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Kocaoglu C, Akturk S. Just a vitamin? Should cobalamin (Vitamin B12) levels be checked in children with neurological disadvantages? North Clin Istanb 2023; 10:790-796. [PMID: 38328734 PMCID: PMC10846572 DOI: 10.14744/nci.2022.33279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/20/2022] [Accepted: 12/13/2022] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE The assay of serum cobalamin (Cbl) level is commonly used to diagnose Cbl deficiency. Unexpectedly, the elevated Cbl levels may be determined in some of the patients and its interpretation is difficult. We investigated the association between elevated Cbl levels and a variety of clinical entities in patients presenting with various neurological symptoms. METHODS The data were obtained from the patients' electronic medical records in a tertiary hospital affiliated with a university. The pediatric patients with serum Cbl levels above 1000 pg/mL were included in the study. The patients with serum Cbl levels below 900 pg/mL and above 200 pg/mL constituted the control group. RESULTS The mean Cbl level of the patients with neurological problems was 1424.2±354.2 pg/mL, whereas the average Cbl level of neurologically healthy was 1316±317.8 pg/mL, and the difference was statistically significant. While the rate of having neurological deficits or symptoms in the study group was found to be 24%, this rate was only 18% in the control group. Unexpectedly, despite elevated Cbl level, the high mean corpuscular volume rate was higher in the study group compared to the control group. CONCLUSION This study highlights the importance of the disorders of Cbl metabolism in patients presenting with various neurological symptoms. In children with neurological deficits, serum Cbl levels should be checked. In case of high Cbl level is determined, patients should be followed up closely, and further investigations should be performed in terms of Cbl metabolism disorders.
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Affiliation(s)
- Celebi Kocaoglu
- Department of Pediatric Intensive Care, University of Health Sciences, Konya City Hospital, Konya, Turkiye
| | - Seyma Akturk
- Department of Pediatrics, University of Health Sciences, Konya City Hospital, Konya, Turkiye
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Kocaoglu C, Akturk S. Analysis of patients presenting with serum electrolyte imbalance in terms of the differential diagnosis of pseudohypoaldosteronism. North Clin Istanb 2023; 10:754-760. [PMID: 38328721 PMCID: PMC10846578 DOI: 10.14744/nci.2022.70105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The aim of this study was to contribute to the differential diagnosis of transient pseudohypoaldosteronism (t-PHA). METHODS Twenty-nine infants, younger than 24 weeks, and with high aldosterone levels were included in the study. The patients were divided into two groups as t-PHA and other diagnoses group. Of 29 patients, 18 were in the t-PHA group and 11 were in other diagnoses group. RESULTS The means aldosterone, plasma renin activities (PRA), adrenocorticotropic hormone (ACTH), cortisol, and 17-hydroxyprogesterone (17-OHP) of those with t-PHA were 138±92.8 ng/dL, 8.39±10.57 ng/mL/h, 26.86±19.56 ng/L, 19.44±21.84 μg/dL, and 7.66±10.71 ng/mL, respectively. In other diagnoses group, the mean level of aldosterone, PRA, ACTH, cortisol, and 17-OHP levels was 100.9±70 ng/dL, 5.49±8.41 ng/mL/h, 408.28±491.9 ng/L, 19.99±14.43 μg/dL, and 11.99±12.21 ng/mL, respectively. In the t-PHA group, the number of patients with high PRA was eight (50%), while the number of patients with high levels was two (18.1%) in other diagnoses group. In the t-PHA group, although the average serum K levels were the same in both groups, serum aldosterone/K ratios were higher. CONCLUSION When an infant younger than 24 weeks, with urinary tract infection and/or urinary tract malformation has electrolyte abnormalities, pediatricians should primarily consider the diagnosis of t-PHA. Thus, many unnecessary investigations and inappropriate treatments can be avoided.
