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Clinical significance of low transaminase levels in children with inflammatory bowel disease

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World Journal of Pediatrics 2019年第2期15卷 143-147页

作者： Murat Cakir elif Sag Guzide Dogan Fatih Unal Erhun kasirga Department of Pediatric Gastroenterology Hepatology and Nutrition Faculty of MedicineKaradeniz Technical UniversityTrabzonTurkey Department of Pediatric Gastroenterology Hepatology and Nutrition Faculty of MedicineManisa Celal Bayar UniversityManisaTurkey Department of Pediatric Gastroenterology Hepatology and Nutrition BursaTurkey

Background Low alanine aminotransaminase (LALT) levels may be seen in patients with inflammatory bowel disease (IBD),but there has been no study about the frequency and its clinical significance.We aimed to analyze the frequency of LALT,and its clinical significance in children with IBD.Methods The study included the 89 patients with IBD without hepatobiliary involvement.LALT was defined as ALT levels ks in 12 of the 16 patients with LALT whereas it was seen in 16 of the 73 patients without LALT during the follow-up (75 vs.21.9%,P ker of relapse and steroid dependency.

关键词： Children Inflammatory bowel disease Low transaminase levels Vitamin B6

Exploration of the shared pathophysiological mechanisms of gestational diabetes and large for gestational age offspring

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World Journal of Diabetes 2019年第6期10卷 333-340页

作者： Sofia Nahavandi Sarah Price Priya Sumithran elif Ilhan Ekinci The Royal Children’s Hospital Melbourne Parkville VIC 3052 Australia Department of Endocrinology Austin Health Repatriation Campus Heidelberg West Melbourne VIC 3081 Australia Department of Medicine Austin Health and the University of Melbourne (Austin Campus) Parkville Melbourne VIC 3084 Australia

Gestational diabetes mellitus (GDM) and large for gestational age (LGA) offspring are two common pregnancy complications. Connections also exist between the two conditions, including mutual maternal risk factors for the conditions and an increased prevalence of LGA offspring amongst pregnancies affected by GDM. Thus, it is important to elucidate potential shared underlying mechanisms of both LGA and GDM. One potential mechanistic link relates to macronutrient metabolism. Indeed, derangement of carbohydrate and lipid metabolism is present in GDM, and maternal biomarkers of glucose and lipid control are associated with LGA neonates in such pregnancies. The aim of this paper is therefore to reflect on the existing nutritional guidelines for GDM in light of our understanding of the pathophysiological mechanisms of GDM and LGA offspring. Lifestyle modification is first line treatment for GDM, and while there is some promise that nutritional interventions may favourably impact outcomes, there is a lack of definitive evidence that changing the macronutrient composition of the diet reduces the incidence of either GDM or LGA offspring. The quality of the available evidence is a major issue, and rigorous trials are needed to inform evidence-based treatment guidelines.

关键词： Gestational diabetes mellitus Large for gestational age Metabolism Biomarkers Glucose Lipids

A case of mediastinal mesenchymal tumor resembling hemopericardium

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Journal of Geriatric Cardiology 2021年第7期18卷 591-594页

作者： Aynur Acibuca Mustafa Yilmaz elif karadeli Emine Tuba Canpolat Tansel Erol Department of Cardiology Baskent University School of MedicineDr Turgut Noyan Practice and Research CenterAdanaTurkey Department of Radiology Baskent University School of MedicineDr Turgut Noyan Practice and Research CenterAdanaTurkey Department of Pathology Baskent University School of MedicineDr Turgut Noyan Practice and Research CenterAdanaTurkey

Mediastinal neoplasms are rare in the elderly,and clinical suspicion is the first and most important step of differential diagnosis.Mediastinal tumors can be misdiagnosed because their symptoms or signs can overlap with cardiovascular diseases,which have a higher prevalence among the older population.The diagnostic process should be managed with multimodality imaging and clinical judgement.Here,the case of a 74-year-old male patient,who presented with shortness of breath,is examined.A chest X-ray revealed an increased cardiothoracic ratio,and he was diagnosed with hemopericardium following an emergent chest computed tomography.In the echocardiography,it was suspected that a hyperechogenic area adjacent to the heart might be due to a mass,and further examinations confirmed a mediastinal neoplasm.A surgical biopsy was performed,and it was determined to be a mesenchymal tumor.To conclude,clinicians should keep in mind the possibility of paracardiac neoplasm in the elderly,as well as in other age groups,when encountering mediastinal widening so that the patient can be protected from unnecessary interventions such as pericardiocentesis.

