Browsing by Author "Balamtekin, Necati"
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Item Are indications and findings of upper gastrointestinal system endoscopy changing in children over the years?(Galenos Yayıncılık, 2021-09-03) Arslan, Melike; Işık, Hilal; Balamtekin, NecatiIntroduction: There are few studies of diagnostic endoscopy indications in children, despite the fact that it is a commonly performed procedure. The aim of the present study was to determine the relation between indications for upper gastrointestinal system (GIS) endoscopy and endoscopic and histopathologic findings in children in an effort to minimize unnecessary procedures. Materials and Methods: The hospital files of 501 children and adolescents 1-18 years of age who underwent diagnostic upper GIS endoscopy examinations between June 2017 and June 2020 were evaluated retrospectively. Results: The mean age of the 501 patients was 14.5±3.1 years and 311 (62.0%) were female. The most common indications for esophagogastroduodenoscopy (EGD) were epigastric pain (38.7%) and abdominal pain (29.3%) with abnormal endoscopic and histopathologic findings of 88.6% and 92.6%, respectively. The co-detection rates of endoscopic and histologic abnormalities for the esophagus, stomach, and duodenum were 71.8%, 97.6%, and 55.8%, respectively. The most commonly detected endoscopic findings were antral gastritis (66.4%), pangastritis (18.0%), bile reflux (12.6%), and duodenitis (9.4%). The most commonly detected histopathologic findings were chronic gastritis (45.3%), chronic Helicobacter pylori gastritis (37.3%), edematous gastric mucosa (5.4%), coeliac disease (4.4%), and esophagitis (4.4%). No complications were associated with the procedure itself or the required sedation. Conclusion: Diagnostic endoscopy indications may vary between countries and centers. It has been established by many studies that the rates of negative endoscopic procedures and complications associated with EGD are high; therefore, the determination of accurate indications for this procedure is important.Item Candida özofajiti ile prezente olan eozinofilik özofajitli bir çocuk hasta: olgu sunumu(Bursa Uludağ Üniversitesi, 2020-05-18) Arslan, Melike; Balamtekin, Necati; Günal, ArmağanEozinofilik özofajit, özofagus disfonksiyonu ve özofageal biyopsi örneklerinde eozinofilik inflamasyon ile karakterize klinikopatolojik bir tanıdır. Klinik bulgular yaş gruplarına göre değişmekle birlikte irritabilite, gıda reddi, büyüme geriliği, kusma, regürjitasyon, göğüs-karın ağrısı, katı gıda disfajisi ve mide yanmasını içerir. Eozinoflik özofajitli hem çocuk hem yetişkin hastalarda sıklıkla eşlik eden alerjik hastalıklar (örneğin astım, egzama, besin alerjisi, alerjik rinit) bulunur. Kandida özofajijti, özofagusun kandidiyal enfeksiyonu olup çocukluk çağında çoğunlukla immün yetmezliği olan hastalarda bildirilmektedir. İmmün yetmezliği olmayan çocuklarda çok nadir görülen bir klinik durum olup tedavi edilmeyen kronik gastroözofageal reflü hastalığı ile ilişkili olabileceği bildirilmektedir. Yedi yaşında, inek sütü protein alerjisi ile takipli, dispeptik yakınmalar ve reflü semptomları başlaması nedeniyle özofagogastroduodenoskopi yapılan ve candida özofajiti ile eozinofilik özofajit tanısı alan erkek bir hasta sunulmuştur. Özofagus mukozasının kronik hasarlanmasıyla giden hastalıklarından eozinofilik özofajit ve immün yetmezliği olmayan kişilerde genellikle sağlıksız özofagus mukozası zemininde fırsatçı enfeksiyon olarak ortaya çıkan kandida özofajiti literatürde ilk kez birlikte bildirilmişlerdir. Klinisyenlerin eozinofilik özofajitli hastalarda kandida özofajitinin de olabileceğini akılda tutmaları gerekmektedir.Publication Familial mediterranean fever mutation analysis in pediatric patients with inflammatory bowel disease: A multicenter study(Aves, 2021-03-01) Urgancı, Nafiye; Özgenç, Funda; Kuloğlu, Zarife; Yüksekkaya, Hasan; Sarı, Sinan; Erkan, Tülay; Önal, Zerrin; Caltepe, Gönul; Akçam, Mustafa; Arslan, Duran; Arslan, Nur; Artan, Reha; Aydoğan, Aysen; Balamtekin, Necati; Baran, Masallah; Baysoy, Gökhan; Çakır, Murat; Dalgıç, Buket; Doğan, Yaşar; Durmaz, Özlem; Ecevit, Çiğdem; Eren, Makbule; Gökçe, Selim; Gülerman, Fulya; Gürakan, Figen; Hızlı, Şamil; Işık, İshak; Kalaycı, Ayhan Gazi; Kansu, Aydan; Kutlu, Tufan; Karabiber, Hamza; Kasırga, Erhun; Kutluk, Günsel; Hoşnut, Ferdağ Özbay; Özen, Hasan; Özkan, Tanju; Öztuürk, Yeiim; Soylu, Özlem Bekem; Tutar, Engin; Tumgör, Gökhan; Unal, Fatih; Uğraş, Meltem; Üstündağ, Gonca; Yaman, Aytaç; ÖZKAN, TANJU MUNEVVER; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Gastroenteroloji Anabilim Dalı.; JGY-1667-2023Background: the aim of the study was to evaluate familial Mediterranean fever (FMF) mutation analysis in pediatric patients with inflammatory bowel