Browsing by Author "Acikgoz, Mehmet"

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Acute Respiratory Distress Syndrome Occurred After Hanging Result of the Attached To Rope: a Case Report
(Aves, 2012) Kaya, Avni; Okur, Mesut; Akbayram, Sinan; Avcu, Serhat; Acikgoz, Mehmet; Dogan, Murat; Akil, Muhammed
A-13-year-old male patient was admitted to our emergency unit because of near-hanging while playing with a rope. On physical examination, his general condition was not good, his state of consciousness was evaluated to be stuporous and his spontaneous respiration was weak. The patient had been intubated. The Glasgow coma score was 7. Rope marks were observed on his neck. Thorax computed tomography revealed widespread ground-glass appearance and bilateral parenchymal consolidation in the lungs. This findings correlated with acute respiratory distress syndrome. This case was reported for reminding that acute respiratory distress syndrome can be associated with near-hanging. (Turk Arch Ped 2012; 47: 302-4)
Biotidinase Deficiency Accompanied by Diffuse Demyelination and Cerebral Atrophy
(Modestum Ltd, 2012) Okur, Mesut; Bektas, Mehmet Selcuk; Temel, Hayrettin; Caksen, Huseyin; Acikgoz, Mehmet; Sal, Ertan
Biotinidase deficiency is an inherited disorder which has autosomal recessive pattern; it occurs in approximately 1 in 60,000 live births. Usually it manifests seborrheic dermatitis, alopecia, ataxia, convulsions, hypotonia, developmental delay, hearing loss, chronic lactic acidosis and immune deficiency. Its diagnosis is made by the measurement of serum biotinidase enzyme activity and determination of the enzyme. Herein presented that a two and half-month-old boy with biotinidase enzyme deficiency which had cerebral atrophy without any skin signs. In the patients presented with refractory convulsions with unexplainable etiology without any skin lesions, as in our patient, biotinidase enzyme deficiency should be considered and the treatment should be established in early period to prevent many complications that may develop.
Biotinidaz Enzim Eksikliği: Üç Vakanın Sunumu
(2005) Köse, Yurdagül; Bay, Ali; Doğan, Murat; Çaksen, Hüseyın; Acikgoz, Mehmet; Yılmaz, Cahide
Biotinidaz eksikliği, proteine bağlanmış biotininin ayrılıp tekrar kullanılamaması ile karakterize kalıtsal bir hastalıktır. Otozomal resesif geçiş gösterir. Yaklaşık olarak 60.000 doğumda bir görülür. Çok farklı klinik tablolarla neden olabilen biotinidaz eksikliği genellikle seboreik dermatit, alopesi, ataksi, konvülsiyonlar, hipotoni, gelişme geriliği, işitme kaybı, kronik laktik asidoz ve immün yetmezlik bulguları ile karşımıza çıkar. Bu çalışmada nörolojik bulguların ön planda olduğu 3 biotinidaz enzim eksikliği olgusunu sunduk. Olgularımızın birinde daha önce biotinidaz eksikliği ile birlikte literatürde hiç bildirilmemiş olan ödem klinik bulgulara eşlik ediyordu.
Brucellosis Concomitant With Acute Leukemia
(All india inst Medical Sciences, 2007) Bay, Ali; Oner, Ahmet Faik; Dogan, Murat; Acikgoz, Mehmet; Dilek, Imdat
We present two patients with brucellosis concomitant with acute leukemia. Co-existence of acute leukemia with brucellosis which may have similar symptoms, have not been reported earlier. The first case presented with generalized arthralgia, fever, paleness, and pancytopenia. The second patient had mild leucopenia and thrombocytopenia. She presented with fever. We carried out the chemotherapy for both ALL and brucellosis simultaneously. While the first patient's fever disappeared within 3 days, the second patient's fever had continued on subfebril level for five days and then disappeared. We achieved the remission in both patients and no reactivation was observed during the follow-up period.
