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Demirkiran H.G.,Hacettepe University | Bekmez S.,Dr Sami Ulus Childrens Hospital | Celilov R.,Hacettepe University | Ayvaz M.,Hacettepe University | And 2 more authors.
Journal of Pediatric Orthopaedics

Background: Serial casting is an effective treatment modality in early-onset idiopathic scoliosis; however, the role of this method in congenital scoliosis is not well studied.Methods: A total of 11 patients with progressive congenital scoliosis were treated with serial cast application. Age at initial cast application, magnitudes of the congenital, compensatory and sagittal deformities, coronal balance, T1 to T12 height, number of casts and time-in cast per patient, subsequent surgical interventions, and complications were evaluated.Results: Mean age at the first cast application was 40 months, and the average number of cast changes was 6.2 per patient. There were no major complications. The average precasting curve magnitude was 70.7 degrees (range, 44 to 88 degrees) and was significantly reduced to 55.1 degrees (range, 16 to 78 degrees) at the latest follow-up (P=0.005). The average precasting compensatory curve was 55.8 degrees (range, 38 to 72 degrees) and was significantly reduced to 39.8 degrees (range, 23 to 62 degrees) at the latest follow-up (P=0.017). Average T1 to 12 height increased from 12.8 cm at post-first cast to a 14.6 cm at the latest follow-up (P=0.04). Average time in cast was 26.3 months (range, 13 to 49 mo). During the treatment period, none of the patients required surgery for curve progression.Conclusions: Serial derotational casting is a safe and effective time-buying strategy to delay the surgical interventions in congenital deformities in the short-term follow-up.Level of Evidence: Level IV, case series. © 2014 by Lippincott Williams and Wilkins. Source

Tumer T.B.,Middle East Technical University | Tumer T.B.,Canakkale Onsekiz Mart University | Sahin G.,Dr Sami Ulus Childrens Hospital | Arinc E.,Middle East Technical University
Archives of Toxicology

Microsomal epoxide hydrolase, EPHX1, plays a central role in the detoxification of potentially genotoxic epoxide intermediates. In this study, we firstly aimed to investigate the relationship between EPHX1 Tyr113His and His139Arg variants, and the risk of incidence of childhood acute lymphoblastic leukemia (ALL) in Turkish population, comprised of 190 healthy controls and 167 ALL patients. In exon 3 Tyr113His polymorphism, 113His/His homozygous mutant genotype with slow activity was 18.6% in ALL patients and 9% in controls, indicating 113His/His slow activity genotype was significantly associated with an increased risk of childhood ALL (OR: 2.3, 95% CI, 1.2-4.4, P = 0.01). No significant association was found between exon 4 His139Arg variant and the risk of ALL. When both exon 3 Tyr113His and exon 4 His139Arg polymorphisms were considered together, only the exon 3 113His/His, homozygous mutant, slow activity genotype with exon 4 wild-type genotype 139His/His was significantly increased the risk of ALL 2.4-fold (OR: 2.4, P = 0.02). We also evaluated whether haplotype analysis for EPHX1 Tyr113His polymorphism together with DNA protein XRCC1 Arg399Gln variant known for its deficient DNA repair capacity would represent more prominent risk factors for the development of childhood ALL. Accordingly, the co-presence of Tyr113His variant of EPHX1 and Arg399Gln variant of XRCC1 in the same individuals significantly increased the risk of childhood ALL up to 2.1-fold (OR = 2.1, P = 0.03). Moreover, homozygous mutant genotype for both genes significantly and considerably increased the risk of childhood ALL 8.5-fold (OR: 8.5, P = 0.03). In conclusion, individuals with EPHX1 113His/His slow activity genotype may not detoxify reactive carcinogenic epoxides efficiently, binding of reactive epoxides to DNA cause DNA damage. With the inadequate polymorphic DNA repair protein, XRCC1, this situation ultimately leads to significantly increased susceptibility for childhood ALL. © 2011 Springer-Verlag. Source

Yucwe M.,Ondokuz Mayis University | Zoroglu S.S.,Istanbul University | Ceylan M.F.,Dr Sami Ulus Childrens Hospital | Kandemir H.,Harran University | Karabekiroglu K.,Ondokuz Mayis University
Neuropsychiatric Disease and Treatment

