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Öğe 99mTc-HMPAO single photon emission computed tomography (SPECT) in both asphyxiated and epileptic children with or without status epilepticus(Sage Publications Inc, 2005) Öner, N; Cermik, TF; Alpay, M; Turan, Ç; Aladag, N; Karasalihoglu, SIn this study, technetium 99m hexamethylpropyleneamine oxime (Tc-99m-HMPAO) single photon emission computed tomography (SPECT) was performed on 18 asphyxiated and epileptic children who also had a status epilepticus episode, and the results were compared with those for 21 children without a status epilepticus episode. All patients underwent a detailed neurologic history, interictal electroencephalography, computed tomography, and/or magnetic resonance imaging. Visual evaluation of the SPECT study showed that 16 patients of group 1 had 56 hypoperfused regions in cerebral blood flow. However, in group 2, visual evaluation showed only six detectable hypoperfusion areas in five patients. When an asymmetric index value of 3 was considered as a cutoff point, 82 regions in group 1 and 57 regions in group 2 were above this value after the quantitative SPECT evaluation. The mean number of pathologic brain regions was found to be higher in group 1 (5.1 +/- 4.3) than in group 2 (2.7 +/- 2.4) (P = .014). The localization of hypoperfused regions that were observed in temporal and frontal regions was generally similar in both groups. In conclusion, the functional activities of the brain vary in both asphyetic and epileptic children, with and without status epilepticus. These children might be candidates for refractory convulsive disease, and interictal SPECT can be a reliable method for the detection of brain lesions in these patients.Öğe Body mass index percentiles among adolescent girls living in Edirne, Turkey(Wiley, 2003) Karasalihoglu, S; Öner, N; Ekuklu, G; Vatansever, Ü; Pala, ÖBackground : Body mass index (BMI) is the simplest way to measure obesity; therefore, it is chosen by many authorities as a screening method for adolescent obesity. Body mass index is positively correlated with the complications of childhood and adolescent obesity, such as hypercholesterolemia, insulin resistance, hyper-tension and long-term development of cardiovascular diseases. The aim of the present study was to produce percentile curves for bodyweight, height and BMI in a representative sample of adolescent girls living in urban and rural areas of Edirne, Turkey, and to compare these percentile curves with curves from other countries. Methods : The present study was a cross-sectional study, including a representative sample of 1687 adolescent girls from rural and urban areas of Edirne, who were evaluated between May and July 2001. Bodyweight and height were measured using standard procedures. Body mass index (kg/m(2) ) was calculated as the ratio of bodyweight to body height squared. Smoothed percentiles for these variables were calculated using polynominal regression models. Crude weight, height and BMI percentile values, as well as smoothed percentile curves are presented. Results : Body mass index, weight and height reference curves for adolescent girls were produced. When we compared the BMI values of subjects in the present study with those of other countries, 85th and 95th percentiles of BMI in the present study were found to be generally lower than those for other ethnicities. Conclusion : Our findings show ethnic differences in BMI among adolescent girls. It will be usefull for each country to produce its own BMI percentiles.Öğe Bone mineral metabolism changes in epileptic children receiving valproic acid(Wiley, 2004) Öner, N; Kaya, M; Karasalihoglu, S; Karaca, H; Çeltik, C; Tütüncüler, FObjective: The aim of this study was to evaluate bone mineral density (BMD) in epileptic children receiving valproic acid (VPA) and to determine differences between osteopenic and non-osteopenic children. Methods: Thirty-three epileptic children, receiving VPA for at least 6 months, were compared with 33 healthy children for BMD. BMD was measured by dual-energy X-ray absorptiometry at lumbar vertebrae, femoral neck and greater trochanter. Serum calcium, phosphorus, alkaline phosphates, osteocalcin and VPA levels were also determined. Results: Patient's osteocalcin levels were significantly higher (P = 0.02) and femur and trochanter BMD values were significantly lower (P = 0.04 and P = 0.03, respectively). Duration of VPA therapy was significantly longer and doses of VPA were significantly higher in seven osteopenic patients compared with 26 non-osteopenic patients. Osteopenic patients (4.6 +/- 2.4 years) were younger than non-osteopenic patients (7.8 +/- 3.2 years) (P = 0.01). Conclusion: Long-term and high dose VPA therapy may cause osteopenia, primarily in younger epileptic children. These patients should be followed closely by BMD measurements.