Browsing by Author "Ünal, F"

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    Retrospective Evaluation of Cases Diagnosed with Ulcerative Colitis
    Ünal, F; Sahin, G; Cebe, A; Ayhan, S; Eren, F; Kasirga, E
    Introduction: Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal canal characterised by remissions and exacerbations. This study aimed to make a retrospective evaluation of clinical and laboratory findings of patients being monitored with a diagnosis of IBD. Materials and Methods: Medical records of 18 patients with a diagnosis of IBD and 7 years of follow-up at our pediatric gastroenterology departments were investigated with respect to demographic data, complaints on presentation and accompanying diseases. Unusual findings from physical examination, endoscopic findings, histopathological findings and the applied treatments were examined. Results: The 18 patients (10 female, 8 male) included in this study had a mean age of 13.6 +/- 2.9 years and the mean time from onset of symptoms to diagnosis was 6.9 +/- 4.5 months. Seventeen patients were diagnosed with ulcerative colitis and 1 patient with intermediate colitis. There was a positive family history of the disease in 2 patients (11%). At the time of diagnosis, the most common complaints on presentation were found to be abdominal pain (100%), bloody diarrhea (94.5%) and tenesmus (44.4%). The most frequent laboratory findings were CRP positivity (89%), increased sedimentation rate (83.3%) and iron-deficient anaemia (77.7%). On colonoscopy, pancolitis involvement (66.6%) was most frequently encountered. Accompanying diseases to IBD were found to be familial Mediterranean fever (FMF) (11%), celiac disease (5.5%) and Heliobacter pylori gastritis (5.5%). One patient (5.5%) who did not respond to medical treatment for pancolitis involvement underwent a colectomy. Discussion: The number of diagnoses of IBD in childhood is gradually increasing. Nonetheless, it can be difficult to define diseases with non-specific symptoms and this may cause a delay in diagnosis. Because of the association of autoimmune diseases with IBD, despite appropriate therapy, diseases with no remission which lead to gastrointestinal inflammation, such as FMF, should be further investigated.
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    Portal Hypertension in Childhood: Two Centers Experience and Literature Review
    Appak, YÇ; Ünal, F; Kasirga, E
    Introduction: In this study, our objective is to make an assessment of the patients whom we have followed with portal hypertension. Materials and Methods: A total of 21 portal hypertension patients, followed between 2005 and 2013, were evaluated retrospectively with regards to demographic data, complaints leading to their application and treatments they received. Results: The average age of the patients was 9.3 +/- 5.3, 38.1% of the patients were female and 61.9% were male. Of the patients, 28.6% received portal hypertension diagnosis due to gastrointestinal system bleeding, 14.3% due to abdominal distention, 28.6% due to splenomegaly, 9.5% due to hepatosplenomegaly and 19% due to elevated liver function tests. The average age of receiving the diagnosis was 6.8 +/- 4.7 and duration of the follow-up was 3.4 +/- 1.7 years. Of the patients, 85.7% had esophageal varices according to the upper gastrointestinal system endoscopy and beta-blocker therapy was applied to all patients except for one. The follow-up of the patients revealed that 52.4% of them had gastrointestinal bleeding secondary to portal hypertension. The patients received sclerotherapy ( 4.8%), band ligation (19%), band ligation and sclerotherapy together (23.8%). One patient received Rex Shunt and two patients had distal splenorenal shunt.
