Olgu sunumu: Kistik fibrosisi taklit eden çölyak hastalığı

In this report, a ten-year-old boy was presented with a history of chronic diarrhea, recurrent wheezing, recurrent respiratory infections, finger clubbing, and growth retardation. Due to bronchiectasis in the chest tomography, low gaita elastase levels, and symptoms and signs of the case, the patient was diagnosed with cystic fibrosis at first. Nevertheless, since the patient’s response to enzyme replacement therapy was poor, sweat test results detected at intermediate levels, and gene analysis of cystic fibrosis-associated mutations were not found. A further evaluation was performed for a differential diagnosis, and Celiac disease was the final diagnosis of the patient. Our paper highlighted that patients with cystic fibrosis symptoms should be evaluated further for Celiac disease, especially in cases resistant to standard cystic fibrosis treatment. Thus, Celiac disease must be kept in mind in differential diagnoses of cystic fibrosis patients resistant to therapy or in conditions in which cystic fibrosis diagnosis is not certain.Bu yazıda kronik ishal, tekrarlayan hışıltılı solunum atakları, sık solunum yolu enfeksiyonu, parmaklarda çomaklaşma ve büyüme geriliği bulunan 10 yaşında bir olgu sunulmuştur. Vakanın semptom ve bulguları, akciğer tomografisinde bronşiektazi saptanması, düşük dışkı elastaz seviyeleri nedeni ile başlangıçta kistik fiboz tanısı düşünülmüştür. Ancak, hastanın enzim replasman tedavisine yanıtının düşük olması, ter testi sonuçlarının orta düzeyde olması ve gen analizinde kistik fibroz ilişkili mutasyonların saptanmaması nedeniyle ayırıcı tanılar için ileri incelemeler yapılmış ve hastaya Çölyak hastalığı tanısı konmuştur. Makalemizde, özellikle kistik fibroz tedavisine dirençli kistik fibroz bulgu ları olan hastaların Çölyak hastalığı açısından ileri incelenmesinin gerekli liği vurgulanmıştır. Diğer bir deyişle, Çölyak hastalığı, kesin kistik fibrozis tanısı konulamayan veya enzim replasman tedavisine dirençli kistik fibroz tanılı hastalarda ayırıcı tanıda düşünülmelidir

Lactoferrin Levels in the Gastric Tissue of Helicobacter pylori-Positive and -Negative Patients and Its Effect on Anemia

Aim. To determine gastric tissue lactoferrin (Lf) levels of Helicobacter pylori- (Hp-) positive and -negative patients and its effect on anemia. Methods. Cases in which initial presentation was of abdominal pain and that were Hp-positive at endoscopy were included. Hp-positive cases and -negative controls were divided into two groups. Results. The study included 64 cases (average: 10.2 ± 0.4 years, 39 male and 25 female). Lf levels were subsequently studied on 61 cases. 45 (73.8%) of these were Hp-positive, while 16 (22.2%) were Hp-negative. In Hp-positive cases, mean staining percentages and density of glands in the antral mucosa were 45.5 ± 4.7% and 1.9 ± 0.1, respectively. Hp-negative cases showed significantly different values of 17.8 ± 4.5% and 1.3 ± 0.2, respectively. Hemoglobin and serum ferritin values of Hp-positive cases were 12.7 ± 0.2 g/dL and 32.5 ± 2 ng/mL, but these were comparable with Hp-negative cases (12.6 ± 0.1 g/dL and 30.7 ± 4.4 ng/mL). Conclusions. Tissue Lf was significantly higher in Hp-positive cases compared to Hp-negative cases, but no difference was observed between the two groups with regards to hemoglobin and ferritin level. As a result, it is difficult to say that this rise in Lf plays a role in the development of iron deficiency anemia in Hp-positive patients

Dietary glycotoxins and infant formulas

Advanced glycation end products constitute a complex group of compounds derived from the nonenzymatic glycation of proteins, lipids, and nucleic acids formed endogenously, but also from exogenous supplies such as tobacco smoking (glycotoxins). Accumulating evidence underlies the beneficial effect of the dietary restriction of glycotoxins in animal studies and also in patients with diabetic complications and metabolic diseases. Composition of infant formulas and their processing methods render an extraordinary favorable milieu for the formation of glycotoxins, and the content of glycotoxins in infant formula exceeds that of breast milk by hundred folds. Data from a limited number of short-term small studies in healthy infants do not provide direct evidence of acute negative health effects of glycotoxins in early infancy. However, the effects in sensitive groups on the state of future health in adulthood remain unclear

