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Biomedical subjects

U Oneş

Publications and source records attributed to U Oneş.

13 recordsLinked to original sources
PubMed2000

Sonographic assessment of ceftriaxone-associated biliary pseudolithiasis in children.

PURPOSE: Ceftriaxone is a widely used third-generation cephalosporin. In this prospective study, we used sonography to investigate the incidence and outcome of biliary complications in children receiving ceftriaxone therapy. METHODS: Ceftriaxone was administered intravenously at a dosage of 100 mg/kg/day for 1-3 weeks to 118 children hospitalized for severe infection. Serial gallbladder sonograms were obtained on days 1, 5-7, and 10-14 of therapy and the day after therapy ended if it had lasted more than 2 weeks. When sonographic abnormalities were found, additional sonograms were obtained every 3 days until the abnormalities had completely resolved. RESULTS: Twenty patients (17%), all asymptomatic, demonstrated sonographic abnormalities: 8 had gallbladder sludge, defined as echogenic material without associated acoustic shadowing, and 12 had pseudolithiasis, defined as echogenic material with acoustic shadowing. These abnormalities spontaneously resolved within 2 weeks of stopping the ceftriaxone (mean time to disappearance, 8.2 +/- 3.4 days). No significant differences were found between patients with normal versus abnormal sonographic findings in sex, age, duration of treatment, or other risk factors for drug precipitation. CONCLUSIONS: Ceftriaxone-associated biliary pseudolithiasis is usually asymptomatic and was rapidly reversible after cessation of therapy in this group of Turkish children.

Adolescent↗
PubMed1999

Calvarial tuberculosis.

We report a six-year-old boy who presented with swelling of the forehead, and had calvarial tuberculosis, a rare form of tuberculous osteitis.

Antitubercular Agents↗
PubMed1999

The significance of sputum ECP levels in differential diagnosis of asthma in children.

Asthma and chronic bronchitis are diseases that may present similar symptoms. Because eosinophil granulocytes play an important role in the pathogenesis of asthma, the assessment of eosinophilic inflammation may be useful in making a differential diagnosis of these two diseases. This study investigated the serum and sputum eosinophil cationic protein (ECP) levels in children with asthma and chronic bronchitis and compared them with controls. Fifty asthmatic patients being treated for mild or moderately severe asthma at a university hospital were enrolled in the study. Fifteen children with symptoms of cough and sputum production lasting more than 3 months were studied in the chronic bronchitis group and 25 healthy children were included in the control group. Asthmatic patients were divided into subgroups according to the presence or absence of asthmatic exacerbations. Clinical evaluation and determination of ECP concentrations in serum and sputum were performed for each group. Increased activity of eosinophils was found in patients with asthma as assessed by high serum ECP (mean 21.44 +/- 20.33 microg/L) and sputum ECP (mean 129.65 +/- 125.01 microg/L) levels. In patients diagnosed with chronic bronchitis, serum ECP levels were similar to those of the control group (mean serum ECP 11.04 +/- 10.23 microg/L and 12.07 +/- 6.12 microg/L, respectively). More importantly, sputum ECP levels of the chronic bronchitis group were much lower (mean 53.36 +/- 55.43 microg/L) than those in patients with asthma (mean 129.65 +/- 125.01 microg/L). The serum and sputum ECP levels of the asthmatic patients who were evaluated during an acute exacerbation were also higher than those in the chronic bronchitis group. Sputum ECP levels may be helpful in the differential diagnosis of asthma and chronic bronchitis in children.

Adolescent↗
PubMed1998

Community-acquired severe staphylococcal septicemia in children: the relationship with blunt trauma.

BACKGROUND: With the aim of establishing the role of blunt trauma, a trauma without any fracture or obvious wound, as a risk factor in children who were admitted for community-acquired severe staphylococcal septicemia with various organ involvement, 63 patients were investigated during a seven-year study period. All children were previously healthy. RESULTS: Blunt trauma was present in 12 (46%) of 26 septicemic patients in whom skeletal infections were diagnosed and the relative risk of trauma was high (odds ratio 15.0; confidence interval 2.9-75.8, P < 0.001) in these children. Patients with multiple organ involvement and with multifocal skeletal infections were more frequent among traumatized patients. Children with skeletal involvement were significantly older than others (P < 0.001). The period between the first symptom of infection and the diagnosis was shorter in traumatized children (P < 0.001). None of the children with staphylococcal pulmonary or soft tissue infection had any history of trauma. We conclude that blunt trauma is one of the important risk factors for skeletal involvement in staphylococcal septicemia. Its immunosuppressive nature, especially in local damage of the skin barrier, may be the cause of seeding and multifocal infection.

