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    Antibiotic Susceptibility of Microorganisms Grown in Tracheal Aspirate Cultures of Pediatric Intensive Care Patients
    (Cureus Inc, 2022) Orhan, Ozhan; Yilmaz, Kamil; Pirinccioglu, Ayfer Gozu; Solmaz, Murat; Karakoc, Ferhat
    Background Microorganisms proliferating in the hospital setting cause infections with high morbidity and mortality rates. In intensive care units (ICUs), the rates of antibiotic resistance and microorganisms grown in cultures may vary by time period. Antibiotic sensitivity must be known for a correct empirical treatment approach. This study aimed to investigate the distribution and antibiotic resistance profiles of pathogenic microorganisms isolated from tracheal aspirate samples in the ICU. Methodology This study enrolled 100 tracheostomized patients aged one month to 18 years, regardless of gender, who were followed in the ICU of Dicle University for more than 72 hours. Medical data were retrospectively evaluated from the medical records. Care was taken to collect samples before changing antibiotics. Antibiotherapy was continued until after culture antibiogram results were obtained, or empirical antibiotic therapy was started by giving consideration to the potential source in patients with a suspected infection. Results An analysis of the tracheal aspirate culture samples of the patients showed that Pseudomonas aeruginosa (54%), Acinetobacter baumannii (16%), and Staphylococcus aureus (8%) were the most common pathogens. An analysis of the culture antibiogram results of the tracheal aspirate samples obtained from the entire study population showed that P. aeruginosa was 100% resistant against vancomycin, clindamycin, and teicoplanin, but highly sensitive to colistin and amikacin. A. baumannii was highly resistant to almost all antibiotics but showed no resistance against colistin. Carbapenems being frequently preferred for cases where empirical therapy should be initiated for ICU infections can be one of the reasons for a high carbapenem resistance rate in our hospital. Conclusions We believe that starting empirical therapy with colistin when infections caused by Pseudomonas and Acinetobacter are suspected may be an appropriate initial therapy until culture antibiogram results become available. Microbiological data are crucial for a correct empirical treatment approach. In this way, intensive antibiotic usage and subsequent high antibiotic resistance can be adequately controlled.
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    Cranial magnetic resonance imaging findings of nutritional Vitamin B12 deficiency in 15 hypotonic infants
    (Elsevier Sci Ltd, 2012) Taskesen, Mustafa; Yaramis, Ahmet; Pirinccioglu, Ayfer Gozu; Ekici, Faysal
    Background: Nutritional vitamin B-12 deficieny is common among infants in the developing and underdeveloped countries. There is limited information concerning neuroimaging findings in infants with vitamin B-12 deficiency in the literature. Aims: The aim of this study is to evaluate the cranial magnetic resonance imaging (MRI) changes and clinical characteristics of hypotonic infants due to vitamin B-12 deficiency. Materials and methods: A total of 15 infants with neuroradiologic investigations were diagnosed with nutritional B-12 vitamin deficiency. Cranial MRI was performed on all infants. Results: Five infants were female (33%) and the mean age of infants was 12.3 +/- 5.5 months. Hypotonia and neurodevelopmental retardation were present in all patients. MRI demonstrated thinning of the corpus callosum in 6 (40%), cortical atrophy in 5 (33.3%), large sylvian fissures in 5 (33.3%), ventricular dilatation in 3 (20%), asymetric large lateral ventricle in 2 (13.3%) and delayed in myelination in 2(13.3%) patients. Four infants had normal MRI findings. Conclusion: Because of the importance of vitamin B-12 in the development of the brain, MRI findings may be detected and useful in infants with vitamin B-12 deficiency. (C) 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
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    Evaluation of Heavy Metal (Lead, Mercury, Cadmium, and Manganese) Levels in Blood, Plasma, and Urine of Adolescents With Aggressive Behavior
    (Cureus Inc, 2023) Yildiz, Suleyman; Pirinccioglu, Ayfer Gozu; Arica, Enes
    Background Heavy metals can cause health problems by affecting the biological structure even at very low concentrations. Asymptomatic heavy metal poisoning causes non-specific symptoms such as behavioral disorders, difficulty in learning, and aggressive behaviors. There is also a great concern about the incidence of aggressive behavior among adolescents. A few research studies have concluded that a complex interaction or combination of factors leads to an increased risk of aggressive behavior in adolescents. This study aims to determine the correlation between the heavy metal levels in blood, plasma, and urine and the aggression level in adolescents. Materials and methods Two hundred twenty-eight adolescents between the ages of 13 and 19 were enrolled in the study. Blood, plasma, and urine heavy metal levels of the participants were measured by an inductively coupled plasma mass spectrometer (ICP-MS) device (Model 7700x; Agilent, Santa Clara, CA, USA). Buss and Perry's aggression questionnaire was used to investigate the correlation between heavy metals and aggressive behaviors in adolescents. Results Lead blood (r=0.34, p<.01), lead plasma (r=0.22, p<0.01), lead urine (r=0.31, p<.01), mercury blood (r=0.35, p<0.01), mercury urine (r=0.21, p<0.01), manganese blood (r=0.34, p<0.01), manganese plasma (r=0.33, p<0.01) and manganese urine (r=0.39, p<0.01) were positively correlated with tendency to aggression whereas no significant relationship was found between cadmium in blood, plasma, urine and mercury in plasma with aggression. Conclusion The study showed valuable data to associate a significant relationship between adolescents' aggression levels and heavy metals. There is an undeniable relationship between the health of adolescents and environmental pollution caused by heavy metals. Therefore, taking the necessary measures to prevent environmental heavy metal pollution is crucial for adolescent health.
