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Öğe Autonomic nervous system function in childhood migraine(Blackwell Science Asia, 1999) Yakinci, C; Mungen, B; Er, H; Durmaz, Y; Karabiber, HBackground: Although the pathogenesis of migraine is controversial, autonomic nervous system (ANS) dysfunction has been reported in patients with adult migraine in recent years. The present study was planned to investigate ANS function in childhood migraine. Methods: The migraine and control groups consisted of 25 migraineur and 30 healthy children, respectively. Orthostatic test, sustained handgrip, Valsalva ratio, 30/15 ratio and heart rate responses to deep breathing were used as non-invasive ANS function tests in both groups. Results: In the orthostatic test, systolic (SBP) and diastolic blood pressures (DBP) were higher in the upright than the supine position in the migraine group, but were higher in the supine than upright position in the control group. In the sustained handgrip test, the mean difference in SEP was higher in the migraine than the control group (P = 0.0278), but there was no significant difference in DBP between migraine and control groups (P = 0.107). The Valsalva ratio was higher in the migraine than the control group (P = 0.0002), as was the 30/15 ratio (P = 0.0108). Heart rate responses to deep breathing were not different between the migraine and control groups (P = 0.749). Conclusions: Our results demonstrate ANS dysfunction, with hyperactivity of both the sympathetic and parasympathetic nervous system, in children with migraine.Öğe Autonomic nervous system functions in childhood essential hypertension(Blackwell Science, 1996) Yakinci, C; Mungen, B; Tayfun, M; Gunduz, M; Karabiber, HThe etiopathology of essential hypertension (EH) is still controversial, different pathologic mechanisms have been estimated as a cause of EH. One of these mechanisms is autonomic nervous system dysfunction (ANSD). Although there are different studies showing ANSD in adult EH, limited studies on ANSD in childhood EH are present. The present study was planned to investigate the role of ANSD in childhood EH. The study group (SG) consisted of 24 children with EH and the control group (CG) was 24 healthy children. Non-invasive autonomic nervous system function tests: the orthostatic test, Valsalva ratio, 30/15 ratio and heart rate responses to deep breathing were performed on members of both groups. The mean differences in systolic blood pressure between supine resting and standing positions in the study and control groups were significant (z = -2.577, P = 0.0051). The mean differences in diastolic blood pressure between supine resting and standing positions in SG and CG were found to be statistically meaningful (z = -2.722, P = 0.0033). The mean differences in heart rate variation during hyperventilation in SG and CG were significant (z = -2.54, P = 0.0055). The mean differences in the Valsalva ratio between SG and CG were not statistically meaningful (z = 1.52, P = 0.0643). The mean differences in the 30/15 ratio in SG and CG were not found to be significant (z = -1.455, P = 0.0735). In the light of these results, both sympathetic and parasympathetic autonomic nervous system dysfunction in childhood essential hypertension were found.Öğe Autonomic nervous system functions in children with nocturnal enuresis(Elsevier Science Bv, 1997) Yakinci, C; Mungen, B; Durmaz, Y; Balbay, D; Karabiber, HNocturnal enuresis is involuntary urination during night sleep, The pathogenesis of nocturnal enuresis is controversial. Developmental delay, genetic factors, stress and psychological factors, and sleep abnormalities are considered to be the etiologic factors. Various urodynamic studies showed bladder hyperactivity in enuretic children. Since the cause of vesical hyperactivity is not clear, we investigated the possible role of autonomic nervous system dysfunction in these children. The study groups consisted of 41 enuretic (25 boys and 16 girls) and 30 healthy children (18 boys and 12 girls). Four non-invasive autonomic nervous system function tests (orthostatic test, Valsalva ratio, 30:15 ratio, heart rate responses to deep breathing) were carried out in both groups. The differences between the enuretic and control groups were statistically significant in the Valsalva and 30:15 ratios (P < 0.0005 and P < 0.005, respectively). The results of these two tests demonstrated parasympathetic nervous system hyperactivity. No abnormality of the sympathetic nervous system was found. We suggest that the parasympathetic nervous system hyperactivity shown in our study may be a cause of vesical hyperactivity in enuretic children. (C) 1997 Elsevier Science B.V.