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Öğe Covid-19 Yayılma Şekli ve Tedavi(İnönü Üniversitesi Tıp Fakültesi, 2020) Açıkgöz, Ahmet Tuğrul; Tekin, MehmetBULAŞICILIK Salgının başlangıcında Wuhan’da yapılan araştırmaların çoğu ilk hastaların, Wuhan’da deniz ürünleri satan bir pazarda çalıştığını ya da ziyaret ettiğini göstermiştir. İlk önce yılanlardan kaynaklandığı düşünülmüş, daha sonraki çalışmalar ise yarasalarla ilgisi olduğunu göstermiştir. Salgın ilerledikçe bu virüs enfeksiyonunun insandan insana damlacık yoluyla ve kirlenmiş zeminlerle temas eden ellerin yüze sürülmesi yoluyla bulaştığı gösterilmekle birlikte sindirim sistemi yoluyla bulaştığı da düşünülmektedir.Öğe The Diagnostic Efficacy of and Requirement for Postnatal Ultrasonography Screening for Congenital Anomalies of the Kidney and Urinary Tract(Mdpi, 2023) Gulyuz, Abdulgani; Tekin, MehmetBackground: We aimed to investigate the efficacy of postnatal ultrasonography in detecting congenital anomalies of the kidneys and urinary tract in term infants without prenatal history of congenital anomalies of the kidneys and urinary tract. Methods: In this retrospective cohort study, we reviewed the records of term infants between six weeks and three months of age who underwent urinary tract ultrasonography during routine pediatric care. Results: Congenital anomalies of the kidneys and urinary tract were detected on prenatal ultrasonography in 75 of the 2620 patients included in the study. Congenital anomalies of the kidneys and urinary tract were detected via postnatal USG in 46 (1.8%) of 2554 patients without anomalies on prenatal USG screening. The most common anomaly was hydronephrosis (69.6%). Thirty-two cases of hydronephrosis, three cases of renal agenesis, four cases of horseshoe kidney, one case of MCDK, and two cases of duplex systems which were not detected on prenatal USG were detected on postnatal USG. On the other hand, 29 (1.1%) cases with mild or moderate hydronephrosis on prenatal ultrasonography did not have hydronephrosis on postnatal ultrasonography. Conclusions: In our study, approximately one-third of the cases of hydronephrosis, unilateral renal agenesis, duplex systems, horseshoe kidney, and ectopic kidney were not detected in prenatal ultrasonography screening. Therefore, we believe that in addition to prenatal ultrasonography screening, postnatal ultrasonography screening of all children for urinary tract anomalies would be beneficial.Öğe The evaluation of chickenpox in the post-vaccination period in Turkey(2019) Bucak, Ibrahim Hakan; Almis, Habip; Kayak, Davut; Kilic, Fedli Emre; Geyik, Mehmet; Tekin, Mehmet; Konca, Capan; Turgut, MehmetKeywords: key.br /Mateial and Methods: Patients aged 0-17 years presented to Adiyaman University Training and Research Hospital Pediatrics clinics and diagnosed with chickenpox between January 2013 and December 2016 were included in the study. Data were analyzed on Statistical Package for the Social Sciences (SPSS, version 22.0, Chicago, IL, USA) software. p0.05 was regarded as statistically significant.br /Results: 314 patients diagnosed with chickenpox were included in the study. Mean age of the subjects included was 84.76 ± 41.67 months, and 54.1% were males and 46.9% females. A significant difference was observed between the groups in terms of age (p=0.001). Cases’ ages decreased on a year-by-year basis. Fifty (15.9%) cases of chickenpox were identified as having been infected despite vaccine. A significant difference was determined between the mean ages of vaccinated and non-vaccinated patients with chickenpox.br /Conclusion: Although the addition of a single dose chickenpox vaccine to the national immunization schedule in Turkey reduces both severe complication and the incidence of the disease. In the light of our study we think that the addition of a second dose of chickenpox vaccination to our routine vaccine schedule will further reduce hospitalization numbers resulting from chickenpox-related complications. More comprehensive studies on the subject are now needed.br / Chickenpox, Child, Varicella, Vaccine.