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Vaginal discharge and bleeding in children require a through and thoughtful evaluation to diagnose the underlying problem including infections, sexual abuse, and vaginal foreign bodies. We report a 6-year-old girl presenting with bloody... more
Vaginal discharge and bleeding in children require a through and thoughtful evaluation to diagnose the underlying problem including infections, sexual abuse, and vaginal foreign bodies. We report a 6-year-old girl presenting with bloody vaginal discharge, carefully evaluated for sexual abuse, and finally diagnosed as a vaginal foreign body after vaginoscopy. A rolling hair ball was extracted from the vagina and was diagnosed as trichobezoar pathologically without any endo-ecto-mesodermal residual tissue. The hair ball was genetically detected and diagnosed to belong herself by containing no foreign structure. Child sexual abuse was ruled out by forensic interview at CAC and report of forensic science that reported genetic structure belonging to the child. Medicolegal assessment helped in final diagnosis to exclude child sexual abuse.
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Kawasaki disease is a systemic vasculitis, primarily encountered in children. Its clinical presentation is well known, and coronary artery abnormalities are classical complications. Shock is not a common form of presentation of the... more
Kawasaki disease is a systemic vasculitis, primarily encountered in children. Its clinical presentation is well known, and coronary artery abnormalities are classical complications. Shock is not a common form of presentation of the disease. We report a case who presented with shock due to Kawasaki disease in accordance with the recently defined 'Kawasaki disease shock syndrome'. In pediatric intensive care units, Kawasaki disease shock syndrome may be misdiagnosed as toxic shock syndrome. Intensivists and emergency room physicians should be aware of this uncommon presentation and perform an echocardiography to search for coronary involvement in case of clinical doubt.
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Bell's palsy is the most common cause of acquired unilateral facial nerve palsy in childhood. Although the diagnosis depends on the exclusion of less common causes such as infectious, traumatic, malignancy associated and hypertension... more
Bell's palsy is the most common cause of acquired unilateral facial nerve palsy in childhood. Although the diagnosis depends on the exclusion of less common causes such as infectious, traumatic, malignancy associated and hypertension associated etiologies, pediatricians tend to diagnose idiopatic Bell's palsy whenever a child admits with acquired facial weakness. In this report, we present an eight year old girl, presenting with recurrent and alternant facial palsy as the first symptom of systemic hypertension. She received steroid treatment without measuring blood pressure and this could worsen hypertension. Clinicians should be aware of this association and not neglect to measure the blood pressure before considering steroid therapy for Bell's palsy. In addition, the less common causes of acquired facial palsy should be kept in mind, especially when recurrent and alternant courses occur.
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Giris: Ozellikle 2000’li yillardan itibaren bilgi ve iletisim teknolojilerinin cesitlenmesi ve yayginlasmasi, bu gelismelere paralel olarak bilgi ve iletisim araclarinin cocuklarin ve ergenlerin akranlariyla olan iletisimlerinin... more
Giris: Ozellikle 2000’li yillardan itibaren bilgi ve iletisim teknolojilerinin cesitlenmesi ve yayginlasmasi, bu gelismelere paralel olarak bilgi ve iletisim araclarinin cocuklarin ve ergenlerin akranlariyla olan iletisimlerinin vazgecilmez bir parcasi haline gelmesi, bazi arastirmalarda dolayli saldirganlik bazi arastirmalarda ise iliskisel saldirganlik cercevesinde ele alinan yeni bir zorbalik turunun tanimlanmasinda belirleyici rol oynamistir (Burnukara, 2009). Belsey (2008)’e gore bilisim ve iletisim teknolojilerinde gorulen gelismelere ve teknolojik olanaklarin artmasina kosut olarak sanal zorbalik ortaya cikmistir. Willard (2006)’a gore ise sanal zorbalik, dijital teknolojinin diger kisilere rahatsizlik verici mesajlar gondermek veya sosyal saldirganlik yapmak amaciyla kullanilmasidir. Dunyada sanal zorbalik ile ilgili yapilan calismalar incelendiginde 2004 yilinda 4-8. sinifta okuyan 1500 ogrenci arasinda yapilan, The 2004 National I-SAFE anketinde ise ogrencilerin; neredeyse...
