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Öğe Adenoid hypertrophy detection inventory in children for primary care physicians and pediatricians(Springer, 2025) Kurt, Fatih; Belada, Abdullah; Oz, Busra; Cangur, Sengul; Kaya, AbdulkadirObjective Adenoid tissue consists of clusters of lymphoid tissue within the nasopharynx and can cause symptoms due to obstruction when hypertrophied. The gold standard for diagnosis is endoscopic nasopharyngoscopy, but it is not always readily available. This study aims to develop an inventory that primary care physicians and pediatricians can use to predict the degree of adenoid hypertrophy clinically, facilitating the planning of patient follow-up and treatment. Study designA diagnostic test study. Settingstertiary referral hospital. Methods The study involved 123 cases, with 82 in the patient group and 41 in the control group. Evaluation encompassed demographic characteristics, history, and physical examination findings. Additionally, a child psychiatrist assessed cases neurocognitively, behaviorally, and psychologically. Finally, cases underwent endoscopic nasopharyngoscopy by an ENT specialist, recording adenoid sizes and choanae narrowing. Multinomial Logistic Regression (MLR) analysis determined the most suitable model for the clinical inventory. Results Snoring, restless sleep, noisy breathing, recurrent throat infections, and recurrent rhinosinusitis constitute the items of the clinical inventory. The average score of relevant items categorized patients into absent and mild, moderate, and severe groups. The area under the ROC curve for average scores of the inventory was 0.67, significantly surpassing the probability of random assignment (0.17). The inventory's accuracy rate was 70%. Conclusion This user-friendly and highly accurate inventory aids in predicting obstruction degree in patients. Primary care physicians and pediatricians can effectively manage follow-up and treatment, referring cases requiring surgery to an ENT specialist based on the inventory results.Öğe Apoptosis-associated Speck-like Protein Containing a CARD (ASC), TNF Like Factor 1a(TL-1a) and B Cell Chemoattractant Chemokine Ligand 13(CXCL-13) Expression Profiles in Familial Mediterranean Fever (FMF) Patients(Duzce Univ, Fac Medicine, 2023) Kurt, Fatih; Eroz, Recep; Kocabay, KenanObjective: This study was carried out to compare the expression levels of ASC(Apoptosis Associated Speck Like Protein Containing a CARD), TL-1a(TNF Like Factor 1a) and CXCL 13(B Cell Chemoattractant Chemokine Ligand 13) genes in FMF patients According to Tell-Hashomer Criteria and Genetic analysis result in Duzce University Research and Application Hospital with healthy controls and to determine their clinical significance in FMF.Method: 36 patients (20 girls, 16 boys) and 12 healthy controls (7 girls, 5 boys) were included in the study. RNA was isolated from the peripheral blood of each individual and expression levels of ASC, TL-1a and CXCL 13 genes were determined. Routine biochemical parameters were also determined.Results: CXCL 13 and TL-1a gene expression levels were significantly increased in patients with FMF, the expression level of the ASC gene was found to be increased in FMF patients, but not significantly.Conclusion: The expression levels of these genes may be related to the pathogenesis of the disease and these genes could be used as a marker in the early diagnosis of the disease.