Öğe Evaluation of factors associated with time to diabetic ketoacidosis resolution in children(Bayrakol Medical Publisher, 2022) Oztekin, Mehmet; Konca, Capan; Tekin, Mehmet; Bolu, SemihAim: In this study, it was aimed to examine the relationship between clinical, demographic, and laboratory characteristics of patients at admission and time to diabetic ketoacidosis (DKA) resolution. Material and Methods: The files of patients with the diagnosis of DKA between January 2013 and December 2018 were reviewed retrospectively.Results: A total of 25 patients were included in the study. The mean age of the patients was 9.3 +/- 3.41 years. In 19 patients (76%), diabetes mellitus (DM) was diagnosed simultaneously with DKA. The mean time to DKA resolution was found to be significantly longer among patients with a family history of DM, newly diagnosed DM, respiratory distress, odor of acetone on the breath, altered consciousness, and severe coma. There was a significant correlation between the time to DKA resolution and the Pediatric Risk of Mortality score and the length of stay. There was also a significant negative correlation between time to DKA resolution and both pH and HCO3 levels. Discussion: DKA is an acute, severe, and life-threatening complication of type 1 DM in children. It is important to identify the factors affecting the prognosis and resolution time of comas in these patients in order to predict outcomes. Our findings show that the prognosis will be worse and the time to resolution will be longer among children with altered consciousness, newly diagnosed DM, respiratory distress, a high PRISM score, severe DKA coma, and severe acidosis at the time of admission.Öğe An evaluation of inflammation with mean platelet volume in children with celiac disease(2020) Asik, Abdulvahit; Dereci, Selim; Tekin, MehmetAim: The purpose of this study was to evaluate mean platelet volume and platelet distribution width in children with celiac disease.Material and Methods: Fifty children with celiac disease (18 boys, 32 girls) and 63 healthy volunteer children (23 boys, 40 girls) were included in the study. Demographic features such as age, and gender and laboratory values such as platelet count, mean platelet volume, and platelet distribution width were recorded from the patients’ files.Results: Fifty children with celiac disease (18 boys, 32 girls) and 63 healthy volunteer children (23 boys, 40 girls) were included in the study. No statistically significant differences were determined between the celiac disease group and the healthy control group in terms of platelet counts (275,418±70,657/mm3 and 280,888±61,290/mm3, respectively, p=0.661), platelet distribution width (19.27±1.14 fL and 19.16±1.13 fL, respectively, p=0.670) or mean platelet volume (7.31±1.36 fL and 7.38±1.45 fL, respectively, p=0.779). At ROC analysis, a cut off value was determined for platelet distribution width of 18.2 fL with 24.00% sensitivity and 87.30% specificity (AUC: 0.504, 95% Cl: 0.408-0.599 and p=0.947). A cutoff value for mean platelet volume of 0.74 was calculated with 72.00% sensitivity and 44.44% specificity (AUC: 0.520, 95% Cl: 0.424-0.615 and p=0.708).Conclusions: Mean platelet volume values in children with celiac disease were no different to those of the healthy control group. We think that the absence of any change in mean platelet volume, values in children diagnosed with celiac disease may be related to a short duration of inflammation.Öğe Evaluation of Pediatric Delirium Awareness and Management in Pediatric Intensive Care Units in Turkey(Georg Thieme Verlag Kg, 2022) Konca, Capan; Anil, Ayse Berna; Kulluoglu, Emine Pinar; Luleyap, Doga; Anil, Murat; Tekin, MehmetDelirium has been associated with prolonged pediatric intensive care unit (PICU) stay and mechanical ventilation times as well as high hospital costs and mortality rates. This work aimed to examine pediatric delirium awareness and delirium management in Turkey. A total of 19 physicians responsible for their respective PICUs completed the survey. Most of the units (57.9%) did not use any assessment tool. Varying measures were applied in different units to reduce the prevalence of delirium. The number of units that continuously measured noise was very low (15.8%). Eye mask and earpiece usage rates were also very low. In pharmacological treatment, haloperidol, dexmedetomidine, benzodiazepines, and atypical antipsychotics were the most preferred options. Some units have reached a sufficient level of pediatric delirium awareness and management. However, insufficiencies in delirium awareness and management remain in general.