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    Comparison of two different regimens of combined interferon-?2a and lamivudine therapy in children with chronic hepatitis B infection
    (2006) Kansu A.; Doganci T.; Akman S.A.; Artan R.; Kuyucu N.; Kalayci A.G.; Dikici B.; Dalgiç B.; Selimoglu A.; Kasirga E.; Özkan T.B.; Kuloglu Z.; Aydogdu S.; Boşnak M.; Ertekin V.; Tanir G.; Haspolat K.; Girgin N.; Yagci R.V.
    Aim: To evaluate the efficacy of two regimens of combined interferon-?2a (IFN-?2a) and lamivudine (3TC) therapy in childhood chronic hepatitis B. Methods: A total of 177 patients received IFN-?2a, 9 million units (MU)/m2 for 6 months. In group I (112 patients, 8.7±3.5 years), 3TC (4 mg/kg/day, max 100 mg) was started simultaneously with IFN-?2a, in group II (65 patients, 9.6±3.8 years) 3TC was started 2 months prior to IFN-?2a. 3TC was continued for 6 months after antiHBe seroconversion or stopped at 24 months in non-responders. Results: Baseline alanine aminotransferase (ALT) was 134.2±34.1 and 147.0±45.3; histological activity index (HAI) was 7.4±2.7 and 7.1±2.3; and HBV DNA levels were above 2,000 pg/ml in 76% and 66% of patients in groups I and II, respectively (P>0.005). Complete response was 55.3% and 27.6% in groups I and II, respectively (P<0.01). AntiHBe seroconversion was higher and earlier, and HBV DNA clearance was earlier in group I (P<0.05). HBsAg clearance was 12.5% and 4.6% and antiHBs seroconversion was 9.8% and 6.2% in groups I and II, respectively (P>0.05). Breakthrough occurred in 17.9% and 24.6%; breakthrough times were 15.9±4.6 and 14.1±5.1 months; and relapse rates were 6.8% and none in groups I and II, respectively (P>0.05, P>0.05, P>0.05). Responders had higher HAI (HAI>6) and higher pre-treatment ALT than non-responders. Conclusion: Simultaneous 3TC+IFN-?2a yields a higher response and earlier antiHBe seroconversion and viral clearance than consecutive combined therapy. Relapse rate is low. Predictors of response are high basal ALT and high HAI scores. 3TC can be administered for 24 months without any side effect and breakthrough rate is comparable with previous studies. © 2006 International Medical Press.
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    Inflammatory bowel disease in Turkish children
    (Institute of Pediatrics of Zhejiang University, 2015) Cakir M.; Unal F.; Dinler G.; Baran M.; Yuksekkaya H.A.; Tumgor G.; Kasirga E.; Kalayci A.G.; Aydogdu S.
    Background: This study was undertaken to evaluate demographics, clinical manifestations, laboratory findings and outcomes of children with inflammatory bowel disease (IBD) in Turkey. Methods: We analyzed the medical records of 127 children diagnosed with IBD (under 18 years old) between January 2004 and January 2012 in 8 pediatric gastroenterology centers. Results: Of the 127 patients, 90 (70.9%) suffered from ulcerative colitis (UC), 29 (22.8%) from Crohn’s disease (CD), and 8 (6.3%) from IBD unclassified. The mean age of the 127 patients was 11.6±4.1 years, and 11.8% of the patients were below 5 years old. Of the patients, 49.6% were male, and males were more predominant in patients with CD than in those with UC (72.4% vs. 42.2%, P=0.008; a male/female ratio of 2.62 in CD, P=0.0016). Approximately one fifth of the patients had extra-intestinal manifestations and 13.3% of the patients had associated diseases. Extraintestinal manifestations and associated diseases were more common in early onset disease [P=0.017, odds ratio (OR)=4.02; P=0.03, OR=4.1]. Of the patients, 15% had normal laboratory parameters including anemia, high platelet count, hypoalbuminemia, hypoferritinemia, and high sedimentation rate. Area under receiver operation characteristics was used to predict pancolitis in patients with UC. The values of C-reactive protein, sedimentation rate and pediatric ulcerative colitis activity were 0.61 (P=0.06), 0.66 (P=0.01) and 0.76 (P=0.0001), respectively. Four (4.4%) patients with UC underwent colectomy, and finally two (1.5%, 95% confidence interval: 0-3.7%) patients died from primary disease or complications. Conclusions: IBD is an increasing clinical entity in Turkey. Features of IBD are similar to those in other populations, but prospective multicenter studies are needed to analyze the true incidence of IBD in Turkish children. © 2015, Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg.