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Kilic O.,Erzurum District Training and Research Hospital | Somer A.,Istanbul University | Torun S.H.,Istanbul University | Emirolu M.K.,Istanbul University | And 5 more authors.
Turkish Journal of Gastroenterology

Background/Aims: To contribute to the diagnosis and treatment of pediatric abdominal tuberculosis cases by assessing the clinical, laboratory, and radiological features of patients who presented at our clinic and were diagnosed with abdominal tuberculosis. Materials and Methods: Clinical, laboratory, and radiological features were reviewed retrospectively for 35 patients diagnosed with abdominal tuberculosis and followed up at the Pediatric Infectious Diseases Clinic between January 1987 and August 2012. Results: The study group included 16 female (45.7%) and 19 male (54.3%) patients with an age range of 6 months to 16 years (mean: 9.77&±4.36 years). Twenty-nine patients were diagnosed with tuberculosis peritonitis, five patients with intestinal tuberculosis, and one patient with pelvic tuberculosis. The most common signs and symptoms were ascites, abdominal pain, abdominal distention, weight loss, and fever. Mean duration of the complaints was 109 days (range: 10 days to 3 years). Conclusion: Abdominal tuberculosis is a disease with an insidious course without disease-specific clinical and laboratory signs. When the disease is suspected, laparoscopy or laparotomy could be helpful in diagnosis. Employing ultrasound and computed tomography signs, abdominal tuberculosis should be included in differential diagnoses in regions with a high incidence of tuberculosis when there is abdominal pain, weight loss, ascites, history of contact with individuals with tuberculosis, and positive tuberculin skin test when patients have not been Bacillus Calmette Guerin BCG vaccinated. © Copyright 2015 by The Turkish Society of Gastroenterology. Source

Tayman C.,Denizli T.C. Public Health Hospital | Celik H.T.,Ankara University | Klc O.,Erzurum District Training and Research Hospital | Aydemir S.,Dr Sami Ulus Children Research And Training Hospital
Indian Journal of Clinical Biochemistry

Infants with respiratory distress syndrome (RDS) may suffer from severe hypoxia, asphyxia. In this study, we aimed to evaluate serum ischemia-modified albumin (IMA) level as a diagnostic marker for hypoxia in preterm infants with RDS. Thirty-seven premature newborns with RDS were allocated as the study group and 42 healthy preterm neonates were selected as the control group. IMA was measured as absorbance unit (ABSU) in human serum with colorimetric assay method which is based on reduction in albumin cobalt binding. IMA levels were significantly higher in neonates with RDS as compared to the control group (P < 0.001). Cut-off value of IMA (ABSU) was 0.72, the sensitivity level was 91.9 %, the specificity was 78.6 %, positive predictive value was 79.1 % and negative predictive value was 91.7 % at RDS. Area under curve values was 0.93 (P < 0.001; 95 % CI, 0.88–0.98) in the receiver operating characteristic curve. We concluded that elevated blood IMA levels might be accepted as a useful marker for hypoxia in newborn with RDS. © 2015, Association of Clinical Biochemists of India. Source

Dogru M.,Zeynep Kamil Woman And Childrens Diseases Training And Research Hospital | Suleyman A.,Erzurum District Training and Research Hospital
International Journal of Pediatric Otorhinolaryngology

