Browsing by Author "Oner, Ahmet Faik"

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Acquired Methemoglobinemia Due To Application of Prilocaine During Circumcision
(Elsevier Science inc, 2012) Akbayram, Sinan; Akgun, Cihangir; Dogan, Murat; Gundogdu, Mustafa; Caksen, Huseyin; Oner, Ahmet Faik
Acute Itp Due To Insect Bite: Report of 2 Cases
(Sage Publications inc, 2011) Akbayram, Sinan; Akgun, Cihangir; Dogan, Murat; Caksen, Huseyin; Oner, Ahmet Faik
Immune thrombocytopenic purpura (ITP) of childhood is a common hematologic disorder. Immune thrombocytopenic purpura is characterized by increased destruction of antibody-coated platelets in the reticuloendothelial system. In the majority of children with acute ITP, thrombocytopenia occurs within 1 to 3 weeks after an infectious disease. Immune thrombocytopenic purpura may also occur after rubella, rubeola, chickenpox, or live virus vaccination. Here we report 2 cases with acute ITP that were developed after honeybee and insect bite.
An Analysis of Children With Brucellosis Associated With Isolated Thrombocytopenia
(Sage Publications inc, 2011) Akbayram, Sinan; Dogan, Murat; Akgun, Cihangir; Peker, Erdal; Parlak, Mehmet; Oner, Ahmet Faik
Hematologic abnormalities of mild anemia and leucopenia have been frequently associated with acute brucellosis, but thrombocytopenia are less frequently seen. In the present study, we documented 5 (2.6%) isolated thrombocytopenic patients with the manifestations of brucellosis observed during the course of active infection. Five (2.6%) patients, 4 boys and 1 girl, with ages ranging from 2 to 14 years, had isolated thrombocytopenic at diagnosis. In 5 (2.6%) patients, platelet counts ranged from 39 000 to 120 000/mm(3). Tube agglutination tests for brucellosis were positive for all patients (1/160-1/1280). All patients recovered completely, and their thrombocytopenia returned to normal by 2 to 4 weeks after antibiotic treatment of brucellosis. In our study, we present 5 patients with Brucella-induced thrombocytopenia mimicking idiopathic thrombocytopenic purpura to emphasize the isolated thrombocytopenia and the resolution of thrombocyte counts following treatment of brucellosis.
An Analysis of Children With Brucellosis Associated With Pancytopenia
(informa Healthcare, 2011) Akbayram, Sinan; Dogan, Murat; Akgun, Cihangir; Peker, Erdal; Parlak, Mehmet; Caksen, Huseyin; Oner, Ahmet Faik
Brucellosis produces a variety of nonspecific hematologic abnormalities. Hematologic complications of mild anemia and leukopenia have been frequently associated with acute brucellosis, but pancytopenia is less frequently seen. In this study, records of children with brucellosis aged under or equal to 16 years, admitted to Yuzuncu Yil University Hospital between 2004 and 2010, were analyzed retrospectively. Over this time period, 187 patients with brucellosis were diagnosed. Twenty-five (13.3%%) of 187 patients had pancytopenia during admission to hospital. The diagnosis of brucellosis was confirmed by standard tube agglutination test in all patients; titers were 1:320 in 1 patient and 1:1280 in 24 patients. Blood culture was positive for Brucella melitensis in 3 patients (12%%). Fever was the most common manifestation, followed by malaise, anorexia, sweating, and weight loss. Fever and splenomegaly were the common signs in most patients. In addition, arthritis was observed in 5 patients, and epistaxis, headache, and abdominal pain were observed in 3 patients. The common bone marrow aspiration findings consisted of increased megakaryocytes and hyperplasia of erythroid series, with a shift to the left of the granulocytic series. Histiocytic hyperplasia was observed in the bone marrow smear of 2 patients. Mild hemophagocytosis was observed in the bone marrow of 3 patients. All patients recovered completely, and their peripheral blood counts returned to normal by 2 to 6 weeks after antibiotic treatment of brucellosis. In conclusion, the authors would like to emphasize that brucellosis should be considered in the differential diagnosis of children with pancytopenia.