Öğe Autonomic nervous system functions in obese children(Elsevier Science Bv, 2000) Yakinci, C; Mungen, B; Karabiber, H; Tayfun, M; Evereklioglu, CChildhood obesity is a complex syndrome, probably due to the multiplicity of contributing factors, contradictory literature information about etiology, prognosis, prevention and treatment. In the recent reports, autonomic nervous system (ANS) dysfunction has been documented in adult obesity. Autonomic nervous system functions in obese children are not clear. This study was planned to investigate autonomic nervous system function in childhood (7-13 years of age) obesity. Study and control groups consisted of 33 simple obese (23 boys and ten girls, mean age 9.5 +/- 1.4 years) and 30 healthy children (18 boys and 12 girls, mean age 10.1 +/- 1.8 years), respectively. Four non-invasive autonomic nervous system function tests (Orthostatic test, Valsalva ratio, 30/15 ratio, Heart rate responses to deep breathing) and general ophthalmic examination were performed on both groups. The difference between the obese and control groups was found statistically significant in Valsalva ratio, 30/15 ratio and Heart rate responses to deep breathing (P < 0.025), and insignificant in Orthostatic test (P > 0.05). Ophthalmic examinations were normal. The result of these tests suggested normal activity of sympathetic, and hypoactivity of parasympathetic nervous system, implying parasympathetic nervous system dysfunction as a risk factor or associated finding in childhood obesity. (C) 2000 Elsevier Science B.V. All rights reserved.Öğe Effects of valproate and carbamazepine on serum levels of homocysteine, vitamin B12, and folic acid(Elsevier Science Bv, 2003) Karabiber, H; Sommezgoz, E; Ozerol, E; Yakinci, C; Otlu, B; Yologlu, SHomocysteine (HMC) is a sulfur containing amino acid, which plays a role in methionine metabolism. Folic acid (FA) and vitamin B12 (B12) are essential for remethylization of HMC to methionine. HMC level increases in the deficiency of these vitamins. Hyperhomocysteinemia causes vascular endothelial damage, which causes atherosclerosis. The aim of this study is to investigate the effect of valproate (VA) and carbamazepine (CBZ) on the serum levels of HMC, B12, and FA. Thirty-six children receiving CBZ and 30 children receiving VA for epilepsy for the last 1-year period and 29 healthy children as control were the population of this study. After 6 h of fasting serum HMC, B12, and FA levels were measured and results were compared statistically. Mean values of HMC, FA, and B12 levels in control group were 9.2 +/- 2.7 mumol/l, 9.0 +/- 2.0 ng/ml, and 342 +/- 162 pg/ml, in VA group 14.0 +/- 6.8 mumol/l, 7.3 +/- 2.9 ng/ml, and 368 +/- 159 pg/ml, in CBZ group 16.0 +/- 13.1 mumol/l, 7.5 +/- 3.3 ng/ml, and 285 +/- 158 pg/ml, respectively. Serum HMC levels were higher in VA and CBZ groups than control group (P < 0.01 and P < 0.05, respectively). Serum FA levels were lower in VA and CBZ groups compared to control group (P < 0.05). Serum levels of B12 were not different between VA and control groups (P > 0.05). In CBZ group serum B 12 levels were lower than control group (P < 0.05). FA may be added to the treatment protocol (if the patients take only CBZ, then B 12 should also be added) for patients taking these antiepileptic drugs to decrease the degenerative effect of VA and CBZ on vascular endothelium. (C) 2002 Elsevier Science B.V. All rights reserved.Öğe Giant congenital nevomelanocytic nevus and intracerebral calcified lesion(Wiley, 1996) Arisoy, AE; Akbasak, A; Oram, Y; Muftuoglu, M; Karabiber, H; Baysal, T; Arisoy, ES[Abstract Not Available]Öğe Head circumference measurement of urban children aged between 6 and 12 in Malatya, Turkey(Elsevier Science Bv, 2001) Karabiber, H; Durmaz, Y; Yakinci, C; Kutlu, O; Gumusalan, Y; Yologlu, S; Yalaz, KHead circumference (HQ is one of the most significant findings in physical examination, especially in the evaluation of the development and early diagnosis of neurological disorders in children. In the standard charts for developmental evaluation of Turkish children, there is no HC reference values for children over 6 years of age. Since the HC standards show differences among races and generations, many researchers have obtained normal values for their own populations, and recommend periodic reevaluation of these standards. In this study, the HC of 1826 healthy children (945 male, 881 female) aged between 6 and 12 years was measured in order to establish the Turkish standards. The sample represented various socioeconomic levels in the city of Malatya, Turkey. The study was conducted in ten schools and measurements were done twice by a pediatrician and the mean was recorded. Charts and graphs for boys and girls were prepared separately. Results were compared to the values of other populations. HC values of Turkish children were similar to that of Irish children. The data obtained in this study may replace the Nelhaus criteria to be used in clinics. However, a more widespread study should be carried out by including children from different regions of Turkey. (C) 2001 Elsevier Science B.V. All rights reserved.