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Biomedical subjects

Tiraje Celkan

Publications and source records attributed to Tiraje Celkan.

12 recordsLinked to original sources

Venous and intrapericardial thrombosis: secondary to transient protein C deficiency.

We present a 2-month-old male infant with thrombosis in the superior vena cava and pericardium due to transient protein C deficiency. Protein C deficiency was related to sepsis and hepatitis-induced liver function impairment. The patient's cardiac anatomy was otherwise normal. The patient was referred to us with signs of superior vena cava syndrome. Pericardial mass was excised. Pathological examination diagnosed the mass as organized thrombus. After the operation, signs of superior vena cava syndrome totally resolved. Serial echocardiographic examinations revealed regression of thrombus in the superior vena cava. This is the first case reported in the literature with intrapericardial thrombus secondary to transient protein C deficiency.

Cardiac Surgical Procedures↗

Retinoblastoma in Turkey: survival and clinical characteristics 1981-2004.

BACKGROUND: In this study, the authors aim to describe the survival and clinical characteristics of 141 retinoblastoma cases treated at Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey, between 1981 and 2004. METHOD: The authors retrospectively analyzed the clinical records of 141 children (177 eyes) diagnosed with retinoblastoma and treated between 1981 and 2004. Information on gender, laterality, age at diagnosis, presenting signs, spread of tumor, treatment modality, survival rate, and family history were collected. RESULTS: A total of 105 cases (74.5%) were unilateral and 36 cases (25.5%) were bilateral. The mean age overall at the time of diagnosis was 25 months; in unilateral cases, 29 months; and in bilateral cases, 16 months. The most common presenting signs were leukocoria (116 cases, 82%), strabismus (14 cases, 10%) and proptosis (11 cases, 8%). A total of 28 cases had orbital extension, nine patients had central nervous system invasion, and five cases exhibited bone marrow involvement. In total, 16 patients (11%) had a family history of retinoblastoma. One case developed a secondary neoplasm. The 3 year cumulative survival rate of 141 patients was 89.69% (unilateral, 90.74%; bilateral 87.35% P = 0.9371, P > 0.05, log rank test). CONCLUSION: The study's survival rate was similar to developed countries. The success in higher survival rates is based on the authors multidisciplinary team approach done by the same group and the support of the authors' clinic and government in sponsoring the medical insurance of all patients.

Child↗

Prevalence of anemia and the risk factors among schoolchildren in Istanbul.

Anemia is a frequent manifestation and an important health problem. The aim of this study was to found the prevalence of anemia among primary schoolchildren and determine the risk factors associated with anemia. The study group was composed of 1531 students between 6 and 16 years old from 14 primary schools located in seven different regions of Istanbul. Data were collected via a questionnaire filled out by parents. For all students, a complete blood cell count detected by an automated cell counter and anemia prevalence was determined according to Dallman criteria. The overall prevalence of anemia was found to be 27.6 per cent. There was no significant relationship between the prevalence of anemia and the students' age, gender, parents' educational level and employment, and monthly family income by logistic regression analysis. Only the number of family members and malnutrition were risk factors for anemia. Today, anemia is a common problem among primary schoolchildren in Istanbul. Identification of the risk factors is essential for the prevention of anemia.

Adolescent↗

The anemia of familial Mediterranean fever disease.

