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Öğe CD4(+), CD25(+), FOXP3(+) T Regulatory Cell Levels in Obese, Asthmatic, Asthmatic Obese, and Healthy Children(Springer/Plenum Publishers, 2015) Donma, Mustafa Metin; Karasu, Erkut; Özdilek, Burcu; Turgut, Burhan; Topçu, Birol; Nalbanto?lu, Burçin; Donma, OrkideThe aim of this prospective case control study is to determine CD4(+), CD25(+), and FoxP3(+) T regulatory cells (Tregs) and T helper cells (Ths) in obese, asthmatic, asthmatic obese, and healthy children. Obese (n = 40), asthmatic (n = 40), asthmatic obese (n = 40), and healthy children (n = 40) were included in this study. Blood samples collected from children were marked with CD4, CD25, ve Foxp3 in order to detect Tregs and Ths by flow cytometric method. Statistical analyses were performed. p a parts per thousand currency signaEuro parts per thousand 0.05 was chosen as meaningful threshold. Tregs exhibiting anti-inflammatory nature were significantly lower in obese (0.16 %; p a parts per thousand currency signaEuro parts per thousand 0.001), asthmatic (0.25 %; p a parts per thousand currency signaEuro parts per thousand 0.01), and asthmatic obese (0.29 %; p a parts per thousand currency signaEuro parts per thousand 0.05) groups than control group (0.38 %). Ths were counted higher in asthma group than control (p a parts per thousand currency signaEuro parts per thousand 0.01) and obese (p a parts per thousand currency signaEuro parts per thousand 0.001) groups. T cell immunity plays important roles in chronic inflammatory diseases such as obesity and asthma pathogeneses. Decreased numbers of Tregs found in obese, asthmatic, and asthmatic obese children might represent a challenge of these cells.Öğe Childhood asthma and vitamin D deficiency in Turkey: is there cause and effect relationship between them?(Bmc, 2013) Uysalol, Metin; Mutlu, Levent Cem; Saraçoğlu Varol, Gamze; Karasu, Erkut; Güzel, Savaş; Kayaoğlu, Semra; Uzel, NedretBackground: Epidemiological studies show that vitamin D deficiency and insufficiency are common worldwide and associated with many diseases including asthma. Our aim was to evaluate vitamin D insufficiency and its clinical consequences. Methods: This cross-sectional study was carried out on 170 children consisted of 85 who were asthmatic and 85 who were not, aged 2 to 14 years in Tekirdag, Turkey, from September 2009 to May 2010. Children's basal serum D vitamin levels were determined, and their eating habits, vitamin D intake, exposure to sunlight and use of health services during the previous year were investigated. The severity of asthma and levels of asthma control were assessed according to the Global Initiative for Asthma guidelines. Results: The difference between mean vitamin D levels in the asthmatic group (mean +/ SD) 16.6 +/ 8.5 ng/mL and the healthy control group (mean +/- SD) 28.2 +/- 19.5 ng/mL was found to be statistically significant (p < 0.001). Children in the asthma group had less exposure to sunlight and ate a diet less rich in vitamin D (p < 0.001). A significant difference was observed between the groups regarding the frequency of respiratory tract infections leading to emergency unit admissions and number of hospitalizations (p < 0.001). It was also shown that a decrease in vitamin D level increased the severity of asthma (p < 0.001) and decreased the frequency of controlled asthma (p = 0.010). Conclusion: This study has demonstrated the correlation between plasma 25 (OH) D levels and childhood asthma. Evidently, this relationship being influenced by multiple factors other than vitamin D, further studies should be conducted to explore the interrelation between all such factors.