Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Koleksiyonu
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Öğe Clınıcal and laboratory characterıstıcs of hyperprolactınemıc chıldren and adolescents: natıonal survey(Karger, allschwılerstrasse 10, ch-4009 basel, swıtzerland, 2017) Doger, Esra; Akıncı, AyşehanÖğe Analysis of magnetic resonance imaging findings of children with neurologic complications after livertransplantation(Sprınger-verlag ıtalıa srl, vıa decembrıo, 28, mılan, 20137, ıtaly, 2017) Ozturk, Mehmet; Akdulum, Ismail; Dag, Nurullah; Sigirci, Ahmet; Gungor, Serdal; Yilmaz, SezaiObjective To analyze the magnetic resonance imaging findings in children diagnosed with neurologic complications after liver transplantation (LT). Materials and methods A total of 39 patients diagnosed with neurologic complications following LT between 2010 and 2016. Neuroradiologic imaging was performed using cranial magnetic resonance imaging (MRI). Descriptive statistics regarding age, gender, type of complication, diagnostic and therapeutic modalities were calculated and presented as number and percentage. Results Our series consisted of 18 girls and 21 boys. Cryptogenic hepatitis (n = 13, 32%), metabolic diseases (Wilson's disease, tyrosinemia and glycogen storage disease) (n = 7, 18%) and fulminant toxic hepatitis (n = 4, 11%) constitute the most frequent indications for LT. The indications for neuroradiological imaging were convulsion and alteration of mental status. Conclusion These central nervous system complications may present in a variable spectrum and convulsions and altered mental state were the most frequent clinical pictures. Imaging studies were normal in approximately one-third of cases; the most frequent pathologic findings were diffuse cerebral edema, atrophy, and PRES. Clinical history, careful examination and integrated analysis of radiologic data as well as close collaboration and multidisciplinary approach are of utmost importance for establishing the diagnosis rapidly and accurately.Öğe Vitamin D levels of pediatric ıntensive care patients(Duzce unıv, konuralp yerleskesı, duzce, 81620, turkey, 2018) Açık, Sait; Yakıncı, Mehmet CengizObjective: By measuring serum 25-hydroxyvitamin D (25-OHVitD) levels of the patients in Pediatric Intensive Care Unit (PICU), vitamin D supplementation is aimed to those who have been determined to have vitamin D deficiency. Furthermore, it is aimed to compare the vitamin D levels of only acute disease patients with acute disease added to the chronic disease in PICU. Methods: 327 patients (Group A) aged in the range of 1 month to 18 years, that have been hospitalized in PICU of Inonu University TurgutOzal Medicine Centre from January 2015 to June 2016, and 90 healthy subjects as a control group (Group B) were included. Group A was divided into two; patients with only acute disease (A1=125 patients) and patients with acute disease added to the chronic disease (A2=202 patients). Demographic information and 25-OHVitD, Ca, P, ALP levels of all cases were recorded retrospectively. Results: Mean of the 25-OHVitD level was 20.9 +/- 16.4 ng/dl in Group A; 25.7 +/- 17.2 ng/dl in Group A 1 ;17.9 +/- 15.2 ng/dl in Group A2 and 25.9 +/- 14.4 ng/dl in Group B, respectively. Vitamin D deficiency was 55% in Group A, 43.2% in Group Al, 62.4% in Group A2 and 40% in Group B. In addition, vitamin D insufficiency was 16% in Group A, 17.6% in Group Al, 14.9% in Group A2 and 20% in Group B. On the other hand, vitamin D sufficiency was 29% in Group A, 39.2% in Group Al, 22.8% in Group A2, and 40% in Group B. The increase of age and presence of chronic illness were the determining factors of vitamin D level. Conclusion: It has been found that, the incidence of vitamin D deficiency increases in prevalence, as age increases. The patients in PICU, especially those who have chronic illness, were found to have vitamin D deficiency more frequent. It is concluded that elimination of vitamin D deficiency may contribute to the treatment of the disease for the patients in PICU and the children with chronic illness.