Browsing by Author "Cesur, Yasar"

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Alstrom Syndrome Associated With Cerebral Involvement: an Unusual Presentation
(Modestum Ltd, 2006) Yilmaz, Cahide; Caksen, Huseyin; Yilmaz, Nebi; Guven, Ahmet Sami; Arslan, Derya; Cesur, Yasar
Alstrom 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.
Assessment of Nutritional Status: Triceps and Subscapular Skin-Fold Thickness in Turkish Children and Adolescent
(Professional Medical Publications, 2011) Yuca, Sevil Ari; Cesur, Yasar; Yilmaz, Cahide; Mazicioglu, Mumtaz; Kurtoglu, Selim
Objectives: To determine the mean and percentile values and constitute the percentile curves of the triceps and subscapular skin-fold thickness (SFT) for obtaining a measure to be used in evaluating nutritional status of children and adolescents for age and gender to determine the threat of adiposity in Turkish children. Methodology: This cross-sectional study was carried out between October 2006 and May 2007 with 6917 students selected among those with pre-defined socio-economic criteria and attending primary schools in Van city center. Based on these data, the subjects were distributed to age groups in 6-month intervals, beginning from the age of 7 up to the age of 17. Results: Analysis of mean values of the thickness of triceps and subscapular SFT according to age in boy subjects demonstrated that these values generally increased with age up to thirteen years of age where peak values were observed, and the thickness decreased between 14 and 15 years of age, increasing again thereafter. A comparison of our data with the data reported from other countries revealed lower than median values of triceps and subscapular SFT in our study for both girls and boys regardless of the age group. Conclusions: Subcutaneous fat accumulation is lower in Turkish children compared to those in other countries and no risk of obesity is imminent, at least in the region where this study was carried out.
Association of Pulmonary Hemosiderosis and Celiac Disease
(Nobel Ilac, 2011) Dogan, Murat; Bektas, Mehmet Selcuk; Dogan, Sekibe Zehra; Aktar, Fesih; Cesur, Yasar
Idiopathic pulmonary hemosiderosis (IPH) is a rare disease of unknown autoimmune etiology mainly affecting children and adolescents. We report the case of an 6-years-old boy with cough and tiredness. There were no gastrointestinal symptoms were not determined. Body weight and height were in normal percentiles. Physical examination revealed cutaneous and mucosal pallor, due to severe anemia (hemoglobin 3 g/dL). Infiltrations were seen at the chest X-rays at both lungs, but markedly at left lung. In sputum examinations, hemosiderin-laden macrophages were seen. The diagnosis of IPH was made. The association of IPH and Celiac disease (CD) is well known. Searching associated CD was performed and then confirmed by biological and histological examinations. A gluten-free diet was initiated. Evolution was favorable. Searching for CD in IPH should be done, even in the absence of gastrointestinal symptoms.
Avian Influenza a (H5n1) Infection in Eastern Turkey in 2006
(Massachusetts Medical Soc, 2006) Oner, Ahmet Faik; Bay, Ali; Arslan, Sukru; Akdeniz, Hayrettin; Sahin, Huseyin Avni; Cesur, Yasar; Ceyhan, Mehmet
Background: An outbreak of highly pathogenic avian influenza A (H5N1) that had previously been detected throughout Asia, with major economic and health repercussions, extended to eastern Turkey in late December 2005 and early January 2006. Methods: We documented the epidemiologic, clinical, and radiologic features of all cases of confirmed H5N1 virus infection in patients who were admitted to Yuzuncu Yil University Hospital in Van, Turkey, between December 31, 2005, and January 10, 2006. Results: H5N1 virus infection was diagnosed in eight patients. The patients were 5 to 15 years of age, and all eight had a history of close contact with diseased or dead chickens. The mean (+/- SD) time between exposure and the onset of illness was 5.0 +/- 1.3 days. All the patients had fever, and seven had clinical and radiologic evidence of pneumonia at presentation; four patients died. Results of enzyme-linked immunosorbent assay and rapid influenza tests were negative in all patients, and the diagnosis was made by means of a polymerase-chain-reaction assay. Conclusions: H5N1, which causes a spectrum of illnesses in humans, including severe and fatal respiratory disease, can be difficult to diagnose.
