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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 evaluation of cases with Factor X deficiency in Southern East of Turkey(Wiley-Blackwell, 2013) Soker, M.; Karabel, M.; Yildirim, A.; Oymak, Y.; Kelekci, S.; Karabel, D.[Abstract Not Available]Öğe Features of patients with immune trombocytopenic purpura south-east of Turkey(Wiley-Blackwell, 2013) Soker, M.; Akyuz, F.; Kelekci, S.; Sen, V; Karabel, M.; Uzel, H.; Yolbas, I[Abstract Not Available]Öğe FeNO levels in children with asthma and other diseases of the lung(Verduci Publisher, 2013) Kelekci, S.; Sen, V.; Yolbas, I.; Uluca, U.; Tan, I.; Gurkan, M. F.BACKGROUND: Prolonged cough in children is one of the major complaints seen in hospitals. It is difficult to make a proper diagnosis and start the appropriate treatment. Fraction of exhaled nitric oxide (FeNO) measurement is a valuable non-invasive diagnostic tool in determining the cause of prolonged cough in children. Although there are several studies on asthma and COPD, there is a lack of them on other lung diseases such as tuberculosis, bronchiectasia, bronchiolitis obliterans (BO), and pneumonia. PATIENTS AND METHODS: In this study, pretreatment FeNO levels of patients with various lung diseases were measured and results from the sick patient groups were compared with the results from the control group. RESULTS: Pre-treatment FeNO levels in BO, asthma, and tuberculosis patient groups were higher than in the control group (p < 0.001). There was no significant difference between the acute bacterial pneumonia and bronchiectasia groups, and the control group (p > 0.05). CONCLUSIONS: FeNO measurement is a highly important guiding tool in diagnosis and treatment of various lung diseases.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 Neutrophil activation, protein oxidation and ceruloplasmin in children with Henoch-Schonlein purpura(Springer, 2007) Ece, A.; Kelekci, S.; Hekimoglu, A. Tas; Kocamaz, H.; Balik, H.; Yolbas, I.; Erel, O.[Abstract Not Available]Öğe A newborn with trisomy 13 who had tetralogy of Fallot and metopic synostosis: Case report(Lithographia, 2013) Karabel, M.; Yolbas, I; Kelekci, S.; Sen, V; Haspolat, Y. K.; Timuroglu, L.Background and Aim: Trisomy 13 (Patau syndrome) was first described by Patau et al in 1960. It is characterized by serious head, facial, and extremity anomalies, congenital heart defects, and mental abnormalities. The incidence rate of Trisomy 13 is 1/10.000 live births. Accompanying symptoms and findings vary in rate and severity among the cases. Tetralogy of Fallot and metopic synostosis are very rare abnormalities in patients with Trisomy 13. In this study, we aimed to present a newborn girl with trisomy 13 who had multiple congenital malformations accompanied by tetralogy of Fallot and metopic synostosis. Description of the case: The patient was delivered at 40 weeks of gestation, and admitted to the neonatal intensive care unit due to respiratory distress and physical abnormalities. The newborn examination revealed multiple dysmorphic features. She had boot-shaped appearance on the chest radiograph. Chromosome analysis demonstrated mosaic trisomy 13. Conclusion: Patients with trisomy 13 may have different type of gene variations and malformations; however, the most common type of gene variation is classic trisomy 47, XX + 13, and the most common malformations are facial anomalies and congenital heart defects. In addition, tetralogy of Fallot and metopic synostosis may accompany trisomyÖğe The prevalence of Familial Mediterranean Fever common gene mutations in patients with simple febrile seizures(Verduci Publisher, 2014) Ozen, F.; Kocak, N.; Kelekci, S.; Yildirim, I. H.; Hacimuto, G.; Ozdemir, O.BACKGROUND: Febrile seizures (FS) represent the most common form of childhood seizures that occurs in 2-5 % of the children younger than 6 years. There have been many recent reports on the molecular genetic and pathogenesis of FC. It has been recognized that there is significant genetic component for susceptibility of FC with different reported mutation. FEB1, FEB2, FEB4, SCNA1, SCNA2, GABRG2 and IL-1 beta are related to with febrile convulsions (FCs). Interleukin 1 beta (IL-1 beta) is a cytokine that contributes to febrile inflammatory responses. There are conflicting results on increasing this cytokine in serum during FC. AIM: The determine the association between mutations of MEFV gene product pyrine and febrile seizures. PATIENTS AND METHODS: The study was carried out on 104 children that were diagnosed as FS and 96 healthy children. MEFV gene mutations were detected and analyzed with Pyro-Mark Q24. PCR was performed using the Pyro-Mark PCR Kit and pyrosequencing reaction was conducted on instrument instructions. RESULTS: M694V is the most common mutation in our patient group and we found a significant association between MEFV gene mutations and FSs. Of 104 patients, 68 were heterozygotes for any mutation and 10 patients were compound. 