20 results on '"Özkan, Tanju Başarır"'
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2. Celiac Disease and Autoimmune Hepatitis Presenting with Fulminant Hepatic Failure: A Case Report.
- Author
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Kaptan, Kadriye Nil, Özgür, Taner, Turan, Enes, and Özkan, Tanju Başarır
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LIVER failure ,AUTOIMMUNE hepatitis ,CELIAC disease ,AUTOIMMUNE diseases ,FAMILY history (Medicine) ,DIAGNOSIS - Abstract
Background: Fulminant hepatic failure (FHF) may be a rare presentation of autoimmune hepatitis (AIH) in previously asymptomatic adolescents. Celiac disease (CD) is a chronic immune disease that may be associated with severe forms of liver disease and coexists with AIH. We report a patient presenting with an FHF at the diagnosis of AIH and CD. Case Report: An 8-year-old female patient who had no known background or family history of liver disease was referred to our center with an FHF diagnosis. Her clinical and laboratory findings fulfilled the criteria of seronegative AIH and CD. After 7 days of starting the medical treatment, encephalopathy and liver function tests gradually improved. Conclusion: AIH and CD usually follow a chronic course and rarely coexist. However, they should be considered the etiologies of FHF and should be treated promptly. [ABSTRACT FROM AUTHOR]
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- 2021
- Full Text
- View/download PDF
3. Çocuklarda H.pylori Enfeksiyonunda Seroloji, Tanı ve Tedavi
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ÖZKAN, Tanju Başarır
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Helicobacter pylori. Children ,Helikobakter pilori,Çocuk - Abstract
H. pylori is a common infectious agent. In developing countries the individuals are infected frequently in relatively younger ages. Oraloral, gastric-oral and fecal-oral transmission is established. Household contacts, particularly infected mothers are known to spread the infection. Only in symptomatic cases, invasive and noninvasive tests are recommended for diagnosis of H.pylori. Although most of the infected children remain asymptomatic, H. pylori is a well-known reason of gastritis, recurrent abdominal pain and non-ulcer dyspepsia. The optimal therapeutic approach to H. pylori infection is not clear. But current suggestions indicate that the children with peptic ulcer and H. pylori infection should receive combined antibiotic (amoxicillin+ clarithromycine) and proton pump inhibitor therapy for 1-2 weeks, H.pylori, dünya üzerinde yaygın ve sık olarak rastlanan bir enfeksiyon etkenidir. H.pylori enfeksiyonu, gelişmekte olan ülkelerde gelişmiş ülkelere göre daha sık ve daha erken yaşta görülmektedir. Bulaş şeklinin, insandan insana; oral-oral, gastrik-oral veya fekal-oral yollarla olabileceği bildirilmiştir. Enfeksiyonun aile içi bulaş ile yayıldığı, bu konuda enfekte annelerin daha çok bulaş nedeni olduğu bilinmektedir. H.pylori enfeksiyonunun saptanmasına yönelik noninvaziv ve invaziv testler ancak klinik semptomların varlığında önerilmektedir. Klinik çalışmaların sonuçlarına göre, H.pylori gastritinin çocuklarda büyük ölçüde asemptomatik kalabileceği kabul edilmiştir. Klasik klinik tablo gastritis, tekrarlayan karın ağrısı ve nonülser dispepsidir. Çocuklarda tedavi yaklaşımları net olmamakla birlikte peptik ülser ve H.pylori pozitifliği saptanan hastaların tedavi edilmesi önerilmektedir. Çocuklarda yeğlenen güncel tedavi; geniş spektrumlu ikili antibiyotik ve proton pompası inhibitörlerinin 1–2 hafta süreyle uygulanmasıdır.
- Published
- 2007
4. Acquired Generalized Lipodystrophy Associated with Autoimmune Hepatitis and Low Serum C4 Level.
- Author
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Eren, Erdal, Özkan, Tanju Başarır, Çakır, Esra D. Papatya, Sağlam, Halil, and Tarım, Ömer
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HEPATITIS diagnosis , *HYPERTRIGLYCERIDEMIA , *ACANTHOSIS nigricans , *GLUCOSE tolerance tests - Abstract
Lipodystrophies are a group of diseases characterized by loss of fat tissue and are associated with insulin resistance. A six-year- old girl followed with the diagnosis of autoimmune hepatitis showed a severe loss of fat tissue, hyperinsulinemia, impaired glucose tolerance, hypertriglyceridemia and low serum complement 4 (C4) levels. She had coarse facial features with generalized loss of subcutaneous fat and prominent muscularity. Remarkable acanthosis nigricans was present over the neck, axilla, and umbilicus. Two hours after glucose loading, the glucose tolerance test revealed a glucose level of 258 mg/dL, a HbA1c value of 6.8%, and an insulin level of 642.9 mIU/mL, documenting a state of insulin resistance and type 2 diabetes mellitus. Acquired generalized lipodystrophy was diagnosed and metformin with dietary intervention was initiated. Low serum complement levels proved the autoimmune nature of the process. We conclude that the serum complement levels must be investigated in patients with acquired lipodystrophy, particularly when it is associated with autoimmune hepatitis. [ABSTRACT FROM AUTHOR]
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- 2010
- Full Text
- View/download PDF
5. Helicobacter pylori infection in children: Nutritional status and associations with serum Leptin, Ghrelin, and IGF-1 levels
- Author
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Gulin Erdemir, Tanju Başarir Özkan, Sinan Cavun, Derya Altay, Güher Göral, Taner Özgür, Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Gastroenteroloji, Hepatoloji ve Beslenme Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Farmakoloji Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı., Erdemir, Gülin, Özkan, Tanju Başarır, Özgür, Taner, Altay, Derya, Çavun, Sinan, Göral, Güher, AAG-8381-2021, and AAC-9702-2019
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Serum ,Leptin ,Male ,Epidemiology ,Growth ,Growth-factor ,Adolescents ,Gastroenterology ,Peptic-ulceration ,0302 clinical medicine ,Nutritional status ,Antibody blood level ,030212 general & internal medicine ,Pylori ,Insulin-Like Growth Factor I ,Child ,media_common ,Priority journal ,education.field_of_study ,Schools ,biology ,Anthropometry ,Stomach ,General Medicine ,H ,Ghrelin ,Risk-factors ,Infectious Diseases ,medicine.anatomical_structure ,Gastritis ,030211 gastroenterology & hepatology ,Female ,medicine.symptom ,Age distribution ,Human ,medicine.medical_specialty ,Adolescent ,media_common.quotation_subject ,Population ,Body-mass index ,Major clinical study ,Microbiology ,Article ,Helicobacter Infections ,Helicobacter infection ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Risk factor ,education ,Students ,Demography ,Helicobacter pylori ,business.industry ,Malnutrition ,Appetite ,Body weight ,biology.organism_classification ,Somatomedin C ,Childhood ,Helicobacter Pylori ,Duodenum Ulcer ,Body height ,Short stature ,Endocrinology ,Cross-Sectional Studies ,Immunoglobulin G antibody ,business ,Hormone blood level ,Gastroenterology & hepatology - Abstract
Background Helicobacter pylori is associated with gastrointestinal diseases such as gastritis, peptic ulcers, malignancy and lymphoma, and extra-gastrointestinal conditions. H. pylori infection is negatively associated with children's growth. Chronic inflammation of the stomach that results in the loss of appetite and, dysregulation of neuroendocrine hormones such as leptin, and ghrelin are the probable reasons of this negative association. The objective of this study is to determine the serum levels of leptin, ghrelin, and IGF-1 in H. pylori-infected children and their relations with growth. Materials and methods A hundred and sixty-one school children aged between 6 and 14 years were selected randomly from five primary schools representing a cross section of population. Demographic and sociocultural characteristics, and anthropometric measurements were recorded. Serum H. pylori IgG, insulin-like growth factor-1, leptin, and ghrelin levels were measured in all children. The children were grouped according to the nutritional status and Helicobacter pylori seropositivity. Nutritional indices were compared among groups in association with serum leptin, ghrelin, and insulin-like growth factor-1 levels. Results H. pylori IgG positivity was found in 34.2%, and 14.9% of children were malnourished. H. pylori seropositivity was significantly higher in older ages (10.32 ± 2.26 vs 9.53 ± 2.36 years, p = .036), and body weight and height Z scores were significantly lower in H. pylori-seropositive children (−0.33 ± 1.08 vs 0.04 ± 1.26, p = .044 and 0.13 ± 0.92 vs 0.23 ± 0.91, p = .018 respectively). H. pylori seropositivity was found to be an independent risk factor for shorter body height (p = .01). Serum leptin, ghrelin, and IGF-1 levels were not associated with H. pylori IgG seropositivity (0.35 vs 0.55 ng/mL, p = .3; 3267.4 ± 753.0 vs 2808.3 ± 911.4 pg/mL, p = .06; 470 ± 176 vs 521 ± 179 ng/mL, p = .32, respectively). Conclusions Children infected with H. pylori are prone to short stature. This effect seems to be independent of neuroendocrine hormones.