Objective: We aimed to determine distribution and diversities of psychiatric comorbidities in children and adolescents with attention deficit/hyperactivity disorder (ADHD) in terms of age groups, sex, and ADHD subtype. Materials and methods: The sample included 6-18 year old children and adolescents from Turkey (N=108; 83 boys, 25 girls) diagnosed with ADHD. All comorbid diagnoses were determined based on the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version assessment. Results: 96.3% of the cases were found to have at least one psychiatric comorbid diagnosis. The most frequent psychiatric comorbid disorder was oppositional defiant disorder (69.4%) followed by anxiety disorders (49%) and elimination disorders (27.8%). Disruptive behavior disorders were more common in ADHD-combined type. Depression and anxiety disorders were more common in girls. Separation anxiety disorder and elimination disorder were more common in children, whereas depression, bipolar disorder, obsessive-compulsive disorder, and social phobia were more common in the adolescents. Conclusion: According to our results, when a diagnostic tool was used to assess the presence of comorbid psychiatric disorders in children and adolescents diagnosed with ADHD, almost all cases had at least one comorbid diagnosis. Therefore, especially in the clinical sample, ADHD cases should not be solely interpreted with ADHD symptom domains, instead they should be investigated properly in terms of accompanying psychiatric disorders. © 2013 Yüce et al. Source

Senel F.M.,Dr Sami Ulus Childrens Hospital | Demirelli M.,Elif Medical Center | Oztek S.,GAP Circumcision Clinic
Pediatric Surgery International

Purpose: We aimed to analyze the outcome of circumcisions performed with a new minimally invasive circumcision device. Methods: This is the first study, which reports the results of 7,500 children circumcised with minimally invasive technique utilizing a plastic clamp device (Ali's clamp®) in our country. The results of this technique are compared to those of 5,700 children who underwent conventional circumcision. Results: The most common complication encountered after minimally invasive circumcision technique was found to be buried penis (1.04%). The second complication observed was infection (0.6%), which was significantly lower than the conventional group (p < 0.001). The third complication in plastic clamp group was bleeding with a rate of 0.4%. Bleeding was found to be the most common complication seen after conventional circumcision (5%) and was significantly higher than that of the plastic clamp group (p < 0.001). Total number of complications seen after plastic clamp technique was 2% when compared with 10.4% complication rate occurred after conventional circumcision (p < 0.001). The mean duration of circumcision time with plastic clamp technique was 4.5 ± 1.5 min whereas with conventional circumcision it was 23 ± 4 min (p < 0.0001). Conclusion: Minimally invasive circumcision technique utilizing plastic clamp significantly reduced the complication rates. The cosmetic appearance after circumcisions performed with this technique was observed to be better than the conventional circumcisions. Due to reduced complications, as well as short duration and ease of application, the minimally invasive technique is suggested as the circumcision procedure of choice. © 2010 Springer-Verlag. Source

Karatayli-Ozgursoy S.,Dr Sami Ulus Childrens Hospital | Demireller A.,Kent Hospital
Ear, Nose and Throat Journal

We report our experience with hyoid suspension surgery in patients with obstructive sleep apnea (OSA) diagnosed on the basis of polysomnographic criteria. We conducted a prospective, observational study of 20 patients-18 males and 2 females, aged 15 to 52 years (mean: 42.1)-who were treated at our tertiary care center. All patients underwent hyoid suspension surgery and uvulopalatopharyngoplasty (UPPP) in a single session. Postoperative success was defined as either (1) a reduction in the apnea-hypopnea index (AHI) from 20 or higher to less than 20 or (2) a reduction in AHI of at least 50%. Postoperative follow-up polysomnography indicated that surgery was successful in 18 of 20 patients (90%). No important complications were observed. We conclude that hyoid suspension surgery is an effective procedure with low morbidity for the treatment of OSA in selected patients with hypopharyngeal obstruction. We believe it is a good option for those patients who will not or cannot tolerate therapy with continuous positive airway pressure. © 2012 Vendome Group, LLC. Source

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