17.7% of control group were heterozygotes for any studied mutation. Statistical analyses showed that there was strongly significant statistical difference between results obtained from FS and control group (X = 46.20, p < 0.0001). CONCLUSIONS: MEFV gene mutations, especially M694V mutation, are positively associated with FSs.Öğe The relationships between clinical outcome and the levels of total antioxidant capacity (TAC) and coenzyme Q (CoQ10) in children with pandemic influenza (H1N1) and seasonal flu(Verduci Publisher, 2012) Kelekci, S.; Evliyaoglu, O.; Sen, V.; Yolbas, I.; Uluca, U.; Tan, I.; Gurkan, M. F.BACKGROUND AND AIM, This study was planned to evaluate the relationships between the levels of total antioxidant capacity (TAC) and Coenzyme 0 (Coal 0) and clinical outcome in hospitalized children with pandemic influenza (H1N1). Serum copper (Cu) and zinc (Zn) levels were also determined to evaluate the changings of oxidative stress's enzyme activities depending on their cofactor concentrations. PATIENTS AND METHODS, Children with suspected H1N1 virus infection were hospitalized and nasal swabs were sent to laboratory for confirmation of H1N1 by rRT-PCR assay. Age and sex matched 31 healthy children were included as Control Group. Total antioxidant capacity and CoQ10 were determined by spectrophotometry and HPLC, respectively, and Cu and Zn were determined using atomic absorption spectrometer. RESULTS, Totally 28 children had H1N1 and 37 children had seasonal influenza (SI). TAC, CoQ10 and Zn levels were found to be significantly decreased in H1N1 patients (1.01 +/- 0.19, 752.2 +/- 163, 69 +/- 27, respectively) compared to Control Group (1.64 +/- 0.36, 934 +/- 21, 92 +/- 4, respectively). Seasonal Influenza group had significantly decreased TAC and Zn levels (1.31 +/- 0.27, 78 +/- 34 respectively) compared with control group (1.64 +/- 0.36, 92 +/- 41, respectively). CoQ10 levels were also found as decreased in H1N1 compared to seasonal influenza (752.2 +/- 163 vs 1022 +/- 199, p = 0.003). There was a significant correlation between CoQ10 levels of sera and chest radiographic findings of patients with H1N1 pneumonia. No significant differences were found in serum Cu levels between patients with H1N1 and SI or control group (150 +/- 45 vs 127 +/- 37, p = 0.215). CONCLUSIONS, Pandemic influenza infection had increased oxidative stress compared to the seasonal influenza.Öğe Surgical Outcome of Bronchiectasis in Children: Long Term Results of 60 Cases(Georg Thieme Verlag Kg, 2014) Sahin, A.; Meteroglu, F.; Kelekci, S.; Karabel, M.; Eren, C.; Eren, S.; Celik, Y.Background: Bronchiectasis is described as destruction and the irreversible dilatation of bronchial structure. We wanted to demonstrate our surgical practice and outcome of surgical treatment in bronchiectasis. Methods: We studied records of 60 pediatric patients who underwent surgical resection in our clinic between January 2000 and January 2013. The results were analyzed regarding factors influencing the outcome. Results: There were 32 boys and 28 girls with a mean age of 9.45 years (range 2-15). The most common cause was childhood infection in 25 (41.66 %). The mean duration of the symptoms was 42.93 months. Patients underwent 64 operations including 2 staged thoracotomies and 2 rethoracotomies. Atelectasis was the most frequent complication. Longer duration of symptoms related to postoperative complication. The morbidity and mortality rates were 20 % and 3.33 %, respectively. The outcome was optimal in 92 %. Forced expiratory volume in 1 s less than 60 % of the predicted value, hemoptysis and duration of symptoms were found prognostic variables for postoperative morbidity with high ratios of odds coefficients by using Binary Logistic Regression Method. Conclusions: Complete and early resection of bronchiectasis provides a successful outcome. Duration of symptoms and timely intervention have a major impact on the management and prognosis.
