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Öğe 99mTc-HMPAO brain perfusion single-photon emission computed tomography in children with Down syndrome(Sage Publications Inc, 2006) Altiay, Suriye; Kaya, Meryem; Karasalihoglu, Serap; Gultekin, Aziz; Oner, Naci; Biner, BetulIn recent years, it has been possible for patients with Down syndrome to live longer with advanced medical treatment and social support. As a result, the problems of these patients, such as thyroid diseases, leukemia, and Alzheimer disease, would be encountered more frequently. In this study, we aimed to perform the brain perfusion of children with Down syndrome by technetium 99m hexamethylpropylene amine oxime (Tc-99m-HMPAO) single-photon emission computed tomography (SPECT) and to determine the relationship between brain perfusion and epilepsy, thyroid function tests, congenital heart disease, and level of mental and motor development. Thirty patients with Down syndrome, aged between 1 and 15 years, were included in our study. Demographic data, the existence of epilepsy and congenital heart defects, the level of mental and motor development, serum. levels of thyroid hormones, and autoantibodies were determined. All patients underwent computed tomography (CT) and/or magnetic resonance imaging (MRI). Cerebral SPECT was per-formed in all cases to evaluate the brain perfusion pattern. According to the visual evaluation of cerebral SPECT results, hypoperfusion was detected in 11 cases (37%). Patients with cerebral hypoperfusion (group 1) and patients with normal cerebral perfusion (group 2) were compared. There was no difference between group 1 and group 2 in terms of demographic data, congenital heart defects, IQ levels, thyroid hormones, and autoantibodies, but the incidence of epilepsy was significantly higher in group 1 (P < .001). When motor and mental development levels were compared, it was found that cases in group 1 were significantly more retarded in personal-social and fine motor skills (P < .05). The present study showed that cerebral hypoperfusion in children with Down syndrome is mostly related to epilepsy and the other coexisting conditions, congenital heart disease and hypothyroidism. Patients with cerebral hypoperfusion also have more retarded developmental levels, especially in personal-social and fine motor skills.Öğe A cost analysis of radiologic imaging in pediatric trauma patients(Turkish Assoc Trauma Emergency Surgery, 2010) Guzel, Ahmet; Temizoz, Osman; Aksu, Burhan; Sut, Necdet; Karasalihoglu, SerapBACKGROUND The aim of this study was to examine the cost of radiologic imaging in pediatric trauma patients admitted to the pediatric emergency department. METHODS All patients were retrospectively evaluated according to age, gender, details of injury, radiological investigations ordered and their results, cost of radiologic imaging, length of stay, outcome of the injury, and hospitalization rates. RESULTS The cost of radiologic imaging was retrospectively analyzed in 1231 trauma patients aged between one month and 15 years (mean 5.91 +/- 3.82 years). For the 996 patients who had radiological imaging, 3382 images were taken in total. Of these, only 300 (8.8%) were abnormal. The mean (and SD) total cost of radiologic imaging was US$ 40.42 ($34.38) (range $4.67 to $139.26). Total cost correlated inversely with Glasgow Coma Scale (GCS) (r=-0.37, p<0.001), directly with Injury Severity Score (ISS) (r=0.27, p<0.001) and was not correlated with the Pediatric Trauma Score (PTS) (r=-0.16, p>0.05). The mean (and SD) duration of hospital stays was 8.54 (10.91) hours. CONCLUSION Advanced radiological images may help in early diagnosis of trauma cases. However, periodic education programs to prevent unnecessary radiological imaging in emergency departments are also necessary to decrease the cost of these imaging modalities.