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Affiliation(s)
- Celebi Kocaoglu
- Department of Pediatric Intensive Care, University of Health Sciences, Konya City Hospital, Konya, Turkiye
| | - Seyma Akturk
- Department of Pediatrics, University of Health Sciences, Konya City Hospital, Konya, Turkiye
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3
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Sık G, Inamlık A, Akçay N, Kesici S, Aygun F, Kendırlı T, Atay G, Sandal O, Varol F, Ozkaya PY, Duyu M, Bırbılen AZ, Ozcan S, Arslan G, Kangın M, Bayraktar S, Altug U, Anıl AB, Havan M, Yetımakman AF, Dalkıran T, Zengın N, Oto A, Kıhtır HS, Gırgın Fİ, Telhan L, Yıldızdas D, Yener N, Yukselmıs U, Alakaya M, Kılınc MA, Celegen M, Dursun A, Battal F, Sarı F, Ozkale M, Topal S, Kocaoglu C, Yazar A, Alacakır N, Odek C, Yaman A, Cıtak A. Mortality risk factors among critically ill children with MIS-C in PICUs: a multicenter study. Pediatr Res 2023:10.1038/s41390-023-02518-0. [PMID: 36813951 PMCID: PMC9946280 DOI: 10.1038/s41390-023-02518-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/21/2022] [Accepted: 01/09/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND This study evaluated of clinical characteristics, outcomes, and mortality risk factors of a severe multisystem inflammatory syndrome in children admitted to a the pediatric intensive care unit. METHODS A retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 41 PICUs in Turkey. The study population comprised 322 children diagnosed with multisystem inflammatory syndrome. RESULTS The organ systems most commonly involved were the cardiovascular and hematological systems. Intravenous immunoglobulin was used in 294 (91.3%) patients and corticosteroids in 266 (82.6%). Seventy-five (23.3%) children received therapeutic plasma exchange treatment. Patients with a longer duration of the PICU stay had more frequent respiratory, hematological, or renal involvement, and also had higher D-dimer, CK-MB, and procalcitonin levels. A total of 16 patients died, with mortality higher in patients with renal, respiratory, or neurological involvement, with severe cardiac impairment or shock. The non-surviving group also had higher leukocyte counts, lactate and ferritin levels, and a need for mechanical ventilation. CONCLUSIONS In cases of MIS-C, high levels of D-dimer and CK-MB are associated with a longer duration of PICU stay. Non-survival correlates with elevated leukocyte counts and lactate and ferritin levels. We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality. IMPACT MIS-C is a life-threatening condition. Patients need to be followed up in the intensive care unit. Early detection of factors associated with mortality can improve outcomes. Determining the factors associated with mortality and length of stay will help clinicians in patient management. High D-dimer and CK-MB levels were associated with longer PICU stay, and higher leukocyte counts, ferritin and lactate levels, and mechanical ventilation were associated with mortality in MIS-C patients. We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality.
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Affiliation(s)
- Guntulu Sık
- Department of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey.