Öğe Effect of overweight on P-wave and QT dispersions in childhood(Turkish Soc Cardiology, 2013) Akyüz, Aydın; Alpsoy, Şeref; Akkoyun, Dursun Çayan; Nalbanto?lu, Burçin; Tülübaş, Feti; Karasu, Erkut; Donma, Mustafa MetinObjectives: The effects of obesity on atrial conduction and ventricular repolarization have been studied in detail, but these parameters have not been well documented in overweight children. The aim of our study was to investigate the effects of overweight on atrial conduction and ventricular repolarization in children by using P-wave dispersion (Pw-d) and QT dispersion (QT-d) analyses. Study design: Sixty-seven overweight children and 70 children within normal limits were included in this cross-sectional prospective controlled study. All subjects underwent electrocardiographic and anthropometric evaluation, and blood samples were obtained. Pw-d and QT-d were investigated between two groups. Results: Homeostatic model assessment of insulin resistance levels were higher in the overweight group (2.9 +/- 1.2 vs. 1.1 +/- 0.8, p=0.001). No statistically significant differences were found in Pw-d and QT-d when the groups were compared. The following findings were recorded for the overweight and control groups, respectively: mean RR interval (635 +/- 42 msec vs. 645 +/- 45 msec, p=0.867), Pw-d [30 (1055) msec vs. 27.5 (15-50) msec, p=0.441] and QT-d (30 (15-55) msec vs. 22.5 (10-60) msec, p=0.476). In addition, Pw-d and QT-d were not correlated with the levels of insulin or body mass index. Conclusion: There was no significant difference in atrial conduction or ventricular repolarization features between overweight children and normal-weight children.Öğe İki Vaka Nedeniyle PFAPA Sendromu(İstanbul Üniversitesi, 2011) Nalbantoğlu, Burçin; Uysalol, Metin; Karasu, Erkut; Özdilek, BurcuYineleyen veya periyodik ateş yakınmasına çocuk hekimli- ğinde nispeten sık rastlanmaktadır. PFAPA sendromu, yük- sek ateş, servikal lenfadenopati, aftöz stomatit ve farenjit ile karakterizedir. Sekiz yaşında kız hasta olan ilk vakanın 3-4 haftada bir yineleyen ateş, farenjit ve aftöz stomatit atakları vardı. Ateşli dönem 5-6 gün sürmekte antibiyotik tedavisine yanıt alınamamaktaydı. Atak sırasında akut faz reaktanlarının yükseldiği ve ataklar arasında tamamen normale döndüğü saptandı. Bu bulgularla hastada PFAPA sendromu düşünüldü. Hastanın yakınmaları tek doz predni- zon ile dramatik bir şekilde düzeldi. Üç buçuk yaşında erkek hasta olan ikinci vakanın ayda bir membranöz tonsil- lit, yüksek ateş yakınmaları vardı. Atakların bazılarında servikal lenfadenopati gözlenirken, aftöz stomatit hiç olmu- yordu. Ataklar sırasında antibiyotik kullanımına rağmen, ateş 5-6 gün sürüyor ve akut faz reaktanları yüksek olarak bulunuyordu. Atak sırasında tek doz prednizon tedavisine yanıt veren hastaya PFAPA tanısı kondu. PFAPA sendromu- nun 5 yaş üzeri de görülebileceğini, aftöz stomatit olmadan da tanı koyulabileceğini vurgulamak ve iki atipik vaka nedeniyle PFAPA sendromunu vurgulamak ve literatürü derlemek istedikÖğe infection and vaccination status of children aged 6 months-12 years: Time for mass vaccination(Kowsar Medical Publishing Company, 2013) Nalbanto?lu, Burçin; Donma, Mustafa Metin; Özdilek, Burcu; Karasu, Erkut; Nalbantoğlu, AyşinObjective: This study was designed to determine the current age-related hepatitis A virus (HAV) seroprevalance, vaccination status of children and to evaluate the epidemiological shift in HAV serostatus living in Tekirda?, which is located in Thrace region, the European part of Turkey. Methods: Children 6 months-12 years of age with simple health problems were included. Blood samples were studied for HAV IgM and IgG collectively. A questionnaire addressing several characteristics of subjects was administered to obtain basic descriptive data on HAV epidemiology. Vaccination status of the children was recorded according to the immunization cards. Findings: The overall anti-HAV IgM and anti-HAV IgG prevalance in children aged 6 months - 12 years was 3.3% and 25.4% respectively. Maximum hepatitis A IgM positivity was in the 7-12 years age group 4.8% (n= 12; P<0.001) and maximum hepatitis A IgG positivity in the same age group was 34% (n=85; P<0.001). HAV vaccination rate among patients aged more than 2 years was 11.03%. HAV IgG seroprevalance was higher in children of low monthly income families (36.1%, n=78; P<0.001) than in the intermediate (17%, n=31) and high income families (11.1%, n=6). Conclusion: These results indicate a shift in Hepatitis A seroprevalance when compared with the previous studies. As HAV infection in childhood is decreasing, the pool of susceptible adolescents and young adults is increasing. Introduction of hepatitis A vaccination into the national immunization schedule of Turkey should be considered. © 2013 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved.Öğe Jacobsen syndrome without thrombocytopenia: a case report and review of the literature(Turkish J Pediatrics, 2013) Nalbantoğlu, Burçin; Donma, Mustafa Metin; Nisli, Kemal; Paketci, Cem; Karasu, Erkut; Özdilek, Burcu; Mintaş, Nuriye EceJacobsen syndrome (JS), a rare disorder with multiple dysmorphic features, is caused by the terminal deletion of chromosome 11q. Typical features include mild to moderate psychomotor retardation, trigonocephaly, facial dysmorphism, cardiac defects, and thrombocytopenia, though none of these features are invariably present. The estimated occurrence of JS is about 1/100,000 births. The female/male ratio is 2:1. The patient admitted to our clinic at 3.5 years of age with a cardiac murmur and facial anomalies. Facial anomalies included trigonocephaly with bulging forehead, hypertelorism, telecanthus, downward-slanting palpebral fissures, and a carp-shaped mouth. The patient also had strabismus. An echocardiogram demonstrated perimembranous aneurysmatic ventricular septal defect and a secundum atrial defect. The patient was <3rd percentile for height and weight and showed some developmental delay. Magnetic resonance imaging (MRI) showed hyperintensive gliotic signal changes in periventricular cerebral white matter, and leukodystrophy was suspected. Chromosomal analysis of the patient showed terminal deletion of chromosome 11. The karyotype was designated 46, XX, del(11) (q24.1). A review of published reports shows that the severity of the observed clinical abnormalities in patients with JS is not clearly correlated with the extent of the deletion. Most of the patients with JS had short stature, and some of them had documented growth hormone deficiency, or central or primary hypothyroidism. In patients with the classical phenotype, the diagnosis is suspected on the basis of clinical findings:intellectual disability, facial dysmorphic features and thrombocytopenia. The diagnosis must be confirmed by cytogenetic analysis. For patients who survive the neonatal period and infancy, the life expectancy remains unknown. In this report, we describe a patient with the clinical features of JS without thrombocytopenia. To our knowledge, this is the first case reported from Turkey.Öğe Sarkoidoz: On Altı Yaşında Bir Vaka Sunumu(İstanbul Üniversitesi, 2011) Nalbantoğlu, Burçin; Mutlu, Levent Cem; Uysalol, Metin; Karasu, ErkutSarkoidoz, etiyolojisi bilinmeyen kronik multisistematik granülomatoz bir hastalıktır. Granülomlar, enfeksiyoz ya da organik ajanlara bağlı bir etiyolojiyi düşündürmekle beraber, nedeni hâlâ belli olmayan bir hastalıktır. On altı yaşında kız hasta, 4 aydır devam eden öksürük, halsizlik, bacaklarda morluklar yakınması ile başvurdu. Hastanın muayenesinde bacaklarında gözlenen eritema nodozum benzeri mor renkli hafif ağrılı en büyüğü 5 cm olan lezyon- lar dışında patolojik bulgu yoktu. Laboratuvar bulguların- da sedim 60/1 saat, CRP 15,66 mg/L olarak bulundu. Anjiotensin dönüştürücü enzim düzeyi yüksek olarak bulun- du. Toraks HRCT’de multipl mediastinal lenfadenopatiler, sağ orta ve altta mikronodüler parankimal infiltrasyonlar saptandı. Bronkoskopide lenfadenopati dışında patolojik bulgu izlenmedi, biyopside granülomatoz lezyonlar görül- dü. Bu bulgularla sarkoidoz düşünülen hasta klinik bulgu- ların çok ağır olmaması üzerine tedavisiz izleme alındı. Sarkoidoz, çocukluk çağında ender görülen bir hastalıktır. Spontan düzelme görülebildiği gibi, kronikleşebilmektedir. Hastaların muayene ve solunum fonksiyon testleri ile takibi gerekmektedir. Kliniğin ağırlığına göre steroid veya metot- rexat ile tedavi edilebilir, ancak sonuçlar tartışmalıdır. Ender görülen bir durum olduğu için bir vaka nedeniyle sarkoidozu vurgulamak ve literatürü derlemek istedikÖğe Shifting Epidemiology of Hepatitis A Infection and Vaccination Status of Children Aged 6 Months-12 Years: Time for Mass Vaccination(Kowsar Corp, 2013) Nalbantoğlu, Burçin; Donma, Mustafa Metin; Özdilek, Burcu; Karasu, Erkut; Nalbantoğlu, AyşinObjective: This study was designed to determine the current age-related hepatitis A virus (HAV) seroprevalance, vaccination status of children and to evaluate the epidemiological shift