Öğe Nasotracheal ıntubation in children for outpatient dental surgery: Is fiberoptic bronchoscopy useful(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, B-9, KANARA BUSINESS CENTRE, OFF LINK RD, GHAKTOPAR-E, MUMBAI, 400075, INDIA, 2018) Özkan, Ahmet Selim; Akbaş, S.Background: The aim of our study was to compare the hemodynamic responses and adverse events associated with nasotracheal intubation (NTI) using a fiberoptic bronchoscope (FOB) and a direct laryngoscope (DLS) in children undergoing general anesthesia for outpatient dental surgery. Methods: Eighty children (aged 5u15 years) were scheduled to undergo outpatient dental surgery under general anesthesia and of these children those who required NTI were included. Results: NTI was significantly longer in the FOB group (P = 0.03). In both groups, systolic blood pressure (SBP) and heart rate (HR) significantly decreased after the induction of anesthesia when compared with the baseline values. SBP was significantly higher in both groups at intubation and 1 and 3 min after intubation when compared with postinduction. SBP significantly increased in the DLS group compared with the FOB group at intubation and 1 min after intubation. HR was significantly increased at intubation and 1 min after intubation in the DLS group compared with the FOB group. Nose bleeding after intubation was significantly more frequent in the DLS group (30%) than in the FOB group (7.5%) (P = 0.034). The incidence of sore throat 24 h after surgery was 20% (8/40) in the DLS group and 2.5% (1/40) in the FOB group (P = 0.014). Conclusions: There are fewer hemodynamic responses and adverse events in the FOB group than in the DLS group; therefore, FOB can be safely used for NTI in children undergoing outpatient dental surgery, and FOB may be more successful than DLS for NTI.Öğe Risk factors for early dialysis dependency in autosomal recessive polycystic kidney disease(Mosby-elsevıer, 360 park avenue south, new york, ny 10010-1710 usa, 2018) Taranta-Janusz, KatarzynaObjective To identify prenatal, perinatal, and postnatal risk factors for dialysis within the first year of life in children with autosomal recessive polycystic kidney disease (ARPKD) as a basis for parental counseling after prenatal and perinatal diagnosis. Study design A dataset comprising 385 patients from the ARegPKD international registry study was analyzed for potential risk markers for dialysis during the first year of life. Results Thirty-six out of 385 children (9.4%) commenced dialysis in the first year of life. According to multivariable Cox regression analysis, the presence of oligohydramnios or anhydramnios, prenatal kidney enlargement, a low Apgar score, and the need for postnatal breathing support were independently associated with an increased hazard ratio for requiring dialysis within the first year of life. The increased risk associated with Apgar score and perinatal assisted breathing was time-dependent and vanished after 5 and 8 months of life, respectively. The predicted probabilities for early dialysis varied from 1.5% (95% CI, 0.5%-4.1%) for patients with ARPKD with no prenatal sonographic abnormalities to 32.3% (95% CI, 22.2%-44.5%) in cases of documented oligohydramnios or anhydramnios, renal cysts, and enlarged kidneys. Conclusions This study, which identified risk factors associated with onset of dialysis in ARPKD in the first year of life. may be helpful in prenatal parental counseling in cases of suspected ARPKD.