Vulnerable Children and Youth Studies, Mar 20, 2017
The present study aimed to assess the acceptability of a 12-week training programme, Youth Dissem... more The present study aimed to assess the acceptability of a 12-week training programme, Youth Disseminating Life Skills Programme whose aims were to help university students acquire knowledge on and to increase sensitivity towards child abuse and neglect by adopting a qualitative methodology. The sample consisted of 13 university students who took part in the Youth Disseminating Life Skills Programme (10 female, 3 male: mean age 22 years; age range: 20-31). With the help of a general interview guide, the focus group meetings were held. Established conventions guided the analysis. Participants recounted feelings about and benefits of the Programme, and ways to improve the Programme. Feelings about the Programme included both positive (e.g. feeling hopeful) and negative feelings (e.g. feeling traumatised). Participants recounted a variety of benefits of the Programme (e.g. correcting some myths about child abuse). Participants proposed some ways whereby the Programme could be improved. Some findings could be interpreted in terms of existing literature/theory. Other findings extended the literature and could be viewed as targets for future child protection programmes.
Clinical and Experimental Pharmacology and Physiology, Nov 1, 1998
SUMMARY1. The aims of the present study were to detect changes in superoxide anion (O2−), nitric ... more SUMMARY1. The aims of the present study were to detect changes in superoxide anion (O2−), nitric oxide (NO) and other reactive oxygen species (ROS) directly by measurement of chemilumin‐escence (CL) and to investigate the role of L‐arginine, a nitric oxide synthase (NOS) substrate, and NG‐nitro‐L ‐arginine methyl ester (L‐NAME), a NOS inhibitor, together with their molecular enantiomers D‐arginine and D‐NAME, in a rat mesenteric ischaemia‐reperfusion (I/R) model.2. Seventy‐nine female Wistar albino rats were divided into eight groups. The first three groups underwent sham operation; group 1 was the control group, group 2 received L‐arginine and group 3 received L‐NAME. Ischaemia was produced in the remaining five groups by ligation of the superior mesenteric artery for 30 min followed by 60 min reperfusion. Group 4 rats were control I/R rats and groups 5‐8 received either L‐arginine, L‐NAME, D‐arginine or D‐NAME, respectively.3. Both luminol and lucigenin CL was significantly increased in I/R groups compared with sham‐operated groups. L‐Arginine significantly reduced CL measurements. D‐Arginine was also protective, but not as much as L‐arginine. Both L ‐ and D‐arginine had in vitro O2−‐scavenging potential, as tested by the xanthine‐xanthine oxidase system. NG‐Nitro‐L‐arginine methyl ester decreased lipid peroxidation values in addition to reducing CL measurements. Nitric oxide concentrations were significantly increased in I/R groups in comparison with sham‐operated groups. Peroxynitrite formation was increased by I/R. Treatment with L‐NAME was beneficial by reducing NO concentrations in the reperfused ileum.4. In our I/R model, O2−, NO and other ROS were increased. Although NOS inhibitors were effective in reducing oxidative damage, increasing NO concentrations with L‐arginine was also beneficial, presumably due to the ability of L‐arginine to inhibit phagocyte adherence and its radical scavenging potential. In fact, NO may have different effects in terms of tissue injury or protection depending on the concentration of oxygen and the haemodynamic state of the tissue.
Solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm in children that mainly occu... more Solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm in children that mainly occurs in young females. We herein report a rare case of SPT arising from the tail of the pancreas. A 13-year-old girl was admitted to our clinic with abdominal pain and anorexia. A mass was palpated on the physical examination. A 90x72 mm, encapsulated, heterogeneous mass with solid and cystic components was defined on computerized tomography (CT). Distal pancreatectomy was performed during the operation. Histopathological examination revealed that the tumor was a SPT with negative surgical margins. A six-month follow-up after surgical resection showed no evidence of recurrent disease. SPT should always be considered in the differential diagnosis in a young female with a palpable mass.
