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Öğe A de novo t (X;8)(p11.2; q24.3) demonstrating Cornelia de Lange Syndrome phenotype(2005) Egemen A.; Ulger Z.; Özkınay F.; Gulen F.; Cogulu O.A de novo T (X;8)(p11.2; q24.3) demonstrating Cornelia De Lange Syndrome phenotype: Cornelia de Lange syndrome is a rare syndrome of hitherto unknown etiology. We present a 9-months old female patient with de novo t (X;8)(p11.2; q24.3) and Cornelia de Lange Syndrome phenotype. De novo t (X;8)(p11.2; q24.3) was not reported so far in Cornelia de Lange syndrome.Öğe Foot drop developed after gluteal intramuscular drug injection: A case report [Gluteal intramusküler ilaç enjeksiyonu sonrasi gelişen düşük ayak: Bir vaka takdimi](2007) Bulut Y.; Ülger Z.; Bulut S.; Egemen A.The rules of parenteral drug administration are universal world wide. Administration conditions, standardization of technical facilities and quality of care create differences in details of administration. In addition, parenteral drug administration provides indispensable health benefits; it may rarely cause undesirable side effects. Although parenteral route of treatment is not first choice, it is a commonly used treatment modality in childhood. In this case report, we present a 10-year-old boy patient with the diagnosis of attention deficit-hyperactivity disorder, in whom foot drop developed after gluteal intramuscular analgesic injection, although injection was applied at correct localization, with appropriate technique, and with suitable injector and drug, in order to discuss the complications of intramuscular drug injection and reasons for these complications. In the past medical history of this 10-year-old boy admitted with the symptoms of loss of sensation, burning and pain in the foot and inability to move the foot, it was learned that he admitted to a hospital due to renal colic and received the treatment of intramuscular diclofenac sodium injection and that three days after this treatment, foot drop developed. After evaluation of the history, physical examination and laboratory findings of the patient, we thought that this important neurological sequel a might have developed due to inadequate stabilization of the patient during the injection and toxic effect of the drug on the nerve.Öğe A generally neglected threat in infant nutrition: Incorrect preparation of infant formulae(2002) Egemen A.; Kusin N.; Akşit S.; Emek M.; Kurugöl Z.Breast milk is the most appropriate food for infants. At least 4-6 months of breast feeding is sufficient for all babies if appropriate growth is monitored monthly. However, for those infants unable to breast-feed sufficiently or at all, formula can be given as an alternative. However, serious health problems such as hypernatremic dehydration, malnutrition, and obesity may develop if powdered formula is not appropriately prepared. In the present study, our aim was to investigate whether or not mothers of formula-fed babies in Özkanlar (Izmir, Turkey) district prepared powdered infant formula appropriately. For this purpose, we visited all (328) families with infants younger than 12 months of age. Forty-two (13%) of these 328 infants were still fed formula. The mothers of the infants were asked to prepare formula for two different meals, and duplicate samples from each prepared formula were taken for the measurement of dry matter. Fifty percent of the mothers diluted formula with 10% more or 10% less water for the second meal as compared with the first meal. Four (10%) mothers diluted formula with 10% or less of the required water, while 27 (64%) prepared formula with 10% or more of the required water. It is concluded that mothers must be informed about the preparation of formula when formula is prescribed for their babies.Öğe Hepatitis A seroprevalence in a random sample of the Turkish population by simultaneous EPI cluster and comparison with surveys in Turkey(Turkish Journal of Pediatrics, 2002) Kanra G.; Tezcan S.; Badur S.; Turkish National Study Team; Alp H.; Bulut A.; Şükrü C.; Çan C.; Dağbaşı N.; Dündar C.; Egemen A.; Eskiocak M.; Evliyaoğlu N.; Güraksın A.; Mocan H.; Öztürk F.; Saka G.; Sıdal M.; Ulukol B.; Tanyer G.; Taş M.A.; Velicangil O.; Yazıaoğlu M.This study was conducted to determine the hepatitis A virus (HAV) seroprevalence in nine provinces representative of Turkey as a whole. These provinces are representative of the country's geographical location, and demographic, economic and social characteristics. In each province, sample sizes were determined using published data on HAV seroprevalence, and sample sizes for each province and for the cluster were calculated for each group of subjects under the age of 30 for seroprevalence estimates within a 95% confidence interval. The