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Öğe Antioxidant enzyme activities, lipid peroxidation, and total antioxidant status in children with Henoch-Schonlein purpura(Springer, 2008) Ece, Aydin; Kelekci, Selvi; Kocamaz, Halil; Hekimoglu, Askin; Balik, Hasan; Yolbas, Ilyas; Erel, OzcanThe aim of this study was to assess the role of oxidative stress in the pathogenesis of Henoch-Schonlein purpura (HSP) vasculitis. The activities of catalase (CAT), arylesterase (ARYL), and paraoxonase (PON) as antioxidant enzymes and serum malondialdehyde (MDA) level as an indicator of lipid peroxidation, together with total antioxidant status (TAS), were measured in 29 children with HSP (mean age 9.3 +/- 2.7 years), both at the onset of the disease and at the remission period and in matched controls. Active-stage HSP had significantly higher MDA level (15.5 +/- 7.3 vs 7.8 +/- 3.9 nmol/l, respectively, P<0.001) and lower TAS (524 +/- 122 vs 699 +/- 122 mu mol Trolox Equiv/1, P< 0.001), PON (97 +/- 47 vs 136 +/- 95 U/1, P=0.042), ARYL (158 +/- 39 vs 212 +/- 52 U/1, P<0.001), and CAT (50 +/- 27 vs 69 +/- 20 U/1, P=0.002) activities compared with the control subjects. Although CAT (P>0.05) and PON (P>0.05) activities were found to be similar between active and remission stages of HSP, the active stage of the disease had significantly lower ARYL (P=0.011) and TAS (P=0.006) and higher MDA (P<0.001) values compared with remission period. Significant positive correlations were found between CAT and MDA (r=0.433, P=0.019) and between CAT and C-reactive protein (r=0.386, P=0.035) in the active stage of HSP. No significant differences were detected in oxidant/antioxidant parameters between patients with or without renal, gastrointestinal, or joint involvement (P>0.05). Increased oxidative stress and lipid peroxidation may play important roles in the pathogenesis of HSP vasculitis. Antioxidant therapeutic interventions in longlasting vasculitis and risk of atherosclerosis secondary to increased oxidant stress remain to be investigated.Öğe Assesment of Quality of Life in Children with Asthma(Derman Medical Publ, 2012) Gumus, Serhat; Kelekci, Selvi; Yolbasi, Ilyas; Gurkan, FuatAim: Bronchial asthma is among the most common chronic pediatric diseases that can result in variable restriction in the physical, emotional and social aspects of the patient's life. The aim of this study was to assess impairment on quality of life (QOL) in asthmatic children. Material and Method: Ninety seven patients aged between 7 and 15 years which followed up at Pediatric Pulmonology Department of Dicle University Hospital were included into the study, during October 2009 - January 2010. To assess the quality of life Pediatric Asthma Quality of Life questionnaire's (PAQLQ) self-applied Turkish version was used. In addition, the severity of asthma was measured using by Childhood Asthma Control Test (C-ACT). Results: The male to female ratio of asthmatic children was 2/1 and the mean age was 10.0. boxed times 2.5 years. Severity of asthma, history of steroid use and low family income were found as having negative effect on the PAQLQ scores (p < 0.001). Mother's education level also had statistically significant effect on the PAQLQ scores (P = 0.02). Father's education level; patient's age, gender, passive smoking exposure, family history of asthma or eczema and duration of disease did not have statistically significant effect on PAQLQ scores (p> 0.05). Asthma control test score had a significant correlation with PAQLQ score (p < 0.001). Discussion: Steroid use, severity of Asthma and lower socio-economical status of family had negative effects on quality of life in children with asthma.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 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 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 Complementary and alternative medicine in children with asthma and/or allergic rhinitis(Bilimsel Tip Yayinevi, 2014) Tuncel, Tuba; Cetemen, Aysen; Karabel, Musemma; Kelekci, Selvi; Sen, Velat; Gurkan, M. FuatObjective: The aim of this study is to evaluate the complementary and alternative medicine methods, the prevalance of their use, and to assess the factors that influence using these methods in children with asthma and/or allergic rhinitis. Materials and Methods: The study was conducted between November 2012-May 2013. The data collection form consisting 34 questions was prepared. These questions were posed to mothers of children with asthma and/or allergic rhinitis who were followed at least three months in pediatric allergy outpatient clinic. The data were recorded in SPSS for Windows v.16. Descriptive statistics, chi square, and logistic regression analysis were used. p< 0.05 was considered as significant. Results: The study included 177 patients. The complementary and alternative medicine methods were suggested to 136 (77%) patients and 68 (38.4%) patients used these methods anytime. 