Browsing by Author "Akbayram, S"

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Acute Amitriptyline Intoxication
(Sage Publications Ltd, 2006) Çaksen, H; Akbayram, S; Odabas, D; Özbek, H; Erol, M; Akgün, C; Yilmaz, C
The tricyclic antidepressant agents, particularly amitriptyline and dothiepin, are recognized for their potentially lethal cardiovascular and neurological effects in poisoned patients. In this article, the clinical and laboratory findings of 44 children with amitriptyline intoxication are reviewed. Our purpose was to investigate amitriptyline intoxication in childhood. Of 44 patients, 21 ( 47.7%) were boys, 23 ( 52.3%) were girls, and the ages ranged from 12 months to 14 years ( mean +/- SD; 4.09 +/- 2.9 years). All children except one who took an overdose of amitriptyline to decrease his pain accidentally ingested an overdose of amitriptyline. The amount of amitriptyline ingested was between 2 mg/kg and 97.5 mg/kg (mean +/- SD; 13.6 +/- 17.7 mg/kg per dose) (the drug dosage was not known in 13 children). The most commonly observed clinical and laboratory findings were lethargy, tachycardia, convulsion, hyperglycemia and leukocytosis. In all patients except for two children who died the abnormal clinical and laboratory findings returned to normal within a few days after admission and they were discharged from the hospital in good health within the fourth day of admission. One of the children ingested 97.5 mg/kg amitriptyline and probably died due to status epilepticus and another child who died ingested 36 mg/kg amitriptyline and died due to cardiopulmonary arrest. In conclusion, our findings showed that initial symptoms and signs of acute amitriptyline intoxication appeared severe, but they disappeared with only supportive care required in most children except for cases that ingested high doses of drug within a few days. In contrast to adults, we infrequently noted respiratory insufficiency, arrhythmia and hypotension in children with acute amitriptyline intoxication.
A Case of Enteric Fever Presenting With Insidious Neuropsychiatric Manifestations
(Elsevier Science inc, 2004) Çaksen, H; Akbayram, S; Odabas, D; Anlar, Ö
A Case of Typhoid Fever Associated With Hemophagocytic Syndrome
(Elsevier Science inc, 2003) Çaksen, H; Akbayram, S; Öner, AF; Kösem, M; Tuncer, O; Atas, B; Odabas, D
Congenital Cytomegalovirus Infection Associated With Anomalies of the Left Foot
(Medecine Et Hygiene, 2005) Ceylan, A; Tuncer, O; Akbayram, S; Çaksen, H; Dogan, M; Gülmehmed, F; Kirimi, E
Deadly Nightshade (Atropa Belladonna) Intoxication
(Arnold, Hodder Headline Plc, 2003) Çaksen, H; Odabas, D; Akbayram, S; Cesur, Y; Arslan, S; Üner, A; Öner, AF
Deadly nightshade (Atropa belladonna) intoxication has been infrequently reported in both children and adults in the literature. In this article, the clinical and laboratory findings of 49 children with acute deadly nightshade intoxication are reviewed. Our purpose was to enlighten the findings of deadly nightshade intoxication in childhood. The most common observed symptoms and signs were meaningless speech, tachycardia, mydriasis, and flushing. None of the children required mechanical ventilation or died in our series. The patients were categorized into two groups, mild/moderate and severe intoxication. Children with and without encephalopathy were accepted as severe and mild/moderate intoxication, respectively. While 43 children were placed in the group of mild/moderate intoxication, six were in severe intoxication group. We found that meaningless speech, lethargy, and coma were more common, but tachycardia was less common in the severe intoxication group (children with encephalopathy) (P < 0.05). In the treatment, neostigmine was used in all children because of no available physostigmine in our country. In conclusion, our findings showed that the initial signs and symptoms of acute deadly nightshade intoxication might be severe in some children, but no permanent sequel and death were seen in children. We also showed that meaningless speech, lethargy, coma, and absence of tachycardia were ominous signs in deadly nightshade intoxication in childhood. Lastly, we suggest that neostigmine may be used in cases of deadly nightshade intoxication if physostigmine cannot be available.