A Case of Congenital Hypothyroidism Presented With Dysmyelinization Findings
(Elsevier Science Bv, 2014) Yuca, Sevil An; Yilmaz, Cahide; Kaya, Avni; Ustyol, Lokman; Sal, Ertan; Cesur, Yasar; Caksen, Huseyin
The central nervous system is one of the most crucial targeted systems of hyphotiroidism where tissues undergo various broad developmental processes such as neuronal and glial cellular differentiation, migration and myelinization. However brain images are mainly normal. In this articlel. we present findings related to a 1-year-old girl who has been referred to our outpatient he clinic with complaints of slowing of movement and lack of interest. She was diagnosed with hypothyroidism. Her brain magnetic resonance image obtained during diagnosis displayed dysmyelinization. It showed improvement after Na-L thyroxin therapy during follow up.
Cerebral Venous Sinus Thrombosis in 2 Children With Celiac Disease
(Sage Publications inc, 2011) Dogan, Murat; Peker, Erdal; Akbayram, Sinan; Bektas, Mehmet S.; Basaranoglu, Murat; Cesur, Yasar; Caksen, Huseyin
Cerebral venous sinus thrombosis (CVST) is an uncommon disease in childhood. In the largest study carried out so far, the incidence was 0.67 case per 100 000 children per year. A number of etiologies and risk factors have been so far identified for CVST in childhood, including head trauma, local and systemic infectious diseases, malignancies, and autoimmune diseases. Celiac disease (CD) is a disease of the small intestine caused by an immune response to ingested gluten. Epilepsy, bilateral occipital calcification, cerebellar ataxia, degenerative central nervous system disease, peripheric neuropathy, myopathy, and rarely stroke were defined as neurologic disorders. In this presentation, we report 2 cases (16-year-old boy and 2-year-old boy) with CD and CVST. We emphasized that CD can be investigated in patients with CVST even with the absence of gastrointestinal symptoms. Finally, we suggest that algorithm of CVST can be involved in the investigation of CD.
Concurrent Celiac Disease, Idiopathic Thrombocytopenic Purpura and Autoimmune Thyroiditis: a Case Report
(Sage Publications inc, 2011) Dogan, Murat; Sal, Ertan; Akbayram, Sinan; Peker, Erdal; Cesur, Yasar; Oner, Ahmet F.
Celiac disease (CD) is a disease of the small intestine caused by an immune response to ingested gluten. Idiopathic thrombocytopenic purpura (ITP) is a common acquired bleeding disorder of childhood. It may follow a viral infection or immunization and is caused by an inappropriate response of the immune system. Autoimmune thyroiditis (AT) is a disease that occurs due to autoimmune mechanisms. Celiac disease associated with autoimmune thyroid disease is well known, but the association of CD, autoimmune thyroid disease, and ITP has been reported very rarely in the literature. In the current report, we have presented a case with CD, AT, and acute ITP, because this association is rarely seen, and to emphasize that CD and AT should be kept in mind in patients with ITP.
Congenital Hypothyroidism With Isolated Fibula Agenesis
(Nobel Ilac, 2010) Dogan, Murat; Yilmaz, Cahide; Caksen, Hueseyin; Cesur, Yasar; Akpinar, Fuat; Gueven, Ahmet Sami
Although congenital hypothyroidism is seen often as an isolated case, it can also be seen as a part of some syndromes like Schinzel-Giedion, Aicardi-Goutieres-like, cleidocranial dysplasia and deletion of 18q. It is also well known that congenital hypothyroidism may be associated with other congenital malformations, especially with cardiac heart diseases, skeletal abnormalities, Central nervous system and eye malformations. In this article, 11-years-old-girl with fibula agenesis associated with congenital hypothyroidism because of thyroid gland hypoplasia is presented. In our knowledge, both congenital hypothyroidism and isolated fibula agenesis have not been published before in the literature.
