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Songu M.,Dr Behcet Uz Childrens Hospital | Songu M.,Izmir Ataturk Research and Training Hospital | Adibelli H.,Dr Behcet Uz Childrens Hospital
International Journal of Pediatric Otorhinolaryngology | Year: 2010

Objective: The prominent ear is the most common congenital deformity of the auricle. It is often recommended that prominent ears be surgically repaired before children start school and most surgeons seem to perform the surgery after 5 years of age. The aim of our study is to summarize the rationale of performing otoplasty procedure in children under the age of 5, to discuss the advantages and disadvantages, and to review the patient (parent) satisfaction. Methods: A retrospective study was performed on 10 children under the age of 5 who underwent otoplasty procedure and was followed for over a year. Results: Ten patients (3 boys and 7 girls) between the ages of 48 months and 59 months, with a median age of 51.5 months were evaluated. Otoplasty was bilateral in 8 patients and unilateral in 2 patients. Global Aesthetic Improvement Scales of the patients were rated as "improved" or "better" at 52 weeks. The patient (parent) satisfaction was measured by a telephone survey. Parents revealed that 9 out of 10 were "very" or "completely" satisfied with the appearance and symmetry of their children's ears. We did not observe any visible disturbance or growth restriction in our patients, even in the unilateral operated group. Conclusion: Timing of surgery is an issue of concern with regard to otoplasty in children. There may be significant psychosocial benefit to early intervention, particularly in light of changing norms for interaction with peers at ages considerably earlier than what had previously been thought of as the "school age." Our preference is to plan the otoplasty as young as four years of age, after the child has expressed some concern about the deformity. © 2009 Elsevier Ireland Ltd.


Kamer E.,1834 sok. No 9 4 | Unalp H.R.,Ankent Bl. No 7 | Diniz G.,Dr Behcet Uz Childrens Hospital | Bozdag A.D.,Mithatpasa Cad. No 387 7 | Ortac R.,Dr Behcet Uz Childrens Hospital
Langenbeck's Archives of Surgery | Year: 2010

Purpose We aimed to investigate the effect of sildenafil on the healing process of abdominal wall wound in rats. Materials and methods The study was performed with adult female Wistar-Albino rats. Control group (n=50) were fed on standard laboratory diet until 12 h before surgery. Study group (n=50) were applied orally with orogastric tube 10 mg/kg once a day for 10 days of sildenafil therapy. Each rat was anesthetized, and a 4-cmlong midline laparotomy was performed. Ten animals from each group were killed at postoperative days (PODs) 4, 7, 14, 21, and 35. Breaking strength analysis was measured, and the abdominal incision wounds were examined histologically. Results Breaking strength for the midline incision, acute inflammation score on POD 14, and neovascularization on PODs 7, 14, 21, and 35 were significantly higher in the study group. Conclusions Sildenafil can be used as a supporting factor in wound healing. © Springer-Verlag 2009.


Songu M.,Dr Behcet Uz Childrens Hospital | Adibelli H.,Dr Behcet Uz Childrens Hospital | Diniz G.,Izmir Dr Behcet Uz Childrens Hospital
Pediatric Dermatology | Year: 2012

White sponge nevus is a rare, autosomal-dominant disorder that affects the noncornified stratified squamous epithelia. Clinically, the presence of white, spongy plaques mostly in the buccal, labial, and gingival mucosa and the floor of the mouth characterize the lesions. The differential diagnosis of the lesion may be difficult and it is best diagnosed by biopsy. We report a case of white sponge nevus in the oral cavity of a 16-year-old boy and review of the literature. © 2012 Wiley Periodicals, Inc.


Ulug M.,Ozel Umit Hospital | Yaman Y.,Dr Behcet Uz Childrens Hospital | Yapici F.,Ozel Sante Plus Hospital | Can-Ulug N.,Ozel Umit Hospital
Turkish Journal of Pediatrics | Year: 2011

Brucellosis, whether in an endemic region or not, remains a diagnostic puzzle due to occasional misleading unusual presentations and non-specific symptoms. The aim of this study was to evaluate the clinical and laboratory findings, complications and treatment outcome of brucellosis in children in southeastern Anatolia, Turkey. This study focuses on the frequency of clinical and laboratory findings and complications in cases with brucellosis. Of 22 patients, 8 (36.3%) were female and 14 (63.7%) were male. Fever, malaise, lack of appetite, arthralgia, and night sweating were the main presenting symptoms overall. Hematologic complications (n=13, 59.1%) were most common, followed by skeletal (n=7, 31.8%) and cutaneous system (n=1, 4.5%). Brucellosis may affect any organ system and imitate a variety of clinical entities. Diagnosis of brucellosis should be considered whenever there is a febrile illness associated with rheumatological complaints. Consequently, early recognition of the infection, prolonged antibiotic treatment and careful long-term follow-up should improve the patient outcome.


