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Öğe Brusellaya Bagli Trombositopenik Purpura(Aves Yayincilik, Ibrahim Kara, 2009) Ozen, Metehan; Ozgen, Unsal; Gungor, SerdalBrucellar infections are still a major public health issue in Mediterranean countries. Brucellosis may cause hematological abnormalities, particularly cytopenias. Severe thrombocytopenia leading to mucosal bleeding and purpuric rash is relatively infrequent. We herewith present three patients who were admitted with mucosal bleeding and purpura, and were finally diagnosed as brucellosis. The severe isolated thrombocytopenia, purpuric rash and compatible bone marrow findings on admission suggested the presumed diagnosis of ITP in all cases. All three patients received different treatment regimens and finally recovered without complications. There is no consensus regarding the management of brucella-induced thrombocytopenic purpura in the literature. The hematological consequences of brucellosis should always be kept in mind in the differential diagnosis of isolated thrombocytopenia in endemic areas.Öğe Clinical and Imaging Findings in Childhood Posterior Reversible Encephalopathy Syndrome(Iranian Child Neurology Soc, 2018) Gungor, Serdal; Kilic, Betul; Tabel, Yilmaz; Selimoglu, Ayse; Ozgen, Unsal; Yilmaz, Sezai; Sigirci, AhmetObjective Posterior reversible encephalopathy syndrome (PRES) is characterized by typical radiologic findings in the posterior regions of the cerebral hemispheres and cerebellum. The symptoms include headache, nausea, vomiting, visual disturbances, focal neurologic deficits, and seizures. The aim of this study is to evaluate the clinical and radiological features of PRES in children and to emphasize the recognition of atypical features. Materials & Methods We retrospectively examined 23 children with PRES from Mar 2010-Apr 2015 in Inonu University Turgut Ozal Medical Center in Turkey. We compared the clinical features and cranial MRI findings between underlying diseases of PRES. Results The most common precipitating factors were hypertension (78.2%) and medications, namely immunosuppressive and antineoplastic agents (60.8%). Manifestations included mental changes (100%), seizures (95.6%), headache (60.8%), and visual disturbances (21.7%) of mean 3.6 (range 1-10) days' duration. Cranial magnetic resonance imaging (MRI) showed bilateral occipital lesions in all patients, associated in 82.6% with less typical distribution of lesions in frontal, temporal or parietal lobes, cerebellum, corpus callosum, basal ganglia, thalamus, and brain stem. Frontal involvement was predominant, observed in 56.5% of patients. Clinical recovery was followed by radiologic resolution in all patients. Conclusion PRES is often unsuspected by the clinician, thus radiologists may be the first to suggest this diagnosis on an MRI obtained for seizures or encephalopathy. Atypical MRI finding is seen quite often. Rapid diagnosis and treatment are required to avoid a devastating outcome.Öğe Evaluation of the left ventricular function with tissue tracking and tissue Doppler echocardiography in pediatric malignancy survivors after anthracycline therapy(Wiley, 2008) Karakurt, Cemsit; Kocak, Gulendam; Ozgen, UnsalAlthough the anthracyclines have gained widespread use in the treatment of childhood hematological malignancies and solid tumors, cardiotoxicity is the major limiting factor in the use of anthracyclines. The aim of this study was to assess the mitral annular displacement by tissue tracking in pediatric malignancy survivors who had been treated with anthracycline groups chemotheraphy and compare with the tissue Doppler and conventional two dimensional measurements and Doppler indices. In this study, 32 pediatric malignancy survivors and 22 healthy children were assessed with 2D, colour-coded echocardiography. Left ventricular ejection fraction, fractional shortening, stroke volume, cardiac output, cardiac index and diastolic functions were measured. All subjects were assessed with tissue Doppler echocardiography, mitral annular displacements, and also with tissue tracking method. We detected that peak velocity of the early rapid filling on tissue Doppler (E') was lower (p < 0.05) and the ratio of early peak velocity of rapid filling on pulse Doppler to tissue Doppler (E/E') values were statistically higher in patient group than control group (p < 0.05). Myocardial performance index values were also higher in patient group than the control group (p < 0.01). It appears that MPI is a useful echocardiograghic method than tissue tracking of mitral annular displacement in patients with pediatric cancer survivors who had subclinical diastolic dysfunction.