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Akköprü H, Alnak A, Karadoğan ZN, Çağlayan AO, Özçetin M, Coşkun M. Peripheral Expression of ADORA2A Is Increased and Is Correlated with Autism Spectrum Disorder Severity in a Sample of Turkish Children. PSYCHIAT CLIN PSYCH 2023; 33:14-19. [PMID: 38764528 PMCID: PMC11082569 DOI: 10.5152/pcp.2023.22509] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/06/2022] [Indexed: 05/21/2024] Open
Abstract
Background The aim of this study was to evaluate the peripheral expression of ADORA2A (Adenosine A2A receptor gene) in young subjects with autism spectrum disorder compared with healthy controls and its relationship with clinical characteristics. Method This study included 93 children and adolescents with a diagnosis of autism spectrum disorder as the study group and 105 healthy age- and gender-matched controls. Blood samples were obtained from all participants, and a real-time quantitative polymerase chain reaction was performed. Parent- and clinician-rated assessment instruments were used to assess and rate the severity of autism spectrum disorder and other emotional/behavioral problems. Results The mean age of the study group was 9.06 ± 3.57 and 86% were male (n = 83), whereas the mean age of the control group was 9.22 ± 3.86 and 86.7% were male (n = 91). We have found a higher level of peripheral expression of ADORA2A in children and adolescents with autism spectrum disorder compared with healthy controls (fold change = 1.33, P = .001). We also found a weak negative correlation with autism spectrum disorder severity (r = -0.216; P = .038) and stereotyped behaviors (r = -0.207, P = .046). Conclusion ADORA2A genes may have a role in the pathophysiology of autism spectrum disorder. Further studies are needed to evaluate whether peripheral expression of ADORA2A genes may be among the biomarkers for diagnosing or measuring the severity of autism spectrum disorder.
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Affiliation(s)
- Hilal Akköprü
- Bingöl Maternity and Child Health Hospital Bingöl, Turkey
| | - Alper Alnak
- Sakarya University Training and Research Hospital, Sakarya, Turkey
| | | | | | - Mustafa Özçetin
- Department of Child Health and Diseases, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Murat Coşkun
- Department of Child and Adolescent Psychiatry, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
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Yetim A, Aygüler E, Özçetin M, Bayramoğlu Z, Hançerli Törün S, Çelik M, Güdek K, Korur Fincanci Ş, Kiliç A. Foreign Body Reaction Due to a Forgotten Rubber Band on the Neck of a Toddler Girl. Pediatr Emerg Care 2021; 37:e491-e494. [PMID: 30624419 DOI: 10.1097/pec.0000000000001702] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT In the presence of an unhealed granulation tissue-like wound, a possibility of abuse and neglect along with a foreign body should come to mind. However, it may be difficult to recognize a foreign body in patients with atypical clinical presentations. We demonstrated delayed diagnosis of a rubber band embedded into subcutaneous tissue in a 2½-year-old girl who presented with a circumferential scar with 2 granulation tissue-like wounds on her neck due to a foreign body reaction developed over years. With this rare case presentation, we remind the possibility of abuse/neglect along with foreign bodies in neck lesions of children.
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Affiliation(s)
| | | | | | | | | | | | | | - Şebnem Korur Fincanci
- Department of Forensic Medicine, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
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Kılıç A, Yener GO, Yetim A, Özçetin M, Gökçay G, Çoban A, Ince Z, Yaşa B, Öksüz L, Uğurlucan FG, Gürler N. The Impact of Early Postpartum Maternal Pertussis Vaccination on the Protection of Infants: A Randomized Clinical Trial. Iran J Immunol 2019; 16:225-234. [PMID: 31552831 DOI: 10.22034/iji.2019.80273] [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] [Indexed: 06/10/2023]
Abstract
BACKGROUND Despite primary vaccination, infants under six months run a risk of infection with pertussis. OBJECTIVE To determine the impact of early postpartum maternal pertussis vaccination on protecting infants from the disease. METHODS All mothers (n=405) who gave birth to healthy term infants were educated on the cocoon strategy. The mothers who consented were immunized with the tetanus-diphtheria-acellular pertussis vaccine within the first three postpartum days. All infants received their pertussis vaccines according to the national schedule. The anti-pertussis IgG titers of infants of thirty vaccinated mothers were compared with those of thirty unvaccinated mothers. RESULTS The pertussis antibody levels in the infants of vaccinated mothers were significantly higher than those of unvaccinated mothers at the mean infant age of 5.6 ± 1.2 months. Only 6 infants of vaccinated mothers exhibited pertussis-like symptoms, none of whom had positive pertussis PCR. Seventeen infants of unvaccinated mothers had pertussis-like symptoms, and 4 tested positive for pertussis PCR. CONCLUSION Our results showed that maternal pertussis vaccination, administered within the first three postpartum days, may protect infants against pertussis in their first ten months.
