Browsing by Author "Çaksen, H."

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Alström Syndrome Associated With Cerebral Involvement: an Unusual Presentation
(TIP ARASTIRMALARI DERNEGI, 2006) Yilmaz, C.; Çaksen, H.; Yilmaz, N.; Güven, A.S.; Arslan, D.; Cesur, Y.
Alström syndrome (AS) is a rare autosomal recessive disorder, characterized by retinal degeneration, progressive hearing impairment, truncal obesity and non-insulin dependent diabetes mellitus. A 6-year-old girl was admitted with aphasia, deafness, strabismus, abdominal distention, and weakness on the right body side. The physical and laboratory examination revealed psychomotor retardation, right hemiparesis, sensorioneural hearing loss, aphasia, eye and teeth abnormalities, hyperpigmentation, truncal obesity, hepatosplenomegaly, severe iron deficiency anemia, delayed bone age, and cerebral hemiatrophy. Based on these abnormal findings she was diagnosed as AS. According to our knowledge this is the first case of AS with cerebral involvement. This last finding may be a component of the syndrome.
Anal Protrusion of Ventriculo-Peritoneal Shunt Catheter: Report of Two Infants
(2004) Yilmaz, N.; Kiymaz, N.; Yilmaz, C.; Çaksen, H.; Yuca, S.A.
In general, treatment of hydrocephalus requires the application of a ventriculo-peritoneal shunt. Despite the peritoneal cavity being convenient for absorption of cerebrospinal fluid, multiple complications related to the shunt tends to develop within this area. The most frequent complications are abdominal. A rare complication can occurs with perforation of the organs located in peritoneal cavity by the catheter when infection occurs. Here we report two cases (because of unusual presentation) of shunt complication, they were operated for hydrocephalus. Acute traumatic anal protrusion of the peritoneal catheter occurred in the first case while a spontaneous anal protrusion during follow-up period, in the second case. The predisposing factors were thought to be previous abdominal infection and the use of trocar during operation in the first case and chronic irritative effect of the ventriculo-peritoneal catheter in the second case. © 2004, IOS Press. All rights reserved.
Asymmetric Crying Facies Associated With Hemihypertrophy: Report of One Case
(2003) Çaksen, H.; Patiroǧlu, T.; Çiftçi, A.; Çikrikçi, V.; Ceylaner, S.
An infant whose face appears symmetrical at rest yet whose mouth is pulled downward to one side when crying is said to have an "asymmetric crying facies". The cause of the facial asymmetry in this disorder is congenital absence or hypoplasia of the depressor anguli oris muscle at the corner of the mouth. Associations of this minor facial defect with major congenital anomalies have been reported, most commonly in the cardiovascular system and less frequently involving the genitourinary, musculoskeletal, cervicofacial, respiratory, and, rarely, the central nervous system. In this article, a 40-day-old boy with asymmetric crying facies associated with malformed right ear, patent foramen ovale, hemivertebrae, thoracic scoliosis, and hemihypertrophy is presented. The last anomaly has not previously been published in association with asymmetric crying facies in the literature according to our knowledge.
Auditory Brainstem Response in Children With Iron Deficiency Anemia
(2003) Çankaya, H.; Öner, A.F.; Egeli, E.; Çaksen, H.; Üner, A.; Akçay, G.
To investigate the neurosensorial influences with auditory brainstem response (ABR) in iron deficiency anemia. We recorded ABR in 33 children with iron deficiency anemia followed and in 31 healthy children (control group 1, 0-12 months, control group 2, 13-36 months, control group 3, 37-60 months) as a control group. The patients and controls were divided into three group: group I, at 12 months of age, group II, 13-36 months, and group III, 37-60 months. In all groups, composed latency time, inter-peak latency, amplitude of peaks, I-V wave amplitude ratio and waveform were evaluated and compared with control groups. In group I, I-V interpeak latency was increased compared with control group 1 (4.58 vs. 4.20 ms, p < 0.05). In group II, Wave V latency time and III-V interpeak latency were increased compared with control group 2 (6.21 ms vs. 5.63 ms. p < 0.005 and 0, 48 vs. 0.22 p < 0.005, respectively). In group III, wave I latency time was increased compared with control group 3 (1.56ms vs. 1.46 ms) (p < 0.05). We considered that increases in ABR latencies might be explained by delayed maturation of myelinisation, which requires iron, and/or by dysfunction of iron containing enzymes.
