Elif Sağ

Istanbul University

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MÇ

Murat Çakır

Karadeniz Technical University

Burcu Güven

Karadeniz Technical University

Ulaş Emre Akbulut

Sağlık Bilimleri Üniversitesi

Ayşenur Bahadır

Karadeniz Technical University

Alper Han Çebi

Karadeniz Technical University

Gülay Kaya

Karadeniz Technical University

Fazıl Orhan

Karadeniz Technical University

MÇ

Murat Çakır

Necmettin Erbakan University

Erol Erduran

Karadeniz Technical University

Fİ

Fatma İSSİ

Denizli Devlet Hastanesi

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Sağlık Bilimleri Üniversitesi

130

Karadeniz Technical University

Ministry of Health

Recep Tayyip Erdoğan University

University of Health Science

University of Health Sciences

University of Health Sciences Antigua

Universidad CES

Pediatrics and Genetics

Izmir University

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Complementary and Alternative Medicine Use in Pediatric Gastroenterology Outpatient Clinic: Cross-sectional Study

Turkiye Klinikleri Journal of Pediatrics (2021)

Burcu Güven Elif Sağ Fatma İSSİ Fazıl Orhan Murat Çakır

Objective: Although there is sufficient data on the use of complementary and alternative medicine (CAM) in adults, the data on children is relatively limited. The present study was designed to investigate the frequency and factors associated with CAM usage in children with chronic liver and gastrointestinal diseases. Material and Methods: The study included patients aged 0-18 years who were followed up for chronic liver disease or gastrointestinal diseases. A questionnaire was administered to their parents, which probed information on the demographic characteristics and CAM use in children and the socioeconomic status and educational level of parents. Results: The study involved a total of 135 patients (60% girls, mean age of 10.45±5.05 years). Of these, 20 patients (14.8%) were found to be using CAM. The duration of CAM users' follow-up period was significantly higher than non-CAM user (5.84±3.71 years vs. 4.06±3.25 years, p=0.030). The frequency of CAM usage was significantly higher in patients with celiac disease (22.9%, p=0.049) and liver transplant recipients (44.4%, p=0.009). The frequency of CAM usage was significantly higher in patients who were not prescribed or were currently not using any conventional medicine compared to patients using conventional medicine (65% vs. 38.3%, odds ratio: 2.997). Conclusion: Although the frequency of CAM usage was low in our patient group, we consider that parents and physicians should be in full cooperation about the use of CAM and the effectiveness, side effects, toxicity, and potential drug interactions of CAM therapies.

Cross-sectional study

Pediatric gastroenterology

Outpatient clinic

10.5336/pediatr.2021-84922

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Citations (1)

Radyasyon Maruziyeti

Sema Yılmaz Rakıcı Burak Uzunibrahimoğlu Çiğdem Kanburoğlu Ahmet Fatih Oruç Şule Karabulut Gül

Bir sonraki kitabınız ne zaman çıkacak? Denildiğinde ihtiyaçlara cevap veren kitaplara öncülük etmeye başladığımızı anladım. Bu kitap projesi ile yaptığımız, kliniklerde çalışan hekimler olarak ihtiyaçların gün yüzüne çıkardığı en ufak ayrıntılar ve bunlarla başa çıkmak için sarf ettiğimiz gayretlerin kitaba dönüştürülmesi oldu. Genel olarak yazılan radyasyon onkoloji kitaplarının aksine bu kitap; iyonize radyasyonun etkileri kadar, radyoterapinin yan etkilerinin çözümünde multidisipliner yaklaşım gereksiniminden yola çıkarak neredeyse tüm disiplinlerin katılımı ile yazıldı. Radyasyona dahil temel konular, radyasyonun patolojisi, radyasyon radyolojisi, akut radyasyon maruziyeti, radyoterapi sonrası cerrahi zorlukları ve radyasyondan korunma ana bölümler altında seçilmiş konular anlatıldı.