Öğe Ceftriaxone-associated biliary pseudolithiasis in children(John Wiley & Sons Inc, 2006) Biner, B; Öner, N; Çeltik, C; Bostancioglu, M; Tunçbilek, N; Güzel, A; Karasalihoglu, SPurpose. Ceftriaxone is known to induce reversible precipitations, known as pseudolithiasis, in the gallbladder and urinary tract. The aim of this study was to investigate the incidence and predisposing factors that contribute to this side effect. Methods. A prospective study was conducted in 156 children admitted for the treatment of various infections with different daily ceftriaxone doses (50 mg/kg, 75 mg/kg, and 100 mg/kg). Sonographic examinations of the gallbladder and urinary tract were performed before treatment on the third and seventh day of therapy, and at the first and second month after the end of treatment. Patients with positive findings were followed with weekly sonographic examinations until the abnormality resolved. Results. Abnormal gallbladder sonograms were demonstrated in 27 children (17%); 16 of them (10%) had gallbladder lithiasis, 11 had gallbladder sludge (7%) (n = 4 on the third day, n = 23 on the seventh day), and 1 developed urolithiasis (0.6%). Five children (19%) were symptomatic. The abnormalities resolved after a mean of 16 days (range 10-30 days). Patients with pseudolithiasis were older and treated with higher drug doses than those with normal sonographic findings (P< 0.01 and P< 0.05, respectively). Conclusions. Biliary pseudolithiasis (and infrequently nephrolithiasis) usually occurs in children receiving high doses of ceftriaxone. It is generally asymptomatic. When this reversible complication becomes symptomatic, unnecessary cholecystectomy should be avoided. (C) 2006 Wiley Periodicals, Inc.Öğe Dietary intakes among Turkish adolescent girls(Pergamon-Elsevier Science Ltd, 2005) Öner, N; Vatansever, Ü; Garipagaoglu, M; Karasalihoglu, SThe aim of this study was to obtain data about the nutritional intake of adolescent girls from Edirne, Turkey. In a sample of 940 healthy adolescent girls aged between 12 and 17 years, intake of macronutrients and micronutrients was assessed from 3-day self-reported food records. In general, macronutrient intake was found to be adequate whereas micronutrient intake was lower than the recommended dietary allowance (RDA). The percentage of energy distribution of the subjects derived from carbohydrates, proteins, and fats was 53.6%, 10.9%, and 35.5%, respectively. Compared with the RDA, reported intakes of thiamin, riboflavin, niacin, calcium, phosphorus, iron, zinc, and fiber were most likely to be inadequate; those of folic acid and potassium were adequate; and those of vitamins A and C were well above. Adolescent girls living in the rural area consumed lower amounts of energy, carbohydrate, protein, niacin, folic acid, vitamin C, and sodium and higher amounts of thiamin compared with those living in the urban area. Based on the findings of this study, a preventive nutritional concept for Turkish adolescent girls was proposed. (c) 2005 Elsevier Inc. All rights reserved.Öğe The evaluation of bone mineral density in epileptic children receiving valproic acid(Springer-Verlag, 2001) Kaya, M; Karasalihoglu, S; Öner, N; Carman, H; Üstün, F; Çeltik, C[Abstract Not Available]Öğe Intraerythrocytic potassium levels and early insulin release in children with moderate malnutrition(Oxford Univ Press, 2003) Karasalihoglu, S; Bi, M; Öner, N; Çeltik, CK; Pala, ÖPotassium deficiency and insulin releasing defect in severe protein-energy malnutrition (PEM) have been reported previously. The aim of this study was to investigate the existence of potassium deficiency and early insulin releasing defect in moderate PEM, which is more common in children. This study was carried out prospectively in the Pediatrics Department at Trakya University. The study group comprised 30 children with moderate PEM who were also classified as stunted, wasted, and stunting-wasting. Thirty healthy children were selected as controls. Although there was no statistical difference between the study and control groups in terms of serum potassium and initial insulin levels, intraerythrocytic potassium and early insulin release in patients were significantly lower than in controls. The stunting-wasting cases had the lowest intraerythrocytic potassium and early insulin response to intravenous glucose administration. This study suggests that it is appropriate to evaluate moderate PEM cases for intraerythrocytic potassium deficiency and early insulin releasing defect. Potassium supplements should be given if necessary.