladder, contributing to the development of enuresis. Conclusion: This study showed that investigated neurotrophin gene polymorphisms did not make a significant contribution to the development of PMNE, but urine levels of neurotrophin gene products were higher in PMNE. Owing to the complexity and heterogeneity of genotype–phenotype relationships in enuresis, further studies are needed in PMNE.Öğe Cardiac Tamponade may be the First Symptom of Leukemia(Informa Healthcare, 2014) Karabel, Musemma; Soker, Murat; Kelekci, Selvi; Karabel, Duran; Yel, Servet; Bilici, Meki[Abstract Not Available]Öğe Clinical and laboratory characteristics and follow up results of 121 children with juvenile idiopathic arthritis(Sağlık Bilimleri Araştırmaları Derneği, 2013) Ece, Aydın; Şen, Velat; Yel, Servet; Güneş, Ali; Uluca, Ünal; Tan, İlhan; Karabel, Duran; Yıldırım, Buğra; Şahin, CahitThis study aimed to investigate the clinical and laboratory features of children with juvenile idiopathic arthritis (JIA) that followed up at Dicle University Hospital Department of Pediatrics. Totally, 121 (64 male, 57 female) children with the mean age of 10.0±4.1 (range, 1.5-1.8) years were included. The mean disease onset age was 7.9±3.8 (range, 0.8-15.4) years and the mean follow up period was 2.1±1.9 years. The percentages of JIA subtypes were as follows: Oligoarticular JIA 67 (55.4%), polyarticular 45 (37.2%), enthesitis related arthritis 5 (4.1%) and systemic JIA 4 (3.3%). The most common complaints were arthralgia (91.7%), fever (57.0%), fatigue (38.8%) and malaise (34.7%) and the most frequently involved joints were knee (74.4%), ankle (57.9) and wrist (48.8%). Complete remission were achieved in 28 (23.1%) and partial remission in 56 (46.3%), however 27 (21.3%) cases not responded to treatment satisfactorily. Significant risk factors for poor response to treatment with logistic regression were found as delay in treatment ≥6 months (Odds ratio, OR:11.1; p=0.006), existence of thrombocytosis (OR: 7.5; p=0.009) and early disease onset (age<5 years) (OR:18.1; p=0.004). In conclusion, JIA is a heterogeneous childhood disease with varied clinical manifestations. Early onset disease, delay in treatment and existence of thrombocytosis were the risk factors for an unfavorable outcome.Öğe Clinical and Laboratory Characteristics and Follow Up Results of 121 Children with Juvenile Idiopathic Arthritis(Modestum Ltd, 2013) Ece, Aydin; Sen, Velat; Yel, Servet; Gunes, Ali; Uluca, Unal; Tan, Ilhan; Karabel, DuranThis study aimed to investigate the clinical and laboratory features of children with juvenile idiopathic arthritis (JIA) that followed up at Dicle University Hospital Department of Pediatrics. Totally, 121 (64 male, 57 female) children with the mean age of 10.0 +/- 4.1 (range, 1.5-1.8) years were included. The mean disease onset age was 7.9 +/- 3.8 (range, 0.8-15.4) years and the mean follow up period was 2.1 +/- 1.9 years. The percentages of JIA subtypes were as follows: Oligoarticular JIA 67 (55.4%), polyarticular 45 (37.2%), enthesitis related arthritis 5 (4.1%) and systemic JIA 4 (3.3%). The most common complaints were arthralgia (91.7%), fever (57.0%), fatigue (38.8%) and malaise (34.7%) and the most frequently involved joints were knee (74.4%), ankle (57.9) and wrist (48.8%). Complete remission were achieved in 28 (23.1%) and partial remission in 56 (46.3%), however 27 (21.3%) cases not responded to treatment satisfactorily. Significant risk factors for poor response to treatment with logistic regression were found as delay in treatment >= 6 months (Odds ratio, OR: 11.1; p=0.006), existence of thrombocytosis (OR: 7.5; p=0.009) and early disease onset (age<5 years) (OR: 18.1; p=0.004). In conclusion, JIA is a heterogeneous childhood disease with varied clinical manifestations. Early onset disease, delay in treatment and existence of thrombocytosis were the risk factors for an unfavorable outcome.