This study prospectively analysed the effect of using a dartos flap on the complication rates of ... more This study prospectively analysed the effect of using a dartos flap on the complication rates of TIPU (tubularised incised plate urethroplasty) in hypospadias repair. Patients having TIPU repair for hypospadias at our university hospital between January 2010 and August 2013 were prospectively divided into two groups. Group 1 had TIPU repair with dorsal dartos flap, whereas group 2 had flapless repair. At the end of the follow-up period (mean 23.3 m, median 20.2), complication rates were compared between two groups. There were 107 patients in each group. The overall complication rate was 9.3%. The complication rates were 12.1% in group 1 (6 glans dehiscence and 7 fistula) and 6.5% in group 2 (2 glans dehiscence and 5 fistula). The differences between complication rates and fistula were statistically insignificant (p = 0.2511 and p = 0.7710, respectively). Our prospective and randomised study found that the use of dartos flaps in hypospadias offers no statistically significant advantage over flapless repair for complication rates.
While there are many options for children with treatment refractory urinary incontinence, there i... more While there are many options for children with treatment refractory urinary incontinence, there is no single accepted method. This study's aim was to prospectively evaluate the effect of transcutaneous electrical nerve stimulation in children with urinary incontinence resistant to standard medical, urological therapy and/or biofeedback. This study was performed at a university hospital. For inclusion, patients >5 years of age first underwent evaluation with urinary ultrasonography, uroflow-electromyogram and voiding diaries. Treatment with biofeedback, alpha adrenergic blockers, anticholinergics and/or urotherapy was commenced according to uroflow-EMG and voiding diary findings. Patients with partial or no response to this standard therapy were then included in this study, performed between April 2012 and February 2014. Patients with anatomical or neurological causes for urinary incontinence were excluded. TENS was performed on S3 dermatome, every day for 3 months. Each session lasted 20 min with a frequency of 10 Hz and generated pulse of 350 μs. Intensity was determined by the child's sensitivity threshold. Medical treatment and urological therapy was continued during TENS. Uroflow parameters (voiding volume as percentage of expected bladder capacity, Qmax, Qave, flow and voiding time, postvoiding residual urine) and urinary system symptoms (presence of urinary tract infection, frequency, urge incontinence, fractionated voiding and constipation) were compared immediately before commencement and immediately after the completion of 3 months of TENS. Twenty-seven patients were included in this study (4 males, 23 females). Patients' average age was 7.2 years, 11 had overactive bladder and 16 had dysfunctional voiding. Comparison of urinary system symptoms and uroflow parameters before and after TENS are shown in Table. After 3 months of TENS; a statistically significant decrease was observed in the number of patients with frequency, urge incontinence, urinary tract infections and constipation. There was a decrease in the number of patients with fractionated voiding, although this change was not statistically significant. Similarly, for uroflow-EMG parameters; bladder capacity, Qmax, Qave and flow time increased while voiding time and PVR decreased. Changes seen in bladder capacity, Qmax and PVR were statically significant, while other changes were not. Patients' response rates after 3 months of TENS were; complete response in 70.4%, partial response in 22.2% and no response in 7.4%. This study has shown that transcutaneous electrical nerve stimulation is a promising treatment option for standard-treatment refractory children with urinary incontinence.
