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Öğe Can intravenous cyclophosphamide be used for steroid-dependent nephrotic syndrome?(Springer Verlag, 1997) Bircan, Z; Soran, M; Kervancioglu, M; Gonlusen, G; Tuncer, I[Abstract Not Available]Öğe Cardiac troponin-1 as a marker of myocardial dysfunction in children with septic shock(E M H Swiss Medical Publishers Ltd, 2004) Gurkan, F; Alkaya, A; Ece, A; Haspolat, K; Boşnak, Mehmet; Bilici, M; Kervancioglu, MObjectives: Cardiac depression is well known in severe sepsis and septic shock. Our aim was to investigate the incidence of myocardial ischaemia as shown by cardiac troponin I (cTnI) levels in patients with septic shock and to evaluate the correlation with myocardial dysfunction measured by echocardiography. Methods: The study was performed in the paediatric intensive care unit in Dicle University Hospital, Turkey, between January 2001 and December 2002. Patients in septic shock, with a mean age of 6.4 +/- 2.8 months, were simultaneously submitted to a two-dimensional echocardiograin and biochemical investigation on admission. Results: The mean serum cTnI level of the patients was 3.1 +/- 2.6 ng/ml (0.01-9.80 ng/ml) and the mean LVEF value was calculated as 48% +/- 11%. 21 patients (75%) had a cTnI level greater than or equal to0.6 ng/ml, and 15 patients (54%) had a LVEF <0.5. For cTnI levels greater than or equal to0.6 ng/ml, sensitivity and specificity were 9 3.3% and 46.2%, and positive and negative predictive values were 66.7% and 85.7% respectively. For cTnI values greater than or equal to2.0 ng/ml, sensitivity and specificity were 86.7% and 76.9%, and positive and negative predictive values were 81.3% and 83.3%, respectively. There was a statistically significant relationship between LV dysfunction and cTnI positivity (r(2) = 0. 3 16, p = 0.002). No significant difference was found for the cTnI levels greater than or equal to0.6 ng/ml between non-survivors and survivors (p >0.05). Conclusion: Myocardial ischaemia and cell injury seem to be common in patients with septic shock and correlate with left ventricular dysfunction. Measurement of cTnI may be an easy and practical tool for monitoring cardiac damage in critically ill septic patients.Öğe Chronic renal failure in south eastern anatolia(Springer Verlag, 1996) Bircan, Z; Bircan, ML; Kervancioglu, M; Kilinc, M; Inci, D[Abstract Not Available]Öğe Does albumin and furosemide therapy affect plasma volume in nephrotic children?(Springer, 2001) Bircan, Z; Kervancioglu, M; Katar, S; Vitrinel, AAlbumin infusions transiently increase plasma volume (PV) and oncotic pressure, and may restore diuretic responsiveness in nephrotic edema. To determine if albumin and furosemide therapy have an effect on PV in nephrotic children, 14 severely edematous children with minimal change nephrotic syndrome were evaluated with standard clinical parameters (heart rate, blood pressure, body weight, pretibial edema, abdominal circumference) and echocardiography [inferior vena cava index (IVCI), inferior vena cava collapsibility index (IVCCI)] before, 1 h and 24 h after albumin (20%, 0.5 g/kg, 1 h) and furosemide (2 mg/kg, IV) therapy. An increase in IVCI (P <0.05), decrease in IVCCI (P<0.05), edema (P0.005), and hematocrit (P <0.005) were statistically significant 1 h after albumin and furosemide therapy, with a transient effect 24 h later. Body weight (P <0.005), abdominal circumference (P <0.05), and edema (P <0.005) decreased significantly at 24 h. It is concluded that albumin and furosemide therapy increases PV transiently in nephrotic edema, returning to baseline values at 24 h with a decrease in body weight, abdominal circumference, and edema.Öğe Echocardiographic study of aortic root diameter in healthy children(Saudi Med J, 2006) Kervancioglu, P; Kervancioglu, M; Tuncer, CMObjectives: Echocardiography is commonly used to measure the internal diameter of aortic root, which provides the evaluation of aortic root dilatation. Aortic root dilatation provide information concerning prognosis of aortic regurgitation and predisposition to aortic root dissection or rupture. The purpose of the study was to create normal values for aortic root diameters by using echocardiography in healthy children. Methods: We obtained the aortic root diameters in 229 normal children, aged one day to 15 years by using M-mode echocardiography. We performed the