A Case of Bartter’s Syndrome Associated With Nephrocalcinosis Presenting With Tetany
(2004) Ataş, B.; Çaksen, H.; Tuncer, O.; Kirimi, E.; Arslan, S.; Erol, M.; Yuca, S.A.
A 10-year-old boy was admitted to hospital with a 3 month history of intermittent spasms of the wrists and ankles, and twitching of the eyelids. He also had polyuria, polydipsia, nocturnal enuresis, fatigue and constipation since he was a toddler. Physical examination revealed normal blood pressure, myokymia on the right eyelid and bilateral carpopedal spasms. Laboratory investigation revealed hypocalcemia, hypokalemia, increased plasma renin and aldosterone, hypercalciuria, metabolic alkalosis, and bilateral medullary nephrocalcinosis. Cranial computed tomography was normal. Based on the clinical and laboratory findings he was diagnosed as having Bartter’s syndrome, which is characterized by hypochloremia, hypokalaemia and metabolic alkalosis associated with potassium renal leakage, with normal blood pressure despite increased plasma renin activity. It is well known that tetany is not uncommon in the neonatal form of Bartter’s syndrome and nephrocalcinosis is usually not present in the classic form. Interestingly, our patient had both the clinical manifestations of the neonatal form and of the classic form of Bartter’s syndrome. In conclusion, we would like to emphasize that both the clinical manifestations of neonatal and classic forms of Bartter’s syndrome (as an overlapping syndrome) might be seen in children and that Bartter’s syndrome should also be considered in children with tetany as in our case. © 2004, IOS Press. All rights reserved.
A Case of Benzydamine Hcl Intoxication
(2006) Doǧan, M.; Yilmaz, C.; Çaksen, H.; Güven, A.S.
Benzydamine HCl is a nonsteroidal anti-inflammatory drug (NSAID) and is available in mouthwash, dermal cream, aerosol and vaginal douche preparations, besides other compounds administered orally or by otic drops. Acute poisoning with benzydamine HCL is associated with agitation, hallucinations, seizures and rarely somnolence. In this study, we reported a rare case of benzydamine poisoning in a girl who presented with somnolence and visual hallucinations one hour after taking five benzydamine HCL dragees orally equal with 14.7 mg/kg for suicide. An 11 years old girl was brought to our hospital because of visual hallucinations. About 1,5 hours before the admission, she received five benzydamine HCL dragees orally for suicide. Visual hallucinations appeared one hour after ingestion of the drug. She especially mentioned to see snakes and her relatives such as her father who was not in the hospital. On laboratory examination complete blood count, serum electrolytes, renal and liver function tests were normal. The patient was hospitalized with the diagnosis of acute benzydamine HCl intoxication. Gastric lavage was performed and activated charcoal (1 g/kg/dose four doses daily) was given. The hallucinations were resolved and she became symptom and sign free two hours after hospitalization. We suggest that if a patient is presented with somnolence and visual hallucinations, drug intoxication should be considered in the differential diagnosis.
A Case of Idiopathic Intracranial Hypertension Related With Vesicoureteral Reflux
(2011) Akgün, C.; Taşkin, G.A.; Akbayram, S.; Kaya, A.; Temel, H.; Yuca, S.A.; Çaksen, H.
Pseudotumor cerebri is idiopathic intracranial hypertension. The etiology of this syndrome has not been fully clarified. Excess cerebrospinal fluid production, scarcity of cerebrospinal fluid absorption, intracranial venous pressure elevation, increased intracranial blood volume are all thought to be responsible. The symptoms of the disease may be ordered according to prevalence as follows: headache due to increased intracranial pressure, blurred vision and diplopia. A thirteen-year-old female patient was brought in with complaints of headache, double and blurred vision. Systemic arterial hypertension (140/70 mmHg) was determined. Vesicoureteral reflux was detected as the hypertension etiology. In this article a rare pseudotumor cerebri case is presented secondary to vesicoureteral reflux which caused hypertension.