Öğe Pediatric wilson's disease: findings in different presentations. A cross-sectional study(Assocıacao paulısta medıcına, av brıg luıs antonıo, 278-7 andar, sao paulo, cep01318-901, brazıl, 2018) Gungor, Sukru; Selimoglu, Mukadder Ayse; Varol, Fatma Ilknur; Gungor, SerdalBACKGROUND: Wilson's disease (WD) may present with different manifestations: from an asymptomatic state to liver cirrhosis. Here, we aimed to evaluate clinical presentations and laboratory findings and prognoses among WD cases. DESIGN AND SETTING: Cross-sectional study based on patients' records from the university hospital, Inonu University, Malatya, Turkey. METHODS: The medical records of 64 children with WD were evaluated focusing on the clinical, laboratory and liver biopsy findings in different clinical presentations. RESULTS: The mean age at diagnosis was 8.6 +/- 3.26 years (range 3.5-17) and mean length of follow-up was 2.49 years (range 0-9). There were 18 cases (28.1%), 12 (18.8%), 9 (14.1%) and 6 (9.4%) of chronic liver disease, fulminant liver failure, neurological WD and acute hepatitis, respectively. Nineteen (29.7%) were asymptomatic. The most common sign and laboratory finding were jaundice (45.3%) and hypertransaminasemia (85.9%), respectively. The lowest serum zinc level was found in the fulminant liver failure group (P = 0.035). Hepatosteatosis was detected in 35% of the 20 patients who underwent liver biopsy. Among those with hepatosteatosis, 57.1% were asymptomatic. While 35% had copper staining, 25% presented iron accumulation in liver biopsies. Nine cases underwent liver transplantation and seven of these presented fulminant liver failure (77.8%). CONCLUSION: The presentation, symptoms and signs of our cases were similar to those in previously reported series, except for the high proportion of fulminant WD cases. Further studies are needed to clarify the relationship between zinc levels and development of a fulminant course and between iron status and WD.Öğe Factors predicting postoperative febrile urinary tract infection following percutaneousnephrolithotomy in prepubertal children(Elsevıer scı ltd, the boulevard, langford lane, kıdlıngton, oxford ox5 1gb, oxon, england, 2018) Kaygisiz, Onur; Satar, Nihat; Gunes, Ali; Dogan, Hasan SerkanBackground Predictive tables and scoring systems can predict stone clearance. However, there is a paucity of evidence regarding the prediction of complications during percutaneous nephrolithotomy (PCNL), particularly in children, which remains under-researched. To our knowledge, no studies have evaluated the risk factors for febrile urinary tract infection (FUTI) after pediatric PCNL. Objectives To assess the predictive factors of FUTI in prepubertal children after PCNL and determine whether any prophylactic cephalosporins are superior for decreasing the FUTI rate. Study design Data from 1157 children who underwent PCNL between 1991 and 2012 were retrieved from the multicenter database of the Turkish Pediatric Urology Society. Children >12 years of age were excluded, leaving 830 children (364 girls, 466 boys). Data were analyzed according to the presence of FUTI and compared between the FUTI and non-FUTI groupsÖğe Hospitalisation: a good opportunity to detect developmental difficulty in children(Medcom ltd, room 504-5, cheung tat centre, 18 cheung lee st, chaı wan, hong kong 00000, peoples r chına, 2018) Kum, Y. E.; Dogan, D. G.; Canaloglu, S. K.; Kivilcim, M.This study aimed to determine children at risk of developmental difficulty by using a developmental monitoring tool during their hospital stay. The development of 113 hospitalised children aged 2-42 months was evaluated by using expressive and receptive language, fine and gross motor, social-emotional and relational functions, play, and self-help skills areas of the Guide for Monitoring Child Development (GMCD). There were 49 (42.4%) children with developmental difficulties. Developmental difficulty was found in 72.9% of the children of mothers who expressed a concern (p<0.001). Developmental difficulties were significantly more common in children of mothers without regular prenatal follow-up (p<0.001), with low educational level (p<0.001), and who had previously suffered stillbirth (p<0.013); and in children with a birth weight below 2500 g (p<0.002), and with consanguineous parents (p<0.007). The hospitalisation period is a good opportunity to identify children at risk of developmental problems and refer them for further assessment and early intervention.