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Affiliation(s)
- Ayşe Kılıç
- Department of Pediatrics, Istanbul Medical School, Istanbul University, Istanbul, Turkey
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Özçetin M, Gümüştaş F, Çağ Y, Gökbay İZ, Özmel A. The relationships between video game experience and cognitive abilities in adolescents. Neuropsychiatr Dis Treat 2019; 15:1171-1180. [PMID: 31190825 PMCID: PMC6514119 DOI: 10.2147/ndt.s206271] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 04/04/2019] [Indexed: 11/27/2022] Open
Abstract
Objectives: Video games are especially popular among adolescents and young adults as a form of entertainment and the amount of time spent playing video games has increased rapidly. The main objective of this study is to assess the effect of video games on cognitive functions in adolescents. Methods: An exploratory, cross-sectional study was employed to investigate cognitive function in adolescent video game players. Cognitive functions, including memory, attention, and executive functions, were evaluated in 46 adolescents who had been playing video games regularly for at least 1 h per day, 5 days per week, for at least a year, and 31 adolescents (who played video games <5 h per week) using cognitive function assessment tests. Other data, such as demographics, medical information, video game types, and time spent playing video games were collected by questionnaires. Results: No significant difference was detected between the groups in terms of age, gender, IQ levels, and sociodemographic variables. Our findings show that visual memory results were slightly better in the playing group. Moreover, in the group that plays video games regularly, the increase in daily time spent playing games significantly increased the total error value in the Stroop Test and total interference value in California Verbal Learning Test-Children's Version test. We also found that more time is spent on online games compared with traditional games. Conclusions: In this study, we emphasize the pathological and uncontrolled consumption of video games and the possible consequences of time spent playing games. Our findings indicate the need for more extensive research. Future research should address the various implications of video game play, especially between the potentially positive and negative effects of video games.
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Affiliation(s)
- Mustafa Özçetin
- Istanbul Faculty of Medicine, Department of Pediatrics, Istanbul University, Istanbul, Turkey
| | - Funda Gümüştaş
- Department of Child and Adolescent Psychiatry, Marmara University Research and Training Hospital, Istanbul, Turkey
| | - Yakup Çağ
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Pediatrics, Istanbul, Turkey
| | - İnci Zaim Gökbay
- Department of Informatics, Istanbul University, Istanbul, Turkey
| | - Ahu Özmel
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Pediatrics, Istanbul, Turkey
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Cag Y, Özdemir AA, Yükselmiş U, Akdeniz E, Özçetin M. Association Between Rapid Antigen Testing and Antibiotic Use and Accuracy of Peripheral Blood Parameters in Detecting Group A Streptococcus in Children With Tonsillopharyngitis. Front Pediatr 2019; 7:322. [PMID: 31428594 PMCID: PMC6688128 DOI: 10.3389/fped.2019.00322] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 07/18/2019] [Indexed: 11/13/2022] Open
Abstract
Objectives: To investigate the effect of rapid antigen testing (RAT) on the practice of antibiotic prescription as well as the accuracy of peripheral blood neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) values in detecting group A beta-hemolytic Streptococcus (GABHS) in children with tonsillopharyngitis. Methods: In a multicenter study performed in Turkey, we retrospectively analyzed data from 668 consecutive pediatric patients under 17 years of age, who presented with signs and symptoms of tonsillopharyngitis and underwent RAT. The rates of positive and negative RAT results were determined and patients' antibiotic prescriptions were examined in relation to RAT results. In addition, the accuracy of peripheral blood NLR and CRP values was examined for 212 patients whose laboratory data were available, with RAT as the reference standard. Results: Positive RAT results were observed in 190 of 668 (28.4%) patients. Antibiotics were prescribed to all 190 patients with positive RAT results and to 8 of 478 patients with negative RAT results. Overall, the rate of antibiotic prescription was 29.6%. Patients with positive and negative RAT results did not differ significantly with regard to NLR and CRP values. In ROC analysis, the area under the ROC curve (AUC) of NLR and CRP were 0.54 (95% confidence interval [CI] 0.45-0.64), and 0.55 (95% CI 0.45-0.65), respectively. Conclusion: RAT results proved highly associated with antibiotic prescribing, suggesting that RATs could be of great value in preventing unnecessary antibiotic use. Our findings also suggest that NLR and CRP are poorly accurate to identify GABHS in children with tonsillopharyngitis.