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Objective: The relationship between eosinopenia and infection was previously described, but is still not fully elucidated. The aim of this study was to determine the diagnostic value of eosinophil counts in patients with bacterial... more
Objective: The relationship between eosinopenia and infection was previously described, but is still not fully elucidated. The aim of this study was to determine the diagnostic value of eosinophil counts in patients with bacterial infection. Material and Methods: We compared white blood cell count, absolute neutrophil count, C-reactive protein, and absolute eosinophil count values of 55 inpatients at Izmir Dr. Behcet Uz Children’s Diseases and Surgery Training and Research Hospital between January 2013 and March 2014 who had bacterial growth in blood, urine or other (abscess, sputum, gaita, thoracentesis fluid, joint fluid) cultures with the control group. Results: The white blood cell count, absolute neutrophil count and C-reactive protein values in children with bacterial infection were significantly higher than in healthy children, while the absolute eosinophil count was lower. ROC analysis revealed that the absolute eosinophil count had the highest sensitivity in differentiating...
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GIRIŞ ve AMAC: Laktat yuksekliginin kritik hasta izleminde mortalite ve morbiditeyi belirleyici oldugunu gosteren calismalar mevcuttur. Bu arastirmanin amaci, kritik hastaligi olan cocuklarda laktat yuksekliginin nedenlerini belirlemek,... more
GIRIŞ ve AMAC: Laktat yuksekliginin kritik hasta izleminde mortalite ve morbiditeyi belirleyici oldugunu gosteren calismalar mevcuttur. Bu arastirmanin amaci, kritik hastaligi olan cocuklarda laktat yuksekliginin nedenlerini belirlemek, mortaliteyi belirleyen bir esik deger olup olmadigini saptamak ve cocuk yogun bakim unitesinde laktat yuksekliginin klinik sonuclarini degerlendirmektir.YONTEM ve GERECLER: Cocuk yogun bakim unitesine basvuran toplam 202 olgunun (Erkek/Kiz: 101/101; median yas: 3 [IQR: 9.2]) dosya kayitlari geriye donuk olarak incelendi. Hastalarin yasi, cinsiyeti, basvuru tanisi, arteriyel kan gazi sonuclari, hastanede kalma suresi, ve olum varligi kaydedildi. Laktat yuksekligi, yas gruplarina gore duzeylerine gore tanimlandi. Basvuruda laktat yuksekligi olan ve olmayan olgular, olum oranlari ve klinik sonuclar acisindan karsilastirildi.BULGULAR: Basvuruda saptanan hiperlaktatemi sikligi %64.3 (n: 130) idi. Akut gastroenterite bagli dehidratasyon, akut solunumsal ye...
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Gereç ve Yöntem: Patoloji laboratuvarımızda, 2007 ile 2012 yılları arasında kas biyopsisi incelenen 20 hasta retrospektif olarak değerlendirildi. Tüm hastalar klinik olarak müsküler distrofi tanısı almış olup, biyopsiler 5 farklı nöroloji... more
Gereç ve Yöntem: Patoloji laboratuvarımızda, 2007 ile 2012 yılları arasında kas biyopsisi incelenen 20 hasta retrospektif olarak değerlendirildi. Tüm hastalar klinik olarak müsküler distrofi tanısı almış olup, biyopsiler 5 farklı nöroloji kliniğinde alındı. Hasta DNA’ları kas dokusu veya periferik kandan çıkartıldı ve genetik testler (gama sarkoglikan geni için mutasyon analizleri ve tüm 4 sarkoglikan için delesyon duplikasyon testleri) yapıldı.
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1. Danne T, Bangstad H-J, Deeb L, et al. Insulin treatment in children and adolescents with diabetes. Pediatric Diabetes 2014; 15 (Suppl. 20): 115–134. 2. Wang Y, Gong C, Cao B, et al. Influence of initial insulin dosage on blood glucose... more
1. Danne T, Bangstad H-J, Deeb L, et al. Insulin treatment in children and adolescents with diabetes. Pediatric Diabetes 2014; 15 (Suppl. 20): 115–134. 2. Wang Y, Gong C, Cao B, et al. Influence of initial insulin dosage on blood glucose dynamics of children and adolescents with newly diagnosed type 1 diabetes mellitus. Pediatric Diabetes. 2016 Mar 6. doi: 10.1111 3. Malik FS, Taplin CE. Insulin therapy in children and adolescents with type 1 diabetes. Paediatr Drugs. 2014 Apr;16(2):141-50 4. Tridgell DM, Tridgell AH, Hirsch IB. Inpatient management of adults and children with type 1 diabetes. Endocrinol Metab Clin North Am. 2010;39 (3):595-608 5. Sherr J, Tamborlane WV, Xing D et al. Achievement of target A1C levels with negligible hypoglycemia and low glucose variability in youth with short-term type 1 diabetes and residual beta-cell function. Diabetes Care 2012; 35: 817–820 6. Colino E, Álvarez MÁ, Carcavilla A, Alonso M, Ros P, Barrio R. Insulin dose adjustment when changing fro...
