Aysun Ankay YILBAŞ, Betül BAŞARAN, Filiz ÜZÜMCÜGİL, Başak AKÇA, Murat İZGİ, Özgür CANBAY
Aysun Ankay YILBAŞ, Betül BAŞARAN, Filiz ÜZÜMCÜGİL, Başak AKÇA, Murat İZGİ, Özgür CANBAY
Many types of supraglottic airway devices (SAD) including the traditional
LMA (Laryngeal Mask Airway) are commonly used as conduits for intubation
in pediatric patients with difficult airway. The aim of this study was to
evaluate the feasibility of four types of commonly used neonatal and infant
sized SADs as conduits of intubation. Fiberoptic-guided tracheal intubation
with uncuffed, cuffed and armored uncuffed endotracheal tubes (ETT) sized
between 2.5 and 4.5 through four commonly used types of size 1 and 1.5
SADs (i-gel, LMA-classic, LMA-supreme, LMA-proseal) were performed by
two investigators on an infant manikin. The investigators scored two main
outcomes with a 5-point scale: 1) passage of ETT during intubation through
the SAD, and 2) passage of SAD over the ETT during SAD removal. The
differences between the study groups were evaluated using the Bonferroniadjusted Mann-Whitney U test and p<0.0083 was considered as statistically
significant according to Bonferroni correction. i-gel sizes 1 and 1.5 both
performed better as conduits for fiberoptic-guided intubation compared with
LMA-proseal, LMA-classic and LMA-supreme with most of the uncuffed ETTs
investigated (p<0.0083). We found i-gel sizes 1 and 1.5 easily feasible to use
even with uncuffed ETTs with an inner diameter of 3.5 mm and 4.5 mm,
respectively. i-gel was the only SAD that was feasible for use as a conduit for
armored ETTs. The passage of cuffed ETTs was problematic with all types of
studied SADs. In conclusion; the choice of i-gel as a conduit for intubation
could be safer than LMA-classic, LMA-supreme and LMA-proseal.
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Yunus Emre DÖNMEZ, Özlem ÖZCAN, Ayhan BİLGİÇ, Dilşad Yıldız MİNİKSAR
Yunus Emre DÖNMEZ, Özlem ÖZCAN, Ayhan BİLGİÇ, Dilşad Yıldız MİNİKSAR
Stuttering is a multi-factorial speech disorder characterized by various
dysfluencies in the beginning and/or smooth flow of speech. Its incidence
is about 1% in the general population, with 80% of stuttering cases seen in
children aged three to eight years. The etiology of developmental stuttering
has not been precisely explained. Several researchers report that neurological
factors, especially atypical lateralization of the speech and language processes,
play an important role in the etiology of stuttering. Various hypotheses
suggest that prenatal testosterone causes atypical hemispheric lateralization.
The aim of this study was to investigate the role of prenatal testosterone in
the etiology of developmental stuttering by the use of the ratio of secondand fourth-digit lengths (2D:4D).
Totally 133 boys (49 boys who stutter and 84 boys who do not stutter)
were included in the study. The age range of children participating in the
study was determined as 2–12 years. In the comparative evaluation conducted
between the stuttering group and the control group in terms of their right
2D:4D and left 2D:4D ratios, it was found that the left 2D:4D ratio of the
patients was significantly higher than that of the control group.
We are of the opinion that prenatal testosterone may play a role in the
etiology of developmental stuttering. The present study is the first study
in the literature to reveal a relationship between prenatal testosterone and
developmental stuttering.
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Pelin ASFUROĞLU, Aslıhan Araslı YILMAZ, Zehra AYCAN
Pelin ASFUROĞLU, Aslıhan Araslı YILMAZ, Zehra AYCAN
Adolescence is a long period involving many physical and psycho-social changes
experienced during transition from childhood to adulthood. In this period,
behaviors such as curiosity and risk-taking are common, and cigarette smoking
initiation is one of those behaviors. In this study, it was aimed to find out
whether chronic diseases are an effective factor or not in the cigarette smoking
initiation of adolescents. One-hundred adolescents with Type 1 Diabetes
Mellitus (T1DM) and 50 adolescents with Congenital Adrenal Hyperplasia
(CAH) aged 12 and above under follow-up at the Pediatric Endocrinology
Clinic and 100 healthy adolescents within the same age group who applied
to the Adolescent Outpatient Clinic were included in the study. A survey was
applied to all of these adolescents, which had been developed by researchers
and contained questions about their socio-demographic features and cigarette
smoking. Fourteen (5.6%) of the 250 adolescents were smokers. The rate of
those who tried, but quitted cigarette smoking was found as approximately
20%. Cigarette smoking rate of those with T1DM was 1%, of those with
CAH was 4%, and of the healthy adolescents was 11%. Cigarette smoking
was significantly lower in those with a chronic disease (2%) than those
who were healthy (11%). Adolescents’ parents and friends had an effect on
the cigarette smoking initiation, and adolescents smoked their first cigarette
generally because of curiosity.