Öğe The Clinical Findings and Prophylactic Treatment in Children with Factor X Deficiency(Informa Healthcare, 2013) Karabel, Musemma; Soker, Murat; Yildirim, Aysen Turedi; Oymak, Yesim; Kelekci, Selvi; Karabel, DuranFactor X (FX) is the component of both extrinsic and intrinsic coagulation cascade and is the first enzyme of the common pathway which results in thrombus. Congenital FX deficiency (FXD) is an extremely rare coagulation defect. In this study, we aimed to investigate the clinical and laboratory data of the patients diagnosed with FXD. The files of the 15 patients (7 female, 8 male) diagnosed and followed up for FXD within the last 4 years were evaluated retrospectively. The mean age of the patients was 29 months (min-max: 1-144 months). The most presenting complaints were easy bruisability (n=8; 53%) and epistaxis (n=8; 53%). FX levels were <1% in six patients, 1-5% in four patients, and >5% in five patients. Heparin added-Protrombin Complex was used for prophlaxy (n=11; 73%). Any treatment-related complication was not observed. Heparin-added PCC can be used safely for effective prophlaxy. We suggest that family history is important when considering prophlaxy and in patients with life-threatening bleeding or with FXD sibling the prophlaxy should be introduced in the early course.Öğe Ergen polikliniğine başvuran olguların sosyodemografik özelliklerinin değerlendirilmesi(Dicle Üniversitesi, 2016) Haspolat, Y. Kenan; Karabe, Müsemma; Karabel, Duran; Kelekçi, Selvi; Tuncel, Tuba; Şen, Velat; Uluca, Ünal; Tan, İlhanAmaç: Araştırmamızda bölgemiz ergenlerini tanımlayarak gereksinimlerini belirlemek, problemleri saptayarak çözümlere odaklanmak ve bundan sonra planlanacak çalışmalara destek olmayı amaçladık. Yöntemler: Ergen polikliniğine son 6 ayda gelen hastalar geriye dönük incelendi. Demografik bilgiler, vücut kitle indeksi (VKİ), okul durumu, ders başarısı, alışkanlıkları, geçirilen travmalar ve psikososyal durumları ile ilgili veriler kaydedildi. Bulgular: 124’ü kız, 244 ergen çalışmaya alındı. Yaş ortalaması 12,99 ± 1,89 yıl (10-18 yıl) idi. Ergenlerin %48,3’ü düşük VKİ’ne sahipti. Sigara kullanımı %32,4 (n=79) olup erkeklerde daha fazlaydı. Sigara kullananlarda hem okul başarısı daha düşüktü (p=0,002), hem de intihar düşüncesi daha fazlaydı (p<0,001). Ailesinde intihar öyküsü olanların, intihar girişiminde bulunmuş olma veya intihar düşüncesine sahip olma oranı daha yüksekti (p=0,005, p=0,022, sırasıyla). Fiziksel şiddet görenlerde intihar girişiminde bulunmuş olma veya intihar düşüncesine sahip olma oranı daha fazlaydı (p=0,011, p=0,001, sırasıyla). Psikolojik şiddet görenlerde, intihar girişiminde bulunmuş olma veya intihar düşüncesine sahip olma oranı daha yüksekti (p<0,001, p<0,001, sırasıyla). Sonuç: Ergenlik döneminin en sağlıklı şekilde tamamlanması için başta ebeveynler ile onlara sağlık, eğitim ve bakım hizmeti sağlayanlar, döneme özgü sorunlar konusunda bilinçlendirilmeli, ergenlere özel hizmet veren merkezler oluşturulup, devlet ve özel kurumlarca desteklenmelidir.Öğe 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 FuatIntroduction 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.Öğe Geçirilmiş miyokarditte antikonjestif tedavi ne zaman kesilmelidir?(2016) Karabel, Duran; Uluca, Ünal; Demir, Fikri; Bilici, Meki; Akın, Alper; Yılmazer, Murat MuhtarMiyokardit miyokard dokusunun enflamasyonu ve miyokard fibrillerinin hasarı ile seyreden bir hastalıktır. Asemptomatik seyirden, kalp yetersizliği ve ani ölüme kadar değişken bulgular gösterir. Tedavinin köşe taşı, antikonjestif ilaçlar ve gerektiğinde mekanik ventilasyonu da kapsayan destekleyici tedavidir. Miyokardit düzeldikten sonra ilaç tedavisinin kesilmesi için en uygun zaman belirsizdir. Burada, izleminin beşinci ayında kalp yetersizliği bulguları düzelen ancak ilaçları kesildikten sonra kalp yetersizliği bulguları tekrarlayan hastayı sunarak antikonjestif tedavinin kesilmesi konusunda temkinli olunması gerektiğini vurgulamak istedik.