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    Childhood Brucellosis in Southeastern Region of Turkey: A retrospective analysis
    (Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2013) Konca, Capan; Tutanc, Murat; Gunes, Ali; Tas, Mehmet Ali
    Objective: To evaluate the clinical and laboratory findings, treatment modalities and outcomes of children with brucellosis in a four-year period Methods: This retrospective study included 34 children who were admitted to Dicle University Pediatric Infectious Diseases Service with brucellosis between 2003-2007. Demographic features, clinical symptoms, physical examination and laboratory findings of patients were evaluated. The standard tube agglutination test, Rose Bengal test and clinical findings were used as diagnostic criteria for brucellosis. Results: In the study, twelve patients (35%) were female and 22 (65%) were male. The mean age was 9.2+/-3.4 years. Twenty-one patients (61.7%) were from rural areas of Turkey. All of the children except two patients have reported to consume unprocessed milk and dairy products. The most frequent complaints and clinical findings were fever (88.2%) and musculo-skeletal system symptoms (76.4%). Hematological involvement was significantly apparent in laboratory results. Trimethoprimsulfamethoxazole+ rifampicin were administered to children smaller than 8 years and doxycycline+ rifampicin to children older than 8 years during 6 weeks for treatment. Four patients were relapsed. Conclusion: Musculoskeletal system complaints and fever are the most common symptoms in brucellosis. Brucellosis should be considered in the differential diagnosis of patients with hematological signs. Combined treatments should be administered within a sufficient period to provide successful treatment and prevent relapse.
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    The effect of malnutrition on kidney size in children
    (Springer, 2007) Ece, Aydin; Gozu, Ayfer; Bukte, Yasar; Tutanc, Murat; Kocamaz, Halil
    Malnutrition is a widespread disorder in children, and ultrasonography is the method of choice to estimate kidney dimensions. Previously, kidney sizes had been studied in healthy newborns and in pediatric patients; however, kidney sizes were not investigated sufficiently in malnourished children. The study group consisted of 74 children with energy malnutrition (marasmus), and the control group consisted of 47 healthy children. Kidney sizes were mesaured by the same radiologist using ultrasonography. The mean age of the marasmic group was 29.6 +/- 14.0 months. Malnourished children had significantly lower kidney length and renal volume but higher relative kidney volume (cm(3)/body weight) compared with controls (P < 0.05). The mean length and volume of left kidney were higher than those of right kidney in both marasmic and control groups (P < 0.05). The strongest positive correlations were found between body height and kidney length, depth and volume in marasmic group. Regression analysis revealed that height and age of marasmic children had a significant effect on kidney volume; however, only body height had an effect on kidney length. In conclusion, malnourished children had smaller kidney sizes, and body height was the main determinant of their kidney length and volume. The potential long-term detrimental consequences of poor renal growth in malnutrition need to be investigated.
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    Evaluation of cases with diabetic ketoacidosis monitorized in intensive care units
    (Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2011) Tutanc, Murat; Celik, Tanju; Basarslan, Fatmagul; Gunes, Ali; Konca, Capan; Yel, Servet; Boşnak, Mehmet
    Objective: In this study, we have investigated the demographic and clinical characteristics of pediatric cases with diabetic - ketoacidosis (DKA) followed-up in intensive care units. Methods: This is a retrospective analysis of all patients' files with respect to their demographic factors as gender, complaints, age and clinical features. Mann Whitney U and chi-square statistical tests were performed. Results: The study group consists 16 female and 9 male children with a mean age of 9.9 +/- 3.7 years. The most frequent complaints of the cases were dyspnea, polydipsia, weight loss and polyuria in decreasing order of frequency. They admitted to the hospital because of respiratory distress, tachypnea tachycardia and acidosis. They treated by DKA protocol in the intensive care unit. We normalized Glasgow Coma Scores (GKS) in 12 +/- 5, blood sugar levels in 14 +/- 7, and blood gas levels in 14 +/- 7 hours. Any complication had not developed and the patients under glycemic control were discharged from the hospital with recommendations for outpatient follow-up. Conclusion: DKA cases could be treated rapidly and successfully thanks to accurate and rapid diagnosis followed by strict monitorization protocol. In conclusion we wanted to emphasize that monitorization of patients with DKA should be performed in pediatric intensive care units.
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    Relationships between leptin, insulin, IGF-1 and IGFBP-3 in children with energy malnutrition
    (Pergamon-Elsevier Science Ltd, 2007) Haspolat, Kenan; Ece, Aydin; Gurkan, Fuat; Atamer, Yildiz; Tutanc, Murat; Yolbas, Ilyas
    Objectives: Leptin has a key role in energy homeostasis and there may be a link between leptin and insulin-like growth factor-1 (IGF-I) system. The aim of this study was to analyze the relationships between long-lasting insufficient caloric intake (marasmus), leptin and IGF-1 system. Design and methods: The study group consisted of 30 marasmic children and control group included 28 healthy children. After an overnight fasting; leptin, insulin, IGF-1 and IGFBP-3 levels were measured. Results: Marasmic children had significantly lower body weight, height, mid-arm circumference (MAC), skinfold thickness, mean serum leptin, insulin, IGF-1 and IGFBP-3 levels compared with healthy subjects (P < 0.05). Serum IGF-1 and IGFBP-3 levels were significantly correlated with insulin, MAC and height Z score in patients (P < 0.05). In controls, significant positive correlations were found between BMI, 1GF-1 and leptin (P < 0.05). Conclusions: Energy malnutrition is characterized by the important decreases in the leptin, insulin, IGF-I and IGFBP-3 levels. Understanding details of these changes may lead to new therapeutic approaches in disease states associated with malnutrition. (c) 2006 The Canadian Society of Clinical Chemists. All rights reserved.
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    Seropositivity for Chlamydia Pneumoniae and Mycoplasma Pneumoniae in Asthmatic Children
    (Derman Medical Publ, 2015) Tutanc, Murat; Gurkan, M. Fuat; Yel, Servet; Gunes, Ali; Konca, Capan; Bilen, Gulseren
    Acute respiratory tract infections may trigger acute asthma attacks and may be held responsible for etiopathogenesis in children with asthma. Although bacterial infections attract a limited amount of attention, recently Chlamydia pneumoniae (CP) and Mycoplasma pneumoniae (MP), in particular, are reported to be the possible factors. IgM and IgG seroprevalence was investigated in 66 children patients with bronchial asthma (between the ages of 3 and 14) for CP and Mycoplasma pneumoniae. In a total of 66 cases, 18 (27.2%) patients were detected with IgG positivity for CP whereas 27 of them (40.9%) were detected with IgG positivity for MP. IgG positivity was determined in 6 patients (13.0%) in the control group for CP, and in 6 patients (10.8%) in the control group for MP. The rate of the asthma patients with IgG seropositivity for MP was 4 times higher than that of the control group. It was seen that IgG antibody seropositivity for CP was higher in those with more frequent attacks. No such difference was observed in terms of IgG antibody seropositivity for M. pneumoniae. There are many studies indicating that CP and MP infections take an importance place in the etiology of bronchial asthma and asthma attacks in children. The results obtained reveal the effect of both microorganisms on the etiopathogenesis of the bronchial asthma and the increased number of asthma attacks.