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Affiliation(s)
- Yakup Cag
- Department of Pediatrics, Kartal Dr. Lutfi Kırdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | - Ufuk Yükselmiş
- Department of Pediatrics, Kartal Dr. Lutfi Kırdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ezgi Akdeniz
- Department of Pharmacy, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mustafa Özçetin
- Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Abstract
BACKGROUND The thyroid gland and hormonal regulation are among the most important systems to be investigated in pre-term infants. This study sought to investigate thyroid hormone levels of healthy and unhealthy pre-term infants. METHODS The prospective study included 53 consecutive premature infants admitted to the neonatal intensive care unit within a duration of one year. Of these preterm babies, 20 were healthy, while 33 had problems such as asphyxia or RDS. Venous blood samples were collected at baseline 0-24 hours, 7 and 14 days and FT3, FT4, and TSH levels were determined. Other data recorded included demographic characteristics of the patients and clinical variables. RESULTS The most frequent health problems were RDS (87.9%), sepsis (30.3%), and retinopathy of prematurity (24.2%). The mean TSH levels showed a consistent decline at three consequent measurements in both groups, which were always significantly lower in unhealthy pre-terms. In both groups, TSH levels showed significant decreases on Day 7 and Day 14 compared to the baseline levels (p<005). The levels of FT3 and FT4 consistently showed significant correlations with gestational week and birth weight at each of the three measurements. CONCLUSION Pre-term infants, especially those having problems, have significant hypothyroxinemia that may require thyroid hormone replacement therapy.
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Affiliation(s)
- Gökten Korkmaz
- Süleymaniye Maternity and Children Diseases Training and Research Hospital, Department of Pediatrics, Istanbul, Turkey
| | - Mustafa Özçetin
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey
| | - Yakup Çağ
- Dr. Lutfi Kirdar Kartal Training and Research Hospital, Department of Pediatrics, Istanbul, Turkey
| | - Ufuk Yükselmiş
- Dr. Lutfi Kirdar Kartal Training and Research Hospital, Department of Pediatrics, Istanbul, Turkey
| | - Volkan Öngel
- Beykent University, Department of Economics, Istanbul, Turkey
| | - Olcay Işık
- Kocaeli University Faculty of Medicine, Department of Neonatology, Kocaeli, Turkey
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Yükselmiş U, Girit S, Çağ Y, Özçetin M. A child with acute liver failure associated with influenza A and resolved with plasma exchange treatment. HONG KONG J EMERG ME 2018. [DOI: 10.1177/1024907918754441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction: Although liver support systems play a major role as a bridge to transplantation, they may sometimes serve as a lifesaving treatment eliminating this need. Case presentation: We report on a 4-year-old boy who developed acute liver failure due to an influenza A (H3N2) infection as confirmed by clinical and laboratory data (molecular typing, stage 3 encephalopathy, brain edema, increased levels of ammonia, bilirubin, and international normalized ratio 5.2). Testing for any possible underlying liver disease showed no congenital or acquired liver pathology. Oral oseltamivir treatment was initiated and liver support therapy with plasma exchange was performed as a bridge to transplantation. A total of three plasma exchange sessions every other day, with fresh frozen plasma 1.5 times the total blood volume for the first course and 1 times for the subsequent courses, were performed. After the first plasma exchange, encephalopathy improved to stage 2, accompanied by substantial decreases in the elevated liver function tests. At the end of three plasma exchange sessions, the patient’s clinical condition improved significantly. At 14 days after admission, deep tendon reflexes of the patient were normal and levels of alanine transaminase, aspartate transaminase, bilirubin, ammonia, and international normalized ratio returned to normal. Liver support treatment with plasma exchange resulted in complete recovery and the patient was discharged on the 17th day of admission. Conclusion: Acute supportive treatment with plasma exchange proved to be life-saving in our case.
