Publications by authors named "Kamil Yılmaz"

10 Publications

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Relationship Between Pituitary Siderosis and Endocrinological Disorders in Pediatric Patients with Beta-Thalassemia.

Cureus 2021 Jan 23;13(1):e12877. Epub 2021 Jan 23.

Radiology, Dicle University School of Medicine, Diyarbakir, TUR.

Introduction Excess iron accumulation occurs mainly in organs such as reticuloendothelial cells, the pituitary gland, and the pancreas in beta-thalassemia because of blood transfusions. In the present study, it was aimed to investigate the relationship between T2* values on magnetic resonance imaging (MRI) and clinically diagnosed pituitary endocrinological disorders in children with thalassemia major. Methods This study enrolled patients diagnosed with beta-thalassemia at pediatric hematology outpatient clinics. In the study, in addition to the medical history of the patients, routinely performed tests, including hemoglobin electrophoresis, routine biochemical tests, and tests for pubertal development (follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, etc.), as well as iron deposition measured by hepatic MRI T2* (STAR) sequence, were retrospectively assessed. A total of 29 patients were enrolled. Results Hypothyroidism was detected in 34.6% (9/26) of patients, short stature in 37% (10/27), and pubertal retardation in 50% (14/28) of the patients. There was no significant correlation between hypothyroidism and pituitary MRI T2* values. No significant correlation was found between laboratory parameters and pituitary MRI examination. Although the sensitivity of T2* levels could rise above 80%, their specificity remained low. This is one of the major limitations of the pituitary MR T2* study for the prediction of short stature. The best lower cut-off level of MR T2* to predict short stature was found 14.6 ms. Conclusion The diagnostic specificity pituitary MR examination levels for short stature were detected as low. Thus, the clinical standardization and validation of pituitary MR T2* values examination are needed before clinical follow-up and multifaceted studies are needed.
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http://dx.doi.org/10.7759/cureus.12877DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899051PMC
January 2021

Investigating the effects of neuromobilization in lateral epicondylitis.

J Hand Ther 2020 Nov 13. Epub 2020 Nov 13.

Physical Medicine and Rehabilitation, Konya Farabi Hospital, Konya, Turkey.

Study Design: Randomized controlled study.

Introduction: Lateral epicondylitis (LE) causes pain and loss of function in the affected limb. Different exercises have been used for the treatment of LE. In recent years, the technique of neuromobilization has been frequently used to treat tendinopathy. However, there is no study that demonstrates the effects of neuromobilization techniques on patients with LE.

Purpose Of The Study: The aim of the present study was to determine the effects of neuromobilization techniques on pain, grip strength, and functional status in LE patients and to compare them with conservative rehabilitation treatment.

Methods: A total of 40 patients (26 females and 14 males; age: 42.80 ± 8.91 years) with a history of LE participated in the study. The patients were randomly assigned to two groups: the neuromobilization group and the control group. The neuromobilization group completed a 6-week conservative rehabilitation and radial nerve mobilization program, whereas the control group received conservative rehabilitation therapy only. Both groups underwent a 7-day weekly conservative home rehabilitation program. Pain severity, grip strength, pinch strength, joint motions, and upper extremity functional level were assessed before treatment, at the third week after treatment, and at the sixth week after treatment.

Results: There was a significant decrease in all pain scores in favor of the neuromobilization group at week 6 after treatment (at rest: P = .001, effect size (ES) = 0.84; at night: P = .001, ES = 0.91 and during activity: P = .004, ES = 1.06). No significant differences were found for grip strength, pinch strength, joint motions, and functional level in the neuromobilization group, although trends toward better improvement were observed.

Conclusions: Radial nerve mobilization techniques are more effective on pain than conservative rehabilitation therapy in LE patients, and this effect continues after treatment.
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http://dx.doi.org/10.1016/j.jht.2020.11.003DOI Listing
November 2020

Comparison of Inflammatory Markers between Adult and Pediatric Brucellosis Patients.

Rev Soc Bras Med Trop 2020 5;53:e20190356. Epub 2020 Oct 5.

Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.

Introduction: This study aimed to evaluate and compare with healthy control subjects the levels of indirect inflammatory markers such as mean platelet volume (MPV), platelet to lymphocyte ratio (PLR), and neutrophil to lymphocyte ratio (NLR) in adults and children with brucellosis.

Methods: White blood cell, neutrophil, lymphocyte, and platelet counts, and C-reactive protein (CRP) levels were retrospectively recorded for all participants.

Results: NLR and neutrophil counts were significantly higher in adult patients compared to those in pediatric patients.

Conclusions: Indirect inflammatory markers such as NLR, PLR, MPV, red distribution width, and CRP levels may be helpful for follow-up of brucellosis.
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http://dx.doi.org/10.1590/0037-8682-0356-2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7534967PMC
October 2020

Is vitamin D deficiency a risk factor for COVID-19 in children?

Pediatr Pulmonol 2020 12 13;55(12):3595-3601. Epub 2020 Oct 13.

