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Öğe Effects of interferon-? therapy on insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) levels in children with chronic hepatitis B(Karger, 2009) Ertekin, Vildan; Tosun, Mahya Sultan; Orbak, Zerrin; Selimoglu, Mukadder Ayse[Abstract Not Available]Öğe Insulin resistance in patients with vitamin D hypervitaminosis(Karger, 2009) Orbak, Zerrin; Akinci, Aysehan; Okten, Aysenur; Doneray, Hakan[Abstract Not Available]Öğe Intestinal tuberculosis mimicking Crohn's disease(Elsevier Science Inc, 2007) Ertekin, Vildan; Selimoglu, Mukadder Ayse; Okcu, Nihat; Orbak, Zerrin; Guendogdu, Cemal[Abstract Not Available]Öğe Neonatal Screening for Congenital Adrenal Hyperplasia in Turkey: Outcomes of Extended Pilot Study in 241,083 Infants(2020) Güran, Tülay; Tezel, Başak; Çakır, Meltem; Akıncı, Ayşehan; Orbak, Zerrin; Keskin, Mehmet; Eklioğlu, Beray; Ozon, Alev; Özbek, Mehmet Nuri; Karagüzel, Gülay; Hatipoğlu, Nihal; Gürbüz, Fatih; Çizmecioğlu, Filiz; Kara, Cengiz; Şimşek, Enver; Baş, Firdevs; Aydın, Murat; Darendeliler, FeyzaAbstract: Objective: Turkish Directorate of Public Health introduced the first pilot screening program for congenital adrenal hyperplasia (CAH) in four Turkish cities in 2017, and in 2018 extended the program, with a slight change in screening strategy, to fourteen cities. To evaluate the performance of the extended study and update previously reported outcomes. Methods: Retrospective, descriptive study. Neonates of ?32 gestational weeks and ?1500 gr birth weight from fourteen cities, born between May-December 2018, were included. Screening protocol included one sample, two-tier testing as applied in the previous pilot study. In the first step, 17?-hydroxyprogesterone (17-OHP) was measured by fluoroimmunoassay in dried blood spots (DBS) obtained at 3-5 days of life. Cases with positive initial screening underwent second tier testing by steroid profiling in DBS using liquid chromatographytandem mass spectrometry to measure 17-OHP, 21-deoxycortisol (21-S), cortisol (F), 11-deoxycortisol and androstenedione. The babies with a steroid ratio (21-S+17-OHP)/F of ?0.7 (increased from ?0.5 in the earlier pilot study) were referred to pediatric endocrinology clinics for diagnostic assessment. Results: In the evaluated period, 241,083 newborns were screened. 12,321 (5.11%) required second-tier testing and 880 (0.36%) were referred for clinical assessment, twenty of whom were diagnosed with CAH (10 females, 10 males). Sixteen were diagnosed as classical 21-hydroxylase deficiency (21-OHD) CAH (12 with salt-wasting and four with simple virilising CAH), and four cases were identified with 11?-OHD CAH. No case of salt-wasting CAH was missed by neonatal screening (sensitivity was 100%). The incidence of classical 21-OHD and 11?-OHD in the screened population was 1: 15,067 and 1: 60,270, respectively. Conclusion: Turkish neonatal CAH screening effectively led to earlier diagnosis of 21-OHD and 11?-OHD, using steroid profiling as a second-tier test. This will result in improved care of these patients in the future.Öğe Tüberküloz menenjitli 19 çocuk olgunun değerlendirilmesi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 1996) Energin, V. Meltem; Orbak, Zerrin; Alp, Handan; Akdağ, Recep; Selimoğlu, M. AyşeBu çalışma Atatürk Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Kliniğinde Ocak 1991-Ocak 1994 tarihleri arasında yatırılarak izlenen 19 tüberküloz menenjitli olgu üzerinde gerçekleştirildi. Olguların ortalama yaşı 55.5 ± 31.7 ay olup %68.4'ü kız idi. En sık görülen şikayetler ateş (%89.5), kusma (%57.9), ve dalgınlık (%42.1) idi. Sekiz olguda (%42.1) pozitif aile öyküsü, dört (%10.5) olguda PPD pozitifliği tesbit edildi. Başvurudaki ortalama beyin omurilik (BOS) protein düzeyi 160 mg/dl, BOS/serum glukoz oram %30.8, BOS lökosit sayısı 148/mm3 ve % lenfosit 69±16 (25-100) bulunmuştur. 11 hastada (%57.9) tüberküloz lehine akciğer grafisi bulguları saptandı. 12 olguya bilgisayarlı beyin tomografisi(BBT) çektirilebildi, yedi(%58.3)'sinde hidrosefali tesbit edildi. Altı olguda bakılan adenozin deaminaz (ADA) seviyesi yüksekti (33.4+4.7 U/L) dört olgunun tanısı da polimeraz zincir reaksiyonu (PCR) ile doğrulandı. Beş hastada kültürde Mycobacterium Tuberculosis üredi. Başvuru esnasında iki (%10.5) olgu Evre I, sekiz (%42.1) olgu Evre II. dokuz (%47.4) olgu ise Evre III olup mortalite oranı %47.4 idi. Evre l'de sekel oranı % 100 iken Evre ll'de % 57.1 olarak bulundu. Tüberküloz menenenjitte mortalite ve morbiditeyi azaltmak açısından erken tanının önemi vurgulandı.