Browsing by Author "Cesur, Y."

Now showing 1 - 20 of 23

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.
The Anthropometric Measurements and Percentile Curves of Children Aged 0-5 Years in Eastern Turkey
(Univ West indies Faculty Medical Sciences, 2021) Sal, E.; Dogan, M.; Cesur, Y.; Ariyuca, S.; Basaranoglu, M.; Kaya, A.; Mazicioglu, M.
Objective: To determine the growth reference value of children in our province and to compare these values with current values of the USA and other local values of our country. Methods: A total of 615 boys and 586 girls with different socioeconomic levels and ages of 0-5 years were included in the study. In all children, weight, height, head circumference, abdominal circumference, hip circumference, mid-arm circumference, and lower segment length were taken. All measurements were performed by the same paediatrician. The lambda-mu-sigma method was used for the preparation of percentile curves. Results: The body weight, head circumference and chest circumference measurements of boys were significantly higher than those in girls. Anthropometric measurements of children in high-income groups were higher than those in the low-income group. All of the anthropometric parameters except upper mid-arm circumference were higher in children fed with breast milk and formula milk than in children who only fed with breast milk. The relation between the mother's education level and anthropometric parameters was insignificant. Conclusion: Our results showed that the anthropometric measurements of our children were similar to those of west Turkey as well as those of the United States. On the other hand, our children's anthropometric measurements were higher than other local values. Relatively high values of height have been interpreted as a genetic feature.
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.
Celiac Disease With Celiac Crisis
(TIP ARASTIRMALARI DERNEGI, 2010) Dogan, M.; Yuca, S.A.; Acikgöz, M.; Doǧan, S.Z.; Kaya, A.; Cesur, Y.
Celiac crisis is a life threatening and very rare complication of Celiac disease. Clinically, it is characterized by severe diarrhea, dehydration and metabolic disturbances like hypokalemia, hypomagnesemia, hypocalcemia, hypoproteinemia. A 2.5-years-old-girl with diarrhea, weight loss, abdominal distention, extremities edema, vomit which occurred after the beginning of supplementary nutrition was presented to emphasize that celiac crisis should be keep in mind in patient with gastrointestinal symptoms, which are best known in celiac disease, metabolic disturbance and abdominal distention.
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.
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.
Circulating Insulin-Like Growth Factor Binding Protein-4 (igfbp-4) Is Not Regulated by Parathyroid Hormone and Vitamin D in Vivo: Evidence From Children With Rickets
(2010) Bereket, A.; Cesur, Y.; Özkan, B.; Adal, E.; Turan, S.; Onan, S.H.; Haklar, G.
Objective: Insulin-like growth factor binding protein-4 (IGFBP-4), inhibits IGF actions under a variety of experimental conditions. Parathyroid hormone (PTH), 1.25-hydroxy(OH)vitamin D, IGF-I, IGF-II and transforming growth factor (TGF)-β are the major regulators of IGFBP-4 production in vitro. However, little is known about the in vivo regulation of circulating IGFBP-4 in humans. Methods: We measured serum concentrations of calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), PTH, vitamin D, IGF-I, IGFBP-3, and IGFBP-4 in infants (n=22) with nutritional rickets before and after treatment of rickets with vitamin D (300 000 U single dose po). Results: The mean±SD age of the patients was 1.3±1.6 years (range 0.2-3). Serum Ca and P increased, whereas ALP and PTH decreased after treatment (Ca from 6.6±1.4 to 9.5±1.6 mg/dL, P from 3.9±1.4 to 5.4±0.8 mg/dL, ALP from 2590±2630 to 1072±776 IU/mL and PTH from 407±248 to 27.4±20.8 ng/dL, respectively). Vitamin D levels were low (7.8±2.5 ng/mL) and increased after treatment (18.1±4.0 ng/mL, p<0.001). Serum IGF-I and IGFBP-3 levels both increased after treatment (IGF-I: 13.5±12.2 vs. 23.7±14.2 ng/mL, p<0.001 and IGFBP-3: 1108±544 vs. 1652±424 ng/mL, p<0.001). However, serum IGFBP-4 levels did not change significantly after treatment (18.8±8.0 vs. 21.5±4.8 ng/mL). No correlation between PTH and IGF-I, IGFBP-3 or IGFBP-4 was detected. Significant correlations were observed between PTH and ALP (r=0.53, p<0.05), and between IGF-I and IGFBP-3 (r=0.46, p<0.05). Conclusion: The results demonstrate that contrary to in vivo studies, circulating IGFBP-4 levels are not influenced by secondary hyperparathyroidism in vitamin D deficiency rickets since IGFBP-4 levels did not change after normalization of PTH with vitamin D treatment. © Journal of Clinical Research in Pediatric Endocrinology, Published by Galenos Publishing.