A Case of Nephrotic Syndrome Associated With Relapsing Hepatitis A
(IOS Press, 2007) Ataş, B.; Tuncer, O.; Çaksen, H.; Arslan, Ş.
Viral hepatitis A infection is a self-limited infection occurring predominantly among children usually as an anicteric often-subclinical illness. Almost all patients with hepatitis A virus infection recover completely. However, a relapsing course can occur with clinical signs, symptoms and biochemical findings of hepatic inflammation one or four months after the acute phase. In this article, we report a case of nephrotic syndrome associated with relapsing hepatitis A. Although it has been reported that hepatitis A can lead to nephrotic syndrome, an association of relapsing hepatitis A and nephrotic syndrome has not been reported in the literature to the best of our knowledge. © 2007 IOS Press. All rights reserved.
A Case of Wilms’ Tumor With Spinal Cord Involvement
(2003) Bay, A.; Akbayram, S.; Öner, A.F.; Çaksen, H.; Köseoğlu, B.; Ünal, Ö.
Wilms’ tumor is the most common renal tumor of childhood. However, spinal cord involvement has rarely been reported in children with Wilms’ tumor. In this article, we report a 5-year-old boy with Wilms’ tumor who had the unusual presentation of spinal cord involvement. Our purpose is to emphasize that spinal cord involvement may be seen in children with Wilms’ tumor. © 2003, IOS Press. All rights reserved.
Central Diabetes Insipidus Following Intracranial Hemorrhage Due To Vitamin K Deficiency in a Neonate
(2005) Çaksen, H.; Odabaş, D.; Kaya, A.; Cesur, Y.; Kiymaz, N.; Etlik, Ö.; Turhan, S.
A previously healthy 30-day-old girl presented with seizures, irritability and inability to sleep for three days. Vitamin K was not given just after birth. She was lethargic. A multifocal clonic seizure was evident during examination. Anisocoria was diagnosed on eye examination. Brain magnetic resonance imaging showed intracerebral hemorrhage, ventricular dilatation, and hematoma in the left temporofrontal region extending to the hypothalamus. Central diabetes insipidus was diagnosed by water deprivation due to dehydration and hypernatremia, and then desmopressin was added to phenobarbital. The possible mechanism of central diabetes insipidus in our patient is damage of vasopressin pathway resulting from compression of hemorrhage. An operation of ventriculoperitoneal shunt was also performed due to hydrocephalus. While she was symptom-free except for neurological sequel during routine control examinations after discharging from hospital, the parents said that she died, most probably from bronchopneumonia, at the age of 7.5 months. In conclusion, we emphasize that prophylactic vitamin K should be administrated to all babies just after birth, and infants with intracranial hemorrhage should carefully be monitored for central diabetes insipidus.
Central Nervous System Manifestations of Mycoplasma Pneumoniae: Report of Two Children
(IOS Press, 2005) Abuhammour, W.M.; Yilmaz, C.; Hurst, M.D.; Allarakhia, I.; Çaksen, H.
Mycoplasma pneumoniae is a common infection in the early adolescent period, presenting most commonly as an upper respiratory tract infection with variable severity. Extrapulmonary manifestations include neurologic, hematologic, hepatic, and cardiac involvement. Hemiparesis and dysarthria are frequently encountered in the setting of cerebrovascular accidents. We present two patients who had neurological complications secondary to Mycoplasma pneumoniae infection. The first patient was a 12-year-old boy who presented with recurrent episodes of transient hemiparesis and dysarthria. The second patient was a 3-year-old girl who presented with seizures and aphasia. Both patients had pneumonia and positive serum immunoglobulin M against Mycoplasma pneumoniae. Follow up revealed a full recovery in the first case and moderate articulation disorder in the second patient. © 2005 - IOS Press and the authors. All rights reserved.
Cerebral Hemiatrophy Associated With Hematological and Developmental Disorders
(2004) Ünal, Ö.; Çaksen, H.; Kiymaz, N.; Dilek, I.; Kayan, M.; Anlar, Ö.
