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Öğe Antenatal and delivery risk factors and prevalence of cerebral palsy in Duzce (Turkey)(Elsevier Science Bv, 2007) Öztürk, Ayhan; Demirci, Fuat; Yavuz, Taner; Yıldız, S.; Değirmenci, Yıldız; Döşoğlu, M.; Avşar, Y.This cross-sectional study aimed at investigating the prevalence and the etiological factors of cerebral palsy (CP) and comparing them with normal population within the rural and urban areas of Duzce province. Of the 102 children with cerebral palsy, 98 were associated with antenatal and delivery risk factors. The mean crude prevalence of cerebral palsy was 1.1 per 1000 live births. The children with CP were compared with 530 control subjects. The mothers of the children with cerebral palsy were significantly younger than the mothers of children in control group, and they had less parity and abortion. Preeclampsia, premature rupture of membranes, home births, prolonged labor, and twin pregnancies were significantly more common in the mothers of children with cerebral palsy, where no significant differences were found between the groups in terms of breech delivery, rate of cesarean births, gestational diabetes, and hemorrhage in late pregnancy. Birth asphyxia, liqueur with meconim stained, prolonged jaundice and neonatal seizure were also significantly more common in the group with cerebral palsy. Of the children with cerebral palsy, 78% were born at term, 20% were born with gestational ages of 32-36 weeks, 2% were born with gestational ages of 30-31 weeks. Nine percent of those children had a birth weight of >= 3000 g, 12.2% had a birth weight of 2500-2999 g, 33.7% had a birth weight of 1500-2499 g, and 5.1% had a birth weight of <= 1500 g. The causes of low prevalence of cerebral palsy were due to insufficient neonatal care, resulting in low survival in preterm and low birth weight children, and poor postnatal care of children with cerebral palsy. (c) 2006 Elsevier B.V. All rights reserved.Öğe Changing patterns of hepatitis A and E sero-prevalences in children after the 1999 earthquakes in Duzce, Turkey(Wiley, 2008) Kaya, Ayşe Demet; Öztürk, Cihadiye Elif; Yavuz, Taner; Özaydın, Çiğdem; Bahçebaşı, TalatHepatitis A and E are enteric viral diseases that are characteristically found in developing countries. Sero-epidemiological data about both infections showed higher prevalence rates soon after the 1999 earthquakes in Duzce, Turkey. The aim of the present study was to evaluate the data 4 years after the earthquakes. The study group included 589 children (72.3% boys) who were between the ages of 6 months and 17 years (mean age 11.5 years). The children were separated into three groups: Group 1 (ages 6 months to 5.9 years), Group 2 (ages 6.0-12.9 years) and Group 3 (ages 13.0-17.0 years). Serum anti-hepatitis A virus IgG and anti-hepatitis E virus IgG were determined using commercial enzyme-linked immunosorbent assay kits. The data were tested for statistical significance with the chi(2)-test. The sero-prevalence rates of hepatitis A and E were 63.8% and 0.3%, respectively. The sero-prevalence rates of both hepatitis A and E increased with age, and there was no significant difference between the genders. Hepatitis A infection was associated with socio-economic condition, crowded living environment, and education level of the family (P < 0.01). Hepatitis A infection is still common, whereas hepatitis E infection appears to be relatively rare in paediatric age groups in Duzce, Turkey.