Dietary glycotoxins and infant formulas

Advanced glycation end products constitute a complex group of compounds derived from the nonenzymatic glycation of proteins, lipids, and nucleic acids formed endogenously, but also from exogenous supplies such as tobacco smoking (glycotoxins). Accumulating evidence underlies the beneficial effect of the dietary restriction of glycotoxins in animal studies and also in patients with diabetic complications and metabolic diseases. Composition of infant formulas and their processing methods render an extraordinary favorable milieu for the formation of glycotoxins, and the content of glycotoxins in infant formula exceeds that of breast milk by hundred folds. Data from a limited number of short-term small studies in healthy infants do not provide direct evidence of acute negative health effects of glycotoxins in early infancy. However, the effects in sensitive groups on the state of future health in adulthood remain unclear

Spirulina (Arthrospira): Kanatlı Kümes Hayvanlarında Yem Katkı Maddesi Olarak Kullanılma Potansiyeli

Spirulina platensis, which cyanobacteria, is a crucial functional food additive. Spirulina platensis which is a photosynthetic microalgae, contains high crude protein content (62-70%) as well as precious metabolites. These proteins are mainly composed of essential amino acids. In line with the manufacture's demands, poultry producers use to natural, functional additives rather than synthetic additives. Studies on poultry have shown that Spirulina is a natural and functional nutrient. It was determined that Spirulina supports growth and development, increases fertility, improves carcase colour and egg yolk colour score, provides resistance to animal against diseases, and improves product quality. In this study were presented, the nutritional values of the microalgae species Spirulina were explained and the usability of the past and current sources and poultry rations. The basis for application as a poultry (broiler and laying hens) feed supplement is discussed.Siyanobakteri olan Spirulina platensis önemli bir gıda katkı maddesidir. Fotosentetik bir mikroalg olan Spirulina platensis yüksek oranda ham protein (%62-70) içeriğine sahiptir ayrıca kıymetli sekonder metabolitleri de içerir. Yapısında bulunan proteinler ağırlıklı olarak esansiyel amino asitlerden oluşur. Kanatlı hayvan yetiştiriciliğinde tüketici talepleri doğrultusunda üreticiler sentetik katkı maddeleri yerine doğal ve fonksiyonel besin katkı maddelerine yönelmiştir. Kanatlı kümes hayvanları üzerine yapılan çalışmalarda Spirulina’ nın büyüme ve gelişmeyi desteklediği, kuluçka ve kuluçka sonrası performansı arttırdığı, yumurta sarı skoru ve ürün kalitesini iyileştirdiği, hastalıklara karşı direnç kazandırdığı dolayısıyla fonksiyonel bir yem katkı maddesi olduğu tespit edilmiştir. Bu çalışmada Spirulina mikroalginin besin değeri ve kompozisyonu açıklanarak fonksiyonelliği ve kanatlı kümes hayvanları (etlik piliç, yumurtacı tavuk ve damızlık) rasyonlarında uygulanabilirliği çalışılmıştır

Effects of Supplemented Spirulina platensis to Layer Diets on Egg Cholesterol Level and Fatty Acid Composition

Spirulina platensis tek hücreli, fotosentetik bir mikroalg türüdür. Hem insan hem de hayvan tüketimi için protein ve fonksiyonel gıda katkı maddesidir. Yapısında keşfedilen değerli fitonütrientler ve pigmentler sayesinde sağlıklı beslenme, nutrasötik ve farmasötik alanda yoğun ilgi görmüştür. %5-6 toplam lipit oranının, %1,5-2 oranında çoklu doymamış yağ asitleri içeren (PUFAs) Spirulina, toplam PUFAs değerinin %36’sı kadar ?-linoleik asit içermektedir. Ayrıca Linoleik Asit, Stearidonik Asit, Eikosapentaenoik Asit, Dodosaheksaenoik Asit, Araşidonik Asit gibi kıymetli yağ asitlerini de içermektedir. Bu çalışmada kahverengi yumurtacı tavuk (ATAK-S) yemlerine ilave edilen Spirulina ununun yumurta sarısı yağ asit kompozisyonu ve yumurta sarısı kolesterol seviyesine etkisi belirlenmiştir. 72 adet benzer canlı ağırlıkta 38 haftalık yumurtacı tavuk, her birinde 18 hayvan bulunacak şekilde 4 gruba rastgele dağıtılmıştır. Bireysel kafes sisteminde barındırılan tavuklar 8 hafta süreyle denemede tutulmuş ve %0 (Kontrol), %0,5, %1, %2 (%KM’ de) Spirulina unu içeren standart yumurtacı tavuk yemleriyle beslenmiştir. Deneme süresince 16:8 saatlik aydınlık:karanlık aydınlatma periyodu uygulanmıştır. Yem ve su ad libitum verilmiştir. Deneme sonucunda kontrol grubu ile kıyaslandığında, muamele grupları yumurta sarısı kolesterol miktarları arasındaki fark istatistiki açıdan önemsiz bulunmuştur. Yağ asidi komposizyonuna ilişkin elde edilen bulgulara göre rasyona ilave edilen Spirulina unu gruplar arasında linolenik asit miktarları üzerine etkili olmuştur.Spirulina platensis is a photosynthetic, single-cell microalgae. Microalgae could be utilized for the production of several chemicals which are either unique to the algae or found at relatively high concentrations and command a high market value. In this respect, Spirulina is one of the more promising microalgae. It is especially rich, relative to other sources, in the polyunsaturated fatty acid ?-linolenic acid (GLA) and in pigments such as phycocyanin, myxoxanthophyl and zeaxanthin. Spirulina containing 5-6% total lipid ratio, 1.5-2% polyunsaturated fatty acids (PUFAs), contains 36% of ?-linoleic acid as total PUFAs. It also contains precious fatty acids such as Linoleic Acid, Stearidonic Acid, Eicosapentaenoic Acid, Dodosahexaenoic Acid, Arachidonic Acid. The present study was conducted to evaluate whether dietary Spirulina would affect egg cholesterol level and fatty acid composition of ATAK-S. Seventy two similar weight layer hens at the 38 weeks age were randomly divided to four groups comprising 18 birds each. The hens were fed with standard layer diets containing %0, %0.5, %1, %2 Spirulina for 8 weeks. The hens were housed in individual cages. 16:8 hours light:dark photoperiod was employed. Feed and water were given ad libitum. Egg cholesterol was assessed by weekly and the fatty acid composition of the egg yolk was analyzed at the end of experimental period. The results showed that dietary supplemental Spirulina did not have significant effect on egg yolk cholesterol level, but the fatty acid composition is significant affected by the ratio of linolenic acids

