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Öğe A Case of Chemical Ventriculitis Due to Intraventricular Colistin Treatment(Derman Medical Publ, 2014) Dorum, Bayram Ali; Bal, Tayibe; Ozer, Utku; Aygun, Fatma Deniz; Silfeler, IbrahimNosocomial infections of central nervous system have high mortality, if they are due to Acinetobacter spp., the rate can be as high as 70%. Intraventricular treatment of ventriculitis, caused by Acinetobacter baumannii can be considered as current treatment choice, because of this high mortality. Here in, we report a case of ventriculitis, caused by A. baumannii related to ventriculoperitoneal shunt. We used to treat both with intravenous meropenem, colistin, rifampicin and intraventricular colistin and gentamcin because of persistent ventriculitis after removel of the shunt and multi drug resistant blood flow infection of A. baumannii. The culture of cerebrospinal fluid (CSF) became sterile with intraventricular treatment, but pleocytosis, fever and low glucose level of CSF persisted and chemical ventriculitis was considered to become. We continued the treatment with decreasing the dosage and increasing the interval of drug and were successful both in treatment of the infectious and chemical ventriculitis. The aim of this article is to report the successful treatment of ventriculitis caused by A. baumannii with intraventricular colistin in the fail of intravenous treatment, despite of reversible chemical ventriculitis.Öğe Çocuk acil polikliniğine ateş ve konvulziyon şikayetiyle başvuran hastaların lomber ponksiyon ve laboratuvar bulguları açısından değerlendirilmesi(2011) Sümergen, Dilek; Silfeler, İbrahim; Dorum, Bayram Ali; Canbak, Yekta; Kurnaz, Hilal; Pekün, Fügen; Nuhoğlu, AsiyeAMAÇ: Febril konvülziyon çocuklarda en sık görülen konvülziyon tipidir ve 6 ay ile 6 yaş arası çocuklarda ortaya çıkar. Febril konvülziyon patolojisi halen tam olarak aydınlatılamamıştır, fakat genetik yatkınlığı olduğu bilinmektedir. Bu çalışmada ateş ve konvülziyonla başvuran hastalara hangi koşullarda ve ne zaman lomber ponksiyon yapılması gerektiğini incelemeyi amaçladık. YÖNTEMLER: Bu çalışmada, ateş ve konvülziyon ile başvuran, yaşları 6 ay–6 yaş arasında değişen 199 çocuğun klinik ve laboratuvar sonuçları değerlendirildi. BULGULAR: Febril konvülziyon geçiren hastalarda en sık ateş nedeni üst solunum yolu enfeksiyonuydu. Laboratuvar bulguları değerlendirildiğinde rutin olarak topladığımız C-reaktif protein değerleri, herhangi bir yaş grubu için anlamlı bulunmadı. SONUÇ: On iki aydan küçük hastalar değerlendirilirken lökosit sayısı yol gösterici olabilir, fakat tek başına lomber ponksiyon veya tanı açısından yeterli değildir. Dolayısıyla, Amerikan Pediatri Akademisi’nin önerileri doğrultusunda, özellikle 1 yaş altı ateşli havale ile başvuran hastalara, klinik ve laboratuvar bulgulara bakılmaksızın rutin olarak lomber ponksiyon yapılması kanaatindeyiz.Öğe Comparison of levels in preterm and term neonates mean platelet volume(2013) Şilfeler, İbrahim; Dorum, Bayram Ali; Şilfeler Benk, Dilek; Günher Arıca, SeçilAmaç: Trombositlerin fonksiyonlarının belirleyicilerinden biriside ortalama trombosit hacmidir. Biz çalışmamızda preterm ve term yenidoğanların ortalama trombosit hacmi (MPV) düzeylerinin karşılaştırılmasını amaçladık. Gereç ve Yöntem: Hastanemizde doğan, herhangi bir hematolojik ve başka metabolik bir sorunu olmayan 58’i term 80’i preterm olan toplam 138 yenidoğan çalışmamıza alındı. MPV değerleri açısından istatistiksel olarak karşılaştırıl- dı. Bulgular: Term yenidoğanlar ile Preterm yenidoğanların MPV değerleri karşılaştırıldığında istatistiksel olarak ileri derecede anlamlı farklılık olduğu görülmüştür. Tartışma: Hasta preterm yenidoğanlarda mpv’yi değerlendirirken sağlıklı prematürelerdeki MPV düzeylerinin term yenidoğanlardan daha yüksek olduğu unutulmamalıdır. Bu fark muhtemelen genç trombosit üretimindeki artıştan kaynaklanmaktadır.