- Published
- 2016
6. Evaluation of fecal calprotectin and fecal lactoferrin in childhood bowel infections
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Özdener, Melek, Özkan, Tanju Başarır, and Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
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Diarrhea ,Calprotectin ,Lactoferrin ,fluids and secretions ,Intestinal diseases ,Çocuk Sağlığı ve Hastalıkları ,Child Health and Diseases ,Diarrhea-infantile ,Gastroenteritis - Abstract
Akut gastroenterit bütün dünyada, özellikle gelişmekte olan ülkelerde yenidoğan ve küçük çocuklar için önemli bir sağlık sorunu ve önde gelen bir ölüm sebebidir.Bu çalışmanın amacı gastroenterit ile başvuran olgularda, enfeksiyöz kaynaklı ishali olan olgularda sistemik inflamatuvar belirteçler ile kolonik inflamasyonu gösteren fekal belirteçler arasındaki ilişkiyi belirlemektir. Fekal kalprotektin ve fekal laktoferrin gastrointestinal inflamasyonunu gösteren, nötrofil kaynaklı, invaziv olmayan, sensitif ve spesifik fekal belirteçlerdir.Prospektif olarak yapılan bu çalışmaya Mayıs 2011 ? Aralık 2011 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Ana Bilim Dalı Gastroenteroloji ve Çocuk Acil polikliniklerine ishal yakınması ile başvuran ve bu tanıyla kliniğe yatırılan 140 hasta alındı. Hastalardan başlangıçta gaita mikroskopisi, hızlı fekal kalprotektin, hızlı fekal laktoferrin, tam kan sayımı, C-Reaktive Protein, sedimentasyon (ESR),laktat dehidrogenaz (LDH) çalışıldı.FC ve FL pozitif saptanan hastaların tümünde gaita mikroskopisinde lökosit pozitifliği mevcuttu. Sistemik belirteçlerden CRP artışı olan, lökositozu olan, ESR artışı olan hastalarda FC ve FL pozitifliği istatistiksel olarak anlamlı saptandı.Sonuç olarak fekal kalprotektin ve fekal laktoferrin çocuklarda tüm gastrointestinal sistemdeki mukaozal inflamasyonu kolayca göstermede sensitiftir ancak tek bir hastalığa spesifik değildir. Hem FC hem de FL infeksiyöz ve non-infeksiyöz ishali ayırt etmede ve hastaların tedavi yönetiminde yol gösterici olmaktadır. Söz konusu fekal belirteçler fonksiyonel bağırsak hastalıklarının ayırıcı tanısında ve mukozal inflamasyonla giden organik hastalıkların belirlenmesinde yardımcıdır.Anahtar Kelimeler: Çocuklarda diyare, fekal kalprotektin, fekal laktoferrin Acute gastroenteritis is a significant health problem and causes death in infants and young children in the world, especially in developing countries.The aim of this study is to determine the association between fecal biomarkers that identify colonic inflammation and systemic inflammatory markers in patients with infectious gastroenteritis.FC (fecal calprotectin) and FL (fecal lactoferrin) are neutrophil derived, non-invazive, sensitive and spesific fecal markers that indicate gastrointestinal inflammation.In this prospective study 140 pediatric patients who presented with diarrhea to Uludag University Medical Faculty Pediatric Gastroenterology and Emergency Policlinics and hospitalized in clinic between May 2011 and December 2011 were included. Stool microscopy, rapid fecal calprotectin, rapid fecal lactoferrin, total blood count, C-Reaktive Protein, erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH) levels of patients were evaluated at admission.All patients with positive FC and FL values had leukocytes in stool microscopy. In patients with increased CRP, leukocyte and ESR levels , positiveness of FC and FL was statistically significant .In conclusion fecal calprotectin and fecal lactoferrin are sensitive but not disease spesific markers to easily detect inflammation throughout the whole gastrointestinal tract in children. Both FC ve FL are useful to differentiate , infectious or non-infectious diarrhea and guide patient management in treatment. The markers abovementioned may identfy an organic disease caused by intestinal mucosal inflammation and the differantial diagnosis of functional bowel disorders.Key words: Diarrhea in children, fecal calprotectin, fecal lactoferrin 86
- Published
- 2012
7. Yenidoğan ve süt çocukluğu döneminde kolestaz tanısıyla izlenen 70 vakanın etyolojisi,klinik, laboratuvar, histolojik bulguları ve klinik seyirleri
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Aytekin Ceylan, Latife, Özkan, Tanju Başarır, and Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
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Cholestasis ,Infant-newborn diseases ,Gallbladder diseases ,Infant ,Biliary atresia ,Çocuk Sağlığı ve Hastalıkları ,Child Health and Diseases ,Hepatitis ,Infant-newborn - Abstract
Kolestatik hastalıklar yenidoğan ve erken çocukluk döneminde ciddi mortalite ve morbiditeye neden olan bir grup hastalıktır. Klinik ve histopatolojik bulguların genellikle özgül olmaması nedeniyle tedavi ve prognoz açısından farklılıklar gösteren bu hastalıklara tanı konulması güç olabilmektedir. Çalışmamızda kliniğimize yenidoğan döneminde kolestaz ile başvuran 25 kız (%35,7), 45 erkek (%64,2) 70hastanın başvuru yakınmaları, fizik muayene bulguları, laboratuvar tetkikleri, karaciğer biyopsisi bulguları incelenmiş ve klinik seyirlerine etki edebilecek faktörler araştırılmıştır. Hastaların 12'si (%17,1) biliyer atrezi, 22'si (%31,4) idiyopatik neonatal hepatit, 2'si (%2,8) metabolik hastalık, 2'si (%2,8) PFIC, 2'si (%2,8) safra kanalı hipoplazisi, 10'u (%14,2) enfeksiyöz ve 12'si (%17,1) de diğer grupta yer aldı. Hastaların en sık başvuru yakınması sarılık olup 65 hastada mevcuttu (%92,9). Fizik muayene bulgusu olarak sarılık hastaların hepsinde saptandı (%100). Hepatomegali ve asit metabolik hastalık grubundaki hastaların 2'sinde de görüldü. Diğer fizik muayene bulguları açısından anlamlı fark görülmedi. Biliyer atrezi hastalarının başlangıç sırasındaki ve izlemdeki en yüksek GGT düzeyleri daha yüksek saptandı. Biliyer atrezi hastalarının tanısında ultrasonografinin duyarlılığı %80 özgüllüğü % 64,3 olarak bulunurken, sintigrafinin duyarlılığı %100 özgüllüğü %75 olarak saptandı. Düşük doğum ağırlığı toksik nedenlere bağlı kolestaz grubunun hepsinde görüldü, aradaki fark istatistiksel olarak anlamlıydı (p=0,032). Toplam 40 (%57,1) hastanın biyopsi bulguları tanıları bakımından karşılaştırıldığında safra kanalı proliferasyonu biliyer atrezi grubunda daha sık görüldü ve diğer gruplara göre anlamlı bir fark vardı (p=0,021). Sonuç olarak, hepatobiliyer sistem patofizyolojisinin daha iyi anlaşılmasıyla son yıllarda kolestatik hastalıkların tanı spektrumu oldukça genişlemiştir. Yenidoğan döneminde kolestaz varlığında öncelikli olarakerken cerrahi tedavi gerektiren biliyer atrezinin diğer kolestaz nedenlerinden ayrılması gerekmektedir. It may be difficult to diagnose these diseases which shows differences towards prognosis due to not being specific and