Öğe The effects of surgical repair on P-wave dispersion in children with secundum atrial septal defect(Springer, 2008) Yavuz, Taner; Nişli, Kemal; Öner, Naci; Dindar, Aygun; Aydoğan, Ümrah; Ömeroğlu, Rukiye Eker; Ertuğrul, TürkanIntroduction: Atrial septal defect (ASD) is one of the most common congenital heart diseases in children. P-wave dispersion has been reported to be associated with non-homogeneous propagation of sinus impulses. The heterogeneity of atrial conduction time may predispose the atria to arrhythmias. The aim of this study was to determine the impact of surgical repair on P-wave indices in children with isolated secundum ASD. Methods: Children with isolated secundum ASD undergoing surgical repair (n=50; mean age, 7.0 +/- 3.0 years) and healthy controls (n=51; mean age, 7.6 +/- 2.7 years) were compared. Maximum P-wave duration (Pmax), shortest duration (Pmin) and P-wave dispersion (Pd) were measured using 12-lead surface electrocardiography. Results: Mean Pmax was found to be significantly higher in children with ASD compared with controls (95.2 +/- 10.8 vs 84.1 +/- 9.2 msec; P < 0.001), and Pd before surgery was significantly higher compared with controls (47.4 +/- 12.0 vs 38.8 +/- 9.7 msec; P < 0.001). Both P-wave indices were significantly decreased within the first year after surgical closure - the values decreased to those comparable to healthy controls (Pmax, 86.2 +/- 9.7 msec; Pd, 39.8 +/- 10.7 msec; P > 0.05). Conclusion: Surgical closure of ASD in children decreases Pmax and P-wave conduction time. We speculate that earlier closure of the defect may play an important role in avoiding permanent changes in the atrial myocardium and atrial fibrillation in adulthood.Öğe Factors influencing outcome of inpatient pediatric resuscitation(Turkish J Pediatrics, 2006) Akçay, Ahmet; Baysal, Serpil Uğur; Yavuz, TanerThe aims of this study were: 1) To define the rate of long-term survivors (LTS) after cardiopulmonary resuscitation (CPR) in children; 2) To identify the predictors of survival in pediatric resuscitation; and 3) To assess the outcome six months after discharge. Three groups of patients were identified based on outcome: 1. Long-term survivors (LTS), who were discharged, 2. Short-term survivors (STS), who survived longer than 24 hours after CPR but not until discharge, and 3. Nonsurvivors (NS), who died within 24 hours after their arrest. Of the 67 patients, 10 (14.9%) children were STS, while 46 (68.7%) were NS. Only eleven (16.4%) were LTS who were eventually discharged from the hospital and six were alive six months after discharge. Four patients had neurological sequelae. Less than 5 minutes' duration of CPR and reactive pupils at the onset of cardiopulmonary arrest (CPA) were the most important factors that predicted long term survival. We suggest that a positive pupillary light reflex at the onset of CPA and the duration of CPR should be considered as important predictors of survival in children with CPA.Öğe Intestinal parasitic infection in children in post-disaster situations years after earthquake(Wiley-Blackwell, 2004) Öztürk, Cihadiye Elif; Şahin, İdris; Yavuz, Taner; Öztürk, Ayhan; Akgünoğlu, Mustafa; Kaya, DemetBackround: Two earthquakes in the north-west region of Turkey destroyed 80% of the houses and schools in Duzce in 1999. This study was conducted to determine the parasitic infection rate associated with the post-earthquake unhealty living conditions and related epidemiological risk factors. Methods: Two populations living and studying in different socioeconomic conditions as a result of the earthquake were compared: Group 1 (study group) consisted of 326 children living and studying in transitory houses and classes. Group 2 (control) consisted of 127 children living in normal houses and studying in normal school classes. Fecal samples were obtained from both groups and examined for intestinal parasites' eggs