10.37609/akya.1796

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Çocuklarda Fonksiyonel Kabızlık

Turkiye Klinikleri Pediatric Surgery - Special Topics (2020)

Elif Sağ

Source

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Acute pancreatitis in children: A single center experience over ten years

The Turkish Journal of Pediatrics (2018)

Elif Sağ Gülay Kaya Elif Bahat-Özdoğan Süleyman Caner Karahan Abdurrahim İmamoğlu

Sağ E, Kaya G, Bahat-Özdoğan E, Karahan SC, İmamoğlu M, Sarıhan H, Çakır M. Acute pancreatitis in children: A single center experience over ten years. Turk J Pediatr 2018; 60: 153-158. Acute pancreatitis (AP) is an inflammatory disease characterized by sudden onset abdominal pain together with elevation of pancreatic enzymes and radiographic changes. Increased incidence of AP in children have been reported in recent reports. In this study; we aimed to analyze the demographic characteristics, etiology, outcome and incidence of AP among hospitalized children in our center. Medical records of the children with AP since January 2005 were analyzed from hospital files (N=63). Major etiologies were systemic diseases (14.3%), trauma (11.1%), cholelithiasis (9.5%); 54% (N=34) of the patients had mild AP, while 28.6% (N=18) had moderately severe AP and 17.4% (N=11) had severe AP. Organ dysfunction was found in 11 patients (17.4%) at initial examination. During the follow-up period (68.1±24.3 months), 10 patients (15.9%) experienced 24 recurring AP (RAP) attacks. Male gender, presence of local pancreatic or systemic complications at initial attack, metabolic and hereditary diseases were associated with the increased risk of RAP (p < 0.05 for all). The mortality rate associated with AP was 4.84%. There was an increase in the incidence of AP since 2010 (9.57 in 2009-2010 vs. 39.17/10,000 patients in 2015-2016 years; p=0.0002; OR: 4.1) among the hospitalized patients. Our results indicate that AP is a mild disease in children and the incidence is increasing among hospitalized children. Male gender, presence of local pancreatic or systemic complications at initial attack, metabolic diseases and hereditary diseases were associated with the increased risk of RAP.

Etiology

Single Center

Medical record

10.24953/turkjped.2018.02.006

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When Should Endoscopic Interventions Be Performed in Children with Severe Anemia?

Turkish Archives of Pediatrics (2022)

Elif Sağ Burcu Güven Ayşenur Bahadır Gökçe Pınar Reis Murat Çakır

Anemia is a common problem in outpatient clinics, and endoscopic interventions are one of the initial steps to rule out the gastrointestinal causes. In this study, we aimed to analyze the diagnostic yield of endoscopic interventions in children with severe anemia.The demographic features, laboratory findings, and endoscopic and histopathological findings of 65 children with severe anemia (hemoglobin <7 g/dL) (mean age of 12.1 ± 4.4 years, 73.8% female) who underwent endoscopic interventions were recorded from the files. Patients were divided into 2 groups according to the presence of positive endoscopic findings and/or histopathological examination. Factors that may predict the presence of positive endoscopic findings and/or histopathological examination were analyzed.After a colonoscopy and/or upper gastrointestinal endoscopy, the etiology of anemia was identified in 35 patients, and the major diagnosis of Helicobacter pylori gastritis in 16.9% and gastrointestinal ulcer in 10.8% of the patients was made. No gastrointestinal pathology was detected in 30 patients. The diagnostic yield of endoscopic examination in patients with severe anemia was 53.8% (95% CI: 63.3-67.7). Presence of hypoalbuminemia (P = .021), high erythrocyte sedimentation rate (P = .006), and high C-reactive protein (P = .03) was significantly associated with positive findings in endoscopic interventions.We recommend performing upper gastrointestinal endoscopy and/or colonoscopy in patients with severe anemia associated with gastrointestinal symptoms and using laboratory findings of hypoalbuminemia, high erythrocyte sedimentation rate, and C-reactive protein in order to rule out gastrointestinal pathologies.