| | - Aysegul Inamlık
- grid.411117.30000 0004 0369 7552Department of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Nihal Akçay
- grid.414177.00000 0004 0419 1043Department of Pediatric Intensive Care, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Selman Kesici
- grid.14442.370000 0001 2342 7339Department of Pediatric Intensive Care, Hacettepe University, Ankara, Turkey
| | - Fatih Aygun
- grid.506076.20000 0004 1797 5496Department of Pediatric Intensive Care, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Tanıl Kendırlı
- grid.7256.60000000109409118Department of Pediatric Intensive Care, Ankara University, Ankara, Turkey
| | - Gurkan Atay
- grid.417018.b0000 0004 0419 1887Department of Pediatric Intensive Care, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Ozlem Sandal
- Department of Pediatric Intensive Care, Dr Behcet Uz Child Disease and Surgery Training and Research Hospital, Izmir, Turkey
| | - Fatih Varol
- grid.414850.c0000 0004 0642 8921Department of Pediatric Intensive Care, Sancaktepe Şehit Prof. MD İlhan Varank Training and Research Hospital, İstanbul, Turkey
| | - Pınar Yazıcı Ozkaya
- grid.8302.90000 0001 1092 2592Department of Pediatric Intensive Care, Ege University, Izmir, Turkey
| | - Muhterem Duyu
- Department of Pediatric Intensive Care, Goztepe Prof. MD Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ahmet Ziya Bırbılen
- Department of Pediatric Intensive Care, Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Gaziantep, Turkey
| | - Serhan Ozcan
- grid.449874.20000 0004 0454 9762Department of Pediatric Intensive Care, Ankara Yıldırım Beyazıt University, Ankara Children’s Hospital, Ankara, Turkey
| | - Gazi Arslan
- grid.21200.310000 0001 2183 9022Department of Pediatric Intensive Care Unit, Dokuz Eylül University, Izmir, Turkey
| | - Murat Kangın
- Department of Pediatric Intensive Care, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Suleyman Bayraktar
- grid.413752.60000 0004 0419 1465Department of Pediatric Intensive Care, Sultangazi Haseki Training and Research Hospital, Istanbul, Turkey
| | - Umit Altug
- Department of Pediatric Intensive Care, Sanlıurfa Training and Research Hospital, Sanlıurfa, Turkey
| | - Ayşe Berna Anıl
- Department of Pediatric Intensive Care, Tepecik Training and Research Hospital, Izmır Katip Çelebi University, Izmir, Turkey
| | - Merve Havan
- Department of Pediatric Intensive Care, Mersin City Hospital, Mersin, Turkey
| | - Ayse Filiz Yetımakman
- grid.411105.00000 0001 0691 9040Department of Pediatric Intensive Care, Kocaeli University, Kocaeli, Turkey
| | - Tahir Dalkıran
- Department of Pediatric Intensive Care, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Neslihan Zengın
- grid.411688.20000 0004 0595 6052Department of Pediatric Intensive Care, Manisa Celal Bayar Unıversity, Manisa, Turkey
| | - Arzu Oto
- Department of Pediatric Intensive Care, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Hasan Serdar Kıhtır
- grid.413819.60000 0004 0471 9397Department of Pediatric Intensive Care, Antalya Training and Research Hospital, Antalya, Turkey
| | - Feyza İnceköy Gırgın
- grid.16477.330000 0001 0668 8422Department of Pediatric Intensive Care, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Leyla Telhan
- grid.411781.a0000 0004 0471 9346Department of Pediatric Intensive Care, Medipol University, Istanbul, Turkey
| | - Dincer Yıldızdas
- grid.98622.370000 0001 2271 3229Department of Pediatric Intensive Care, Cukurova University, Adana, Turkey
| | - Nazik Yener
- grid.411049.90000 0004 0574 2310Department of Pediatric Intensive Care, Samsun 19 Mayıs University, Samsun, Turkey
| | - Ufuk Yukselmıs
- grid.414850.c0000 0004 0642 8921Department of Pediatric Intensive Care, Kartal Dr Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Alakaya
- grid.411691.a0000 0001 0694 8546Department of Pediatric Intensive Care, Mersin University, Mersin, Turkey
| | - Mehmet Arda Kılınc
- Department of Pediatric Intensive Care, Basaksehir Cam ve Sakura City Hospital, Istanbul, Turkey
| | - Mehmet Celegen
- Department of Pediatric Intensive Care, Afyonkarahisar Tarining and Research Hospital, Afyon, Turkey
| | - Adem Dursun
- grid.513116.1Department of Pediatric Intensive Care, Kayseri City Hospital, Kayseri, Turkey
| | - Fatih Battal