Department of Pediatric Pulmonology, Dicle University School of Medicine, Diyarbakir, Turkey.

Objective: Coronavirus disease 2019 (COVID-19) is a global health problem that can result in serious complications. The aim of this study was to investigate the prevalence and clinical importance of vitamin D deficiency in children with COVID-19.

Material And Methods: This study includes 40 patients who were diagnosed to have COVID-19 and hospitalized with the real-time reverse transcription polymerase chain reaction method, 45 healthy matched control subjects with vitamin D levels. The age of admission, clinical and laboratory data, and 25-hydroxycholecalciferol (25-OHD) levels were recorded. Those with vitamin D levels which are below 20 ng/ml were determined as Group 1 and those with ≥20 ng/ml as Group 2.

Results: Patients with COVID-19 had significantly lower vitamin D levels 13.14 μg/L (4.19-69.28) than did the controls 34.81 (3.8-77.42) μg/L (p < .001). Patients with COVID-19 also had significantly lower serum phosphorus (4.09 ± 0.73 vs. 5.06 ± 0.93 vs. (U/L) (p < .001)) values compared with the controls. The symptom of fever was significantly higher in COVID- 19 patients who had deficient and insufficient vitamin D levels than in patients who had sufficient vitamin D levels (p = .038). There was a negative correlation found between fever symptom and vitamin D level (r = -0.358, p = .023).

Conclusion: This is the first to evaluate vitamin D levels and its relationship with clinical findings in pediatric patients with COVID-19. Our results suggest that vitamin D values may be associated with the occurrence and management of the COVID-19 disease by modulating the immunological mechanism to the virus in the pediatric population.
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http://dx.doi.org/10.1002/ppul.25106DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675606PMC
December 2020

Evaluation of the novel coronavirus disease in Turkish children: Preliminary outcomes.

Pediatr Pulmonol 2020 12 7;55(12):3587-3594. Epub 2020 Oct 7.

Department of Pediatric Pulmonology, Dicle University School of Medicine, Diyarbakir, Turkey.

Background: The novel coronavirus disease (Covid-19) can progress with mild to moderate or self-limiting clinical findings in children. The aim of this study was to investigate the disease features of Covid-19 in Turkish children.

Methods: Children diagnosed by the method of real-time reverse transcription-polymerase chain reaction for Covid-19 at the Dicle University Department of Pediatric, between April and June 2020, were evaluated. Hospital records were investigated retrospectively.

Results: One hundred and five patients children with the mean age of 108.64 ± 65.61 months were enrolled in this study. The most common cause of transmission in pediatric patients was in contact with a family member diagnosed with COVID-19 (n = 91, 86.7%). The most common admission complaints were dry cough (n = 17, 16.2%), fever (n = 16, 15.2%), lassitude and fatigue (n = 14, 13.3%) respectively. More than 95% of all children with Covid-19 were asymptomatic, mild, or moderate cases. CRP was identified only independent factor associated with long duration of hospitalization.

Conclusion: The results of this study show the effect of Covid-19 on Turkish children. A clear understanding of the local epidemiology of corona virus infections and identification of risk factors are critical for the successful implementation of the prevention and control program.
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http://dx.doi.org/10.1002/ppul.25095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536995PMC
December 2020

Evaluation of the relationship between splenic iron overload and liver, heart and muscle features evident on T2*-weighted magnetic resonance imaging.

Adv Clin Exp Med 2020 Apr;29(4):475-480

Department of Radiology, Medical School, Dicle University, Diyarbakir, Turkey.

Background: Splenic iron overload is the most common clinical condition in patients with thalassemia. However, few studies of the effects of splenectomy have been published.

Objectives: To evaluate the relationship between splenic iron overload and liver, heart and muscle features visible in T2*-weighted magnetic resonance imaging, and to investigate the effects of splenectomy on these tissues in patients with beta-thalassemia major (TM).

Material And Methods: We retrospectively included 131 patients (76 male and 55 female) diagnosed with TM. All radiological assessments were performed with the aid of a Philips Achieva 1.5T scanner running a multiecho gradient-echo sequence. Hepatic and splenic T2* values were assessed in the same gradient multiecho series. Muscle T2* values were assessed in the shoulder girdle muscles adjacent to the heart area. The relationships among splenic T2*, hepatic T2*, cardiac T2* and muscle T2* parameters, serum ferritin levels, age and other parameters were evaluated.

Results: The splenic T2* value correlated with serum ferritin level and the hepatic T2* value (p < 0.001 and p < 0.001, respectively). The splenic T2* value did not correlate with age, cardiac or muscle T2* values, or with spleen size (p = 0.27, 0.21, 0.99, and 0.39, respectively). The muscle T2* value correlated weakly with the serum ferritin level (p = 0.022). The cardiac T2* value was lower and the liver size greater in patients who had undergone splenectomy compared with those who had not (p < 0.001 and 0.001, respectively).