Hypoalbuminemia

Etiology

Erythrocyte sedimentation rate

10.5152/turkarchpediatr.2022.21177

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Acquired noncaustic esophageal strictures in children

Clinical and Experimental Pediatrics (2020)

Elif Sağ Ayşenur Bahadır Abdurrahim İmamoğlu Sefa Sağ Gökçe Pınar Reis

Esophageal stricture (ES) is an uncommon clinic entity in pediatrics that may be congenital or acquired in childhood. Acquired noncaustic ES is very rare, and clinical features of affected patients are unknown.We aimed to evaluate the clinical findings, and outcomes of patients with acquired noncaustic ES to aid physicians in the early referral of patients to gastroenterologists.The medical data of patients with acquired noncaustic ES who were followed in our gastroenterology clinic between January 2009 and December 2019 were reviewed.Acquired noncaustic ES was found in 12 of the 4,950 patients (0.24%) who underwent endoscopy during the study period. The main symptoms were dysphagia (58.3%), vomiting (33.3%), and chronic anemia (8.3%). Chronic malnutrition and underweight were found in 66.6% of the patients. The most common etiological factors were radiotherapy, peptic reflux, and achalasia (16.6%, each), while chemotherapy, squamous-cell carcinoma (SC) of the esophagus, eosinophilic esophagitis (EoE), esophageal web, epidermolysis bullosa, and esophageal diverticulum (8.2%, each) were the other etiological factors. Patients with EoE underwent endoscopic bougie dilation in addition to steroid use and elimination diet. Patients with epidermolysis bullosa and esophageal web underwent bougie dilation. Patients with peptic reflux-related ES were initially put on antireflux therapy, but during follow-up, one patient required esophageal replacement with colonic interposition. Patients with radiotherapy-related ES recovered with medical therapy. The patient with initially underwent surgical gastrostomy and tumoral mass excision. The patient then received chemotherapy and radiotherapy and underwent jejunal interposition. Patients with achalasia underwent surgical esophagomyotomy.The presence of solid dysphagia, malnutrition, and an associated disease may alert physicians to the presence of ES.

Esophageal stricture

Peptic

Etiology

Esophagitis

10.3345/cep.2020.00199

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Impact of Fecal Calprotectin Measurement for Inflammatory Bowel Disease in Children with Alarm Symptoms

The Journal of Pediatric Research (2022)

Burcu Güven Fatma İSSİ Elif Sağ Celal Kurtuluş Buruk Murat Çakır

ABS TRACTAim: The differentiation of inflammatory bowel diseases (IBD) from other gastrointestinal diseases in pediatric patients is highly important and the definitive diagnosis of IBD is established by endoscopic examination.The use of non-invasive methods (clinical symptoms and laboratory tests) allows for the early and accurate referral of patients from first step health centers to advanced health centers.We aimed to investigate the effectiveness of fecal calprotectin (FC) in the differentiation of IBD from other gastrointestinal diseases in children. Materials and Methods:This retrospective study included patients who had undergone FC testing and colonoscopy.The demographic characteristics, alarm symptoms (AS), and abnormal laboratory findings (ALF) were recorded for each patient.A negative calprotectin result was considered to be less than 50 μg/g, and a second cut-off value for FC was accepted as 150 μg/g.Definitive diagnosis was established by colonoscopy in each patient. Results:The study included 88 consecutive patients (mean age, 10.2±6.1 years; 51.1% female).Of these, 20 (22.7%) patients were diagnosed with IBD.No significant difference was found between IBD and non-IBD patients with regard to the presence of AS except for involuntary weight loss (p<0.001).The prevalence of increased C-reactive protein and hypoalbuminemia was significantly higher in the IBD patients (p=0.002 and p=0.026, respectively).FC>50 μg/g [80.0 vs 39.7%, p=0.044, odds ratio (OR): 6.07, 95% confidence interval (CI) 1.83 to 23.42] and >150 μg/g (60.0 vs 16.2%, p=0.002,OR: 7.78, 95% CI 1.83 to 20.14) was significantly higher in the IBD patients compared to the non-IBD patients.AS combined with ALF and FC>150 μg/g had the highest specificity (95.12%). Conclusion:Although primary care clinicians often use AS and laboratory parameters in the differentiation of IBD from non-IBD diseases, FC was found to have a relatively higher diagnostic value.