Öğe Comparison of Levels in Preterm and Term Neonates Mean Platelet VolumePreterm(Derman Medical Publ, 2013) Silfeler, Ibrahim; Dorum, Bayram Ali; Silfeler, Dilek Benk; Arica, SecilGunherAim: One of the determinants of the functions of platelets and average platelet volume. In our study, preterm newborns with Mean Platelet Volume levels and term newborns with MPV levels are compared. Material and Method: The results of hemogram of a total of 138 newborns (80 preterm and 58 term), which were born in Hospital and have no problem with any other metabolic hematological were evaluated retrospectively. MPV values were compared by statistical analysis. Results: When the MPV values of Term newborns and preterm newborns were compared, The difference was highly statistically significant. Discussion: While the MPV of the sick preterm newborns were assessed, it should not be forgotten that the MPV level of healthy premature babies were higher the MPV level of term newborns. This difference is probably due to the increase in the production of young platelets.Öğe Duodenal perforation: an unusual complication of sickle cell anemia(African Field Epidemiology Network-Afenet, 2014) Acipayam, Can; Aldic, Guliz; Akcora, Bulent; Celikkaya, Mehmet Emin; Askar, Hasan; Dorum, Bayram AliDuodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presented with abdominal and back pain. The patient was operated on for acute abdomen and diagnosed with duodenal perforation. Helicobacter pylorus was negative. There was no risk factor to account for duodenal perforation other than sickle cell anemia. Surgical intervention was successful and without significant sequelae. Duodenal perforation is a rare entity described in patients with sickle cell anemia. To our knowledge, this is the first report of duodenal perforation in a patient sickle cell anemia.Öğe EBV-induced fulminant hepatic failure treated with liver transplantation(Professional Medical Publications, 2010) Silfeler, Ibrahim; Kurnaz, Hilal; Acar, Yesim; Dorum, Bayram Ali; Arica, Vefik; Pekun, FugenViral hepatitis is the leading cause of fulminant hepatitis. Infectious mononucleosis caused by primary infection of EBV is a self-limiting lymphoproliferative disease, and shows concomitant clinical features such as pyrexia, cervical lymphadenopathy, liver dysfunction and hepatosplenomegaly. Even though approximately more than 90 percent of all humans are infected with EBV it rarely causes hepatitis and even if it does it is usually benign and it rarely causes hepatic failure in which the outcome has a high mortality rate. We report a case of fulminant hepatic failure in an immunocompetent 3.5 years old girt caused by primary EBV infection that was treated by orthotropic liver transplantation. This observation emphasizes that EBV must be known as a possible cause of fulminant hepatitis and that liver transplantation is probably the unique therapeutic option to avoid a usually fatal course.