It was seen in this study that the adolescents with a chronic disease less
frequently smoked cigarettes than the healthy adolescents, the rate of cigarette
smoking in parents of cigarette smoking adolescents was very high, and their
parents and friends had an effect on cigarette smoking initiation of adolescents.
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Hüseyin Anıl KORKMAZ, Rahmi ÖZDEMİR, Mehmet KÜÇÜK, Cem KARADENİZ, Timur MEŞE, Behzat ÖZKAN
Hüseyin Anıl KORKMAZ, Rahmi ÖZDEMİR, Mehmet KÜÇÜK, Cem KARADENİZ, Timur MEŞE, Behzat ÖZKAN
21-hydroxylase-deficient congenital adrenal hyperplasia (CAH) is associated
with cardiovascular risk factors such as, hypertension, obesity, dyslipidemia,
and insulin resistance. It is not known whether 21-hydroxylase-deficient CAH
is risk factor for atrial and ventricular arrhythmias. The purpose of this study
was to compare the 12-lead electrocardiographic measures in patients of
21-hydroxylase-deficient congenital adrenal hyperplasia with those in healthy
control subjects matched for age, sex, height, weight and body mass index
(BMI). Twenty-five patients with 21-hydroxylase-deficient CAH and twenty-five
heathy control subjects were enrolled into this observational, cross-sectional,
controlled study. The evaluation consisted of anthropometric measurements,
biochemical parameters, and electrocardiographic (ECG) measures. The standard
12-lead electrocardiography was performed in all patients and P-wave dispersion
(PWd), QT interval, QTd, QTcd, Tp-e dispersion, Tp-e/QT and Tp-e/QTc
ratios were calculated. There were no significant differences in the groups for
age, sex, height, weight and BMI (median age 9.4 (1.5–16.75) years, mean
weight 37.6±21.5 vs. 27.9±18.3 kg, mean height 125.4±28.9 vs. 114.7±31
cm, mean BMI 21.4±5.7 vs. 18.9±3.4 kg/m2, respectively). P dispersion and
Tp-e dispersion were significantly higher in patients of 21-hydroxylase-deficient
CAH compared to the healthy subjects (median P dispersion 50 (25) vs.
40 (40) ms, mean Tp-e dispersion 48±15.5 vs. 35.2±17.5 ms). Our study
revealed that 21-hydroxylase deficient CAH is associated with high risk of
atrial and ventricular arrhythmias in children.
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Mehmet MUTLU, Yakup ASLAN, Şebnem KADER, Filiz Aktürk ACAR, Embiya DİLBER
Mehmet MUTLU, Yakup ASLAN, Şebnem KADER, Filiz Aktürk ACAR, Embiya DİLBER
Digoxin is widely used in the treatment of congestive heart failure and
some arrhythmias. Digoxin toxicity may occur easily because digoxin has a
narrow therapeutic index. This retrospective study was conducted to evaluate
the clinical signs and symptoms of toxic serum digoxin levels in neonates.
Medical reports of the neonates who had serum digoxin concentrations >2
nanogram/milliliter (ng/ml) were reviewed in terms of patient demographics,
serum digoxin concentrations, signs and symptoms of digoxin toxicity, serum
digoxin and electrolyte levels, renal function tests, electrocardiograms,
echocardiography, and treatments applied. Digoxin toxic levels were identified
in the 13 neonates. Of the 13 neonates with digoxin toxic level, 9 (69%)
were term and 8 (62%) were female. Twenty-three percent (3/13) of
newborn infants were symptomatic. Symptomatic patients had statistically
significantly higher serum digoxin levels, at 7.76±2.76 (5.4-10.8) ng/ml,
than asymptomatic patients, at 3.31±1.09 (2.02-4.95) (p=0.036). Symptoms
related to toxic digoxin levels were observed in the three neonates with
plasma digoxin levels >5 ng/ml. Gastrointestinal and central nervous system
symptoms were the major clinic findings. Despite high digoxin levels, no
digoxin-related arrhythmia was observed on electrocardiography, other than
sinus bradycardia. Two premature neonates were treated with digoxin-specific
antibody Fab fragments (DigiFab®) and hypokalemia developed in both of
them. Our data suggests that symptoms related with digoxin toxic levels were
observed in neonates with plasma digoxin levels >5 ng/ml. Serum digoxin
levels should be measured in case of signs and symptoms of digoxin toxicity
or risk factors for such toxicity.
