Browsing by Author "Caksen, H."

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Acute Motor Axonal Neuropathy Cases in Van Region
(Comenius Univ, 2011) Sayin, R.; Tombul, T.; Gulec, T. C.; Anlar, O.; Akbayram, S.; Caksen, H.
Acute motor axonal neuropathy (AMAN) is a form of Guillain Barre Syndrome (GBS) seen in summer months in Northern China to cause epidemics. This form of the disease, which is also sporadically observed in other countries, constitutes less than 5 % of GBS in Western countries. It usually develops with motor findings. No sensory findings are observed. In some of the cases, the severe impairments in tissues improve however slowly and inadequately. In the motor conduction studies of cases with AMAN, motor action potential values are lowered. On needle electromyography (EMG), motor unit potential (MUP) activity is diminished with spontaneous denervation findings. Investigations were conducted on nerve conduction of patients with GBS aged from 1 to 77 years. AMAN was detected in 25 of these patients. In our investigation, AMAN as a GBS variant was detected in 39.7 % of the patients. The conduction velocities of motor nerves were in normal ranges whereas combined muscle action potentials were significantly lower. No F response could be obtained. Although AMAN is a rare variant of GBS and shows different clinical courses, it has been brought under intense scrutiny since there is high prevalence of acute inflammatory neuropathies in our region (Tab. 1, Ref. 7). Full Text in free PDF www.bmj.sk.
Acute Respiratory Distress Syndrome Due To Overdose Desferrioxamine: Report of a Child
(2005) Atas, B.; Caksen, H.; Tuncer, O.; Oner, A.F.; Kirimi, E.; Akbayram, S.
In this article, we present an 18-month-old girl with acute iron poisoning who died from acute respiratory distress syndrome due to overdose of desferrioxamine. Our purpose is to emphasize the importance of close follow-up of children with acute iron poisoning for desferrioxamine toxicity.
Asymmetric Crying Facies
(2000) Caksen, H.
Budd-Chiari Syndrome in a Patient Heterozygous for Both Factor V Leiden and the G20210a Mutation on the Prothrombin Gene
(Schattauer GmbH, 1999) Oner, A.F.; Arslan, S.; Caksen, H.; Ceylan, A.
A Case of Acute Disseminated Encephalomyelitis Mimicking Leukodystrophy
(2010) Kaya, A.; Acikgoz, M.; Ustyol, L.; Avcu, S.; Sal, E.; Okur, M.; Caksen, H.
Acute disseminated encephalomyelitis (ADEM) is a monophasic, immune-mediated demyelinating disorder that can follow immunizations or more often infections including rubeola, rubella, varicella, herpes zoster, mumps, Mycoplasma pneumoniae, or, more commonly, other nonspecific upper respiratory tract infections. Documentation of a preceding illness is not required to make this diagnosis. This report examines the case of a 9-month-old male patient presenting with the features of an acute leukodystrophy following innoculation with the mixed vaccine Pentaxim (Sanofi Pasteur, LyonFrance) while suffering from a lower respiratory tract infection, and who was eventually diagnosed as ADEM. The case is presented as a reminder that ADEM can sometimes be linked to lower respiratory tract infection and vaccination, and that the features in such cases can be confused with leukodystrophy.
A Case of Infantile Cortical Hyperostosis
(2001) Caksen, H.; Cesur, Y.; Odabas, D.; Aslan, H.; Rastgeldi, L.
Infantile cortical hyperosteosis (ICH) is usually a self-limited disease of infancy with bony changes, soft tissue swelling, fever, irritability, decreased appetite, and decreased movement of the affected bones. Its description in isolated patients or in multiple members of families suggests the existence of two different forms, namely a sporadic form and a familial form with incomplete penetrance. In this article, we report a 2.5-month-old girl with ICH of sporadic form, due to unusual presentation.
A Case of Neurobrucellosis With Hydrocephaly
(Univ West indies Faculty Medical Sciences, 2013) Yilmaz, C.; Kaya, A.; Guven, A. S.; Yilmaz, N.; Caksen, H.
Ceftriaxone Induced Thrombocytopenia in a Child
(Comenius Univ, 2011) Akbayram, S.; Akgun, C.; Dogan, M.; Caksen, H.; Oner, A. F.
A variety of diseases, hereditary conditions, toxins and drugs may cause thrombocytopenia. Thrombocytopenia induced by ceftriaxone has been rarely reported. In this case, ceftriaxone-induced thrombocytopenia is presented in a 2-year-old girl due to rare presentation (Ref. 10). Full Text in free PDF www.bmj.sk.