The aim of this study was to evaluate the incidence of anemia detected in familial Mediterranean fever (FMF) and the effect of disease activity and colchicine therapy along with interleukins to laboratory tests, including serum transferrin receptor (TfR), in the diagnosis of anemia seen in FMF in children. After detecting anemia in 63.4% of 172 FMF patients followed up by our rheumatology outpatient polyclinics, it was decided to study 3 groups of patients: group 1, 17 newly diagnosed FMF patients; group 2, 36 FMF patients on colchicine therapy; and group 3, 17 healthy children as control for the symptom of anemia. All 3 groups of patients were investigated for their hematological parameters, iron status, including soluble transferrin receptor (sTFR) concentrations and sTFR index, and IL-6 levels. Anemia ratio was 9/17, 53%; 11/36, 31%; and 1/17, 5% in the groups 1, 2 and 3, respectively. There was a significant difference between hemoglobin (Hb) values in the first group and the second (patients who were on colchicine therapy). Furthermore, in the second group there was a significant difference between the Hb concentrations at the time of diagnosis and after colchicine therapy (p = .003). There was a positive correlation between Hb and plasma iron and transferrin saturation in group 1 and disease beginning age, iron, transferrin saturation, and erythrocyte sedimentation rate (ESR) in the second group. In the first group the anemic patients' iron and transferrin saturation were significantly lower than normal, while ferritin levels were higher. In the second group, a good correlation was found with ESR and Hb levels; the higher ESR values were detected in patients with lower Hb values. Of the anemic and nonanemic patients of the first and second groups, values for interleukin 6 and iron parameters, including sTFR, were found similar. Anemia detected in FMF patients was found related to iron status more than interleukins. Colchicine therapy had a positive effect on anemia as well as on disease activity. Resolution of symptoms of FMF occurred with correction of the anemia, if the patient ESR values also decreased on colchicine therapy.

Anemia↗

Antibody titers and immune response to diphtheria-tetanus-pertussis and measles-mumps-rubella vaccination in children treated for acute lymphoblastic leukemia.

The objective of this study was to investigate the diphtheria-tetanus-pertussis and/or measles-mumps antibody titers before and after vaccination at various time points of acute lymphoblastic leukemia (ALL) therapy and to suggest an appropriate vaccination approach for ALL patients. The authors studied 37 ALL patients and 14 healthy control subjects, divided into three groups. In group 1 (newly diagnosed patients), baseline anti-diphtheria, anti-tetanus, and anti-pertussis titers were determined. Patients in group 2 (on maintenance chemotherapy) and group 3 (patients not receiving therapy for 3-6 months) were vaccinated with diphtheria-tetanus with or without acellular pertussis; group 3 and control subjects were also given measles-mumps-rubella vaccine. Preimmunization and 1-month postimmunization titers were drawn. Preimmunization anti-diphtheria and anti-tetanus antibody titers between the groups and the controls were statistically similar. The seropositivity rate for anti-measles antibody in group 3 was significantly lower than controls. After vaccination, all of the patients developed protective anti-diphtheria and anti-tetanus antibody titers. The seroconversion rates of group 3 and controls for anti-measles and anti-mumps antibodies were statistically similar. The results showed that patients on maintenance therapy and after cessation of therapy made good antibody responses to diphtheria and tetanus toxoids, but response to measles and mumps vaccines was not as sufficient as toxoid vaccines. Children with ALL can receive the appropriate vaccines during and after maintenance treatment.

Adolescent↗

NAD(P)H:quinone oxidoreductase 1 null genotype is not associated with pediatric de novo acute leukemia.

BACKGROUND: NAD(P)H:quinone oxidoreductase1 (NQO1) is a two-electron reductase that detoxifies quinones derived from the oxidation of phenolic metabolites of benzene. Exposure to benzene metabolites increases the risk of hematotoxicity and leukemia. NQO1 enzyme activity protects the cells against metabolites of benzene. C to T base substitution at nucleotide 609 of NQO1 cDNA (C609T) results in loss of enzyme activity. Low NQO1 activity may play a role in etiology of acute leukemia. PROCEDURE: We analyzed NQO1 C609T gene polymorphism using the PCR-RFLP method in 273 patients with de novo acute leukemia (189 acute lymphoblastic leukemia (ALL), and 84 acute myeloid leukemia (AML) and 286 healthy volunteers to investigate the role of NQO1 polymorphism in the etiology of acute leukemia. RESULTS AND CONCLUSIONS: The frequency of homozygosity for NOQ1 C609T polymorphism was 3.5% in the healthy control population and 2.5% in pediatric acute leukemia. The NQO1 C609T allele frequency was not statistically different in the children with acute leukemia in comparison to the controls (odds ratio (OR), 0.76; 95% confidence interval (CI), 0.58-1.01; P = 0.06). The distribution of NQO1 genotypes among children with acute leukemia was not statistically different from the control group (P = 0.13). These findings do not support the role of NQO1 C609T polymorphism in the etiology of de novo pediatric acute leukemia.