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    Relationship Between Duodenal Histopathology and Strong Positive Tissue Transglutaminase Antibodies in Children with Celiac Disease
    Dogan, G; Ayhan, S; Yilmaz, B; Appak, YÇ; Dündar, PE; Ecemis, T; Ünal, F; Kasirga, E
    Introduction: In celiac disease (CD) strong positive tissue transglutaminase antibody (TTGA) levels (> 100 U/A) have been shown to almost always indicate villous atrophy. The aim of this study is to determine the sufficiency of >= 100 U/A Ig A type TTGA levels for diagnosis of CD. Materials and Methods: Results from duodenum biopsy performed due to positive TTGA in 197 children were retrospectively examined. IgA TTGA levels had a positive value of > 18 U/A. Increases of 5 times or more than this threshold value (>= 100 U/A) are accepted as strong positivity. CD diagnosis was made according to ESPGHAN criteria. A modified Marsh stage >= 2 was accepted as significant for CD. Results: Of the cases, 129 were female (65.5%) and 68 were male (34.5%). Duodenum histopathology was compatible with Marsh 0 for 1 case (0.5%), Marsh 2 for 17 cases (8.6%), Marsh 3a for 41 (20.8%), Marsh 3b for 81 (41.4%) and Marsh 3c for 57 (28.9%). The TTGA levels of 64 of the 197 cases (32.5%) were >= 100 U/A. In cases with strong positivity for TTGA the duodenum histology was compatible with Marsh 3 (villous atrophy) for 63 and Marsh 0 (normal histology) for 1 case (type 1 diabetic and asymptomatic for CD). For Marsh 3c TTGA levels >= 100 U/A had a sensitivity of 85.96% (95% CI: 74.2-93.7%), specificity of 89.29% (95% CI: 82.9-93.8%), positive predictive value of 76.56% (95% CI: 64.3-86.2%) and negative predictive value of 93.9% (95% CI: 88.4-97.3%). Conclusions: This study showed that positive IgA TTGA levels (>= 100 U/A) were almost always accompanied by Marsh 3 duodenal histopathological changes. Diagnosis of CD without biopsy may miss certain accompanying diseases, however in some cases with advanced examinations CD may be diagnosed by pediatric gastroenterology specialists without endoscopy.
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    The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T)
    Ercan, ES; Polanczyk, G; Ardic, UA; Yuce, D; Karacetin, G; Tufan, AE; Tural, U; Aksu, H; Aktepei, E; Arman, AR; Basgülk, S; Bilac, O; CosKunm, M; Celik, GG; Demirkaya, SK; Dursun, BO; Durukan, I; Fidan, T; Fis, NP; Gençoglan, S; Gökçen, C; Görker, I; Görmez, V; Gündogdu, OY; Gurkan, CK; Hergüner, S; Hesapçioglu, ST; Kandemir, H; Kiliç, BG; Kilinçaslan, A; Mutluer, T; Nasiroglu, S; Özcan, ÖÖ; Öztürk, M; Öztop, D; Sapmad, SY; Süren, S; Sahin, N; Tahiroglu, AY; Toros, F; Ünal, F; Vural, P; Yazici, IP; Yazici, KU; Yildirim, V; Yulaf, Y; Yüce, M; Yüksel, T; Akdemir, D; Altun, H; Ayik, B; Bilgic, A; Bozkurt, ÖH; Çakir, ED; Çeri, V; Demir, NÜ; Dinç, G; Irmak, MY; Karaman, D; Kinik, MF; Mazlum, B; Memik, NÇ; Özdemir, DF; Sinir, H; Tasdelen, BI; Taskin, B; Ugur, Ç; Uran, P; Uysal, T; Üneri, Ö; Yilmaz, S; Yilmaz, SS; Açikel, B; Aktas, H; Alaca, R; Aliç, BG; Almaidan, M; Ari, FP; Aslan, C; Atabay, E; Ay, MG; Aydemir, H; Ayranci, G; Babadagi, Z; Bayar, H; Bayhan, PÇ; Bayram, Ö; Bektas, ND; Berberoglu, KK; Bostan, R; Canli, MA; Cansiz, MA; Ceylan, C; Coskun, N; Coskun, S; Çakan, Y; Demir, I; Demir, N; Demirdögen, EY; Dogan, B; Dönmez, YE; Dönder, F; Efe, A; Eray, S; Erbilgin, S; Erden, S; Ersoy, EG; Eseroglu, T; Firat, SK; Gök, EE; Güler, G; Güles, Z; Günes, S; Günes, A; Günay, G; Özgür, BG; Güven, G; Goksoy, SC; Horozcu, H; Irmak, A; Isik, U; Kahraman, Ö; Kalayci, BM; Karaaslan, U; Karadag, M; Kilic, HT; Kiliçaslan, F; Kinay, D; Kocael, O; Koç, EB; Mutlu, RK; Lushi-San, Z; Nalbant, K; Okumus, N; Özbek, F; Özdemir, FA; Özdemir, H; Özkan, S; Özyurt, EY; Polat, B; Polat, H; Sekmen, E; Sertçelik, M; Sevgen, FH; Sevince, O; Süleyman, F; Shamkhalova, Ü; Simsek, NE; Tanir, Y; Tekden, M; Temtek, S; Topal, M; Topal, Z; Türk, T; Uçar, HN; Uçar, F; Uygun, D; Uzun, N; Vatansever, Z; Yazgili, NG; Yildiz, DM; Yildiz, N
    Aim: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. Method: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. Results: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. Conclusion: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.
