Publications (9)15.4 Total impact
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Article: Arachnoid cyst with growth hormone deficiency
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ABSTRACT: On clinical grounds, arachnoid cysts are usually associated with neurological dysfunction. Little is known concerning their involvement in endocrine disorders. A seven-year-old boy was admitted to the hospital for evaluation of an unprovoked afebrile seizure. His neurological examination was normal, however, he had growth retardation. Insulin tolerance and L-dopa growth hormone stimulation tests revealed an inefficient growth hormone response. An MRI of hypophysis and cranium yielded a shift of hypophysis and a large arachnoid cyst.The Indian Journal of Pediatrics 04/2012; 74(3):294-296. · 0.52 Impact Factor -
Article: Clinical and epidemiological features of Turkish children with 2009 pandemic influenza A (H1N1) infection: experience from multiple tertiary paediatric centres in Turkey.
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ABSTRACT: In April 2009 a novel strain of human influenza A, identified as H1N1 virus, rapidly spread worldwide, and in early June 2009 the World Health Organization raised the pandemic alert level to phase 6. Herein we present the largest series of children who were hospitalized due to pandemic H1N1 infection in Turkey. We conducted a retrospective multicentre analysis of case records involving children hospitalized with influenza-like illness, in whom 2009 H1N1 influenza was diagnosed by reverse-transcriptase polymerase chain reaction assay, at 17 different tertiary hospitals. A total of 821 children with 2009 pandemic H1N1 were hospitalized. The majority of admitted children (56.9%) were younger than 5 y of age. Three hundred and seventy-six children (45.8%) had 1 or more pre-existing conditions. Respiratory complications including wheezing, pneumonia, pneumothorax, pneumomediastinum, and hypoxemia were seen in 272 (33.2%) children. Ninety of the patients (11.0%) were admitted or transferred to the paediatric intensive care units (PICU) and 52 (6.3%) received mechanical ventilation. Thirty-five children (4.3%) died. The mortality rate did not differ between age groups. Of the patients who died, 25.7% were healthy before the H1N1 virus infection. However, the death rate was significantly higher in patients with malignancy, chronic neurological disease, immunosuppressive therapy, at least 1 pre-existing condition, and respiratory complications. The most common causes of mortality were pneumonia and sepsis. In Turkey, 2009 H1N1 infection caused high mortality and PICU admission due to severe respiratory illness and complications, especially in children with an underlying condition.Scandinavian Journal of Infectious Diseases 08/2011; 43(11-12):923-9. · 1.72 Impact Factor -
Article: Comparison of in vitro activity of ertapenem with other carbapenems against extended-spectrum beta-lactamase-producing Escherichia coli and Kleibsella species isolated in a tertiary children's hospital.
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ABSTRACT: The purpose of this study was to evaluate the susceptibility of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae clinical isolates to ertapenem in a tertiary pediatric care center in Turkey. All isolates of ESBL-producing Enterobacteriaceae were collected from clinical specimens from children, and susceptibility tests were done using the Vitek 2 compact system. Ninety-nine per cent of the ESBL-producing Escherichia coli isolates were found to be susceptible to ertapenem, 99.5% to imipenem and 100% to meropenem. In the Klebsiella species, 91.5% of the isolates were susceptible to ertapenem, 99.3% to imipenem and 100% to meropenem. The results of our data, including isolates from children, showed that ertapenem had high in vitro activity against the majority of the ESBL-producing E. coli and Klebsiella species, as reported in previously published studies. However, additional clinical studies are required to assess the clinical activity of ertapenem and the clinical importance of the resistant isolates.Expert Opinion on Pharmacotherapy 02/2011; 12(6):845-9. · 3.20 Impact Factor -
Article: A novel homozygous HESX1 mutation causes panhypopituitarism without midline defects and optic nerve anomalies.
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ABSTRACT: There are many genes reported to have been associated with combined pituitary hormone deficiencies, but mutations in HESX1 strongly correlate with septo-optic dysplasia. Our aim was to determine the cause of panhypopituitarism in our patient. We studied an 8-month-old child having panhypopituitarism. The coding exons of PIT1, PROP1, LHX3, and HESX1 genes were amplified. Direct sequencing was done after denaturing HLPC. We identified a novel homozygous mutation (R160H) within the homeodomain of HESX1, which, to our knowledge, is the first to be described in humans. Neuroimaging studies revealed anterior pituitary aplasia, a normal posterior pituitary gland, and a thin pituitary stalk but no midline abnormalities. Optic nerve studies showed no pathology. This mutation is also carried in the parents of the affected child in a heterozygous pattern, suggesting an autosomal recessive inheritance. These data demonstrate that homozygous HESX1 mutation causing an R160H substitution can result in panhypopituitarism without midline defects.Journal of pediatric endocrinology & metabolism: JPEM 01/2011; 24(9-10):779-82. · 0.88 Impact Factor -
Article: Risk factors for isoniazid hepatotoxicity in children with latent TB and TB: difference from adults.