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Kawasaki disease is a systemic vasculitis, primarily encountered in children. Its clinical presentation is well known, and coronary artery abnormalities are classical complications. Shock is not a common form of presentation of the... more
Kawasaki disease is a systemic vasculitis, primarily encountered in children. Its clinical presentation is well known, and coronary artery abnormalities are classical complications. Shock is not a common form of presentation of the disease. We report a case who presented with shock due to Kawasaki disease in accordance with the recently defined 'Kawasaki disease shock syndrome'. In pediatric intensive care units, Kawasaki disease shock syndrome may be misdiagnosed as toxic shock syndrome. Intensivists and emergency room physicians should be aware of this uncommon presentation and perform an echocardiography to search for coronary involvement in case of clinical doubt.
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Objective: A number of illness severity scores have been established to predict mortality and morbidity in neonatal intensive care units (NICUs). The objective of this study was to compare SNAPPE-II (Scores for Neonatal Acute Physiology-... more
Objective: A number of illness severity scores have been established to predict mortality and morbidity in neonatal intensive care units (NICUs). The objective of this study was to compare SNAPPE-II (Scores for Neonatal Acute Physiology- Perinatal Extension-II) and CRIB- II (Clinical Risk Index for Babies-II), the latest versions of European and American scoring systems, in predicting hospital mortality and overall morbidity of surviving infants. Material and Methods: Very low birthweight infants (VLBW) admitted to the neonatal intensive care unit were identified. CRIB-II and SNAP-PE-II scores were electronically calculated for each patient via the website www.sfar.org. The receiver operating characteristics (ROC) curve was used to check the accuracy of the mortality and morbidity prediction. Results: A total of 189 VLBW neonates (mean CRIB-II:9.9±3.8; mean SNAP-PE-II: 45.8±25.4) were evaluated. The mean birth weight, gestational age, CRIB-II, SNAP-PE-II scores were associated with ...
An 11-year-old girl applied for having a spongy consistency of swellings in various part of her scalp. The overlying skin and hair growth of these areas appeared normal. There was no evidence of systemic disease except for exogenous... more
An 11-year-old girl applied for having a spongy consistency of swellings in various part of her scalp. The overlying skin and hair growth of these areas appeared normal. There was no evidence of systemic disease except for exogenous obesity. Ultrasonography showed thickening of the subcutaneous tissue on the swelling part of the scalp. Histopathological examination revealed elastic fibre fragmentation on dermis and increased thickness in the subcutaneous fat tissue containing numerous hair follicles. The clinical features and the histopathological changes in the lesion were consistent with a diagnosis of lipedematous scalp, which has previously been described predominantly in adult women.
The incidence of inflammatory bowel disease (IBD) has become a global disease in newly industrialized countries. Inflammation leads to a structural modification in platelets, and the secretion of cytokines results in a change of mean... more
The incidence of inflammatory bowel disease (IBD) has become a global disease in newly industrialized countries. Inflammation leads to a structural modification in platelets, and the secretion of cytokines results in a change of mean platelet volume (MPV). To evaluate the relationship between IBD activity parameters and MPV. The study group included 26 patients [consisting of 18 ulcerative colitis (UC), 6 Crohn's disease (CD), and 2 indeterminate colitis patients] followed-up at Dr. Behçet Uz Children's Hospital between 2004 and 2016. The data of patients were screened retrospectively and the demographic, clinical and laboratory characteristics were evaluated. The changes in MPV during the activation, remission and relapse periods of the disease and correlation with other disease activity markers were investigated. The study group consisted of 26 IBD patients (female/male: 11/15) and 71 healthy controls. We used the Pediatric Ulcerative Colitis Activity Index and the Pediatr...