echocardiograms from the Department of Pediatric Echocardiography Laboratory, Medical Faculty, Dicle University, Turkey. We divided the children into 6 groups according to their body surface area (BSA): 0.20-0.25 m(2), 0.25-0.50 m(2), 0.50- 0.75 m(2), 0.75-1.0 m(2), 1.0-1.25 m(2), and 1.25-1.50 m(2). We corrected the aortic root diameters for BSA. Results: The aortic root diameters in children were 7.6 min to 24 mm with a mean value of 14.8 mm. The corrected aortic root diameter for BSA ranged from 10.7 to 40.6 mm/m(2) with a mean value of 19.9 m/m(2). Aortic root diameters increased with age, weight and BSA. In contrast, aortic root diameter/BSA values were higher in younger children. Conclusion: The presented aortic root diameters according to the BSA will serve as reference data for echocardiographic evaluation of patients with various cardiac diseases.Öğe Growth hormone stimulation tests in chronic renal failure with metabolic acidosis(Blackwell Publishing Asia, 1998) Bircan, Z; Kervancioglu, M; Soran, M; Yildirim, IMetabolic acidosis is one of the possible causes of growth retardation in chronic renal failure (CRF). Data about the effect of metabolic acidosis on growth hormone (GPI) secretion in CRF are limited. A study was carried out on eight CRF patients, hospitalized because of severe metabolic acidosis, and eight age-matched prepubertal healthy short children. Growth hormone stimulation tests were done with L-dopa and clonidine before or during acidosis therapy and after the correction of metabolic acidosis. The levels of GH were measured by radio-immunoassay. The mean of the peaks of both tests were used for each patient and statistical significance was tested by Mann-Whitney U and Wilcoxon tests. No difference was found between the GH peaks of the two groups during acidosis and after the correction of acidosis (Wilcoxon test, P > 0.05). In view of this data it was concluded that metabolic acidosis has little effect on GH stimulation tests.Öğe Oxidative stress, inflammation and early cardiovascular damage in children with chronic renal failure(Springer, 2006) Ece, A; Gürkan, F; Kervancioglu, M; Kocamaz, H; Günes, A; Atamer, Y; Selek, SThe relationship between inflammation, oxidant stress and cardiovascular damage in children with chronic renal failure (CRF) has not previously been investigated. The aim of this study was to investigate markers of oxidative stress, inflammation and early cardiovascular abnormalities. Therefore, erythrocyte superoxide dismutase (SOD) and catalase (CAT) activities; blood glutathione (GSH) and serum malondialdehyde (MDA) levels; C-reactive protein (CRP) and proinflammatory cytokines (IL-6, TNF-alpha,); and left ventricular masses (LVM) and intima media thicknesses (IMT) were measured in children with CRF. A total of 29 children with CRF (19 nondialysis, 10 peritoneal dialysis) were included. The control group consisted of 25 healthy subjects. CRF children had significantly increased IL-6, TNF-alpha, CRP and MDA concentrations and decreased SOD, CAT and GSH levels compared with controls (P < 0.05). Nondialysis and peritoneal dialysis subgroups had similar oxidative stress and inflammation biomarkers (P > 0.05). Erythrocyte CAT was positively correlated with CRP, TNF-alpha, and IL2-R in the study group. Positive correlations were found between cytokine concentrations, CRP and urea/creatinine levels. Significantly increased LVM and IMT values were found in CRF children (P < 0.05). In conclusion, increased oxidant stress and inflammation together with early cardiovascular damage were found in CRF children. Further studies with more patients are needed to verify these results.Öğe Plasma concentrations of NT-pro-BNP and cardiac troponin-I in relation to doxorubicin-induced cardiomyopathy and cardiac function in childhood malignancy(Saudi Med J, 2005) Soker, M; Kervancioglu, MObjective: Anthracyclines are well established as highly efficacious antineoplastic agents for childhood malignancy, but they frequently cause dose-related cardiotoxicity. For this reason, children who have received anthracyclines need periodical cardiac evaluation. The plasma levels of B-type natriuretic peptide (BNP) have been shown to increase in proportion to severity of cardiac dysfunction. N-terminal BNP (NT-pro-BNP) is secreted from the cardiac ventricles in response to volume expansion and pressure overload. The aim