Chest 03/2010; 137(3):737-8. · 5.25 Impact Factor -
Article: The effects of topical iodine containing antiseptics on thyroidal status of preterm versus term babies.
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ABSTRACT: To determine the effect of iodine containing antiseptics on thyroid function for the first 3 weeks in non-very-low-birth weight preterm and term babies, and to evaluate their thyroid function and behavioral status 7 years later. Cohort I (between the years 1997-1998) was studied in 57 preterm (30-35 weeks) and 29 term newborns, 7 years later cohort II (in the year 2005) was created from same 28 preterm and 18 term infants at Behcet Uz Children's Hospital, Izmir, Turkey. Serum thyrotropin, triiodothyronine, total and free thyroxine were measured on the first, seventh, and twenty-first days (cohort I), and at the age of 7 (cohort II). In respect of used antiseptics, the patients were divided into 2 groups. The evaluation of patients was performed according to the Turgay Diagnostic and Statistical Manual for Psychiatric Disorders, 4th edition based child and adolescent behavior disorders screening and rating scale. On the seventh day of life, iodine-exposed newborns had significantly higher mean thyrotropin levels and lower free thyroxine, total thyroxine, and triiodothyronine levels. On the twenty-first day, thyrotropin levels of iodine-exposed newborns were similar to controls. The cohort II results showed normal thyroid function in all patents with increased hyperactivity among children born prematurely, and particularly experienced exposure to iodine. Iodine excess may cause transient hypothyroxinemia in preterm babies (>30 weeks gestational age, >1.5 kg) and this may be one of the reasons for behavior problems observed later in these children.Saudi medical journal 07/2009; 30(6):783-7. · 0.52 Impact Factor -
Article: Interleukin-12/-23 receptor beta 1 deficiency in an infant with draining BCG lymphadenitis.
Pediatrics International 05/2009; 51(2):310-2. · 0.63 Impact Factor -
Article: Insulin detemir improves glycemic control and reduces hypoglycemia in children with type 1 diabetes: findings from the Turkish cohort of the PREDICTIVE observational study.
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ABSTRACT: Insulin detemir is a basal insulin analog designed to produce a superior pharmacokinetic profile to basal formulations of human insulin. It has shown consistently improved tolerability in comparison to neutral protamine Hagedorn (NPH) insulin in adult cohorts, but there are relatively few publications involving pediatric cohorts. The efficacy and safety of insulin detemir in children with type 1 diabetes was assessed using data from the Turkish cohort of PREDICTIVE (a large, multinational, observational) study. The children investigated were using basal-bolus therapy involving NPH insulin or insulin glargine at baseline but were switched to insulin detemir as part of routine clinical care by their physicians. Twelve weeks of treatment with insulin detemir significantly reduced mean hemoglobin A1c (9.7-8.9%, p < 0.001) and mean fasting glucose [185-162 mg/dL (10.3-9 mmol/L), p < 0.01]. Fasting glucose variability was also lower after treatment with insulin detemir than previously (on either NPH or glargine, p < 0.05). The frequencies of total, major and nocturnal hypoglycemic events were significantly reduced with insulin detemir relative to baseline, with an estimated mean of 6.89 fewer events/patient/yr overall (p < 0.001) and 2.6 fewer nocturnal events/patient/yr (p < 0.01). Weight and insulin dose remained relatively unchanged. Twelve weeks of treatment with insulin detemir improved glycemic control and reduced hypoglycemia in children with type 1 diabetes. This improved tolerability might allow further dose titration and therefore additional improvements in glucose control.Pediatric Diabetes 02/2009; 10(6):401-7. · 2.16 Impact Factor -
Article: Arachnoid cyst with growth hormone deficiency.
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ABSTRACT: On clinical grounds, arachnoid cysts are usually associated with neurological dysfunction. Little is known concerning their involvement in endocrine disorders. A seven-year-old boy was admitted to the hospital for evaluation of an unprovoked afebrile seizure. His neurological examination was normal, however, he had growth retardation. Insulin tolerance and L-dopa growth hormone stimulation tests revealed an inefficient growth hormone response. An MRI of hypophysis and cranium yielded a shift of hypophysis and a large arachnoid cyst.The Indian Journal of Pediatrics 03/2007; 74(3):294-6. · 0.52 Impact Factor