Öğe Attention! One of the Causes of Second Degree Mobitz Type 1 AV Block: Pheniramine Maleate(Duzce Univ, Fac Medicine, 2024) Kurt, Fatih; Karademir, Selmin; Maleat, PheniraminAtrioventricular (AV) blockade is the loss of function of the pathways that provide electrical conduction between the sinoatrialA(SA) node and the atrioventricular (AV) node. It is rated according to the level of distortion in the transmission. treatment with drugs such as beta-blockers, calcium channel blockers, digoxin, and amiodarone can cause AV blockade. A patient was referred to the emergency department with swelling of her lips, itching, and rash. There were widespread urticarial rashes on her body. Pheniramine maleate was administered intramuscularly. Ten minutes later, the patient developed bradycardia and hypotension. A 2nd-degree Mobitz type 1 block was detected on the ECG. Pheniramine maleate is a first-generation, stable, potent sedative and antihistamine from the alkylamine group. It should be kept in mind that pheniramine maleate may cause AV blocks.Öğe Clinical Characteristics of Cases Developing Neonatal Pneumothorax: 10 Years of Experience(Tıbbi Kayıtlar Derneği, 2025) Kurt, Fatih; Kaya, Abdulkadir; Kocabay, Kenan; Kaya, MuratAim: Pneumothorax is a serious emergency condition that increases mortality and morbidity due to the accumulation of air between the visceral and parietal pleura layers. Neonatal pneumothorax is more frequently encountered in neonates admitted to neonatal intensive care units. It is known that the most important risk factors are prematurity and ventilation with a bag mask. Material and Method: Forty-two pneumothorax cases followed in the neonatal intensive care unit (NICU) were included in our study. The characteristics, risk factors, treatment methods and prognoses of the cases were retrospectively analyzed. Results: Twenty eight of the cases (66.67%) were male, and Pneumothorax developed within the first 3 days of life in 41 cases (97.61%). Nineteen cases (45.24%) were premature, 16 cases (38.10%) underwent resuscitation at birth, and 15 cases (35.71%) received surfactant therapy. An intercostal chest tube was placed for treatment in 34 cases (80.95%), and invasive mechanical ventilation was required in 33 cases (78.57%). Thirty six cases (85.71%) were regained the health, while those who passed away were found to be more premature. Conclusion: In our study, prematurity, resuscitation at birth, and surfactant therapy were identified as risk factors for neonatal pneumothorax. Newborns with these risk factors should be closely monitored, and neonatal pneumothorax should be kept in mind if respiratory distress develops.Öğe COVID-19 enfeksiyonunun yeni bir komplikasyonu; ulnar duyusal nöropati(2022) Kurt, FatihŞiddetli akut solunum sendromu koronavirüs 2’nin (SARS-CoV-2) neden olduğu “Coronavirus Disease 2019 (COVID-19)’’ ilk olarak Aralık 2019’da Çin’in Wuhan kentinde tespit edildi. O günden beri tüm dünyayı etkisi altına alan çok ciddi bir küresel sağlık sorunu haline geldi. COVID-19’un klinik spektrumu asemptomatik ile şiddetli solunum semptomları, ekstrapulmoner belirtiler ve ölüm arasında değişmektedir. Her geçen gün Coronavirüse bağlı yeni komplikasyonlar ortaya çıkmaktadır. En sık anosmi olmak üzere bir çok nöropatik komplikasyon tanımlanmıştır. Makalemizde yer alan COVID-19 enfeksiyonuna bağlı ulnar duyusal nöropati literatürde daha önce bildirilmemiştir.Öğe Dirençli epilepside akılda tutulması gereken tanı; tuberoskleroz(2022) Kurt, Fatih; Eröz, Recep; Doğan, Mustafaİlaca Dirençli epilepsi; nöbet tipine uygun seçilmiş, tolere edilebilen iki antiepileptik ilacın uygun doz ve sürede verilmesine rağmen nöbetlerin devam etmesidir. Gelişme geriliği, fokal nörolojik bulguların olması, organik beyin lezyonu olması, spesifik EEG bozukluğu ve ailede epilepsi varlığı dirençli epilepsi açısından risk faktörleridir. Tüberoskleroz hastalığı deri, merkezi sinir sistemi, böbrek ve akciğer gibi birçok organda hamartomlarla seyreden, multisistemik, otozomal dominant geçişli genetik bir hastalıktır. Tuberoskleroz hastalığında görülen beyin hamartomları ve diğer santral sinir sistemi lezyonları dirençli epilepsinin ortaya çıkmasına neden olmaktadır. Bu yazıda dirençli epilepsi tanısıyla takip edilen, tipik fizik muayene bulguları olmasına rağmen 16 yaşında Tuberoskleroz tanısı alan hasta sunuldu. Dirençli epilepsi etyolojisinde Tuberosklerozun akılda tutulması gerektiği ve fizik muayenenin ne kadar önemli olduğunu tekrar vurgulanmak istendi.