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.
Congenital Primary Hypothyroidism Associated With the Rare Form of Nonimmune Hydrops Fetalis
(2010) Yuca, S.A.; Cesur, Y.; Kirimi, E.; Sari, S.; Kaya, A.; Doǧan, M.
We present a male newborn born with diffuse edema and ascites. A diagnosis of congenital primary hypothyroidism was made based on thyroid hormone levels of total T4 1.74 μg/dL, free T4 0.30 ng/dL and TSH >75 μIU/mL and thyroid hormone replacement therapy was initiated. At day 15 of therapy, the thyroid function tests of the patient reached normal limits, and his edema and ascites regressed. In this report we present a newborn case of hypothyroidism that was accompanied by nonhydrops fetalis. We want to emphasize that congenital hypothyroidism may present with severe symptoms such as hydrops.
Drug Allergy
(1999) Ceylan, A.; Cesur, Y.; Rastgeldi, L.
The numbers of drugs used for therapy are increasing every day and the risk of allergy is rising. Medicines which have different chemical structure cause a lot of reactions. Allergic symptoms related to the drugs change from simple to fatality. Especially, peniciline allergy may be fatal. The drug allergies is reviewed summarize in this article.
The Effect of 25-Hydroxyvitamin D3 on the Immune System
(Freund Publishing House Ltd, 2009) Dogan, M.; Erol, M.; Cesur, Y.; Yuca, S.A.; Zehra Doǧan, S.
Aim: To examine the effect of 25-OH vitamin D3 on the immune system in patients with nutritional rickets. Methods: Fifty-three patients were included in our study between April 2002 and March 2004. Diagnosis of rickets was based on clinical, biochemical and radiological examinations. Cell surface markers (CD), complement factors (C), and immunoglobulin (Ig) levels were determined to find out any relationship between rickets and immune system deficiency. Results: Among the causes of admission to hospital, fever (66%) and coughing (62.2%) were the most frequent. Pneumonia was accompanied by rickets in 47.1% of the cases. Plasma CD4 levels before the treatment were higher than those in the post-treatment period, whereas CD20 and CD56 levels were lower. Conclusion: B cell and natural killer cell reduction which occur because of vitamin D deficiency may contribute to the development of pneumonia and other infections in patients with nutritional rickets. © Freund Publishing House Ltd.
Ellis-Van Creveld Syndrome
(TIP ARASTIRMALARI DERNEGI, 2008) Cesur, Y.; Yuca, S.A.; Üner, A.; Yuca, K.; Arslan, D.
Ellis-van Creveld syndrome (EVCS) or chondroectodermal dysplasia is a rare autosomal recessive disorder characterized by a variable spectrum of clinical findings. Classical EVC syndrome comprises a tetrad of clinical manifestations of chondrodystrophy, polydactyly, ectodermal dysplasia, and cardiac defects. The patient presented with short stature, polydactyly, triangular face and dental dismorphism was found appropriately as radiographic with ectodermal dysplasia. In addition to the presence of single atrium, mitral, tricuspid and pulmonary valve insufficiency and pulmonary hypertension wererevealed by echocardiography. Her history involved a sister who was dead in 3-month-ages.
Homozygous Familial Hypercholesterolemia
(2001) Cesur, Y.; Caksen, H.
Oxidant/Antioxidant System Markers and Trace Element Levels in Children With Nutritional Rickets
(2012) Doǧan, M.; Cesur, Y.; Doǧan, S.Z.; Kaba, S.; Bulan, K.; Cemek, M.
Objective: To determine the oxidative stress and trace element levels in vivo in patients with nutritional rachitism associated with vitamin D deficiency. Materials and method: A total of 30 patients, 18 males and 12 females, were included in the study. Age, sex, medical history, vital, and physical examination findings of each patient documented at presentation were recorded. Serum calcium, phosphorus, alkaline phosphatase, parathormone, and 25-OH vitamin D levels, as well as oxidant and antioxidant system parameters and trace element levels were studied. After being diagnosed with rachitism, the patients were administered a single dose of 300,000 IU vitamin D by intramuscular injection. The same analyses were repeated post-treatment. Thirty children with normal anthropometric measurements were included as the control group. The analyses described above were performed only once for the control group. Results: Serum calcium, phosphorus, alkaline phosphatase, parathormone, and 25-OH vitamin D levels were different between the controls and children in the patient group (p <0.001). Analysis of trace element levels demonstrated markedly lower pretreatment zinc levels for the patient group compared to the controls, with a statistically significant difference (p =0.001). Comparison of pretreatment oxidant and antioxidant system markers between the patient and control groups demonstrated higher values for vitamin C, β-carotene, reduced glutathione, and superoxide dismutase in the control group, whereas MDA was higher in the patient group. Conclusion: The present study demonstrated increased oxidative stress, reduced antioxidant defence system in patients with nutritional rachitism, with reduced oxidative stress and a pronounced improvement in the antioxidant system with vitamin D treatment.