A Case of Acute Disseminated Encephalomyelitis Presented With Transvers Myelitis
(Turkish Pediatrics Assoc, 2010) Kaya, Avni; Ozkan, Mustafa; Bektas, M. Selcuk; Acikgoz, Mehmet; Temel, Hayrettin; Sal, Ertan; Caksen, Huseyin
Acute disseminated encephalomyelitis is an inflammatory and demyelinating disorder of central nervous system. A 9-year-old male was admitted with unable to walk, non-sensation of legs, urinary incontinence and encopresis for 2 days. On physical examination, muscle strength was 5/5 on upper extremities and 1/5 on lower extremities. Loss of pain, temperature and touch sensation was present on both lower extremities, reaches to T8 level. On spinal magnetic resonance imaging, diffuse hyperintensity from C3 to conus medullaris was detected. While electromyography was consistent with polyradiculoneuritis, magnetic resonance imaging findings were concordant with acute disseminated encephalomyelitis. On account of this case, we would like to emphasize that acute disseminated encephalomyelitis should be considered in patients presented with transverse myelitis; therefore, in addition to spinal magnetic resonance imaging, cranial magnetic resonance imaging should be examined in these patients. (Turk Arch Ped 2010; 45: 299-302)
A Case of Leptospirosis With Multiple Organ Dysfunction
(Aves Yayincilik, Ibrahim Kara, 2010) Okur, Mesut; Akgun, Cihangir; Bektas, Mehmet Selcuk; Kaya, Avni; Temel, Hayrettin; Acikgoz, Mehmet; Dogan, Sekibe Zehra
Leptospirosis is a zoonotic infection caused by a spirochete of the genus Leptospira, which may affect both humans and animals and is common worldwide. The disease may lead to distinct clinical pictures in humans varying from subclinical infection to multiple organ dysfunction and even death. In this paper, we presented a 8-year-old male patient admitted with the complaints of fever, malaise, fatigue and night sweating, who had been feeding a pet rabbit in the house, and who had jaundice of the sclera and skin, a rash, gastrointestinal bleeding and hepatosplenomegaly found on examination. He developed encephalopathy, bleeding diathesis, hepatic and renal failure; and was diagnosed with leptospirosis based on the clinical symptoms and laboratory tests. After 14-days of therapy with crystallized penicillin and intensive supportive treatment, the neurological and hematological anomalies improved as well as the renal and hepatic dysfunction. In conclusion, we would like to emphasize that the probability of leptospirosis should be considered in children presenting with jaundice, encephalopathy, multiple organ dysfunction and bleeding diathesis if there are any environmental risk factors.
Chediak-Higashi Syndrome
(Nobel Ilac, 2009) Dogan, Murat; Acikgoz, Mehmet; Bay, Ali; Kaya, Avni; Oner, Faik
Chediak-Higashi syndrome (CHS) is a rare autosomal recessive disorder of children and characterized by variable degrees of partial oculocutaneous albinism, increased susceptibility to recurrent pyogenic and respiratory tract infections with neutropaenia, impaired chemotaxis and bactericidal activity, and bleeding tendency as a result of deficient platelets. The hallmark of CHS is the presence of giant cytoplasmic granules in circulating granulocytes and many other type of cells. The CHS usually leads to death at a young age. We report a girl patient with CHS who has admitted to our hospital because of fever, cough, abdominal pain and diarrhea due to a rare condition.
Çocukluk Çağı Akut Lenfoblastik Lösemi Olgularında L-asparajinaz'a Bağlı Toksisite
(2005) Mukul, Yurdagül; Öner, Ahmet Faik; Acikgoz, Mehmet; Demir, Cengiz; Cesur, Yaşar; Bay, Ali
L-Asparajinaz yüksek oranda toksisiteye sahip olmakla birlikte çocukluk çağı akut lenfoblastik lösemi (ALL) tedavisinde vinkristin ve prednizon ile başlama tedavisinin standart bileşenidir ve başarıyı önemli oranda artırır. Bu çalışmada indüksiyon kemoterapisinde L-asparaginaz kullandığımız 85 ALL'Ii olguda gelişen yan etkiler ye tedavileri incelendi. Olgularımızın 28 (%32.9) tanesinde L-aşparaginaza bağlı yan etki gelişti. Olgularımızda en sık görülen yan etkiler allerji, hiperglisemi ve hipertrigliseridemi idi. Daha az görülen yan etkiler ise pankreatit, parotitis ve trombozdu. Sonuç olarak, olgularımızdaki L-asparaginaza bağlı toksisite görülme sıklığı ve tipi ülkemizde diğer merkezlerden bildirilen oranlara benzer olarak izlendi.
