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    Breast-feeding duration and childhood acute leukemia and lymphomas in a sample of Turkish children
    (Lippincott Williams & Wilkins, 2006) Altinkaynak, Sevin; Selimoglu, Mukadder Ayse; Turgut, Ahmet; Kilicaslan, Buket; Ertekin, Vildan
    Objectives: Whether breast-feeding is associated with decreased incidence of the lymphoid malignancies in children is uncertain. We evaluated childhood acute leukemia and lymphoma in relation to duration of breast-feeding. Methods: We investigated this issue in a case-control study comprising 137 patients, aged I to 16 years, with acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin or non-Hodgkin lymphoma, in addition to 146 controls matched for age and sex. Results: The median duration of breast-feeding among patients was shorter than that of controls (10 vs 12 months). Patients with ALL and AML had shorter mean breast-feeding duration compared with healthy children (P = 0.001 and P < 0.001, respectively). The shortest mean breast-feeding duration was noted in the children with AML. Breast-feeding for a duration of 0 to 6 months, when compared with feeding of longer than 6 months, was associated with increased odds ratios (ORs) for ALL [OR = 2.44, 95% confidence interval (Cl) = 1.17-5.101, AML (OR = 6.67 95% Cl = 1.32-33.69), Hodgkin lymphoma (OR 3.33, 95% Cl = 0.60-18.54), non-Hodgkin lymphoma (OR 1.90, 95% Cl = 0.68-5.34) and overall (OR = 2.54, 95% Cl = 1.51-4.26). Conclusions: Our findings suggest that breast-feeding of more than 6 months is protective against childhood lymphoid malignancies, especially for AML and ALL.
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    Fecal Calprotectin Concentration in Celiac Disease
    (Lippincott Williams & Wilkins, 2010) Ertekin, Vildan; Selimoglu, Mukadder Ayse; Turgut, Ahmet; Bakan, Nuri
    Goals: We aimed to determine fecal calprotectin (FC) concentration and its relation with histopathologic findings of children with celiac disease (CD) and to observe the probable alterations under gluten-free diet (GFD). Background: As FC is regarded as a marker of inflammation in the gastrointestinal tract, we hypothesized that it might be increased in untreated CD. Study: The study included 29 newly diagnosed patients with CD (mean age: 6.6 +/- 0.6 y) and sex and age-matched 10 healthy children. All of the children with CD admitted to the hospital were classical form who has chronic diarrhea and failure to thrive. The degree of mucosal damage was graded according to the modified Marsh criteria. FC concentration was determined by enzyme-linked immunosorbent assay method on admission and after 1 year of GFD. Results: Mean FC concentration of children with CD on admission and of healthy children were 13.40 +/- 8.5 and 4.3 +/- 3.3 mg/L, respectively (P = 0.004). FC concentration under GFD was 4.6 +/- 2.7 mg/L and there was a significant statistical difference between untreated patients and those under GFD for 1 year (P = 0.001). There was no statistical difference between FC concentration of those under GFD and healthy children (P = 0.8). Mean FC concentrations of children with total-villous atrophy and partial-villous atrophy were significantly different (13.8 +/- 9.3 mg/L vs. 3.7 +/- 1.8 mg/L, P = 0.005). Conclusions: It was found that FC concentration is increased in childhood CD, related to the severity of histopathologic findings and responsive to GFD. The pathogenetic mechanism by which FC is increased in CD should be investigated in further studies.
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    Treatment results of chronic hepatitis B in children: a retrospective study
    (Turkish J Pediatrics, 2010) Selimoglu, Mukadder Ayse; Ertekin, Vildan; Karabiber, Hamza; Turgut, Ahmet; Gursan, Nesrin
    Selimoglu MA, Ertekin V, Karabiber H, Turgut A, Gursan N. Treatment results of chronic hepatitis B in children: a retrospective study. Turk J Pediatr 2010; 52: 360-366. In this retrospective study, we aimed to share our experience with different treatment modalities for chronic hepatitis B in a series of children. The study included 126 children (mean: 9.5+/-3.8 years). Normalization of alanine aminotransferase (ALT), loss of hepatitis B virus (HBV)-DNA and hepatitis B e antigen (HBeAg), and development of antibody to HBeAg (anti-HBe) altogether at the end of the treatment was considered as end of therapy response (ETR). Seroconversion ongoing one year after the cessation of therapy was considered as sustained response. Of the total children, 90 (71.4%) were treated, whereas the remaining were just followed-up. High-dose interferon (IFN)-alpha (10 MU/m(2)) alone, standard-dose IFN-alpha (6 MU/m(2)) plus lamivudine (4 mg/kg/d), high-dose IFN-alpha plus lamivudine, or lamivudine alone was used, IFN-alpha thrice weekly for six months, and lamivudine daily for one year. Of children who had completed their treatment, 34 (37.8%) achieved ETR. Sustained response rate was 36.7%. Response rates were different in the different treatment groups (p: 0.01). The highest response rate was observed in those who received standard-dose IFN-alpha plus lamivudine treatment (61.5%). Of children without treatment, one (2.8%) had anti-HBe seroconversion. Standard-dose IFN-alpha plus lamivudine treatment was found superior to the other treatment modalities. Predictors of ETR were similar to those found in previous studies.