Thrombotic Microangiopathy Associated with Pediatric Transplantation

Transplant-associated thrombotic microangiopathy is a bothersome complication in terms of morbidity and mortality after allogeneic stem cell transplantation. It is believed that the endothelial injury causes to thrombotic microangiopathy, but the pathogenesis is not known completely. Although there is a consensus about diagnostic criteria, there is no concurrence for the treatment particularly. Even though thrombotic microangiopathy is considered by transplantation physician recently, adequate prospective multi-center studies and broad serial cases are not presented yet

Kompleks parsiyel epilepsili hastalarda klinik ve psikososyal prognoz

TEZ5411Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2005.Kaynakça (s. 56-59) var.vii, 60 s. ; 29 cm.In epilepsy, knowledge of prognosis and factors contributing to prognosis are very important for physician, family and patient. Complex partial seizures have a poorer prognosis than other seizure types. Aim of this study was to evaluate prognosis of seizures, developmental and psychiatric prognosis and risk factors. At first application 1 month - 16 years old patients who were followed with the diagnosis of complex partial seizures, and regularly attended to controls, in Cukurova University Medical Faculty Pediatric Neurology Department, between years of 2001-2004 were included to the study. Age that seizures started, etiology, relationship between parents, presence of perinatal asphyxia, neonatal seizures, febrile seizures and family history of epilepsy, pretreatment frequency of seizures, treatment, presence of neuro-radiological abnormalities and abnormal neurological examination findings were evaluated as suggested risk factors which would be effective on prognosis. We found that etiology, number of antiepileptic drugs and presence of mental retardation were effective on control of seizures (p0.05). Mental retardasyon varlığı üzerine, etyoloji, nöbetin kontrol altında olması ve kullanılan ilaç sayısının etkili olduğu (p0.05). Psikiyatrik prognoz üzerine, sadece etyolojinin etkili olduğu (p0.05). Sonuç olarak, özellikle semptomatik etyolojiye sahip ve birden fazla ilaç kullanan hastalarda prognozun kötü olduğu, bu hastaların takibinde daha erken dönemde dikkate alınarak alternatif tedavi yöntemlerine başvurulması gerektiği vurgulandı

Allojenik kök hücre nakli yapılan malign ve nonmalign hastalığa sahip çocuklarda transplant ilişkili trombotik mikroanjiopati

TEZ7067Tez (Yandal Uzmanlık) -- Çukurova Üniversitesi, Adana, 2008.Kaynakça (s.57-65) var.viii, 66 s. : res. ; 29 cm.Purpose: Transplant-associated thrombotic microangiopathy is a bothersome complication in terms of morbidity and mortality after allogeneic stem cell transplantation. It is believed that the endothelial injury causes to thrombotic microangiopathy, but the pathogenesis is not known completely. Although there is a consensus about diagnostic criteria, there is no concurrence for the treatment particularly. Even though thrombotic microangiopathy is considered by transplantation physician recently, adequate prospective multi-center studies and broad serial cases are not presented yet. We aimed to report transplant-associated thrombotic microangiopathy insidence, mortality rates and risk factors prospectively between January 2006 and June 2008 in Çukurova and Hacettepe University pediatric stem cell transplantation units. Material and Methods: Fifty transplantation cases were included in our study. Patients? data were analysed retrospectively. Peripheral blood and bone marrow were used as a source of stem cell. The Diagnosis of transplant-associated thrombotic microangiopathy was done according to the reports of International Working Group in 2007.Amaç: Transplant ili?kili trombotik mikroanjiopati, hematopoetik kök hücre nakli sonrası morbidite ve mortalite açısından oldukça can sıkıcı bir komplikasyon olarak kar?ımıza çıkmaktadır. Olayı endotel hasarının ba?lattığına inanılmakla birlikte patogenez tam olarak bilinmemektedir. 2007 yılında tanı kriterleri açısından fikir birliği sağlanmasına rağmen, özellikle tedavi konusunda henüz bir fikir birliği bulunmamaktadır. Son yıllarda transplant hekimleri tarafından bu klinik komplikasyon daha fazla akıllara gelmekle birlikte, henüz yeterli prospektif, çok merkezli ve geni? olgu serilerinin yer aldığı çalı?malar bulunmamaktadır. Bu amaçla bizde öncelikle geriye dönük olarak, Ocak 2006 - Haziran 2008 yılları arasında, Çukurova Üniversitesi ve Hacettepe Üniversitesi Çocuk Kök Hücre Nakil Ünitelerindeki, transplant ili?kili trombotik mikroanjiopati sıklığını, mortalite oranlarını ve risk faktörlerini saptamayı amaçladık. Gereç ve Yöntem: Çalı?maya toplam 50 transplantasyon olgusu alındı. Olguların dosyaları geriye dönük olarak incelendi. Kök hücre kaynağı olarak periferik kan ve kemik iliği kullanıldı. Transplant ili?kili trombotik mikroanjiopati tanısı 2007 yılında, Uluslar arası Çalı?ma Grubu?nun belirlediği tanı kriterlerine göre konuldu.Bu çalışma Ç.Ü. Bilimsel Araştırma Projeleri Birimi Tarafından Desteklenmiştir. Proje No