Öğe Comparison of practical application steps of the previously used adrenaline auto injector in Turkey (EpiPen) and the currently available adrenaline auto injector (Penepin): a multi-center study(AVES, BUYUKDERE CAD 105-9, MECIDIYEKOY, SISLI, ISTANBUL 34394, TURKEY, 2018) Topal, ErdemAim: It has been shown by a great number of studies that the correct use of adrenaline auto injectors prescribed to patients with anaphylaxis is associated with the design of the auto injector, in addition to training. The aim of this study was to compare the skills of adults in using two different auto injectors prescribed to patients with anaphylaxis. Material and Methods: Parents of patients aged between 1 and 18 years who referred to allergy outpatients were included in the study. Results: A total of 630 volunteers from nine centers were included in the study. Four hundred fifty-seven (72.5%) of the participants were females and 235 (37.3%) were undergraduates. The rate of showing all the steps of auto injector trainers correctly e by the participants was found as (60.2%) (n=379) for EpiPen and 42.9% (n=270) for Penepin (p<0.001). The most frequent mistake with both auto injector trainers was the step of "place appropriate injection tip into outer thigh/press the trigger so it clicks." When the preferences of the volunteers were asked after training and application, 527 (83.7%) chose EpiPen, stating that it was easier and simpler to use. Conclusions: Our study showed that the correct usage rates of both adrenaline auto injectors were much lower than expected and there could be mistakes in the application of both. It could be appropriate to make improvements in the design of Penepin, which is still the only available adrenaline auto injector in Turkey, such that its application steps will be simpler and quicker.Öğe Does atopy affect the course of viral pneumonia?(Elsevıer espana slu, av josep tarradellas, 20-30, 1era planta, barcelona, cp-08029, spaın, 2018) Catal, F; Girit, S; Can, D; Erdem, S. B; Sen, VBackground: The presence of atopy is considered as a risk factor for severe respiratory symptoms in children. The objective of this study was to examine the effect of atopy on the course of disease in children hospitalised with viral pneumonia. Methods: Children between the ages of 1 and 6 years hospitalised due to viral pneumonia between the years of 2013 and 2016 were included to this multicentre study. Patients were classified into two groups as mild-moderate and severe according to the course of pneumonia. Presence of atopy was evaluated with skin prick tests. Groups were compared to evaluate the risk factors associated with severe viral pneumonia. Results: A total of 280 patients from nine centres were included in the study. Of these patients, 163 (58.2%) were male. Respiratory syncytial virus (29.7%), Influenza A (20.5%), rhinovirus (18.9%), adenovirus (10%), human metapneumovirus (8%), parainfluenza (5.2%), coronavirus (6%), and bocavirus (1.6%) were isolated from respiratory samples. Eighty-five (30.4%) children had severe pneumonia. Atopic sensitisation was found in 21.4% of the patients. Ever wheezing (RR: 1.6, 95% CI: 1.1-2.4), parental asthma (RR: 1.5, 95% CI: 1.1-2.2), other allergic diseases in the family (RR: 1.8, 95% CI: 1.2-2.9) and environmental tobacco smoke (RR: 1.6, 95% CI: 1.1-3.5) were more common in the severe pneumonia group. Conclusions: When patients with mild-moderate pneumonia were compared to patients with severe pneumonia, frequency of atopy was not different between the two groups. However, parental asthma, ever wheezing and environmental tobacco smoke exposure are risk factors for severe viral pneumonia in children. (C) 2017 SEICAP. Published by Elsevier Espana, S.L.U. All rights reserved.