Bacteremia↗
PubMed1997

Prevalence of childhood asthma in Istanbul, Turkey.

In order to determine the asthma prevalence in 6-12-year-old schoolchildren in Istanbul, we issued 2350 questionnaires, according to ISAAC criteria, in six randomly selected city primary schools to be completed at home by parents. A total of 2232 of the questionnaires were completed, an overall response rate of 94.9%, and 2216 questionnaires were taken into consideration. The prevalence of asthma was found to be 9.8% and wheezing 15.1%. To investigate the effect of socioeconomic status on the prevalence of asthma, we evaluated the heating system at home, the place of residence, the educational levels of the mother and father, the number of people living in the house, the sharing of bedrooms, and the annual family income. In conclusion, the prevalence of childhood asthma was not affected by any of these factors. Atopic family history, food allergy, eczema, and frequent otitis media and sinusitis attacks were evaluated and found to be significant in asthma prevalence.

Asthma↗
PubMedDate not supplied

Alatop: a new in vitro screening test for atopy.

The value of a new in vitro multiallergen IgE antibody test in the diagnosis of atopy in children was compared with that of skin-prick tests and total serum IgE level determination. Twenty children with clinical histories and symptoms of asthma, median age 5 years, and 20 healthy children, median age 5.5 years, were enrolled. Total serum IgE levels were evaluated as either normal or high by referring to kit values. Specific IgE antibodies to 12 different inhalant allergens were screened by the Alatop test. The accuracy figures for the tests compared with clinical diagnosis were 65.0%, 72.5% and 80.0%, for the total serum IgE determination, the Alatop test and the skin-prick test, respectively, and the other measures of clinical reliability showed a similar pattern. Although the skin-prick tests were the most sensitive and specific of the three, for screening atopic disease in children, the Alatop test provides a valuable alternative, and the combined use of skin-prick tests with the Alatop test will provide a more reliable screen than using any single test.

Allergens↗
PubMedDate not supplied

Egg and milk allergy in asthmatic children: assessment by immulite allergy food panel, skin prick tests and double-blind placebo-controlled food challenges.

There is a perception that asthmatic symptoms may be worsoned by ingestion of certain foods. This study aimed to investigate whether ingestion of cow's milk or egg might induce respiratory symptoms in asthmatic children. Fifty asthmatic children aged 1.5 to 6 years old, with positive Immulite Food Panel FP5 test results were included in the study. Fifty healthy children within the same age group were accepted as control group. Total serum IgE levels were measured and skin prick tests for food allergens including milk and egg were performed. All of the subjects underwent oral, double-blind, placebo-controlled challenge with fresh egg and cow's milk powder. Two medical histories were confirmed by double-blind, placebo-controlled challenge in 9 patients (22.2%). Skin prick tests were positive in 9 patients (18%) with milk and 18 patients (36%) with egg antigen. Two children experienced wheezing, one after ingesting milk and the other after egg challenge (4%). In the control group no positive reactions were seen with egg or milk challenges. Our findings confirm that food allergy can elicit asthma in children, but its incidence is low, even with major allergens such as egg and milk. History, specific IgE determinations and skin prick tests are not reliable in diagnosing food reactions. Since any diet can cause rapid deficiencies in infancy, diet restrictions must not be applied, without performing double-blind, placebo-controlled challenge.

Animals↗
PubMedDate not supplied

A review of 43 cases of tetanus neonatorum.