samples were selected by a cluster method, and the planned recruitment was a total of 4,800 subjects, including 600 subjects each from five large provinces (Istanbul, Ankara, Izmir, Adana, Diyarbakir) and 450 subjects from each of the remaining four provinces (Samsun, Erzurum, Trabzon, Edirne). These numbers were distributed in accordance with the percentages for age groups in five-year increments starting from age five for the population under the age of 30 living in the rural and urban areas in each province. This study of 4,462 subjects under the age of 30 in nine provinces of Turkey identified an overall HAV seroprevalence rate of 71.3%. The distribution of HAV seroprevalences by age showed a steady increase from one year of age from 42.7% to 91.1% at 25-29 years of age. HAV seroprevalence was slightly higher in female subjects (73%) than in male subjects (69.3%). By educational status, seroprevalences were comparable except in young children under age six. Seroprevalence was notably higher in large families with six and more members (80.1%) than in small families with five or fewer members (66.7%). According to our study results, 50% of Tarkish children are seropositive for HAV by the age of 10 years. We believe the date support the need for a routine primary immunization policy in Turkey and the development of effective prophylactic programs after possible exposure. Consequently, an immunization policy can be developed for each region according to its epidemiological conditions. © 2002, Turkish Journal of Pediatrics. All rights reserved.Öğe Hepatitis B and measles seroprevalence among Turkish children(2005) Kanra G.; Tezcan S.; Badur S.; Alp H.; Bulut A.; Cin S.; Mocan G.; Dagbaşi N.; Dündar C.; Egemen A.; Eskiocak M.; Evliyaog¨lu N.; Güraksin A.; Kara A.; Mocan H.; Özmert E.; Oztürk F.; Saka G.; Sidal M.; Ulukol B.; Tanyer G.; Tas M.A.; Velicangil Ö.; Yazicioglu M.This study was performed to determine hepatitis B and measles seroprevalence among the population under 30 years of age in Turkey. Blood samples of 2,683 subjects from eight provinces of Turkey were studied. Measles IgG was determined by hemagglutinin inhibition method, and hepatitits B surface antigen (HBsAg), anti-hepatitis B surface antibody (anti-HBs) and anti-hepatitis B core antibodies (anti-HBc) were determined by ELISA method. Overall seropositivity for measles was found to be 59.6%. There was a significant difference in seropositivity among provinces. The seropositivity was found to increase with age. The overall seropositivities for HBsAg, anti-HBs and anti-HBc were found to be 5.4%, 17% and 15.1 %, respectively. The seroprevalences differed significantly among provinces. Although seroprevalence for anti-HBs and anti-HBc increased with age, HBsAg seropositivity did not change significantly after one year of age. Seroprevalence was not affected by sex. It was concluded that every effort should be given to vaccinate infants as early as possible for hepatitis B and that the coverage of infancy measles vaccination should be increased with a second dose.Öğe Low-dose oral methotrexate therapy in resistant juvenile rheumatoid arthritis [Direncli juvenil romatoid artritte dusuk doz oral metotreksat tedavisi](1998) Aksit S.; Egemen A.; Caglayan S.; Parlar A.; Kansoy S.Twelve children with resistant juvenile rheumatoid arthritis were given 10 mg of oral methotrexate per square meter of body-surface area per week for eight to 24 months (mean±SD, 18±6 months). The patients were eight to 16 years old (mean 10.9±2.4 years) and the mean duration of the disease was 4.5±1.6 years (range, two to nine years). The patients had active polyarthritis at the onset of the methotrexate therapy. All the patients had used hydroxychloroquine, and four of them also sulfasalazine as second-line agents. Methotrexate therapy decreased swelling count by a mean of 47 percent, swelling index by 55 percent, articular count 52%, articular index by 54 percent and morning stiffness by 65 percent. In addition, methotrexate therapy increased hemoglobin value by more than 2 gm/dl in four (33%) patients and decreased the number of platelets by more than 200,000/mm3 in three (25%) patients. The erythrocyte sedimentation rate was 80±26 mm/hr and 32±18 mm/hr before and after methotrexate therapy, respectively. No adverse effects severe enough to withdraw methotrexate therapy were observed during the study. Compliance with methotrexate therapy was complete in all patients. From the data presented here, we conclude that low-dose oral methotrexate is an effective treatment for children with resistant juvenile rheumatoid arthritis. We recommend earlier consideration of methotrexate in place of other slow-acting antirheumatic drugs of cases of juvenile rheumatoid arthritis not responding well to usual therapy.