Öğe Evaluation of mass mercury poisoning cases occurring in a center in Turkiye: symptomatology, treatment methods, and follow-up processes(Springer, 2025) Kurt, Fatih; Akcil, Abdullah; Cangur, Sengul; Yildiz, MustafaMercury (Hg) is a toxic heavy metal with extensive applications. In children, mercury exposure often occurs inadvertently through laboratories, thermometers, or fluorescent lamps. Inhalation of elemental mercury can affect the central nervous system and urinary system. Early diagnosis and treatment are crucial to prevent severe complications. A retrospective evaluation was conducted on 82 pediatric cases of mercury poisoning who presented to Bingol State Hospital on January 15, 2020. Blood and urine mercury levels were measured. Patients with mercury levels > 10 mu g/L received intravenous treatment with 2,3-dimercaptopropane sulfonic acid (DMPS) for 5 days. Plasma and urine mercury levels were analyzed before and after treatment. Adverse effects of treatment and follow-up processes were also examined. Of the patients, 43.9% were female, and 56.1% were male, with a mean age of 9.4 +/- 3.2 years. A total of 42.7% of cases were symptomatic, with headache being the most common symptom (26.8%). Significant reductions in blood and urine mercury levels were observed after treatment (p < 0.001). Adverse effects of the drug were reported in 43.9% of cases, with nausea (50%) and itching (25%) being the most frequent. Conclusion: Chelation therapy was effective in significantly reducing mercury levels in cases of mercury poisoning. Adverse effects must be carefully managed, and long-term follow-up is essential. This study provides significant contributions to the literature on mass mercury poisoning cases.Öğe İletişimsizliğin Çocuk Sağlığına Etkilerinden Biri: Nutrisyonel Rikets(2022) Bolu, Semih; Kurt, Fatih; Yalçın, NilgünD vitamini, parathormon ve kalsitonin ile birlikte kemik, böbrek ve bağırsak arasındaki kalsiyum (Ca)-fosfor(P) metobolizmasını ve kemik mineralizasyonunu sağlamaktadır. Nütrisyonel rikets, D vitaminive/veya kalsiyum eksikliğine bağlı olarak büyüme plaklarında kusurlu kondrositve osteoid mineralizasyonundankaynaklanır. Ülkemizde Sağlık Bakanlığı tarafından 2005 yılından itibaren ilk bir yıl tüm süt çocuklarına ücretsiz 400 IU/gün D vitamini desteği yapılmaktadır. Ülkemizde bulunan göçmen aile bebeklerine D vitamini desteği verilmesine rağmen, aileler birinci basamak sağlık merkezlerindeki görevli sağlık çalışanları ile iletişim kuramadığı için bu destek tedaviyi hangi dozda ve ne zamana kadar kullanması gerektiğini bilmemekte, eksik dozda veya kısa süreli kullanabilmektedir. Biz bu makalede nutrisyonel rikets tanısı ile tedavi verilen hastayı sunarak literatüre katkı yapmak ve göçmen aileler ile iletişim eksikliğine bağlı oluşabilecek sorunlara dikkat çekmek istedik.Öğe Investigation of Microvascular Involvement Through Nailfold Capillaroscopic Examination in Children with Familial Mediterranean Fever(Mdpi, 2025) Kurt, Fatih; Uyar, Belkiz; Erguven, Muferet; Cangur, SengulBackground and Objectives: Familial Mediterranean fever (FMF) is a lifelong autoinflammatory disease characterized by episodes of fever and aseptic polyserositis. Commonly associated with vasculitis, FMF's impact on microcirculation was investigated by examining nailfold capillaries using capillaroscopy. Materials and Methods: This study included 32 female and 28 male FMF patients diagnosed according to the Tel Hashomer and Yal & ccedil;& imath;nkaya criteria and a control group of 20 female and 10 male age-matched cases. Demographic characteristics, medical history (abdominal pain, fever, chest pain, and joint pain), and physical