Öğe Evaluation of the frequency, follow-up, and treatment of patients with multisystem inflammatory syndrome related to COVID-19(2022) Öncül, Mehmet; Karakurt, Cemşit; Elkıran, Özlem; Tekin, Mehmet; Bağ, Harika GözükaraAim: Aim of this study is evaluate the clinical features, laboratory values, treatment and follow-up of in children with COVID-19-associated multisystem inflammatory syndrome (MIS-C) disease. Materials and Methods: In this study, patients aged between 2 months and 17 years, who applied to the Inonu University Faculty of Medicine, Department of Pediatrics between March 2020, and February 2021 due to MIS-C related to COVID-19 disease, were reviewed retrospectively. Demographic data, clinical features, laboratory values, treatment and follow-up data of the patients were evaluated. Results: Forty-nine patients diagnosed with MIS-C between March 2020 and February 2021 were included in the study. Thirty-one (72.7%) patients were male and 18 (27.3%) were female. The most common indications for admission were fever (100%), abdominal pain (51.6%), vomiting (42.9%), cough (38.8%), diarrhea (28.8%), shortness of breath, rash, conjunctivitis, and convulsion. Levels of CRP (93.9%), D-dimer (85.7%), fibrinogen (73.4%), interleukin 6 (IL6) (73.4%), procalcitonin (71.4%), NT-proBNP (63.2%) remained at high levels in respective number of patients. The (32.6%) patients were followed up in the intensive care unit. These patients had cardiogenic shock (26.5%), severe pneumonia (18.3%), and acute gastroenteritis (14.3%). It was determined that the mean age of the patients followed up for cardiogenic shock was 12.5 years and relatively higher (p<0.05). One patient died during follow-up. Conclusion: Although the manifestations of MIS- C due to COVID -19 are seen relatively rarely in children, it constitutes a serious problem and they mostly require hospitalization in intensive care unit, simultaneously involves many organ systems, and leads a serious course with higher risk of mortality. Another problem in these patients is higher rates of cardiac involvement. For this reason, it is important to take necessary precautions to protect children against COVID 19 and its associated MIS-C, and to include them in vaccination programs.Öğe Familial Mediterranean Fever in a Patient with PFAPA Syndrome(Galenos Yayincilik, 2015) Tekin, Mehmet; Konca, Capan; Gulyuz, Abdulgani; Toplu, YukselPeriodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome is one of the recurrent fever syndrome in childhood. Headache, abdominal pain, and joint pain can be seen in some patients, in addition to the classical signs. PFAPA attacks resolve with prednisolone. Membranous tonsillitis, lymphadenopathy, and occasionally aphthae were detected during each episode in a patient presenting with high fever, about 12 times until four years of age. All attacks were resolved completely with single-dose prednisolone in the patient, who was diagnosed with PFAPA syndrome. Genetic analysis was requested because of abdominal pain that was occasionally observed during attacks. Heterozygous mutation of M694V was detected through genetic investigation, and colchicine was initiated. The patient was diagnosed with familial Mediterranean fever (FMF) due to resolved abdominal pain and recurrent fever after colchicine therapy. It is known that some FMF patients benefit from prednisolone therapy. Therefore, other periodic fever syndromes should be excluded before the diagnosis of PFAPA and FMF should be considered in patients with PFAPA syndrome complaining of recurrent abdominal pain.