histopathologic findings. The factors were investigatedthat may affect the clinical progress, the 70 patients presenting symptoms with cholestasis in newborn period of whom 25 percent female (%35,7), 45 male (%64,2), their physical examination findings, laboratory tests, biopsy of liver findings were examined. The patients %12 percent of idiopathic neonatal hepatitis, %2 percent of metabolic diseases, %2 percent of PFIC, %2 bileduct hypoplasia, %10 percent of infectious and %12 percent of also took part in the other group. The 65 percent of patients common presenting symptom was jaundice. The %100 percent of patients were found with jaundice in physical examination findings. Hepatomegaly and ascites were seen in both group of patients with metabolic disease.There was no difference in terms of other physical examination findings. Patients with biliary atresia their GGT levels were significantly higher between start up and monitoring. The sensitivity of scintigraphy was found as %100 percent,ıts specifity %75 percent while the sensivity of ultrasonography in the diagnosis of biliary atresia patient, ıts sensivity %80 percent and ıts specifity %64,3 percent. Due to toxic causes low birth weight was seen in all cholestasis group and the difference was significant statistically. Total of 40 patients diagnosis was more common in comparison of findings of biopsy and purposes in proliferation channel biliary atresia group. As a result, in recent years diagnostic spectrum of cholestatic diseases has been greatly extended, thanks to the hepatobilier system better understanding. For the presence of cholestasis which primiraly requires early surgical treatment biliary atresia cases, sould be separated from othercauses of cholestasis in early neonatal period. 87
- Published
- 2011
8. Çocuklarda kronik karaciğer hastalıklarının yaşam kalitesi üzerine etkisi
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Demiral, Meliha, Özkan, Tanju Başarır, and Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
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Gastroenteroloji ,Quality of life ,Gastroenterology ,Children ,Liver diseases ,Çocuk Sağlığı ve Hastalıkları ,Child Health and Diseases - Abstract
Bu çalışmada; kronik karaciğer hastalığı olan çocukların yaşam kalitelerini belirlemek, sağlam çocuklar ile karşılaştırmak ve yaşam kalitelerine etki eden faktörleri değerlendirmek amaçlanmıştır.Kronik karaciğer hastalığı olan 101 hasta ve ebeveyninin, kontrol grubu olarak 100 sağlam çocuk ve ebeveyninin sağlıkla ilişkili yaşam kaliteleri değerlendirilmiştir. Çalışmanın başında ilaçsız izlemde olan 75 hastadan 31 tanesine izlemde ilaç tedavisi başlanmış, tedavinin 6. ayında tekrar yaşam kalitesi değerlendirilmiştir. ilaçsız takibe devam edilen 39 hastaya sağlıklı yaşam kuralları anlatılmış, 6 ay sonra tekrar yaşam kalitesi değerlendirilmiştir.Hastaların 48'i (%47.5) kız, 53'ü (%52.5) erkek, yaş ortalaması 12.9 ± 3.9 yıl (5-18 yıl) idi. Hastaların 51'inde (%50.5) viral-enfeksiyöz, 29'unda (% 28.7) metabolik, 9'unda (%8.9) fibrokistik, 7'sinde (%6.9) kriptojenik, 5'inde (%4.9) otoimmun karaciğer hastalığı mevcuttu. Hastaların 90'ı sirozsuz, 7'si Child A, 4'ü Child B tipi sirozlu hastalardı. Ortalama yaşam kalitesi ölçek toplam puanı hastalarda 38.6±18.9, ebeveynlerinde 35.4±14.2; sağlam çocuklarda 55.4±14.3, ebeveynlerinde 54.0±16.9, izlemde ilaç başlanan hastalarda tedavinin başında 33.6±8.9, tedavinin 6. ayında 35.8±13.4; ilaçsız takibe devam edilen hastalarda bilgilendirme öncesi 38.6±18.9, bilgilendirmeden 6 ay sonra 38.0±18.1, sirozsuz hastalarda 38.8± 10.2 , Child A sirozda 27.8±10.8, Child B sirozda 25.6±10.4 saptanmıştır.Sonuç olarak; kronik karaciğer hastalığı olan çocuk hastaların ve ebeveynlerinin; sağlam çocuk ve ebeveynlerine göre sağlıkla ilişkili yaşam kalitelerini düşük algıladıkları saptanmıştır. Kronik karaciğer hastalıklarının 10 yaş ve üzerinde özellikle psikososyal sağlığı daha fazla etkilediği , sirozlu hastalarda sirozun şiddeti ile orantılı olarak yaşam kalitesinin daha düşükalgılandığı; ilaç tedavisinin tedavinin 6. ayından sonra yaşam kalitesini iyileştirdiği gözlenmiştir.Anahtar kelimeler: Çocuk, kronik karaciğer hastalığı, çocuklar için yaşam kalitesi ölçeği. The aims of this study are evaluating the life quality of patients with chronic liver disease (CLD), determining factors influencing their life quality and comparing them with healthy children.We have evaluated health related life quality of 101 pediatric chronic liver patient and 100 healthy children both including their parents. 31 of 75 patients who were in outpatient care without any treatment at the beginning of the study started medical therapy, 39 patients have been followed up with oral health advice. Their life quality was evaluated after six months.The study group consisted of 48 female (47,5 %) and 53 male patients (52,5 %). Mean age was 12,9 ± 3,9 years. 51 of the patients (50,5 %) had viral infectious, 29 (28,7 %) had metabolic, 9 (8,9%) had fibrocystic, 7 (6,9%) had cryptogenic, 5 (4,9%) had autoimmune liver disease. 90 of the patients were non cirrhotic. 7 were Child A and 4 were Child B type cirrhotic patients. Mean life quality total score of CLD patients and their parents were 38,6±18,9 and 35,4±14,2 consecutively. Mean life quality total score of healthy children and their parents were 55,4±14,3 and 54,0±16,9 consecutively. Mean life quality total score of CLD patients who started medication within the study was 33,6±8,9 at the beginning. After 6 months of therapy mean life quality total score was 38,0±10,8. Mean life quality total score of CLD patients who were followed up with only health advice was 38,6±18,9 at the beginning. After six months it was 38,8±10,2 among non cirrhotic patients, 27,8±10,8 among Child grade A patients and 25,6±10,4 among Child Grade B patients.As a result of this study; in comparison to healthy children and their parents, children with CLD and their families perceive their health related life quality. CLD influence psychosocial health of patients especially over 10 years of age. The quality of life decreases with the existence and progression of cirrhosis. Drug therapy of six months rehabilitates the quality of life.Key words: Children, chronic liver disease, life quality measure for children. 84
- Published
- 2011
9. Mutations In Vipar Cause An Arthrogryposis, Renal Dysfunction And Cholestasis Syndrome Phenotype With Defects In Epithelial Polarization
- Author