examination findings of the cases were assessed. FMF gene mutations, acute-phase reactants, urine analysis, and spot urine protein/creatinine ratios were evaluated. Nailfold capillaries were examined via capillaroscopy by the same dermatology specialist. Results: There was no significant age or gender difference between groups. The most common symptoms in the case group were abdominal pain (81.7%) and joint pain (65%). Pathological findings in capillaroscopy, such as microhemorrhages and avascular areas, were significantly more frequent in the FMF case group (p < 0.001; p < 0.001). Physiological findings, including hairpin-shaped capillaries and shortened loops, were significantly more common in the control group (p = 0.001; p = 0.034). No significant relationships were found between kidney involvement, subclinical inflammation, presence of microhemorrhages and avascular areas in capillaroscopy, and disease duration. Additionally, no significant differences were observed in capillaroscopic findings between those with exon-10 mutations in the MEFV gene and those with non-exon-10 mutations. Conclusions: In conclusion, our study demonstrated secondary microvascular findings due to inflammation in FMF patients using capillaroscopy, a cost-effective and safe tool.Öğe Investigation of plasma vitamin D, vitamin B12, and folate levels in newborns with pathological jaundice without risk factors(Springer, 2025) Kurt, Fatih; Davran, Fatih; Kaya, Abdulkadir; Kocabay, KenanBackground Physiological jaundice of the newborn is usually benign condition. Hyperbilirubinemia occurs as a result of postnatal breakdown of hemoglobin F and functional failure of the neonatal liver. Neonatal physiologic jaundice is seen in approximately two-thirds of term infants. Fifteen percent of neonatal jaundice reaches the pathological level. The etiology of nearly half of the cases is unknown. Considering the prevalence of pathological jaundice and its neurological side effects, it is very important to elucidate the etiology. This study was designed to investigate the potential role of vitamin B12, folate, and 25-OH vitamin D in the etiology of neonatal jaundice, considering their effects on erythrocyte maturation and cell lysis through various mechanisms. Methods A patient group was formed from 40 newborns and their mothers who developed pathological jaundice despite the absence of known risk factors. The control group consisted of 36 infants and their mothers who did not develop pathological jaundice. Demographic characteristics (age, gender, etc.), laboratory findings, plasma 25(OH) vitamin D, vitamin B12, and folate level results of both groups were compared. Results Newborn plasma vitamin B12 and especially plasma folate levels were significantly lower in the patient group (p 0.048, < 0.001, respectively). There was no significant difference in 25(OH) vitamin D levels in both groups. A positive correlation was found between the vitamin levels of mothers and babies. Conclusion Our study suggests that lower neonatal folate and vitamin B12 levels, along with higher maternal 25(OH) vitamin D levels, may be associated with pathological jaundice.Öğe Kronik Öksürükte Vasküler Ring Anomalilerine Dikkat(2024) Kurt, FatihÖksürük hava yolunu temizleyen ve aspirasyonu önleyen çok önemli bir reflekstir. Çocuklarda 4 haftadan uzun sürerse kronik öksürük olarak kabul edilir. Etyolojide astım, persistan bakteriyel bronşit, Postnazal akıntı sendromu ve gastroözofageal reflü gibi birçok önemli faktör vardır. Nadir de olsa vasküler ring anomalilerini düşünmek gerekir. Tanı koyarken ayrıntılı öykü ve fizik muayene çok önemlidir. İlk istenen tetkik olan direk grafide sadece akciğer parankimi değil diğer yapılar da sistematik bir şekilde incelenmelidir. Bu olgu sunumunda kronik öksürük şikayeti olan hasta sunuldu. Kronik öksürük şikayeti olan çocuklarda vasküler ring anomalilerinin ayırıcı tanılarda düşünülmesi gerektiği ve akciğer grafisini değerlendirirken sistematik bir şekilde diğer torakal yapıların da incelenmesi konusunda farkındalık oluşturmak amaçlandı.