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A retrospective view of exaltation of refraction observed for many unsaturated and aromatic compounds demonstrates that this physical phenomenon is undeservedly considered only as a qualitative measure of conjugation. This mini-review discusses numerous papers by the author that have been published earlier in inaccessible periodicals and collections of scientific papers. Using a great number of illustrations, the author shows that this parameter can be successfully used for quantitative estimate of resonance effects in organic and polymer chemistry. The methods for derivation of strictly additive atomic and group refraction constants are described; these constants were subsequently used as a tool that allowed quantitative estimation of resonance effects in mono-, di-, tri- and polyalkylbenzenes, alkylnaphthalenes, some alkyl derivatives of unsaturated hydrocarbons. These effects cause strictly fixed increase in refraction of carbon atoms in different structural modifications (graphene, fullerene, diamond) and in polycyclic aromatic hydrocarbons. The relevant results regarding quantitative estimation of degree of steric inhibition of resonance in sterically hindered ortho-dialkylbenzenes, 1,2,3- trialkyl-, 1,2,3,4-tetraalkyl-, and 1,2,3,4,5-polyalkylbenzenes accumulated by the author are summarized.

WOS: 000429950700006 PubMed ID: 27543730 Background: Despite the increasing frequency of anaphylaxis, there is inadequate information on the etiology and clinical features in various countries, regions and age groups, especially in developing countries. Objective: Our aim is to assess the etiology and clinical findings of anaphylaxis in Turkey. Gathering reliable data about the etiology and clinical findings of anaphylaxis in the general population will decrease the related morbidity and mortality. Method: We obtained the names and phone numbers of individuals who had been prescribed an epinephrine auto-injector with a diagnosis of anaphylaxis from ministry of health. Demographic data, clinical history of the first episode of anaphylaxis including the triggering agent, clinical findings, course of hospitalization, and the management of anaphylaxis were obtained by phone survey. Results: A total of 843 patients with a mean age of 21.4 +/- 17.3 years were evaluated. There was a significant male predominance among children younger than 10 years of age but a female predominance in older subjects. The most common causes of anaphylaxis were foods(40.1%) in children and bee venom(60.8%) in adults. The biphasic reaction rate was 4.3% and the median length of stay at an emergency department was 4.0 hours. Almost 60% of the patients had recurrent anaphylaxis episodes. Only 10.7% of the cases were prescribed an epinephrine auto-injector at their first anaphylaxis episode and only 59.2% of the patients were referred to an allergist during discharge from the emergency department. Conclusions: In Turkey, bee venom was the most common cause of anaphylaxis, followed by food and drug. While more than a half of patients reported recurrent attacks; only 10% had been prescribed epinephrine auto-injector kit after their first episode. Strategies to improve the anaphyalxis management are therefore urgently required.

Amaç: Atopik dermatit (AD) çocukluk çağında en sık görülen inflamatuvar deri hastalığıdır. AD, atopik yürüyüşün ilk bulgusu olarak astım ve alerjik rinit olarak devam edebilir. Çalışmada polikliniğimizde AD tanısı almış olan hastalarımızın erken dönem prognozunun belirlenmesi ve gelişen alerjik hastalıklar açısından değerlendirilmesi amaçlandı.Gereç ve Yöntemler: Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim Araştırma Hastanesi Çocuk İmmünolojisi ve Alerji Hastalıkları Bölümünde Mart 2009-Ocak 2012 tarihleri arasında AD tanısı almış ve en az 2 yıl süre ile takip edilen hastalar AD bulgularının devamlılığı ve gelişen diğer alerjik hastalıklar açısından değerlendirildi.Bulgular: Çalışmaya, 104 hasta (59 erkek, 45 kız) dahil edildi. İki yıllık izlem sonunda 14 (%13.5) hastanın AD lezyonları devam ediyordu. Hastaların 14 (%13.5)’ünde alerjik rinit gelişmişti ve 16 (%15.4) hastaya astım tedavisi başlanmıştı. Atopik dermatit lezyonlarının devamlılığında besin alerjisi olması risk faktörü olarak bulundu OR (5.1) GA (1.4-18.3) (p=0,011). Astım ve/veya alerjik rinit gelişiminde parental astım varlığı (OR (6.2) (1.4-27.6) p=0,015) ve AD lezyonlarının devam ediyor olması (OR (7.2) (1.7-34.9) p=0,007) risk faktörü olarak bulundu.Sonuç: Çalışmamızda AD lezyonlarının devamlılığı ve astım/alerjik rinit gelişim sıklığı literatüre göre daha düşük bulundu. Hastaların, lezyonların devamlılığı ve gelişebilecek diğer alerjik hastalıklar açısından uzun dönem izlemi gereklidir., Objective: Atopic dermatitis (AD) is the most frequent inflammatory skin disease in childhood. Atopic dermatitis, as the first manifestation of atopic march may continue as asthma and allergic rhinitis. The aim of this study was to evaluate the early prognosis of AD in children.Material and Methods: Children who were diagnosed with AD before three years old between March 2009 and January 2012, and were followed for at least 2 years in the Pediatric Allergy Department of our tertiary hospital were enrolled in this study. Persistence of AD symptoms and development of asthma and/or allergic rhinitis were explored. Results: One hundred and four patients (59 male, 45 female) were included in the study. Atopic dermatitis persisted in 14 (13.5%) patients. Fourteen patients (13.5%) developed allergic rhinitis and 16 (15.4%) patients developed asthma. Food allergy was found to be a risk factor for persistence of AD lesions (OR (5.1) CI (1.4-18.3) (p=0.011).The presence of parental asthma (OR (6.2) (1.4-27.6) p=0,015) and persistence of AD lesions (OR (7.2) (1.7-34.9) p=0.007) were found to be risk factors for the development of asthma and/or allergic rhinitis.Conclusion: Persistence of atopic dermatitis and development of asthma and/or allergic rhinitis were significantly lower in our study group than in the literature. Long-term follow-up of patients with AD is required

Giriş: Subkütan allerjen immünoterapi, allerjik rinit ve astım tedavisinde etkili olmasına ve böcek sokmalarına karşı gelişen anafilaksileri önlemesine rağmen, lokal ve sistemik reaksiyon gelişme riski taşır. Bu çalışmanın amacı; çocuklarda subkütan allerjen immünoterapi sonrası gelişen yan etki sıklığını saptamaktır. Gereç ve Yöntem: Polen veya arı venomu ile subkütan allerjen immünoterapi uygulanan hastaların verileri standart immünoterapi kayıt formundan retrospektif olarak değerlendirildi. İmmünoterapi standart allerjen ekstreleri kullanılarak yapıldı. Sistemik reaksiyonlar Dünya Allerji Organizasyonu tarafından önerilen evreleme sistemine göre sınıflandırıldı. Enjeksiyon bölgesinde hastanın kendi avuç içinden daha büyük olan endürasyon geniş lokal reaksiyon olarak tanımlandı. Bulgular: Kırk yedi hastaya toplam 960 doz aşı uygulandı. Bu hastaların 27’sine polen, 20’sine arı venomuyla immünoterapi yapıldı. Sadece bir hastada üç sistemik reaksiyon gelişti. Sistemik reaksiyon sıklığı %0.3 olarak saptandı. Hastaların 15 (%31.9)’inde toplam 31 (%3.2) geniş lokal reaksiyon gelişti. Sonuç: Allerjik hastalıklarda subkütan allerjen immünoterapi güvenli bir tedavi modalitesi olmasına rağmen, yan etkileri nedeniyle uygun müdahale koşulları olan merkezlerde uygulanmalıdır. Objective: Although subcutaneous allergen immunotherapy is effective in treating allergic rhinitis and asthma and in preventing stinging insect anaphyla- xis, it carries risk of local and systemic reactions. The purpose of this study was to determine the frequency of adverse reactions of subcutaneous allergen immunotherapy in children. Materials and Methods: A retrospective data were examined from pediatric patients who received pollen or venom allergen subcutaneous allergen immunotherapy. Standard allergen extracts were used for immunotherapy. The severity of the systemic reactions was graded according to criteria of the World Allergy Organization. A large local reaction was defined as a local swelling greater than the size of the patient& #8217; s palm at the site of allergen injection. Results: A total of 960 injections were administered to 47 patients. Twenty seven and 20 out of 47 patients received pollen and venom immunotherapy respectively. Three systemic reactions were observed in only one patient. The frequency of systemic reactions was 0.3%. Fifteen (31.9%) patients developed a total of 31 large local reactions which correspond to 3.2% of the administered doses. Conclusion: Although subcutaneous allergen immunotherapy is a safe treatment modality of allergic diseases; it must be administrated only in centers that have appropriate emergency equipments because of side effects.