The Association of Oxidant Status and Antioxidant Capacity in Children With Acute and Chronic Itp
(Lippincott Williams & Wilkins, 2010) Akbayram, Sinan; Dogan, Murat; Akgun, Cihangir; Mukul, Yurdaguel; Peker, Erdal; Bay, Ali; Oner, Ahmet Faik
Purpose: This study was undertaken to investigate oxidant and antioxidant systems in patients with immune thrombocytopenic purpura (ITP). With this purpose, we measured the levels of serum malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant status (TOS), and other oxidative stress parameters. Patients and Methods: Fifty-two pediatric patients with ITP (25 acute, 27 chronic) and 21 healthy children were included in the study. Patients with acute ITP were studied, before and after, methylprednisolone treatment. Results: Hemoglobin, hematocrit, platelet count, and TAC were statistically significantly lower in patients with acute ITP before treatment than those in the control group (P<0.05). In addition, in this group, MDA, TOS levels, and OSI (oxidative stress index) were found to be higher than those in the control group. In chronic ITP group, although hemoglobin hematocrit, platelet counts, and TAC levels were statistically significantly lower than those in the control groups, the mean platelet volume, MDA, TOS, and OSI were found to be statistically significantly higher (P<0.05). Platelet count and mean platelet volume values were statistically significantly lower in patients with acute ITP before treatment than after treatment (P<0.05). We also found a positive correlation between thrombocyte count and TAC, in patients with acute ITP before treatment (r: 0.601, P<0.001) and acute ITP after treatment (r: 0.601, P<0.001) and chronic ITP (r: 0.601, P<0.001). A negative correlation was found between thrombocyte count and serum MDA levels, in patients with acute ITP before treatment (r: -0.356, P<0.001) and acute ITP after treatment (r: -0.356, P<0.001) and chronic ITP (r: -0.356, P<0.001). We also found a negative correlation between thrombocyte count and serum OSI, in patients with acute ITP before treatment (r: -0.494, P<0.001) and acute ITP after treatment (r: -0.494, P<0.001) and chronic ITP (r: -0.494, P<0.001). A negative correlation was found between thrombocyte count and TOS, in patients with acute ITP before treatment (r: -0.470, P<0.001) and acute ITP after treatment (r: -0.470, P<0.001) and chronic ITP (r: -0.470, P<0.001). In conclusion, increased MDA, TOS and OSI, and decreased TAC levels were found in patients with acute and chronic ITP. Conclusions: On the basis of these findings, we suggest that free oxygen radicals may have an effect on the structural and functional damage of platelets, and on the mechanism of thrombocytopenia in both, acute and chronic ITP.
Atypical Presentation of Herpes Zoster in a Case With Acute Myeloblastic Leukemia
(Elsevier Science Bv, 2013) Aktar, Fesih; Akbayram, Sinan; Akdeniz, Necmettin; Aktar, Sirac; Akgun, Cihangir; Dogan, Murat; Oner, Ahmet Faik
Herpes zoster (HZ) is often associated with painful erythematous vesicular eruptions of the skin or mucous membranes. Approximately 10% to 30% of the population will suffer from HZ during their lifetime. HZ is infrequent in healthy children. However, diminished cellular immunity seems to increase risk of reactivation because incidence increases with age and in immunocompromised states. We report a 7 year old girl with acute myeloblastic leukemia HZ infection on the right palmar, elbow and forearm region (C7, C8 and T1 dermatomes). We want to indicate unusual localization of HZ on the acute myeloblastic leukemia child patient.
Avian Influenza
(Aves, 2007) Oner, Ahmet Faik
Recent spread of avian influenza A (H5N1) virus to poultry and wild birds has increased the threat of human infections with H5N1 virus worldwide. In this review, the epidemiology, virolgy, clinical and laboratory characteristics and management of avian influenza is described. The virus has demonsrated considerable pandemic potential and is the most likely candidate of next pandemic threat. For pandemic preparedness, stockpiling antiviral agents and vaccination are the most important intervention measurements.
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.
Brucellar Aortitis and Meningoencephalitis in an Adolescent
(Lippincott Williams & Wilkins, 2016) Bayhan, Gulsum Iclal; Ece, Ibrahim; Oner, Ahmet Faik
Brucellosis can affect any organ system and result in possible complications. We present an adolescent male who had brucellar aortitis and meningitis simultaneously. Brucellar aortic involvement is a rare complication of brucellosis and can occur without concomitant endocarditis. Here, the patient was managed with prolonged antibiotic therapy without any surgery.
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.