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Tanju Başarir Özkan, Figen Gürakan, Andreas Zaucker, Ferenc Müller, Randolph P. Matthews, Hanna Mandel, Steve G. Thomas, Jurica Vuković, Hartwig Wolburg, A.S. Knisely, Eda Utine, Andrew R. Cullinane, Fatimah Rahman, Irwin M. Arias, Paul Gissen, Jonas Denecke, Maja Di Rocco, Joshua Z. Rappoport, Guanmei Luo, Yoshiyuki Wakabayashi, Christopher K. Bruce, Deirdre Kelly, Hakan Cangul, Eamonn R. Maher, Anna Straatman-Iwanowska, Çocuk Sağlığı ve Hastalıkları, Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Genetik Anabilim Dalı., Özkan, Tanju Başarır, and Cangül, Hakan
- Subjects
Lymphocyte antigen ,Pathology ,Carrier proteins ,Unclassified drug ,Mouse ,Vesicular Transport Proteins ,Protein function ,VIPAR ,ARC syndrome ,epithelial polarization ,medicine.disease_cause ,Epithelium ,Biliary excretion ,Mice ,Membrane proteins ,Zebrafish ,Priority journal ,Arthrogryposis ,Genetics & Heredity ,Kidney ,Mutation ,Cholestasis ,Kidney diseases ,Arc (protein) ,Tight junction ,Plasma-membrane ,Protein interaction ,Syndrome ,Cadherins ,Phenotype ,medicine.anatomical_structure ,Cell polarity ,Gray Platelet Syndrome ,Megakaryocytes ,Blood Platelets ,Protein vipar ,medicine.symptom ,Uvomorulin ,medicine.medical_specialty ,Recycling endosomes ,Vacuole fusion ,Down regulation ,Protein degradation ,Biology ,Article ,Protein ceacam 5 ,Complex ,Genetics ,medicine ,Animals ,Humans ,Kidney dysfunction ,Animal model ,Rab11a protein ,Animal experiment ,Gene mutation ,Tight junctions ,Danio rerio ,E-cadherin ,Myosin VB ,Nonhuman ,medicine.disease ,Zebrafish proteins ,Animals, genetically modified ,Membrane protein ,Rab11 ,Arc syndrome ,Immunology ,Carcinoembryonic antigen ,Protein structure ,Rab11 protein ,Protein expression ,Cell ,Controlled study ,Intracellular trafficking - Abstract
Arthrogryposis, renal dysfunction and cholestasis syndrome (ARC) is a multisystem disorder associated with abnormalities in polarized liver and kidney cells. Mutations in VPS33B account for most cases of ARC. We identified mutations in VIPAR (also called C14ORF133) in individuals with ARC without VPS33B defects. We show that VIPAR forms a functional complex with VPS33B that interacts with RAB11A. Knockdown of vipar in zebrafish resulted in biliary excretion and E-cadherin defects similar to those in individuals with ARC. Vipar-and Vps33b-deficient mouse inner medullary collecting duct (mIMDC-3) cells expressed membrane proteins abnormally and had structural and functional tight junction defects. Abnormal Ceacam5 expression was due to mis-sorting toward lysosomal degradation, but reduced E-cadherin levels were associated with transcriptional downregulation. The VPS33B-VIPAR complex thus has diverse functions in the pathways regulating apical-basolateral polarity in the liver and kidney. Children Liver Disease Foundation Framework 6 IP EUTRACC (LSGH CT 2006037445) European Molecular Biology Organization (EMBO) (ASTF 121:2007) European Science Foundation (ESF) European Commission (2008) UK Research & Innovation (UKRI) Biotechnology and Biological Sciences Research Council (BBSRC) (BB/H002308/1) ARC syndrome association Children Living with Inherited Metabolic Diseases (CLIMB) Birmingham Children's Hospital Research Foundation (BCHRF) WellChild Wellcome Trust European Commission United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) (ZIAHD008807) United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) (R01DK035652) NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) (P30DK034928)
- Published
- 2010
10. Çocukluk çağında kronik hepatit B enfeksiyonunda mannoz bağlayan lektin gen polimorfizminin rolü
- Author
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Erdemir, Gülin, Özkan, Tanju Başarır, and Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
- Subjects
Lectins ,Hepatitis B ,Children ,Polymorphism-genetic ,Çocuk Sağlığı ve Hastalıkları ,Child Health and Diseases ,Hepatitis - Abstract
Önlenebilir kronik hastalıklar arasında kronik hepatit B önemli yer kaplamaktadır. Koruyucu hekimlik hizmetlerine rağmen çocuk ve adölesan yaş grubu gerek vertikal gerekse de horizontal olarak bulaş riskinin en çok olduğu popülasyondur. Hepatit B enfeksiyonunun seyrini etkileyen faktörler bulaş yolu, virüse ait virülans faktörleri ve konağın immün sistemidir.Mannoz bağlayan lektin kompleman sistemi lektin yolundan aktive ederek doğal bağışıklıkta rol alır. Mannoz bağlayan lektin eksikliğinin birçok enfeksiyöz ve otoimmün hastalıkla ilişkili olduğu anlaşılmıştır.Bu çalışmada çocuklarda kronik hepatit B enfeksiyonu seyrinde mannoz bağlayan lektin gen polimorfizmi ve serum düzeyinin rolü araştırılmıştır.Çalışmaya kronik hepatit B tanısı ile izlenmekte olan 2-18 yaş grubun 67 hasta alındı ve bu hastalar immuntoleran, kronik inaktif ve tedavi grubu olmak üzere üç gruba ayrılarak incelendi. Tüm hastalarda mannoz bağlayan lektin gen polimorfizmi ve serum düzeyleri çalışıldı. Hastaların klinik, laboratuar ve histopatolojik özelliklerinin ve kronik hepatit B enfeksiyonu seyrinin mannoz bağlayan lektin gen polimorfizmi ve serum düzeyi ile ilişkisi incelendi.Hastaların %8,9'unda homozigot, %11'9'unda heterozigot kodon 54 mutasyonu saptandı ve çalışma grubunda MBL mutasyon sıklığı toplum ortalamasına göre fazla bulundu. Serum MBL düzeyleri mutasyon varlığı ile ters korelasyon göstermekteydi. Kodon 54 mutasyonu sıklığı ve serum MBL düzeyi gruplar arasında farklılık göstermedi, ayrıca tedaviye yanıtlı ve yanıtsız hastalar arasında da farklı değildi. İstatistiksel anlam taşımamakla birlikte MBL serum düzeyi düşük olan hastalarda karaciğer histolojik aktivitesinin daha fazla olduğu görüldü.Sonuç olarak, MBL genindeki kodon 54 polimorfizmi kronik hepatit B tanılı çocuk hastalarda ortalamanın üzerinde bir sıklıkta görülmektedir. Bu mutasyonun hastalığın kronikleşmesine zemin oluşturduğu ancak kronikleşmiş hastalığın çocukluk yaş grubundaki progresine etkisi bulunmadığı görülmüştür. Although chronic hepatitis B is a preventable infectious disease, it is still an important health problem. Vertical and horizontal ways are the main transmission routes for children and adolescents. The progression of hepatitis B infection depends on transmission route, virulence factors of the virus and immune system of the host.Mannose binding lectin is a member of innate immune system and activates complement system through lectin pathway. Mannose binding lectin deficiency is considered to be associated with infectious and autoimmune diseases.In this study the relation of mannose binding lectin gen polymorphism and serum levels with the progression of chronic hepatitis B infection in children is evaluated.The study included 67 patients between 2-18 years of age with the diagnosis of chronic hepatitis B. The patients divided into immuntolerant, chronic inactive and treatment groups according to their clinical status. Mannose binding lectin gen polymorphism and serum levels were measured