Öğe Neuron-specific enolase as a marker of the severity and outcome of hypoxic ischemic encephalopathy(Elsevier Science Bv, 2004) Çeltik, C; Acunas, B; Öner, N; Pala, ÖThe aim of this study was to evaluate serum concentrations of neuron-specific enolase (NSE) as a marker of the severity of hypoxic ischemic encephalopathy (HIE) and to elucidate the relation among the concentrations of NSE, grade of HIE and short-term outcome. Forty-three asphyxiated full-term newborn infants who developed symptoms and signs of HIE (Group 1) and 29 full-term newborn infants with meconium-stained amniotic fluid but with normal physical examination (Group 2) were studied with serial neurological examination, Denver developmental screening test (DDST), electroencephalogram and computerized cerebral tomography (CT) for neurological follow-up. Thirty healthy infants were selected as the control group. In the patient groups, two blood samples were taken to measure NSE levels, one between 4 and 48 It and the other 5-7 days after birth. Serum NSE levels were significantly higher in infants with HIE compared to those infants in Group 2 and control group. The mean serum concentrations of the second samples decreased in all groups studied but they were significantly higher in Group I compared to those in Group 2. Serum NSE concentrations of initial samples were significantly higher in patients with stage III HIE than in those with stages 11 and I. The sensitivity and specificity values of serum NSE as a predictor of HIE of moderate or severe degree (cut-off value 40.0 mug/l) were 79 and 70%, respectively, and as a predictor of poor outcome (cut-off value 45.4 mug/l) were calculated as 84 and 70%, respectively. The predictive capacity of serum NSE concentrations for poor outcome seems to be better than predicting HIE of moderate or severe degree. However, earlier and/or CSF samples may be required to establish serum NSE as an early marker for the application of neuroprotective strategies. (C) 2004 Elsevier B.V. All rights reserved.Öğe A newborn infant with left diaphragm agenesis, radial aplasia and preauricular appendices(Lippincott Williams & Wilkins, 2004) Öner, N; Basaran, ÜN; Yalçin, Ö; Vatansever, Ü; Acunas, BWe report the case of a baby girl born to consanguineous parents who died 36 hours after birth. She had multiple preauricular appendices, right radial aplasia, triphalangeal thumb and several other anomalies. Differential diagnosis included Fryns syndrome, Pallister-Killian syndrome, and hemifacial microsomia. However, since our patient had congenital diaphragmatic hernia, a rare finding in hemifacial microsomia we suggest that she had a variant form of hemifacial microsomia or an undescribed new syndrome.Öğe The prevalence of folic acid deficiency among adolescent girls living in Edirne, Turkey(Elsevier Science Inc, 2006) Öner, N; Vatansever, Ü; Karasalihoglu, S; Ekuklu, G; Çeltik, C; Biner, BPurpose: A high incidence of iron-deficiency is a common observation among adolescent girls, whereas only limited data are available regarding the folic acid status of this group. This study was designed to determine the prevalence of biochemical folic acid deficiency in a group of Turkish adolescent girls. Methods: We Surveyed the serum folic acid, complete blood count, and dietary folic acid intake of Turkish adolescent girls after using three-clay self-reported food intakes in urban and rural areas of Edirne, Turkey. Results: A sample population was composed of 704 adolescent girls; their serum folic acid levels were found to be adequate for 37.6% (>= 6 ng/mL), marginal for 46% (3 to 5.9 ng/mL), and at deficient levels for 16.3% (< 3 ng/mL). Folic acid deficiencies were found in 20.1% (36 of 179) and 14.7% (61 of 416) of adolescent girls from rural and urban areas, respectively. Self-reported three-day folic acid intakes were correlated with the corresponding blood values for this nutrient. In the logistic regression analysis, three factors emerged as significant independent predictors of folic acid deficiency: low income (odds ratio [OR]: 2.4, 95% confidence interval [CI]: 1.3-4.2, p < .001), low vitamin C (OR: 1.9, 95% CI: 1.1-3.5, p < .05), and folic acid intake (OR: 4.8, 95% CI: 2.8-8.1, P < .001). Conclusion: Data from the present study may indicate that serum folic acid is low in a group of Turkish adolescent girls. These low values appear to be associated with low income, and low dietary intakes of folic acid and vitamin C. (c) 2006 Society for Adolescent Medicine. All rights reserved.