Çoklu Organ Yetersizliği ile Seyreden Bir Leptospiroz Olgusu
(2010) Okur, Mesut; Bektaş, Mehmet Selçuk; Acikgoz, Mehmet; Doğan, Şekibe Zehra; Temel, Hayrettin; Akgün, Cihangir; Kaya, Avni
Leptospiroz, leptospira genusundan spiroketlerin neden olduğu, insanları ve hayvanları etkileyebilen, dünyada sık görülen zoonotik bir enfeksiyondur. İnsanlarda subklinik enfeksiyondan çoklu organ yetersizliği ve ölüme neden olabilecek kadar farklı klinik tablolara neden olabilir. Burada ateş, halsizlik, yorgunluk, gece terlemesi yakınmalarıyla getirilen, öyküsünden evde tavşan besledikleri öğrenilen, muayenesinde cilt ve skleralarda sarılık, döküntü, gastrointestinal kanama, hepatosplenomegali tespit edilen, izleminde ensefalopati, kanama diyatezi, hepatik ve renal yetmezlik gelişen, klinik ve laboratuar bulgularıyla leptospiroz tanısı konulan 8 yaşında erkek hasta sunuldu. 14 günlük kristalize penisilin ve yoğun destek tedavisi ile nörolojik ve hematolojik anormallikler ile birlikte renal ve hepatik yetmezliğin düzeldiği görüldü. Sonuç olarak, çocuklarda sarılık, ensefalopati, çoklu organ yetersizliği, kanama diyatezi kliniği ile başvuran hastalarda çevresel risk faktörü varlığında leptospiroz ihtimalinin göz önünde bulundurulması gerektiğini vurgulamak isteriz.
Endemik Bölge Dışında (Patnos) Görülen Bir Kala-azar Olgusu
(2005) Bay, Ali; Okur, Mesut; Öner, Ahmet Faik; Acikgoz, Mehmet; Doğan, Murat
Kala-azar tatarcıklar tarafından bulaştırılan, karaciğer, dalak ve kemik iliğinin makrofajlarmı infekte edip orada çoğalabilen intraselüler parazitik bir infeksiyondur. Hastalık düzensiz ateş, pansitopeni, hepatosplenomegali ve hipergamaglobulinemi ile karakterizedir. Burada 5 yaşında erkek kala-azar olgusu sunuldu. Hasta 2 aydan uzun süredir devanı eden ateş, solukluk ve karın şişliği öyküsü ile başvurdu. Endemik bölgelere seyahat öyküsü yoktu. Sonuç olarak endemik bölgelere seyahat öyküsü olmasa da uzamış ateş, hepatosplenomegali, ve sitopeni ile başvuran hastalarda kala-azar da ayırıcı tanıda dikkate alınmalıdır.
The Frequency of Hashimoto Thyroiditis in Children and the Relationship Between Urinary Iodine Level and Hashimoto Thyroiditis
(Walter de Gruyter Gmbh, 2011) Dogan, Murat; Acikgoz, Emel; Acikgoz, Mehmet; Cesur, Yasar; Ariyuca, Sevil; Bektas, Mehmet Selcuk
The aim of this study was to determine the frequency of thyroid autoimmunity in second grade primary school students and to examine the relationship between iodine and Hashimoto thyroiditis (HT). This was a cohort study performed with 1000 students. Urinary iodine levels, antithyroid peroxidase (anti-TPO) and antithyroglobulin (anti-Tg) antibodies were determined in all children. Children with anti-TPO or anti-Tg antibody positivity or with goiter were summoned for detailed examinations. In total, 36 cases (3.6%) were diagnosed as HT. The goiter frequency was found in 17.5% of the whole cohort. Additionally, iodine deficiency was found in 64.2% of all children. The median urinary iodine excretion was determined as 132 mu g/L (range 382 mu g/L) in the HT group, whereas it was 73 mu g/L (range 390 mu g/L) in children with goiter but without HT and 81 mu g/L (range 394 mu g/L) in normal children. The urinary iodine level of HT cases was significantly higher than the other two groups (p < 0.001). HT was also determined in 2% of patients with low urinary iodine levels, in 6.2% of patients with normal urinary iodine levels, and in 7.5% of patients with high urinary iodine levels. Our data demonstrates the close relationship between excessive iodine levels and autoimmunity.