Songu M.,Dr Behcet Uz Childrens Hospital | Songu M.,Izmir Kâtip Celebi University | Kutlu A.,Dr Behcet Uz Childrens Hospital
European Archives of Oto-Rhino-Laryngology | Year: 2014

To investigate health-related quality of life changes that occurred in children with prominent ears applied pre- and postoperatively. A prospective study was performed in 67 consecutive children who underwent otoplasty procedures between April 2008 and July 2010 and followed up for more than 2 years. Evaluations and interviews performed in the pre-and postoperative periods included the patients' history, clinical and routine laboratory examinations. Glasgow children's benefit inventory was the basis of the used inquiry for detecting the changes in health-related quality of life after otoplasty. For the children's cohort, the mean total Glasgow children's benefit inventory score was 23.9 (p < 0.001), indicating a benefit from the operation. All Glasgow children's benefit inventory subscores (emotion, physical health, learning, and vitality) were raised (mean 30.84, 14.98, 18.89, and 23.96, respectively). The health-related quality of life was raised in 63 of 67 children (94.03 %). Negative Glasgow children's benefit inventory scores or subscores were not found in a single case. Otoplasty can significantly increase patients' health-related quality of life and leads to a high rate of patient satisfaction in children with prominent ears. © 2014 Springer-Verlag.


Yilmaz U.,Dr Behcet Uz Childrens Hospital | Celegen M.,Dr Behcet Uz Childrens Hospital | Yilmaz T.S.,Dokuz Eylül University | Gurcinar M.,Alsancak Center | Unalp A.,Dr Behcet Uz Childrens Hospital
European Journal of Paediatric Neurology | Year: 2014

Background Headaches are common in children and brain magnetic resonance imaging (MRI) studies are widely used in everyday clinical practice because of increasing demands by parents. Aim To determine headache types and to evaluate the frequency and clinical significance of brain MRI abnormalities in children with headache. Methods A total of 449 children (261 male and 188 female with a mean age of 11.16 ± 3.22 years) with headache were included into the study. The criteria defined by International Headache Society were used to classify the headache types. Results The causes of headache were migraine in 247 (55.0%), tension-type in 133 (29.6%), secondary in 48 (10.7%), and unspecified headaches in 21 (4.7%) patients. Overall, 324 (72.2%) patients underwent cerebral MRI, which revealed abnormalities in 68 (21.0%) patients. Two (0.6%) patients had cerebral MRI abnormalities relevant to headache, including tumor and hydrocephalus each 1 (0.3%). Twenty-nine (8.9%) patients had incidental cerebral MRI abnormalities including 14 (4.3%) white-matter hyperintensities, 4 (1.2%) old infarcts, 3 (0.9%) Chiari malformations, arachnoid cysts and demyelinating lesions each 2 (0.6%), and subdural hygroma, fibrous dysplasia, pineal cyst and perivascular widening, each 1 (0.3%). Remaining 36 (11.1%) patients had extra-cerebral MRI abnormalities including 34 (10.5%) sinus disease, and 2 (0.6%) adenoid vegetation. Indications for brain MRI were atypical headache pattern or presence of neurologic abnormalities in 59 (18.2%) patients and parents' concerns in 265 (81.8%) patients. The rates of abnormal MRI findings were similar between these 2 groups. Conclusions The most frequent cause of headache in children is migraine. Despite the high rate of imaging abnormalities, the yield of brain MRI is not contributory to the diagnostic and therapeutic approach. © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.


