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Öğe Evaluation of the Mean Platelet Volume and Platelet Distribution width in Children with Familial Mediterranean Fever(Bursa Uludag Univ, 2020) Duksal, Fatma; Guven, Ahmet Sami; Arslan, Mesut; Dogan, Melih Timucin; Aygunes, UtkuINTRODUCTION: Platelet activation plays a key part in the process of atherosclerosis. The risk of atherosclerosis increased in familial Mediterranean fever (FMF). Mean platelet volume (MPV), platelet distribution width (PDW) and platelet counts are important in platelet activation. The aim of present study was to evaluate the relationship between the MPV, PDW, PLT counts and mutation types of FMF in children in attack free period. MATERIALS and METHODS: PLT counts, MPV, PDW, age, sex and mutation types of patients were recorded retrospectively from medical records of patients. Three hundred sixty-eight children with FMF in attack-free period and 379 healthy children were included in the study. RESULTS: MPV of the patients were lower than those of control (p<0.001). However PDW counts of the patients were higher than those of control groups (p<0.001). The PLT counts were not different between patients and control subjects (p>0.05). Of 368 patients, homozygous, heterozygous, and compound mutations were seen, respectively, in 51, 267, and 51 patients. The MPV of patients with homozygous (p=0.029) and heterozygous(p=0.041) mutations were found higher than that of patients with compound mutations. There was no difference between heterozygous and homozygous mutation in terms of MPV (p>0.05). In addition, there was no difference between heterozygous, homozygous and compound mutations in terms of PDW and PLT counts (p>0.05). The most common mutations were M694V (n=131), E148Q (n=82), M6801, (n=37), and V726A (n=32). There wasn't seen significant difference among these mutations in terms of MPV, PDW and PLT counts (p > 0.05). CONCLUSIONS: Although, atherosclerosis risk is increased in high MPV levels, we couldn't find this relationship in current study. It may be due to all the patients were under colchicine treatment. On the other hand PDW levels were found higher in patients than control group. To verify this relationship between PDW and MPV values, further investigations are needed.Öğe The Association of Birth Weight with Cardiovascular Risk Factors in Early Childhood(Gazi Univ, Fac Med, 2021) Dogan, Melih Timucin; Duksal, Fatma; Gultekin, AsimObjective: Our objective was to determine the effect of birth weight (BW) on risk factors of cardiovascular disease and body composition in early childhood. Method: This descriptive and cross-sectional study included 66 early childhood aged between 2-5 years. The study population were stratified to three categories according to birth weight group: term appropriate for gestational age (AGA) children (n=22), term small for gestational age (SGA) children (n=22), term macrosomic children (n=22). Results: There was no significant difference with regard to gender, mode of delivery. The height, head circumference, triceps skinfold thickness, chest and waist circumference in early childhood were similar in the three groups. Body mass index (BMI) were significantly higher in macrosomic group compared wtih SGA and AGA groups. The fasting glucose levels were significantly higher in SGA group and macrosomic group respectively than in AGA group. The children in SGA group had significantly higher insulin levels and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index when compared to the children in AGA and macrosomic groups. Total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, systolic and diastolic blood pressure were comparable among the study groups. Coclusion: Our study shows that insulin levels and HOMA-IR indexes were higher at early childhood in SGA group when compared to the children in AGA and macrosomic groups. There were no differences between three groups in terms of anthropometric measurements, except BMI.Öğe What Is the Safe Approach for Neonatal Hypernatremic Dehydration? A Retrospective Study From a Neonatal Intensive Care Unit(LIPPINCOTT WILLIAMS & WILKINS, 2013) Bolat, Fatih; Oflaz, Mehmet Burhan; Guven, Ahmet Sami; Ozdemir, Goktug; Alaygut, Demet; Dogan, Melih Timucin; Icagastoglu, Fusun Dilara; Cevit, Omer; Gultekin, AsimObjectives: The aims of this study were to evaluate the prevalence, complications, and mortality of hypernatremic dehydration in neonates and to compare the effect of correction rate at 48 hours on mortality and on neurological outcome in the short term. Methods: This retrospective study was conducted between January 2007 and 2011 in the neonatal intensive care unit. Term neonates were included. The wpatients were grouped as follows: group 1 = 150 to 160 mmol/L, group 2 = 161 to 170 mmol/L and group 3 = 171 to 189 mmol/L. Results: Among 4280 neonates, 81 cases (1.8%) had hypernatremic dehydration. Groups 1, 2, and 3 consisted of 55, 23, and 3 patients, respectively. Mortality rates were as follows: 3.6%, 17.3%, and 66.6%. Mean serum sodium (Na) correction rates at 0 to 24 hours and 24 to 48 hours were 0.48 +/- 0.2 versus 0.38 +/- 0.31 mmol/L per hour (group 1) and 0.49 +/- 0.21 versus 0.52 +/- 0.28 mmol/L per hour (group 2), respectively. In 32 patients (58.1%) from group 1 and in 13 patients (56.5%) from group 2, correction rate of 0.5 mmol/L per hour or less was achieved. Twenty-two patients developed convulsions, which was the most common complication during therapy. Serum Na greater than 160 mmol/L at admission (odds ratio, 1.9; 95% confidence interval, 1.3-3.7) and serum Na correction rate of greater than 0.5 mmol/L per hour (odds ratio, 4.3; 95% confidence interval, 1.2-6.5) were independent risk factors for death or convulsion. There was a significant difference between groups 1 and 2 in Denver Developmental Screening Test II results (64.1% vs 30.7 %, P = 0.001). Conclusion: Hypernatremic dehydration is an important problem that should be managed properly to avoid adverse outcomes.