Hastaneye Yatırılarak Tedavi Edilen Çocukluk Çağı Pnomonilerinde Farklı Tedavi Yaklaşımlarının Değerlendirilmesi
(2009) Kaya, Ali; Acikgoz, Mehmet; Çakman, Hüseyin; Kaya, Avni; Odabaş, Dursun; Doğan, Murat; Bay, Ali
Amaç: Hastaneye yatırılarak tedavi edilen çocuklukçağı pnömonilerinde farklı tedavi yaklaşımlarınındeğerlendirilmesi.Materyal ve metod: Bu çalışmada bakteriyelpnömoni tanısı alan (pnömoniyle birlikte konjenitalveya kronik hastalığı olanlar çalışmaya dahiledilmedi) toplam 515 hasta retrospektif olarakincelenerek çalışmaya alındı. Hastalar yaşlarınagöre dört gruba ayrıldı. Grup I; 0-1 aylık, grup II;2–3 aylık, grup III; 4–59 aylık, grup IV; 5 yaş veüzeri hastalardan oluştu. Kliniğimizde yataraktedavi edilen bakteriyel pnömonili hastalara, yatıştauygulanan tedavi ve tedavi değişiklikleri, tedavihastanemize yatmadan kaç gün önce pnömonisemptomlarının başladığı, hastanemize yatmadanönce ayaktan veya yatarak başka bir merkezdetedavi alıp almadığı, yatışta tesbit edilenpnömoninin şekli (lober veya bronkopnömoni)hasta dosyalarındaki kayıtlardan elde edildi. İstatistik: Hasta verilerinin değerlendirilmesindeChi-square testi kullanıldı. P<0.05 değerleri anlamlıkabul edildi.Bulgular: Çalışmamızda, sultamisilin ve amikasintedavisi ile iyileşme oranı, grup I’de %84.7, grupII’de %98.3, grup III’de %100, sultamisilin vesefotaksim tedavisi ile iyileşme oranı, grup I’de%87.5, grup II’de %90, grup III’de %85.7,penisilin-G ve kloramfenikol tedavisi ile iyileşmeoranı, grup III’de %84.8, grup IV’de %90,vankomisin ve sefotaksim tedavisi ile iyileşmeoranı, grup III’de %93.7, grup IV’de %90 vepenisilin-G tedavisi ile iyileşme oranı, grup IV’de%75, olarak bulundu. Gruplardaki iyileşmeoranları istatistiksel olarakta anlamlı bulundu.Sonuç: Dirençli pnömokok ve stafilokok pnömonisidüşünülmüyorsa, 0–12 ay grubu hastalardasultamisilin ve amikasin, 4 ay–5 yaş grubuhastalarda, penisilin-G ve kloramfenikol tedavisigüvenle verilebilir.