Central Nervous System Involvement in a Case of Familial Hemophagocytic Lymphohistiocytosis With Perforin Mutation
(Medecine Et Hygiene, 2011) Akbayram, S.; Akgun, C.; Dogan, M.; Caksen, H.; Okur, H.; Oner, A. -F.
Central nervous system involvement in a case of familial hemophagocytic lymphohistiocytosis with perforin mutation: Familial hemophagocytic lymphohistiocytosis (FHL) is a rare autosomal recessive lethal condition characterized by fever, cytopenia, hepatosplenomegaly and hemophagocytosis. The presence of central nervous system involvement has a profound impact on the prognosis, treatment, and clinical outcome of the disease. Therefore, the identification of the clinical manifestations of the disease and the characterization of the accompanying neurological symptoms are of prime importance for the rapid diagnosis and subsequent clinical management of the disease. Herein, we report a case of FHL with homozygosity for perforin gene mutation, who presented with central nervous system involvement in the absence of systemic findings.
Childhood Brucellosis: a Retrospective Study of 103 Cases
(1999) Arslan, S.; Oner, A.F.; Caksen, H.; Cesur, Y.; Ceylan, A.; Atas, B.; Abuhandan, M.
In this study, the clinical and laboratory findings of 103 patients who were followed in our hospital with the diagnosis of brucellosis in our hospital were reviewed retrospectively. Our purpose was to determine the initial drug combination used in its treatment, and to stress the importance of this disease as a public health problem in Turkey, particularly in the Van region. Of the 103 patients, 52 were female and 51 were male. The patients' ages ranged from 20 months to 16 years (mean 8.31 ± 3.58 years). The most observed symptoms were fever (55.3%), arthralgia (53.3%), malaise (41.7%) and loss of appetite (30%). The most observed signs were hepatosplenomegaly (22.5%), hepatomegaly (20.5%), arthritis (17.4%) and splenomegaly (15.5%). Anemia was present in 18 (17.4%) patients, leukopenia in eight (7.7%), and leukocytosis in 15 (14.5%). Erythrocyte sedimentation rate was studied in 84 (81.5%) patients; it was higher than 20 mm/hour in 52 (61.9%) patients. Liver function tests were studied in 55 (53.3%) patients; AST (aspartate aminotransferase) and ALT (alanine amino transferase) were abnormal in 31 (56.3%) and in 55 (53.3%) patients respectively. Brucella agglutination test was 1/160 or higher in all patients; it was ≥1/320 in most patients (83.5%). In the treatment, 12 types of drug combination used, primarily rifampin + co- trimoxazole, rifampin + tetracycline and streptomycin + co-trimoxazole. All except seven patients were successfully treated with the initial drug combination used. For the these seven patients, the initial drugs were changed for different drug regimens. There was no difference between the drug combination and recovery ratio (p>0.05). No relaps were noted.
Chronic Mercury Poisoning: Report of Two Siblings
(2010) Yilmaz, C.; Okur, M.; Geylani, H.; Caksen, H.; Tuncer, O.; Ataş, B.
Mercury exists as organic inorganic and elementary forms in nature and is one of the most toxic metals that are poisonous for human beings. Mercury is commonly used in many different sectors of industry such as in insects formulas, agriculture products, lamps, batteries, paper, dyes, electrical/electronic devices, jewelry, and in dentistry. In this study, two siblings (one a 7-year-old boy and the other a 13 years old girl) are reported who developed chronic mercury poisoning as a result of long-term contact with batteries. Our aim is to emphasize the importance of mercury poisoning that is extremely rarely seen in childhood.
Clinical Presentation and the Efficacy of Antiepileptic Therapy in the Patients With Partial and Generalized Epilepsy
(2011) Sayin, R.; Tombul, T.; Anlar, O.; Caksen, H.
Epilepsy is an abnormal recurrent disease, resulting from various disorders of central nervous system. In this study, we aimed to compare the patients in terms of therapeutic efficiency. We enrolled a total of 106 patients in the study and of them, 45 were male and 61 were female, aged between 2 to 52 years. Of these patients, 69 (65%) had partial and 37 (35%) had generalized seizures. Seventy three patients were being treated with monotherapy and 33 patients were being treated with polytherapy. The number of the patients that were taking monotherapy was higher in the pediatric group (age, 0 to 16) compared to adult group (age, above 16). In the study, we tried to express the importance of monotherapy in the pediatric patients, the higher number of the pathologies that can be detected using an imaging method in the patients with partial epilepsy compared to that of generalized epilepsy, and the most frequent occurrence of therapeutic resistance in the partial epilepsies, ©2011 Academic Journals.
Comparison of Nifedipine and Captopril in Children With Pulmonary Hypertension Due To Broncopneumonia
(Oxford Univ Press, 2008) Uner, A.; Dogan, M.; Demirtas, M.; Acikgoz, M.; Temel, H.; Kaya, A.; Caksen, H.