Vezir E, Beyin omurilik sıvısı (BOS) incelemesi ile tanı konulan nörometabolik hastalıklar. Hacettepe Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Uzmanlık Tezi. Ankara, 2011.Giriş: BOS rutin olan ve olmayan metabolit incelemesi ile tanı konulan hastalıklar; GLUT1 eksikliği, serin eksikliği sendromu, glisin ensefalopatisi, yenidoğan dönemi vitamin bağımlı ensefalopatileri, serebral folat eksikliği, kalıtsal nörotransmitter metabolizması bozukluklarıdır.Materyal ve Metod: Hacettepe Üniversitesi İhsan Doğramacı Cocuk Hastanesi Metabolizma Laboratuvarı Metabolik hastalıklar Tanı Tarama Merkezi?nde, Mart 2009-Eylül 2010 tarihleri arasında, BOS rutin olan ve olmayan metabolit incelemesi yapılan ve verilerine ulaşılabilen 62 hasta çalışmaya dahil edilmiş ve hastaların klinik, muayene, laboratuvar bulguları özgül tanı alan ve almayan grupta karşılaştırılmıştır.Sonuçlar: Hastaların 16?sında (25.8%) özgül tanı konulabilmiş, tanı gruplarını aromatik L-aminoasit dekarboksilaz (AADC) eksikliği (n= 4), süksinik semialdehit dehidrogenaz (SSADH) eksikliği (n= 4), dopa-duyarlı distoni (n= 3), glisin ensefalopatisi (n= 2), serin biyosentez defekti (n= 1), serebral folat eksikliği (n= 1), ve piridoksal fosfat bağımlı nöbetler (n= 1) oluşturmuştur. Tanı alan hastaların biri dışında hepsinde akrabalık mevcuttu. Tanısal BOS incelemesi ile, bulguların başlama yaşı arasında geçen süre 21.5 ay (median 0.4-111.4 ay) idi. BOS incelemesinin özgül tanıya pozitif katkısı % 25.8 idi.Akrabalık (%93.8), okülojirik kriz ve anormal göz hareketleri (%50), ve diurnal flüktuasyon (%81.8) özgül tanı alan ve almayan grupta, bu seride istatistiksel olarak farklılık gösteren değişkenler idi. Laboratuvar bulguları (EEG ve nörogörüntüleme) özgül değildi.Tartı?ma: Pediatrik kalıtsal nörotransmitter metabolizması bozukluklarının tanınması klinik bulguların oldukça heterojen olması, ideal bir tanı seti oluşturmak mümkün olmadığından güçtür. Akrabalık öyküsü, diurnal flüktuasyon, anormal göz hareketleri (okülojirik kriz) uyarıcı olup, özel tedavi seçenekleri ve genetik danışma/ prenatal tanı açısından da bu grup hastalarda BOS rutin olan ve olmayan metabolit incelemesi planlanmalıdır. Vezir E, Neurometabolic diseases diagnosed by cerebral spinal fluid (CSF) metabolite analysis. Hacettepe University Faculty of Medicine, Thesis in Pediatrics. Ankara 2011.Background: Neurometabolic diseases diagnosed by CSF examination are, GLUT1 deficiency, serine-deficiency syndromes, glycine encephalopaty, neonatal vitamin-responsive epileptic encephalopathies, cerebral folate deficiency, disorders of monoamine metabolism and ?-amino butyric acid (GABA) metabolism. There is a wide clinical spectrum of manifestations involving nervous system and psychomotor development, hormone secretion, cardiovascular, respiratory, gastrointestinal control, sleep mechanisms, body temperature and pain.Materials and Methods: We retrospectively analysed demographic, clinical, neurological findings, laboratory and neuroimaging features of 62 patients admitted to Departments of Pediatric Neurology and Metabolism, in whom CSF examination were performed for neurometabolic disorders. Patients with and without a final diagnosis were compared.Results: Among 62 patients, 16 (25.8%) had a final diagnosis, including aromatic L-amino acid decarboxylase (AADC) deficiency (n= 4), succinic semialdehyde dehydrogenase (SSADH) deficiency (n= 4), dopa-responsive dystonia (n= 3), glycine encephalopathy (n= 2), serine biosynthesis defect (n= 1), cerebral folate deficiency (n= 1), , and pyridoxal phosphate dependent seizures (n= 1). There was consanguinity in all, except one. The median age of performing a diagnostic LP and time lag between the onset of symptoms in the group having a diagnosis was 21.5 months (min : 0.4, max : 111.4). Positive yield of a diagnostic LP fort he diagnosis of inherited neurotransmitter metabolism disorder was over all 25.8%.Consanguinity (93.8%), oculogyric crisis (50%) and diurnal variation (81.8%) were the only statistically significant variables, in patients with and without a specific diagnosis. Laboratory findings (EEG and neuroimaging) were non-specificConclusions: It is challenging to diagnose neurotransmitter defects, since there is not an ideal set of clinical symptoms. Consanguinity, diurnal variation and abnormal ocular movements (oculogyric crises) are the most significant findings associated with a diagnosis of a specific neurometabolic disorder by CSF examination in our cohort. Early diagnosis is of great importance not only for specific treatments but also for genetic counseling and prenatal diagnosis. 157