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Affiliation(s)
- Ufuk Yükselmiş
- Division of Pediatric Intensive Care Unit, Department of Pediatrics, Dr. Lutfi Kırdar Kartal Educational and Research Hospital, Istanbul, Turkey
| | - Saniye Girit
- Division of Pediatric Pulmonology, Department of Pediatrics, Dr. Lutfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Yakup Çağ
- Department of Pediatrics, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Mustafa Özçetin
- Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Yükselmiş U, Özçetin M, Çağ Y, Yıldızdaş D, Yılmaz HL. The role of plasmapheresis in organophosphate poisoning: Case reports of three pediatric patients. Turk J Pediatr 2017; 59:491-496. [PMID: 29624234 DOI: 10.24953/turkjped.2017.04.020] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Yükselmiş U, Özçetin M, Çağ Y, Yıldızdaş D, Yılmaz HL. The role of plasmapheresis in organophosphate poisoning: Case reports of three pediatric patients. Turk J Pediatr 2017; 59: 491-496. The aim of the study was to assess the impact of plasmapheresis treatment in the management of three pediatric patients with organophosphate poisoning who did not respond to standard treatment. The treatment of signs and symptoms, and supportive treatment has been evaluated in this paper. Patients were initially given atropine infusion and 0.05 mg/kg atropine with five-minute intervals. Despite pralidoxime loading and three consecutively infusions clinical symptoms did not respond to the treatment and plasma pseudocholinesterase levels did not decrease. At this point, plasmapheresis was used on three consecutive days. Accordingly, the clinical signs improved and mechanical ventilation was no longer necessary. Patients were discharged on the sixteenth day after their admission to the hospital. Plasmapheresis may be an option for the patients who do not respond to atropine and pralidoxime treatment in organophosphate poisoning.
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Affiliation(s)
- Ufuk Yükselmiş
- Department of Pediatrics, Dr. Lutfi Kirdar Kartal Training and Research Hospital, University of Health Sciences, İstanbul
| | - Mustafa Özçetin
- Department of Pediatrics, Istanbul University Istanbul Faculty of Medicine, İstanbul
| | - Yakup Çağ
- Department of Pediatrics, Dr. Lutfi Kirdar Kartal Training and Research Hospital, University of Health Sciences, İstanbul
| | - Dinçer Yıldızdaş
- Departments of Pediatric Intensive Care, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Hayri Levent Yılmaz
- Departments of Pediatric Emergency, Cukurova University Faculty of Medicine, Adana, Turkey
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Özçetin M, Karacı M, Toroslu E, Edebali N. A pediatric case of pituitary macroadenoma presenting with pituitary apoplexy and cranial nerve involvement: case report. Turk Arch Pediatr 2016; 51:162-165. [PMID: 27738402 DOI: 10.5152/turkpediatriars.2016.1945] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 02/26/2014] [Accepted: 07/21/2014] [Indexed: 11/22/2022]
Abstract
Pituitary adenomas usually arise from the anterior lobe of the pituitary gland and are manifested with hormonal disorders or mass effect. Mass effect usually occurs in nonfunctional tumors. Pituitary adenomas may be manifested with visual field defects or rarely in the form of total oculomotor palsy. Visual field defect is most frequently in the form of bitemporal hemianopsia and superior temporal defect. Sudden loss of vision, papilledema and ophthalmoplegia may be observed. Pituitary apoplexy is defined as an acute clinical syndrome characterized with headache, vomiting, loss of vision, ophthalmoplegia and clouding of consciousness. The problem leading to pituitary apoplexy may be decreased blood supply in the adenoma and hemorrhage following this decrease or hemorrhage alone. In this article, we present a patient who presented with fever, vomiting and sudden loss of vision and limited outward gaze in the left eye following trauma and who was found to have pituitary macroadenoma causing compression of the optic chiasma and optic nerve on the left side on cranial and pituitary magnetic resonance imaging.