and trofozoid forms. In addition, selotype procedure was applied to both populations. Epidemiological data determining the socioeconornic status of the populations were collected by questionnaire. Results: In group 1, Giardia lamblia (G. lamblia) cysts were observed in 10.4% of the fecal samples and Enterobius vermicularis (E. vermicularis) eggs were observed in 13.5% of selotype samples. In group 2, Giardia cysts were observed in 3.1% of the samples and E. vermicularis eggs were observed in 5.5% of selotype samples. The rate of Giardiasis and Enterobiasis was found to be significantly higher in children still living and studying in temporary houses and schools years after the earthquakes (P < 0.05). The following pidemiological and social factors arising after the earthquakes were associated with increased rate of G. lamblia and E. Vermicularis infections: number of communal toilets per child at school, socioeconomic level of the children, dimensions of the classrooms where the children are studying and living and frequency of hand-washing at school. These parameters are significantly different between the groups (P < 0.05). Conclusion: Giardiasis should be considered as an emerging disease in postdisaster situations and adequate prevention measures should be implemented in these circumstances. It should also be known that the rate of Enterobiasis is increased in populations living in crowded unhealthy conditions.Öğe Long term follow-up results of 139 Turkish children and adolescents with rheumatic heart disease(Springer, 2008) Yavuz, Taner; Nişli, Kemal; Öner, Naci; Dindar, Aygun; Aydoğan, Ümrah; Ömeroğlu, Rukiye Eker; Ertuğrul, TürkanWe aimed to evaluate the predictors of the severity of chronic rheumatic valvar disease. The long term follow-up records of 139 patients with chronic rheumatic carditis were reviewed. Children were followed-up on an outpatient basis for a period ranging from 1-16 years (5.0 +/- 3.7 years). Mitral regurgitation either isolated (51%, n=71) or combined with aortic regurgitation (AR) (49%, n = 68) was observed in all cases of the initial attack of rheumatic carditis. AR at initial attack of the rheumatic carditis was found to be affected by gender (AR was more associated with males, p = 0.032), combined mitral and aortic regurgitation (CMAR), and presence of MR at initial attack (p = 0.000 and p = 0.012, respectively) with univariate analysis. The effect of CMAR on AR at initial attack was also significant by multivariate analysis (p = 0.000). CMAR, MR, and AR at initial attack had significant effects on CMAR at final evaluation (p = 0.000, p = 0.020, and p = 0.000, respectively) in univariate analysis. Multivariate analysis revealed the significant effects of CMAR and MR at initial attack on CMAR at final evaluation (p = 0.000 and p = 0.005, respectively). Univariate analysis showed that MR and AR at initial attack, and CMAR at final evaluation, had significant effects on MR at final evaluation (p = 0.000, p = 0.029, and p = 0.000, respectively). MR at initial attack and CMAR at final evaluation had significant effects on MR at final evaluation with multivariate analysis (p = 0.001 and p = 0.003, respectively). AR at final evaluation was affected by CMAR and AR at initial attack (p = 0.000 and p = 0.000, respectively), and CMAR and MR at final evaluation (p = 0.000 and p = 0.000, respectively) with both univariate and multivariate analysis. Mitral valve prolapsus was more common in patients with a longer duration (37.5%, 6 out of 16) than those with a shorter duration (11%, 14 out of 123) and the difference was significant (p = 0.020). In conclusion, the initial severity of valve involvement and the presence of CMAR at initial attack were found to be the best predictors for the severity of chronic rheumatic valvar disease in this study.