Prevalence of Overweight and Obesity in Children and Adolescents in Eastern Turkey
(2010) Yuca, S.A.; Yilmaz, C.; Cesur, Y.; Doǧan, M.; Kaya, A.; Başaranoǧlu, M.
Objective: The aim of this study was to estimate the prevalence of overweight and obesity in school children in Eastern Turkey. Methods: This study included 9048 school children aged 6-18 years. The subjects were classified as overweight and obese, according to the International Obesity Task Force. Results: We found prevalence of overweight of 11.1% in the studied population. It was detected that 2.2% of the population in the study was obese; 2.1% of males and 2.3% of females. While the prevalence of obesity was extremely low before 9 ages and after 15, it reached to high values at puberty and just before pubertal period in boys. The prevalence of overweight was higher in girls and reached to peak point at pubertal ages. Generally, the prevalence of obesity and overweight was slightly higher in girls than in boys, although the boys were more obese in prepubertal ages. Conclusion: Overweight and obesity are concerns for children and adolescents in low socio-economic status regions as well. © Journal of Clinical Research in Pediatric Endocrinology.
Psychotic Disorder, Hypertension and Seizures Associated With Vitamin B12 Deficiency: a Case Report
(Sage Publications Ltd, 2012) Dogan, M.; Ariyuca, S.; Peker, E.; Akbayram, S.; Dogan, S. Z.; Ozdemir, O.; Cesur, Y.
This report highlights a rare presentation of vitamin B-12 deficiency (concurrent psychotic disorder, seizures and hypertension). A 16-year-old girl presented with nervousness that had been persisting for 2 weeks. She had stopped eating and there was decreased self-care and she could not walk and sleep. Two days prior to admission, generalized tonic clonic convulsions were noted. On physical examination, vital signs were normal, except for hypertension (150/100 mm Hg). She did not respond to conversation; she could not answer the questions. Mood was depressive and hallucinations were noted. Laboratory analyses were normal, except for a low vitamin B-12 level (<150 pg mL(-1)). The patient was not given any treatment of hypertension, psychosis or seizures, except vitamin B-12 injections. After that, she showed improvement within 1 week. In the 7 days of hospitalization, the arterial blood pressure returned to normal, psychotic symptoms were resolved, the visual hallucinations and the depressive mood subsided, and she could eat and speak clearly. No hypertension or convulsions have been detected on the control examinations, and she has now been followed-up without any symptoms or findings. In conclusion, with this report we emphasized that psychosis, seizures and hypertension can be a rare manifestation of vitamin B-12 deficiency, which is reversible with therapy and serum vitamin B-12 level should be checked in patients who do not have an obvious cause for psychosis, seizures or hypertension.
Rickets in Healthy Adolescents in Van, the Eastern of Turkey
(TIP ARASTIRMALARI DERNEGI, 2010) Üner, A.; Acar, M.N.; Cesur, Y.; Doǧan, M.; Çaksen, H.; Temel, H.; Özbek, H.
Aim: To investigate the ratio of rickets and vitamin D deficiency in healthy adolescents at Van region. Method: Totally 126 cases were included in this study. All cases were evaluated for the presence of rickets symptoms, daily sun exposure, and vitamin usage, covering and eating habit. Diagnosis of rickets was made based on biochemical findings. The children whose vitamin D levels were lower than 10 ng/dl were accepted as vitamin 25(OH)D3 deficiency, but whose levels between 10-20 ng/dl were accepted as vitamin D insufficiency. Result: Sixty girls (47.6%) and 66 boys (52.4%) were included in this study. They were between 9 and 17 years old (11.94 ± 1.9 years). Vitamin D levels in 60 (47.6%) cases were normal, but 48 (38.1%) cases had rickets, 13 (10.3%) cases had vitamin D insufficiency and 5 (4.0%) cases had vitamin D deficiency. There was no statistically significant difference in the incidence of rickets between the cases with or without covered-dress. However, there was a significant difference in the incidence of vitamin D insufficiency (p<0.05). All of the cases had less daily calcium, phosphorus, protein and vitamin D intake than recommended daily amount. In the rickets group, alkaline phosphatase levels were significantly higher comparing with the others (p<0.05), but there was no difference in plasma intact parathyroid hormone levels. Conclusion: Our findings revealed that most adolescents who appeared to be healthy (52.4%) could have vitamin D insufficiency. Therefore, we believe that dietary education and/or vitamin D prophylaxis might be given to all adolescents. However, more extensive researches should be done to elucidate of our suggestion's correction.