Öğe Refugee and asylum-seeker children and health problems in the city of Duzce, Turkiye(Wiley, 2024) Cakmak, Hatice Mine; Kocabay, Kenan; Temizkan, Ramazan Cahit; Turay, Sevim; Ozde, Sukriye; Kurt, Fatih; Sav, Nadide MelikeIntroduction: This study examines the health problems and healthcare needs of refugee and asylum-seeker children and aims to develop strategies for improvement. Methods: Based on quantitative data from 448 refugee and asylum-seeker children and 222 non-refugee local children, this study was conducted at D & uuml;zce University, Department of Paediatrics, between 2010 and 2021. The refugee children originated from three countries: Iraq (n = 304), Syria (n = 101) and Afghanistan (n = 43). The data were analysed using the SPSS data analysis program. Ethical clearance was obtained from the Ethics Committee of Duzce University. Results: The results suggest that refugee and asylum-seeker children have significantly higher rates of acute illness or infection, malnutrition (p < 0.001) and anaemia (p < 0.001) than local children as a result of living in overcrowded families (p = 0.017) and unhealthy conditions. Adolescent pregnancy (p = 0.049) emerges as an important social problem as a result of child marriage among refugee children, mostly in the form of consanguineous marriages (p < 0.001). The rate of having at least two adolescent pregnancies (under 18) was highest among Syrian refugee girls (p = 0.01). Although refugee and asylum-seeker children have higher rates of health insurance (between 74% and 95%), they have lower rates of insurance compared to local children. This research also compares the data from three nationalities, including Syria, Afghanistan and Iraq children; Iraqi and Afghan children under the international protection (IP) system with limited social support and rights had worse health conditions compared to other groups. Although Iraqi children had the highest rates of health insurance on admission (p < 0.001), they also had higher rates of chronic diseases (p = 0.001), infections (p = 0.004), allergic rhinitis (p = 0.001) and malnutrition (p < 0.001). The youngest age of admission (p = 0.006) and the shortest length of stay (p = 0.004) were for Afghan children who also had higher rates of upper respiratory infections (p = 0.021). Conclusions: This study highlights the urgent need for improved screening programmes and the importance of collaborative efforts to address the specific health needs of these populations. Addressing the health status of child refugees is a complex and multifaceted task that requires the active participation of healthcare professionals, policymakers and researchers, each of whom has a crucial role to play.Öğe Waardenburg Sendromu'nda Tanımlanan Çok Nadir Bir PAX3 Geni Varyantı: c.232G>A(p.Val78Met)(2021) Kurt, Fatih; Doğan, Mustafa; Eröz, RecepWaardenburg Sendromu(WS); İlk olarak PJ Waardenburg tarafından tanımlanmış, deri, saç, göz veya kohleadaki stria vascularis'te melanositlerin fiziksel yokluğundan kaynaklanan hastalıktır. Poliozis (saçta beyaz perçem), hipopigmente maküller, canlı mavi gözler veya heterokromik iris ve sensörinöral işitme kaybı dahil pigmentasyon anormalliklerinin birlikteliği ile karakterizedir. Bu sendromda altı gen mutasyonu suçlanmaktadır. Bunlar; PAX3 (Paired box 3 transkripsiyon faktörün) geni, MITF (Mikroftalmi ile ilişkili transkripsiyon faktörü) geni, EDN3 (Endotelin 3) geni, EDNRB (Endotelin reseptör tip B) geni, SOX10 (Sry bOX10 transkripsiyon faktörü) geni ve SNAI2 (Snail homolog 2) genleridir. Çok nadir bir hastalıktır, prevelansı 1/42000’dir. Kadın ve erkeklerde eşit oranda görülür. Bu yazıda PAX3 geni ekzon 2’de c.232G>A(p.Val78Met) patojenik varyantı tespit edilerek Waardenburg Sendromu teşhisi konan 2 aylık nadir bir olgu sunulmuştur.Öğe What is the ideal thyroid-stimulating hormone (TSH) threshold value in congenital hypothyroidism screening? Twin study(Lippincott Williams & Wilkins, 2024) Kurt, Fatih; Oz, Busra Olcay; Kaya, Abdulkadir; Kocabay, KenanCongenital hypothyroidism is the most common preventable cause of intellectual disability. Therefore, the majority of developed countries have aimed to diagnose cases early through screening programs. In these screening programs, levels of thyroid-stimulating hormone (TSH) and free thyroxine are examined in dried blood spots taken between days 3 and 5 of life. While many countries accept TSH threshold value of 8 mU/L, there is still no consensus on the ideal TSH threshold value. As no twin studies on the TSH threshold value have been conducted previously, this study was planned. Eight pairs of twins were included in the study, with one of the twins having plasma TSH value >= 8 mU/L and the other <8 mU/L, measured between days 3 and 5 of life. The study aimed to investigate whether determining threshold TSH value of 8 mU/L would be beneficial by comparing somatic growth, mental development, and neuromotor development between twins. The age, gender, gestational weeks, birth weights, height, weight, and initial TSH values taken between days 3 and 5 of all cases were recorded. The patients' plasma Vitamin B12, folate, 25-OH Vitamin D, ferritin, and hemoglobin levels were measured. After that, they were evaluated by a child and adolescent psychiatry. Finally, the Denver Developmental Test was applied to the cases. There was no significant impairment in somatic growth, mental development, and neuromotor development in the long-term outcomes of cases with plasma TSH >= 8 mU/L compared to those with plasma TSH < 8 mU/L among the twins participating in our study.Öğe Winters Are Always Harsh: Factors Affecting Prognosis in Children Diagnosed with Lower Respiratory Tract Infection(Duzce University, 2025) Kurt, Fatih; Temizkan, Ramazan Cahit; Akbaş, Emel; Kaya, Abdulkadir; Sağlam, Mukaddes Kılıç; Kocabay, KenanAim: A significant proportion of patients with acute lower respiratory tract infections (ALRTIs) require hospitalization. This study aims to determine the prognostic factors affecting morbidity and mortality by comparing respiratory infection panels, demographic characteristics, and laboratory findings of patients diagnosed with ALRTI who required hospitalization and those treated on an outpatient basis. Material and Methods: Ninety-three patients diagnosed with ALRTI based on history, physical examination, chest radiography, and laboratory tests, who presented to our pediatric health and diseases clinics, were included. The patients' chest radiographs, demographic data, and laboratory and clinical findings were compared. Results: Of the cases included in our study, 56 (60.22%) were treated through hospitalization. The respiratory infection panel identified RSV in 44 (47.31%) cases and Influenza A in 20 (21.5%) cases. It was found that the infectious agents had no significant effect on the length of hospital stay. In our study, patients infected with Influenza had a longer disease duration compared to other cases, but their fever degree, WBC, and neutrophil count were lower. When comparing cases infected with bacterial, viral, and co-infection agents, it was found that the co-infected cases had significantly higher fever degrees and plasma C-reactive protein (CRP) levels. Viral and co-infected cases had significantly lower sPO2 levels. Conclusion: It was observed that plasma vitamin levels and infectious agents did not affect the need for hospitalization. Co-infected cases had significantly higher fever degrees and plasma CRP levels, while viral and co-infected cases had significantly lower sPO2 levels.
