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Öğe Demographic and systemic manifestations of patients diagnosed with ataxia-telangiectasia(Bilimsel Tip Yayinevi, 2014) Catal, Ferhat; Topal, Erdem; Celiksoy, Mehmet Halil; Ermistekin, Halime; Kutluturk, Kazim; Yildirim, Nurdan; Sinanoglu, Muhammed SelcukObjective: Ataxia-telangiectasia is rare, an autosomal recessive, neurodegenerative disorder characterized by progressive cerebellar ataxia, cutaneous and conjunctival telangiectasia, immunodeficiency, and increased risk of malignancy. In this study, we aim to determinate demographics, neurological, dermatological and immunological manifestation of children diagnosed with ataxia-telangiectasia in our clinics. Materials and Methods: We did a retrospective medical chart review of pediatric allergy and immunology database for children diagnosed with ataxiatelangiectasia in Inonu and Ondokuz Mayis University Faculty of Medicine between 2006 and 2013. Results: Ataxia-telangiectasia was diagnosed in 25 patients. The mean age was 10.08 +/- 4.14 (died children were included) and 16 (64%) of the patients were male. The mean follow up period was 5.32 +/- 3.84 years. Ataxia was the first sign of disease which was noticed by the parents and median diagnosis age was 4 years old (min: 1.5, max: 12). Neurological and dermatological manifestations were seen in all patients. Also immunological manifestations were seen in 85% of all patients. The most frequent neurologic sign was ataxia and present in all patients, followed by dysmetria (96%), dysarthria (92%), bradykinesia (80%) and ocular apraxy (60%), respectively. Telangiectasia was present in all patients and the most frequent localization was conjunctiva. Pigmentary anomalies were present in 17 (68%) patients, molluscum contagiosum in 2 (8%) patients and verruca in 1 (4%) patient. The most frequent form of immunologic deficiency was IgA deficiency (80%) which was followed by Ig G deficiency (60%) and lymphopenia (12%). Growth failure was present in 96% of patients and head circumference was under -1 SD in 56% of patients. In follow up, 5 (20%) patients had experienced recurrent otitis media, 18 (% 72) patients had experienced recurrent pulmonary infection. Bronchiectasis was developed in 7 (28%) patients and hemophagocytic sendrome was developed in one patient. Seven patients died (three due to non-Hodgkin lymphoma, two due to pulmonary infection, one due to hemophagocytic sendrome and one due to acute lymphoblastic leukemia). Conclusion: Ataxia and telenjiectasia were the most frequent signs of the disease and followed by immunological and pigmentary anomalies. Therefore, ataxia telenjiectasia should be consider in diagnosis if the patients who have dermatological signs such as telangiectasia and pigmentary anomalies and growth failure with ataxia.Öğe The effect of modification of inhaler spacer’s visual user guideline on the correct use of the inhaler spacer(2018) Topal, Erdem; Demirtas, Mehmet Semih; Kutluturk, Yesim; Kutluturk, Kazim; Turker, Kenan; Sayan, Yekbun Gamze; Alatas, CemAim: To determine the effect of modification of visual user guideline of inhaler spacer device on the skill of correct usage. Material and Method: The medical faculty intern students at İnönü University were enrolled in the study. The participants were interviewed face-to-face and requested to fill out questionnaires for modified and non-modified visual user guideline. Result: A total of 172 students were included in the study; 104 (60.5%) of the students were male. The study group included 90 students who were evaluated with the modified visual user guidelines; the other group included 82 students who were evaluated with the non-modified visual user guidelines. 76 (84%) out of 90 participants in the group who was given modified visual user guideline performed the inhaler spacer device technique correctly. In contrast, only 12 (15%) of 82 participants in the group who was given non-modified visual user guideline carried out the inhaler spacer device technique correctly (p=0.001). The most common mistakes made in non-modified visual user guideline group were; taking 5-6 deep and slow breaths; 28 (34.1%), shaking MDI and removing cap; 45 (54.9%), and placing mouthpiece between teeth and lips or placing facemask; 57 (69.5%), respectively. Having compared the both groups for the steps of inhaler spacer device use, the modified visual user guideline group fulfilled all the steps more correctly. Conclusion: The visual user guideline of the inhaler devices in our country are insufficient. We are of the opinion that especially visual improvements on user guideline will increase the correct usage of the device by parents.Öğe Evaluation of drug poisoning cases in pediatric emergency department(2021) Kutluturk, Kazim; Aslan, MehmetAim: This study aims to examine the demographic and clinical characteristics of childhood drug poisoning, review changes in diagnostic methods and treatments and identify factors affecting mortality to ultimately determine the present clinical picture. In doing so, more insight can be provided on the diagnosis, treatment, and prevention of poisonings. Materials and Methods: The retrospective evaluation of 655 patients between ages 1 month-18 years who were admitted to the Pediatric Emergency Department of Turgut Ozal Medical Center between January 2009 and June 2016 with cases of drug poisoning (mean 44±18 months). Results: Four hundred and nine female (62.4%) and 246 male patients (37.6%) were evaluated for a total of 655 cases. Drug poisoning cases were found to account for 1.08% of all visits to the emergency department. It was discovered that 62.1% of the poisonings were accidental, whereas 33% were suicide attempts and 4.9% therapeutic mistakes. 94.8% of drug poisonings occurred at households, while 5.2% occurred in non-household environments. Drug poisonings presented differences in terms of gender (62.4% female, 37.6% male). The number of drug poisoning cases were found to be higher in the months of summer and spring. The number of female cases peaked in the 13-18 age group (211 cases) and were higher than the same age group of males (30 cases). Conclusions: In our present study, we highlighted the profile of pediatric drug poisoning cases admitted to the Pediatric Emergency Service.Öğe The Prevalence of Allergic Diseases and Associated Risk Factors in the 6-7 Age Children Who are Living in Malatya, Turkey(Bilimsel Tip Yayinevi, 2017) Topal, Erdem; Kaplan, Fatih; Turker, Kenan; Kutluturk, Kazim; Gozukara Bag, HarikaObjective: The prevalence of allergic disease in children has been increasing in the recent years. There is no previous study on the prevalence of allergic disease in Malatya, Turkey. We aimed to investigate the prevalence of allergic disease and related risk factors among children aged 6-7 years in Malatya. Materials and Methods: We administered the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC) translated into the Turkish language to 480 children aged 6-7 years living in Malatya. The questionnaires were completed by the parents for 413 (86%) of the children. Results: There were 210 (50.8%) males and the overall mean age was 6.6 +/- 0.49 years. The lifetime prevalence of wheezing, rhinitis and eczema was 20.3%, 37% and 7.5% respectively and the reported prevalence for the last 12 months was 12.3%, 32% and 6.5% respectively. When the risk factors associated with allergic disease were analyzed; male gender (p=0.001), history of parental asthma (p=0.002), doctor's diagnosis of allergic rhinitis (p=0.025) and having cockroaches at the home (p=0.002) were associated with asthma. A history of doctor's diagnosis of asthma (p<0.001) and atopic eczema (p=0.001) were associated with rhinitis as risk factors. History of parental atopic eczema (p<0.001) and doctor's diagnosis of asthma (p=0.006) were associated with atopic eczema as risk factors. Conclusion: This study is the first to investigate the prevalence of allergic disease in the 6-7 years age group in Malatya using the ISAAC questionnaire. The current study shows the prevalence of allergic diseases is considerable in children living in Malatya.