Öğe Measles revaccination response in 4-7-year-old children(1995) Kurugol Z.; Ozsacar T.; Egemen A.; Arcasoy M.; Yenigun A.; Bilgic A.In Turkey, two measles outbreaks occurred in 1989 and 1993. The majority of cases has been previously vaccinated children. We evaluated the necessity of measles revaccination in 4-7-year-old children by establishing the increase in anti-measles IgG level following revaccination, and by determining the percentage of measles-susceptible subjects in previously vaccinated children. Seventy-five children were revaccinated and sera were collected just prior to revaccination and after two weeks. Anti-measles IgG titers were determined by enzyme immunoassay. Four-fold and greater increases in anti-measles IgG titers were obtained in 17.3% of children, and they were defined as immunologically susceptible to measles. Pre-revaccination measles specific IgG titers less than 3224 ng/ml were a significant risk factor for measles susceptibility. None of the revaccinated children had notable complications. These data support the necessity and safety of measles revaccination.Öğe Measles seroprevalence in Izmir with special emphasis on measles vaccination policy for Turkey(2001) Egemen A.; Aksit S.; Ozacar T.; Kurugol Z.; Keskinoglu P.; Pehlivan T.; Mutlu S.Background: Measles outbreaks seem to occur every 2- to 3-year intervals in Turkey. However, seroepidemiological studies are limited, Knowing the prevalence of measles susceptibility as measured either by serologic markers of immunity or surveys of vaccination coverage is an important tool to assess the risk for measles outbreaks. Methods: In order to determine the seroprevalence of measles antibodies among a 1 to 29-year-old population in Izmir (Turkey) and to develop the best vaccination policy for measles, a total of 600 people aged from 1 to 29 were selected for the study with cluster sampling. The information on sociodemographic characteristics, vaccination status and measles history was gathered for each participant. Measles-specific IgG antibodies were screened qualitatively by using microenzyme immune assay for 595 subjects. Results: Of the 595 participants screened for the measles antibodies, 56 (9.4%) were seronegative. The proportion of the susceptible individuals in the age groups of 1-4, 5-9, 10-14, 15-19 and 20-29 was 20.0, 10.4, 6.0, 10.3 and 3.0%, respectively. The logistic regression analysis showed that none of the independent characteristics (sex, socioeconomic status, past measles history, vaccination status) with the exception of age group, was significantly associated with measles seronegativity. Conclusion: The optimal measles vaccination policy for Turkey may be to increase vaccination coverage above 90%, to conduct a catch-up campaign covering persons aged 1-19, regardless of previous vaccination status. Another factor to consider is to adopt a routine two-dose vaccination, giving the first dose at 12- 15 months of age and the second dose at school entry.Öğe Mothers' attitudes towards their own presence during invasive procedures on their children(2005) Karapinar B.; Yilmaz D.; Egemen A.This study assessed of the preferences 742 mothers regarding their own presence during invasive procedures performed on their children. The relationships between socio-demographical characteristics and preferences of the mothers and disease characteristics of the children were examined. A mother's desire to be present was found to increase with decreasing invasiveness of the procedure as well as with increasing analgesia and sedation provided. The desire to be present was higher in young mothers with higher socio-economic levels and educational backgrounds, with younger children and with children who had undergone prior recurrent interventions. This study demonstrated that most of the mothers preferred to be present during the procedure, and that the ratio of mothers willing to do so increased significantly if the children were sedated. The results suggested that pediatricians can improve the quality of service and physician-patient-family relationship by taking mothers' preferences into consideration.Öğe Nutritional status of children with leukemia [1](1997) Kurugol Z.; Egemen A.; Cetingul N.; Oztop S.; Kavakli K.; Nisli G.