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Işık Odaman AL, Alper GEZDİRİCİ, Melek YILDIZ, Gizem ERSOY, Gönül AYDOĞAN, Zafer SALCIOĞLU, Tuba Nur TAHTAKESEN, Hasan ÖNAL, Banu Küçükemre AYDIN
Işık Odaman AL, Alper GEZDİRİCİ, Melek YILDIZ, Gizem ERSOY, Gönül AYDOĞAN, Zafer SALCIOĞLU,
... Devamını oku
Thiamine-responsive megaloblastic anemia (TRMA) is a very rare syndrome
characterized by the triad of early onset megaloblastic anemia, sensorineural
deafness and diabetes mellitus. Here we report, a 5-year-old boy who
presented with transfusion dependent anemia and diabetes mellitus and was
diagnosed with TRMA. Besides reporting a novel mutation of the causative
gene SLC19A2, we wanted to emphasize this syndrome in the aspect of
coexistence of insulin dependent diabetes, transfusion dependent anemia and
thrombocytopenia.
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Aydan DEĞERLİYURT, Mehmet GÜNDÜZ, Serdar CEYLANER, Özlem ÜNAL
Aydan DEĞERLİYURT, Mehmet GÜNDÜZ, Serdar CEYLANER, Özlem ÜNAL
Biotin-thiamine-responsive basal ganglia disease is characterized by seizures,
dystonia and encephalopathy attacks, with an acute-subacute onset in
childhood. It causes cerebral damage especially with caudate head and putamen
involvement and may lead to severe sequelae and even death if left untreated.
We report a patient with the neonatal form of biotin-thiamine-responsive basal
ganglia disease who presented with encephalopathy and lactic acidosis in the
neonatal period together with the diagnostic magnetic resonance imaging
(MRI) clues. MRI in the neonatal period revealed bilateral involvement of the
putamen, thalamus, and perirolandic cortical regions. However, MRI obtained
at 32 months revealed involvement of the caudate nuclei in addition to the
putamen and thalami. The neuroimaging findings of our patient and relevant
literature indicate that patients with biotin-thiamine-responsive basal ganglia
disease who are symptomatic in the neonatal period have putamen, thalami,
and perirolandic cortical involvement. However, these patients do not have
caudate involvement, unlike the patients who present in childhood.
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Aslı Çelebi TAYFUR, Raziye Merve YARADILMIŞ, Fatma ULUS, Aysun Çaltık YILMAZ, Esra ÖZAYAR, Berrin KOŞAR, Bahar BÜYÜKKARAGÖZ, Eyüp HORASANLI
Aslı Çelebi TAYFUR, Raziye Merve YARADILMIŞ, Fatma ULUS, Aysun Çaltık YILMAZ, Esra ÖZAYAR, Berrin KOŞAR,
... Devamını oku
Bismuth intoxication is a rare cause of acute kidney injury (AKI) and is
usually reversible by appropriate therapeutic measures. We present here a
case of an adolescent pregnant girl who developed AKI due to an overdose
of colloidal bismuth subcitrate (CBS, total amount of 6 g). She received
parenteral chelating agent dimercaprol for 14 days. Continuous venovenous
hemodiafiltration (CVVHD) with high-flux membrane was carried out in the
first 3 days of chelating therapy and intermittent hemodialysis for 11 days,
thereafter. The patient recovered clinically and was discharged after 21 days.
She gave birth to a healthy term boy. At the last visit, the baby was 6 months
old with normal growth and development as well as normal kidney functions.
Neither deterioration in renal functions nor emergence of proteinuria was
recorded in the patient during follow-up care after hospital discharge. In cases
of AKI due to an overdose of CBS, treatment with dimercaprol combined
with high flux hemodiafiltration and subsequently hemodialysis appears to
be both useful and safe for bismuth elimination.
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Yasemin DÜZÇEKER, Sinem AKGÜL, Yasemin ÖZSÜREKÇİ, Orhan DERMAN, Ateş KARA, Nuray KANBUR
Yasemin DÜZÇEKER, Sinem AKGÜL, Yasemin ÖZSÜREKÇİ, Orhan DERMAN, Ateş KARA, Nuray KANBUR
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Zeliha GÜZELKÜÇÜK, Dilek KAÇAR, Rabia DEMİR, Meltem KÜRTÜL, Hüsniye Neşe YARALI, Namık Yaşar ÖZBEK
Zeliha GÜZELKÜÇÜK, Dilek KAÇAR, Rabia DEMİR, Meltem KÜRTÜL, Hüsniye Neşe YARALI, Namık Yaşar ÖZBEK
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