Öğe Hodgkin's lymphoma associated with paraneoplastic cerebellar degeneration in children: a case report and review of the literature(Springer, 2017) Gungor, Serdal; Kilic, Betul; Arslan, Mujgan; Ozgen, Unsal; Dalmau, JosepParaneoplastic cerebellar degeneration (PCD) can occur severely and appear as subacute cerebellar syndrome. PCD may be associated with small cell lung cancer, adenocarcinoma, breast cancer, ovarian carcinoma, and Hodgkin's lymphoma. An 11-year-old male was admitted with acute cerebellar ataxia, dysarthria, and diplopia. Mediastinal conglomerated lymph nodes were depicted in a chest computed tomography (CT) examination, and diagnosis of stage IV Hodgkin's lymphoma was obtained after a lymph node biopsy. The antibodies against Purkinje cells (anti-Tr antibody) were positive immunohistochemically. Thus, paraneoplastic cerebellar degeneration depending on Hodgkin's disease was diagnosed. Despite the completion of chemotherapy, neurological recovery was not observed in the patient and plasmapheresis with immunoadsorption, and intravenous immunoglobulin (IVIG) was performed. Truncal ataxia, gait disturbance, and tremors decreased. Consequently, we thought that plasmapheresis with the immunoadsorption method and IVIG therapy might be a treatment option for cerebellar ataxia caused by a mechanism of immune ancestry.Öğe Hodgkin's lymphoma associated with paraneoplastic cerebellar degeneration in children: a case report and review of the literature (vol 33, pg 1025, 2017)(Springer, 2017) Gungor, Serdal; Kilic, Betul; Arslan, Mujgan; Ozgen, Unsal; Dalmau, Josep[Abstract Not Available]Öğe Prevalence of Demodex folliculorum and Demodex brevis in childhood malnutrition and malignancy(Wiley, 2013) Kaya, Sadik; Selimoglu, Mukadder Ayse; Kaya, Ozlem Aycan; Ozgen, UnsalBackground Hair follicle mites, Demodexfolliculorum and Demodexbrevis, are known to accompany immune-deficiency states, however no study so far has investigated their presence in malnutrition. In this study we aimed to determine the prevalence of those mites in childhood malnutrition, malignancy and risk factors. Methods One hundred children with malnutrition, 31 children with malignancy and 63 children without any chronic disease and infection were included in this study. History, physical examination, anthropometric measurements and routine laboratory findings were recorded. Demodex spp. were investigated by standard superficial skin biopsies. Results Demodex was found in 25 patients (25%), 10 patients (32.3%), and one patient (1.6%) among malnutrition, malignancy, and control groups, respectively (P = 0.001). By using multilogistic regression binary method, it was found that malnutrition, malignancy and low socioeconomic level increased the risk 17.37 times (P = 0.006), 27.29 times (P = 0.002), and 2.3 times (P = 0.037), respectively. Of 22 children who were evaluated after 6 months, 13 (59.1%) were negative for Demodex. In 11 (84.6%) of those 13, nutritional status was improved. Conclusion Demodex was detected in approximately in one-quarter and one-third of children with malnutrition and malignancy, respectively. Eliminating the cause of immunosuppression, such as poor nutritional status, seems also to be an effective method for eliminating Demodex.Öğe Publication Pattern of Turkish Medical Theses: Analysis of 22.625 Medical Theses Completed in Years 1980-2005(Ortadogu Ad Pres & Publ Co, 2011) Ozgen, Unsal; Egri, Mucahit; Aktas, Mumtaz; Sandikkaya, Ayse; Ozturk, O. Faruk; Can, Sermet; Ozcan, CemalObjective: The objective of this study was to determine the conversion rates of Turkish residency theses to scientific articles. Material and Methods: 22.625 residency theses written at 28 university hospitals, nine state hospitals and two military hospitals' residency programmes and recorded at the web of National Thesis Center were searched through Web of Science in order to evaluate their publication pattern in SCI-expanded journals in 1980-2005. Results: The number of published thesis at SCI expanded journals was found to be 1397 (6.2%) with the median number of citations received per paper ranging from 0.3 to 5.0. Publication percentage was highest for theses written at military hospitals and lowest for those written at state hospitals. Conclusion: Percentage of published thesis in Turkey is lower when compared to the remaining European Countries. Therefore, we need alternative practices to use our manpower, time and financial resources more effectively. The first alternative is to put an end to the obligation to write thesis in order to complete residency training in some types of hospitals or to convert this obligation to an option. Another alternative is to establish a National Thesis Advisory Center and make it essential to get approval from this center in order to conduct a thesis project.