Congenital Primary Hypothyroidism Diagnosed at Advanced Ages
(Nobel Ilac, 2010) Yuca, Sevil Ari; Cesur, Yasar; Yilmaz, Cahide
Objective: Aim of this study was to investigate that clinical and laboratory findings of sixteen cases who were referred to our endocrinology outpatient clinic due to a complaint of growth and developmental delay and who were diagnosed with primary congenital hypothyroidism at advanced ages. Material and Method: Sixteen cases of which the youngest was minimum six and the oldest was 23 years old were enrolled into the study. Anthropometrical measures, chrono-logical, height and bone ages of the patients were recorded. Hypothyroidism was diagnosed by the decrease in free thyroxin (sT4) levels and the elevated in serum thyroid stimulating hormone (TSH) levels. To clarify the etiology, thyroglobulin (TG) level and thyroid ultrasonography were studied from the patient. Also thyroid scintigraphy was performed to the patients without a thyroid tissue at a normal anatomical localization. Results: The mean diagnostic age in our cases was 12.6 +/- 4.3 years and female were predominant was present (female/male: 4/14). Height, weights and bone ages of patients were severely retarded. Ectopia was determined in two patients while in twelve patients the thyroid gland was hypoplastic. The thyroid gland was within normal borders in one patient for age and gender and hyperplasic in another case. Conclusion: We wanted to emphasize that congenital hypothyroidism should be kept in mind in cases with developmental delay and mental retardation as these may be non-diagnosed congenital hypothyroidism also infant or early childhood outside. It must be remember, diagnose of these patients may delay until the pre-adolescence and even prior the adulthood. We wish attract attention to the national screening program for congenital hypothyroidism by this study.
Cystinosis in Eastern Turkey
(Walter de Gruyter Gmbh, 2016) Dogan, Murat; Bulan, Keziban; Kaba, Sultan; Cesur, Yasar; Ceylaner, Serdar; Ustyol, Lokman
Background: This study was conducted to investigate CTNS (cystinosin, lysosomal cystine transporter) gene mutations and the clinical spectrum of nephropathic cystinosis among patients diagnosed with the disease in a single center in Turkey. Methods: Patients' clinical and laboratory data were extracted from an electronic health registry. Molecular CTNS gene analysis was performed using either next-generation sequencing or Sanger sequencing. Results: Eleven patients (age range: 1.5-12 years) from nine families were identified. The presenting complaint was growth retardation in seven patients; polydipsia and polyuria in three patients; and vomiting in two patients. At presentation, electrolyte loss was noted in all patients, of which eight patients presented with metabolic acidosis, and three patients presented with metabolic alkalosis. All patients also presented with proteinuria and -glucosuria, and four patients developed varying degrees of renal insufficiency, for which peritoneal dialysis was initiated in one patient. Cystine crystals were detected via ocular examination in one patient at presentation. No cystine crystals were detected among patients who underwent bone marrow aspiration. In the CTNS gene, a p.T7FX7 (c.18-21del4bp) mutation was detected in three patients, whereas a p.E227E (c.681 G > A) (homozygous) mutation was detected in eight patients. Conclusions: We detected two distinct mutations, p.T7FX7 (c.18-21del4bp) and p.E227E (c.681 G > A) (homozygous), in the CTNS gene in 11 patients with cystinosis from the East Anatolian region of Turkey. Patients with a homozygous c.681 G > A (p.E227E) mutation are more likely to develop chronic renal failure and should be monitored closely, whereas patients with a p.T7FX7 (c.18-21del4bp) mutation have a milder phenotype. Additionally, metabolic alkalosis does not exclude cystinosis, although cystinosis is a cause of proximal renal tubular acidosis.
Evaluation of Children With Nutritional Rickets
(Walter de Gruyter Gmbh, 2011) Cesur, Yasar; Dogan, Murat; Ariyuca, Sevil; Basaranoglu, Murat; Bektas, Mehmet Selcuk; Peker, Erdal; Caksen, Huseyin
Aim: To evaluate the clinical findings, risk factors, therapy and outcome in 946 children with nutritional rickets. Patients and methods: This retrospective study included a review of medical records of patients with nutritional rickets between March 2004 and 2009. Patients who displayed both the biochemical inclusion criteria and the clinical signs/symptoms or radiological signs of rickets were included in the study. Results: The present study included 946 patients aged between 4 months and 15 years. Distribution of the cases showed a density between December and May. The age at diagnosis, showed two peaks and most of the patients were in the age range 0-23 months and 12.0-15 years. In infants and young children, most of the patients had been admitted to the hospital due to infectious diseases. In older children, short stature and obesity were the most common complaints. Conclusion: Children aged between 0-23 months and 12.0-15 years were under most risk for nutritional rickets, especially in winter and spring and vitamin D should be given to them as supplementation dose.