A Girl With a Giant Bladder Stone
(Elsevier Science inc, 2004) Atas, B; Caksen, H; Arslan, S; Akbayram, S; Kirimi, E; Tuncer, O; Kayan, M
Report of a Turkish Child With Sjogren-Larsson Syndrome Associated With Peripheral Nerve Involvement
(Japanese dermatolgical Assoc, 2003) Akdeniz, N; Çalka, Ö; Anlar, Ö; Akbayram, S; Çaksen, H; Metin, A; Çinal, A
Sjogren-Larsson syndrome is a rare hereditary neurocutaneous disorder characterized by ichthyosis, spastic di- or tetra-plegia, and mild to moderate mental retardation. In this article, we present a nine-year-old girl with the classical features of the syndrome associated with peripheral nerve involvement because of its rare presentation. To the best of our knowledge, only three cases of Sjogren-Larsson syndrome with peripheral nerve involvement have been previously reported in the literature. We assume that Sjogren-Larsson syndrome involves extensive disorders of the ectodermal tissues, including the peripheral nerves as well as the skin and the central nervous system.
Report of Eight Children With Amitraz Intoxication
(Arnold, Hodder Headline Plc, 2003) Çaksen, H; Odabas, D; Arslan, S; Akgün, C; Atas, B; Akbayram, S; Tuncer, O
Many pesticides are formulated in organic solvents. An example is amitraz, one of the formamidine groups of pesticidal chemicals. It is commonly used for the treatment of generalized demodicosis in dogs and for the control of ticks and mites in cattle and sheep. In this article, the clinical and laboratory findings of eight children with amitraz intoxication are reviewed. The purpose was to enlighten the findings of amitraz intoxication in children. Of the eight patients, five (62.5%) were boys, three (37.5%) were girls, and the ages ranged from 1 to 4 years. All children accidentally ingested amitraz orally, with no dermal exposure. The most common observed signs were decreased consciousness and bradycardia. Leukocytosis, hyperglycemia, hypernatremia, increased serum aspartate transaminase level, and prolonged partial prothrombin time were diagnosed in children. None of the children had hypothermia, hypotension, or convulsion and none of the patients died. The findings show that the initial signs and symptoms of acute amitraz intoxication appeared severe but they disappeared, with only supportive care needed in most cases within a few days.
Report of Five Children With Guillain-Barre Syndrome Following a Nationwide Oral Polio Vaccine Campaign in Turkey
(Neurol Soc india, 2003) Anlar, O; Tombul, T; Arslan, S; Akdeniz, H; Caksen, H; Gundem, A; Akbayram, S
Five children with Guillain-Barre syndrome (GBS), following a national oral polio vaccination campaign to eradicate disease, are reported. Clinical examination, cerebrospinal fluid and electromyographic findings conformed to the classical description of GBS. Four of them received therapeutic dose of intravenous immunoglobulin G. Two children succumbed to the disease. It was observed that the number of cases of,GBS in children increased during the period of the oral polio vaccination campaign in Turkey, suggesting a causal relationship.
Report of Two Children With Subacute Sclerosing Panencephalitis Displaying an Atypical Clinical Course
(Elsevier Science inc, 2004) Tepebasili, I; Çaksen, H; Odabas, D; Atas, B; Akbayram, S
Silent Stroke in a Case of Β-Thalassemia Major Associated With Chronic Renal Failure and Diabetes Mellitus
(B C decker inc, 2003) Çaksen, H; Odabas, D; Akbayram, S; Öner, AF; Arslan, S; Cesur, Y; Üner, A
Severe anemia, growth retardation, diabetes mellitus, cardiac disorders, and, infrequently, stroke are well-known complications of thalassemia major. We report a girl, age 7 years, 2 months, with beta-thalassemia major associated with chronic renal failure, diabetes mellitus, and cardiomyopathy in whom a silent stroke was noted during follow-up. She was diagnosed with thalassemia major at age 6 months, chronic renal failure at age 3 years, 3 months, and diabetes mellitus and cardiomyopathy at age 7 years. Although cranial computed tomography was found to be normal at the age of 3 years, 3 months, magnetic resonance imaging showed cerebral infarct in the right frontal region at 7 years, 2 months. A thrombophilic panel revealed increased factor VIII and decreased protein C concentrations. She died from disseminated intravascular coagulation at age 7 years, 9 months. We did not record any clinical findings of stroke during her follow-up. We think that diabetes mellitus, dilated cardiomyopathy, and increased factor VIII and decreased protein C concentrations led to the occurrence of cerebral infarct. In conclusion, we emphasize that children with thalassemia major should be monitored closely for stroke. We also suggest that stroke can show a silent progression in severely affected children, as in our case.
Use of Interferon Alpha-2b and Prednisolone in the Treatment of Severe Intractable Diarrhea in a Child With Systemic Mastocytosis
(Blackwell Publishing Asia, 2003) Çaksen, H; Odabas, D; Öner, AF; Cesur, Y; Arslan, S; Akbayram, S; Erol, M