Öğe REVERSIBLE POSTERIOR LEUCOENCEPHALOPATHY IN AN 11 YEAR-OLD MALE CHILD WITH LUPUS NEPHRITIS(Marmara Univ, Fac Medicine, 2010) Tabel, Yilmaz; Akin, Ilke Mungan; Gungor, Serdal; Karakurt, Cemsit; Ozgen, UnsalSystemic lupus erythematosus is a chronic inflammatory disease characterized by highly diverse clinical manifestations. The major organ system involvements in childhood systemic lupus erythematosus are similar to those found in adults. Recognizing and reversing secondary causes of central nervous system abnormalities in patients with systemic lupus erythematosus are essential for preventing long-term neurologic disability or death. In this manuscript, we present an 11 year-old male followed up in our clinic, who had the very rare involvement and complications of systemic lupus erythematosus in childhood. He developed a reversible posterior leucoencephalopathy after the first dose of cyclophosphamide, but cyclophosphamide therapy was not stopped as there was no clear evidence in the literature related to the role of this drug in reversible posterior leucoencephalopathy. The patient has now recovered.Öğe The Second and Third Hemoglobin Kansas Cases in the Turkish Population(Galenos Yayincilik, 2017) Tanriverdi, Zeynep Kayra; Akyay, Arzu; Sen, Askin; Taskapan, Cagatay; Ozgen, Unsal[Abstract Not Available]Öğe Therapeutic plasma-exchange in hematologic disease: Results from a single center in Eastern Anatolia(Pergamon-Elsevier Science Ltd, 2013) Erkurt, Mehmet Ali; Kuku, Lrfan; Kaya, Emin; Ozgen, Unsal; Berber, Ilhami; Koroglu, Mustafa; Ozgul, MustafaTherapeutic plasma-exchange (TPE) is used as primary and adjunctive therapy in treatment of several hematologic diseases. We retrospectively evaluated the results of TPE in hematologic diseases during 2008-2012. A total of 301 TPE procedures were performed in 44 patients (19 male and 25 female, with mean age of 50.6 +/- 15 years). Fifteen of 44 patients had thrombotic thrombocytopenic purpura (TTP), 14 patients had HELLP syndrome (Hemolysis Elevated Liver enzymes, Low Platelet count), 10 patients had multiple myeloma-hyperviscosity and the rest five patients had snake bite. Fresh frozen plasma (FFP) was used as replacement fluid. Complete response (CR) was achieved on 13 patients (87%) in primarily TTP. CR was achieved in all other three diseases. Total complications were detected in 8.1% of the TPE procedures. Adverse events (AEs), were seen in 5.4% of all procedures. None of the patients died from any complication. AE occurred in 4% (Grade-I), 1% (Grade-II), and 0.3% (Grade-III) of the procedures. The most common AE were nausea/vomiting, hypotension, pruritus and abdominal pain. TPE is effectively and safely carried out in our center in hematologic diseases. (C) 2013 Elsevier Ltd. All rights reserved.Öğe Thromboembolism in Children(Springer India, 2023) Oncul, Yurday; Akyay, Arzu; Ozgen, UnsalObjectiveTo study pediatric patients who were diagnosed with thrombosis between January 2009 and March 2020.MethodsPatients were evaluated with respect to thrombophilic risk factors, localization of the thrombus, response to treatment, and recurrence rates during the last 11 y.ResultsAmong 84 patients, 59 (70%) had venous thrombosis and 20 (24%) had arterial thrombosis. The number of documented thrombosis amongst hospitalized children in authors' hospital has increased over the years. It has been observed that the annual incidence of thromboembolism has increased after 2014. Thirteen patients were recorded between 2009 and 2014 and 71 patients between 2015 and 2020 (until March 2020). Exact thrombosis localization could not be detected in 5 patients. The median age of patients was 8 +/- 5.95 (range 0-18). Fourteen children (16.9%) had a history of familial thrombosis. Genetic and/or acquired risk factors were detected in 81 (96.4%) of the patients. Overall, 64 patients (76.1%) had acquired risk factors such as infection (20.2%), catheterization (13.1%), liver disease (11.9%), mastoiditis (8.3%), liver transplantation (6%), hypoxic-ischemic encephalopathy (4.8%), dehydration (3.6%), trauma (3.6%) and cancer (2.4%). As genetic risk factors, the most common genetic mutations were PAI-1 4G>5G, MTHFR C677T, and MTHFR A1298C mutations. Twenty-eight (41.2%) patients had at least one genetic thrombophilic mutation. At least one homozygous mutation in 37 patients (44%) and at least one heterozygous mutation in 55 patients (65.4%) were detected.ConclusionsThe annual incidence of thrombosis has increased over the years. Genetic predisposition and acquired risk factors play an important role in etiology, treatment, and follow-up in children with thromboembolism. Especially, genetic predisposition is common. Thrombophilic risk factors should be investigated and optimal therapeutic and prophylactic measures should be promptly taken in children with thrombosis.Öğe Typhlitis in rectum(Wiley, 2010) Ozgen, Unsal; Uzum, Isa; Mizrak, Buelent; Sarac, Kaya[Abstract Not Available]