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    Evaluation of oxidative stress in children with congenital heart defects
    (Wiley, 2012) Pirinccioglu, Ayfer Gozu; Alyan, Omer; Kizil, Goksel; Kangin, Murat; Beyazit, Nurcan
    Background: A significant cause of death and chronic illness in childhood is caused by cardiovascular diseases, including congenital heart disease (CHD). This study aims to investigate the oxidative stress status and to establish its association with CHD in children. Methods: The study involves measurements of malondialdehyde (MDA), protein carbonyl (PCO), total anti-oxidant capacity, high-sensitive C-reactive protein (hs-CRP), fibrinogen and cytokine (interleukin [IL-6] and tumor necrosis factor-alpha) levels in 43 children with CHD and 30 healthy age-matched children. Results: MDA, PCO, hs-CRP, fibrinogen, IL-6 and tumor necrosis factor-alpha were significantly elevated while total anti-oxidant capacity was significantly declined in patients compared with the controls. MDA was positively correlated with PCO, hs-CRP, Qp/Qs and systolic pulmonary artery pressure. PCO was positively correlated with hs-CRP, fibrinogen, IL-6 and systolic pulmonary artery pressure. Conclusion: Oxidative stress and its association with other markers in children with CHD was established. To the best of our knowledge, this is the first time that PCO has been used as a biomarker in CHD and it may be employed as a new diagnostic biomarker in CHD and in the assessment of its severity.
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    Intracranial hemorrhage: Clinical and demographic features of patients with late hemorrhagic disease
    (Wiley, 2011) Pirinccioglu, Ayfer Gozu; Gurkan, Fuat; Boşnak, Mehmet; Acemoglu, Hamit; Davutoglu, Mehmet
    Background: This retrospective study presents clinical, demographical features and radiological findings as well as outcomes of 31 infants with intracranial hemorrhage (ICH) due to vitamin K deficiency and hence evaluates the risk factors involved. Methods: Thirty-one cases (17 males and 14 females) having a mean age of 52.52 +/- 20.80 days with intracranial hemorrhage due to late hemorrhagic disease of the newborn (LHDN), hospitalized in our clinics were included in the study. Cranial computerized tomography (CT) was performed in all patients for the diagnosis and evaluation of ICH. Results: It was found that the most frequent presenting symptoms were pallor (77.4%), seizures (58%), altered consciousness (58%), vomiting (44%) and poor feeding (35%). Pulsatile fontanel was found in 61% and bulging in 26%. Seven (22.5%) patients had prior history of antibiotic usage. All patients (93.5%) except two were breast fed. Sixteen (51.6%) were delivered at home. Eighteen (58%) had a history of single-dose vitamin K prophylaxis on the first day of delivery. Parenchymal (44%), subdural (39%) or subarachnoidal (22.5%) bleeding was observed. Seven (22.6%) were exitus. During the follow-up period (ranging from 3 months to 18 months) neurological examination findings were recorded. Conclusion: Our results indicate that it may be questionable whether single-dose vitamin K prophlaxis at birth is adequate for the prevention of LHDN and if a different timing of this prophylaxis should be made for the exclusively breast fed infants.