Öğe Dermatological Emergencies in Childhood: 5 Years Experience(Aves, 2009) Guzel, Ahmet; Karasalihoglu, Serap; Sayar, Esra Hazar; Arican, Ozer; Kavalci, CemilBackground and design: The aim of this study was to examine clinical and demographic characteristics of patients who presented with dermatological lesions to the pediatric emergency department. Materials and Methods: All patients who presented with the complaint of dermatological problems within the last 5 years were evaluated retrospectively. Results: Of 498 patients applied to our clinic, 273 (54.8%) were males, 225 (45.2%) were females. The median age of the patients was 5.56 +/- 3.72 years. Our study included four (0.8%) neonates, seventy (14.1%) infants, one hundred sixty one (32.3%) preschool and two hundred sixty three (52.8%) school going children who were applied for the management of dermatological emergencies. The most common dermatological diseases were infectious skin disorders, urticaria, and drug reactions. Systemic therapy was prescribed in 66.9% and local therapy in 9.9% of the patients. Combined local and systemic therapy was given to 17.3% of the cases. Of all patients, 23 (4.6%) were consulted by dermatology. Of all patients, 20.9% were admitted to our hospital, while 78.9% treated with outpatient and one patient left hospital before completion of his therapy. Conclusion: The most common dermatological diseases are infectious skin disorders in pediatric emergency department. Common skin diseases in pediatric emergency department must be established and periodical education programs associated with these diseases were planned.Öğe Evaluation of Clinical and Laboratory Features of Epstein-Barr Virus-Associated Acute Infectious Mononucleosis in Children(Aves Yayincilik, Ibrahim Kara, 2008) Celtik, Coskun; Kuecuekugurluoglu, Yasemin; Balci, Demet Benek; Oener, Naci; Duran, Ridvan; Karasalihoglu, SerapObjectives: The various symptoms of infectious mononucleosis associated with Epstein-Barr virus may confuse physicians in differential diagnosis. The aim of this study is to evaluate the clinical and laboratory findings of this disease in symptomatic children. Patients and Methods: This study was retrospectively performed on 52 cases (31 boys, 21 girls; mean age 5.4 +/- 3.4 years; range 1 to 13 years) with acute Epstein-Barr virus infection. The clinical and laboratory findings were evaluated according to admission time after initial complaints (<= 5/>5 days) and the age groups of the cases (<= 2/>2 years). Results: The major symptoms were fever, lymphadenopathy and tonsillopharyngitis in the classical triad. Moreover, atypical cases who had ascites, arthritis and severe abdominal pain were defined. No case had a poor prognosis. The most frequent laboratory finding was lymphocytosis. While the major symptoms were more frequent in the group admission time <= 5 days, the count of atypical lymphocyte were higher in the group admission time > 5 days. However, these differences could not be defined between age groups. Conclusion: Infectious mononucleosis due to Epstein-Barr virus is a disease with good prognosis in children. The features of the disease may vary according to admission time, and this fact should be taken into consideration in the diagnosis.Öğe Evaluation of the fall-related trauma cases applied to our pediatric emergency department(Turkish Assoc Trauma Emergency Surgery, 2007) Guzel, Ahmet; Karasalihoglu, Serap; Kucukugurluoglu, YaseminBACKGROUND The aim of this study was to evaluate the fall-related trauma cases who were admitted to our pediatric emergency unit. METHODS We retrospectively evaluated the files of 161 cases (100 males [62.1%], 61 females [37.9%]) who had sustained falls and were admitted to our pediatric emergency unit. Data on the patients' age, sex, arrival type, type of fall, height fallen, type of injuries, radiological findings and hospitalization rates were investigated. RESULTS Of 161 cases mean age was 4.29 +/- 3.33 years and height fallen was 135 +/- 95 centimeters. The common types of fall were from furniture (35.4%), stairs (17.4%) and balconies and windows (11.2%). Major injuries included head trauma (84.4%), soft tissue (72.7%) and extremity (37.9%). Thirty cases (18.6%) were hospitalized, while 112 cases (69.6%) were treated as outpatient and 11.8% of them were discharged due to their own demand. CONCLUSION The majority of fall-related injuries in childhood mostly occurs in private houses and head trauma is the most frequent injury. To decrease the frequency of the fall injuries, strategies should include parents' education about the mechanism of falls and increase prevention strategies.