- grid.412364.60000 0001 0680 7807Department of Pediatric Intensive Care, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Ferhat Sarı
- grid.14352.310000 0001 0680 7823Department of Pediatric Intensive Care, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Murat Ozkale
- grid.411548.d0000 0001 1457 1144Department of Pediatric Intensive Care, Dr Turgut NOYAN Hospital, Baskent University, Adana, Turkey
| | - Sevgi Topal
- Department of Pediatric Intensive Care, Erzurum Bölge Training and Research Hospital, Erzurum, Turkey
| | - Celebi Kocaoglu
- Department of Pediatric Intensive Care, Konya City Hospital, Konya, Turkey
| | - Abdullah Yazar
- grid.411124.30000 0004 1769 6008Department of Pediatric Intensive Care, Necmettin Erbakan University, Konya, Turkey
| | - Nuri Alacakır
- grid.411693.80000 0001 2342 6459Department of Pediatric Intensive Care, Trakya University, Edirne, Turkey
| | - Caglar Odek
- grid.34538.390000 0001 2182 4517Department of Pediatric Intensive Care, Bursa Uludağ University, Bursa, Turkey
| | - Ayhan Yaman
- grid.508740.e0000 0004 5936 1556Department of Pediatric Intensive Care, Istınye University Liv Hospital, Istanbul, Turkey
| | - Agop Cıtak
- grid.411117.30000 0004 0369 7552Department of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
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Kocaoglu C, Durmaz MS, Sivri M. Shear wave elastography evaluation of testes with non-communicating hydrocele in infants and toddlers: A preliminary study. J Pediatr Urol 2018; 14:445.e1-445.e6. [PMID: 29724465 DOI: 10.1016/j.jpurol.2018.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 03/31/2018] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Shear wave elastography (SWE) is a new technology and non-invasive ultrasound device that can measure tissue rigidity and elasticity. OBJECTIVE This controlled prospective study aimed to demonstrate using SWE whether there was a difference between the elasticity of testes with non-communicating (NC) hydrocele in infants and toddlers and elasticity of controls' testes without hydrocele, and to reveal quantitative values of elasticity reflecting histological findings. MATERIAL AND METHODS Testes of 37 cases at an average age of 6.32 months and diagnosed with NC hydrocele between December 2016 and April 2017 were evaluated for hydrocele and testicular volumes, and testes elasticity through ultrasonography and SWE. RESULTS Of all cases, 15 had bilateral hydroceles, while 22 were diagnosed with unilateral hydrocele. Testes with NC hydrocele (n = 52) in infants and toddlers were compared with testes without hydrocele (n = 36) in controls. Median hydrocele volume of 52 testes with NC hydrocele was 5.0 cm3 (0.2-37). Median volume of testes with hydrocele was 0.6 cm3 (0.2-1.5) in the study group, and 0.5 cm3 (0.3-1) in controls (P = 0.577). Although median elastography values were measured as 1.67 m/s (1.29-2.59) and 10.0 kPa (2.1-23) in patients, those of controls were found to be 1.61 m/s (1.27-2.34) and 8.25 kPa (5.1-18.9) (P = 0.03, P = 0.005, respectively). While there was no between-group difference in testes volumes, a statistically significant difference was observed in SWE-derived quantitative data (Summary Table). DISCUSSION As a novel elastographic method, SWE is used to track shear waves passing through tissues by quantifying the elasticity of structures and nodules, such as liver fibrosis, and to improve the characterization of breast and thyroid nodules. Shear wave elastography was assessed to be a beneficial ultrasonography tool to predict the histologic features of undescended testicles, which might replace testicular biopsy in the modern management of undescended testes. This study also quantitatively measured whether there was a change in testicular tissues with NC hydrocele through SWE, and found that SWE values of testes with NC hydrocele were significantly higher compared with those of controls, despite the absence of a significant difference in testes volumes. CONCLUSIONS The present study confirmed that quantitative changes in testes elasticity can reliably be evaluated through SWE. Non-communicating hydrocele may be damaging to testicular tissues. More definitive results will be achieved with further comprehensive studies including larger patient populations. It is believed that the operation age of children with NC hydrocele can be re-evaluated in the future.
