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    The Diagnostic Efficacy of and Requirement for Postnatal Ultrasonography Screening for Congenital Anomalies of the Kidney and Urinary Tract
    (Mdpi, 2023) Gulyuz, Abdulgani; Tekin, Mehmet
    Background: We aimed to investigate the efficacy of postnatal ultrasonography in detecting congenital anomalies of the kidneys and urinary tract in term infants without prenatal history of congenital anomalies of the kidneys and urinary tract. Methods: In this retrospective cohort study, we reviewed the records of term infants between six weeks and three months of age who underwent urinary tract ultrasonography during routine pediatric care. Results: Congenital anomalies of the kidneys and urinary tract were detected on prenatal ultrasonography in 75 of the 2620 patients included in the study. Congenital anomalies of the kidneys and urinary tract were detected via postnatal USG in 46 (1.8%) of 2554 patients without anomalies on prenatal USG screening. The most common anomaly was hydronephrosis (69.6%). Thirty-two cases of hydronephrosis, three cases of renal agenesis, four cases of horseshoe kidney, one case of MCDK, and two cases of duplex systems which were not detected on prenatal USG were detected on postnatal USG. On the other hand, 29 (1.1%) cases with mild or moderate hydronephrosis on prenatal ultrasonography did not have hydronephrosis on postnatal ultrasonography. Conclusions: In our study, approximately one-third of the cases of hydronephrosis, unilateral renal agenesis, duplex systems, horseshoe kidney, and ectopic kidney were not detected in prenatal ultrasonography screening. Therefore, we believe that in addition to prenatal ultrasonography screening, postnatal ultrasonography screening of all children for urinary tract anomalies would be beneficial.
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    Familial Mediterranean Fever in a Patient with PFAPA Syndrome
    (Galenos Yayincilik, 2015) Tekin, Mehmet; Konca, Capan; Gulyuz, Abdulgani; Toplu, Yuksel
    Periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome is one of the recurrent fever syndrome in childhood. Headache, abdominal pain, and joint pain can be seen in some patients, in addition to the classical signs. PFAPA attacks resolve with prednisolone. Membranous tonsillitis, lymphadenopathy, and occasionally aphthae were detected during each episode in a patient presenting with high fever, about 12 times until four years of age. All attacks were resolved completely with single-dose prednisolone in the patient, who was diagnosed with PFAPA syndrome. Genetic analysis was requested because of abdominal pain that was occasionally observed during attacks. Heterozygous mutation of M694V was detected through genetic investigation, and colchicine was initiated. The patient was diagnosed with familial Mediterranean fever (FMF) due to resolved abdominal pain and recurrent fever after colchicine therapy. It is known that some FMF patients benefit from prednisolone therapy. Therefore, other periodic fever syndromes should be excluded before the diagnosis of PFAPA and FMF should be considered in patients with PFAPA syndrome complaining of recurrent abdominal pain.
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    The mean platelet volume levels in children with PFAPA syndrome
    (Elsevier Ireland Ltd, 2014) Tekin, Mehmet; Toplu, Yuksel; Kahramaner, Zelal; Erdemir, Aydin; Gulyuz, Abdulgani; Konca, Capan; Uckardes, Fatih
    Objectives:. To assess whether mean platelet volume (MPV) can be used as a marker in the differential diagnosis of periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome. Methods: The leucocyte counts, thrombocyte counts, and MPV values of 57 children with PFAPA syndrome were recorded during an attack and an attack free period. These values were compared with a healthy control group of 55 individuals. Demographic features of the PFAPA patients group including age, gender and age of first attack, age at diagnosis, frequency of attacks, serum reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were also recorded. Results: The MPV values of the children with PFAPA both during an attack and attack free period were found significantly lower than the MPV values of healthy control group (p < 0.001). Also, the MPV values of the children with PFAPA during an attack were significantly lower than in attack free periods (p < 0.001). The MPV values showed no correlation with leucocytes counts, CRP, and ESR during attacks. A 8.30 fl [area under the curve (AUC: 0.965)] optimal cutoff value of MPV with a sensitivity of 89.5% and specificity of 92.8% was determined during an attack in children with PFAPA. Conclusions: The MPV values during an attack and attack free period of patients with PFAPA is lower than in controls. The MPV values may be used as a marker in the differential diagnosis of PFAPA syndrome but more studies are needed and they should be prospective in order to validate this data. (C) 2014 Elsevier Ireland Ltd. All rights reserved.