in all patients and their associations with clinical, laboratory and histopathological properties were evaluated.Mannose binding lectin gen polymorphism rates were found to be higher in our patient group than general population that homozygous codon 54 mutation was found in 8.9% and heterozygous mutation was found in 11.9% of our patients. Serum mannose binding lectin levels were inversely correlated with gene polymorphism. The rate of mutation was similar in all groups and moreover it was not different in responsive and non-responsive patients in the treatment group. Lower levels of serum mannose binding lectin are found to be related with higher histological activity in liver biopsy specimens, without a statistical significance.Consequently, codon 54 mutation of mannose binding lectin gene is seen commonly in children with chronic hepatitis B infection. This mutation is considered to be a risk factor for the persistence of disease but it did not have an influence on the progression of chronic hepatitis B infection in children. 56
- Published
- 2010
11. Çocuklarda kronik hepatit B enfeksiyonun sistemik etkileri
- Author
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Erdemir, Gülin, Özkan, Tanju Başarır, and Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
- Subjects
Gastroenteroloji ,Hepatitis B virus ,Gastroenterology ,Growth disorders ,Hepatitis B ,Bone density ,Prognosis ,Children ,Çocuk Sağlığı ve Hastalıkları ,Child Health and Diseases - Abstract
Çocuklarda kronik hepatit B enfeksiyonu gerek kronik bir karaciğer inflamasyonu olması açısından özellikle büyüme geriliği, osteoporoz gibi tablolara predispozisyon yaratmakta, gerekse de tedavisinde kullanılan Interferona bağlı iştahsızlık, kilo kaybı gibi yan etkiler sonucu büyümeyi etkileyebilmektedir. Uzun sureli yaşam beklentisi olması nedeniyle çocuk yaş grubundaki kronik hastalıkların yönetimi ve bu hastalıklara bağlı sistemik komplikasyonların da önlenmesi ayrı ayrı önem taşımaktadır.Bu tez çalışmasında kronik hepatit B tanısı ile izlenen hastaların demografik, klinik ve laboratuar özellikleri ile hastalık progreslerinin incelenmesi amaçlanmıştır.Çalışmada Uludağ Üniversitesi Tıp Fakültesi, Çocuk Gastroenteroloji, Hepatoloji ve Beslenme bilim dalında kronik hepatit B tanısı ile izlenen 2-18 yaş arası 24 hastaya ait veriler retrospektif olarak incelenmiştir. Kronik hepatit B enfeksiyonun 3 farklı fazında olan 8'er hasta seçilerek immuntoleran olanlar Grup 1, kronik inaktif olanlar Grup 2 ve tedavi almış olanlar ise Grup 3 olarak tanımlanmıştır. Hastaların cinsiyet, tanı yaşı, izlem süresi, aile öyküsü, başvuru semptomları, başvuru sırasındaki serum HBV DNA, ALT düzeyleri, AFP düzeyleri, histopatolojik özellikler, tedavi dozları ve süreleri, tedaviye yanıt durumları ile ayrıca boy ve kilo Z skorları, serumdaki vitamin A, E ve D düzeyleri ve kemik mineral dansitesi Z skorları kaydedilmiştir.Farklı progresyon gösteren üç grup pediatrik kronik hepatit B hastasının kilo ve boy Z skorları arasında farklılık bulunmadı. Benzer şekilde hastaların kemik dansiteleri ve serum vitamin A, E, D düzeyleri arasında da farklılık bulunmadı.Sonuç olarak kronik hepatit B enfeksiyonu olan çocuklar gerek immuntoleran gerek inaktif taşıyıcı gerekse de aktif hepatit tablosunda olsalar da büyümeleri bozulmamaktadır, osteoporoz riski artmamıştır ve bu parametreler üstüne tedaviye bağlı olumsuz bir etki gözlenmemiştir. Chronic hepatitis B infection in childhood may be a risk factor for growth retardation as a result of hepatic inflammation, moreover the drugs used for the treatment may increase this risk with some side effects such as loss of appetite and weight loss. Children have long life expectance therefore the management and prevention of complications in chronic disease of childhood have great importance.The aim of this study is to evaluate the associations between the progression of chronic hepatitis B infection and the demographic, clinical and laboratory characteristics of patients.The study was conducted in Uludag University Medical Faculty Pediatric Gastroenterology, Hepatology and Nutrition Department and included twenty-four patients aged between 2-18 years with the diagnosis of chronic hepatitis B. the data of patients were collected retrospectively. The patient group divided into three groups according to phases of chronic hepatitis B infection and group 1 was defined as immuntolerant phase, Group 2 was defined as inactive carrier phase and group 3 included the patients with successfully treated chronic active hepatitis B.Age, gender, the age at the diagnosis, follow up period, family history, admission symptoms, serum HBV DNA, alanine aminotransferase, alpha-fetoprotein levels, liver histopathology, the dose and duration of therapy, and therapy responses were recorded. Moreover weight and height Z scores, serum vitamin A, E and D levels, and bone mineral density Z scores were recorded.The results revealed that three different progression groups did not have any difference in growth, bone mineral density and serum vitamin a, E, and D levels.Consequently, chronic hepatitis B infection in childhood does not have any unfavorable effect on growth and bone mineralization even with chronic active or chronic inactive or immuntolerant forms. 54
- Published
- 2010
12. Trace element concentrations in breast milk and sera: Relations with lactation
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Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı., Özkan, Tanju Başarır, Durmaz, Neslihan, Erdemir, Gülin, and İlçöl, Yeşim Özarda
- Subjects
Zinc ,Breast milk ,Immune system ,Iron ,Lactation period ,Anemia ,Growth - Abstract
Breast milk has unique properties; one is the variability of the compounds in ratio according to the baby’s needs for every lactation period. Iron and zinc are essential elements for life. The aim of this study is to determine Fe and Zn levels in plasma and breast milk of mothers through the first 4 months after delivery and to evaluate its relation with infants’ growth and immune system functions. The study conducted through January 2000 – April 2001 in Bursa with 27 mother-infant couples. The babies grouped into two: Group 1 (n: 16) was formed by the breast milk fed babies, and Group 2 (n: 11) included the babies fed with both breast milk and formula. Besides clinical assessment of the babies, laboratory evaluations were performed on the sera of couples and breast milk. While the comparison of Zn level in colostrum with mature and late mature breast milk demonstrated a statistical significance (p0.05). Our study affirms the suggestion for Fe supplementation for healthy, term infants beginning from 4th month regardless of nutritional model.