The etiology of cerebral hemiatrophy may be congenital or acquired. Trauma, infection, vascular abnormality, ischemic and hemorrhagic conditions may be the etiologic factors in acquired type. There is limited information about its association with other disorders in the literature. We presented three new cases of cerebral hemiatrophy associated with some hematological and developmental disorders. Cerebral hemiatrophy was associated with thalassemia major in a 10-year-old girl, acute myeloblastic leukemia and Marfan syndrome in a 23-year-old man, and craniosynostosis in a 1-year-old boy. To the best of our knowledge, thalassemia major, myeloblastic leukemia, Marfan syndrome and craniosynostosis have not been reported in cerebral hemiatrophy in the literature. © 2004, IOS Press. All rights reserved.
Childhood Parapneumonic Pleural Effusion and Empyema
(2002) Çaksen, H.; Öztürk, M.K.; Yüksel, P.; Üzüm, K.; Üstünbap, H.B.
Comparison of Low and High Dose of Vitamin D Treatment in Nutritional Vitamin D Deficiency Rickets
(Freund Publishing House Ltd, 2003) Cesur, Y.; Çaksen, H.; Gündem, A.; Kirimi, E.; Odabaş, D.
In this study, we compared three different therapy modes (150,000 IU, 300,000 IU, and 600,000 IU vitamin D p.o.) in infants with nutritional vitamin D deficiency rickets (VDR). Our purpose was to determine the most effective dosage of vitamin D with least side effects for treating VDR. The study included 56 patients, 3-36 months of age, with nutritional VDR and 20 age-matched control infants. In all infants, serum calcium, phosphorus, alkaline phosphatase, magnesium, serum 25-hydroxycholecalciferol, plasma intact parathormone levels and urinary Ca/creatine ratio were determined. Of 56 patients, 52 were able to be followed long-term. These patients were reexamined on the 3rd day, 7-10th day, and 25-30th day after treatment. On the 30th day post-treatment, we did not find any difference between the doses in the improvement of rickets. However, hypercalcemia was present in eight infants who had been administered 300,000 IU (two infants) and 600,000 IU (six infants) of vitamin D. In conclusion, our findings showed that 150,000 IU or 300,000 IU of vitamin D was adequate in the treatment of VDR, but 600,000 IU of vitamin D may carry the risk of hypercalcemia.
Comparison of Various Treatments in Childhood Brucellosis
(2006) Yuca, S.A.; Ceylan, A.; Çaksen, H.; Kirimi, E.; Yilmaz, C.; Bay, A.
The aim of this study was to evaluate the effectiveness of different drug combinations for treatment of brucellosis in children. Sixty children (mean age 9.2 ± 3.1 years, range 10 months to 15 years) were treated with four different drug combinations. The diagnosis of brucellosis was established by positive serum agglutination titer, and/or the isolation of Brucella species from blood cultures. The most frequent findings were fever and arthritis in 12 (20%) and 13 (21.6%) patients respectively. The children under 8 years old comprised Group 1 and 2, and older than 8 years comprised Group 3 and 4 according to treatment regimens. Nine patients (Group 1) were treated with trimethoprim-sulfamethoxazole (TMP-SMZ) for 45 days plus ceftriaxone for 5 days and, rest nine patients (Group 2) were managed with TMP-SMZ for 45 days plus gentamicin for 5 days. Twenty-one patients (Group 3) were managed with doxycycline for 45 days and ceftriaxone for 5 days and, other 21 (Group 4) patients were managed with doxycycline for 45 days and gentamicin for 5 days. All patients recovered. Relapse and improvement rates were similar for all groups (P >0.05). Each regimen was effective in the treatment of childhood brucellosis. Using cheaper drugs such as doxycycline and gentamicin in children 8 years of age and older, and TMP-SMZ and gentamicin in children 7 years of age or younger for the treatment of brucellosis in children is a practical and useful approach in our region and in the developing countries. © 2006 - IOS Press and the authors.
Cranial Ct/Mri Findings in Children With Acute Herpes Simplex Encephalitis
(IOS Press, 2007) Çaksen, H.; Ünal, Ö.; Yilmaz, C.; Güven, A.S.; Özen, Ö.
