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Öğe Anti-CCP Antibodies Are Not Associated with Familial Mediterranean Fever in Childhood(Hindawi Ltd, 2013) Onur, Hatice; Aral, Hale; Arica, Vefik; Bercem, Gamze; Usta, Murat; Kasapcopur, OzgurObjective. Anticyclic citrullinated peptide antibodies (anti-CCP) testing is useful in the diagnosis of rheumatoid arthritis (RA) with high specificity. Arthritis is a very common clinical manifestation in children with familialMediterranean fever (FMF). The aim of the study was to show the presence of anti-CCP antibodies in child individuals diagnosed with FMF. Material and Methods. The study groups comprised one hundred and twenty-six patients (126) diagnosed with FMF (female/male (n): 66/60) and 50 healthy controls (female/male (n): 25/25). Clinical and laboratory assessments of the FMF patients were performed during attack-free periods. Erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), fibrinogen, and anti-CCP antibody levels were measured. Results. Anti-CCP was negative in healthy controls and also in all FMF patients. There was not a significant difference in anti-CCP between the patient and the control groups. Our study has shown that anti-CCP was correlated moderately with age (rs = 0.271; p = 0.0020), duration of illness (rs = 0.331; p < 0.0001), and colchicine therapy (rs = 0.259; p = 0.004). Conclusion. Our data show that anti-CCP antibodies are not associated with FMF. Anti-CCP does not have a priority for identifying FMF arthritis from the other inflammatory arthritis.Öğe Beta-ketothiolase deficiency brought with lethargy: Case report(Sage Publications Ltd, 2011) Arica, Vefik; Arica, Secil Gunher; Dag, Huseyin; Onur, Hatice; Obut, Omer; Gulbayzar, SayatBeta-ketothiolase deficiency is a rare autosonnal recessive disorder of isoleucine and ketone body metabolism. This disorder is clinically characterized by ketoacidotic attacks. Ketoacidosis, vomiting, and dehydration, lethargy and coma may be seen during attacks. A 9-month-old girl was admitted to our hospital with acidosis and dehydration. The patient was lethargic. Ketoacidosis was suspected because of acetone odor on her breath. Her blood glucose level was 262 mg/dL and urine ketone was (++++). Branched chain amino acid levels were elevated in her blood sample. Organic acid analysis of urine revealed 2-methylacetoacetyl-CoA thiolase deficiency. This was reported because of rarity of the disease and we should consider it in the differential diagnosis of ketoacidotic episodes.Öğe Comparison of Quantiferon Test with Tuberculin Skin Test for the Detection of Tuberculosis Infection in Children(Springer/Plenum Publishers, 2012) Onur, Hatice; Hatipoglu, Sami; Arica, Vefik; Hatipoglu, Nevin; Arica, Secil GunherThe efficacy of Quantiferon-TB gold test (QFT-GIT) remains to be documented in pediatric population. Tuberculin skin test (TST) is a conventional test available for the diagnosis of latent tuberculosis infection (LTBI). We aimed to investigate the concordance between QFT-GIT and TST in children with and without tuberculosis infection. Ninety-seven patients, aged 3 months-14 years, admitted to pediatric outpatient clinics of Dr. Sadi Konuk Training Hospital BakA +/- rkoy, Turkey between March 2008 and April 2009 were recruited. Demographic features, TST results, history of exposure to active tuberculosis (TB), chest X-ray findings, clinical history, presence of Bacillus Calmette Guerin (BCG) vaccination scar were recorded. Patients were categorized into four groups namely, active TB, LTBI, no TB and healthy. It was found that BCG scar positivity did not influence QFT-GIT results. There was a statistically significant agreement between QFT-GIT and TST results (kappa = 0.486; p < 0.01). In patients a parts per thousand yen5 years of age, TST positivity and QFT positivity had a significant relationship (p < 0.01). In all patient groups, sensitivity and specificity was 65.85 % and 82.14 %, respectively. In active TB group, TST and QFT-GIT results demonstrated significant agreement ratio of 40.8 % (kappa = 0.364; p < 0.01). Sensitivity and specificity was 100 % and 30 %, respectively. Utilization of QFT-GIT in the diagnosis of LTBI reduces false-positive results and prevents unnecessary treatment with INH and its adverse effects.Öğe Daily and every other day use of iron prophylaxis in the first year of life(Galenos Yayincilik, 2010) Arica, Vefik; Arica, Secil; Tutanc, Murat; Motor, Sedat; Onur, Hatice; Dogan, MuratAim: In countries like Turkey where iron deficiency anemia (IDA) is common, it was that iron prophylaxis can be used every other day as intermittent because it would show the same effect and easier for compliance. Material and Method: Two groups of infants born healthy, breastfed exclusively for the first six months and given 400 IU vitamin D were included in the study. In the fourth month of their life, infants started to take iron (Fe +2) 1 mg/kg/day and the second group 2 mg/kg/48 h In use of daily 1 mg/kg/day dose as of the fourth month till the first year 75 patients (the first group), in use of 2 mg/kg/48 h 80 patients (the second group) were involved in our study group. 