Hemiplegic Migraine: a Case Report
(Galenos Yayincilik, 2010) Yilmaz, Cahide; Sonmez, Bulent; Basaranoglu, Murat; Kaya, Avni; Acikgoz, Mehmet; Caksen, Hueseyin
The girl patient aged twelve had been brought to the hospital having weakness at her left side. After having fallen from a balcony, her paroxysmal headeche accompanying nause and vomiting had began. This case was cured by valproic acid. Electroencephalography showed focal slowing and deep wave discharge. This case was presented to remind that hemiplegic migraine can seldomly begin, after minor head trauma. (Turk Arch Ped 2010; 45: 153-4)
Investigation of Oxidant and Antioxidant Pathway Changes in Acute Rheumatic Fever
(Taylor & Francis Ltd, 2010) Uner, Abdurrahman; Sal, Ertan; Dogan, Murat; Sanli, Fatih M.; Acikgoz, Mehmet; Cemek, Mustafa; Cagan, Eren
Aim - The purpose of this study was to investigate the role of oxidant stress in the clinical process and pathogenesis of acute rheumatic fever (ARF). Material and methods - The study included 33 children with ARF and 20 healthy control subjects. The diagnosis of ARF was established according to the Jones Criteria. Malondialdehyde (MDA), reduced glutathione (GSH), alpha-tocopherol, ascorbic acid, retinol and beta-carotene levels were measured as markers of oxidative stress together with some antioxidant markers. Results - Our study includes 33 (19 male, 14 female) children with ARF and 20 (11 male, 9 female) healthy control subjects. The mean age ranged between 5-16 years and 5-15 years in the study and control groups, respectively. MDA was measured as 2.1 +/- 0.9 nmol/mL in the control group, 3.3 +/- 2.7 nmol/mL in the study group before treatment, and 2.1 +/- 1.2 nmol/mL after treatment. Blood GSH levels were 48.2 +/- 12.7 mg/dL in the control group, 24.7 +/- 16 mg/dL in the study group before treatment, and 40.6 +/- 21.3 mg/dL in the study group after treatment. MDA and GSH levels prior to the treatment were found to be significantly high and low as compared with the levels of the control group, respectively (P < 0.05, P < 0.001). After treatment, statistically important decrements and increments were determined in the levels of MDA (P < 0.05) and GSH (P < 0.01), respectively. Furthermore, alpha-tocopherol, retinol and beta-carotene levels prior to treatment in the study group, were significantly lower in comparison with control group levels (P = 0.05, P < 0.05, P < 0.01, respectively). Conclusion - We suggested that tissue damage in ARF may not only occur in the presence of increased oxidative stress, but also as a consequence of decreased antioxidant markers.
Kronik İmmün Trombositopenik Purpuralı Çocuklarda İntravenöz Anti-d Tedavisinin Etkinliği
(2006) Bay, Ali; Dilek, İmdat; Doğan, Murat; Öner, Ahmet F.; Acikgoz, Mehmet
Bu çalışmada steroid ve intravenöz immunoglobuline dirençli 11 kronik immun trombositopenik purpuralı (ITP) olguda Anti D ile tedavi sonuçları değerlendirildi. Olguların hepsi Rh + kan grubundandı ve hiç birisine splenektomi yapılmamıştı. Anti D 30 µg/kg/gün dozunda 0, 1, 7, 14, 21, 28. günlerde 1 saat içinde İV yavaş infüzyonla verildi. Olguların 3 tanesi (%27) tam cevap, 3 tanesi (%27) parsiyel cevap, 3 tanesi (%27) minor cevap verirken, 2 tanesi (%18) cevapsızdı. Cevap veren olguların sadece 1 tanesinde trombosit sayısı 1 yıldan daha fazla yüksek kaldı. Diğer olguların trombosit sayısı 1-3 ay içinde tedavi öncesi değerlerine düştü. Önemli bir yan etki saptanmadı. Dirençli kronik ITP li çocuklarda anti D tedavisinin de bir seçenek olarak dikkate alınması gerektiği sonucuna varıldı.
Megaloblastik Anemili 45 Olgunun Klinik ve Hematolojik Yönden Değerlendirilmesi
(2006) Acikgoz, Mehmet; Nalbantoğlu, Özlem; Demirtaş, Maşuk; Bay, Ali; Öner, Ahmet Faik
Amaç: Yüzüncü Yıl Üniversitesi Tıp Fakültesi Çocuk Hematoloji Kliniğinde 1997-2005 yılları arasında takip ve tedavi edilen megaloblastik anemili 45 olgunun klinik ve hematolojik özelliklerinin değerlendirilmesi. Metod: Hasta dosyaları retrospektif olarak incelendi. Megaloblastik anemi tanısı periferik yayma ve kemik iliği aspirasyon bulguları ve vit B12 ve folik asit serum düzeylerine bakılarak kondu. Bulgular: Hastaların 15 (%33,3)i kız 30 (%66,6)u erkekti. Yaş ortalaması 34,4 (9-174) aydı. Hastaların en sık başvuru nedeni solukluk, halsizlik ve iştahsızlıkdı. Hastaların 3'ünde folik asit, 42'sinde vit B12 eksikliği saptandı. Olguların ortalama hemoglobin konsantrasyonu 5.5 g/dl, ortalama MCV değeri 96.3 fl, ortalama beyaz küre sayısı 9334/mm3, ortalama RDW değeri 24,2 idi. Proteinüri 6 (%13,3) olguda saptandı. Olgularımız parenteral B12 vitamini ve oral folik asit ile tedavi edildi ve hepsinde düzelme saptandı. Tedavi sonrası 3 (%6,6) olguda demir eksikliği anemisi gelişti. Megaloblastik anemi saptanan olgularımızın yaklaşık olarak 1/3 ünde ilk başvuru anında MCV değeri 90 fl nin altında idi. Sonuç: Sonuç olarak bu olguları sunarak makrositer olmayan anemi durumlarında da megaloblastik anemi olabileceğini ve yöremizde özellikle hamile kadınlarda ve süt çocuklarında dengeli beslenmenin önemini vurgulamak istedik.