The risperidone-induced leukopenia and neutropenia: a case at 7 years old

WOS: 000294932500013

ÇOcukluk ÇA���Ndaki Akut Myeloid L�Semi Tedavisinde Azalt�Lm��� Doz İDarubisin Ve Parenteral Beslenme Tedavisi

Aim: Disease free survival rate for acute myeloid leukemia (AML) is still below 50% for the last 30 years. Our objective was to compare the results of two different dosages of idarubicin (12 mg/m2 versus 8 mg/m2) therapy for newly diagnosed AML patients. Method: Sixty eight patients with AML were treated between February, 1998 and January, 2005. We designed two therapy groups comprising of 12 mg/m2/day idarubicin therapy (group I), 8 mg/m2/day idarubicin therapy and when oral nutrition is broken, we have given parenteral nutrition (group II). Overall survival (OS), event free survival (EFS), disease free survival (DFS) data were assessed and other tests were performed when needed. Result: There were 26 patients (38.2%) in group I and 42 patients (61.8%) in group II. After the first induction therapy, 20 patients (76.9%) in group I and 36 in group II (85.7%) had CR or partial remission. After two courses of induction, treatment-related mortality (TRM) was 34.6% in group I and 7.1% in group II (p: 0.006). OS of the patients in group I/II were 44/81% for 12 months, 34/54% for 24 months, 29/48% for 36 months. EFS were 43/65% for 12 months, 34/50% for 24 months, and 29/50% for 36 months. OS and DFS rates were statistically significant but EFS rates were not, in group I and II. Conclusion: The protocol with idarubicin dose of 8 mg/m2/day has less TRM in comparison to that of 12 mg/m2/day and has better OS and EFS.Amaç: Akut myeloid lösemi (AML) hastalığı için sağkalım oranı, son 30 yıldır % 50’nin hala altındadır. Amacımız, idarubicinin iki farklı dozları ile tedavi edilen (12 mg/m2 karşı 8 mg/m2) yeni tanı AML hastalarının sonuçları karşılaştırmaktır. Metod: Altmış sekiz AML hastası Şubat 1998 ve Ocak 2005 tarihleri arasında tedavi edildi. İki tedavi grubu; idarubicin tedavisi 12 mg/m2/gün (grup I), 8 mg/m2/gün ve oral beslenme bozulduğunda parenteral beslenme verilen hastalar (grup II) olarak şekillendirildi. Genel sağkalım (OS), olaysız sağkalım (EFS), hastalıksız sağkalım (DFS) verileri değerlendirildi ve diğer testler gerektiğinde yapıldı. Bulgular: Grup I’de 26 hasta (% 38.2) ve grup II’de 42 hasta (% 61.8) vardı. İlk tedavi kürü sonrası grup I’deki hastaların 20’sinde (% 76.9), grup II’deki hastaların ise 36’sında (% 85.7) tam ya da kısmi düzelme vardı. İki kür sonra, tedaviye bağlı mortalite (TRM) grup I’de % 34.6 ve grup II’de ise % 7.1 idi (p: 0.006). OS grup I/II hastalarda 12 ay, 24 ay, 36 ay için sırasıyla % 29/48, %34/54 ve % 44/81 olduğu saptandı. EFS 12 ay, 24 ay için %34/50 için 43/65 ve% 29/50% 36 ay idi. Grup I ve II için OS ve DFS oranları istatistiksel olarak anlamlı, fakat EFS oranı için anlamlı değildi. Sonuç: İdarubisinin 8 mg/m2/gün dozu verilen protokolü, 12 mg/m2/gün doz verilen protokole göre daha az tedavi ilişkili mortalite olduğu ve OS ve EFS oranlarının daha iyi olduğu saptand