in HAV serostatus living in Tekirdag, which is located in Thrace region, the European part of Turkey. Methods: Children 6 months-12 years of age with simple health problems were included. Blood samples were studied for HAV IgM and IgG collectively. A questionnaire addressing several characteristics of subjects was administered to obtain basic descriptive data on HAV epidemiology. Vaccination status of the children was recorded according to the immunization cards. Findings: The overall anti-HAV IgM and anti-HAV IgG prevalance in children aged 6 months-12 years was 3.3% and 25.4% respectively. Maximum hepatitis A IgM positivity was in the 7-12 years age group 4.8% (n=12; P<0.001) and maximum hepatitis A IgG positivity in the same age group was 34% (n=85; P<0.001). HAV vaccination rate among patients aged more than 2 years was 11.03%. HAV IgG seroprevalance was higher in children of low monthly income families (36.1%, n=78; P<0.001) than in the intermediate (17%, n=31) and high income families (11.1%, n=6). Conclusion: These results indicate a shift in Hepatitis A seroprevalance when compared with the previous studies. As HAV infection in childhood is decreasing, the pool of susceptible adolescents and young adults is increasing. Introduction of hepatitis A vaccination into the national immunization schedule of Turkey should be considered.Öğe The effect of obesity and dietary habits on mean platelet volume and other platelet indices(Georg Thieme Verlag Kg, 2014) Aydın, Murat; Nalbanto?lu, Burçin; Donma, Mustafa Metin; Tülübaş, Feti; Küçükyalçın, Volkan; Karasu, Erkut; Gürel, AhmetIn this study, the mean platelet volume (MPV) and platelet distribution width (PDW) parameters in obese children and the control group were compared with the amount of fast food consumed in the diet to determine whether there is a correlation. After the patients' medical records were examined, parameters such as height, body weight, waist circumference, and hip circumference measurements were recorded. Among the study patients, those whose complete blood counts were tested due to medical requirements or routine check-ups were included, and the patients' MPV and PDW were evaluated. The MPV and PDW concentrations of obese children were significantly higher than those of healthy controls. There was a positive correlation between fast food consumption, and MPV and PDW. In the presence of obesity and excessive consumption of fast food, increased MPV concentrations might trigger the pathogenesis of atherosclerosis starting from childhood years onward. Therefore, in this age group obesity should be controlled with diet and other treatment methods to prevent the mortality and morbidity that might ensue in adult years.Öğe Yenidoğanda Over Kisti(İstanbul Üniversitesi, 2013) Özdilek, Burcu; Nalbantoğlu, Burçin; Donma, Mustafa Metin; Çelik, Cem; Paketçi, Cem; Karasu, Erkut; Mintaş, Nuriye EceYenidoğanda over kisti ender görülen bir durumdur. Ultrasonografinin yaygın olarak kullanıma girmesinin ardından tespit edilme oranı artmıştır. Ancak halen bu hastaların tanı, takip, prognozu ve tedavisi tartışmalıdır. On bir aylık kız hasta polikliniğimize, doğumdan beri devam eden ve küçülmeyen over kistleri nedeniyle başvur- du. Hastanın muayenesi ve gelişimi normaldi. Yapılan ult- rasonografide, en büyüğü 12x11 mm boyutlarında basit kistler tespit edildi. Hastanın takiplerinde kistlerin boyu- tunda küçülme saptanması ve komplikasyon gelişmemesi üzerine hasta takibe alındı. Yenidoğan döneminde gözlenen over kistlerinin bir çoğu selimdir. Konjenital pilor stenozu, hidrosefali, korpus kallozum agenezisi ve fetal hipotirodizm gibi anomaliler eşlik edebilmektedir. Prognozu belirlemede en önemli faktörler kist çapı ve ekojenitesidir. Potansiyel komplikasyonları arasında over torsiyonu, over rüptürü, kanama ve diğer organlara bası bulunmaktadır. Torsiyon en önemli ve ciddi komplikasyondur ve 5 cm’den küçük kistlerde bile gözlenebilmekte ve over kaybı ile sonuçlana- bilmektedir. Yenidoğan döneminde görülen over kistleri, genellikle kendiliğinden küçülerek kaybolmaktadır. Bu yüz- den ultrason ile takip, bu hastaların izleminde en sık tercih edilen yoldur. Ciddi komplikasyonları olmasına rağmen, bunların görülme sıklığı çok enderdir