Mycoplasma Pneumoniae Meningoencephalitis: a Case Report
(Wolters Kluwer Medknow Publications, 2013) Bektas, Mehmet Selcuk; Aktar, Fesih; Acikgoz, Mehmet; Sal, Ertan; Caksen, Huseyin
Nervous system is the most affected area in mycoplasma pneumoniae infections with exception of respiratory system. It is an important agent of childhood acute encephalitis and respiratory system infections in school-age children and young adults. Routine clinical and laboratory findings to identify spesific diagnosis is limited. Twelve-year-old female patient was admitted with fever, fatigue, sore throat, slipping the right eye, withdrawal of the mouth from the right and right hemiclonic seizures. Test of anti-Mycoplasma pneumoniae (M. pneumoniae) IgM was positive and IgG antibodies were found to be 4-fold increase in the sera of follow-up. This article was presented with the aim of remembering M. pneumoniae to be an differential diagnosis in children with acute encephalitis.
New Coagulant Agent (Ankaferd Blood Stopper) for Open Hemorrhages in Hemophilia With Inhibitor
(Sage Publications inc, 2010) Oner, Ahmet Faik; Dogan, Murat; Kaya, Avni; Sal, Ertan; Bektas, Mehmet Selcuk; Yesilmen, Osman; Acikgoz, Mehmet
The treatment of hemophilia A patients with inhibitor could be very expensive. Ankaferd blood stopper (ABS) is a unique folkloric medicinal plant extract, which has historically been used in Turkish traditional medicine as a hemostatic agent. In this article, a 16-year-old boy was presented with uncontrolled bleeding, despite the treatment of factor VIII, rVIIa, factor VIII inhibitor bypass activity (FEIBA), cyclophosphamide, and prednisolone at circumcision site that resolved with ABS in minutes. Our patient with hemophilia A and inhibitor is the first clinical pediatric case.
Rapidly Progressive Renal Disease as Part of Wolfram Syndrome in a Large Inbred Turkish Family Due To a Novel Wfs1 Mutation (P.leu511pro)
(Elsevier, 2012) Yuca, Sevil Ari; Rendtorff, Nanna Dahl; Boulahbel, Houda; Lodahl, Marianne; Tranebjaerg, Lisbeth; Cesur, Yasar; Acikgoz, Mehmet
Wolfram syndrome, also named "DIDMOAD" (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness), is an inherited association of juvenile-onset diabetes mellitus and optic atrophy as key diagnostic criteria. Renal tract abnormalities and neurodegenerative disorder may occur in the third and fourth decade. The wolframin gene, WFS1, associated with this syndrome, is located on chromosome 4p16.1. Many mutations have been described since the identification of WFS1 as the cause of Wolfram syndrome. We identified a new homozygous WFS1 mutation (c. 1532T>C; p.Leu511Pro) causing Wolfram syndrome in a large inbred Turkish family. The patients showed early onset of IDDM, diabetes insipidus, optic atrophy, sensorineural hearing impairment and very rapid progression to renal failure before age 12 in three females. Ectopic expression of the wolframin mutant in HEK cells results in greatly reduced levels of protein expression compared to wild-type wolframin, strongly supporting that this mutation is disease-causing. The mutation showed perfect segregation with disease in the family, characterized by early and severe clinical manifestations. (C) 2011 Elsevier Masson SAS. All rights reserved.
Rituximab in a Child With Relapsed Burkitt Lymphoma
(Wiley-liss, 2007) Bay, Ali; Dogan, Murat; Acikgoz, Mehmet; Oner, Ahmet Faik