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Affiliation(s)
- Mustafa Özçetin
- Clinic of Pediatrics, Süleymaniye Maternity and Children Diseases Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Karacı
- Department of Pediatrics, Bülent Ecevit University School of Medicine, Zonguldak, Turkey
| | - Ertuğ Toroslu
- Department of Pediatrics, Bülent Ecevit University School of Medicine, Zonguldak, Turkey
| | - Nurullah Edebali
- Department of Neurosurgery, Bülent Ecevit University School of Medicine, Zonguldak, Turkey
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Çelik A, Özçetin M, Ateş Ö, Altunkaş F, Karaman K, Akar İ, İnce İ, Yalçın M, Karayakalı M, Ceyhan K, Koç F. Analyses of C-Reactive Protein, Endothelial Nitric Oxide Synthase and Interleukin-6 Gene Polymorphisms in Adolescents with a Family History of Premature Coronary Artery Disease: A Pilot Study. Balkan Med J 2016; 32:397-402. [PMID: 26740900 DOI: 10.5152/balkanmedj.2015.151190] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 02/05/2015] [Accepted: 05/12/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Family history of premature atherosclerosis imposes a high risk to people. The relationship between atherosclerosis and gene polymorphisms of various biomarkers such as Endothelial Nitric Oxide Synthase (eNOS), C-Reactive Protein (CRP), and Interleukin-6 (IL-6) has shown in previous studies. AIMS The major aim of the study was to evaluate the CRP, eNOS, and IL-6 gene polymorphisms in a group of adolescents who have a parental history of early coronary artery disease (CAD). STUDY DESIGN Case-control study. METHODS Thirty-six volunteers with a father with obstructive CAD during the first four decades and 46 subjects with a father with normal coronary arteries documented with coronary angiography were included in the study. Polymerase chain reaction-restriction fragment length polymorphism techniques were used to analyze CRP, eNOS, and IL-6 polymorphisms. RESULTS We did not find any differences between the two groups with regard to age, sex, body mass index, renal functions, systolic and diastolic blood pressures, lipid profile, and fasting glucose, hemoglobin, and high sensitivity CRP. A significant difference was only observed in IL-6-572 G/C genotype distribution and allele frequency between two groups (Pc=0.036 OR=3.48 CI (95%) 1.17-10.32). CONCLUSION The present study showed a significant association between the IL-6-572 G/C gene polymorphism (presence of C allele) and adolescents with a parental history of premature CAD.