34 infants (the third group) who did not start to take iron prophylaxis or use any was taken in our study as a control group. Results: It was found out that in the first group 14 infants (18.6%) developed iron deficiency (ID), 3 infants (4%) iron deficiency anemia (IDA), in the second group 16 infants (20%) developed ID and 4 infants (5%) IDA, in the third group, namely in the control group 12 infants (35,3%) developed ID and 10 infants (29.4%) IDA. In comparison of the control group with the first and second groups, IDA portion was less in iron prophylaxis groups, this value was found statistically reliable (p=0.001). When the first and second groups were compared with one another, a statistical difference could not be found between ID/IDA proportions. Because ID and IDA were encountered in both prophylaxis groups it was assumed that iron prophylaxis given just during the first year of life should also be given afterwards. Conclusions: There is no statistical difference between the first and second prophylaxis groups, thus, it was considered that instead of daily use, taking iron every other day would be more effective when it was given in a proper dose. (Turk Arch Ped 2010; 45: 343-7)Öğe Knowledge, attitude and response of mothers about fever in their children(Bmj Publishing Group, 2012) Arica, Secil Gunher; Arica, Vefik; Onur, Hatice; Gulbayzar, Sayat; Dag, Huseyin; Obut, OmerAim This study was conducted to determine mothers' knowledge about fever, and their attitudes and responses to fever in children, along with the influence of demographic characteristics on the level of knowledge, and to identify occurrences of fear of fever. Materials and Methods The study consisted of 4500 mothers with children 0-12 years of age who were referred to the pediatric health and disease polyclinic and primary care polyclinic over a period of 24 months. Data were collected using a questionnaire containing 32 open-ended, multichoice questions, and assessed using number, percentage and chi(2) analyses. Results In this study, 36% of mothers regarded body temperatures lower than 37 degrees C as fever; 83% believed that fever was harmful for their children, and 92.3% experienced fear and concern due to their child's fever. The most significant reason for fear was the belief that the child may have a seizure. Moreover, 12% of mothers feared that their child would die due to fever. The level of fear triggered by fever was lower as the education level of the mothers increased. Meanwhile, when their child had a fever, 28.9% of mothers used antifebrile drugs without consulting a physician, while 19% applied cold water and 7.7% applied water with alcohol or vinegar, among other inappropriate practices. Conclusion Increased information about fevers geared towards the caregivers of children, particularly mothers, would prevent the unnecessary treatment of children, as well as minimising delayed and insufficient responses to fever.Öğe Koruyucu demir dozunun hayatın ilk yılında günlük ve günaşırı kullanımı(2010) Arıca, Vefik; Arıca, Seçil; Tutanç, Murat; Motor, Sedat; Onur, Hatice; Doğan, MuratAmaç: Ülkemiz gibi demir eksikliği anemisi (DEA) sıklığının yüksek olduğu ülkelerde aynı etkide olup kullanımı ve hatırlanması daha kolay olduğundan koruyucu demir tedavisinin günaşırı olarak aralıklı şeklinde de kullanılabileceği amaçlandı. Gereç ve Yöntem: Zamanında sağlıklı olarak dünyaya gelen ve ilk altı ay sadece anne sütü ile 400 IU D vitamini alan bebeklere hayatlarının dördüncü ayında birinci gruba günlük 1 mg/kg/gün ve ikinci gruba günaşırı 2 mg/kg/48 sa dozunda Fe +2 başlandı. Dördüncü aydan bir yaşa kadar 1 mg/kg/gün tek doz olarak kullanma 75 hasta (1. grup), 2 mg/kg/48 sa tek doz olarak kullanan 80 hasta (2. grup) çalışma grubumuza alındı. Koruyucu demir tedavisi hiç başlanmamış ya da hiç kullanmayan 34 bebek ise kontrol grubu (3. grup) olarak çalışmamıza alındı. Bulgular: Birinci grupta demir eksikliği (DE) 14 bebekte (%18,6 ) ve DEA üç bebekte (%4), 2. grupta DE 16 bebekte (%20 ) ve DEA dört bebekte (%5), kontrol grubu olan 3. grupta DE 12 bebekte (%35,3 ) ve DEA ise 10 bebekte (%29,4 ) olarak saptadık. Kontrol grubu (3. grup) ile 1. ve 2. çalışma grubu karşılaştırıldığında DEA oranı koruyucu demir tedavisi alanlarda daha azdı, bu değer istatistiksel olarak anlamlı bulundu (p=0,001). Birinci ve 2. çalışma grubu kendi aralarında karşılaştırıldığında ise DE/DEA oranı arasında istatiksel olarak fark bulunmadı. Koruyucu demir tedavisi alan iki grupta da DE/DEA görüldüğü için hayatın ilk yılındaki koruyucu demir tedavisinin bir yaştan daha uzun süreli kullanılması gerektiği kanısına varıldı. Çıkarımlar: Birinci ve 2. koruyucu demir tedavisi alan gruplar arasında da istatiksel olarak kendi aralarında fark bulunamadığı için günlük yerine, iki günde bir kullanımının uygun dozda verildiği zaman etkili olabileceği düşünüldü.