Frequency of Gluten Sensitive Enteropathy in Children With Short Stature, and the Values of Markers Used in Diagnosis
(Karger, 2008) Nalbantoglu, Ozlem; Cesur, Yasar; Yuca, Sevil Ari
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.
Hypernatremia in Hospitalized Children
(Modestum Ltd, 2017) Yuca, Sevil; Cesur, Yasar; Caksen, Huseyin; Arslan, Derya; Yilmaz, Cahide; Kaya, Avni
Objective: Hypernatraemia has serious complications such as brain injury, brain oedema and seizure. In this study, the incidence among children hospitalized hypernatremia, causes, development time, clinical features, and morbidity, and aimed to reveal the effect on mortality. Method: In this retrospective study, clinical and laboratory data from patients with hypernatremic were recorded. The study period was 33 months. The groups were separated into two groups; group I: Hypernatremia was present at hospital admission, group II: Hypernatremia was acquared after the hospitalization. Results: Overall incidence of hypernatraemia was 1.3% of all hospitalised children. While 42% of patients were from group I, 58% of patients had acquired hypernatremia during hospital stay. In group I, 61% of patients had infections on hospital admission. The most common cause of hypernatraemia in group II was neurological disorders (53%). The mortality rate was 30.5% (11/36) in patients with hypernatraemia on admission, 67.3% (33/49) in those with hospital-acquired hypernatraemia (P<0.05; significantly greater than for those with hypernatraemia on admission), and 51.7% (44/85) overall. Mean serum sodium level was higher in non-survivors than in survivors (161.7 +/- 8.3 mg/dL vs. 160 +/- 7.4 mg/dL), but the difference was not statistically significant. Similarly, there was no significant difference in peak serum sodium levels in survivors versus non-survivors, P>0.05. Conclusion: Hypernatraemia in pediatric age is associated with mortality and morbidity, and should be closely monitored in pediatric patients hospitalized for any reason in order to prevent complication.
Hypernatremia in Hospitalized Children: a Clinical Study in Turkiye
(Karger, 2008) Yuca, Sevil Ari; Cesur, Yasar; Caksen, Huseyin; Arslan, Derya
Hyponatremia in Hospitalized Children: Review of 400 Cases
(Karger, 2009) Cesur, Yasar; Yuca, Sevil Ari; Dogan, Murat; Yilmaz, Cahide; Kaya, Avni; Akgun, Cihangir
Iatrogenic Cushing's Syndrome Due To Topical Steroid
(Nobel Ilac, 2009) Kaya, Avni; Yuca, Sevil Ari; Dogan, Murat; Sal, Ertan; Temel, Hayrettin; Cesur, Yasar
Diaper dermatitis (napkin rash) is a skin disease which can be seen in diaper areas of babies as rubor and in more serious cases as bulla and open wounds For treatment in necessary conditions, it is suggested to use antifungals and/or 0.5% hydrocortisone pomads in addition to symptomatic therapy such as moistening of the skin and removal of irritant agents from area Seven-month-girl and six-month-boy case was brought with excess weight intake complaints They were excessively obese and had an increase adipose tissue under their skins Both cases had used pomads involving clobetasol 17-propionate for the last 3 months Their family history was normal. Serum ACTH levels was <5 00 pg/mL (25-100 pg/mL) and plasma cortisol levels was <1 00 mu g/dL (5-23 mu g/dL) in both cases Cushing's syndrome associated with pomade with topical steroid was diagnosed in the cases and pomades that they used were abandoned. The cushinglike appearance has declined over time and disappeared after some time Cases are being followed as asymptomatically. It would not be surprising to sec more new cases of iatrogenic Cushing's syndrome, until usage of topical pomades, which has high steroid effect, without indication and especially without prescription is stopped.