Öğe Factor V Leiden mutation, deficiency of antithrombin III and elevation of factor VIII in a child with ischemic stroke(Elsevier Science Bv, 2006) Duran, Ridvan; Biner, Betul; Demir, Muzaffer; Celtik, Coskun; Karasalihoglu, Serap; Acunas, BetulA 4-year-old boy was admitted with left hemiplegia. Thrombophilia marker examination resulted with factor V Leiden mutation heterozygosity, a deficiency of antithrombin III and a high level of factor VIII. Cranial computed tomography scan revealed an ischemic infarct in the region of right anterior cerebral artery. In the literature, combinations of multiple thrombophilia risk factors that trigger cerebral ischemic stroke in children have been emphasized. To our knowledge, this is the first child with these combinations of thrombophilia risk factors and ischemic stroke to be reported in the literature. (c) 2006 Elsevier B.V. All rights reserved.Öğe A fat headache(New Zealand Medical Assoc, 2009) Karasalihoglu, Serap; Guzel, Ahmet; Ugurluoglu, Yasemin Kucuk; Unlu, Ercuement[Abstract Not Available]Öğe Fatal Acute Diclofenac-Induced Rhabdomyolysis in A Pediatric Patient(Galenos Publ House, 2011) Guzel, Ahmet; Biner, Betul Orhaner; Karasalihoglu, Serap; Aylanc, HakanDiclofenac, a widely used nonsteroidal anti-inflammatory drug, has been reported to cause fatal drug-induced rhabdomyolysis very rarely. We report a case of a 13-month-old girl who developed fatal rhabdomyolysis after administration of intramuscular diclofenac for relief of pain caused by a scalding burn injury. Rhabdomyolysis due to diclofenac has not been reported in children. Here, we present the first case report to demonstrate rhabdomylysis secondary to diclofenac administration.Öğe Indications for Brain Computed Tomography and Hospital Admission in Pediatric Patients with Minor Head Injury: How Much Can We Rely upon Clinical Findings?(Karger, 2009) Guzel, Ahmet; Hicdonmez, Tufan; Temizoz, Osman; Aksu, Burhan; Aylanc, Hakan; Karasalihoglu, SerapObjectives: The aim of this study was to describe the characteristics of patients with a minor head injury (MHI) who were admitted to a pediatric emergency unit and to identify the clinical signs and symptoms that most reliably predict the need for cranial computed tomography (CCT) and hospital admission following MHI. Methods: All patients were retrospectively evaluated according to age, gender, details of injury, presenting symptoms, physical examination findings, radiological investigations ordered and results, length of stay, outcome of the injury and hospitalization rates. Results: The factors affecting indications for computed tomography and hospitalization were retrospectively analyzed in 916 patients - 585 males and 331 females, aged between 1 month and 15 years (mean: 5.01 +/- 3.58 years), with MHI. A multivariate analysis revealed significant correlations between CCT abnormalities and Glasgow Coma Scale scores of 13 or 14, headache, posttraumatic amnesia, blurred vision, cephalohematomas, periorbital ecchymoses, otorrhea and abnormal neurological findings. CCT abnormalities were identified in 67 (19.8%) of the 338 CCT scans. Twenty of the 67 patients (29.9%) with CCT scan abnormality had no clinical signs. Of all cases, 125 (13.6%) were hospitalized, 617 (67.4%) were treated as outpatients, and 174 (19.0%) left the emergency department based on a personal decision. Conclusion: Some clinical risk factors can be used as predictors of abnormalities in CCT scans following MHI, but the absence of such clinical findings does not exclude the possibility of intracranial injuries. Copyright (C) 2009 S. Karger AG, BaselÖğe A Rare Cause of Epilepsy: Two Cases of Dyke-Davidoff-Masson Syndrome(Galenos Yayincilik, 2009) Guzel, Ahmet; Gezgin, Tuba; Unlu, Ercument; Vatansever, Binay; Karasalihoglu, SerapDyke-Davidoff-Masson syndrome (DDMS) is clinical characterized by epilepsy, contralateral hemiplegia, hemiparesia, difficulty in learning, mental retardation, cerebral hemiatrophy, in nevroimaging, unilateral calvarial thickening, enlargement of paranasel sinus and increased of aeration in radiologic imaging. Cogenital disorders, infections, vascular diseases, trauma, tumor, ischemic and hemorrmagic reasons have been implicated in the etiology in this report, we discussed as a reason of resistant epilepsy in a10 myear old female and 2 month old male patient with DDMS that has been found comparatively rarerly.