The authors aimed to find out the roles of free oxygen radicals, nitric oxide (NO), and endotheli... more The authors aimed to find out the roles of free oxygen radicals, nitric oxide (NO), and endothelin (ET) in caustic injury of rat esophagus. Methods: Forty-five Wistar albino rats were used to form 6 groups. The study groups are summarized as 1, sham (S; n ϭ 7); 2, sham ϩ L-arginine (SA; n ϭ 7); 3, sham ϩ L-NAME (SN; n ϭ 7); 4, injury (I; n ϭ 8); 5, injury ϩ L-arginine (IA; n ϭ 8); 6, injury ϩ L-NAME (IN; n ϭ 8). Normal saline in the sham groups and 50% NaOH in the caustic injury groups were administered to the distal esophagus. Free oxygen radicals and NO were detected by chemiluminescence from tissue samples, and they were correlated with histologic examinations. Tissue ET was measured also with immunohistochemistry. Results: The injury was verified histologically. Free oxygen radical levels were found to be increased as well as NO and ET with the caustic injury (P Ͻ .05). L-arginine caused a histologic increase in the injury that was close to statistical significance (P ϭ .08). L-NAME showed no significant effect. Conclusions: Free radicals, NO, and ET increase in the early phase of caustic esophageal injury. Understanding their early interactions during the caustic injury may help in future therapeutic strategies.
Niemann-Pick disease (NPD) is a rare, autosomal-recessively inherited lipid storage disease which... more Niemann-Pick disease (NPD) is a rare, autosomal-recessively inherited lipid storage disease which is characterized by intracellular deposition of sphingomyelin in various body tissues. The disease is heterogeneous and classified into six groups. Pulmonary parenchymal involvement may be a feature of several subtypes of NPD, including type B. Progressive pulmonary involvement in NPD type B is a major cause of morbidity and mortality. It is usually diagnosed at older ages. Only a few cases with early pulmonary involvement have been reported. In this report, a patient with NPD type B, hospitalized with the diagnosis of pneumonia at age 3 months, is presented. Following treatment for pneumonia, she continued to have persistent respiratory symptoms and became oxygen-dependent. High-resolution computed tomography of the chest revealed diffuse interstitial changes. During follow-up, the patient developed hepatosplenomegaly. Lung, liver, and bone marrow biopsies showed characteristic findings for NPD. Biochemical studies also confirmed the diagnosis, and the sphingomyelinase enzyme level of the patient was low. Unilateral lung lavage was performed in order to decrease lipid storage as a treatment modality. However, there was no clinical or radiological improvement. The patient died at age 15 months due to progressive respiratory failure. Pulmonary involvement is a rare entity in early childhood in patients with NPD type B, but should be considered in the differential diagnosis of persistent interstitial lung disease. It may cause progressive respiratory failure, but the treatment options remain limited.
In this paper a case o f hypertrophic pyloric stenosis (HPS) complicating esophageal atresia (E A... more In this paper a case o f hypertrophic pyloric stenosis (HPS) complicating esophageal atresia (E A) and tracheoesophageal fistula (TEF) is presented. Being a rare but an important anomaly, the association o f hypertrophic pyloric stenosis with esophageal atresia and tracheoesophageal fistula is discussed emphasiz ing the early diagnostic problem.
Son yıllarda elektronik oyuncak ve aletlerin kullanımının artması sonucu disk pillerin çocuklar t... more Son yıllarda elektronik oyuncak ve aletlerin kullanımının artması sonucu disk pillerin çocuklar tarafından yutulmasının sıklığında da artış olmuştur. Özofagus takılan disk pilleri erken dönemde çıkarılmadığı takdirde ciddi komplikasyonlara neden olabilmektedir. Bu makalede disk pil yutulması sonrasında trakeaözofageal fistül gelişen iki olgumuz sunularak; olguların geliş bulguları, klinik seyirleri ve fistüllerin spontan olarak kapanmalarıyla sonuçlanan konservatif tedavi tartışılmıştır.
Turkish journal of trauma & emergency surgery, 2017
Foreign body ingestion is a common problem in children. Most of these foreign bodies spontaneousl... more Foreign body ingestion is a common problem in children. Most of these foreign bodies spontaneously pass through the gastrointestinal tract. When there is a persistent foreign body in the abdomen, it is impossible to make a diagnosis without exploration. We herein present the case of a child who was admitted to our hospital with a coin trapped in Meckel's diverticulum and our laparoscopic approach in this case. The diagnosis of Meckel's diverticulum should be considered when there is a prolonged lodgment of a foreign body in the right lower quadrant, and the laparoscopic approach is the preferred choice in these cases.