Öğe Development of severe hyponatremia due to cerebrospinal fluid leakage followingmeningomyelocele surgery in a newborn(Amer assoc neurologıcal surgeons, 5550 meadowbrook drıve, rollıng meadows, ıl 60008 usa, 2018) Gokce, Ismail Kursad; Turgut, Hatice; Ozdemir, Ramazan; Onal, Selami CagatayCerebrospinal fluid leakage following meningomyelocele surgery is a frequent complication in the wound healing period and is associated with wound dehiscence. CSF loss can cause severe hyponatremia, especially in the newborn and early infancy periods when dietary sodium content is relatively low. Hyponatremia in the newborn period can result in adverse neurodevelopmental outcomes. In addition, hyponatremia's cerebral effects can increase complications in neurosurgery patients. The authors present the case of a newborn in whom CSF leakage from the operative site and severe hyponatremia developed following meningomyelocele surgery. To the best of their knowledge, severe hyponatremia caused by CSF leakage after meningomyelocele surgery has not been previously reported in the literature.Öğe Clınıcal, epıdemıologıcal and prognostıc features of chıldren wıth hemolytıc uremıcsyndrome: multıcenter experıence of turkey(Sprınger, 233 sprıng st, new york, ny 10013 usa, 2018) Ertan, Pelin; Bulut, Ipek Kaplan; Guven, Sercin; Cicek, Neslihan; Tulpar, Sebahat; Coskun, Seda; Donmez, Osman; Dusunsel, Ruhan; Serdaroglu, Erkin; Bek, KenanÖğe Clınıcal course of c3 glomerulopathy ın turkısh chıldren: a multıcenter study(Sprınger, 233 sprıng st, new york, ny 10013 usa, 2018) Dursun, İsmail; Pınarbaşı, Ayşe Seda; Gökçe, İbrahim; Comak, Elif; Saygili, Seha; Bayram, Meral Torun; Dönmez, Osman; Melek, Engin; Tekcan, Demet; Yılmaz, DilekÖğe Characteristics of persistent diaper dermatitis in children with food allergy(Blackwell Publishing Inc., 2018) Celiksoy, M.H.; Topal, E.; Hazıroglu Okmen, Z.; Alataş, C.; Demirtaş, M.S.Background/Objectives: Diaper dermatitis is often caused by irritant contact occurring beneath the diaper of an infant, and it is aggravated by factors such as dampness, friction, urea, and feces. Food-allergic patients are known to exhibit various skin lesions ranging from urticaria to eczema. This study aims to determine the relationship between persistent diaper dermatitis and food allergy. Methods: A retrospective chart review was conducted of pediatric patients with a diagnosis of persistent diaper dermatitis between August 2015 and November 2017. Results: The study included 157 patients diagnosed with persistent diaper dermatitis (67 male, 72 female; median age: 13 months). Diaper dermatitis was more common and included the whole perineum in children who had multiple food allergies (P = 0.001). In children with multiple food allergies, the course of diaper dermatitis was more severe, and the condition did not respond to topical treatment (P = 0.025). A longer elimination diet was required for patients with Type I reactions and persistent diaper dermatitis (P = 0.018). In patients with Type II and mixed reactions, diaper dermatitis was more diffuse and covered the whole perineum (P = 0.025). In patients with Type II and mixed reactions, diaper dermatitis was more severe and did not respond to topical treatment (P = 0.025). Conclusions: Persistent diaper dermatitis lasting longer than a month may be associated with food allergy. The diaper rash may also be the only indicator of the food allergy. Elimination of the responsible food may allow these patients to recover from persistent diaper dermatitis. © 2018 Wiley Periodicals, Inc.Öğe Blood pressure is normal, but is the heart?(Sprınger, 233 sprıng st, new york, ny 10013 usa, 2018) Celik, Serkan Fazli; Karakurt, Cemsit; Tabel, Yilmaz; Elmas, Taner; Yologlu, SaimThere is no detailed strain analysis of cardiac functions in treated hypertensive pediatric patients. The aim of this study was to evaluate the cardio-protective effects of different drug classes in treated pediatric hypertensive patients. Sixty non-obese-treated hypertensive patients with preserved left ventricular (LV) systolic function and 45 age-, sex-, and body mass index-matched healthy subjects underwent clinical evaluation, including 24-h ambulatory blood pressure monitoring, standard echocardiographic examination, tissue Doppler imaging, and two-dimensional Speckle