Öğe Protective Effect of Ellagic Acid on Paraquat-induced Kidney Hazards in Rats(Iranian Soc Nephrolgy, 2017) Silfeler, Ibrahim; Alp, Harun; Dorum, Bayram Ali; Nacar, Emel; Arslan, Selda; Uygur, VeliIntroduction. Paraquat is a commonly used highly toxic herbicide. Despite many studies on detoxification of paraquat, an efficient and safe antidote has not been introduced for toxic cases in human being. The aim of this study was to investigate the effect of ellagic acid (EA) on paraquat-induced kidney hazards in rats. Materials and Methods. Sixty rats were randomly assigned as controls and 5 treatment groups (n = 10 each) receiving EA only, paraquat at doses of 15 mg/kg and 45 mg/kg, and paraquat at the same doses plus EA. Paraquat was intraperitoneally injected and the EA was orally given. Kidney tissues were stained with hematoxylin-eosin for histopathologic investigation. Results. Pathologic scoring showed that paraquat at the higher dose was associated with higher scores than the in the controls, EA group, and the high-dose paraquat group with EA treatment (P < .001 for all comparisons). It was noted that paraquat caused a serious damage in the kidney and the EA treatment significantly reduced the extent of the damage. Conclusions. This study showed the protective effects of EA against paraquat-induced nephrotoxicity histologically. Ellagic acid provided significant improvement in glomerular and tubular structure.Öğe Protective Effects of Caffeic Acid Phenethyl Ester on the Dose-Dependent Acute Nephrotoxicity with Paraquat in a Rat Model(Wiley-Blackwell, 2015) Rifaioglu, Murat Mehmet; Sefil, Fatih; Gokce, Hasan; Nacar, Ahmet; Dorum, Bayram Ali; Davarci, MurselParaquat (PQ), which is used extensively as a potent herbicide throughout the world, is highly toxic in humans. We aimed to determine PQ-induced biochemical and histologic changes in the kidneys, and to evaluate the ability of the protective effects of caffeic acid phenethyl ester (CAPE) against PQ-induced injury in rats. Forty-eight rats were divided into eight groups of six: Group 1: Control; Group 2: 10 mol/kg CAPE; Group 3: 15 mg/kg PQ; Group 4: 30 mg/kg PQ; Group 5: 45 mg/kg PQ; Group 6: 15 mg/kg PQ+CAPE; Group 7: 30 mg/kg PQ+CAPE; Group 8: 45 mg/kg PQ+CAPE. PQ and CAPE were injected intraperitoneally. The levels of the total oxidant status (TOS) and total antioxidant status (TAS) were determined in the supernatants of the excised left kidney. Right kidney tissue of each rat was removed to obtain a histologic score. When PQ-administrated (15, 30, 45) groups compared with other groups, TOS values were found to be significantly higher (p<0.01). PQ (15, 30, 45) groups had significantly diminished values of TAS than the other groups (p<0.001). Of histologic score evaluation, only the PQ45 group had a significantly higher value than the sham, and CAPE groups (p<0.05). Moreover, in CAPE+PQ45 group, the level of histologic score was decreased compared to PQ45 group (p<0.001). In conclusion, the evaluation of the data suggests that CAPE can be used to prevent the acute effects of PQ nephrotoxicity. (c) 2013 Wiley Periodicals, Inc. Environ Toxicol 30: 375-381, 2015.Öğe Reference Values of Serum Cystatin-C for Full-Term and Preterm Neonates in Istanbul(All India Inst Medical Sciences, 2012) Dorum, Sevil; Silfeler, Ibrahim; Dorum, Bayram Ali; Silfeler, Dilek B.; Canbak, Yekta; Say, AysuTo determine the level and distribution of Cystatin C values in full-term and preterm healthy neonates for the purpose of diagnosis and follow-up of renal diseases of the neonates. Eighty-eight newborn infants, including 55 preterm and 33 term born in the authors' hospital having no urinary tract pathology, symptoms or signs during prenatal and postnatal follow-up, were studied . There were 25 neonates born between gestational wk of 28 and 32 (Group 1), 30 neonates born between gestational wk of 33-36 (Group 2) and 33 neonates born after gestational wk of 37 (Group 3). Average cystatin C values were determined to be 1.41 mg/l, 1.22 mg/l and 1.21 mg/l for Group 1, Group 2 and Group 3, respectively. Evalution of cystatin C can be effective for follow-up of renal pathologies, because it is not affected by gender, body weight and muscle mass and has a constant production rate.