Öğe Hışıltılı infantlarda risk faktörlerinin değerlendirilmesi(Modestum Publishing Ltd., 2013) Karabel, Müsemma; Kelekçi, Selvi; Tuncel, Tuba; Şen, Velat; Karabel, Duran; Uluca, Ünal; Tan, İlhan; Gürkan, M. FuatAmaç: Bu çalışmada, en az bir hışıltı atağı geçirmiş olan çocukların demografik özellikleri ve çevresel risk faktörlerinin araştırılması amaçlandı. Yöntemler: Yaşları 6-24 ay arasında olan 118 hastadan oluşan çalışma grubu, ilk defa hışıltı geçirenler ve tekrarlayan hışıltı geçirenler olmak üzere iki alt grupta incelendi. Kontrol grubu olarak, benzer yaş ve cinsiyetteki sağlıklı çocuklar alındı. Gruplarda anne-babaya verilen anket formu üzerine, olguların sosyo-demografik özellikleri ile ailesel ve kişisel atopik hastalık öyküsü, anne-baba eğitim durumu, pasif sigara içiciliği, soba kullanımı, ev kalabalıklığı indeksi, aşılanma durumu ve eşlik eden kalp hastalığı durumları kaydedildi. Bulgular: İlk hışıltı alt grubuna 52 hasta, tekrarlayan hışıltı alt grubuna 66 hasta alındı. Kontrol grubundaki 60 hasta ile çalışma grubu arasında yaş, cinsiyet, doğum tartısı ve anne sütü alma süresi açısından istatistiksel olarak anlamlı farklılık yoktu (p>0,05). Çalışma grubunda sigara içen anne ve annenin düşük eğitim düzeyi sıklığı kontrol grubuna kıyasla anlamlı yüksekti (p<0,05). Ailede atopik hastalık varlığı, çalışma grubunda % 27,5, kontrol grubunda % 6,3 olarak, istatistiksel anlamlı farklılık gösterdi. Eşlik eden konjenital kalp hastalığı ve atopik dermatit varlığı, çalışma grubunda kontrol grubuna kıyasla fazlaydı ve tekrarlayan hışıltı grubunda anlamlı yüksek bulundu. Aşısı olmayan çocuk oranı çalışma grubunda (% 31), kontrol grubundan (% 6,7) anlamlı yüksek bulundu.. Sonuç: Hışıltı nedeniyle hastaneye yatan hastalarda annenin eğitim düzeyi, annenin sigara içmesi, aşıdan kaçınma ve evde soba kullanımı önlenebilir çevresel risk faktörleridir. Risk faktörleri sorgulayarak gerekli önerilerde bulunmak, hem tekrarlayan yatışların önüne geçmek, hem de kalıcı bronş hasarından koruma açısından önemlidir.Öğe Indications of a Major Cause of Hospitalization in Intensive Care: Child and Adolescent Acute Poisoning(Duzce Univ, 2016) Uluca, Unal; Sen, Velat; Karabel, Duran; Gunes, Ali; Bozkurt, Fatma; Sahin, Cahit; Sabaz, Muhammed NurullahAim: Acute poisoning is an important health problem in pediatric patients. The aim of this study is to evaluate the epidemiological and clinical signs and treatment results of the children with acute poisoning. Methods: All of the cases that admitted to the children hospital between September 2012 and June 2014 enrolled to the study. File records of cases was retrospectively evaluated. Age, gender, admission season, intended purpose of agent, feature of agent, ingested route, symptoms, physical examination findings, mental state, applied treatments and intensive care needs were recorded. Results: 65 males, 63 girls were included to the study. 57.8% of patients were under the age of 5. The most admission seasons were autumn (50.8%) and summer (26.6%). Ten cases, mostly girls, had suicidal ingestion. In all cases, except one, oral poisoning had occurred. Three patients were mentally handicapped. The most frequent symptoms and signs during admission were nausea and vomiting (10.9%) and lethargy (7.8%). Before admission, the majority of patients (68.0%) had undergone gastric lavage and activated charcoal. Intensive care was required in 21 (16.4%) patients. Pharmacological or non-pharmacological intoxication were not related with intensive care need. Hospitalization duration was significantly longer in patient hospitalized in intensive care unit. The age of the patients who need intensive care were lower than those without. Nine (7.0%) patients died during follow-up in intensive care. Death mostly had occurred as a result of non-pharmacological intoxication. Conclusion: Acute poisoning cases among the important reasons for emergency visits, and can result in significant morbidity and mortality. Therefore, this issue of parents and health professionals to increase their level of knowledge in daily practice is important to consider acute intoxication.