of our study was to investigate whether plasma levels of NT-pro-BNP and cardiac troponin I (cTnI) can be used as specific markers for doxorubicin-induced cardiotoxicity children with malignancy. Methods: We performed the study in Dicle University Hospital, Pediatric Hematology and Oncology clinic. Were measured plasma NT-pro-BNP and cTnI in 31 patients (14 boys and 17 girls) who received doxorubicin-containing chemotherapy for their malignancy at cumulative doses of 30-600 mg/m(2), between October 2000 and December 2004. Cardiac evaluation of the patients included recording of electrocardiography and assessment of systolic and diastolic functions of the heart by echocardiography. Results: Of the 31 patients, 4 (12.9%) had left ventricular dysfunction as assessed by echocardiography. Plasma NT-pro-BNP levels in these patients were significantly elevated in comparison with healthy controls (p < 0.001). Plasma NT-pro-BNP levels were significantly elevated in patients with cardiac dysfunction when compared with normal cardiac function (p < 0.008). The cTnI levels were found under normal value in all patients. Conclusion: Measurement of NT-pro-BNP level may be an easy and practical tool, and during treatment may allow earlier-identification of individuals at risk for monitoring cardiac damage. Plasma NT-pro-BNP concentration may, be a useful and sensitive indicator of cardiac dysfunction in children receiving doxorubicin therapy.Öğe Severe microangiopathic hemolytic anemia and thrombocytopenia in a child with Brucella infection(Springer-Verlag, 2001) Yaramis, A; Kervancioglu, M; Yildirim, I; Soker, M; Derman, O; Tas, MAWe present a case of severe microangiopathic hemolytic anemia and thrombocytopenia with epistaxis, gross hematuria, hemoglobinuria. and skin purpura in a child with Brucella septicemia proven by culture. The patient showed the features of this illness: leukopenia, severe hemolytic anemia, thrombocytopenia, fragmentation of erythrocytes in the peripheral blood smear, increased erythropoiesis, megakaryopoiesis, and granulomata cell invasion in the bone marrow. The patient was treated with rifampin and doxycycline. Platelets and leukocyte numbers rose to normal values by the 6th day. She was discharged on the 14th day. Follow-up of the patient 1 year later showed normal bone marrow morphology. Differential diagnosis, pathogenesis, and therapy of Brucella infection are discussed.Öğe Sialic acid in childhood renal diseases: Correlation with clinical and laboratory indices(Blackwell Science, 1998) Bircan, Z; Batun, S; Kervancioglu, M; Soran, M; Kaplan, A; Onur, H; Demir, FThere are many kinds of glycoproteins that have sialic acid residues and it has been reported that these are elevated in some renal diseases and their significance in the pathogenesis of several renal diseases has been investigated. In the present study the serum and urine levels of sialic acid were measured in healthy controls and in children with either poststreptococcal acute glomerulonephritis (PSAGN) or minimal change nephrotic syndrome (MCNS) to test if there is any correlation with clinical and laboratory indices. In PSAGN and MCNS patients the serum and urine sialic acid concentrations at onset and relapse were significantly different from healthy controls (Mann-Whitney U-test P < 0.005). There was not a significant correlation between the clinical severity, serum creatinine and complement C-3 levels and serum sialic acid concentrations in PSAGN patients. Also there was not a significant correlation between edema, serum albumin, IgG, transferrin, alpha-1-antitrypsin and serum sialic acid concentrations in MCNS patients. Although high serum and urine sialic acid levels were found in both PSAGN and MCNS patients, it does not have any clinical significance nor is it important as a diagnostic or prognostic marker.Öğe Two cases of nephrotic syndrome and tertian malaria in south-eastern Anatolia(Springer Verlag, 1997) Bircan, Z; Kervancioglu, M; Soran, M; Gonlusen, G; Tuncer, ITertian malaria is endemic in south-eastern Anatolia. As in Europe and America, in south-eastern Anatolia, an etiological agent is seldom identified in nephrotic syndrome, Two patients with Plasmodium vivax and nephrotic syndrome are described here. The possible relationship between Plasmodium vivax and nephrotic syndrome should be explored in children in endemic malarial regions.