Scurvy Is an Important Problem in the East of Anatolia, Turkiye: Three Cases Report
(2010) Ari Yuca, S.; Yilmaz, C.; Cemek, M.; Cesur, Y.; Çaksen, H.
Scurvy is a multisystemic nutritional disorder which synthesis of collagen is destructed due to deficiency of vitamin C and its characteristic findings on hematological system and bone. Scurvy may occur at any age, frequently in infants aged 6-24 months. It is usually affected in children with severely developmental problems and suffered from malnutrition. Causes of inadequate ascorbic acid in infancy are usually starting weaning late, giving limited fresh fruits and vegetables, and mistakes in preparing foods. There is general tenderness, frog position at legs, edematous swelling along the shafts of legs, subperiosteal hemorrhage at the knees joints in with scurvy patients. Petechial hemorrhages may occur in skin and mucous membranes. The diagnosis of scurvy is usually based on the characteristic clinical picture, the roentgenographic changes in the long bones, and history of inadequate intake of ascorbic acid in infancy. We described here, three children with suffered from scurvy who had markedly vitamin C deficient in their diets. We wish to emphasize that, it is still a problem among malnutrition children in our country. Copyright © 2010 by Türkiye Klinikleri.
Serum Immunoglobulins and Immunoglobulin G Subclasses With Recurrent Wheezing
(The Indian Journal of Pediatrics, 2000) Öner, A.F.; Çaksen, H.; Çelik, A.; Cesur, Y.; Üner, A.; Arslan, S.
In this study serum immunoglobulins (Ig) and IgG subclasses were measured in 42 patients (ranging 9 month-6 year) with recurrent wheezing and in 37 healthy children determined the relationship between serum Igs and recurrent wheezing. Patients were divided into two groups according to the age [9 month-2 year (n: 15), and 2-6 year (n: 27)]. In the patients placed in 9-24 month age group, serum IgG4 level was found to be lower than controls (p<0.05). But there was not a significant difference in mean serum concentrations of total IgG, IgA, IgM, IgE, IgG1, IgG2 and IgG3 subclasses between the groups (P>0.05). In the 25 month-6 year age group the mean IgE level was increased compared to the control while IgG3 and IgG4 levels were decreased (p<0.05). On the other hand, in the 9-24 month age group there was no significant difference between the patients and controls for IgG subclasses deficiency (P>0.05). However, significant difference in IgG subclasses deficiency was present between the patients and controls in the 25 month-6 year group (P<0.001). In conclusion, our findings suggest that wheezing in childhood may be associated with low IgG3 and/or IgG4, and in older children high IgE level may be a part of pathogenetic mechanism in patients with recurrent wheezing.
Serum Insulin-Like Growth Factor-I and Insulin-Like Growth Factor Binding Protein-3 Levels in Children With Zinc Deficiency and the Effect of Zinc Supplementation on These Parameters
(Walter de Gruyter GmbH, 2009) Cesur, Y.; Yordam, N.; Doǧan, M.
Aim: To determine the effect of zinc (Zn) therapy on serum insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) levels in children with Zn deficiency and growth retardation, but without systemic disease, and to investigate the effect of Zn supplementation on these parameters. Methods: Twenty-nine children (11 girls and 18 boys) were included. Blood samples were obtained for serum IGF-I and IGFBP-3 determination before and after 50 mg/day Zn supplementation for two months. Results: The mean age of the children was 11.0 ± 3.1 years (range 3.7-16.2 years). Serum IGF-I and IGFBP-3 levels were below the mean values in 28 (96.6%) and all children, respectively. After Zn therapy, serum IGF-I levels were increased in 62% of the children; this increase was statistically significant in 48.3% of the children. Serum IGFBP-3 levels were significantly increased in 10 children. There was a positive correlation between serum Zn level and bone age, and serum IGF-I and IGFBP-3 levels. A positive correlation was present between BMI (r = 0.485, p <0.001) and serum IGF-I levels before therapy. Conclusion: Serum IGF-I and IGFBP-3 levels were decreased in children with Zn deficiency, and were increased after Zn supplementation. In addition, after Zn supplementation, increment of serum IGF-I levels was found to be higher in children with low BMI than those with normal BMI; therefore, the nutritional status of children may also be important, as well as Zn supplementation. Additionally, the determination of higher variation percentile of serum IGF-I level in prepubertal children compared to pubertal children was an interesting finding and necessitates further investigation. © Freund Publishing House Ltd.