Öğe Kronik hastalığı olmayan çocuklarda tamamlayıcı ve alternatif tıp kullanımı(Turkish Pediatric Association, 2014) Tuncel, Tuba; Şen, Velat; Kelekçi, Selvi; Karabel, Müsemma; Şahin, Cahit; Uluca, Ünal; Karabel, Duran; Haspolat, Yusuf KenanAmaç: Bu çalışmada amacımız, kronik hastalığı olmayan çocuklarda kullanılan tamamlayıcı ve alternatif tıp yöntemlerini değerlendir- mek, bu yöntemlerin kullanım sıklıklarını saptamak ve kullanılma- larını etkileyen etmenleri araştırmaktır. Gereç ve Yöntemler: Çalışma 15 Ekim-15 Kasım 2012 tarihleri ara- sında yapıldı. Yerel etik kurul onayı alındı (08.10.2012/732). Hazır- lanan çalışma formu, genel çocuk polikliniğine başvuran ve kronik hastalığı olmayan çocukların annelerine uygulandı. Veriler SPSS for Windows v.16 programına kaydedildi. Tanımlayıcı istatistiklerki- kare, Mann-Whitney U ve lojistik regresyon analizleri uygulandıp<0,05 anlamlı kabul edildi. Bulgular: Çalışmaya 206 çocuk alındı. Hastaların %83ünde tamam- layıcı ve alternatif tıp uygulanmıştı. Nazardan korumak amacıyla na- zar boncuğu takma (%45) ve okutma (%35) en sık kullanılan uygula- malardı. Tamamlayıcı ve alternatif tıp kullanımına en sık neden olan tıbbi rahatsızlıklar, kansızlık, ishal, kabızlık ve öksürük idi. Hastaların %73ünde inanış temelli uygulamalar, %57sinde bitkisel yöntemler kullanılmaktaydı. Hastaların %18inde kesi yapmak gibi girişimsel yöntemler uygulanmıştı. Bu yöntemleri uygulayan ve uygulamayan hastalar arasında, ailenin gelir düzeyi, anne ve baba eğitim düzeyleriaile tipi ve yaşam yeri açısından fark olmadığı saptandı (p>0,05). Çıkarımlar: Çocuklarda tamamlayıcı ve alternatif tıp yöntemleri ol- dukça sık uygulanmaktadır. Hekimlerin, etkileri ve yan etkileri açı- sından bu yöntemler hakkında bilgi sahibi olmaları ve olası riskleri konusunda aileleri ve özellikle de anneleri uyarmaları gerekmektedir. (Türk Ped Arş 2014; 49: 148-53).Öğe Nadir Görülen Bir lmmun Yetmezlik: Chediak Higashi Sendromu(2013) Söker, Murat; Kelekçi, Selvi; Karabel, Duran; Güneş, Ali; Karabel, Müsemma[Abstract Not Available]Öğe A Rare cause of recurrent oral lesions: Chediak-higashi syndrome(Galenos Yayıncılık, 2014) Karabel, Musemma; Kelekçi, Selvi; Şen, Velat; Söker, Murat; Karabel, Duran; Aliosmanoğlu, Çiğdem[Özet Yok]Öğe Serum galectin-3 levels in children with chronic hepatitis B infection and inactive hepatitis B carriers(International Scientific Literature Inc., 2015) Uluca, Ünal; Şen, Velat; Ece, Aydın; Tan, İlhan; Karabel, Duran; Aktar, Fesih; Karabel, Müsemma; Balık, Hasan; Güneş, AliBackground: Chronic hepatitis B virus (HBV) infection is common worldwide. Follow-up of patients by the use of non-invasive techniques may be valuable in clinical practice. The aim of this study was to investigate serum galectin-3 (GAL-3) levels for monitoring disease status in children with chronic HBV infection. Material/Methods: Thirty-two patients with chronic hepatitis B (CHB), 30 inactive HBV carrier patients, and 30 matched healthy controls were enrolled in the study. We performed basic laboratory tests: serum glucose, albumin, alanine aminotransferase (ALT), aspartate aminotransferase, gamma-glutamyl transferase (GGT), total bilirubin, prothrombin time, and activated partial thromboplastin time. In addition, serum GAL-3 levels were measured by ELISA technique. Results: Significantly higher serum GAL-3 levels (16.5±3.6, 1.1±0.3, 0.7±0.5 ng/ml, respectively, p<0.001) and ALT levels (80.2±30.6, 26.8±12.6, 28.1±4.4 IU/L, respectively, p<0.001) were found in the CHB group compared with the inactive carriers and the control groups. There were no significant differences in ALT levels and GAL-3 levels or between inactive HBV carriers and the control groups (p>0.05, for each). Significantly higher GGT levels were found in the CHB group (51.3±27.5 IU/L) compared with the inactive HBV carriers (35.7±10.1 IU/L) and the control group (31.3±9.5 IU/L) (p<0.001, and p=0.004, respectively). A significant correlation was found between GAL-3 and ALT levels in the CHB group (r=0.82, p<0.001). Conclusions: Our results suggest that serum GAL-3 level may be a beneficial indicator of chronicity in hepatitis B infection in children.