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Affiliation(s)
- C Kocaoglu
- Department of Pediatric Surgery, University of Health Sciences Konya Education and Research Hospital, Meram Yeni Yol, Konya, Turkey.
| | - M S Durmaz
- Department of Radiology, University of Health Sciences Konya Education and Research Hospital, Meram Yeni Yol, Konya, Turkey
| | - M Sivri
- Department of Radiology, University of Health Sciences Konya Education and Research Hospital, Meram Yeni Yol, Konya, Turkey
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Kocaoglu C. The Collocation of Ischemia-Modified Albumin and Blood Gas Parameters in the PICU Setting. Clin Pediatr (Phila) 2018; 57:417-420. [PMID: 28959892 DOI: 10.1177/0009922817730348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ischemia modified albumin (IMA) is a marker that has been determined to be elevated in hypoxic conditions. This study aimed to investigate the relationships between serum IMA and blood gas parameters (BGPs) and evaluate whether IMA can be used as a parameter clinically in terms of reflecting tissue hypoxia in ventilator management. BGPs and serum IMA level were measured in blood samples drawn simultaneously from patients. Mean serum IMA levels, mean pCO2, mean pO2, and lactate levels were 82.56 ± 25.47 ng/mL, 47.99 ± 22.81 mm Hg, 53.62 ± 30.43 mm Hg, and 2.13 ± 3.22 mmol/L, respectively. No correlation was found between serum IMA level and BGPs. Our findings showed that serum IMA level can be concluded not to be a suitable parameter in ventilator management. However, IMA can be a reliable guide if used together with venous BGPs in terms of the estimating of tissue oxygenation, especially within the last few hours.
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Kocaoglu C, Soran M, Kocaoglu C, Onen A. Factors Affecting the Number of Shock Wave Lithotripsy Session in Children with Renal Stones: Are age and Radiolucency the Predictors of Success? Erciyes Med J 2017. [DOI: 10.5152/etd.2017.16126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Talebi Bezmin Abadi A, Kocaoglu C. Lack of evidence for Helicobacter pylori to prevent children growth efficiently. World J Pediatr 2016; 12:506. [PMID: 27807738 DOI: 10.1007/s12519-016-0059-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Amin Talebi Bezmin Abadi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, 14115-111, Iran.
| | - Celebi Kocaoglu
- Department of Pediatric Intensive Care, Konya Education and Research Hospital, Konya, Turkey
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Talebi Bezmin Abadi A, Kocaoglu C. Correspondence. World J Pediatr 2016; 12:506-507. [PMID: 27807739 DOI: 10.1007/s12519-016-0060-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Amin Talebi Bezmin Abadi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, 14115-111, Iran.
| | - Celebi Kocaoglu
- Department of Pediatric Intensive Care, Konya Education and Research Hospital, Konya, Turkey
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Abstract
Studies performed on mice suggest that adropin is a peptide hormone playing a role in metabolic homeostasis and prevention of obesity-associated insulin resistance. Our study was conducted to investigate the role of adropin in children with obesity or metabolic syndrome. The study group consisted of 70 patients, including 42 obese and 28 with metabolic syndrome, and 26 healthy volunteers. After anthropometric variables and blood pressure of all participants were measured, serum lipids were analyzed, liver USG and oral glucose tolerance test were performed, and HOMA-IR values were calculated. Plasma adropin levels were collectively analyzed from collected plasma samples. In patient and control groups, no difference was observed in the levels of adropin (327.7±124.7 vs. 344.6±208.5 ng/L, respectively). The adropin levels of metabolic syndrome, obesity, and control groups also showed no difference (316±142.3, 335.8±112.5, and 344.6±208.5 ng/L, respectively). While the adropin levels of patients with and without hepatic steatosis were 319.6±123.7 and 347.8±128.7 ng/L, respectively, patients with HOMA-IR values of <3.16 and ≥3.16 had levels 342.3±124.8 and 296.5±136.7 ng/L, respectively. Although statistically insignificant, our findings are considered to support the hypothesis suggesting a nexus between adropin and obesity and metabolic syndrome. Small sample size in our study may have prevented our results to reach a more significant level. So, long-term follow-up studies with large population are needed to enlighten the role of adropin in metabolic homeostasis.