Tracking Echocardiography. The patients were divided into two subgroups based on the effects of the drugs on the Renin Angiotensin Aldosterone System. The subgroup hypertension (HT) 1 received angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and HT 2 subgroup received calcium channel blocker, beta-blocker, or diuretics. There was no difference between the two groups and subgroups with respect to clinical, demographic, ABPM, ventricular volumes, ejection fraction, and tissue Doppler imaging (TDI) parameters. For patients and controls, respectively, global longitudinal strain was - 18.70 +/- 3.41 versus - 21.01 +/- 3.82 (P < 0.001), and global radial strain was 40.6 +/- 9.8 versus 54.8 +/- 12.8 (P = 0.004). Peak LV twist and peak LV torsion were not significantly different. The patient subgroup analyses with each other revealed no difference in systolic and diastolic myocardial deformation properties. Strain parameters were reduced in all treated hypertensive children compared to normotensive children, and the various cardiac mechanic parameters were similarly abnormal no matter what type of antihypertensive agent was used.Öğe Ablation of supraventricular tachycardia in children using a limited fluoroscopy approach with the electro-anatomical system guidance(Logos medical publishing, 2018) Elkıran, Ö.; Akdeniz, C.; Tuzcu, V.Aim: Athough, catheter ablation has become established therapy for treatment of pediatric SVT, X-ray has been used during electrophysiological procedures. Recent advances in electroanatomic mapping technologies resulted in a decrease or elimination of fluoroscopy during catheter ablation. Although, radiofrequency ablation (RFA) is a common option for treatment of tachyarrhythmias, it has irreversible risk of AV block. Cryoablation is preferred for septal tachycardia substrates due its safety. In this study, we presented our results of children who underwent SVT ablation using electroanatomical system and experiences in cryoablation. Method: A total of 48 children underwent ablation of SVT. All procedures were performed using the EnSite System (St. Jude Medical, Inc., St. Paul, MN, USA). Results: Thirty patients had AVNRT, one of these had an additional atrial tachycardia and the other one had atypical AVRNT, 7 had concealed AP, 9 had manifest AP, 2 had atrial tachycardia, and one had Mahaim AP. Fluoroscopy was not used in 42 patients (87.5%). The mean fluoroscopy time in the remaining 6 (12.5%) patients was 6.0±2.28 minutes.Cryoab-lation was used in 34 (70.8%) and RFA in 14 (29.2%). Acute success was 9A5.8%. During follow-up of duration, SVT recurred in 3 patients (6.2%). These patients underwent second successful ablation procedures. Final success was 100 %. No permanent AV block was observed. An uneventful pericardial needle injury occured in one patient during transseptal puncture with minimal effusion. Conclusions: Catheter ablation of SVT can be performed effectively with limited fluoroscopy approach. Cryoablation should be preferred for ablation of septal tachycardia substrates, including AVNRT. © 2018, Logos Medical Publishing. All rights reserved.Öğe Anaphylaxis: Turkish national guideline 2018(BILIMSEL TIP YAYINEVI, BILIMSEL TIP YAYINEVI, ANKARA, 00000, TURKEY, 2018) Topal, ErdemAnaphylaxis is an acute and potentially fatal systemic reaction that sould be recognized and managed by all helthcare professionals. This is the first national guideline of Turkish National Society of Allergy and Clinical Immunology on diagnosis and management of anaphylaxis. The guideline is prepared by Anaphylaxis Interest Group with the incorporation of 20 allergy/immunology specialists and the epidemiology, etiology, pathophysiology, symptoms and signs, diagnosis/differentials, and acute and long-term management of anaphylaxis are reviewed in detail.