- Published
- 2007
13. Çocuklarda H.pylori enfeksiyonunda seroloji, tanı ve tedavi
- Author
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Uludağ Üniversitesi/Tıp Fakültesi/Pediatrik Gastroenteroloji, Hepatoloji ve Beslenme Bilim Dalı. and Özkan, Tanju Başarır
- Subjects
Helicobacter pylori ,Helikobakter pilori ,Children ,Çocuk - Abstract
H.pylori, dünya üzerinde yaygın ve sık olarak rastlanan bir enfeksiyon etkenidir. H.pylori enfeksiyonu, gelişmekte olan ülkelerde gelişmiş ülkelere göre daha sık ve daha erken yaşta görülmektedir. Bulaş şeklinin, insandan insana; oral-oral, gastrik-oral veya fekal-oral yollarla olabileceği bildirilmiştir. Enfeksiyonun aile içi bulaş ile yayıldığı, bu konuda enfekte annelerin daha çok bulaş nedeni olduğu bilinmektedir. H.pylori enfeksiyonunun saptanmasına yönelik noninvaziv ve invaziv testler ancak klinik semptomların varlığında önerilmektedir. Klinik çalışmaların sonuçlarına göre, H.pylori gastritinin çocuklarda büyük ölçüde asemptomatik kalabileceği kabul edilmiştir. Klasik klinik tablo gastritis, tekrarlayan karın ağrısı ve nonülser dispepsidir. Çocuklarda tedavi yaklaşımları net olmamakla birlikte peptik ülser ve H.pylori pozitifliği saptanan hastaların tedavi edilmesi önerilmektedir. Çocuklarda yeğlenen güncel tedavi; geniş spektrumlu ikili antibiyotik ve proton pompası inhibitörlerinin 1–2 hafta süreyle uygulanmasıdır. H. pylori is a common infectious agent. In developing countries the individuals are infected frequently in relatively younger ages. Oraloral, gastric-oral and fecal-oral transmission is established. Household contacts, particularly infected mothers are known to spread the infection. Only in symptomatic cases, invasive and noninvasive tests are recommended for diagnosis of H.pylori. Although most of the infected children remain asymptomatic, H. pylori is a well-known reason of gastritis, recurrent abdominal pain and non-ulcer dyspepsia. The optimal therapeutic approach to H. pylori infection is not clear. But current suggestions indicate that the children with peptic ulcer and H. pylori infection should receive combined antibiotic (amoxicillin+ clarithromycine) and proton pump inhibitor therapy for 1-2 weeks.
- Published
- 2007
14. Çocuklarda fonksiyonel konstipasyon
- Author
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Uludağ Üniversitesi/Tıp Fakültesi/Pediatrik Gastroenteroloji, Hepatoloji ve Beslenme Bilim Dalı. and Özkan, Tanju Başarır
- Subjects
Functional ,Fonksiyonel ,Konstipasyon ,Child ,Constipation ,Çocuk - Abstract
Fonksiyonel konstipasyon çocuk gastroenteroloji polikliniklerine başvuru nedenlerinin % 25’ ini oluşturur. Roma II kriterlerine göre süt çocuğu ve okul çocuklarında, yapısal, metabolik, endokrin hastalık olmaksızın >2 hafta, katı kıvamda dışkılama olarak tanımlanır. Konstipasyonun en sık rastlanan tipidir. Fonksiyonel fekal retansiyon ise ağır formudur. Konstipasyona yaklaşım ve tedavisinde temel prensip diyetin düzenlenmesi ve uygun dışkılama eğitiminin verilmesidir. Functional constipation accounts for 25 % of pediatric gastroenterology patients. According to Rome II criteria, functional constipation is defined as the compactness of stool more than 2 weeks in children without any metabolic or endocrinologic disorder. It is the most common form of constipation. The term functional fecal retention defines the severe form of functional constipation. The management of functional constipation is proper timing of toilet training and dietary regulation.
- Published
- 2007
15. Antiviral therapy in neonatal cholestatic cytomegalovirus hepatitis
- Author
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Reşit Mistik, Hulya Ozturk Nazlioglu, Bunyamin Dikici, Tanju Başarir Özkan, Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı Başkanlığı., Mıstık, Reşit, Özkan, Tanju Başarır, and Nazlıoğlu, Hülya Öztürk
- Subjects
Male ,Cirrhosis ,Enzyme linked immunosorbent assay ,Aminotransferase ,Cytomegalovirus ,Gastroenterology ,Biochemistry ,Serology ,Controlled clinical trial ,Disease ,Treatment outcome ,Drug safety ,Newborn hepatitis ,Ganciclovir therapy ,Intrahepatic cholestasis ,General Medicine ,gamma-Glutamyltransferase ,Liver biopsy ,Cholestatic hepatitis ,Polymerase chain reaction ,Jaundice, Neonatal ,Neonatal hepatitis ,Clinical trial ,Cytomegalovirus Infections ,Female ,medicine.symptom ,Infection ,Virus identification ,medicine.drug ,Human ,Hepatomegaly ,Research Article ,Ganciclovir ,medicine.medical_specialty ,Hepatitis, Viral, Human ,Gamma glutamyltransferase ,Clinical article ,Symptom ,Newborn jaundice ,Cholestasis, Intrahepatic ,Cytomegalovirus-Specific Hyperimmune Globulin ,Valganciclovir Prominence percentile ,Aspartate aminotransferase ,Asymptomatic ,Antiviral Agents ,Article ,Treatment duration ,Cholestasis ,Physical examination ,Internal medicine ,Virology ,Virus DNA ,medicine ,Humans ,Cytomegalic inclusion body disease ,lcsh:RC799-869 ,Antivirus agent ,Disease severity ,Transaminases ,Hepatitis ,business.industry ,Virus hepatitis ,Infant, Newborn ,Infant ,Bilirubin ,Hepatology ,medicine.disease ,Newborn ,Alkaline Phosphatase ,Drug efficacy ,Immunoglobulin M ,Hepatitis, hiral, human ,Immunoglobulin G ,Immunology ,DNA, Viral ,Alanine aminotransferase ,lcsh:Diseases of the digestive system. Gastroenterology ,business ,Gastroenterology & hepatology ,Controlled study - Abstract
dikici, bunyamin/0000-0001-7572-6525 WOS: 000245455600001 PubMed: 17355631 Background: Neonatal hepatitis refers to a heterogeneous group of disorders, caused by many factors including cytomegalovirus infection, revealing similar morphologic changes in the liver of an infant less than 3 months of age. Approximately 40% of cholestasis in infants is due to neonatal hepatitis. It may cause latent or acute cholestatic or chronic hepatitis, including cirrhosis in immunocompetant infant. Methods: Twelve infants diagnosed with neonatal cytomegalovirus hepatitis in the last one year were included in the study. Group 1 consisted of seven babies treated with ganciclovir for 21 days. Group 2 included five cases who did not receive antiviral treatment. Physical examination, biochemical, serologic and virologic tests were done for both groups at the time of diagnosis and in the third month. Results: Initial levels of total bilirubin, aminotransferases, gamma glutamyl transpeptidase, and alkaline phosphatase revealed a significant decrease after the treatment in Group 1 ( p < 0.05) when compared with Group 2. This study revealed that ganciclovir treatment is a safe and effective in cases with cholestatic hepatitis. Similarly, all the patients in the treatment group had evidence of improvement serologically and virologically, while the comparison group did not reveal any significant change( p < 0.01). Conclusion: The clinical spectrum of perinatal infection varies from an asymptomatic infection or a mild disease to a severe systemic involvement, including central nervous system. The treatment in the early period of infection improved serologic markers and cholestatic parameters significantly. Further studies will lead us to clarify the efficacy of ganciclovir treatment in the early period of cytomegalovirus hepatitis, and the preventive role of anti-viral therapy on progressive liver disease due to cholestasis and hepatitis in neonatal cytomegalovirus infection.