Circumcision in Patients With Congenital Factor X Deficiency
(Springer india, 2014) Akbayram, Sinan; Garipardic, Mesut; Karaman, Kamuran; Bilici, Salim; Oner, Ahmet Faik
The Clinical Outcome of 260 Pediatric Itp Patients in One Center
(Sage Publications inc, 2011) Akbayram, Sinan; Dogan, Murat; Ustyol, Lokman; Akgun, Cihangir; Peker, Erdal; Bilici, Salim; Oner, Ahmet Faik
In the current study, clinical and laboratory findings and treatment modalities of children with acute and chronic immune thrombocytopenic purpura (ITP) were evaluated retrospectively. Our purpose was to determine clinical outcome of children with ITP and their responses to different treatment regimes. Total of 260 children with ITP were enrolled in the study. The mean age of patients was 76.8 +/- 48.1 months. The therapy responses of high-dose methylprednisolone (HDMP; n = 134), standard dose methylprednisolone (n = 32), and intravenous immunoglobulin (IVIG; n = 15) treatments were similar. Two (0.8%) of the 260 ITP patients had intracranial bleeding. None of the patients died due to hemorrhage. Of all the patients with ITP, 191 (73.5%) completely resolved within 6 months after initiation of the disease and therefore they were diagnosed as acute ITP; 69 patients (26.5%) had progressed into chronic ITP. The therapy responses of HDMP, standard dose methylprednisolone, and IVIG treatments are similar.
A Desensitization Protocol in Children With L-Asparaginase Hypersensitivity
(Lippincott Williams & Wilkins, 2010) Akbayram, Sinan; Dogan, Murat; Akgun, Cihangir; Caksen, Hueseyin; Oner, Ahmet Faik
Background: L-asparaginase is effective in the treatment of malignant diseases, but it has been associated with hypersensitivity reactions in 5% to 45% of the patients. Purpose: To determine whether a desensitization protocol in children with native Escherichia coli L-asparaginase hypersensitivity allows subsequent safe administration of native E. coli L-asparaginase. Patients and Methods: A desensitization protocol was used in 9 children with leukemia (n = 8) or Langerhans cell histiocytosis (n = 1) and previous severe (n = 4) or mild/moderate (n = 5) L-asparaginase hypersensitivity. Dexamethasone (2 mg/kg intravenously) and pheniramine hydrogen maleate (1 mg/kg intravenously) were administered 1 hour before each of the following L-asparaginase administrations. Subsequently, 0.1%, 1%, 5%, 10%, and the remaining 84% of the total dose of L-asparaginase (10,000 IU/m(2)) were each prepared in 240 mL 0.9% saline and infused over 4 hours (20 h in total). Results: After desensitization, none of the patients had recurrence of hypersensitivity reactions during the subsequent 2 to 15 doses (median: 6 doses/patient; 68 doses in total) of native E. coli L-asparaginase. Conclusion: This desensitization protocol was safe and allows continued administration of native E. coli L-asparaginase administration.
Disseminated Intravascular Coagulation in a Case of Brucellosis
(Sage Publications inc, 2011) Akbayram, Sinan; Dogan, Murat; Akgun, Cihangir; Peker, Erdal; Parlak, Mehmet; Oner, Ahmet Faik
Brucellosis is a multisystem disease with a broad spectrum of clinical manifestations; hematological abnormalities ranging from fulminant as of disseminated intravascular coagulation (DIC) to anaemia, leucopoenia, thrombocytopenia, and clotting disorders. In this report, we present DIC in a case of brucellosis because of rare presentation. A 3-year-old boy was admitted with the complaints of continuous fever, vomiting, abdominal pain, and bruise on leg. He looked pale and his physical examination revealed purpuric skin lesions on both legs. A mild hepatosplenomegaly was noted on palpation. Laboratory tests showed hematocrit 21%, hemoglobin 7 g/dL, platelet count 20,000/mm(3), prothrombin time 19 seconds, activated partial thromboplastin time 48 seconds, plasma fibrinogen level 20 mg/dL, and D-dimer 8 mu g/mL. Serum antibrucella titration agglutination test was found to be 1 of 1280 positive. Blood cultures performed on specimens obtained at the time of admission yielded Brucella melitensis. The clinical and laboratory findings were consistent with DIC.
Edta-Dependent Pseudothrombocytopenia in a Child
(Sage Publications inc, 2011) Akbayram, Sinan; Dogan, Murat; Akgun, Cihangir; Caksen, Huseyin; Oner, Ahmet Faik
Ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia (PTCP) is the phenomenon of a spurious low platelet count due to antiplatelet antibodies that cause platelet clumping in blood anticoagulated with EDTA. The aggregation of platelets in EDTA-dependent PTCP is usually prevented by other anticoagulants, such as sodium citrate or heparin. EDTA-dependent PTCP has never been associated with hemorrhagic diathesis or platelet dysfunction. In this article, a 10-year-old boy with EDTA-and heparin-dependent PTCP is presented because of rare presentation. We report that EDTA and heparin can induce platelet clumping, and thus spuriously low platelet counts. However, aggregation of platelets was not detected in blood samples with sodium citrate, and platelet count was normal.