10.4274/jpr.galenos.2021.99907

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Wernicke`s encephalopathy manifesting with diplopia after ileojejunostomy: report of a pediatric case with hirschsprung disease

The Turkish Journal of Pediatrics (2020)

Beril Dilber Tülay Kamaşak İlker Eyüboğlu Mehmet Kola Ahmet Taner Uysal

Background. Wernicke`s encephalopathy (WE) is a coenzyme-induced disease with acute neuropsychiatric symptoms leading to high mortality and morbidity due to thiamine deficiency. WE is mostly caused by alcoholism in adult populations; however, it is often associated with gastrointestinal surgical procedures, recurrent vomiting, chronic diarrhea, cancer and chemotherapy treatment, systemic diseases, drugs, magnesium deficiency, and malnutrition in children. Although these predisposing factors are considered to be uncommon in children, they are actually highly frequent and can be fatal if not treated promptly. Case. In this report, we present a patient who developed diplopia during total parenteral nutrition following surgical resection and was diagnosed with WE. The findings of the patient's cranial magnetic resonance imaging (MRI) findings were consistent with those of WE and the ocular findings of the patient resolved completely after thiamine treatment. Conclusion. Although WE is rare in children it can be prevented by early diagnosis and treatment and oculomotor findings such as diplopia can be a warning sign.

Hirschsprung's disease

10.24953/turkjped.2020.02.019

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Efficiency of azathioprine monotherapy for maintenance treatment of autoimmune hepatitis in children

European Journal of Gastroenterology & Hepatology (2020)

Betül Aksoy Maşallah Baran Yeliz Çağan Appak Elif Sağ Murat Çakır

Autoimmune hepatitis (AIH) is a common pediatric liver disease and long-term remission is usually maintained with low dose prednisolone and azathioprine (AZA). The aim of this study is to evaluate the efficiency of AZA monotherapy for maintenance treatment of children with AIH.This study was a retrospective analysis of the 55 children with AIH. Patients were divided into two groups: combination therapy (CT) and AZA group based on maintenance therapy. Results of these two different maintenance treatments were compared in children with AIH.The mean age of the children was 10.67 ± 4.30 years (61.8% females) with a mean follow-up period of 46.8 ± 33.6 months. For maintenance treatment, 39 (70.9%) patients received AZA and 16 (29.1%) patients received CT. Relapse was observed in nine (19.6%) cases in the follow-up period; two were in the CT group (2/16; 12.5%) and seven (7/39; 17.9%) were in the AZA group (P = 0.620). In AZA group, the duration of remission was 22.2 ± 6.1 months and that was longer than CT group (P = 0.025).Our study suggests that AZA monotherapy is an effective and safe therapy for maintaining remission in children with AIH. AZA monotherapy may be used for maintenance treatment of children with AIH, except in cases of overlap syndrome and also to avoid side effects of long-term used steroids and to improve treatment compliance in proper cases.

Autoimmune Hepatitis

Maintenance therapy

Prednisolone

Maintenance dose

10.1097/meg.0000000000001930

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A Rare Cause of Severe Abdominal Pain in Children: Hereditary Angioedema

Gazi Medical Journal (2017)

Hereditary angioedema (HA) is an autosomal dominantly inherited disease characterized by recurrent angioedema attacks.Angioedema is frequently seen in the arms and legs, the neck, the airways, in the genital region and in visceral organs.Edema of the intestinal mucosa can lead to transient obstruction and severe abdominal pain that can mimic acute abdomen.This can result undergoing unnecessary surgery in the patients.We presented a 15 years old girl that admitted to the emergency department due to sudden onset colic-type abdominal pain.The patient's mother had previously under gone surgery three times with the same findings who has been followed up HA.We report this case to emphasize that patients with HA may present to emergency departments with severe abdominal pain related to intestinal involvement and with findings of acute abdomen.

Hereditary Angioedema

10.12996/gmj.2017.44

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