Öğe Rubella seroprevalence among Turkish adolescent girls living in Edirne, Turkey(Turkish J Pediatrics, 2006) Oener, Naci; Vatansever, Uelfet; Karasalihoglu, Serap; Otkun, Mueserref Tatman; Ekuklu, Galip; Kuecuekugurluoglu, YaseminThis study was designed to estimate the rubella seroprevalence in unvaccinated Turkish adolescent girls in urban and rural areas of Edirne, and to create preventive strategies for congenital rubella syndrome (CRS). The sample, representing 12- to 17-year-old adolescent girls, consisted of 1,600 subjects selected from school lists by systematic and random sampling, which was matched by age and urban-rural residency strata proportional to the corresponding distributions in the Edirne population. For each participant, a questionnaire was completed and rubella-specific IgG antibodies were measured. After analysis of samples, seropositivity prevalence, equivocal and seronegative samples of adolescent girls in Edirne were determined as 93.1%, 0.6% and 6.3%, respectively. Data from the present study may indicate that 6.9% of adolescent girls have considerable risk for rubella infection during pregnancy. Eliminating rubella and CRS in Turkey will require national health service efforts, including vaccination of all adolescents and all susceptible women of childbearing age.Öğe Scalds in Pediatric Emergency Department: A 5-Year Experience(Lippincott Williams & Wilkins, 2009) Guzel, Ahmet; Aksu, Burhan; Aylac, Hakan; Duran, Ridvan; Karasalihoglu, SerapScald injuries are the most common type of burn in childhood. The authors' aim in this study was to determine the characteristics of scald burns and to identify clinical signs and symptoms which help to predict the indications for hospitalization after scalding burn injury. All patients were retrospectively evaluated according to gender, ages, cause of burn, burn size and depth, distribution of burn area, first aid given, management, and patient's outcomes. The factors affecting indication for hospitalization were retrospectively analyzed in 165 patients, 95 males and 70 females aged 1 month to 13 years (mean 2.74 +/- 2.44 years), with scalding burn injury. The most common cause of scald injuries were hot water (106 patients) or hot tea and coffee (39 patients). The mean percent of TBSA burned was 10.26 +/- 7.26%. Sixty-nine patients had required hospitalization. In the multivariate logistic regression analyses, among study subjects, only age and TBSA were risk factors significantly correlated to hospitalization (P < .001, P < .01, respectively). Prevention of scald injuries will require a two-prolonged approach: educating families and changing the traditional methods of preparing soup, milk, and tea in Turkey and elsewhere. To create effective programs for preventing scald injuries, it is essential to consider ethnic, cultural, socioeconomic, and environmental factors based on these characteristics. (J Burn Care Res 2009;30: 450-456)Öğe Seroprevalence of autoimmune thyroiditis and celiac disease in children with insulin-dependent diabetes mellitus in the Thrace region of Turkey(Turkish Soc Gastroenterology, 2010) Soyucen, Erdogan; Yilmaz, Sema; Celtik, Coskun; Vatansever, Ulfet; Oner, Naci; Karasalihoglu, SerapBackground/aims: We aimed to estimate the seroprevalence of celiac disease, a gluten-sensitive enteropathy, and autoimmune thyroiditis in children with insulin-dependent diabetes mellitus in the Thrace region of Turkey. Methods: The population studied consisted of 33 children with insulin-dependent diabetes mellitus and 41 healthy children with demographic features similar to the study subjects. Free triiodothyronine, free thyroxine, thyroid-stimulating hormone, anti-thyroid