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Öğe Clinical and imaging findings in childhood posterior reversible encephalopathy syndrome(Iranian Child Neurology Society, 2018) Gungor S.; Kilic B.; Tabel Y.; Selimoglu A.; Ozgen U.; Yilmaz S.; Sigirci A.Objective 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. © 2018, Iranian Child Neurology Society. All rights reserved.Öğe Clinical features of children with henoch-schonlein: Purpura risk factors associated with renal involvement(2012) Tabel Y.; Inanc F.C.; Dogan D.G.; Elmas A.T.Introduction. This study aimed to evaluate renal involvement and factors affecting the prognosis in patients with Henoch-Schonlein purpura (HSP). Materials and Methods. The outcomes of 107 children diagnosed with HSP who had been followed up for at least 6 months were reviewed. Results. Renal involvement was observed in 26.1% of the patients. The mean age of the patients with renal involvement was 8.8±4.0 years as compared to 7.1±2.9 years in the patients without renal involvement (P=.02). The risk of renal involvement was found to be significantly higher in the patients who were 10 years old and over (P<.001). In the group with renal involvement, the frequency of scrotal involvement was significantly higher than that of the group without renal involvement (P=.02). The mean serum immunoglobulin A level of the patients with renal involvements was significantly higher (P=.04) and the mean serum complement C3 levels was significantly lower (P=.04) than those of the patients without renal involvement. None of the patients with renal involvement reached end-stage kidney failure. No significant relationship was observed between the development of renal involvement and early steroid treatment. Conclusions. This study proposes that in old children with HSP, elevated serum immunoglobulin A levels, decreased serum complement C3 levels, and scrotal involvement are associated with renal involvement. We failed to find any effect of steroid treatment on development of renal involvement.Öğe Management of thrombosis in a pediatric renal transplant patient with factor vii deficiency a dilemma concerning recombinant factor VIIa(BETA Medical Publishers Ltd, 2020) Yalcin M.; Simsek A.; Tabel Y.; Dogan S.M.; Piskin T.Hemorrhagic complications in surgical patients with congenital factor VII deficiency are a major concern. Replacement therapy is required, in which recombinant factor VIIa is the first treatment choice, by virtue of its higher efficacy and no risk of infection. Because of the risk of vascular thrombosis, recombinant factor VIIa treatment may result in catastrophic outcomes, includ-ing graft loss in transplant patients. We present the case of a 7-year-old male who underwent renal transplantation and who developed renal thrombosis after recombinant factor VIIa substution therapy for factor VII deficiency. © 2020, BETA Medical Publishers Ltd. All rights reserved.Öğe A rear complication of chronic hypertension in childhood: Aortic dissection: A case report(2010) Karakurt C.; Koçak G.; Erdil N.; Battalo?lu B.; Nisano?lu V.; Tabel Y.; Si?irci A.Aortic dissection is a life-threatining condition and is commonly seen elderly patients with connective tissue disorders, hypertension, and atherosclerosis. Hypertension is a main risk factor of development aortic aneursym and aortic dissection in adult patients. Aortic dissection is rare in infants and children younger than 16 years old, and is not always associated with Marfan's syndrome or other connective tissue di sorder. We descri be a 16-years-old boy, applied our emergency department due to strongly chest pain, with ruptured aortic dissection related to chronic renal hypertension and successfully treated with surgical approach. Chronic hypertensive patients in childhood should be monitoring with echocardiography regularly for aortic root dilatation and dissection. Copyright © 2010 by Tür kiye Klinikleri.Öğe Reversible posterior leucoencephalopathy in an 11 year-old male child with lupus nephritis(2010) Tabel Y.; Akin I.M.; Güngör S.; Karakurt C.; Özgen Ü.Systemic 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.