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    Late onset Proteus Mirabilis Meningitis and Subdural Abscess in a Boy With Lumbosacral Epidermoid Tumor: Case Report
    (Journal Neurological Sciences, 2012) Pirinccioglu, Ayfer Gozu; Ulu, Mustafa Onur; Guzel, Aslan
    Dermal sinus tracts have been reported all along the midline neuroaxis, with the majority being located in lumbar and sacral areas. They are usually associated with split cord malformations, tethered cord and inclusion tumors (dermoid, epidermoid, teratoma). Dermal sinus tracts with concomitant dermoid or epidermoid tumors are frequently associated with recurrent meningitis, but spinal subdural abscess is rare. The authors report a 2 years old boy with lumbar epidermoid tumor, late onset Proteus mirabilis meningitis and spinal intradural abscess, who had a history of a dermal sinus tract removal one year before his admission. The importance of early diagnosis, proper surgical and medical treatment and close follow up in such patients is stressed.
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    Levels of proinflammatory cytokines and hs-CRP in patients with homozygous familial hypercholesterolaemia
    (Acta Cardiologica, 2009) Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Arikan, Senay; Pirinccioglu, Ayfer Gozu; Bahceci, Selen
    Objective - Homozygous familial hypercholesterolemia (FH) is an extremely rare (1/1.000.000) condition characterized by markedly increased LDL cholesterol levels and a significantly increased risk of premature coronary heart disease (CHD). We aimed to evaluate the levels of high-sensitivity C-reactive protein (hs-CRP) and proinflammatory cytokines, which are known to be associated with atherogenesis, in patients with this condition. Method and results - A total of 10 patients with homozygous FH (5 women and 5 men, mean age 17.0 +/- 6.9 years, body mass index (BMI) (18.8 +/- 1.9 kg/m(2)) and 16 healthy controls were included. hs-CRP levels, proinflammatory cytokine levels and lipid parameters were measured and compared between patients and control subjects. Homozygous FH patients had significantly higher total cholesterol, LDL-cholesterol and Lp(a) levels and significantly lower triglycericle and HDL cholesterol levels, compared to controls (P = 0.0001, for all). Serum hs-CRP (3.7 +/- 1.3 mg/L vs. 0.6 +/- 0.6 mg/L) and IL-1 beta, IL-2R, IL-6, IL-8, IL- 10, TNF-alpha levels were all significantly higher in the homozygous FH group, compared to controls (P = 0.0001, for all). Conclusions - Homozygous FH patients have significantly higher levels of hs-CRP and circulating proinflammatory cytokines, which may explain their increased risk of atherosclerotic disease. hs-CRP is an important biomarker that may be helpful in the identification of asymptomatic CHD in FH patients.
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    Malondialdehyde (MDA) and protein carbonyl (PCO) levels as biomarkers of oxidative stress in subjects with familial hypercholesterolemia
    (Pergamon-Elsevier Science Ltd, 2010) Pirinccioglu, Ayfer Gozu; Gokalp, Deniz; Pirinccioglu, Mihdiye; Kizil, Goksel; Kizil, Murat
    Objective: Familial hypercholesterolemia (FH) is clinically characterized by elevated total and low-density lipoprotein (LDL) cholesterol levels in plasma, which has high risk for developing atherosclerosis. Increased oxidative stress (OS) and FH have been related to atherosclerosis. The study aims to evaluate oxidative stress in patients with hypercholesterolemia by measuring lipid peroxidation and protein carbonyl (PCO) levels in these patients. PCO in these patients may provide a new diagnostic biomarker for oxidative damage in atherosclerosis. Design and method: Total cholesterol (Tc), low-density lipoprotein-cholesterol (LDL-c), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-c), lipoprotein(a) (Lp-a) levels and carotid intima-media thickness were measured to evaluate characteristics of patients (11 homozygous and 25 heterozygous) with FH. 25 age-gender-BMI matched healthy control subjects were included in the study for comparison. Results: MDA and PCO levels were significantly higher in homozygous patients compared with those of heterozygous and controls and it was found that they are positively correlated with LDL-c, Tc, Lp-a and IMT while negatively correlated with HDL-c. The heterozygous group also had significantly higher MDA and PCO levels compared with controls. Conclusion: The data obtained could be important for understanding the alterations presented by FH and could be related to their increased risk of developing atherosclerosis. To our knowledge, measurements of PCO in patients with FH are not recorded before and this may be used as a biomarker for protein oxidation, which may play a role in the increased cardiovascular risk of patients with FH. (C) 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