Horner's Syndrome (HS), caused by the interruption of the oculosympathetic pathway, is a rare yet... more Horner's Syndrome (HS), caused by the interruption of the oculosympathetic pathway, is a rare yet morbid complication of tube thoracostomy. However, literature regarding HS secondary to tube thoracostomy is limited to case reports, with little comprehensive information available. We report two cases and review all cases from the published literature to assess the outcome of this complication. HS secondary to tube thoracostomy leaves sequelae in 45.8% of patients. Immediate removal or repositioning of the tube does not affect prognosis. Therefore, precautions must be taken to avoid this complication.
International Journal of Pediatric Otorhinolaryngology, Jul 1, 2009
Foreign body aspiration (FBA) is a serious problem in children. While bronchoscopy should be perf... more Foreign body aspiration (FBA) is a serious problem in children. While bronchoscopy should be performed in all patients with aspiration; patients without aspiration should be carefully excluded to avoid an unnecessary bronchoscopy. In this study we analyzed the details of our series, complication rates and compared the diagnostic findings between patients with an aspirated FB and those without. We also calculated the sensitivities, specificities, positive predictive values and negative predictive values of clinical history, symptoms, physical examination findings and radiological findings in patients with suspected FBA (sFBA). Finally, we evaluated the validity of our bronchoscopy indications in these patients. We reviewed the data of 207 patients who underwent rigid bronchoscopy for sFBA. We used clinical history, symptoms, physical examination and radiological findings as diagnostic findings. Complication rates in addition to these four diagnostic criteria constitute our indications for performing a rigid bronchoscopy. After excluding 15 patients with radiopaque FB or previous fiberoptic bronchoscopy, 138 of 192 patients had an aspirated foreign body. The sensitivity and specificity of clinical history, symptoms, physical examination findings and radiological findings were 90.5% and 24.1%, 97.8% and 7.4%, 96.4% and 46.3, and 71.7% and 74.1% respectively. There was only one major complication which caused moderate neurological sequelae. There was no mortality and no thoracotomy or tracheotomy requirement in this group. While symptoms, physical examination findings and clinical history had high sensitivities, radiological findings had the highest specificity. Low specificities of clinical history, symptoms and physical examination findings were due to our expanded bronchoscopy indication, which aimed to include all patients with foreign body aspiration. Our low complication rate facilitated the expansion of bronchoscopy indications, even for patients with slight clinical suspicion.
A female infant weighing 2,200 g was delivered at 34 weeks of gestation by vaginal delivery. She ... more A female infant weighing 2,200 g was delivered at 34 weeks of gestation by vaginal delivery. She presented with an irreducible mass in the left inguinal region at 32 days of age. An ultrasonography (US) was performed and an incarcerated hernia containing uterus, fallopian tube, and ovary was diagnosed preoperatively. Surgery was performed through an inguinal approach; the uterus, fallopian tube, and ovary were found in the hernia sac. High ligation and an additional repair of the internal inguinal ring were performed. Patent processus vaginalis was found during contralateral exploration and also closed. The postoperative course was uneventful. After one year of follow-up, there have been no signs of recurrence.
Vulnerable Children and Youth Studies, Mar 20, 2017
The present study aimed to assess the acceptability of a 12-week training programme, Youth Dissem... more The present study aimed to assess the acceptability of a 12-week training programme, Youth Disseminating Life Skills Programme whose aims were to help university students acquire knowledge on and to increase sensitivity towards child abuse and neglect by adopting a qualitative methodology. The sample consisted of 13 university students who took part in the Youth Disseminating Life Skills Programme (10 female, 3 male: mean age 22 years; age range: 20-31). With the help of a general interview guide, the focus group meetings were held. Established conventions guided the analysis. Participants recounted feelings about and benefits of the Programme, and ways to improve the Programme. Feelings about the Programme included both positive (e.g. feeling hopeful) and negative feelings (e.g. feeling traumatised). Participants recounted a variety of benefits of the Programme (e.g. correcting some myths about child abuse). Participants proposed some ways whereby the Programme could be improved. Some findings could be interpreted in terms of existing literature/theory. Other findings extended the literature and could be viewed as targets for future child protection programmes.