Forty-three patients with neonatal tetanus admitted to the Infectious Diseases Ward of the Istanbul University Faculty of Medicine Children's Hospital at Capa from 1982-1989 are presented. Thirty-two (74.4%) of the subjects were boys. The overall mortality was found to be 60 percent and the mean incubation period 6.1 +/- 20 days. The mean period between onset of symptoms and hospital admission was 1.7 days. Thirty-nine (90.7%) of the 43 patients were unhygienic home deliveries and only two cases were delivered with a midwife in attendance. None of the mothers of the children in our series had been immunized with tetanus toxoid. The incidence of neonatal tetanus in Turkey is on the decline, but a fraction of the population, the so-called urban poor, is still at high risk for preventable diseases. Every contact an unvaccinated person has with a health care professional should be viewed as an opportunity for tetanus immunization.

Female↗
PubMedDate not supplied

A case of late presenting chronic granulomatous disease.

An eleven-year-old boy with a history of severe lung infection which had been resistant to antibiotic therapy for a period of six months demonstrated a functional leukocyte defect similar to that found in children with chronic granulomatous disease (CGD). X-ray findings suggested a hilar mass, and granulomatous lesions developed on the thorax wall. The documentation of this case suggests that there may be a late presenting form of CGD.

Child↗
PubMedDate not supplied

Invasive pulmonary aspergillosis in chronic granulomatous disease: response to systemic prednisolone treatment and locally applied amphotericin B.

A five-year-old boy with deforming and destructive invasion of pulmonary aspergillosis to the thoracic cage was diagnosed as having chronic granulomatous disease. Conventional antifungal therapy failed in this patient. Prednisolone therapy was added and rapidly improved the general condition of patient but deterioration had already been very rapid. The failure of systemic therapy prompted us to give amphotericin B locally to the granulomatous lesions through the bronchocutaneous fistula. This application yielded a good clinical response with closure of fistula. Despite this improvement the patient died from septicemia. We believe that systemic prednisolone treatment is useless in such cases, but local application of amphotericin B into the granulomatous lesions together with systemic therapy during the earlier stages of infection can contribute to a change in prognosis.

Amphotericin B↗
PubMedDate not supplied

Peripheral and nasal eosinophilia and serum total immunoglobulin E levels in children with ascariasis.

In order to evaluate peripheral and nasal eosinophilia and serum total IgE levels in ascariasis, 30 children between two and 12 years of age whose fecal samples were found to contain Ascaris lumbricoides, and 30 children between 1.5 and 12 years of age who did not have ascaris in their fecal samples, were enrolled in the study. Peripheral eosinophil counts and serum total IgE levels were significantly higher in the study group, but there was no significant difference between the nasal eosinophil counts of the two groups. Since total serum IgE levels differ according to age, the patients and the control groups were also evaluated within three age-groups. Peripheral eosinophil counts and serum total IgE levels of patients with ascariasis in all age ranges were significantly higher, but nasal eosinophil values did not differ significantly. These results show that in ascariasia the presence of peripheral eosinophilia and high total serum IgE levels are similar to those in atopic diseases, and some allergic symptoms such as nasal itching can be caused by parasites. However, nasal itching does not correlate with nasal eosinophilia in ascariasis. This is an important feature in the differential diagnosis.

Animals↗
PubMedDate not supplied

Home environment and asthma in school children from the Edirne region in Turkey.

Studies have shown that environmental factors contribute to the development of asthma. Hence, we investigated the relation between current asthma and indoor environmental factors such as exposure to pets, tobacco smoke, home dampness, number of people living in home, and stuffed toys in child's bedroom in a questionnaire based study in primary school children aged 6 to 12 years living in Edirne (Turkey). In a random sample of 4 primary schools, questionnaires were completed by parents of 1000 children. Following the evaluation of 682 of these, 85 were selected as cases of asthma of which 24 were diagnosed by a physician. When required certain laboratory tests were also performed in order to confirm the diagnosis. Logistic regression was used to investigate the associations between asthma and potential risk factors. In logistic regression analyses, the following factors were associated with asthma. Dampness in the house [(odd's ratio (O.R) = 2.61; 95% CI 1.13 to 6.81), stuffed toys in the child's bedroom (O.R = 2.18; 95% CI 1.27 to 3.74), and the crowding index (O.R = 2.73; 95% CI 1.08 to 6.82)]. In conclusion, it was found that presence of asthma was significantly associated with the presence of dampness in the house, and stuffed toys in the child's bedroom. Asthma can be prevented by improvement of the indoor environment. Therefore providing education to high-risk populations for avoidance of these risk factors is particularly important.

Animals↗