Öğe Midazolam in treatment of various types of seizures in children(Elsevier Science Bv, 1997) Yakinci, C; Müngen, B; Sahin, S; Karabiber, H; Durmaz, YMidazolam is a recently developed water-soluble benzodiazepine that shares anxiolytic, muscle relaxant, hypnotic and anticonvulsant actions with other members of this class. There are limited studies that midazolam can be used successfully to treat seizures in adults and children. In this study, 0.2 mg/kg intramuscular (IM) midazolam was administered to 11 children (eight boys and three girls), aged 3 days to 4 years (mean age 1.8 +/- 1.4 years), with seizures of various types. In all but one child, seizures stopped in 15 s-5 min after injection. No side effects were observed. These results suggest that IM administration of midazolam may be useful in a variety of seizures during childhood, especially in case of intravenous (IV) line problem. (C) 1997 Elsevier Science B.V.Öğe Prevalence of epilepsy in 3637 children of primary school age in the province of Malatya, Turkey(Oxford Univ Press, 2001) Karabiber, H; Yakinci, C; Durmaz, Y; Kutlu, O; Soylu, H[Abstract Not Available]Öğe Prevalence of epilepsy in 3637 children of primary school age in the province of Malatya, Turkey(Oxford Univ Press, 2001) Karabiber, H; Yakinci, C; Durmaz, Y; Kutlu, O; Soylu, H[Abstract Not Available]Öğe Prevalence of febrile convulsion in 3637 children of primary school age in the province of Malatya, Turkey(Oxford Univ Press, 2000) Yakinci, C; Kutlu, NO; Durmaz, Y; Karabiber, H; Egri, M[Abstract Not Available]Öğe Prevalence of hypopigmented maculae and cafe-au-lait spots in idiopathic epileptic and healthy children(Sage Publications Inc, 2002) Karabiber, H; Sasmaz, S; Turanli, G; Yakinci, CThe cutaneous lesions and findings related to the central nervous system are frequently seen concomitantly in many patients. Neurocutaneous syndromes are the most typical examples supporting this observation. The prevalences of hypopigmented maculae and cafe-au-lait spots were investigated in 210 idiopathic epileptic children between the ages of 2 and 17 years and 2754 healthy children between the ages of 5 and 15 years. In the group of epileptic children, hypopigmented maculae and cafe-au-lait spots were observed in 30 (14.3%) and 63 (30%) children, respectively. In the group of healthy children, the prevalence of hypopigmented maculae was 1.6% (44 children) and of cafe-au-lait spots was 2.8% (78 children). The difference between the two groups was very significant statistically (P <.0001).Öğe A rare complication of generalized edema in juvenile dermatomyositis: a report of one case(Elsevier Science Bv, 2004) Karabiber, H; Aslan, M; Alkan, A; Yakinci, CJuvenile dermatomyositis (JDM) is a rare autoimmune disease characterized by inflammation of the muscle, connective tissue, skin, gastrointestinal tract and small nerves. Periorbital and facial edema may also be associated. Although localized edema is a common feature of juvenile dermatomyositis, generalized edema has been reported rarely. In this article, we report a 14-year-old boy with juvenile dermatomyositis presenting with generalized edema. Of the diagnostic criteria of JDM, severe symmetric weakness of the proximal musculature, characteristic cutaneous changes, elevated serum muscle enzymes and myopathic electromyographic abnormalities were observed. Magnetic resonance imaging (MRI) of the lower extremities and pelvis showed marked diffuse edema in the subcutaneous tissue, muscles and myofascia. We suggest that MRI findings, which are not among the diagnostic criteria, may also be included in the diagnostic criteria of JDM. To the best of our knowledge, this is the 19th case of JDM reported for generalized edema in the English literature. (C) 2003 Elsevier B.V. All rights reserved.Öğe Serum nitrite and nitrate levels in epileptic children using valproic acid or carbamazepine(Elsevier Science Bv, 2004) Karabiber, H; Yakinci, C; Durmaz, Y; Temel, I; Mehmet, NIn experimental epilepsy studies, nitric oxide was found to act as both proconvulsant and anticonvulsant. The objective. of this study was to investigate the effects of valproic acid and carbamazepine on serum levels of nitrite and nitrate, which are the metabolites of nitric oxide. To achieve this goal, serum nitrite and nitrate levels were determined in active epileptic 34 children using valproic acid and 23 children using carbamazepine and in non-active epileptic 38 children (control group) not using any antiepileptic drug. In the valproic acid group serum nitrite and nitrate levels were 2.66 +/- 2.11 mumol/l and 69.35 +/- 23.20 mumol/l, 1.89 +/- 1.01 mumol/l and 49.39 +/- 10.61 mumol/l in the carbamazepine group, and 1.22 +/- 0.55 mumol/l, 29.53 +/- 10.05 mumol in the control group, respectively. Nitrite and nitrate levels were significantly high in both valproic acid and carbamazepine groups compared to the control group (P < 0.01). When valproic acid and carbamazepine groups were compared to each other, level of nitrate was found statistically higher in the valproic acid group in relation to the carbamazepine group (P < 0.01), however, there was no statistically significant difference in the levels of nitrite (P > 0.05). No relation could be found between serum drug levels and nitrite and nitrate levels. According to these results, it can be suggested that valproic acid and carbamazepine might have antiepileptic effects through nitric oxide. (C) 2003 Elsevier B.V. All fights reserved.