Öğe Obez Çocuklardaki Hipertansiyon ve İnsülin Direncinin Kardiyak İşlev Bozukluğuna Etkisinin Ekokardiyografi İle Değerlendirilmesi(2016) Erdem, Ayhan; Yavuz, Taner; Arslanoğlu, İlknur; Kocabay, KenanAmaç: Bu çalışmada obez çocukların kardiyak işlevlerinin ekokardiyografi ile değerlendirilmesi, ayrıca bulunan sonuçlara insülin direnci ve hipertansiyonun ne şekilde etki ettiğinin araştırılması amaçlanmıştır.Gereç ve Yöntem: Yaşları 4-19 arasında değişen (ortalama 11,63,70 yıl) ve VKİ 95 persantil ve üzerindeki 52 çocuk (Erkek: 32, Kız: 20) çalışmaya dahil edildi. VKİ normal sınırlarda olan, yaş (4-19, ortalama 11,04,1 yıl) ve cinsiyeti (Erkek: 25, Kız: 19) uyumlu 44 sağlıklı çocuk kontrol grubunu oluşturdu. Obezlerde açlık kan şekeri, tiroit hormonları, lipit profili, insülin ve kortizol düzeyleri ölçüldü. Obez hastalar ayrıca hipertansiyon ve/veya insülin direnci olup olmamasına göre 4 alt gruba da ayrılarak kıyaslandı. Hasta ve kontrol grubunun hem sağ hem de sol ventrikülün M mod, iki boyutlu ve Doppler ekokardiyografi ölçümleri yapıldı. Sağ ve sol ventrikülün MPİ değerleri hesaplandı. Grupların karşılaştırılmasında bağımsız örneklem t-testi, Tek Yönlü Varyans Analizi Testi (One-Way ANOVA) kullanıldı, Post Hoc testinde Sidak yöntemi kullanıldı, p0.05 anlamlı olarak kabul edildi.Bulgular: Obez çocukların VKİ ortalaması 29,375,08 kg/m2 kontrol grubunun VKİ ortalaması ise 26,667,84 kg/m2 bulundu (p0.05). Obez çocukların hem SKB ortalaması (115,913,2 mmHg) hem de DKB ortalaması (70,610,1 mmHg) kontrol grubunun ortalamalarından (sırasıyla 110,88,8 ve 65,77,8 mmHg) anlamlı olarak yüksek idi. Obez grubun SVDSÇ, IVSd, SVK, SVK/boy2.7, SV, IVGZ, EF ve KF değerleri kontrol grubunkinden anlamlı olarak yüksek bulundu. Kontrol grubu ile alt gruplar kıyaslandığında bu istatistiksel farklılığın tek başına İR ve hem İR hem de HT'nun birlikte olduğu obez alt gruplarda daha belirgin olduğu saptandı. Kontrol grubuyla obez çocuk grubunun hem sağ ventrikül ve hem de sol ventrikülün erken ve geç dolum hızları, E/A oranları arasında istatiksel anlamlı farklılık saptanmadı. Buna karşın hem sol ventrikülün hem de sağ ventrikülün İVGZ ve MPİ değerleri obezlerde kontrole göre anlamlı olarak artmıştı. Sol ventrikülün MPİ değeri obez alt grupları arasında farklılık göstermez iken, sağ ventrikül MPİ değerinin kontrollere göre asıl anlamlı farklılığının ise tek başına İR olan ve hem İR hem de HT olan iki obez alt gruptan kaynaklandığını saptadık.Sonuç: Obezite ile İR ve/veya HT birlikteliği kardiyak işlev bozukluğunu belirginleştirebilir. MPİ ve İVGZ değerlerinin, diğer birçok hastalıklarda olduğu gibi obezitede de ve henüz hastalığın asemptomatik evresinde kalp işlev bozukluğunu göstermede kullanışlı ve değerli parametreler olduğu kanısındayız.Öğe A protective effect of pyrrolidine dithiocarbamate on monocrotaline induced pulmonary hypertension(Taylor & Francis Ltd, 2009) Uzun, Özge; Yavuz, Taner; Çomunoğlu, Cem; Yavuz, Ömer; Macit, Aslı S.; Sılan, Coşkun…Öğe Pulmonary Hypoplasia in a Newborn with Goldenhar Syndrome(Mosby-Elsevier, 2010) Ermiş, Bahri; Öztaş, Nilgün; Yıldırım, Mustafa; Hoşnuter, Mübin; Yavuz, Taner…Öğe Pyrrolidine dithiocarbamate attenuates the development of monocrotaline-induced pulmonary arterial hypertension(Elsevier Gmbh, Urban & Fischer Verlag, 2013) Yavuz, Taner; Uzun, Özge; Macit, Aslı; Çomunoğlu, Cem; Yavuz, Özlem; Sılan, Coşkun; Yıldırım, Hayriye AkWe aimed to demonstrate the potential protective effects of pyrrolidine dithiocarbamate (PDTC) on monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH). Adult male rats were