34 (43%) patients with asthma, 25 (39.7%) patients with asthma and allergic rhinitis, 9 (25.7%) patients with allergic rhinitis used complementary and alternative medicine. The differences between the groups were not statistically significant (p> 0.05). The honey use was most common method for both asthma and allergic rhinitis (37% and 22.9%, respectively). Herbal medicines were the %67 of complementary and alternative medicine methods. The diagnosis, education levels of parents, the family income, positivity of skin prick test, severity of the asthma and allergic rhinitis, control of the disease, using multiple drugs, using inhaled steroids were not different between the groups (p> 0.05). Logistic regression analysis revealed that these factors were not related to increased risk of complementary and alternative medicine use. Conclusion: The complementary and alternative medicine use is frequent in children with asthma and/or allergic rhinitis. The physicians should have knowledge about these methods and inform parents about the possible effects and side effects.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 Flexible bronchoscopy findings in lung amoebiasis: a case report(Drunpp-Sarajevo, 2012) Kelekci, Selvi; Sen, Velat; Tuncel, Tuba; Sen, Hadice Selimoglu; Cicek, Muttalip; Erge, Duygu; Gurkan, M. FuatThe protozoon Entamoeba histolytica is an agent of human amoebiasis. Amoebiasis is common around the world, especially in tropical and subtropical regions. About 90% of infections are asymptomatic, while the remaining 10% are characterized by dysentery and abscesses observable in the liver or other organs. The liver is the organ most commonly affected by extraintestinal amoebiasis. Pulmonary and invasive amoebiasis is seen in 2-3% of patients, but isolated pulmonary amoebiasis is rarely seen in the pediatric age group. In this study, a 14 year old male patient diagnosed with isolated pulmonary amoebiasis is presented. Diagnosis was based on the detection of trophozoites through direct examination of bronchoalveolar lavage fluid obtained by flexible bronchoscopy, and the presence of amoebic IgG in the blood. Three weeks of metronidazole combined with antimicrobial treatment significantly improved the patient's clinical and radiologic findings. The aim of this report was to present a rare case of childhood pulmonary amoebiasis without liver or other organ involvement and to demonstrate the efficacy of flexible bronchoscopy for diagnosis.Öğe The MEFV mutations and their clinical correlations in children with familial Mediterranean fever in southeast Turkey(Springer Heidelberg, 2014) Ece, Aydin; Cakmak, Erdal; Uluca, Unal; Kelekci, Selvi; Yolbas, Ilyas; Gunes, Ali; Yel, ServetThe aim of this study was to determine the Mediterranean fever (MEFV) gene mutations and their clinical correlations in children with familial Mediterranean fever (FMF) in southeast Turkey. Clinical and laboratory characteristics of 147 (65 males, 82 females) consecutive children with FMF having a positive MEFV gene mutation were prospectively investigated. Patients with negative MEFV gene mutations or atypical FMF presentations and those from other regions of the country were excluded. Clinical manifestations and disease severity scores were recorded. The six most frequent MEFV mutations including M694V, V726A, R726H, P369S, E148Q and P369S were investigated by a reverse hybridization test method. The median age of study group was 9.0 years, median age at diagnosis was 7.8 years, median age at disease onset was 5.0 years, and median follow-up duration was 4.0 years. A positive family history of FMF and parent-to-offspring transmission was found in 58.5 and 42.2 % of families, respectively. The frequencies of independent alleles, with decreasing order, were E148Q (30.7 %), M694V (26.0 %), R761H (13.5 %), V726A (13.0 %), P369S (10.5 %) and M680I (6.3 %) in FMF patients. The M694V subgroup had higher mean disease severity score and longer attack duration compared with E148Q and other mutations subgroups (p < 0.05). Two patients with amyloidosis had the M694V homozygote genotype. In conclusion contrast to other regions and many other ethnicities of the world, the most frequent MEFV gene mutation was E148Q in southeast Turkey. The M694V mutation frequency was lower, and disease severity was relatively mild in FMF children of this region.