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Kocaoglu C, Ozel A. Persistent metabolic acidosis and severe diarrhoea due to Artemisia absinthium poisoning. J PAK MED ASSOC 2014; 64:1081-1083. [PMID: 25823193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Herbs have long been used in the treatment of various disorders in traditional medicine since ancient age. Artemisia absinthium, one of these herbs, has traditionally been used in different societies for antibiotic, antiparasitic, antifungal and antipyretic purposes. Here, we report a poisoning case of a 10-month-old male infant progressing with severe diarrhoea and persistent metabolic acidosis after ingesting home-prepared Artemisia absinthium extract which was given for the treatment of common cold.
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Kocaoglu C, Akin F, Çaksen H, Böke SB, Arslan Ş, Aygün S. Cerebral atrophy in a vitamin B12-deficient infant of a vegetarian mother. J Health Popul Nutr 2014; 32:367-371. [PMID: 25076673 PMCID: PMC4216972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In developed countries, vitamin B12 (cobalamin) deficiency usually occurs in children, exclusively breastfed ones whose mothers are vegetarian, causing low body stores of vitamin B12. The haematologic manifestation of vitamin B12 deficiency is pernicious anaemia. It is a megaloblastic anaemia with high mean corpuscular volume and typical morphological features, such as hyperlobulation of the nuclei of the granulocytes. In advanced cases, neutropaenia and thrombocytopaenia can occur, simulating aplastic anaemia or leukaemia. In addition to haematological symptoms, infants may experience weakness, fatigue, failure to thrive, and irritability. Other common findings include pallor, glossitis, vomiting, diarrhoea, and icterus. Neurological symptoms may affect the central nervous system and, in severe cases, rarely cause brain atrophy. Here, we report an interesting case, a 12-month old infant, who was admitted with neurological symptoms and diagnosed with vitamin B12 deficiency.
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Affiliation(s)
| | - Fatih Akin
- Konya Education and Research Hospital, Meram, Konya, Turkey
| | - Hüseyin Çaksen
- Necmeddin Erbakan University School of Medicine, Konya, Turkey
| | | | - Şükrü Arslan
- Konya Education and Research Hospital, Meram, Konya, Turkey
| | - Serhat Aygün
- Konya Education and Research Hospital, Meram, Konya, Turkey
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12
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Kocaoglu C, Selma Solak E, Kilicarslan C, Arslan S. Fluid management in children with diarrhea-related hyponatremic-hypernatremic dehydration: a retrospective study of 83 children. Med Glas (Zenica) 2014; 11:87-93. [PMID: 24496346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 10/09/2013] [Indexed: 06/03/2023]
Abstract
AIM To investigate serum creatinine and electrolyte status of children with diarrhea-related hyponatremic or hypernatremic dehydration. METHODS Medical history of 83 patients admitted to the Pediatric Intensive Care Unit of the Konya Education and Research Hospital, Konya, Turkey with diarrhea, dehydration and electrolyte imbalance was retrospectively evaluated according to the degree of dehydration, serum creatinine, electrolytes, blood gas, approaches to the treatment such as content of given fluid, HCO3- and acute periotenal dialysis. Of 65 patients with hyponatremia, 44 (67.7%) were given fluids at appropriate concentration according to their age, and 21 (32.3%) were given fluids at higher concentration. Of 18 hypernatremic patients, 11 (61.1%) were given fluids at appropriate concentration for age, and seven (38.9%) were given fluids at higher concentration. RESULTS Mean duration of amelioration of serum sodium levels for those admitted with hyponatremia and given fluids at appropriate concentration for age and at higher concentration were 33.9 ± 28.3 h and 53.7 ± 31.6 h, respectively. Mean duration of amelioration of serum sodium levels for hypernatremics and given fluids at appropriate concentration for age and at higher concentration were 34.7 ± 22.1 h and 46.3 ± 32 h, respectively. Four (4.8%) hyponatremic patients and three (3.6%) with hypernatremia were treated with acute peritoneal dialysis. Mortality rate was 6% (five of all patients). CONCLUSION The children with severe diarrhea should be closely followed-up as to clinical examination, serum electrolytes, creatinine and blood gases, and because no single intravenous fluid management is optimal for all children, intravenous fluid therapy should be individualized for each patient.