- Published
- 2007
16. Wilson disease in childhood
- Author
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Uludağ Üniversitesi/Tıp Fakültesi/Pediatrik Gastroenteroloji Anabilim Dalı. and Özkan, Tanju Başarır
- Subjects
Seruloplazmin ,Pediatric Seruloplasmine ,Wilson hastalığı ,Pediatrik ,Bakır ,Wilson disease - Abstract
Etyolojisi bilinmeyen karaciğer hastalığı olan her çocukta, özellikle akraba evliliği varsa Wilson hastalığı araştırılmalıdır. Erken tanı bu çocuklara en azından hastalığın ilerlemesini durdurarak yaşam şansı verecek veya normal bir yaşam sağlayacaktır. Bu çocuklarda bakırdan fakir diyetle birlikte yaşam boyu şelasyon veya çinko tedavisi gereklidir. Wilson disease should be considered in every pediatric patient with liver disease of unknown etiology. Early diagnosis and therapy prevent progression of disease and assure normal life expectancy. Lifelong copper chelation or zinc therapy with cupper deficient diet is mandatory.
- Published
- 2006
17. Antiviral therapy in neonatal cytomegalovirus hepatitis and cholestasis
- Author
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Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Gastroenteroloji Hepatoloji ve Beslenme Bilim Dalı. and Özkan, Tanju Başarır
- Subjects
Gansiklovir tedavisi ,Cholestasis ,CMV ,Ganciclovir treatment ,Neonatal hepatitis ,Neonatal hepatit ,Kolestaz - Abstract
Neonatal hepatit, değişik nedenlerle 3 aydan küçük süt çocuklarının karaciğerinde benzer morfolojik değişikliklere yol açan hastalıkların grubudur. Sitomegalovirus enfeksiyonu da neonatal hepatit nedenlerinden biridir. Kolestatik süt çocuklarının yaklaşık % 40’ının etiyolojisinde neonatal hepatit vardır. Sitomegalovirus hepatosit ve kolanjiositleri enfekte ederek çoğalır. İmmün yetersizliği olmayan süt çocuğunda da latent; akut kolestatik veya kronik hepatite yol açabilir. Özellikle ağır olgularda Gansiklovir tedavi şansı değerlendirilmelidir. Ocak 2003-Ocak 2005 arasında CMV neonatal hepatit tanısı alan 12 olguda çalışma yapıldı. Grup 1, 7 bebekten oluşup 21 gün süreyle gansiklovir tedavisi uygulandı. Grup 2, 5 bebekten oluşup antiviral tedavi almadı. Her 2 gruptan çocukların başlangıç ve 3 ay sonra fizik muayene, biyokimya, serolojik değerleri karşılaştırılarak gansiklovir tedavisinin kolestetik hepatitte uygun ve güvenilir olduğu sonucuna varıldı. Neonatal hepatitis refers to a heterogenous group of disorders that result in a some what similar morphologic change in the liver of an infant less than 3 months of age, in response to various insults, including cytomegalovirus infection. Neonatal hepatitis is responsible for approximately 40% of the cases of infants with cholestasis. Cytomegalovirus may infect and replicate in both hepatocytes and cholangiocytes. It may be cause latent or acut cholestatic or chronic hepatitis, including cirrhosis in immunocompatent infant too. It must be discussed treatment choice with ganciclovir particularly in severe cases. In our center, 12 cases with CMV neonatal hepatitis were diagnosed in betwen January 2003-January 2005. Group 1 was consisted of seven babies who were treated with ganciclovir during 21 days. Five cases who were not given antiviral treatment were described as group 2. Physical examination, biochemical tests, antiviral serology were done both groups at the time of diagnosis and repeated at the third month. This study revealed that ganciclovir treatment was safe and efficient in the cholestatic hepatitis cases.
- Published
- 2005
18. Is perihepatic lymphadenopaty a prognostic criteria for chronic hepatitis b?
- Author
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Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı., Özkan, Tanju Başarır, Sevinir, Betül, and Bolca, Naile
- Subjects
Kronik B hepatiti ,Lenf nodu ,Ultrasonografi ,Ultrasound ,Lymph node ,Chronic hepatitis B - Abstract
Kronik B Hepatiti (KBH) tanısı alan hastalarda ultrasonografik olarak saptanan perihepatik LAP’nin antiviral tedavi ile gösterdiği değişimin KBH taşıyıcıları ile karşılaştırmalı olarak araştırılması planlandı. KBH tanısı alan 39 hasta ve KBH taşıyıcısı olan 23 hastada abdominal US incelemesi “e”antijeni(Ag) serokonversiyonu sonrası eş zamanlı olarak tekrarlandı. Perihepatik LAP boyutundaki değişimin ALT düzeyi, HBe Ag varlığı, HBV-DNA negatifleşmesiyle ilişkisi araştırıldı. KBH tanısı alan 39 hastadan 22’sinde (%56) US ile perihepatik LAP saptandı. 19 hastaya interferon tedavisi uygulandı. Bu hastalardan tedaviye yanıt veren 16’sında ve spontan serokonversiyon gösteren 1 hastada lenf nodu boyutlarında anlamlı küçülme saptandı (p0.05).Perihepatik lenf nodu boyutunda küçülmenin interferon tedavisine iyi yanıtın veya viral klirensin indirekt bir göstergesi olarak kabul edilebileceği düşünüldü. The purpose of this study is to evaluate the change of perihepatic Iymph node size after antiviral therapy in a group of patients with chronic B hepatitis and to compare this data with serum ALT and HBV-DNA levels. Sixty two patients were studied; including 39 with chronic B hepatitis and 23 chronic HBV carrier. The presence of perihepatic lymph nodes was investigated using ultrasound before and after antiviral therapy and was compared with serum ALT and HBV-DNA levels as well as the presense of the Hbe antigen. Lymph nodes were detected in 22 patients with chronic B hepatitis and 5 chronic HBV carriers. Antiviral therapy was applied to 19 patients of whom the regression of lymph node size was found after response to the therapy (p0.05). A positive corelation between regression of lymph node size and reduction of in ALT levels in the patient group with chronic hepatitis B was detected. As a conculusion, it is suggested that the regression of the perihepatic lymph node size may be used as an indicator of success of antiviral therapy.