Öğe Neutrophil activation, protein oxidation and ceruloplasmin levels in children with Henoch-Schonlein purpura(Springer, 2007) Ece, Aydin; Kelekci, Selvi; Hekimoglu, Askin; Kocamaz, Halil; Balik, Hasan; Yolbas, Ilyas; Erel, OzcanThe aim of this study was to investigate the role of neutrophil activation, protein oxidation and ceruloplasmin (CLP) in the pathogenesis of Henoch-Schonlein purpura (HSP), which has not been investigated previously. Serum activities of myeloperoxidase (MPO) and arylesterase (ARYL) and levels of free thiol groups, CLP and total oxidant status (TOS) were measured in 29 children with HSP at the onset of the disease and during remission in comparison with 30 healthy subjects. Patients at active stage had significantly higher MPO activity (391 +/- 277 vs. 155 +/- 154 U/l, P<0.001), higher CLP (832 +/- 120 vs. 682 +/- 114 mg/dl, P<0.001) and TOS values (20.7 +/- 11.8 vs. 7.5 +/- 2.8 mu mol H2O2/l, P<0.001) than the controls, respectively. Patients had significantly lower ARYL activity (158x10(3) +/- 3x10(3) vs. 187x10(3) +/- 4 46x10(3) U/l, P<0.001) and lower free thiol levels (234 +/- 48 vs. 279 +/- 26 mu mol/l, P<0.001) than the controls, respectively. Significantly positive correlations were found between TOS and MPO (r=0.437, P=0.018) and TOS and CLP (r=0.409, P=0.028) at disease onset, whereas a negative correlation was found between MPO and thiol (r=-0.597, P=0.001) during remission. In conclusion, protein oxidation and neutrophil activation may play important roles in the pathogenesis of HSP. Further research is required to understand the potential linkage between oxidant stress and complications and to develop therapeutic strategies in HSP.Öğe Papulonecrotic tuberculid. Case report(Soc Argentina Pediatria, 2013) Akkurt, Z. Meltem; Ucmak, Derya; Fidan, Veysi; Turkcu, Gul; Kelekci, SelviA 12-year-old girl was seen with widespread millimetric papules which resolved leaving varioliform scars. Tuberculin test was strongly reactive. Underlying pulmonary tuberculosis was diagnosed. The patient responded to antituberculous treatment. Papulonecrotic tuberculid is a skin eruption thought to be due to hypersensitivity to an underlying focus of tuberculosis and is an indicator of good immunologic status.Öğe The use of complementary and alternative medicine in children with atopic dermatitis(Bilimsel Tip Yayinevi, 2013) Tuncel, Tuba; Karabel, Musemma; Cetemen, Aysen; Kelekci, Selvi; Sen, Velat; Gurkan, M. FuatObjective: The aim of this study is to evaluate the complementary and alternative medicine methods, the prevalence of their use and to assess the factors that influence using unconventional therapies in children with atopic dermatitis. Materials and Methods: The study was conducted between November 2012-May 2013. The data collection form was prepared which consisted 34 questions. These questions were posed to mothers of children with atopic dermatitis who were followed at least three months in pediatric allergy outpatient clinic. The data were recorded in SPSS for Windows v.16. Descriptive statistics, Mann Whitney-U, Fisher's exact test and logistic regression analysis were used. p< 0.05 was considered as significant. Results: The study included fifty children. 46% of patients have used complementary and alternative medicine. The most common methods were prayer, herbal medicines and application of saliva. The most common reason to apply these interventions was defined as inability to benefit from medical treatment (47%). 13% of users thought complete response and 30% partial response. Complementary and alternative medicine interventions were suggested to 68% of the patients. The family elders and friends were the most common proposers. The level of family income, educational levels of mothers and fathers and the type of the family were not related to frequency of complementary and alternative medicine use (p> 0.05). The severity of the atopic dermatitis was different between two groups and complementary and alternative treatment use increased in the patients with severe atopic dermatitis (p< 0.05). Conclusion: The use of complementary and alternative medicine in the children with atopic dermatitis is very common. The physicians should have knowledge about these methods.