disease (IBD). The relation between MEFV mutations and chronic inflammatory diseases hos been reported previously.Methods: Children with IBD (334 ulcerative colitis (UC), 224 Crohn's disease (CD), 39 indeterminate colitis (IC)) were tested for FMF mutations in this multicenter study. The distribution of mutations according to disease type, histopathological findings, and disease activity indexes was determined.Results: A total of 597 children (mean age: 10.8 +/- 4.6 years, M/F: 1.05) with IBD were included in the study. In this study, 41.9% of the patients had FMF mutations. E148Q was the most common mutation in UC and CD, and M694V in IC (30.5%, 34.5%, 47.1%, respectively). There was a significant difference in terms of endoscopic and histopathological findings according to mutation types (homozygous/heterozygous) in patients with UC (P <.05).There was a statistically significant difference between colonoscopy findings in patients with or without mutations (P=.031, P=.045, respectively). The patients with UC who had mutations had lower Pediatric Ulcerative Colitis Activity Index (PUCAI) scores than the patients without mutations (P=.007).Conclusion: Although FMF mutations are unrelated to CD patients, but observed in UC patients with low PUCAI scores, it was established that mutations do not hove a high impact on inflammatory response and clinical outcome of the disease.Publication The frequency of lysosomal acid lipase deficiency in children with unexplained liver disease(Lippincott, 2019-03-01) Kuloğlu, Zarife; Kansu, Aydan; Selbuz, Suna; Kalaycı, Ayhan G.; Şahin, Gülseren; Kırsaçlıoğlu, Ceyda Tuna; Demirören, Kaan; Dalgıç, Büket; Kasırga, Erhun; Önal, Zerrin; İslek, Ali; Eren, Esra; Hoşnut, Ferda Özbay; Urgancı, Nafiye; Yaman, Aytaç; Özkan, Tanju; Bozbulut, Ekşi; Doğan, Güzide; Ekşi Bozbulut, Neslihan; Doğan, Güzide; Durmaz Uğurcan, Özlem; Usta, Ayşe Merve; Arslan, Duran; Akçam, Mustafa; Isik, Ishak Abdurrahman; Ecevit, Çigdem Ömür; Usta, Yusuf; Özgür, Taner; Özçay, Figen; Balamtekin, Necati; Öztürk, Yesim; Balamtekin, Necati; Öztürk, Yeşim; Cantez, Serdar; Gülerman, Fulya; Ustundag, Gonca Handan; Emiroğlu, Halil Haldun; Karacabey, Neslihan; Comba, Atakan; Erdemir, Gülin; Aydoğan, Aysen Uncuoğlu; Gökçe, Selim; Kuyum, Pınar; Gülsan, Meltem; Tosun, Mahya Sultan; Tokgöz, Yavuz; Güven, Burcu; Yüksekkaya, Hasan; Tümgör, Gökhan; Eren, Makbule; Baran, Maşallah; Gümüş, Meltem; Canan, Oğuz; Kocamaz, Halil; Gerenli, Nelgin; Çakır, Murat; Agiı, Mehmet; Hızlı, Samil; Doğan, Yasar; Çeltik, Coşkun; Deveci, Uğur; Balcı Sezer, Oya; Natl Lal-D Study Grp; ÖZKAN, TANJU MUNEVVER; ÖZGÜR, TANER; Bursa Uludağ Üniversitesi/Tıp Fakültesi; AAG-8416-2021; AAG-8381-2021Objectives: Evidence suggests that lysosomal acid lipase deficiency (LAL-D) is often underdiagnosed because symptoms may be nonspecific. We aimed to investigate the prevalence of LAL-D in children with unexplained liver disease and to identify demographic and clinical features with a prospective, multicenter, cross-sectional study.Methods: Patients (aged 3 months-18 years) who had unexplained transaminase elevation, unexplained hepatomegaly or hepatosplenomegaly, obesity-unrelated liver steatosis, biopsy-proven cryptogenic fibrosis and cirrhosis, or liver transplantation for cryptogenic cirrhosis were enrolled. A Web-based electronic data collection system was used. LAL activity (nmol/punch/h) was measured using the dried blood spot method and classified as LAL-D(<0.02), intermediate (0.02-0.37) or normal (>0.37). Asecond dried blood spot sample was obtained from patients with intermediate LAL activity for confirmation of the result.Results: A total of 810 children (median age 5.6 years) from 795 families were enrolled. The reasons for enrollment were unexplained transaminase elevation (62%), unexplained organomegaly (45%), obesity-unrelated liver steatosis (26%), cryptogenic fibrosis and cirrhosis (6%), and liver transplantation for cryptogenic cirrhosis (<1%). LAL activity was normal in 634 (78%) and intermediate in 174 (21%) patients. LAL-D was identified in 2 siblings aged 15 and 6 years born to unrelated parents. Dyslipidemia, liver steatosis, and mild increase in aminotransferases were common features in these patients. Moreover, the 15-year-old patient showed growth failure and microvesicular steatosis, portal inflammation, and bridging fibrosis in the liver biopsy. Based on 795 families, 2 siblings in the same family were identified as LAL-D cases, making the prevalence of LAL-D in this study population, 0.1% (0.125%-0.606%). In the repeated measurement (76/174), LAL activity remained at the intermediate level in 38 patients.Conclusions: Overall, the frequency of LAL-D patients in this study (0.1%) suggests that LAL-D seems to be rare even in the selected high-risk population.