COMMON VARIABLE IMMUNODEFICIENCY

Common variable immunodeficiency is the most commonly seen primary immune deficiency condition in adults, characterized by impaired B cell differentiation. The patient is diagnosed with common variable immunodeficiency by recurrent bacterial infections usually accompanied by chronic lung diseases, gastrointestinal/liver diseases, granulomatous diseases, autoimmunity, lymphoid hyperplasia, splenomegaly or malignancies. Serum IgG concentration is significantly low along with low IgA and/or IgM concentrations. Intravenous immunoglobulin (IVIG) is the first choice of treatment. Immunoglobulin treatment ameliorates recurrent infections and associated complications such as autoimmune diseases and pulmonary injury. The main cause of death in patients with common variable immunodeficiency is chronic lung diseases or malignancies, because acute bacterial infections is usually prevented by IVIG therapy

Caustic gastroesophageal lesions in childhood: An analysis of 473 cases

Ingested corrosive agents produce oropharyngeal and gastroesophageal injuries ranging from minor burns to severe necrosis, depending on the agent amount, concentration, and duration of exposure. The aim of this study was to present our patients with corrosive ingestion retrospectively. Four hundred seventy-three children younger than 16 years of age (mean age, 3.7 +/- 0.1 years) who were admitted to our hospital for suspected corrosive ingestion between the years 1995 and 2003 were studied. Two hundred eighty-six (60.5%) of 473 patients were males. Household bleaches (36.6%) and oven cleaners (23%) were the most frequently encountered corrosive agents. During endoscopy, lesions in the esophagus were recorded in 379 children. Eighty-one of the cases had gastric lesions. During the follow-up, esophageal stricture, esophageal perforation, and gastric outlet obstruction (GOO) developed in 11 cases, 1 case, and 2 cases, respectively. Caustic ingestion of alkali substances such as oven cleaner seem to cause more severe injuries. Early admission to the hospital with clinical and endoscopic evaluation and early surgery when required may reduce morbidity and mortality

Importance of the Human Leukocyte Antigen Tissue Type in Detecting Celiac Disease in Two Families

Celiac disease (CD) is strongly related to human leukocyte antigens (HLA) genes. The incidence of CD is very low in patients without the HLA-DQ2.5 and HLA-DQ8 leukocyte antigens. This study presents two families with CD and shows that the disease might be familial. The determination of HLA tissue groups is important and family screening tests may lead to early diagnose of the disease. In both of the families, the patients' siblings and fathers were asymptomatic, but diagnoses were made after family screening tests. HLA tissue typing was performed in all family members. The patients, siblings and fathers carried the HLADR3-DQA1*0501-DQB1*0201 tissue groups in both two families while this tissue group was not present in the mothers. As CD is strongly related to certain HLA groups and has a genetic predisposition, all members of a family must be screened when a case of CD is diagnosed in any family member. On the other hand, the determination of the HLA tissue type in patients with both symptoms and very positive serologic tests is important in terms of suspicion of the disease