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Affiliation(s)
- Celebi Kocaoglu
- 1Department of Pediatrics, 2Department of Pediatric Nephrology; Konya Education and Research Hospital, Konya, Turkey
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Akin F, Kocaoglu C, Solak ES, Ozdemir H, Pektas B, Arslan S. Coinfection of Plasmodium vivax and Epstein-Barr virus: case report. Asian Pacific Journal of Tropical Disease 2013. [DOI: 10.1016/s2222-1808(13)60016-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kocaoglu C, Sert A, Aypar E, Oran B, Odabas D, Arslan D, Akin F. P-wave dispersion in children with acute rheumatic fever. Pediatr Cardiol 2012; 33:90-4. [PMID: 21898108 DOI: 10.1007/s00246-011-0096-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 08/18/2011] [Indexed: 11/25/2022]
Abstract
As a new and simple electrocardiographic marker, P-wave dispersion is reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. The current study aimed to investigate P-wave dispersion in children with acute rheumatic fever. The study population consisted of 47 children with acute rheumatic fever (29 patients with carditis and 18 patients without carditis) and 31 healthy control subjects. Maximum and minimum P-wave durations were measured from the 12-lead surface electrocardiogram. The P-wave dispersion was calculated as the difference between maximum and minimum P-wave durations. The maximum P-wave duration and the P-wave dispersion of the patients with and without carditis were significantly greater than those of the control subjects. The P-wave dispersion of the patients with carditis was significantly greater than that of the patients without carditis. In conclusion, the P-wave dispersion was higher in the children with acute rheumatic fever than in the healthy control subjects.
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Affiliation(s)
- Celebi Kocaoglu
- Department of Pediatrics, Konya Training and Research Hospital, 42080, Konya, Turkey
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Ciftci I, Sert A, Odabas D, Kocaoglu C, Kayacetin S. A rare suprasternal cystic neck mass in a pediatric patient: epidermoid cyst. Otolaryngol Head Neck Surg 2009; 139:733-4. [PMID: 18984275 DOI: 10.1016/j.otohns.2008.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2008] [Revised: 07/01/2008] [Accepted: 07/08/2008] [Indexed: 11/28/2022]
Affiliation(s)
- Ilhan Ciftci
- Department of Pediatric Surgery, Konya Training and Research Hospital, Konya, Turkey
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Kurtoğlu S, Atabek ME, Gunes T, Akcakus M, Keskin M, Kocaoglu C. Relationship between cord blood levels of IGF-I and ferritin in healthy term neonates. J Pediatr Endocrinol Metab 2004; 17:737-42. [PMID: 15237708 DOI: 10.1515/jpem.2004.17.5.737] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We hypothesize that the balance of maternal and fetal insulin-like growth factor-I (IGF-I) concentrations contributes to the regulation of substrate distribution between mother and fetus, and may thus mediate the maintenance of blood ferritin concentration in the fetus. Therefore, the relationship between cord blood IGF-I to ferritin concentration was investigated. INFANTS AND METHODS Twenty-six term neonates were recruited. Anthropometric measures were recorded and umbilical cord blood samples were collected at birth. We studied serum concentrations of IGF-I in relation to blood ferritin and anthropometric data in term neonates. To assess the importance of the correlation of ferritin with both IGF-I and all other parameters, multiple linear regression analysis was carried out, with ferritin as the dependent variable and IGF-I and anthropometric parameters as independent variables. RESULTS The mean concentrations of cord blood IGF-I and ferritin levels were 45.2 +/- 36.8 ng/ml and 225.5 +/- 124.2 ng/ml, respectively, at birth. A positive correlation was observed between IGF-I and ferritin concentrations of term neonates (r = 0.53, p = 0.005). IGF-I emerged as a significant predictor of ferritin concentration (beta = 1.79, p = 0.005) contributing to 28% of its variability. CONCLUSIONS We showed a relationship between cord blood IGF-I and ferritin levels in term neonates, suggesting that even within an unremarkable population, fetal ferritin level may be influenced by IGF-I. Moreover, we speculated that IGF-I might also be important in the regulation of placental transport of ferritin.