Clinical and Experimental Pharmacology and Physiology, Nov 1, 1998
SUMMARY1. The aims of the present study were to detect changes in superoxide anion (O2−), nitric ... more SUMMARY1. The aims of the present study were to detect changes in superoxide anion (O2−), nitric oxide (NO) and other reactive oxygen species (ROS) directly by measurement of chemilumin‐escence (CL) and to investigate the role of L‐arginine, a nitric oxide synthase (NOS) substrate, and NG‐nitro‐L ‐arginine methyl ester (L‐NAME), a NOS inhibitor, together with their molecular enantiomers D‐arginine and D‐NAME, in a rat mesenteric ischaemia‐reperfusion (I/R) model.2. Seventy‐nine female Wistar albino rats were divided into eight groups. The first three groups underwent sham operation; group 1 was the control group, group 2 received L‐arginine and group 3 received L‐NAME. Ischaemia was produced in the remaining five groups by ligation of the superior mesenteric artery for 30 min followed by 60 min reperfusion. Group 4 rats were control I/R rats and groups 5‐8 received either L‐arginine, L‐NAME, D‐arginine or D‐NAME, respectively.3. Both luminol and lucigenin CL was significantly increased in I/R groups compared with sham‐operated groups. L‐Arginine significantly reduced CL measurements. D‐Arginine was also protective, but not as much as L‐arginine. Both L ‐ and D‐arginine had in vitro O2−‐scavenging potential, as tested by the xanthine‐xanthine oxidase system. NG‐Nitro‐L‐arginine methyl ester decreased lipid peroxidation values in addition to reducing CL measurements. Nitric oxide concentrations were significantly increased in I/R groups in comparison with sham‐operated groups. Peroxynitrite formation was increased by I/R. Treatment with L‐NAME was beneficial by reducing NO concentrations in the reperfused ileum.4. In our I/R model, O2−, NO and other ROS were increased. Although NOS inhibitors were effective in reducing oxidative damage, increasing NO concentrations with L‐arginine was also beneficial, presumably due to the ability of L‐arginine to inhibit phagocyte adherence and its radical scavenging potential. In fact, NO may have different effects in terms of tissue injury or protection depending on the concentration of oxygen and the haemodynamic state of the tissue.
Solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm in children that mainly occu... more Solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm in children that mainly occurs in young females. We herein report a rare case of SPT arising from the tail of the pancreas. A 13-year-old girl was admitted to our clinic with abdominal pain and anorexia. A mass was palpated on the physical examination. A 90x72 mm, encapsulated, heterogeneous mass with solid and cystic components was defined on computerized tomography (CT). Distal pancreatectomy was performed during the operation. Histopathological examination revealed that the tumor was a SPT with negative surgical margins. A six-month follow-up after surgical resection showed no evidence of recurrent disease. SPT should always be considered in the differential diagnosis in a young female with a palpable mass.
This study prospectively analysed the effect of using a dartos flap on the complication rates of ... more This study prospectively analysed the effect of using a dartos flap on the complication rates of TIPU (tubularised incised plate urethroplasty) in hypospadias repair. Patients having TIPU repair for hypospadias at our university hospital between January 2010 and August 2013 were prospectively divided into two groups. Group 1 had TIPU repair with dorsal dartos flap, whereas group 2 had flapless repair. At the end of the follow-up period (mean 23.3 m, median 20.2), complication rates were compared between two groups. There were 107 patients in each group. The overall complication rate was 9.3%. The complication rates were 12.1% in group 1 (6 glans dehiscence and 7 fistula) and 6.5% in group 2 (2 glans dehiscence and 5 fistula). The differences between complication rates and fistula were statistically insignificant (p = 0.2511 and p = 0.7710, respectively). Our prospective and randomised study found that the use of dartos flaps in hypospadias offers no statistically significant advantage over flapless repair for complication rates.