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    Effect of Impairment on the Prevalence and Comorbidities of Attention Deficit Hyperactivity Disorder in a National Survey: Nation-Wide Prevalence and Comorbidities of ADHD
    Ercan, ES; Unsel-Bolat, G; Tufan, AE; Demirkaya, SK; Bilac, O; Celik, G; Kiliç, BG; Ardic, UA; Sapmaz, SY; Aksu, H; Tahiroglu, AY; Karacetin, G; Tural, U; Aktepe, E; Arman, AR; Basgül, S; Coskun, M; Dursun, OB; Durukan, I; Fis, NP; Gençoglan, S; Gökçen, C; Gokten, ES; Görker, I; Görmez, V; Gündogdu, ÖY; Hesapçioglu, ST; Kandemir, H; Mutluer, T; Nasiroglu, S; Özcan, Ö; Sahin, N; Toros, F; Yazici, IP; Yazici, KU; Yulaf, Y; Yüksel, T; Bilgic, A; Altun, H; Akdemir, D; Mazlum, B; Memik, NÇ; Özdemir, DF; Üneri, Ö; Ünal, F
    Objective: This study aimed to determine the prevalence and comorbidities of attention-deficit hyperactivity disorder (ADHD) by evaluating a large-scale nation-wide sample of children. Method: The inclusion criterion was being enrolled as a 2nd, 3rd, or 4th-grade student. A semi-structured diagnostic interview (K-SADS-PL), DSM-IV-Based Screening Scale for Disruptive Behavior Disorders, and assessment of impairment (by both parents and teachers) were applied to 5,842 participants. Results: The prevalence of ADHD was 19.5% without impairment and 12.4% with impairment. Both ADHD with and without impairment groups had similar psychiatric comorbidity rates except for oppositional defiant disorder (ODD) and conduct disorder (CD) diagnoses. Impairment in the ADHD group resulted in significantly higher ODD and CD diagnoses. Conclusion: Even when impairment is not described, other psychiatric disorders accompany the diagnosis of ADHD and may cause impairment in the future. Impairment in the diagnosis of ADHD significantly increases the likelihood of ODD and CD.
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    Familial Mediterranean Fever Mutation Analysis in Pediatric Patients With Inflammatory Bowel Disease: A Multicenter Study
    Urganci, N; Ozgenc, F; Kuloglu, Z; Yüksekkaya, H; Sari, S; Erkan, T; Önal, Z; Çaltepe, G; Akçam, M; Arslan, D; Arslan, N; Artan, R; Aydogan, A; Balamtekin, N; Baran, M; Baysoy, G; Çakir, M; Dalgiç, B; Dogan, Y; Durmaz, Ö; Ecevit, Ç; Eren, M; Gökçe, S; Gülerman, F; Gürakan, F; Hizli, S; Isik, I; Kalayci, AG; Kansu, A; Kutlu, T; Karabiber, H; Kasirga, E; Kutluk, G; Hosnut, FÖ; Özen, H; Özkan, T; Öztürk, Y; Soylu, ÖB; Tutar, E; Tümgör, G; Ünal, F; Ugras, M; Ustundag, G; Yaman, A
    Background: the aim of the study was to evaluate familial Mediterranean fever (FMF) mutation analysis in pediatric patients with inflammatory bowel disease (IBD). The relation between MEFV mutations and chronic inflammatory diseases hos been reported previously. Methods: Children with IBD (334 ulcerative colitis (UC), 224 Crohn's disease (CD), 39 indeterminate colitis (IC)) were tested for FMF mutations in this multicenter study. The distribution of mutations according to disease type, histopathological findings, and disease activity indexes was determined. Results: A total of 597 children (mean age: 10.8 +/- 4.6 years, M/F: 1.05) with IBD were included in the study. In this study, 41.9% of the patients had FMF mutations. E148Q was the most common mutation in UC and CD, and M694V in IC (30.5%, 34.5%, 47.1%, respectively). There was a significant difference in terms of endoscopic and histopathological findings according to mutation types (homozygous/heterozygous) in patients with UC (P <.05). There was a statistically significant difference between colonoscopy findings in patients with or without mutations (P=.031, P=.045, respectively). The patients with UC who had mutations had lower Pediatric Ulcerative Colitis Activity Index (PUCAI) scores than the patients without mutations (P=.007). Conclusion: Although FMF mutations are unrelated to CD patients, but observed in UC patients with low PUCAI scores, it was established that mutations do not hove a high impact on inflammatory response and clinical outcome of the disease.