In this study, cranial computerized tomography (CT) and/or magnetic resonance imaging (MRI) findings were investigated in nine children with acute herpes simplex encephalitis (HSE). HSE was confirmed by polymerase chain reaction. Our purpose was to evaluate the diagnostic value of CT and MRI in the diagnosis of HSE and to determine the widespread of the cranial abnormalities in HSE in childhood. Cranial CT was examined in all children and found to be normal in four children. Cranial MRI was examined in seven children, of whom, three was normal. Temporal involvement was diagnosed in only two children. Our findings revealed that the range of cranial involvement was fairly variable in childhood HSE; aside from typical temporal involvement, cranial images may be normal or widespread involvement including basal ganglia, thalamus, frontal and parietal lobes may be seen in children with HSE. © 2007 IOS Press. All rights reserved.
Effect of Long-Term Carbamazepine Therapy on Serum Lipids, Vitamin B12 and Folic Acid Levels in Children
(Walter de Gruyter GmbH, 2003) Deda, G.; Çaksen, H.; Içaǧasioǧlu, D.
Serum triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), vitamin B12 and folic acid levels were studied in 16 children with epilepsy who had been receiving carbamazepine (CBZ), and in 16 healthy children. Our purpose was to determine whether there was any effect of CBZ therapy on serum lipids, vitamin B12 and folic acid levels. Age ranged from 5 to 19 years (12.25 ± 3.79 years) and 5.5 to 18 years (12.16 ± 3.53 years) in the study and control groups, respectively. The duration of CBZ therapy in the patients was between 1 and 4.5 years (3.01 ± 1.04 years). Serum CBZ level varied between 4 and 12 μg/ml (6.26 ± 2.07 μg/ml). There was no statistically significant difference in serum triglycerides, TC, HDL-C, LDL-C, VLDL-C or vitamin B12. However, mean folic acid level was found to be lower in the study group than that of the control group (p <0.05). Nonetheless, serum folic acid levels were within the normal range in all patients. Our study demonstrated that CBZ therapy does not affect serum lipids, vitamin B12 and folic acid levels, and may safely be used with regard to these parameters in children.; Indications:16 patients with epilepsy.; Results:There was no statistical difference in serum TG, TC, HDL-C, LDL-C, VLDL- C and vitamin B12. Mean folic acid level was found to be lower in the Tegretol group than that of the control group. Serum folic acid levels were within the normal range in all patients. Serum Tegretol ranged from 4 -12 mcg/ml (mean 6.26 mcg/ml).; Patients:32 patients. Tegretol group: 16 patients, 9 males and 7 female, aged 5- 19 years (12.25 ± 3.79). Control group: 16 healthy subjects, 7 male and 9 female, aged 5.5-18 years (12.16 ± 3.53).; TypeofStudy:The effect of Tegretol therapy on the serum lipid profile, cyanocobalamin (vitamin B12), and folic acid levels in children with epilepsy was studied.; DosageDuration:Serum levels ranged from 4-12 μg/ml (6.26 ± 2.07 μg/ml). Dosage not stated. Duration: between 1-4.5 years (3.01 ± 1.04).; AdverseEffects:No adverse events were mentioned.; AuthorsConclusions:In conclusion, our findings showed that CBZ did not affect the serum lipid profile or serum B12 and folic acid levels, and may be safely used with regard to these parameters in children.; FreeText:Tests: fasting serum levels of triglycerides (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), vitamin B12, and folic acid, and serum Tegretol levels in the patient group. Serum TG, TC and HDL-C concentrations were measured by a colometric photometric method. Serum vitamin B12 and folic acid levels were measured by radioimmunoassay. Serum Tegretol (carbamazepine) level was measured by fluorescence polarization immunoassay using Abbott Laboratories Diagnostics kits.
Evaluation of Exercise Performance in Healthy Turkish Adolescents
(2005) Çoksevim, B.; Çaksen, H.
In this study, exercise performance was evaluated in 259 healthy adolescents by using some tests. The purpose of the study was to investigate exercise performance and cardiorespiratory capacity in both adolescent boys and girls. The following tests were applied to all children: ball throw with right and left hands, vertical jump, long jump without prior motion, pull up (repetition number), flexibility, and agility (set repetition number) tests. Additionally, heart rate and systolic and diastolic blood pressures were measured. Applied spirometric tests were as follows: vital capacity, forced vital capacity, forced expiration volume in the first second, ventilation volume, maximum volunteer ventilation and respiration frequency. This study found that heart rate was statistically significantly higher in females than males (p < .05). There was also a statistically significant difference in vital capacity, forced vital capacity and forced expiratory volume in the first second (in both measured and predicted values) between males and females (p < .05). Additionally, it was found that there were statistically significant differences in the 60 and 200 meters races, maximal pull up, maximal sit up, vertical jump, standing long jump, ball throwing with right hand, horizontal bar, and agility between the male and female groups (p < .05). In conclusion, the findings showed that although females were superior in the 60 and 200 meter race, males were superior in agility, horizontal bar, ball throwing with right hand, long jump, and vertical jump. Copyright © 2005 Taylor & Francis Inc.