Erikci V.,Dr Behcet Uz Childrens Hospital | Hosgor M.,Dr Behcet Uz Childrens Hospital
Journal of Plastic, Reconstructive and Aesthetic Surgery | Year: 2014

Introduction A retrospective clinical trial was conducted to evaluate the clinical features and treatment outcomes and to determine the incidence of complications in children with congenital neck lesions (CNLs) treated at our institution with a special emphasis on thyroglossal duct remnant (TGDR), branchial cleft anomaly (BCA), and dermoid cyst (DC). Materials and methods This series had 72 patients with CNL. The diagnosis of CNL was made by physical examination, ultrasound (US) in most, and for a potential extension of the mass computed tomography (CT) or magnetic resonance imaging (MRI) in a few patients and confirmed by histopathological examination in all of the children. Results Of the patients in this series, 39 (54.2%) children had thyroglossal duct remnant (TGDR). The most common surgical procedure (n = 36) in these children was Sistrunk's procedure. Four children (10.3%) with TGDR had associated anomalies including Turner syndrome and Morgagni hernia. During the study period, 25 (34.7%) children with branchial cleft anomaly (BCA) were treated and most of these were second branchial anomalies. There were eight children (11.1%) with dermoid cyst (DC). Conclusion TGDR is the most common CNL and is presented clinically rather late with regard to BCA and DC in this series. Surgical resection is optimal choice of therapy in CNLs not only for aesthetic reasons but also for the recurrent infections and the potential danger of malignancy. Definitive surgery may be associated with high morbidity, especially recurrence. Associated anomalies may be observed, especially in children with TGDR. Although the Sistrunk's procedure is a safe and successful technique, life-threatening complications should also be kept in mind during the management of these lesions and early and adequate surgical treatment is suggested. © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.


Genel F.,Dr Behcet Uz Childrens Hospital | Atlihan F.,Dr Behcet Uz Childrens Hospital | Ozsu E.,Dr Behcet Uz Childrens Hospital | Ozbek E.,Dr Behcet Uz Childrens Hospital
Journal of Infection | Year: 2010

Objectives: Down regulation of HLA-DR expression on monocytes has been reported in adult sepsis. The aims of this study were, first to evaluate monocyte HLA-DR expression in late onset neonatal infection and second to investigate the prognostic value of monocyte HLA-DR expression at onset of symptoms for the final outcome. Methods: Peripheral blood samples were taken from neonates, who were classified into three groups: late onset neonatal sepsis group (n= 40); non-infective disorders group (n= 24) and the control group (n= 25). Monocyte expression of HLA-DR was determined by flow cytometry. Results: The percentage of monocytes expressing HLA-DR was lower in neonates with late onset sepsis (p< 0.05). Of the 40 septic patients enrolled in the study, 32 survived, while 8 died. The percentage of HLA-DR expressing monocytes was significantly lower in the non-survivor sepsis group (16.6%) compared with that in the survivor sepsis group (45.2%). The optimal cutoff value of HLA-DR for predicting mortality was 30% with 87% sensitivity and 81% specificity. Patients with monocyte HLA-DR expression ≤30% had lower survival rate with a 30-fold higher risk of mortality (Odds ratio 30; 95% CI 3-295). Conclusion: According to our findings, monocyte HLA-DR expression seems to be an early predictive marker for the prognosis in late onset neonatal sepsis. © 2009 The British Infection Society.


Afsar F.S.,Dr Behcet Uz Childrens Hospital
Current Opinion in Pediatrics | Year: 2010

Purpose of review: In developing countries, where the majority of people have a low income and live in resource-poor settings, skin infections are prevalent. Data from recent studies provide insight into the most common skin infections and their management. Recent findings: Several studies confirm that skin infections account for the majority of pediatric mortality and morbidity in developing countries. They are prevalent in resource-poor settings and rural areas in certain parts of the world. Also, hot, humid climates and overcrowding predispose to skin infections. Most of the skin infections are curable with effective medication. Summary: Skin infections are of particular importance in developing countries. This review focuses on the most common skin infections and summarizes the most recent knowledge on the epidemiology, morbidity, and treatment in resource-poor settings. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Afsar F.S.,Dr Behcet Uz Childrens Hospital
Clinical and Experimental Dermatology | Year: 2010

Skin problems in children during the first few weeks of life can raise concern, even for experienced neonatologists and paediatric dermatologists. The skin of preterm and term newborn babies has distinct differences from juvenile and adult skin. An understanding of the nature of neonatal skin, the physiological and nonphysiological skin conditions of preterm and term neonates, and skin care are essential in paediatric practice. This article discusses the nature of the neonatal skin and its physiological phenomena. © 2009 British Association of Dermatologists.

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