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  • Küçük Resim Yok
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    Detection of Human Metapneumovirus Prevalence in Pediatric Patients with Lower Respiratory Tract Infections
    (Ankara Microbiology Soc, 2012) Gokmen, Aysegul Aksoy; Cicek, Candan; Saz, Eylem Ulas; Ozananar, Yeliz; Duyu, Muhterem
    Human metapneumovirus (hMPV) which is classified in Paramyxoviridae family has been identified in 2001 as the etiological agent of lower respiratory tract infection (LRTI) especially in children. Previous studies indicated that hMPV prevalence in LRTI is between 2-25%, being resposible for 10% of childhood LRTIs and its isolation rate is approximately 6% in hospitalized patients under age three years. The aim of this study was to investigate the hMPV prevalence in children with LRTI in our region. A total of 100 patients (41 female, 59 male) ages between 0-10 years old (median age: 4.8) and who were admitted to Pediatric Clinics of Ege University Medical Faculty Hospital with the diagnosis of LRTI between January-December 2009 were included in the study. Nasopharyngeal swab samples were taken from those patients during the first three days of their symptoms. The presence of hMPV in the samples were investigated by rapid (shell vial) cell culture method using HEp-2 cell line and by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). The methods were performed to the clinical samples simultaneously. In both methods, a standard strain of hMPV provided by Erasmus University was used as positive control and QCMD-2009 hMPV panel was used as external quality control. In our study, 11 and 2 samples were found positive with cell culture and rRT-PCR methods, respectively. Two of rRT-PCR positive samples were also positive in cell culture, while the other nine were positive by only cell culture method. Both of the methods were performed twice due to inconsistent results, however, the same results were obtained in both runs. Studies with QCMD-2009 panel yielded compatible results for five samples, however a positive standard sample (hMPV A subtype, Ct value: 37.31) was found as negative by rRT-PCR test used in this study (RealAccurateTM, Pathofinder, The Netherlands). Our data showed that the prevalence of hMPV detected by rapid cell culture method was 11% in pediatric patients with LRTIs, the age range of hMPV positive cases was 6 months to 7 years old (median age: 20 months), the majority of the admissions was in winter season and the main clinical picture was bronchiolitis. In addition, rRT-PCR assay used in this study was thought to be insufficient to detect the viral RNA in the event of low levels of hMPV A subtypes. Thereby the cell culture method should be used in addition to the new developing molecular methods for the detection of hMPV until standardization is achieved.
  • Küçük Resim Yok
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    The utility of handheld metal detector in confirming metallic foreign body ingestion in the pediatric emergency department
    (Turkish Soc Gastroenterology, 2010) Saz, Eylem Ulas; Arikan, Cigdem; Ozgenc, Funda; Duyu, Muhterem; Ozananar, Yeliz
    Background/aims: We aimed to identify the presence of ingested metallic foreign bodies with handheld metal detector in the pediatric population. Methods: All children (n=40) known or suspected to have ingested a MFB and who presented to the Emergency Department of the Children's Hospital of Ege University were prospectively ascertained. All patients underwent both radiographic evaluation and handheld metal detector scanning of the chest and abdomen on their presentation. In the present prospective study, we compared handheld metal detector scanning with plain radiography. Results: The end point of the study compared metallic foreign body findings with handheld metal detector vs radiological findings during an eight-month period. Forty subjects with possible metallic foreign body ingestion were enrolled into the study. The principle investigator scanned all subjects. Disease was defined by the presence of a foreign body in the gastrointestinal tract on radiograph. Radiographically, 35 foreign bodies were found, and handheld metal detector revealed 31 of them. The sensitivity of handheld metal detector was 88.6% (95% confidence interval [CV: 72.1%-96.5%), specificity 100% (95% CI: 61.8%-100%), positive predictive value (PPV) 100% (95% CI: 85.8%-100%), and negative predictive value 55.5% (95% CI: 34.3%-84.6%). Handheld metal detector revealed that 2 metallic foreign bodies (1 pushpin, I coin) were localized to the chest, which was confirmed by radiography, and urgent removal was performed with endoscopy. Conclusions: Handheld metal detector scanning is an accurate, inexpensive, radiation-free screening tool and should be used for evaluation of patients suspected of ingesting metallic foreign bodies.
  • Küçük Resim Yok
    Öğe
    The utility of handheld metal detector in confirming metallic foreign body ingestion in the pediatric emergency department
    (2010) Saz, Eylem Ulaş; Arıkan, Çiğdem; Özgenç, Funda; Duyu, Muhterem; Ozananar, Yeliz
    Metalik yabancı cisim yutan çocuklarda metal dedektör kullanımının cismi saptamadaki duyarlılığını saptamak. Yöntem: Çalışma periyodu içinde metalik yabancı cisim yutan ya da yutma şüphesi olan 40 çocuk, Ege Üniversitesi Tıp Fakültesi Hastanesi Çocuk Acil servisine başvurdu. Tüm hasta verileri prospektif olarak daha önceden hazırlanmış formlara işlendi. Hastalar hem grafi hem de dedektörle yabancı cisim açısından tarandı. Dedektörle göğüs kafesi, abdomen ve inguinal bölge tarandı. Sonuçlar radyolojik bulgularla karşılaştırıldı. Bulgular: Sekiz aylık çalışma periyodu içinde metalik yabancı cisim yutan ya da şüphesi olan toplam 40 çocuk çalışmaya alındı. Hastalık gastorintestinal sistemde radyolojik olarak yabancı cisim varlığı olarak tanımlandı. Toplamda 35 çocukta yabancı cisim radyolojik olarak saptanırken dedektör bunlardan 31 tanesini tanıyabildi. Dedektör sensitivitesi %88.6 (95% güvenlik aralığı [CI], 72.1%-96.5%), spesifisitesi %100 (95% CI, 61.8%100%), pozitif prediktif değer 100% (95% CI, 85.8%-100%), ve negatif prediktif değer % 55.5 (95% CI, 34.3%-84.6%). Dedektör ile göğüs kafesi taramasından 1 i toplu iğne diğeri de para olmak üzere 2 yabancı cisim saptandı. Bunlar radyolojik olarak özefagusta tespit edildi ve endoskopik olarak acilen çıkartıldı. Sonuç: Metalik yabancı cisim yutan çocuklarda dedektör kullanımı güvenilir, ucuz ve radyasyon yaymayan bir yöntemdir. Tarama testi olarak kullanıma uygun olduğu tespit edilmiştir.