randomly assigned to 4 groups: control group, MCT-treated rats only, MCT-injected rats treated with PDTC, and PDTC-treated rats only. Blood and tissue samples were collected after the sacrifice. Levels of malondialdehyde (MDA) were measured by using the thiobarbituric acid method. Total antioxidant status (TAS) was determined using a commercially available ImAnOx kit. A histopathological evaluation was accomplished by scoring the degree of severity. Endothelial damage of the main pulmonary artery was evaluated by immunohistochemical labeling of endothelial cells using anti-rat endothelial cell antigen 1 (RECA-1) antibody. MCT-induced right ventricular hypertrophy (RVH) was reduced significantly in the MCT + PDTC-treated group. MDA levels were significantly lowered in the MCT + PDTC-treated group. TAS was significantly higher in the MCT + PDTC-treated group when compared with the rats with PAH. Histopathological examination demonstrated that PDTC treatment reduced the development of inflammation, hemorrhage and congestion, and collagen deposition. In conclusion, PDTC attenuated PAH and protected pulmonary endothelium in rats administered MCT. These findings suggest that PDTC treatment may provide a new effective therapeutic approach in the treatment of PAH. (C) 2013 Elsevier GmbH. All rights reserved.Öğe Seroprevalence of Helicobacter pylori Infection in Children in Northwest Region of Turkey: Relationship with Iron Deficiency Anemia(Oxford Univ Press, 2008) Kaya, Ayşe Demet; Gencay, Esra; Öztürk, Cihadiye Elif; Yavuz, Taner…Öğe Supraventriküker taşikardi ile kendini gösteren üç aylık tuberoskleroz olgusu(2009) Uzun, Hakan; Yavuz, Taner; Şenses, Dursun Ali; Arslanoğlu, İlknur; Alagöz, Demet; Kocabay, KenanTuberoskleroz birçok organda hamartomlara neden olan otozomal dominant kalıtımla geçen bir bozukluktur. Çocukluk çağının en sık görülen kalp tümörü olan rabdomyomların tuberoskleroz ile olan ilişkisi iyi bilinmektedir. Kardiyak rabdomyomlara bağlı aritmiler tuberosklerozun başlangıç bulgusu olabilir. Biz burada, ekokardiyografi incelemesinde çok sayıda kardiyak rabdomyom bulunan, supraventriküler taşikardi ile kendini gösteren 3 aylık bir kız olgusunu sunuyoruz.Öğe Ultrasonic evaluation of early atherosclerosis in children and adolescents with type 1 diabetes mellitus(Freund Publishing House Ltd, 2002) Yavuz, Taner; Akçay, Ahmet; Ömeroğlu, Rukiye Eker; Bundak, Rüveyde; Şükür, MineObjective: To assess early atherosclerosis using B-mode imaging of the carotid artery in children and adolescents with type 1 diabetes mellitus (T1DM) and to evaluate the relationship between various risk factors and intimal plus medial thickness (IMT) in this population. Methods: Fifty-two children and adolescents (aged 3-18 years) with uncomplicated T1DM and 43 age- and gender-matched healthy controls were examined. B-mode imaging was used to determine the intimal plus medial thickness (IMT) of the carotid artery in all subjects. Patients with T1DM and control subjects were divided into two groups according to age and gender. Furthermore, duration of DM was considered for comparison. Results: Patients and control subjects showed no association between IMT and sex, systolic blood pressure (sBP), diastolic blood pressure (dBP), serum lipid levels or left ventricular ejection fraction (LVEF). However, statistical analysis indicated a good correlation between age and carotid arterial wall thickness in both diabetic and control groups. These findings were consistent with those in the literature. No correlation was found between IMT and the duration of DM. Conclusions: This study indicates that there is no association between T1DM and IMT in children and adolescents with T1DM.