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Affiliation(s)
- Selim Kurtoğlu
- Department of Pediatrics, Erciyes University, School of Medicine, Kayseri, Turkey.
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Kurtoglu S, Akcakus M, Kocaoglu C, Gunes T, Budak N, Atabek ME, Karakucuk I, Delange F. Iodine status remains critical in mother and infant in Central Anatolia (Kayseri) of Turkey. Eur J Nutr 2004; 43:297-303. [PMID: 15309449 DOI: 10.1007/s00394-004-0474-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2003] [Accepted: 11/10/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND Severe iodine deficiency disorders have been eradicated in many parts of the world, but milder forms still exist and may escape detection. Turkey has long been known to be a mild to moderate iodine deficiency area. AIM OF THE STUDY The aim of this study was to assess the iodine nutritional status and the thyroid function of pregnant women and their neonates in the region of Kayseri (central Anatolia of Turkey) that appeared to be iodine deficient in previous studies performed before the introduction of mandatory salt iodization. METHODS A cross-sectional voluntary screening study was performed in the Maternity Unit of a university hospital. A total of 70 mothers and their healthy full-term neonates were included in this study. Urinary iodine concentration was estimated in spot urine samples obtained from mothers and their neonates on day 5. All the neonates were breastfed. The iodine content was determined in the breast milk of all mothers on day 5. Serum concentrations of TSH, thyroglobulin (Tg), free triiodothyronine (FT3) and free thyroxine (FT4) were investigated in the cord serum of neonates and compared to those of mothers immediately after parturition RESULTS The median urinary iodine on day 5 in mothers and their babies were 30.20 and 23.80 microg/l, respectively. These figures are much lower than normal for these age groups (150-200 microg/l). The median iodine content of breast-milk was 73 microg/l. It is again much lower than in iodine sufficient areas, indicating that the status of iodine nutrition of pregnant and lactating women is clearly insufficient. The median concentrations (and ranges) of neonatal TSH, Tg, FT3 and FT4 were 7.44 mU/l, 71.62 ng/ml, 1.30 pg/ml and 1.34 ng/dl respectively. The corresponding levels for the mothers during labor were 2.19 mU/l, 25.65 ng/ml, 1.31 pg/ml and 1.23 ng/dl respectively. The median neonatal serum concentrations of TSH and Tg were significantly higher than the corresponding maternal levels (P < 0.0001, P < 0.0001, respectively) and 27.1% of the neonates had serum TSH concentrations above 10 mU/l and 57.1 % had cord blood serum Tg concentrations above 54 ng/ml. None of the mothers showed TSH concentrations above 5 mU/l and 41.4% had serum Tg concentrations above 30 ng/ml. CONCLUSION Iodine deficiency with low urinary iodine excretion and high serum Tg and TSH concentrations were recognized among pregnant women and their babies in Kayseri in spite of the program of salt iodization. National measures are urgently required for improving the correction of iodine deficiency in Turkey. This includes regular supplementation with iodine, starting at preconception or in early pregnancy and continuing during the period of nursing in this region.
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Affiliation(s)
- Selim Kurtoglu
- Erciyes University, School of Medicine, Dept. of Pediatrics Divisions of Endocrinology & Neonatology, 38039 Kayseri, Turkey.
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