Objectives: The relationship between vitamin D and allergic diseases such as asthma and atopic dermatitis is shown in several studies. But there is a lack of knowledge about vitamin D status in children with allergic rhinitis (AR). We aimed to investigate serum vitamin D levels of children with AR or nonallergic rhinitis (NAR), to compare with normal subjects and to evaluate the relationship between vitamin D and the severity of AR. Methods: The study included a total of 141 children (76 patients with rhinitis and 65 control subjects), who applied to the Pediatric allergy immunology outpatient. Skin prick tests were performed using the same antigens for all patients. Serum 25-hydroxyvitamin D3 (25OHD3) levels were measured. AR was classified according to the ARIA guidelines. Results: Mean 25OHD3 levels were 18.07 ± 6.1 ng/mL in the AR group, 14.81 ± 4.86 in the NAR, and 24.03 ± 9.43 ng/mL in the control group. These differences among groups were statistically significant (p = 0.001). Vitamin D status was determined as deficient in 32 (66.7%) patients, insufficient in 14 (29.2%) and normal in 2 (4.2%) of the AR group. These frequencies for NAR and control groups are 25 (89.3%), 3 (10.7%), 0, and 25 (38.5%), 32 (49.2%), 8 (12.3%), respectively. Vitamin D status was found to be different among groups (p = 0.001). There were not any association between 25OHD3 levels and allergen sensitivity (p > 0.05). The comparison of the mean 25OHD3 levels according to the severity and duration of AR did not detect statistically significant difference among groups (respectively, p = 0.384, p = 0.23 Denburg J, Fokkens WJ, Togias A5). Conclusions: The mean serum 25OHD3 levels of the children both with AR and NAR were lower than control group. No association between 25OHD3 levels and allergen sensitivities was found in our study. We did not find any relationship between 25OHD3 levels and the severity and duration of allergic rhinitis. © 2015 Elsevier Ireland Ltd. Source

Yilmaz O.,Erzurum District Training and Research Hospital | Ciftel M.,Erzurum District Training and Research Hospital | Ozturk K.,Erzurum District Training and Research Hospital | Kilic O.,Erzurum District Training and Research Hospital | And 3 more authors.
Cardiology in the Young

Purpose: Previous studies have shown that the underlying pathophysiologic mechanism in children with breath holding may be generalised autonomic dysregulation. Thus, we performed cardiac rhythm and heart rate variability analyses using 24-hour Holter monitoring to evaluate the cardiac effects of autonomic dysregulation in children with breath-holding spells. Methods: We performed cardiac rhythm and heart rate analyses using 24-hour Holter monitors to evaluate the cardiac effects of autonomic dysregulation in children during a breath-holding spell. Our study group consisted of 68 children with breath-holding spells - 56 cyanotic type and 12 pallid type - and 39 healthy controls. Results: Clinical and heart rate variability results were compared between each spell type - cyanotic or pallid - and the control group; significant differences (p<0.05) in standard deviation of all NN intervals, mean of the standard deviations of all NN intervals for all 5-minute segments, percentage of differences between adjacent RR intervals >50 ms, and square root of the mean of the sum of squares of the differences between adjacent NN intervals values were found between the pallid and cyanotic groups. Conclusions: Holter monitoring for 24 hours and heart rate variability parameters, particularly in children with pallid spells, are crucial for evaluation of cardiac rhythm changes. © Cambridge University Press 2013. Source

Yilmaz O.,Erzurum District Training and Research Hospital | Olgun H.,Ataturk University | Ciftel M.,Erzurum District Training and Research Hospital | Kilic O.,Erzurum District Training and Research Hospital | And 4 more authors.
Cardiology in the Young

Introduction: Dilated cardiomyopathy is usually idiopathic and may arise secondary to infections or metabolic or genetic causes. Another rare cause is hypocalcaemia. Owing to the fact that calcium plays an essential role in excitation and contraction of myocardial muscle, myocardial contractility may decline in patients with hypocalcaemia. Materials and Methods: Patients with symptoms of congestive heart failure and rickets-related hypocalcaemia were assessed clinically and by echocardiography in a paediatric cardiology clinic. Echocardiography was performed for all patients. Rickets was diagnosed according to the clinical, laboratory, and radiologic findings. Maternal lifestyle and living conditions were investigated, and the maternal 25-OH vitamin D3 blood level was measured. Results: We evaluated eight patients who developed heart failure as a result of severe hypocalcaemia associated with rickets between August, 1999 and June, 2012. The age distribution of the patients was 3-12 months. Laboratory results were consistent with advanced-stage rickets. Severe hypocalcaemia was detected in all patients. The maternal 25-OH vitamin D3 levels were low. Echocardiography revealed increased pre-treatment left ventricle end-systolic and end-diastolic diameters for age and reduced ejection fraction and fractional shortening. After clinical improvement, the patients were discharged. Conclusions: Severe hypocalcaemia associated with rickets must always be kept in mind among the causes of dilated cardiomyopathy and impaired cardiac function in infants. If diagnosed and treated in time, dilated cardiomyopathy and severe heart failure related to rickets respond well. © Cambridge University Press 2013. Source

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