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Öğe Androgen-related hepatocellular tumor of the liver associated with Fanconi's anemia(2003) Aktaş S.; Apa H.; Diniz G.; Erbay A.; Ortaç R.; Vergin C.; Karaca I.; Elmas N.; Yüzer Y.Hepatocellular tumors are quite rare in pediatric age group. Its association with Fanconi's anemia and androgen therapy is well known but the pathogenesis is controversial. Occurrence of significant dysplasia causes great problems to differentiate it as hepatocellular adenoma or hepatocellular carcinoma. In this paper a 13 years old male case of hepatocellular tumor associated with Fanconi's anemia and androgen therapy is presented. He was given androgen and steroid therapy for 5 years and he had had hepatitis C virus infection for 3 years before the multifocal hepatic tumors were observed. Androgen therapy was witheld and surgery was performed twice. Patients taking androgenic-anabolic steroids should be carefully monitored with US and CT and tumor markers should be measured. The worrisome pathology that may occur in hepatic tumor in children particularly with androgen therapy does not necessarily predict malignant behaviour.Öğe A case of hypomagnesemia with secondary hypocalcemia caused by Trpm6 gene mutation(2008) Apa H.; Kayserili E.; Agin H.; Hizarcioglu M.; Gulez P.; Berdeli A.An offspring of marriage between two first cousins presented with atonic seizures developed on the 20th day of life. The physical examination of the case was normal. In laboratory results, Ca+2 level was 5,7 mg/dl, Mg+2: 0,4 mg/dl (1,3-2,1), PTH: 28,4 pg/ml (12-92), and P-: 4,5 mg/dl. The case was diagnosed as hypomagnesemia with secondary hypocalcemia (HSH) and TRPM6 gene mutation analysis revealed a homozygote mutation of E157X. © 2008 Dr. K C Chaudhuri Foundation.Öğe Children with breakthrough varicella infection requiring hospitalization in Turkey (VARICOMP Study 2008-2013)(Elsevier Ltd, 2015) Dinleyici E.C.; Kurugol Z.; Kara A.; Tezer H.; Tas M.A.; Guler E.; Yasa O.; Devrim I.; Ciftci E.; Ozdemir H.; Somer A.; Ozen M.; Sensoy G.; Dalgic N.; Alhan E.; Kuzdan C.; Bayram S.N.; Uygur-Kulcu N.; Sag C.; Nuhoglu C.; Metin O.; Kondolot M.; Tapisiz A.; Celebi S.; Hacimustafaoglu M.; Akarsu S.; Aygun D.; Akin F.; Elevli M.; Velipasalioglu S.; Oncel S.; Emiroglu M.; Karbuz A.; Turel O.; Kuyucu N.; Ceyhan M.; Yilmaz-Ciftdogan D.; Hatipoglu N.; Kilic O.; Siraneci R.; Kara A.; Apa H.; Gulhan B.; Parlakay A.; Kocabas E.; Say A.; Belet N.; Baktir A.; Karli A.; Tanir G.; Ince E.; Bal B.; Akaslan A.; Goksugur Y.; Arisoy E.S.; Hatipoglu S.; VARICOMP Study GroupIntroduction: Varicella in previously immunized individuals, known as "breakthrough varicella". While the majority of breakthrough cases are mild, some may be severe, requiring hospitalization in previously healthy children or children with an underlying condition. Methods: This report, as a part of the prospective national pediatric varicella hospitalizations study (including 29 centers, represent 50% of pediatric population) in Turkey, is aimed to evaluate breakthrough varicella infection requiring hospitalization before the routine use of single-dose live varicella vaccine in national program from 2008 to 2013 (<10% of the pediatric age group received a single-dose vaccine). Results: In the time period, 1939 children were hospitalized due to varicella infection in Turkey; 36 children (20 boys, 16 girls, mean age 68.0 + 37.6 months, all received single dose live varicella vaccine) with breakthrough varicella infection. Breakthrough varicella infection might be severe in previously healthy children (61.1%) and children with immune-compromising conditions (38.9%). The time elapsed between vaccination and hospitalization was approximately 5 years, and neurological complications, mainly encephalitis and meningitis, were the most common reason for hospitalization in previously healthy children. Conclusion: Pediatric breakthrough varicella requiring hospitalization have been seen in Turkey, is mainly observed in previously healthy children at 5 years after a single-dose varicella vaccine. The varicella vaccine has been implemented as part of the National Immunization Program in Turkey in 2013 (a single dose at age 12 months). Further surveillance in the same settings could evaluate the effectiveness of national immunization with single-dose varicella vaccine at 12 months of age and potential need for second dose of vaccine. © 2015 Elsevier Ltd.Öğe Differences between pediatric extra-pulmonary and pulmonary tuberculosis: A warning sign for the future(Universita Cattolica del Sacro Cuore, 2014) Devrim I.; Aktürk H.; Bayram N.; Apa H.; Tulumoğlu S.; Devrim F.; Erdem T.; Gulfidan G.; Ayhan Y.; Tamsel I.; Can D.; Alper H.Background: Tuberculosis (TB) remains a major global health problem. The childhood tuberculosis has some unique features different which makes the diagnosis more complicated. Here we described the epidemiologic, clinical and microbiologic features of children with extra pulmonary and pulmonary TB. Methods: The data of the patients < 14 years with active TB were collected and compared in pulmonary (PTB) and extrapulmonary TB (EXPTB) patients. Results: A total of 128 cases was included. Forty-two cases occurred in children were < 5 years of age, 41 cases between 6-10 years and 45 cases > 10 years. PTB was present in 75,0% of the cases, and EXPTB was present in 25% of cases. There was no significant difference between the EXPTB and PTB by means of distribution of age groups (p=0,201). The rate of patients free of constitutional symptoms were significantly higher in EXPTB compared to PTB(p=0,000). There was no significant difference between EXPTB and PTB by means of sources detection(p=0,069). Conclusion: TB is still a major public health problem. EXPTB has an insidious and silent onset without any constitutional symptoms, and both microbiological confirmation and the source by an adult are not frequently found. Moreover, detection of the adult source is mandatory for controlling the TB disease in children.Öğe Primary subcutaneous actinomycosis: A case report [Birincil derialtı aktinomikozu: Olgu sunumu](AVES Ibrahim Kara, 2017) Kara A.; Çayiröz U.; Bayram N.; Apa H.; Yaman B.; Akalin T.; Devrim I.Actinomycosis is a chronic, suppurative, granulomatous and spreading disease which is caused by anaerobic bacteria of the family Actinomycetaceae. It is an endogenous infection and is induced by some predisposing factors that introduce Actinomyces species, which are the normal in habitants of the host, into the mucosa. There are a variety of forms including cervico-fasial, abdominal, toracic, pelvic, cerebral, and cutaneous actinomycosis. Cutaneous actinomycosis is extremely rare. Further more, actinomycosis is frequently undiagnosed or misdiagnosed and thus is not treated correctly. In most cases, definitive diagnosis is made after surgical resection. We present 9-year-old boy who was referred to our center with the complaint of back mass and the histopathological examination of excisional biopsy which was performed for excluding malignancy revealed actinomycosis . © 2017 by Pediatric Infectious Diseases Society.