- Published
- 2005
19. Current therapeutic approaches in childhood chronic hepatitis B infection: A multicenter study
- Author
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Sema Aydogdu, Ayse Selimoglu, Rasit Vural Yagci, Tanju Başarir Özkan, Seref Targan, Erhun Kasirga, Bunyamin Dikici, Nurten Girgin, Mehmet Bosnak, Aydan Kansu, Selma Tosun, Tumay Doganci, Nur Arslan, Ayhan Gazi Kalayci, Kenan Haspolat, Funda Ozgenc, Benal Büyükgebiz, Uludağ Üniversitesi/Tıp Fakültesi., Özkan, Tanju Başarır, and Ondokuz Mayıs Üniversitesi
- Subjects
Male ,Injection ,interferon-alpha ,Gastroenterology and hepatology ,medicine.disease_cause ,Gastroenterology ,Chronic hepatitis B ,Random group ,Controlled clinical trial ,Hepatitis B e Antigens ,Treatment outcome ,Child ,Children ,Fatigue ,Chronic hepatitis ,Priority journal ,Lamivudine ,Alanine Transaminase ,Hepatitis B ,Arthralgia ,Recombinant Proteins ,Multicenter study ,Virus ,Management ,Clinical trial ,HBeAg ,Seroconversion ,Child, Preschool ,Clearance ,Drug Therapy, Combination ,Hepatitis B(e) antibody ,Female ,Viral disease ,lamivudine ,medicine.drug ,Human ,Drug megadose ,medicine.medical_specialty ,Abdominal pain ,Hepatitis B virus ,Adolescent ,Alpha2b interferon ,Weight reduction ,Alpha interferon ,Major clinical study ,Interferon alpha-2 ,Antiviral Agents ,Hepatitis B(e) antigen ,Drug Administration Schedule ,Article ,Hepatitis B, Chronic ,children ,Internal medicine ,Gastrointestinal symptom ,Virus DNA ,medicine ,Humans ,chronic hepatitis B ,Prospective study ,Interferon alfa ,therapy ,Hepatology ,business.industry ,Interferon-alpha ,Mutation ,Adefovir ,Alopecia ,Myalgia ,Monotherapy ,Drug efficacy ,Flu like syndrome ,Combination treatment ,DNA, Viral ,Immunology ,Alanine aminotransferase ,Therapy ,business ,Controlled study - Abstract
dikici, bunyamin/0000-0001-7572-6525 WOS: 000189072800002 PubMed: 14731120 Background and Aim: The aim of the present study was to compare the therapeutic efficacy of three different regimens in childhood chronic hepatitis B (CHB) infection. Methods: A total of 182 children with CHB infection were prospectively allocated to three random groups. Sixty-two patients in the first group received high-dose interferon (IFN)-alpha 2b (10 MU/m(2)) thrice/weekly alone for 6 months. In the second (n = 60) and third groups (n = 60), IFN-alpha was used for 6 months (5 MU/m(2)) thrice/weekly in combination with lamivudine (LAM) (4 mg/kg, maximum 100 mg/day) for 12 months. Lamivudine was started simultaneously with IFN in the second group, while it was started 2 months prior to IFN injections in the third group. Results: The initial mean alanine aminotransferase (ALT) values for the first, second and third groups were 109 +/- 93 IU/L, 101 +/- 64 IU/L and 92 +/- 42 IU/L, respectively (P > 0.05). At the end of the therapy, ALT values decreased to 82 +/- 111 IU/L, 38 +/- 41 IU/L and 29 +/- 16 IU/L in groups 1, 2 and 3, respectively. The mean ALT value of the first group was significantly different to the second and third groups (P = 0.046 and P = 0.002, respectively) at the end of the therapy and these differences were found to be sustained after 18 months. However, results in the second and third groups were similar (P > 0.05). There were no significant differences in HBeAg clearance and anti-HBe seroconversion at the initial stage, 12 months and 18 months between the three groups (P > 0.05). Hepatitis B virus (HBV) DNA clearance in the first group was different from the second and third groups, while the second and third groups had similar HBV DNA clearance ratios at 12 and 18 months. No significant difference was found in the complete response (normalization of ALT, clearance of HBV DNA and seroconversion of anti HBe) ratios of all groups (at 12 months: 28.8, 45.5, 35.8% and at 18 months 33.3, 49 and 34% in groups 1, 2 and 3, respectively, P > 0.05). Conclusions: Although the ALT normalization and HBV DNA clearance ratios of IFN plus LAM combination groups were better than the high-dose IFN-alpha monotherapy group, no significant difference was found in the complete response ratios of all three groups. (C) 2004 Blackwell Publishing Asia Pty Ltd.
- Published
- 2004
20. The diagnostic value of endoscopic narrow band imaging in helicobacter pylori gastritis in children.
- Author
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Özgür T, Özkan TB, Erdemir G, Özakın C, and Yerci Ö
- Subjects
- Adolescent, Biopsy methods, Breath Tests methods, Child, Child, Preschool, Endoscopy methods, Female, Gastritis microbiology, Gastritis pathology, Helicobacter Infections complications, Humans, Male, Sensitivity and Specificity, Urease analysis, Gastritis diagnosis, Helicobacter Infections diagnosis, Helicobacter Infections pathology, Helicobacter pylori pathogenicity, Narrow Band Imaging methods
- Abstract
Background/aims: In this study we aimed to investigate the sensitivity and specificity of Narrow Band Imaging (NBI) in H. pylori gastritis and compare them with those of rapid urease test and urea breath test., Materials and Methods: A hundred sixty-five children who admitted to Uludag University Pediatric Gastroenterology Unit between October 2009-March 2011 with upper gastrointestinal symptoms were consecutively enrolled. During the endoscopy procedure gastric corporeal, antral and fundal images were obtained, afterwards the same areas were visualized with narrow band imaging and images were recorded again., Results: The study included 68 (41.2%) boys and 97(58.8%) girls. The mean age of the patients were 11.88±4.55. Tissue culture positivity and/or histopathological staining for H. pylori was determined in 56 (33.9%) patients (Group 1) and the other patients (n:109, 43.6%) didn't have an evidence of H. pylori infection (Group 2). Narrow band images have supported H. pylori infection in 56.4%. The sensitivity of narrow band images for determining H. pylori infection was 92.86% (95% CI 82.7-98), specificity was 62.39% (95% CI 52.6-71.5)., Conclusion: Our study is the first to show the role of NBI in diagnosing H. pylori infection in children, as well as determining the sensitivity and specificity of the technique. The specificity is low; however, we suggest that the specific mucosal view of H. pylori gastritis provided by NBI is useful for identifying the areas from which the biopsies should be taken. Moreover, by using this technique, treatment of H. pylori infection may be initiated immediately without performing rapid urease test and without waiting for histopathology report and tissue culture.
- Published
- 2015
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