Öğe Geç çocuklukta tanı konulan konjenital bir anomali: Morgagni hernisi(Ege Tıp Dergisi, 2015) Gülyüz, Abdulgani; Tekin, Mehmet; Konca, Çapan; Yetiş, Muhammed İkbal; Demircan, MehmetÖz: Morgagni hernisi nadir g örülen bir konjenital diyafragmatik herni türüdür ve çoğunlukla minimal bulgularla seyrettiği için ancak ileri yaşlarda tanı konulabilmektedir. Birçok olgu asemptomatik olduğu için, Morgagni hernisi literatürde söylendiğinden daha sık olabilir. Bu herniler bebek ve çocuklarda daha az görülmektedir. Çocuklarda majör bulgu tekrarlayan akciğer enfeksiyonları olmakla beraber nadiren yenidoğan döneminde akut solunum yetmezliği ile de karşımıza çıkabilmektedir. Yan grafi ile tanı konulabilir ve toraks tomografisi ile tanı kesinleştirilir. Genellikle asemptomatik seyretse de ileride gelişebilecek komplikasyonları önlemek amacıyla cerrahi onarım önerilmektedir. Burada iki hafta boyunca öksürük şikayeti bulunan ve Morgagni hernisi tanısı kon an 14 yaşında bir erkek ol gu sunulmaktadır.Öğe The mean platelet volume levels in children with PFAPA syndrome(Elsevier Ireland Ltd, 2014) Tekin, Mehmet; Toplu, Yuksel; Kahramaner, Zelal; Erdemir, Aydin; Gulyuz, Abdulgani; Konca, Capan; Uckardes, FatihObjectives:. To assess whether mean platelet volume (MPV) can be used as a marker in the differential diagnosis of periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome. Methods: The leucocyte counts, thrombocyte counts, and MPV values of 57 children with PFAPA syndrome were recorded during an attack and an attack free period. These values were compared with a healthy control group of 55 individuals. Demographic features of the PFAPA patients group including age, gender and age of first attack, age at diagnosis, frequency of attacks, serum reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were also recorded. Results: The MPV values of the children with PFAPA both during an attack and attack free period were found significantly lower than the MPV values of healthy control group (p < 0.001). Also, the MPV values of the children with PFAPA during an attack were significantly lower than in attack free periods (p < 0.001). The MPV values showed no correlation with leucocytes counts, CRP, and ESR during attacks. A 8.30 fl [area under the curve (AUC: 0.965)] optimal cutoff value of MPV with a sensitivity of 89.5% and specificity of 92.8% was determined during an attack in children with PFAPA. Conclusions: The MPV values during an attack and attack free period of patients with PFAPA is lower than in controls. The MPV values may be used as a marker in the differential diagnosis of PFAPA syndrome but more studies are needed and they should be prospective in order to validate this data. (C) 2014 Elsevier Ireland Ltd. All rights reserved.Öğe A retrospective evaluation of 44 patients followed-up with a diagnosis of deep neck infection(2018) Bucak, Hakan Ibrahim; Almis, Habip; Geyik, Mehmet; Tekin, Mehmet; Ozen, Seval; Sirik, Mehmet; Turgut, MehmetAim: he purpose of this study was to evaluate the demographic data and clinical features of patients diagnosed with deep neck infection over a one-year period and hospitalized for treatment in a tertiary training and research hospital. Material and methods: Files for cases treated and followed-up for deep neck infection in our pediatric department during 2017 were evaluated retrospectively. Age, sex, month of presentation, presentation symptoms, physical examination findings, laboratory results, radiological imaging, consultations requested from other departments, treatments administered, number of days of hospitalization, and complications developing were assessed from these case files. Results: Twenty-eight (63.6%) of the 44 patients hospitalized for treatment for deep neck infection in the pediatric department were boys, and 16 (36.4%) were girls. Patients’ mean age was 57.45 ± 44.35 (5-191) months. Mean duration of hospitalization and treatment was 8.2 ± 2.8 (4-14) days. The most common presentation symptom was swelling in the neck (65.9%), and the most common physical examination finding was cervical lymphadenopathy (81.8%). Tooth decay was present in 27.3% of patients. Consultations were most commonly requested with the ear, nose and throat department, while consultations were requested with the external diseases department for five patients (11.3%). Conclusion: The prevalence of deep neck infection has increased in recent years.Further studies are needed on the subject of deep neck infection, which may involve life-threatening complications. Physicians should pay closeattention to the relation between tooth decay and deep neck infection in all patients followed-up with a diagnosis of such infection.