Conclusions: Splenic iron overload correlated with hepatic overload and the serum ferritin level. Splenectomy increased cardiac iron overload and triggered liver enlargement. However, the muscle iron overload was low and the muscles were therefore unaffected by splenectomy.
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http://dx.doi.org/10.17219/acem/116758DOI Listing
April 2020

Risk Factors for Health Care-Associated Bloodstream Infections in a Neonatal Intensive Care Unit.

Iran J Pediatr 2016 Oct 27;26(5):e5213. Epub 2016 Jul 27.

Clinical Microbiology and Infectious Disease, Medical Faculty, Dicle University, Diyarbakir, Turkey.

Background: Healthcare-associated bloodstream infections (HCA-BSI) are a major cause of morbidity and mortality in neonatal intensive care units (NICUs).

Objectives: We aimed to determine the causative organisms and risk factors of HCA-BSIs in NICUs.

Methods: This study was performed between January 2011 and December 2014 in the neonatal intensive care unit of Dicle university, Turkey. The study consisted of 126 patients (infected group) with positive blood culture and 126 randomly selected patients (uninfected control group) with negative blood culture after four days of hospitalization.

Results: We found that the most common causative agents isolated from nosocomial infections (NIs) were 20.7% , 26.7% spp., and 13.3% spp. Incidences of low gestational age, low birth weight, vaginal birth type, and long length of hospitalization were higher in the infected neonates than in the uninfected neonates. In the univariate analysis, surgical operation, ventriculoperitoneal shunt, use of umbilical catheter, nasogastric or orogastric tube, urinary catheter, mechanical ventilation, surfactant treatment, erythrocyte transfusion, plasma transfusion, thrombocyte transfusion, total parenteral nutrition infusion, intracranial hemorrhage, length of hospital stay, fifth-minute Apgar score, and total parenteral nutrition time were significantly associated with NIs. In the multiple logistic regression analysis, fifth-minute Apgar, use of erythrocyte transfusion and surgical operation were found as the independent risk factors for HCA-BSI.

Conclusions: This study determined the causative organisms and risk factors of HCA-BSIs in NICUs.
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http://dx.doi.org/10.5812/ijp.5213DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297258PMC
October 2016

Recurrent rhabdomyolysis in a child. Case presentation.

Arch Argent Pediatr 2016 Jun 1;114(3):e192-4. Epub 2016 Jun 1.

Department of Infectious Disease and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey.

Viral myositis associated with infections rarely may cause rhabdomyolysis. There is no any pediatric case with severe recurrent rhabdomyolysis triggered by infections in the literature. We reported a two-year-old boy who was hospitalized three times due to severe rhabdomyolysis associated with viral myositis in the winter months. This is the first child case presentation with severe rhabdomyolysis triggered by infections. Prednisolone and intravenous immunoglobulin treatments were ineffective in this case.
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http://dx.doi.org/10.5546/aap.2016.eng.e192DOI Listing
June 2016

Diagnostic role of inflammatory markers in pediatric Brucella arthritis.

Ital J Pediatr 2016 Jan 11;42. Epub 2016 Jan 11.

Department of Pediatric, Dicle University School of Medicine, Diyarbakir, Turkey.

Background: As a multisystem infectious disease, there is an inflammation, which causes increase in acute phase reactants in brucellosis. The mean platelet volume (MPV), platelet distribution width (PDW), red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been identified as markers of inflammation. The present study aimed to evaluate diagnostic values of these biomarkers in brucella arthritis (BA).

Methods: The study included 64 children with BA and 66 healthy control subjects. Demographic features, joint involvement, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and hematological variables were retrospectively recorded. In addition, results of synovial fluid and serum tube agglutination test for brucella together with treatment regimens were recorded.

Results: The mean age of the patients (53.1 % male) was 92.3 ± 41.2 months. The most commonly affected joint was ankle (53.1 %). Synovial fluid puncture-brucella agglutination test was positive in 22 (34.3 %) patients. Puncture culture was positive in 9 patients. Most of the patients (57.8 %) were treated with a combination of rifampicin plus sulfamethoxazole/trimethoprim and gentamicin. Significantly higher mean PDW, RDW, MPV, NLR and PLR values were found in children with BA compared to control subjects (p < 0.05). A positive correlation was found between MPV and NLR values (R (2) = 0.192, p < 0.001).

Conclusion: Our findings indicated that NLR and PLR are indirect markers of inflammation that may be observed abnormally increased in children with brucella arthritis. Further longitudinal studies are needed to investigate this topic to establish the more clear associations.
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http://dx.doi.org/10.1186/s13052-016-0211-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709903PMC
January 2016

Ramifications of recent developments in Turkey's southeast on cannabis cultivation.

Int J Drug Policy 2015 Mar 20;26(3):330-1. Epub 2014 Aug 20.

Turkish National Police Academy, Ankara, Turkey.

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http://dx.doi.org/10.1016/j.drugpo.2014.08.005DOI Listing
March 2015