Öğe A newborn with gastric hemangioma treated using propranolol(Korean soc pedıatrıc gastroenterology & nutrıtıon, 301 dongsung-dong 25-ı, jongno-gu, seoul, 301 dongsung, south korea, 2018) Kaya, Huseyin; Gokce, Ismail Kursad; Gungor, Sukru; Turgut, Hatice; Ozdemir, RamazanGastric hemangiomas are rare benign vascular tumors that can cause severe gastrointestinal system bleeding. We presented the case of a neonate with fresh bleeding and melena from the orogastric tube and detected gastric hemangioma in esophagogastroduodenoscopic examination. Propranolol is widely used in treatment of cutaneous hemangiomas and non-gastric gastrointestinal system hemangiomas. However, the surgical approach is preferred for treating gastric hemangiomas, and there are few reports of gastric hemangiomas associated with non-surgical treatment. Gastric hemorrhage decreased with antacid and somatostatin treatment. Propranolol treatment was initiated before the surgery decision. After three weeks of treatment, we observed regression in the hemangioma with endoscopic evaluation. During the course of treatment, the patient's gastrointestinal system bleeding did not recur, and there were no side effects associated with propranolol.Öğe Clinical and laboratory characteristics of hyperprolactinemia in children and adolescents: national survey(Journal of clınıcal research ın pedıatrıc endocrınology, 2018) Eren, Erdal; Ergur, Ayca Torel; Isguven, Sukriye Pinar; Bitkin, Eda CelebiObjective: We aimed to report the characteristics at admission, diagnosis, treatment, and follow-up of cases of pediatric hyperprolactinemia in a large multicenter study. Methods: We reviewed the records of 233 hyperprolactinemic patients, under 18 years of age, who were followed by different centers. The patients were divided as having microadenomas, macroadenomas, drug-induced hyperprolactinemia and idiopathic hyperprolactinemia. Complaints of the patients, their mode of treatment (medication and/or surgery) and outcomes were evaluated in detail. Results: The mean age of the patients with hyperprolactinemia was 14.5 years, and 88.4% were females. In terms of etiology, microadenomas were observed in 32.6 %, macroadenomas in 27 %, idiopathic hyperprolactinemia in 22.7% and drug-induced hyperprolactinemia in 6.4 %. Other causes of hyperprolactinemia were defined in 11.3%. Common complaints in females (n = 206) were sorted into menstrual irregularities, headaches, galactorrhea, primary or secondary amenorrhea and weight gain, whereas headache, gynecomastia, short stature and blurred vision were common in males (n = 27). Median prolactin levels were 93.15 ng/mL, 241.8 ng/ml, 74.5 ng/mL, 93.2 ng/mL, and 69 ng/mL for microadenomas, macroadenomas, idiopathic hyperprolactinemia, drug-induced hyperprolactinemia, and other causes of hyperprolactinemia, respectively. Of 172 patients with hyperprolactinemia, 77.3 % were treated with cabergoline and 13.4 % with bromocriptine. 20.1 % of the patients with pituitary adenomas underwent pituitary surgery. Conclusion: We present the largest cohort of children and adolescents with hyperprolactinemia in the literature to date. Hyperprolactinemia is more common in females and cabergoline is highly effective and practical to use in adolescents, due to its biweekly dosing. Indications for surgery in pediatric cases need to be revised.Öğe Severe portal hypertension due to congenital hepatoportal arteriovenousfistula associated with intrahepatic portal vein aneurysm(Journal Of Clınıcal Ultrasound, 1998) Altuntaş, Buket; Erden, Ayşe; Karakurt, Cemşit; Kut, Altuğ; Senbil, Nesrin; Yurdakul, MehmetA 13-year-old girl was referred for assess-ment of severe gastrointestinal tract bleeding. Herliver function tests were normal, and she had no evi-dence of chronic liver disease or history of significanttrauma. Clinical and sonographic findings suggestedthe presence of a portal vein aneurysm associatedwith a hepatoportal arteriovenous fistula. Abdominalangiography confirmed the diagnosis. The arteriove-nous fistula was congenital, and the associated portalvein aneurysm was either congenital or secondaryto hemodynamic changes in the portal venous sys-tem. © 1998 John Wiley & Sons, Inc.J Clin Ultra-sound26:357–360, 1998.