A Girl Presenting With Intractable Seizure and Decreased Visual Acuity
(2012) Kocaoǧlu, C.; Akin, F.; Sert, A.; Çaksen, H.; Öner, V.; Kiliçaslan, C.; Arslan, S.
Neuronal ceroid lipofuscinoses are the most common neurodegenerative childhood-onset disorders characterized by autosomal recessive inheritance, epileptic seizures, progressive psychomotor deterioration, visual failure, and premature death. At least eleven subtypes of childhood-onset neuronal ceroid lipofuscinoses have been identified. The most common types are the infantile and classic juvenile forms. In this article, we present a 5-yearold girl with late infantile neuronal ceroid lipofuscinosis who presented with seizures and decreased visual acuity. She was healthy and her developmental milestones were normal until 3 years of age. At the age of 3-year-old, her intractable seizures started and decreased visual acuity was recognized. Based on the clinical findings and enzymatic test results, she was diagnosed as late-infantile ceroid lipofuscinosis.
Hyponatremic Dehydration: an Analysis of 78 Cases
(2001) Çaksen, H.; Odabaş, D.; Şar, A.; Çelebi, V.; Arslan, S.; Kuru, M.; Abuhandan, M.
Our purpose was to determine the frequency of convulsion in children with hyponatremic dehydration (HD). We also investigated whether or not there was a relationship between the severity of hyponatremia and the degrees of malnutrition in our region (Eastern Anatolia of Turkey) in where malnutrition is frequently observed. In this study, the clinical and laboratory findings of 78 patients with diarrhoea (acute, persistent or chronic diarrhoae) and HD were studied. When diarrhoea lasts longer than 2 and 4 weeks they were accepted as persistent and chronic diarrhoea, respectively. Patients were said to have HD if they had the clinical findings of dehydration associated with hyponatremia [Serum sodium (SNa) <130 mmol/L)]. Nutritional status of the children was assessed by the Gomez classification using weight for age; it was accepted as normal those were between 90%-110%, mild malnutrition 75%-89%, moderate malnutrition 60%-74% and severe malnutrition <60%. Of 78 patients, 40 were boys, 38 were girls. The age and weight of the patients ranged from 40 days to 36 months (8.94 ± 5.49 months) and from 2000 to 10300 g (5535.25 ± 1702.10 g) respectively. All patients except four had malnutrition; 15 (20.3%) had mild malnutrition, 30 (40.5%) had moderate malnutrition and 29 (39.2%) had severe malnutrition. Forty-seven patients had acute, 16 patients had persistent, and 15 patients had chronic diarrhoea. SNa levels were between 104 and 129 mmol/L (121.21 ± 6.12 mmol/L). There was not statistically a significant difference between SNa level and the degree of malnutrition, and SNa level and the types (acute, persistent or chronic) of diarrhoea (p > 0.05). Of 78 patients, 12 (15.3%) patients had convulsion, of whom eight had convulsion associated with fever. Convulsion was noted in nine (19.1%) and three (18.7%) patients with acute and persistent diarrhoea, respectively (p > 0.05). Also, we observed that when hyponatremia was severer, convulsions tended to be more occurring (p < 0.05). Five (6.4%) children died and all of them had severe malnutrition and septicemia. We determined that the frequency of convulsion in HD was 15.3% (12/78), and there was not a difference between the cases of acute, persistent and chronic diarrhoea for the frequency of convulsion. We also found a significant difference was not present between SNa level and the degree of malnutrition, and between SNa level and the types (acute, persistent or chronic) diarrhoea. However, we observed that when hyponatremia was severer, convulsions tended to be more occurring.