Hellenistic Ceramics from Southwestern Paphlagonia

The Hellenistic and Roman archaeology of Paphlagonia (Map 1) has been studied in a very uneven manner: the south coast of the Black Sea has hardly been touched by comparison with the century and more of sustained excavations and surveys on the other coastlines. Inevitably, the archaeological picture of these coasts in antiquity looks strangely unbalanced, even though our literary texts offer moments of insight into the Classical Antiquity of the Turkish Black Sea coast, spread across centurie..

Assesment of Upper Gastrointestinal Bleeding in the Pediatric Emergency Department

Introduction:Upper gastrointestinal bleeding is an important emergency problem that can occur at any age in childhood and requires urgent treatment for the underlying cause. Etiological causes of gastrointestinal bleeding vary by age and geographic region. In this study; we aimed to investigate the demographic characteristics, etiological causes, endoscopic intervention results, and the relationship between analgesic/antipyretic drug use and bleeding in patients admitted to the pediatric emergency department with upper gastrointestinal bleeding.Methods:The records of patients aged 1 month to 18 years who presented to our pediatric emergency department with upper gastrointestinal bleeding between January 2017 and 2019 were retrospectively reviewed. Demographic features, complaints at admission, etiological reasons, endoscopy findings, diagnoses, and antipyretic/analgesic drug use were recorded.Results:There were 108 patients presenting with upper gastrointestinal bleeding, and 53.7% of the patients were male. The mean age was 76.7±58.3 months. Hematemesis was present in 100 patients. Symptoms of the patients; vomiting was present in 82.4%, upper respiratory tract infection in 36.1%, fever in 29.6%, and abdominal pain in 25.9%. There were 52 patients with a history of antipyretic and/or analgesic drug use. An endoscopic examination was performed in 74 patients. In patients who underwent endoscopic examination; pathological changes were detected in 26 of 32 patients who used drugs and 30 of 42 patients who did not use drugs.Conclusion:In patients presenting to the pediatric emergency department with upper gastrointestinal bleeding, the bleeding is usually acute and self-limiting, but requires prompt diagnosis and treatment. Approximately half of the patients in our study had a history of antipyretic/analgesic drug use in etiology. When the endoscopic findings of drug users and non-users were compared, no statistically significant difference was observed in terms of pathological findings

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels >2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p < 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

Computed tomography in delayed diagnosis of intestinal Malrotation

İntestinal malrotasyon; intrauterin dönemde orta barsağın (midgut) rotasyonunu tamamlayamaması ve anormal yerleşimidir. Malrotasyonun klinik bulguları genellikle yeni doğan döneminde ortaya çıktığından tanı da sıklıkla bu dönemde konur. Ancak malrotasyon nadiren yenidoğan dönemi sonrasında yineleyen kusma atakları ya da kronik karın ağrısı, ishal, gelişme geriliği, gastrointestinal sistem (GİS) kanamalarıyla ortaya çıkabilir. Burada yenidoğan döneminde kusması olan ve daha sonraki yıllarda kusma atakları tekrarlayan, öncelikle intestinal obstruksiyon düşünüldüğü halde baryumlu grafileri normal olup bilgisayarlı karın tomografisi (BT) ile tanı konularak ameliyat edilen, 3.5 yaşında bir hasta sunulmuştur. Bu olgu nedeniyle kusma ataklarının etiyolojisinde malrotasyon düşünülüyorsa tanıda gerektiğinde BT nin de kullanılabileceği vurgulanmıştır.Intestinal malrotation is a disease of incomplete rotation and abnormal fixation of midgut during the intrauterin period. Intestinal malrotation is often diagnased in the newborn period because patients usually become symptomatic during this period. Rarely symptoms of recurrent vomiting attacks or atypical clinical findings may begin after the neonatal period. In this article, we presented a 3.5 year-old patient who had not been noticed in spite of the vomiting in the neonatal period and the recurrence of the attacks in following years. Although the patient had intestinal obstruction, his upper gastrointestinal series with barium were unremarkable. Abdominal computed tomography revealed the intestinal malrotation which is confirmed by the operation. In this article we emphasize that if the intestinal malrotation is in the diagnostic possibblities, abdominal tomografi can be a good diagnostic tool

Terra Sigillata and Red-Slipped Ware from Hadrianopolis in Southwestern Paphlagonia

Laflı Ergün, Kan Şahin Gülseren. Terra Sigillata and Red-Slipped Ware from Hadrianopolis in Southwestern Paphlagonia. In: Anatolia Antiqua, Tome 20, 2012. pp. 45-120