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Objective: Child Advocacy Centers (CAC) are multidisciplinary centers that evaluate child sexual abuse (CSA) cases. In Turkey, CACs, first in Ankara, has been established all around the country. This study is conducted to evaluate the CSA... more
Objective: Child Advocacy Centers (CAC) are multidisciplinary centers that evaluate child sexual abuse (CSA) cases. In Turkey, CACs, first in Ankara, has been established all around the country. This study is conducted to evaluate the CSA cases demographic findings, admission types, diagnosis and outcomes in the first year of Izmir CAC. Methods: The data of 943 cases were evaluated retrospectively and 848 child diagnosed as CSA were accepted as the study group. Descriptive statistical analysis were performed. Results: The mean age of the study group was 14.1±3.3 with female/male ratio 5.73. The most common presentation type was sexual abuse due to peer relations of adolescent girls. The most frequent admission type was by law enforcement while the most common presentation by medical services was from psychiatry clinics. The 60% of the study group defined CSA with contact while 27% defined penetration. The perpetrators were frequently (60%) recognized persons before CSA, most of them were friend/boyfriends and darlings. The frequency of incest cases was 10.7%. The most frequent perpetrator of incest cases were fathers. The 99% of perpetrators were males in the study group while 100% in the incest group. Forty eight percent of the study group required forensic examination but the diagnostic value was 32%. Discussion: CACs are functional centers in evaluating child sexual abuse cases in a multidisciplinary approach. As the most common type of admissions is sexual abuse due to peer relations in adolescents, we suggest that preventive social works should focus on this issue.
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In this study, it was aimed to describe the clinical, histopathological and genetic features of 20 patients with gamma sarcoglycanopathy confirmed by muscle biopsies and genetic analysis. We retrospectively reviewed 20 patients from whom... more
In this study, it was aimed to describe the clinical, histopathological and genetic features of 20 patients with gamma sarcoglycanopathy confirmed by muscle biopsies and genetic analysis. We retrospectively reviewed 20 patients from whom muscle biopsy specimens were obtained between 2007 and 2012. All patients were clinically diagnosed as muscular dystrophy and biopsy materials were collected from five different centers of neurological disorders. All DNAs were extracted from muscle tissues or blood samples of patients and genetic tests (mutation analyses for gamma sarcoglycan gene and deletion-duplication analyses for all 4 sarcoglycan genes) were performed. The mean age of the patients was 7.6 years (2 -21 years). Only one case (5%) was older than 14 years. The mean CPK level was 10311 U/L (1311 - 35000 U∕L). There were 4 siblings in these series. Expression defects of gamma sarcoglycan staining were determined in (15 males, and 5 females) all patients with muscle biopsy specimens....
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Objective: Irritable bowel syndrome is a disease that negatively affects life. Recently, diet therapies have been emphasized. Our study, the aim was to investigate the effect of low FODMAP (fermented oligo-, di-, monosaccharide and... more
Objective: Irritable bowel syndrome is a disease that negatively affects life. Recently, diet therapies have been emphasized. Our study, the aim was to investigate the effect of low FODMAP (fermented oligo-, di-, monosaccharide and polyols) diet on the frequency of gastrointestinal symptoms and the effects on quality of life in patients with IBS. Method: 18 children aged between 7-18 years, who were diagnosed with IBS, followed by University of Health Sciences Izmir Dr. Behçet Uz Children’s Diseases and Surgery Training and Research Hospital the Child Gastroenterology, Hepatology and Nutrition Clinic were included in the study. The appropriate KINDL scale was applied at the time of application and 2 weeks after the end of the low FODMAP diet. GIS symptoms of the week 0 and 6 KINDL results were compared. KINDL scale was applied to the families before and after dieting and the results were compared. Results: The study was completed with 10 patients. The most common symptom was abdomin...
OBJECTIVE: Congenital heart disease is one of the most common childhood diseases that affect both the children's and their families social life, quality of life and the children's academic achievement. The aim of this study is to... more
OBJECTIVE: Congenital heart disease is one of the most common childhood diseases that affect both the children's and their families social life, quality of life and the children's academic achievement. The aim of this study is to evaluate the school performance of children suffering from congenital heart disease who underwent surgical or catheter based interventions. METHODS: The study group included 50 patients with congenital heart disease underwent surgical or catheter based interventions attending to secondary school (aged 12-15 years old) and 50 healthy controls. The academic success validation from official school grades of lessons Turkish, Mathematics, Science, Social Sciences lessons and behavioral attitudes were obtained from the Ministry of Education ‘’e-school’’ parent information system printouts. The patient group consisted of both cyanotic and acyanotic patients and each groups were compared with controls. RESULTS: Turkish, mathematics, physical education class...