peroxidase antibody, anti-thyroglobulin antibody, IgA, anti-endomysium IgA, and anti-gliadin IgA were measured in all cases and controls. Results: The serum levels of free triiodothyronine and free thyroxine were within the normal range in all cases. However, in one patient who had anti-thyroid peroxidase and anti-thyroglobulin antibodies, the thyroid-stimulating hormone level was high despite a normal free triiodothyronine and free thyroxine value. Ultrasonographic findings confirmed thyroiditis in this patient. Anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies, anti-endomysium IgA and anti-gliadin IgA were detected in 15.4%, 6%, 9.1% and 3% of the diabetic cases, respectively. None of these antibodies was detected in the control group. In the diabetic group, the seroprevalences of the antithyroid peroxidase antibodies and the anti-endomysium IgA were statistically higher than in the control group (p<0.05). Conclusions: Children with insulin-dependent diabetes mellitus in our region should undergo periodic screenings for autoimmune thyroiditis and celiac disease.Öğe Spontaneous spinal epidural hematoma after seizure(Sage Publications Inc, 2007) Guzel, Ahmet; Simsek, Osman; Karasalihoglu, Serap; Kuecuekugurluoglu, Yasemin; Acunas, Betuel; Tosun, Alptekin; Cakir, Bilge[Abstract Not Available]Öğe Thinner Intoxications in Childhood(Aves, 2009) Guzel, Ahmet; Kiziltepe, Cengiz; Aylanc, Hakan; Sayar, Esra; Karasalihoglu, Serap; Kavalci, CemilAim: Thinner is frequently used in industrial and house painting as thinner for paints. Although it has side affects which might affect vital functions associated with the central nervous system and respiratory system, acute intoxications due to thinner are commonly encountered in the childhood period. Materials and Methods: To evaluate patients who presented with the complaint of thinner drinking within the last 5 years. Results: Of 35 cases hospitalized in our clinic, 24 (68.6%) were males, 11 (31.4%) were females. The median age of the patients was 2.3 +/- 1.3 years. On initial administration, 23 (65.7%) had nausea-vomiting, 12 (34.3%) had restlessness, nine (25.7%) had dyspnea and pulmonary rales on auscultation. During follow-up, fever developed in nine (25.7%) of the patients. There was leucocytosis in 21 (60%) of patients. Antibiotherapy was given to 13 (37.1%) of the cases. The median time for hospitalization was 2.7 +/- 1.7 days. Of the hospitalized patients, 80% were discharged in good health, while 20% left hospital before completion of theit therapy. Conclusion: There should be caution in the sale, preservation and use of substances like thinner the intoxication of which have effects on vital organs. In addition, educational seminars about this subject should be held.Öğe Validity of serum tau protein levels in pediatric patients with minor head trauma(W B Saunders Co-Elsevier Inc, 2010) Guzel, Ahmet; Karasalihoglu, Serap; Aylanc, Hakan; Temizoz, Osman; Hicdonmez, TufanBackground: The aim of this study was to investigate the relationship between intracranial injury and serum tau protein levels in pediatric patients with minor head trauma (NI HT). Methods: We included 60 pediatric patients with MELT (Glasgow Coma Scale [GCS], 14-15) and 28 control patients. The patients were divided into 3 groups as follows: those without (group 1) and with (group 2) intracranial lesions shown on cranial computed tomography (CCT) and the control group (group 3). Results: The mean serum tau protein level was 96.06 +/- 70.36 pg/mL in group I. whereas it was 112.04 +/- 52.66 pg/mL in group 2, with no statistically significant difference between the groups (p = .160). The mean serum tau protein levels between the study groups (group I and group 2) and control (38.52 +/- 29.01) were statistically significant (P < .001 and P < .001, respectively). The GCS score and pathologic condition in CCT were only influential variables on tau protein levels. Conclusions: We found that serum tau protein increased after M HT but did not distinguish between those with and those without intracranial lesions demonstrable on CCT. (C) 2010 Elsevier Inc. All rights reserved.