This study included 40 children, who were diagnosed with pneumonia and pulmonary hypertension (from the radiographic and clinical features), was performed at Yuzuncu Yil University Faculty of Medicine, Department of Pediatrics, from September 2003 to July 2005. Patients who had pneumonia and congenital heart disease or systemic hypertension or renal and liver disease together were excluded from the study. Blood gas analysis and oxygen concentration, measured with pulse oximetry, were performed in all patients. Besides chest X-ray, electrocardiography and echocardiographic search was also carried out. Echocardiographic examination was performed by using M mode, two-dimensional echocardiography and colored Doppler sonotron Vingmed CFM 725. At echocardiographic examination, pulmonary hypertension is defined as above 35 mmHg of pulmonary artery pressure. For echocardiographic examination, patients with pulmonary hypertension were divided into two groups. Captopril (2 mg/kg/day, three doses a day) and nifedipine (0.5 mg/kg/day, three doses a day) were given to the first and the second group, respectively. Echocardiography was performed daily until normal pulmonary artery pressure was achieved. At the beginning of the treatment, the patients were treated with double antibiotics and antibiotic change was carried out in needed cases at the follow up. Digoxin was administered to the cases of respiratory infection with heart failure.
Congenital Myasthenic Syndrome: a Case Report
(Medecine Et Hygiene, 2011) Ceylan, A.; Tuncer, O.; Sayin, R.; Peker, E.; Caksen, H.; Sari, S.
Congenital myasthenic syndrome: a case report: Congenital myasthenic syndromes (CMS) are diseases of the neuromuscular junction. They usually belong to the disease groups that begin in the infantile or childhood period and carry genetic characteristics. The following is important in establishing the diagnosis of this disease: clinical findings, electromyography, genetic tests, determination of serum acetylcholine receptor antibodies. Acetylcholine esterase inhibitor drugs are used in treatment of CMS. A seven-month old male patient was brought to our department with the complaints of difficult breathing, falling of the eyelids and swallowing difficulty. With clinical and laboratory findings, he was diagnosed with congenital myasthenia and treatment was started. CMS should be suspected in patients with no pathological findings on the physical examination, and normal chest X-rays.
Cyanide Intoxication With Encephalitis Clinic: a Case Report
(2006) Dogan, M.; Yilmaz, C.; Kaya, A.; Caksen, H.; Taskin, G.
Cyanide intoxication is one of the most dangerous poisonings and may occur by oral, respiratuary and dermal routes. Central nervous system is the most susceptible region to acute cyanide intoxication. A 3.5-yearsold-girl was brought to our pediatric emergency polyclinic with complaints of fever, dullness and convulsion. On physical examination, lethargy and agitation, increased deep tendon reflexes and bilateral extensor plantar response were determined. On brain magnetic resonance imaging, increased signal intensity and decreased diffusion in bilateral basal ganglia on T2-fluid-attenuated inversion-recovery sequences were determined. The patient diagnosed as intoxication or encephalitis was taken to intensive care unit. Gastric lavage was performed and activated charcoal and acyclovir were given. After these managements, it was learnt that she had eaten a lot of apricot, plum and seed of apricot before the complaints. Therefore, she was diagnosed as cyanide intoxication and hydroxycobalamin treatment was given for five days. Our aim is to emphasize that in patients who were brought with symptoms and signs of encephalitis, intoxications also should be thought in differential diagnosis; therefore, we want to underline once again that taking detailed anamnesis is very important.
Do Not Overlook Pendred's Syndrome in Children With Sensorineural Hearing Loss
(Medquest Communications LLC, 2001) Caksen, H.
The Effectiveness of Unilateral Tonsillectomy in Chronic Adenotonsillar Hypertrophy
(2005) Kutluhan, A.; Caksen, H.; Yurttaş, V.; Kiriş, M.; Yuca, K.
OBJECTIVES: This study sought to determine whether unilateral tonsillectomy was effective in the treatment of chronic adenotonsillar hypertrophy. PATIENTS AND METHODS: A total of 197 patients (96 girls, 101 boys) with chronic adenotonsillar hypertrophy were prospectively included. The patients were randomly assigned to either bilateral tonsillectomy (n=113; mean age 10.1 years; range 4 to 18 years) or unilateral tonsillectomy (n=84; mean age 4.5 years; range 3 to 8 years) performed with or without adenoidectomy. All the patients were followed-up for at least a year. RESULTS: The two groups did not differ significantly with respect to preoperative symptoms, the size of tonsils, and the presence of adenoid hypertrophy. At the end of the follow-up, no significant differences were found with respect to relief of snoring, mouth breathing, and upper airways obstruction between the two groups. A greater number of patients achieved complete improvement in snoring in the bilateral tonsillectomy group (p<0.05). With unilateral tonsillectomies, three patients required tonsillectomy to the other side, two had recurrent tonsillitis, and one had severe compensatory hypertrophy with persistent difficulty in inspiration and mouth breathing. CONCLUSION: Unilateral tonsillectomy seems to be as effective as bilateral tonsillectomy in the treatment of chronic adenotonsillar hypertrophy.