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Affiliation(s)
- Ataç Çelik
- Department of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Mustafa Özçetin
- Department of Pediactics, Süleymaniye Obstetrics and Gynecology Training and Research Hospital, İstanbul, Turkey
| | - Ömer Ateş
- Department of Medical Biology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Fatih Altunkaş
- Department of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Kayıhan Karaman
- Department of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - İlker Akar
- Department of Cardiovascular Surgery, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - İlker İnce
- Department of Cardiovascular Surgery, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Murat Yalçın
- Department of Cardiology, GATA Haydarpaşa Military Hospital, İstanbul, Turkey
| | - Metin Karayakalı
- Department of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Köksal Ceyhan
- Department of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Fatih Koç
- Department of Cardiology, Akdeniz University Faculty of Medicine, Antalya, Turkey
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Karakus OZ, Özçetin M, Atılgan Ç, Muslehiddinoglu A. Çocuklarda invajinasyonun nadir bir nedeni: Apendiks müsinöz kistadenomu. Ege Tıp Dergisi 2015. [DOI: 10.19161/etd.83693] [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: 11/23/2022] Open
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12
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Karacı M, Özçetin M, Dilsiz G, Güçlü-Songür YG. Severe childhood amitriptyline intoxication and plasmapheresis: a case report. Turk J Pediatr 2013; 55:645-647. [PMID: 24577986] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Tricyclic antidepressant intoxication is one of the most frequently encountered and life-threatening causes of intoxication among referrals to emergency departments due to drug intoxication. There is no known antidote against any of the tricyclic antidepressants. The American Society for Apheresis (ASFA) recommends plasmapheresis to support primary treatment in this type of drug poisoning, which does not respond to certain and traditional treatments. We present a 15-year-old girl who ingested amitriptyline with suicidal intent. On admission, she was in a comatose state (Glasgow Coma Scale score: 5), with no spontaneous respiration and presence of pathological reflexes. Due to the intake history of lethal doses and the severe clinical picture, plasmapheresis was performed. She was discharged on her fifth day of hospitalization.Due to the high plasma protein binding property of amitriptyline, plasma exchange therapy should be considered in cases of severe amitriptyline intoxication as a life-saving therapeutic modality.
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Affiliation(s)
- Mehmet Karacı
- Department of Pediatrics Bülent Ecevit University, Faculty of Medicine, Zonguldak, Turkey.
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13
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Çelik A, Özçetin M, Ateş Ö, Altunkaş F, Karaman K, Akar İ, İnce İ, Yalçın M, Ceyhan K, Koç F. Association between C-Reactive Protein, Endothelial Nitric Oxide Synthase, and Interleukin-6 Gene Polymorphisms in Adolescents with a Family History of Premature Atherosclerosis. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.378] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Özer I, Özçetin M, Karaer H, Kurt SG, Şahin Ş. Retrospective approach to methylenetetrahydrofolate reductase mutations in children. Pediatr Neurol 2011; 45:34-8. [PMID: 21723457 DOI: 10.1016/j.pediatrneurol.2011.01.019] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 07/20/2010] [Accepted: 01/31/2011] [Indexed: 11/26/2022]
Abstract
Methylenetetrahydrofolate reductase reduces methyltetrahydrofolate, a cosubstrate in the remethylation of homocysteine, from methylenetetrahydrofolate. Congenital defects, hematologic tumors, and intrauterine growth retardation can occur during childhood. This study evaluated clinical and laboratory treatment approaches in children diagnosed with methylenetetrahydrofolate reductase mutations. Our group included 23 boys and 14 girls, aged 103.4 ± 70.8 months S.D. Clinical findings of patients and homocysteine, vitamin B12, folate, hemogram, electroencephalography, cranial magnetic resonance imaging, and echocardiography data were evaluated in terms of treatment approach. Our patients' findings included vitamin B12 at 400.4 ± 224.6 pg/mL S.D. (normal range, 300-700 pg/mL), folate at 10.1 ± 4.5 ng/mL S.D. (normal range, 1.8-9 ng/mL), and homocysteine at 8.4 ± 4.7 μmol/L S.D. (normal range, 5.5-17 μmol/L). Eighty-eight percent of patients demonstrated clinical findings. In comparisons involving categorical variables between groups, χ(2) tests were used. No relationship was evident between mutation type, laboratory data, and clinical severity. All mothers who had MTHFR mutations and had babies with sacral dimples had taken folate supplements during pregnancy. To avoid the risk of neural tube defects, pregnant women with a MTHFR mutation may require higher than normally recommended doses of folic acid supplementation for optimum health.
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Affiliation(s)
- Işıl Özer
- Department of Pediatrics, Goztepe Education and Research Hospital, Istanbul, Turkey.
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