Diagnostic criteria of transplantation associated microangiopathy and treatment options: 2 cases report from Turkey

6th Meeting of the EBMT Paediatric Diseases Working Party/1st Meeting of the EBMT Paediatric Nurses -- JUN 02-04, 2008 -- Poznan, POLANDWOS: 000261232600070…European Grp Blood & Marrow Transplantat, Paediat Dis Working Part

Pseudotumor cerebri, after the withdrowal of steroid treatment

Pseudotumor cerebri or benign idiopathic intracranial hypertension is a disease characterized by increased intracranial pressure without any lesion with mass effect or hydrocephaly. In etiology beside several factors, we want to present a case with pseudotumor cerebri after steroid withdrawal because its rarely seen.Pseudotumor cerebri or benign idiopathic intracranial hypertension is a disease characterized by increased intracranial pressure without any lesion with mass effect or hydrocephaly. In etiology beside several factors, we want to present a case with pseudotumor cerebri after steroid withdrawal because its rarely seen

Transplantasyon ilişkili trombotik mikroanjiopati tanı kriterleri ve tedavi seçeneklerinin iki olgu nedeniyle gözden geçirilmesi

Transplantasyon ilişkili trombotik mikroanjiopati, hematopoetik kök hücre naklinin en ciddi komplikasyonlarındandır. Tanı kriterleri açısından fikir birliğine varılmış olmasına rağmen tedavi konusunda henüz bir uzlaşı bulunmamaktadır. Bu nedenle biz burada, hematopoetik kök hücre nakli sonrası transplantasyon ilişkili trombotik mikrianjiopati gelişen 5 ve 13 yaşındaki hastalarımızı sunarak, transplantasyon ilişkili trombotik mikroanjiopati tanı kriterleri ve tedavi seçeneklerini gözden geçirmek istedik.Transplantation associated thrombotic microangiopathy has been considered to be a severe complication of hematopoietic stem cell transplantation. Although there has been an agreement in terms of transplantation associated thrombotic microangiopathy criteria, treatment options has not been clarified yet. Therefore we want to present two patients aged 5 years and 13 years who developed transplantation associated thrombotic microangiopathy after allogenic peripheric stem cell transplantation and to discuss both diagnostic criteria and treatment options of transplantation associated thrombotic microangiopathy

The evaluation of children with monosymptomatic nocturnal enuresis for attention deficit and hyperactivity disorder

WOS: 000307300500010PubMed: 22122653Objective. Monosymptomatic nocturnal enuresis (MNE) and attention deficit and hyperactivity disorder (ADHD) are multifactorial disorders and biological, social, and psychological factors may play significant roles in the development of both. Children with enuresis display a higher prevalence of ADHD compared to the normal population. This study aimed to evaluate the relationship between MNE and ADHD. Methods. A total of 64 children between the ages of 6 and 13 years who were referred due to primary MNE, their parents, and 42 healthy control cases, were evaluated in terms of attention deficit and hyperactivity by a child psychiatrist using the DSM-IV-2000-TR diagnosic scale. Results. Of the children with enuresis, 17 had predominantly inattentive type (26.6%), nine had predominantly hyperactive-impulsive type (14.1%), and eight had combined type (12.5%). In the control group, two cases had predominantly inattentive type (4.8%), two cases had predominantly hyperactive-impulsive type (4.8%), and one had combined type (2.4%). Conclusions. The prevalence of ADHD is higher in children with MNE compared to the normal population. As attention deficit may also negatively effect the treatment of enuresis, children with MNE should be evaluated in terms of attention deficit and those with positive symptoms should be provided with psychosocial support