Öğe Prevalence of underweight, overweight and obesity in Turkish adolescents(E M H Swiss Medical Publishers Ltd, 2004) Öner, N; Vatansever, Ü; Sari, A; Ekuklu, G; Güzel, A; Karasalihoglu, S; Boris, NWBackground: The aim of this study was to determine under-weight, overweight and obesity prevalence in a representative sample of adolescents living in urban and rural area of central Edirne, Turkey, and to compare the 95(th) percentile BMI curve to the curves of other countries. Material and methods: Data concerning the height and weight of 989 adolescents, aged between 12 and 17 years were collected. The prevalence of underweight was defined as the percentage of adolescents below the 5(th) percentiles of the American adolescents' age and gender specific BMI; prevalence of overweight and obesity were based on the cut off points of the International Obesity Task Force values (excess of the 85(th) and 95 h percentiles), respectively. Results: This study demonstrated that the prevalence of underweight, over-weight and obesity among adolescent girls was 11.1%, 10.6% and 2.1%, respectively, while it was 14.4%, 11.3% and 1.6% for adolescent boys. In the urban area the prevalence of underweight, overweight and obesity among adolescent girls was 10.0%, 10.3% and 2.1%, while it was 14.4%, 11.6% and 1.6% for boys, respectively. In the rural area; the prevalence of under-weight, overweight and obesity among adolescent girls was 15.7%, 12.4% and 2.2%, while it was 14.5%, 9.6% and 1.2% for boys, respectively. Discussion: Analyses of data collected during these studies support that adolescents living in the city of Edirne carry relatively lower further risk of over-weight and obesity than adolescents in other countries do.Öğe Risk factors of status epilepticus in children(Wiley, 2003) Karasalihoglu, S; Öner, N; Çeltik, C; Çelik, Y; Biner, B; Utku, UBackground : Although there is abundant literature about the morbidity and mortality rates of status epilepticus (SE), little is known about the risk factors of this medical emergency. The aim of the present study is to assess the risk factors of SE in children. Methods : The authors reviewed the medical records of 83 patients admitted to the Pediatric Neurology Unit of Trakya University Hospital, Edirne, Turkey from January 1994 to December 2001 with the diagnosis of SE. Eighty-three patients were compared with 166 controls who were admitted to the same unit due to non-status epilepticus (non-SE) seizure. Results : The univariate analysis demonstrated that SE episodes were significantly associated with a history of birth asphyxia, neonatal seizure, discontinuation of antiepileptic medication, epilepsy, partial seizure evolving to secondary generalized seizures, myoclonic seizure, generalized abnormalities in the neurological examination, neuromotor retardation, generalized background abnormalities on electroencephalogram (EEG), generalized abnormalities on neuroimaging and polypharmacy than non-SE episodes. Logistic regression was used to test the independence of these parameters as predictors of SE risk. Four parameters emerged as significant independent predictors of SE in children in multiple logistic regression: polypharmacy (Odds ratio (OR) 5.17, P = 0.0004), discontinuation of antiepileptic medication (OR 4.04, P = 0.0095), neuromotor retardation (OR 4.03, P = 0.0016) and generalized background abnormalities on EEG (OR 2.48, P = 0.0419). Conclusion : Polypharmacy, discontinuation of antiepileptic medication, neuromotor retardation and generalized background abnormalities on EEG are indicators in children of a higher risk of SE.Öğe Seroprevalance of Bordetella pertussis antibodies among healthy adolescent girls in Edirne(E M H Swiss Medical Publishers Ltd, 2005) Vatansever, U; Çöplü, N; Öner, N; Sönmez, C; Karasalihoglu, S; Kurtoglu, D; Esen, BObjective: Immune response against pertussis can be induced by infection and/or vaccination and vaccine induced immunity is known to wane within the decade following vaccination. Our aim was to assess the pertussis immune response among adolescent girls in the province of Edirne in Turkey. In addition we determined the relationship between the immune response and age, residence, and vaccination status. Material and methods: Serum samples were collected from 3 59 adolescent girls, 12 to 17 years old. The subjects were selected by systematic randomisation from school rosters and sampled by age and urban-rural residence strata proportional to the corresponding distributions in the Edirne population. Pertussis immunity was determined by an in-house quantitative ELISA method for anti-PT and anti-FHA antibodies. Results: Protective levels of antibody (>10 EU/ml) for anti-pertussis toxin and anti-filamentons heamagglutinin were found in 95.3% and 97.2% of the overall study group respectively. In 12- to 14-year-olds protective levels were shown in 94.1% and 97.0%, in 15- to 17-year-olds in 97.5% and 97.5%, In rural areas in 96.7% and 97.5%, and in urban areas in 94.5% and 97.5%, respectively (p >0.05). Conclusion: The high percentages of protective levels of antibodies in our study population might be an indicator of previous infections, which are a threat to infants who have not completed primary immunisation. In this respect, adult immunisation should be considered.