While there are many options for children with treatment refractory urinary incontinence, there i... more While there are many options for children with treatment refractory urinary incontinence, there is no single accepted method. This study's aim was to prospectively evaluate the effect of transcutaneous electrical nerve stimulation in children with urinary incontinence resistant to standard medical, urological therapy and/or biofeedback. This study was performed at a university hospital. For inclusion, patients >5 years of age first underwent evaluation with urinary ultrasonography, uroflow-electromyogram and voiding diaries. Treatment with biofeedback, alpha adrenergic blockers, anticholinergics and/or urotherapy was commenced according to uroflow-EMG and voiding diary findings. Patients with partial or no response to this standard therapy were then included in this study, performed between April 2012 and February 2014. Patients with anatomical or neurological causes for urinary incontinence were excluded. TENS was performed on S3 dermatome, every day for 3 months. Each session lasted 20 min with a frequency of 10 Hz and generated pulse of 350 μs. Intensity was determined by the child's sensitivity threshold. Medical treatment and urological therapy was continued during TENS. Uroflow parameters (voiding volume as percentage of expected bladder capacity, Qmax, Qave, flow and voiding time, postvoiding residual urine) and urinary system symptoms (presence of urinary tract infection, frequency, urge incontinence, fractionated voiding and constipation) were compared immediately before commencement and immediately after the completion of 3 months of TENS. Twenty-seven patients were included in this study (4 males, 23 females). Patients' average age was 7.2 years, 11 had overactive bladder and 16 had dysfunctional voiding. Comparison of urinary system symptoms and uroflow parameters before and after TENS are shown in Table. After 3 months of TENS; a statistically significant decrease was observed in the number of patients with frequency, urge incontinence, urinary tract infections and constipation. There was a decrease in the number of patients with fractionated voiding, although this change was not statistically significant. Similarly, for uroflow-EMG parameters; bladder capacity, Qmax, Qave and flow time increased while voiding time and PVR decreased. Changes seen in bladder capacity, Qmax and PVR were statically significant, while other changes were not. Patients' response rates after 3 months of TENS were; complete response in 70.4%, partial response in 22.2% and no response in 7.4%. This study has shown that transcutaneous electrical nerve stimulation is a promising treatment option for standard-treatment refractory children with urinary incontinence.
The authors aimed to find out the roles of free oxygen radicals, nitric oxide (NO), and endotheli... more The authors aimed to find out the roles of free oxygen radicals, nitric oxide (NO), and endothelin (ET) in caustic injury of rat esophagus. Methods: Forty-five Wistar albino rats were used to form 6 groups. The study groups are summarized as 1, sham (S; n ϭ 7); 2, sham ϩ L-arginine (SA; n ϭ 7); 3, sham ϩ L-NAME (SN; n ϭ 7); 4, injury (I; n ϭ 8); 5, injury ϩ L-arginine (IA; n ϭ 8); 6, injury ϩ L-NAME (IN; n ϭ 8). Normal saline in the sham groups and 50% NaOH in the caustic injury groups were administered to the distal esophagus. Free oxygen radicals and NO were detected by chemiluminescence from tissue samples, and they were correlated with histologic examinations. Tissue ET was measured also with immunohistochemistry. Results: The injury was verified histologically. Free oxygen radical levels were found to be increased as well as NO and ET with the caustic injury (P Ͻ .05). L-arginine caused a histologic increase in the injury that was close to statistical significance (P ϭ .08). L-NAME showed no significant effect. Conclusions: Free radicals, NO, and ET increase in the early phase of caustic esophageal injury. Understanding their early interactions during the caustic injury may help in future therapeutic strategies.