Effectiveness of Antiviral Treatment in Human Influenza A(H5n1) Infections: Analysis of a Global Patient Registry
(Oxford Univ Press inc, 2010) Adisasmito, Wiku; Chan, Paul K. S.; Lee, Nelson; Oner, Ahmet Faik; Gasimov, Viktor; Aghayev, Faik; Toovey, Stephen
Background. Influenza A(H5N1) continues to cause infections and possesses pandemic potential. Methods. Data sources were primarily clinical records, published case series, and governmental agency reports. Cox proportional hazards regression was used to estimate the effect of treatment on survival, with adjustment using propensity scores (a composite measure of baseline variables predicting use of treatment). Results. In total, 308 cases were identified from 12 countries: 41 from Azerbaijan, Hong Kong SAR, Nigeria, Pakistan, and Turkey (from clinical records); 175 from Egypt and Indonesia (from various sources); and 92 from Bangladesh, Cambodia, China, Thailand, and Vietnam (from various publications). Overall crude survival was 43.5%; 60% of patients who received >= 1 dose of oseltamivir alone (OS+) survived versus 24% of patients who had no evidence of anti-influenza antiviral treatment (OS-) (P < .001). Survival rates of OS+ groups were significantly higher than those of OS- groups; benefit persisted with oseltamivir treatment initiation <= 6-8 days after symptom onset. Multivariate modeling showed 49% mortality reduction from oseltamivir treatment. Conclusions. H5N1 causes high mortality, especially when untreated. Oseltamivir significantly reduces mortality when started up to 6-8 days after symptom onset and appears to benefit all age groups. Prompt diagnosis and early therapeutic intervention should be considered for H5N1 disease.
Evaluation of Vitamin K Deficiency in Children With Acute and Intractable Diarrhea
(Springer, 2006) Bay, Ali; Oner, Ahmet Faik; Celebi, Vefik; Uner, Abdurahman
The purposes of this study were to determine the frequency of vitamin K deficiency and to assess its effects on bleeding in patients with acute and intractable diarrhea. A total of 90 children with diarrhea and 30 healthy children (group Q were included in this study. Patients were divided into 2 groups, according to the duration of diarrhea. Complete blood count; prothrombin time (PT); activated prothrombin time (APTT); Factors ii, VII, IX, and X; and protein C levels were studied in all patients. A total of 3 mg of vitamin K was administrated to patients with prolonged PT and/or APTT. Coagulation parameters were restudied 8 to 12 h after vitamin K was administered. Mean age, sex, weight, and breastfeeding percentage, as well as history of fever and vitamin K administration at birth, were similar in the 2 groups. The duration of antibiotic administration in group B (intractable diarrhea) was significantly longer than that in group A (acute diarrhea). Gastrointestinal (GI) bleeding was observed in 3 (4.9%) infants in group A and 6 (20.7%) in group B (P <.05). The duration of diarrhea was significantly longer in infants with GI bleeding. Intracranial bleeding occurred in I infant with intractable diarrhea. Prolonged PT levels were noted in groups A and B. Significant improvement in PT and APTT and an increase in coagulation factors were observed after vitamin K had been administered. Investigators in this study conclude that coagulation parameters can be improved by the administration of vitamin K to children with deranged PT and APTT and diarrheal illness.
Global Fibrinolytic Capacity in Pediatric Patients With Sepsis and Disseminated Intravascular Coagulation
(Lippincott Williams & Wilkins, 2006) Bay, Ali; Oner, Ahmet Faik; Kose, Dogan; Dogan, Murat
There are many complex pathophysiologic changes of the coagulation system in sepsis. The fibrinolytic system was evaluated in septic children using the global fibrinolytic capacity (GFC), a new technique reflecting the overall fibrinolytic activity. The study consisted of 24 children with sepsis, 36 children with sepsis plus disseminated intravascular coagulation (DIC), and 20 healthy age-matched control individuals. Compared with controls, 86% of sepsis patients and 87% of sepsis plus DIC patients had decreased GFC levels. Between the sepsis plus DIC and sepsis groups there was no significant difference in terms of GFC levels. While 19 patients (52.7%) died in the sepsis plus DIC group, only three patients (112.5%) died in the sepsis group. When survivors and nonsurvivors were compared in terms of coagulation tests, there were significant differences for protein C, antithrombin, platelet, fibrinogen, aspartate aminotransferase, alanine aminotransferase, prothrombin time, and white blood cell values. In conclusion, the level of GFC reduced in most of the pediatric sepsis patients but no difference was observed between patients with sepsis and patients with sepsis plus DIC. While inhibition of fibrinolysis is an important finding in sepsis, the mortality is mainly associated with the presence of end-organ damage and the status of coagulation parameters.