[No abstract available]Öğe Parental presence during invasive procedures and resuscitation: Attitudes of health care professionals in Turkey(2006) Egemen A.; Ikizoglu T.; Karapinar B.; Coşar H.; Karapinar D.Objectives: An agreement among physician, nurse, and family on the issue and a solution developed by all will improve the quality of work. The aims of this study were to determine health care professionals' (physicians and nurses) attitude toward parental presence during invasive procedures and toward parental participation in this decision and to investigate the difference between the approach of physicians and nurses. Methods: This study was performed on the physicians and nurses of the Medical Faculty of the Department of Pediatrics of Ege University between December 2003 and March 2004. The questionnaire delivered was completed by 49 (94%) of 52 nurses and 51 (89%) of 57 physicians. Results: Parental presence during blood sampling, simple wound repair/suture, lumbar puncture, and bone marrow aspiration/biopsy was approved by 72.5%, 27.5%, 66.7%, and 82.4% of the physicians and 53.1%, 57.1%, 81.6%, and 85.7% of the nurses, respectively. None of the health care professionals preferred parents to attend during any kind of resuscitation. Attitudes of the nurses and physicians were found to be similar between the 2 groups except for simple wound repair. Major determinants of the decision about the agreement for parental presence were procedural invasiveness for physicians (reported by 82.5%) and level of sedation for nurses (reported by 75.5%). The mean ages of both groups of health care professionals who did not approve parental presence during invasive procedures were lower than that of the ones who approved for all procedures. Conclusions: The physicians and nurses in the study population tended to prefer parents not to be present during procedures as the level of invasiveness increased. An agreement between the attitudes of physicians and nurses toward parental presence during invasive procedures is essential for improving quality of service, especially in the dynamic environment of the emergency department. Copyright © 2006 by Lippincott Williams & Wilkins.Öğe Restless legs syndrome in childhood: A case report [Çocukluk çaginda huzursuz bacak sendromu: Bir vaka takdimi](2007) Bayram S.N.; Karaca N.E.; Egemen A.Restless legs syndrome is a neurological movement disorder characterized by a distressing desire to move legs or sometimes other extremities, associated with a marked sense of discomfort usually in the leg or other affected body part. It follows a circadian pattern and the symptoms worsen at rest, in the evening or at night and there is at least momentary relief by activity. Genetic and environmental factors cause the restless legs syndrome. Recent researches have achieved the definition of the pathophysiologic mechanisms of the disorder. It is suggested that iron deficiency is a primary factor in the development of the symptoms. Because the symptoms become much worse at night while sleeping, it causes sleep disturbance and so it may severely disrupt normal life functioning. Although it is more common in adult life, it may occur more frequently in children than previously recognized. This syndrome is a clinical diagnosis that relies entirely on the patient's symptoms, thus the interviews should involve a general medical history about the associated features. Especially in the children experiencing sleep disturbance or growing pain, restless legs syndrome must also be considered in the differential diagnosis.Öğe Serum tetanus antitoxin response to accelerated immunization with diphtheria, tetanus, pertussis vaccine(1995) Kurugol Z.; Kutukculer N.; Egemen A.; Yenigun A.The serum concentrations of IgG antibodies against tetanus toxoid in 40 infants one month and 12 months after completion of primary immunization according to the wide-spaced (2, 4, 6 month) and accelerated (2, 3, 4 month) schedules were compared in order to determine specific antibody response and persistence of antibodies. No significant difference was found between the groups both one and 12 months after primary immunization, and all the serum tetanus antitoxin concentrations were above the protective level. Immunization with DPT vaccine both with monthly intervals completed at 4 months of age and with two-month intervals completed at 6 months of age provided adequate protection against tetanus, and protective antitoxin levels persisted until the first booster a year after the third dose of DPT vaccine.Öğe Suicides in adolescents: Benefit/harm balance of antidepressants(2007) Saz U.E.; Arslan M.T.; Egemen A.Introduction: Depression is an important cause of suicide in adolescents. It has been speculated that antidepressants themselves can increase the risk of suicide. Method: Cases of adolescents admitted to the Ege University Pediatric Emergency Department in Turkey due to suicide attempt were assessed. Results: Nine of 13 suicide attempts during June 2005 were due to overdose of antidepressants prescribed for major depressive disorder. Conclusion: Well-designed studies are needed to elucidate the role of antidepressant drugs in suicide.