Niemann-Pick disease (NPD) is a rare, autosomal-recessively inherited lipid storage disease which... more Niemann-Pick disease (NPD) is a rare, autosomal-recessively inherited lipid storage disease which is characterized by intracellular deposition of sphingomyelin in various body tissues. The disease is heterogeneous and classified into six groups. Pulmonary parenchymal involvement may be a feature of several subtypes of NPD, including type B. Progressive pulmonary involvement in NPD type B is a major cause of morbidity and mortality. It is usually diagnosed at older ages. Only a few cases with early pulmonary involvement have been reported. In this report, a patient with NPD type B, hospitalized with the diagnosis of pneumonia at age 3 months, is presented. Following treatment for pneumonia, she continued to have persistent respiratory symptoms and became oxygen-dependent. High-resolution computed tomography of the chest revealed diffuse interstitial changes. During follow-up, the patient developed hepatosplenomegaly. Lung, liver, and bone marrow biopsies showed characteristic findings for NPD. Biochemical studies also confirmed the diagnosis, and the sphingomyelinase enzyme level of the patient was low. Unilateral lung lavage was performed in order to decrease lipid storage as a treatment modality. However, there was no clinical or radiological improvement. The patient died at age 15 months due to progressive respiratory failure. Pulmonary involvement is a rare entity in early childhood in patients with NPD type B, but should be considered in the differential diagnosis of persistent interstitial lung disease. It may cause progressive respiratory failure, but the treatment options remain limited.
In this paper a case o f hypertrophic pyloric stenosis (HPS) complicating esophageal atresia (E A... more In this paper a case o f hypertrophic pyloric stenosis (HPS) complicating esophageal atresia (E A) and tracheoesophageal fistula (TEF) is presented. Being a rare but an important anomaly, the association o f hypertrophic pyloric stenosis with esophageal atresia and tracheoesophageal fistula is discussed emphasiz ing the early diagnostic problem.
Son yıllarda elektronik oyuncak ve aletlerin kullanımının artması sonucu disk pillerin çocuklar t... more Son yıllarda elektronik oyuncak ve aletlerin kullanımının artması sonucu disk pillerin çocuklar tarafından yutulmasının sıklığında da artış olmuştur. Özofagus takılan disk pilleri erken dönemde çıkarılmadığı takdirde ciddi komplikasyonlara neden olabilmektedir. Bu makalede disk pil yutulması sonrasında trakeaözofageal fistül gelişen iki olgumuz sunularak; olguların geliş bulguları, klinik seyirleri ve fistüllerin spontan olarak kapanmalarıyla sonuçlanan konservatif tedavi tartışılmıştır.
Turkish journal of trauma & emergency surgery, 2017
Foreign body ingestion is a common problem in children. Most of these foreign bodies spontaneousl... more Foreign body ingestion is a common problem in children. Most of these foreign bodies spontaneously pass through the gastrointestinal tract. When there is a persistent foreign body in the abdomen, it is impossible to make a diagnosis without exploration. We herein present the case of a child who was admitted to our hospital with a coin trapped in Meckel's diverticulum and our laparoscopic approach in this case. The diagnosis of Meckel's diverticulum should be considered when there is a prolonged lodgment of a foreign body in the right lower quadrant, and the laparoscopic approach is the preferred choice in these cases.
Horner's Syndrome (HS), caused by the interruption of the oculosympathetic pathway, is a rare yet... more Horner's Syndrome (HS), caused by the interruption of the oculosympathetic pathway, is a rare yet morbid complication of tube thoracostomy. However, literature regarding HS secondary to tube thoracostomy is limited to case reports, with little comprehensive information available. We report two cases and review all cases from the published literature to assess the outcome of this complication. HS secondary to tube thoracostomy leaves sequelae in 45.8% of patients. Immediate removal or repositioning of the tube does not affect prognosis. Therefore, precautions must be taken to avoid this complication.