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    Neurological presentations of nutritional vitamin B12 deficiency in 42 breastfed infants in Southeast Turkey
    (Tubitak Scientific & Technological Research Council Turkey, 2011) Taskesen, Mustafa; Yaramis, Ahmet; Katar, Selahattin; Gozu, Ayfer; Pirinccioglu, Ayfer Gozu; Soker, Murat
    Aim: Nutritional vitamin B12 deficiency is common in developing and underdeveloped countries and has a wide variety of neurological presentations. The aim of this study was to evaluate the neurological characteristics and laboratory results of infants with vitamin B12 deficiency. Materials and methods: A total of 42 infants were included in this study. All patients were evaluated for clinical, physical, and neurological abnormalities, and an attempt was made to obtain short-term neurologic follow-up. Results: Of 42 patients, 24 (57%) were boys and 18 (43%) were girls. The average age at diagnosis was 13.04 +/- 5.68 months. Most of these infants were breastfed only and born from mothers with inadequate animal-derived protein consumption. Hypotonia (100%), anorexia (92.8%), neurodevelopmental (85.7%), and social (80.9%) retardation were the most present symptoms in all infants. Conclusion: Severe neurological and hematological findings may be found in children with vitamin B12 deficiency. Early diagnosis and treatment is crucial in cases of hematological complications and neurologic impairment. Neurologic impairment may be irreversible if the diagnosis is delayed beyond 12 months. We think that dietary management, such as nutritional support with vitamin B12 for the mothers during pregnancy and complementary food for infants, may prevent the neurological deficits and neurodevelopmental retardation.
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    Oxidative stress parameters in children with acute rheumatic fever
    (Wiley, 2019) Pirinccioglu, Ayfer Gozu; Alyan, Omer; Akin, Alper; Kizil, Goksel; Isik, Fatma Birgul
    Background The aim of this study was to investigate of the role of oxidative stress (OS) in acute rheumatic fever (ARF) and its relationship with the progress of the disease. Methods Thirty patients with ARF and 31 age-sex-matched healthy children were enrolled in this study. Serum malondialdehyde (MDA), protein carbonyl (PCO), high-sensitivity C-reactive protein (hs-CRP), cytokines (tumor necrosis factor-alpha and interleukin-6) and total antioxidant capacity (TAC) were measured. The diagnosis of ARF was based on the Jones criteria. Results Patients with ARF had significantly higher serum MDA, PCO, hs-CRP and cytokine levels and lower TAC than healthy controls. On Pearson's correlation analysis we found that oxidative stress markers were positively correlated with hs-CRP and cytokines, while TAC was negatively correlated with MDA, PCO, hs-CRP and cytokines. The number of valves involved as well as the level of mitral valve involvement was also significantly related to the oxidative stress parameters and TAC. All oxidative stress parameters decreased significantly with anti-inflammatory therapy while TAC increased. Conclusion Malondialdehyde and PCO, as biomarkers, as well as hs-CRP together with the other available diagnostic tools, can be used in the evaluation of patients with ARF.
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    A retrospective investigation of clinical and laboratory findings in children with acute rheumatic fever, reactivation and compliance with prophylaxis
    (Turkish Soc Cardiology, 2012) Pirinccioglu, Ayfer Gozu; Alyan, Omer; Kangin, Murat; Taskesen, Mustafa; Fidan, Mucahit; Mermutoglu, Nihat; Sen, Velat
    Objectives: We aimed to retrospectively investigate the patients with acute rheumatic fever (ARF) by evaluating their clinic and laboratory properties, echocardiographic findings as well as the reactivation and the compliance to penicillin prophylaxis. Study design: The study involved 255 patients (143 boys, 112 girls; mean age 10.1 +/- 2.7 years) with ARF. Their sex, age, clinic and laboratory properties, echocardiographic findings, the reactivation and the compliance to penicillin prophylaxis were recorded. Results: Patients spent 13.3 +/- 4.3 days in the hospital, and 94 had a history of ARE. Arthritis was found in 233 patients, carditis in 166. Sydenham's chorea in 14, subcutaneous nodule in 2, and arthritis-carditis in 151 patients. Erythema marjinatum was not found in any patient. Arthralgia (n=15) and fever (n=246) were found in patients. Throat culture was positive in 94 patients and anti-streptolysin-O titers were high in 124 patients. Mitral involvement was found in 205 patients while the combination of mitral and aortic valve involvement were observed in 118 patients. Conclusion: ARF still continues to be a major public health problem in our country. A bad prognosis may be prevented by early diagnosis and treatment. The importance of appropriate prophylaxis should also be emphasized.