Late Onset Arginine Succinate Lyase Deficiency With Normal Plasma Ammonia Level
(Nobel Ilac, 2011) Yilmaz, Cahide; Dogan, Murat; Cesur, Yasar; Caksen, Huseyin; Yuca, Sevil Ari; Atas, Bulent; Tuncer, Oguz
Arginine succinate lyase (ASL) deficiency is one of the most common cause of urea cycle defect and shows all characteristics of this disorders. This disease is presented with hyperammonemia, abnormally kinky hair and mental retardation. 6-years-old-girl was brought to our hospital because of skin eruption, weight loses, abdominal pain, having no appetite, polydipsia and pollakiuria. In physical examination, especially occipital balding, mental retardation, hepatomegaly, ataxia and articulation defect were found. She, who was diagnosed as ASL deficiency after the laboratory examinations, had normal blood ammonia levels. Finally in this study, we emphasize; ASL deficiency must be thought when a child has mental retardation and cerebellar ataxia, even if normal ammonia levels.
Normosmic Idiopathic Hypogonadotropic Hypogonadism Due To a Novel Homozygous Nonsense C.c969a (P.y323x) Mutation in the Kiss1r Gene in Three Unrelated Families
(Wiley, 2015) Demirbilek, Huseyin; Ozbek, M. Nuri; Demir, Korcan; Kotan, L. Damla; Cesur, Yasar; Dogan, Murat; Topaloglu, A. Kemal
ObjectiveThe spectrum of genetic alterations in cases of hypogonadotropic hypogonadism continue to expand. However, KISS1R mutations remain rare. The aim of this study was to understand the molecular basis of normosmic idiopathic hypogonadotropic hypogonadism. MethodsClinical characteristics, hormonal studies and genetic analyses of seven cases with idiopathic normosmic hypogonadotropic hypogonadism (nIHH) from three unrelated consanguineous families are presented. ResultsOne male presented with absence of pubertal onset and required surgery for severe penoscrotal hypospadias and cryptorchidism, while other two males had absence of pubertal onset. Two of four female cases required replacement therapy for pubertal onset and maintenance, whereas the other two had spontaneous pubertal onset but incomplete maturation. In sequence analysis, we identified a novel homozygous nonsense (p.Y323X) mutation (c.C969A) in the last exon of the KISS1R gene in all clinically affected cases. ConclusionsWe identified a homozygous nonsense mutation in the KISS1R gene in three unrelated families with nIHH, which enabled us to observe the phenotypic consequences of this rare condition. Escape from nonsense-mediated decay, and thus production of abnormal proteins, may account for the variable severity of the phenotype. Although KISS1R mutations are extremely rare and can cause a heterogeneous phenotype, analysis of the KISS1R gene should be a part of genetic analysis of patients with nIHH, to allow better understanding of phenotype-genotype relationship of KISS1R mutations and the underlying genetic basis of patients with nIHH.
Prevalence, Demographic Characteristics and Associated Risk Factors of Malnutrition Among 0-5 Aged Children: a Cross-Sectional Study From Van, Eastern Turkey
(Mdpi, 2016) Kizilyildiz, Baran Serdar; Sonmez, Bulent; Karaman, Kamuran; Beger, Burhan; Mercen, Adnan; Alioglu, Suleyman; Cesur, Yasar
Malnutrition in childhood is a dramatic indicator of poor socio-economical status worldwide. To recognize and reveal the socio-demographic features is crucial, especially for developing countries. Our aim was to investigate the prevalence and association with sociodemographic variables of malnutrition in 0-5 years old children in Van, Turkey. A total of 702 children are included in this cross-sectional study. Demographic features of subject including age, gender. family characteristics and other data were obtained. Nutritional assessment was done using anthropometric indices including weight for age, height forage, weight-for-height, head circumference and body mass index-for-age. Multivariate logistic regressions were carried out to assess malnutrition -associated factors. Prevalence of underweight, stunting and wasting were 19.7, 17.7 and 16.2%, respectively. Socio-demographic variables that statistical significantly in association with malnutrition were low monthly family income educational level and employment status of father, parental consanguinity, number of pregnancies, regular intake of vitamin D and history, of prematurity The prevalence of children with head circumference-z score S-2SD and body mass index forage 2SD were 9.8 and 16.3%. respectively. Multivariate analysis detected following risk factors for these indices: low monthly family income, history of prematurity, unemployed father and the period between pregnancies (12 years). We found that prevalence of malnutrition in the city of Van, was still higher than more developed regions of Turkey. The associated risk factors of malnutrition should be specifically interpreted by health professionals and also by government authorities that are responsible for making practical politics of public health.