International Journal of Pediatric Otorhinolaryngology, Jul 1, 2009
Foreign body aspiration (FBA) is a serious problem in children. While bronchoscopy should be perf... more Foreign body aspiration (FBA) is a serious problem in children. While bronchoscopy should be performed in all patients with aspiration; patients without aspiration should be carefully excluded to avoid an unnecessary bronchoscopy. In this study we analyzed the details of our series, complication rates and compared the diagnostic findings between patients with an aspirated FB and those without. We also calculated the sensitivities, specificities, positive predictive values and negative predictive values of clinical history, symptoms, physical examination findings and radiological findings in patients with suspected FBA (sFBA). Finally, we evaluated the validity of our bronchoscopy indications in these patients. We reviewed the data of 207 patients who underwent rigid bronchoscopy for sFBA. We used clinical history, symptoms, physical examination and radiological findings as diagnostic findings. Complication rates in addition to these four diagnostic criteria constitute our indications for performing a rigid bronchoscopy. After excluding 15 patients with radiopaque FB or previous fiberoptic bronchoscopy, 138 of 192 patients had an aspirated foreign body. The sensitivity and specificity of clinical history, symptoms, physical examination findings and radiological findings were 90.5% and 24.1%, 97.8% and 7.4%, 96.4% and 46.3, and 71.7% and 74.1% respectively. There was only one major complication which caused moderate neurological sequelae. There was no mortality and no thoracotomy or tracheotomy requirement in this group. While symptoms, physical examination findings and clinical history had high sensitivities, radiological findings had the highest specificity. Low specificities of clinical history, symptoms and physical examination findings were due to our expanded bronchoscopy indication, which aimed to include all patients with foreign body aspiration. Our low complication rate facilitated the expansion of bronchoscopy indications, even for patients with slight clinical suspicion.
A female infant weighing 2,200 g was delivered at 34 weeks of gestation by vaginal delivery. She ... more A female infant weighing 2,200 g was delivered at 34 weeks of gestation by vaginal delivery. She presented with an irreducible mass in the left inguinal region at 32 days of age. An ultrasonography (US) was performed and an incarcerated hernia containing uterus, fallopian tube, and ovary was diagnosed preoperatively. Surgery was performed through an inguinal approach; the uterus, fallopian tube, and ovary were found in the hernia sac. High ligation and an additional repair of the internal inguinal ring were performed. Patent processus vaginalis was found during contralateral exploration and also closed. The postoperative course was uneventful. After one year of follow-up, there have been no signs of recurrence.
A M o n i t o r i n g R e p o r t f o r C h i l d R i g h t s O r g a n i z a t i o n s Pandemics... more A M o n i t o r i n g R e p o r t f o r C h i l d R i g h t s O r g a n i z a t i o n s Pandemics and natural disasters negatively affect the ability of communities to exercise their economic, social and cultural rights and children are much more negatively affected by such extraordinary events than adults. The main purpose of this report is to identify enhancements needed in the child protection system in Turkey to ensure prioritization of children during pandemics and natural disasters and provide a bibliography and recommendations for policymakers. For this purpose, an extensive desk research was conducted. All available studies and news stories on child protection conducted and published during and after pandemics and natural disasters in the past as well as the ongoing COVID-19 outbreak was reviewed, and a very comprehensive bibliography was created. Moreover, five online meetings with experienced academics and field workers on this subject in Turkey were conducted to collect their feedback regarding problems and good practice examples related to child protection in the fields of education, health, psychology, social services and social policy during the COVID-19 process and to compile their recommendations to ensure that our child protection system can respond better to possible similar conditions in the future. Current literature on the impacts of pandemics and natural disasters on children classifies these impacts under different categories and with different causal relationships. Some studies investigate sector-based impacts, while others make result-based assessments; a group of studies also deal with the consequences of these impacts on vulnerable groups. In this study, all these classifications were analyzed and a four-level “problem tree” was created based on sectors and outcomes in the light of the publications in the bibliography and feedback from field workers.
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Papers by Tolga E Dagli