Acute Disease↗

Bacteremia in childhood cancer.

Infection-related mortality affects the overall survival rates of children who are receiving treatment for cancer. The leading cause of mortality is bacteremia and sepsis related to it in febrile neutropenic patients. All positive blood cultures of febrile neutropenic patients treated in the Department of Pediatric Hematology-Oncology, Cerrahpasa Medical School, between January 1995 and January 2001 were reviewed. Cultures grew 159 micro-organisms, 95 (60 per cent) of which were Gram-positive bacteria, 56 (35 per cent) were Gram-negative bacteria and eight (5 per cent) were fungi. Coagulase-negative staphylococci (63, 40 per cent) and S. aureus (8, 5 per cent) were the most frequent Gram-positive pathogens. Klebsiella, E. coli, Enterobacter and Pseudomonas infections were the primary Gram-negative pathogens. Twenty cases were lost because of sepsis: in 11 cases (55 per cent) Gram-negative bacteria, in eight cases (40 per cent) Gram-positive bacteria, and in only one case a fungus were the causative organisms. Although vancomycin was not included in the first-line treatment, the mortality rate of Gram-positive bacteremia was 8 per cent. In Gram-negative bacteremia it was 20 per cent. Gram-negative pathogens, which were resistant to multiple antibiotics, caused the mortality. Drug resistance and mortality due to micro-organisms must be taken into consideration while febrile neutropenia protocols are prepared.

Adolescent↗

Radiological features in paediatric primary gastric MALT lymphoma and association with Helicobacter pylori.

Primary malignant tumours of the stomach are very rare in children, most being lymphomas and sarcomas. The majority of primary gastric lymphomas are high-grade non-Hodgkin's lymphomas and are of B-cell origin. However, a significant number are low-grade B-cell lymphomas that are derived from mucosa-associated lymphoid tissue (MALT) that is not found in the normal stomach. Helicobacter pylori infection predisposes to the development of MALT in the stomach and provides the pathogenic background for MALT-type lymphomagenesis. To our knowledge, only eight paediatric cases of primary gastric lymphoma have been described. The diagnosis and follow-up of gastric lymphoma are mainly made by endoscopy. Nevertheless, radiologists must be aware of this disease because it may be observed on radiological examinations that are performed for non-specific upper digestive symptoms in children.

Adolescent↗

Anemic or not?

Laboratory data obtained from blood analysis by an electronic cell counter is a routine test along with physical evaluation. We assessed the hematological characteristics of schoolchildren to establish the prevalence of anemia in Istanbul. The study was performed on 1,600 students between the ages of 6-16. Hematological parameters of all the students were measured by an electronic cell counter on blood taken intravenously. Anemia prevalence was primarily determined according to Dallman's criteria. The results showed that if hemoglobin (Hb) was used as the primary criterion to define anemia, 423 students (27.6%) were found anemic; if hematocrit (Hct) was used, 625 students (40.8%) were found anemic and if mean corpuscular volume (MCV) was taken as a criterion to define microcytosis, 121 students (7.9%) remained below the normal level. The difference of anemia prevalence was high (p < 0.001) when two evaluation criteria (Hb or Hct) were compared. Furthermore it is known that a 3% difference occurs when automated and spun Hct values are compared. When a correction was made by adding this 3% to our series' Hct values, the anemic students' number decreased to 418 and the ratio became 27.3%, quite similar to Hb criterion ratio. Population based screening surveys for anemia must be designed and compared cautiously taking into account the method used (electronic counters or gravity based centrifuges), otherwise misleading results can be achieved. We evaluated the data of the survey according to different cut-off values and tried to select the proper one for our conditions.

Adolescent↗