关键词： neoplasms neoplasm media

Emergency department overcrowding:causes and solutions

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Emergency and Critical Care Medicine 2023年第4期3卷 171-176页

作者： Ahmet Butun elif Ece kafdag Hilal Gunduz Vedat Zincir Mehmet Batibay kubra Ciftci Dilan Demir Ramazan Bayram Elanur Yigit Department of Nursing Faculty of Health SciencesMardin Artuklu UniversityMardinTurkey

Background:Emergency department(ED)overcrowding is among the biggest and most important problems experienced by ED staff.The number of ED visits is on the increase and remains an unresolved problem.Emergency department overcrowding has become an important problem for emergency care services worldwide.There is a relationship between overcrowding and patients’negative experi-ences of using ED and therefore reporting reduced patients’satisfaction.This study aimed to identify the causes of ED overcrowding,de-termine the reasons for people’s use of EDs,and develop solutions for reducing ED overcrowding.Methods:This study used quantitative methods using a descriptive approach.The participants were patients who visited the ED.A questionnaire was administered to 296 participants between December 2021 and February 2022.The study included 5 different hospitals in Turkey.The data were analyzed using descriptive statistics.Results:This study identified the most common presenting medical problems in the ED and why patients used the ED.Reasons for using the ED included patients perceiving their condition as really urgent(62.8%),the ED being open for 24 hours(36.1%),and receiving faster care in the ED(31.4%).This study also developed recommendations for alleviating ED overcrowding.Conclusion:This study identified causes of ED overcrowding and some solutions for alleviating the issue.Emergency department over-crowding should be perceived as an international problem,and initiatives for solutions should be implemented quickly.

关键词： Attendance Causes Emergency departments Overcrowding Solutions Visits

Ocular injuries,attention deficit and hyperactivity disorder,and maternal anxiety/depression levels:Is there a link?

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Chinese Journal of Traumatology 2020年第2期23卷 71-77页

作者： Helin Yilmaz kafali elif Demirkilinc Biler Melis Palamar Burcu Ozbaran Department of Child and Adolescent Psychiatry Ankara City HospitalMinistry of HealthAnkaraTurkey Department of Ophthalmology Ege University School of MedicineIzmirTurkey Department of Child and Adolescent Psychiatry Ege University School of MedicineIzmirTurkey

Purpose:Given the increased risk of accidents in patients with attention deficit and hyperactivity dis-order(ADHD)or maternal anxiety/depression,we aimed to investigate the frequency of the two diseases in children with penetrating eye injury(PEI).Methods:Altogether 79 children,39 with PEIs and 40 healthy individuals(control group),aged 5-15 years,underwent a complete ophthalmologic examination.Afterwards,schedule for affective disorders and schizophrenia for school-aged children was conducted to assess the psychiatric diagnosis of all children.Turgay diagnostic and statistical manual of mental disorders(DSM-Ⅳ)-based child and adolescent behavior disorders screening and rating scale(T-DSM-Ⅳ-S)was flled by parents to evaluate the severity of ADHD symptoms.The depression and anxiety levels of mothers of each group were evaluated by two self-report measures:the Beck depression scale and the state-trait anxiety inventory(STAI),respectively.Data were analyzed by IBM SPSS version 22.0.The Chi-square and Fisher's exact test were used to determine whether there is a significant difference between qualitative variables while independent sample t and Mann-Whitney U tests to compare quantitative variables.Results:The only diagnostic difference was a significantly higher frequency of ADHD among patients with PEIs(48.7%in PEI vs.17.5%in control group,χ^2=7.359,p=0.007).The total scores of the T-DSM-Ⅳ-S(attention subscale U=418.000,p=0.006;hyperactivity subscale U=472.000,p=0.022)and maternal state-trait anxiety inventory(maternal STAI-state U=243.00,p=0.003;maternal STAl-trait U=298.000,p=0.021)were significantly higher in the PEI group than in control group.In logistic regression,children with PEI had a tendency to have a 3.5-fold increased risk for ADHD(OR=3.538,CI=0.960-13.039,p=0.058).Conclusion:ADHD was detected almost 1 in 2 children with PEls.Besides,the maternal anxiety level was significantly higher in the PEI group than in the control group.This association should be further explored via a future prospective longitu

关键词： Attention deficit and hyperactivity disorder Child Ocular trauma Penetrating eye injury Maternal anxiety

Prolonged QT dispersion in inflammatory bowel disease

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World Journal of Gastroenterology 2013年第1期19卷 65-71页

作者： elif Yorulmaz Aslihan Sezgin Gupse Adali Hatice Yorulmaz Hilmi Ciftci Department of Gastroenterology Goztepe Training and Research Hospital34470 IstanbulTurkey Department of Ⅲ Internal Medicine Goztepe Training and Research Hospital34470 IstanbulTurkey School of Nursing Halic University34394 IstanbulTurkey