H5n1 Avian Influenza in Children
(Oxford Univ Press inc, 2012) Oner, Ahmet Faik; Dogan, Nazim; Gasimov, Viktor; Adisasmito, Wiku; Coker, Richard; Chan, Paul K. S.; Dreyer, Nancy A.
Background. Avian influenza continues to pose a threat to humans and maintains the potential for greater transmissibility. Understanding the clinical presentation and prognosis in children will help guide effective diagnosis and treatment. Methods. A global patient registry was created to enable systematic collection of clinical, exposure, treatment, and outcomes data on confirmed cases of H5N1. Bivariate and multivariate statistical tools were used to describe clinical presentation and evaluate factors prognostic of survival. Results. Data were available from 13 countries on 193 children <18 years who were confirmed as having been infected with H5N1; 35.2% of cases were from Egypt. The case fatality rate (CFR) for children was 48.7%, with Egypt having a very low pediatric CFR. Overall, children aged <= 5 years had the lowest CFR and were brought to hospitals more quickly and treated sooner than older children. Children who presented for medical care with a complaint of rhinorrhea had a 76% reduction in the likelihood of death compared with those who presented without rhinorrhea, even after statistical adjustment for age, having been infected in Egypt, and oseltamivir treatment (P = .02). Delayed initiation of treatment with oseltamivir increases the likelihood of death, with an overall 75% increase in the adjusted odds ratio for death for each day of delay. Conclusions. The presence of rhinorrhea appears to indicate a better prognosis for children with H5N1, with most patients surviving regardless of age, country, or treatment. For individuals treated with oseltamivir, early initiation of treatment substantially enhances the chance of survival.
Hemofili-a'ya Bağlı Atipik Lokalizasyonda Yumuşak Doku Kanaması Olan Bir Olgu
(2016) Karaman, Kamuran; Oner, Ahmet Faik; Akbayram, Sinan; Garipardıç, Mesut
Hemofili A hastalarındaki temel kusur, X kromozomunda yerleşik olan faktör VIII genindeki spesifik mutasyon nedeniyle karaciğerin sinüzoidal hücrelerinden FVIII koagülasyon faktörünün salgılanmasının ve/veya aktivitesinin bozuk olmasıdır. Hemartroz ve hematom hastalığın en tipik özelliğidir. Hafif, orta ve ağır olmak uzere üç farklı klinik tipi vardır. Sol koltuk altında, ağrı ve şişlik yakınması ile hastanemize başvuran 16 yaşındaki erkek hastanın öyküsünde, yaklaşık 1 gündür sol koltuk altında şişlik şikayetinin başladığı öğrenildi. Öyküsünde travma öyküsünün olmadığı ve şişliğin spontan olarak oluştuğu öğrenildi. Ağır 'Hemofili A' tanısı ile çocuk hematoloji polkliniğimizde takipli olan ve haftada iki gün sekonder profilaksi tedavisi alan hastanın ek bir şikayeti yoktu. Sol orta koltuk altı çizgisinde 6x4 cm ebadında yumuşak doku şişliği mevcuttu. Bakılan tetkiklerinde FVIII düzeyi %1 in altında olup inhibitör negatif olarak saptandı. Rekombinant faktör VIII ile 25 IU/kg 12 saatte bir toplam 2 gün faktör replasmanı yapıldı, immobilizasyon sağlandı. Bu tedaviyle 12 saat sonunda hastanın ağrısı azaldı. İkinci gün hematomda belirgin küçülme ve klinik bulgularda tamamen düzelme saptanması üzerine izometrik egzersizler önerildi. Hemartroz ve hematomlar, özellikle ağır hemofilili hastalarda spontan veya minör bir travmayı takiben sık görülür ve kas içine olan kanamalar, tüm kas, iskelet sistemi kanamalarının %30'unu oluşturur. Hemofili hastalarında kas içi hematomlar spontan veya travmatik sebeplerle olabilir. Konservatif yaklaşım ve faktör replasmanı ile hematomların çoğu geriler