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Öğe C-reactive protein (CRP)/mean platelet volume (MPV) ratio as a new biomarker for community-acquired pneumonia in children(Cukurova Univ, Fac Medicine, 2017) Güzel, Eda Çelik; Fidan, Çiğdem; Güzel, Savaş; Paketci, CemPurpose: Our aim is to evaluate the relationship between C-reactive protein (CRP)/mean platelet volume (MPV) ratio and white blood cell (WBC)/mean platelet volume (MPV) ratio and diagnosis and disease severity in children with community-acquired pneumonia (CAP). Material and Methods: 60 patients with CAP including 33 mild-moderate (Group 1) and 27 severe pneumonia (Group 2) and 30 healthy children were examined for routine blood test. WBC, MPV, neuotrophile/lymhocyte ratio (NLR), CRP, WBC/MPV, CRP/MPV values were recorded on each patient and healthy groups. Result: CRP/MPV, WBC/MPV, NLR and plateletcrit values were significantly higher in patients group than controls, while MPV value is not correlated between patient and control groups. WBC, NLR, WBC/MPV, CRP/MPV and CRP values were higher in the Group 2 compared to Group 1. CRP/MPV and WBC/MPV were positively correlated with duration of symptoms in the CAP. The area under ROC curve of CRP, WBC and WBC/MPV in diagnosing CAP was significant (0.801, 0.761 and 0.731). Also the area under ROC curve of Group 2 in CRP/MPV and CRP in diagnosing CAP was significant (0.733, 0.708). Conclusion: CRP/MPV and WBC/MPV ratio may be used a marker in the evaluation of CAP diagnosis and CRP/MPV ratio can be good marker prediction of disease activity.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 Nocturnal enuresis with spina bifida occulta: Does it interfere behavioral management success?(Springer, 2015) Kurt, Ömer; Yazıcı, Cenk Murat; Paketci, CemWe aimed to investigate the incidence of spina bifida occulta (SBO) in patients with nocturnal enuresis (NE) and its effect on the success of behavioral interventions. We also aimed to identify predictive factors related to success of behavioral interventions. A total of 163 patients with NE and 160 patients without NE were enrolled to study. Urinalysis, urine culture, biochemical evaluation, plain radiography and urinary system ultrasonography were performed before treatment. Patients with NE received behavioral interventions for 3 months. Response to behavioral interventions was analyzed according to the presence and absence of SBO. Possible predictive factors for treatment success were also evaluated. Spina bifida occulta was detected in 47 (28.8 %) children at NE group and 24 (15.0 %) at control group (p = 0.138). Non-monosymptomatic NE was more prevalent in patients with SBO (p < 0.001), and response to the treatment was significantly lower (p = 0.037). Presence of SBO (OR 8.8, 95 % CI 3.1-25.6), NE severity (OR 7.2, 95 % CI 2.4-21.7) and NE frequency on 3-day voiding diary (OR 9.4, 95 % CI 3.7-24.3) were significantly related to the success. The presence of SBO, severe NE and higher frequency of NE in voiding diary affect the response to behavioral interventions. Other treatment options such as medical treatment or enuresis alarm may be recommended for those patients.Öğe Serum Irisin and Oxytocin Levels as Predictors of Metabolic Parameters in Obese Children(Galenos Yayincilik, 2017) Binay, Çiğdem; Paketci, Cem; Güzel, Savaş; Samancı, NedimObjective: Irisin and oxytocin can affect energy homeostasis and it has been suggested that they may play an important role in reducing obesity and diabetes. In this study, we aimed to determine the relationship between metabolic parameters (including irisin and oxytocin levels) and anthropometric parameters in obese children. Methods: Ninety obese children (mean age, 13.85 +/- 1.63 years) and 30 healthy controls (mean age, 14.32 +/- 1.58 years) were enrolled in this study. Anthropometric and laboratory parameters (glucose, insulin, lipid, oxytocin, and irisin levels) were analyzed. The serum irisin and oxytocin levels were measured by enzyme-linked immunosorbent assay. Bioelectrical impedance was used to determine body composition. Results: Irisin level was higher in the patients than in the controls (p = 0.018), and this higher irisin level was correlated with increased systolic blood pressure, body mass index, waist/hip ratio, fat percentage, fat mass, glucose level, insulin level, and homeostasis model assessment of insulin resistance. Serum oxytocin level was significantly decreased in obese children compared to the controls (p = 0.049). Also, among the 60 obese patients, oxytocin level was significantly lower in patients with than in those without metabolic syndrome (8.65 +/- 2.69 vs. 10.87 +/- 5.93 ng/L, respectively), while irisin levels were comparable (p = 0.049 and p = 0.104, respectively). There were no statistically significant relationships between oxytocin or irisin levels and lipid levels (p > 0.05). Conclusion: Obese children had significantly higher irisin levels than the healthy controls. Additionally, this study shows for the first time that oxytocin level is significantly lower in obese compared with non-obese children and also lower in obese children with metabolic syndrome compared to those without.