AIM:To investigate the frequency and factors of prolonged QT dispersion that may lead to severe ventricular arrhythmias in patients with inflammatory bowel disease(IBD).METHODS:This study included 63 ulcerative colitis(UC) and 41 Crohn's disease(CD) patients.Forty-seven healthy patients were included as the control group.Heart rate was calculated using electrocardiography,corrected QT dispersion(QTcd) and the Bazett's formula.Homeostasis model assessment(HOMA) was used to determine insulin resistance(IR).HOMA values 2.5 indicated a high probability of IR.RESULTS:Prolonged QTcd was found in 12.2% of UC patients,and in 14.5% of CD patients compared with the control group(P < 0.05).A significant difference was found between the insulin values(CD:10.95 ± 6.10 vs 6.44 ± 3.28,P < 0.05;UC:10.88 ± 7.19 vs 7.20 ± 4.54,P < 0.05) and HOMA(CD:2.56 ± 1.43 vs 1.42 ± 0.75,P < 0.05;UC:2.94 ± 1.88 vs 1.90 ± 1.09,P < 0.05) in UC and CD patients with and without prolonged QTcd.Disease behavior types were determined in CD patients with prolonged QTcd.Increased systolic arterial pressure(125 ± 13.81 vs 114.09 ± 8.73,P < 0.01) and age(48.67 ± 13.93 vs 39.57 ± 11.58,P < 0.05) in UC patients were significantly associated with prolonged QTcd.CONCLUSION:Our data show that IBD patients have prolonged QTcd in relation to controls.The routine followup of IBD patients should include determination of HOMA,insulin values and electrocardiogram examination.

关键词： Crohn’s disease Homeostasis model assessment Insulin QT dispersion Ulcerative colitis

Bietti crystalline dystrophy and choroidal neovascularization in childhood

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International Journal of Ophthalmology(English edition) 2019年第9期12卷 1514-1516页

作者： Sabiha Gungor kobat Fatih Cem Gul elif Yusufoglu Department of Ophthalmology Elazig Health Sciences UniversityElazig 23000Turkey

Dear Editor,I am Dr.Sabiha Gungor kobat,from the Department of Ophthalmology,Elazig Health Sciences University,Elazig,Turkey.I am writing to present an exceedingly rare case of two siblings,one of whom developed Bietti crystalline dystrophy(BCD)with choroidal neovascularization at the age of 13 years,and the other has asymptomatic BCD at 8 years old.

关键词： RPE BCD Bietti crystalline dystrophy and choroidal neovascularization in childhood

Production and characterization of ZnO nanoparticles and porous particles by ultrasonic spray pyrolysis using a zinc nitrate precursor

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International Journal of Minerals,Metallurgy and Materials 2012年第7期19卷 651-656页

作者： Burak Ebin elif Arτg Burak zkal Sebahattin Gürmen Metallurgical & Materials Engineering Department Istanbul Technical University

ZnO nanoparticles and porous particles were produced by an ultrasonic spray pyrolysis method using a zinc nitrate precursor at various temperatures under air atmosphere. The effects of reaction temperature on the size and morphology of ZnO particles were investi- gated. The samples were characterized by energy dispersive spectroscopy, X-ray diffraction, transmission electron microscopy, and scanning electron microscopy. ZnO particles were obtained in a hexagonal crystal structure and the crystallite shapes changed from spherical to hex- agonal by elevating the reaction temperature. The crystallite size grew by increasing the temperature, in spite of reducing the residence time in the heated zone. ZnO nanoparticles were obtained at the lowest reaction temperature and ZnO porous particles, formed by aggregation of ZnO nanoparticles due to effective sintering, were prepared at higher temperatures. The results showed that the properties of ZnO particles can be controlled by changing the reaction temperature in the ultrasonic spray pyrolysis method.

关键词： zinc oxide nanoparticles nanocrystallites porous materials ultrasonic applications spray pyrolysis

Synergistic effect of multiple predisposing risk factors on the development of bezoars

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World Journal of Gastroenterology 2012年第9期18卷 960-964页

作者： Metin kement Nuraydin Ozlem elif Colak Sadik kesmer Cem Gezen Selahattin Vural Department of General Surgery Samsun Education and Research Hospital Department of General Surgery Kartal Education and Research Hospital

AIM:To describe the clinical characteristics of patients with gastric or intestinal bezoars recently treated in our hospital.METHODS:In this study,a retrospective chart review of consecutive patients with gastrointestinal bezoars,who were treated at the Samsun Education and Research Hospital between January 2006 and March 2011,was conducted.Data on demographic characteristics,clinical presentation,history of risk factors,diagnostic procedures,localization of bezoars,treatment interventions,and postoperative morbidity and mortality rates were collected and evaluated.RESULTS:Forty-two patients [26 (61.9%) males and 16 (31.1%) females] with a mean±SD (range) age of 55.8±10.5 (37-74) years were enrolled in this study.Thirty-six patients (85.7%) had one or more predisposing risk factors for gastrointestinal bezoars.The most common predisposing risk factor was a history of previous gastric surgery which was identified in 18 patients (42.8%).Twenty three patients (54.8%) had multiple predisposing risk factors.Phytobezoars were identified in all patients except one who had a trichobezoar in the stomach.Non-operative endoscopic fragmentation was performed either initially or after unsuccessful medical treatment in 14 patients with gastric bezoars and was completely successful in 10 patients (71.5%).Surgery was the most frequent treatment method in our study,which was required in 28 patients (66.7%).Intestinal obstruction secondary to bezoars was the most common complication (n=18,42.8%) in our study.CONCLUSION:The presence of multiple predisposing factors may create a synergistic effect in the development of bezoars.

关键词：协同效应危险因素粪临床特点