Evaluation of Children With Neurobrucellosis
(Comenius Univ, 2012) Akbayram, S.; Dogan, M.; Peker, E.; Bektas, M. S.; Caksen, H.; Karahocagil, M.
Background: Brucellosis is an endemic disease in many areas throughout the world. Central nervous system involvement is a serious complication of brucellosis with a ratio of 4-11% of all patients. Aim: to describe our experience in diagnosis, treatment, and outcome of 25 pediatric patients with neurobrucellosis. Patients and methods: This study included a review of medical records of patients who were diagnosed with neurobrucellosis between March 2001 and March 2009. Patients who had both clinical findings consistent with neurobrucellosis and positive microbiologic/serologic examinations of CSF with abnormal CSF findings were enrolled in the study. Results: The study included 25 patients between 1 and 15 years of age (mean 8.8 years), while 15 were males and 10 were females. Most of the patients (52 %) were in the age group of 5-9 years with male predominance. The distribution of cases showed density in June and February. The most commonly presented complaints were headache, fever and sweating while the most commonly observed findings were fever and meningeal irritation signs. All patients had positive cerebrospinal fluid agglutination test for brucellosis. Four different regimens were used based on ceftriaxone, doxycycline, cotrimoxasole, streptomycin, and rifampicin. One patient died, three patients were discharged with sequel, and the remaining patients (84 %) were discharged with full recovery. Conclusion: Clinicians, especially those providing health services in endemic areas like Turkey, should keep in mind that neurobrucellosis can be involved in patients with unexplained symptoms like memory impairment or in patients diagnosed with meningitis (Tab. 5, Fig, 2, Ref. 39). Full Text in PDF www.elis.sk.
Evaluation of Lymphocyte Subgroups in Children With Subacute Sclerosing Panencephalitis
(Sage Publications Ltd, 2009) Yilmaz, C.; Yuca, S. A.; Yilmaz, N.; Oner, A. F.; Caksen, H.
The aetiology of subacute sclerosing panencephalitis (SSPE) remains to be fully elucidated, although it follows infection with a hypermutant defective M-protein measles virus. This study analysed peripheral blood lymphocyte subgroups to determine their role in the pathophysiology of SSPE. It included 22 children with SSPE aged 2 - 15 years (patient group) and 22 age- and gender-matched healthy children (control group). In children < 6 years old, there were no statistically significant differences between the two groups in the proportions of lymphocytes expressing the surface markers CD3, CD8, CD19 or CD16/56, or in CD4/CD8 ratio. The proportion of CD4(+) lymphocytes in SSPE patients < 6 years of age was significantly lower compared with the control group. In children >= 6 years old, there were no significant differences in the lymphocyte subgroups. In conclusion, these findings suggest that a low CD4(+) lymphocyte count might be responsible for SSPE in younger children.
Food-Borne Botulism Cases in Van Region in Eastern Turkey: Importance of Electromyography in the Diagnosis
(2003) Anlar, O.; Irmak, H.; Tombul, T.; Akdeniz, H.; Caksen, H.; Kose, D.; Ceylan, A.
Objectives: Food-borne botulism is an acute form of poisoning that results from ingestion of a toxin produced by Clostridium botulinum. Botulism toxin causes its major effect by blocking neuromuscular transmission in autonomic and motor nerve terminals. Methods: In this study, we present the features of eleven cases of food-borne botulism admitted to our hospital in 2001. All of the cases were caused by home-prepared foods; green beans. In these cases, the main symptoms and signs were generalized muscular weakness, dry mouth, dysphagia, dispnea and diplopia. Electrophysiological studies were performed on four patients. Results: Motor conduction studies showed that compound muscle action potentials were decreased with normal latencies and conduction velocities. The needle electromyography showed signs of denervation potentials like fibrillation and positive waves in four patients. Repetitive nerve stimulation with high frequency (20 Hz) induced an increment close to 100% in the amplitudes in 2 of 4 patients. Conclusion: Although toxin could not be detected in the patients, the electromyographic findings supported our diagnosis. We concluded that electromyography has an important role in diagnosis of botulism, especially in the condition that serologic tests are negative or cannot be performed.