Öğe Unutulmakta olan bir epididimoorşit sebebi olarak brusella: 34 hastalık retrospektif çalışma(2013) Karabel, Duran; Yanaral, Fatih; Mengeloğlu, Fırat Zafer; Karabel, Müsemma; Akçin, Soner; Yıldırım, Mehmet ErolGiriş: Brucella özellikle endemik bölgelerde görülen insan ve hayvanları birlikte etkileyen, sistemik tutulumlu bir zoonozdur. Brucella bakterileri insanlara enfekte olmuş hayvanlardan ya da hayvan ürünlerinden en sık gastrointestinal sistem yoluyla geçmektedir. Brusellozlu hastaların %2-20sinde epididimoorşit görülmektedir. Bildirimizde ülkemizde yayınlanmış en geniş brusella epididimoorşiti serisi sunulmaktadır. Materyal ve Metot: 2010-2012 yılları arasında Siirt Devlet Hastanesi ve Siirt Kadın Doğum ve Çocuk Hasta-nesinde Brusella epididimoorşiti tanısı konulup, tedavi edilen 34 adet hastanın dosyası retrospektif olarak ince-lendi. Hastaların tümünün demografik verileri, klinik ve laboratuar bulguları, tedavi, sonuç ve takip bilgileri çıkartıldı. Tüm hastaların tanısı skrotal şişlik ve ağrı, ateş, terleme gibi şikayetlerle hastaneye başvurma son-rası yapılan standart tüp aglutinasyon testleri (?1/160 titre) ile konuldu. Hastalara Tetrasiklin 100 mg peroral günde iki defa ve Rifampisin 600mg/gün peroral olarak 6 hafta süreyle tedavi uygulandı. Hastalar 15. ve 45. günlerde kontrol edildi. Bulgular: Hastaların yaş ortalaması 29,2 (5-50) idi. Unilateral tutulum 30 hastada gözlenirken, bilateral tutulum 4 hastada mevcuttu. Tüm olgular medikal tedavi ile başarılı olarak tedavi edilmesine rağmen, 1 hastada nekrotizan orşite bağlı testiküler apse gelişmiş, medikal sağaltım sonrası ağrı ve şişliğin devam etmesi sonucu sol skrotal içerik testis ile birlikte çıkarıldı. Diğer 33 hastada medikal tedavi ile klinik belirtiler geçti. Sonuç: Özellikle hayvancılığın yaygın olduğu bölgelerde, sistemik semptomların da eşlik ettiği olgularda brusellozun epididimoorşit nedeni olabileceği unutulma-malı, hastalar buna yönelik olarak değerlendirilmeli ve tedavi edilmelidir.Öğe Urinary kidney injury molecules in children with iron-deficiency anemia(International Scientific Literature Inc., 2015) Güneş, Ali; Ece, Aydın; Aktar, Fesih; Tan, İlhan; Söker, Murat; Karabel, Duran; Balık, Hasan; Uluca, Ünal; Şen, Velat; Yolbaş, İlyasBackground: The aim of this study was to investigate the urine levels of human kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-?-D-glucosaminidase (NAG), and liver-type fatty acid-binding protein (L-FABP) in children with iron-deficiency anemia (IDA). Material/Methods: Thirty-five children with IDA and 32 matched healthy controls were recruited. We assessed complete blood count, serum iron, iron-binding capacity, ferritin, serum levels of urea, creatinine (Cr), sodium (Na), potassium (K), calcium (Ca), and glucose levels. Estimated glomerular filtration rate (eGFR) was calculated. Urinary NAG, NGAL, KIM-1, and L-FABP were measured and divided by urine creatinine for comparisons. Results: There were no significant differences in serum urea, Cr, or eGFR between the IDA group and the control group (p> 0.05, for all). IDA patients had significantly higher urine NGAL/Cr, L-FABP/Cr, KIM-1/Cr, and NAG/Cr compared with the control group (p<0.05). There were significant negative correlations between hemoglobin, hematocrit, red blood cell count, and urine NGAL/Cr, NAG/Cr, L-FABP/Cr, KIM-1/Cr levels (p<0.05). Conclusions: Higher urinary kidney injury molecule levels in IDA patients suggest a possible subclinical renal injury in pediatric IDA patients whose renal functions and serum electrolytes were normal.
