Ayşe Özkan

The protective effect of hesperidin on methotrexate-induced intestinal epithelial damage in rats: an experimental study.

Objective: The purpose of this experimental study was to evaluate the efficacy of hesperidin (HES) in protecting against methotrexate (MTX)-induced intestinal damage using histopathological and immunohistochemical techniques. Materials and Methods: Seventy-eight male Wistar albino rats were divided into 4 groups that received (a) saline only (control group), n = 19; (b) HES only, n = 19; (c) MTX only, n = 19, and (d) MTX plus HES, n = 21. On the first day of the study, a single dose of MTX (20 mg/kg) was administered intraperitoneally to group 3 and 4 rats. The HES (200 mg/kg) was administered by gavage for 5 days. For the MTX plus HES group, HES (200 mg/kg) was administered by gavage for 5 days after MTX treatment. Rats were sacrificed on the 2nd, 4th and 6th day of the study. Tissue samples from the jejunum were taken for histopathological and immunohistochemical analysis. Results: On the 4th day, crypt injury in the MTX plus HES group (1.00 ± 0.00) was less than that in the MTX group (2.00 ± 0.89; p < 0.05). The small intestinal damage score was lower in the MTX plus HES group (6.33 ± 0.82) as compared to the MTX group (8.00 ± 2.37). Inducible nitric oxide synthase and interleukin-8 levels were lower in the MTX plus HES group (65 and 25%, respectively) as compared to the corresponding values of the MTX group (80 and 52.5%, respectively). On the 6th day, the Ki-67 proliferation index in the MTX group (45%) was lower than that in the MTX plus HES group (76.67%) and the control group (p < 0.05). The small intestinal damage score was high in the HES group on the 4th day due to increased cellular infiltration. On the 6th day, the Ki-67 proliferation index rose in parallel with the decrease in cellular infiltration and therefore histopathological scoring. The proliferation-enhancing effect of HES also appeared in healthy rats. Conclusion: HES seemed to have a protective effect against MTX-induced intestinal injury.

Meropenem Versus Piperacillin-Tazobactam as Empiric Therapy for Febrile Neutropenia in Pediatric Oncology Patients

BACKGROUND Infection is a serious cause of mortality in febrile neutropenia of pediatric cancer patients. Recently, monotherapy has replaced the combination therapy in empirical treatment of febrile neutropenia. Since there has been no reported trial comparing the efficacy of meropenem and piperacillin-tazobactam (PIP/ TAZ) monotherapies, the present retrospective study was conducted to compare safety and efficacy in febrile neutropenic children with cancer. MATERIALS AND METHODS Charts of febrile, neutropenic children hospitalized at our center between March 2008 and April 2011 for hemato-oncological malignancies were reviewed. Patients received PIP/TAZ 360 mg/kg/day or meropenem 60 mg/kg/day intravenously in three divided doses. Duration of fever and neutropenia, absolute neutrophil count, modification, and success rate were compared between the two groups. Resolution of fever without antibiotic change was defined as success and resolution of fever with antibiotic change or death of a patient was defined as failure. Modification was defined as changing the empirical antimicrobial agent during a febrile episode. RESULTS Two hundred eighty four febrile neutropenic episodes were documented in 136 patients with a median age of 5 years. In 198 episodes meropenem and in 86 episodes PIP/ TAZ were used. Duration of fever and neutropenia, neutrophil count, sex, and primary disease were not different between two groups. Success rates and modification rate between two groups showed no significant differences (p>0.05). Overall success rate in the meropenem and PIP/TAZ groups were 92.4% and 91.9% respectively. No serious adverse effects occurred in either of the groups. CONCLUSIONS Meropenem and PIP/TAZ monotherapy are equally safe and effective in the initial treatment of febrile neutropenia in children with cancer.

Treatment of Wilms Tumor Using Carboplatin Compared to Therapy Without Carboplatin

Wilms tumor (WT) is the most common pediatric malignant primary renal tumor. One of the main drugs used in treatment is actinomycin‐D. This was not readily available in Turkey at one time. Carboplatin was used in the primary treatment of WT in order to prevent delays in treatment. The aim of this study is to present the results of patients with WT receiving carboplatin or actinomycin‐D therapy.

Eltrombopag For Immune Thrombocytopenic Children in a Single Region

Objective Child patients of chronic thrombocytopenic purpura with severe and resistant thrombocytopenia were evaluated to observe whether their clinical or laboratory states improve by one of the thrombomimetic therapeutic agent called Eltrombopag as in adults in a single center of different country from previous studies. Materials and Methods Nineteen patients with chronic immune thrombocytopenia were treated with Eltrombopag to dose in international guidelines. Results Approximately half (11/19:58%) of the patients benefitted from the treatment with Eltrombopag either by an increase of platelet levels at safe levels with a decrease in the frequency of bleedings which needed rescue treatment. Conclusion Thrombomimetic treatment options have strengthened the clinician’s hand where the regular treatment options became insufficient.

The Effectiveness of Enteral Nutrition Support in the Growth of Children Patients with Cancer

DOI: 10.4328/JCAM.2637 Received: 23.06.2014 Accepted: 25.07.2014 Published Online: 25.07.2014 Corresponding Author: Can Acıpayam, Mustafa Kemal University,Tayfur Ata Sokmen Medical School, Department of Pediatric Hematology and Oncology, 31000, Serinyol, Hatay, Turkey. T.: +90 3262291000 F.: +90 3262455654 E-Mail: cacipayam@hotmail.com Özet Amaç: Bu çalışmanın amacı, kemoterapi alan kanserli çocuklarda antropometrik ve biyokimyasal parametreler aracılığla, enteral beslenme desteğinin büyümede olumlu etkisini araştırmaktır. Gereç ve Yöntem: Yeni tanı almış ve yoğun kemoterapi alan ardışık 43 pediatrik kanserli hasta çalışmaya dahil edildi. Yirmi altı hasta enteral beslenme formülası aldı. Onyedi kontrol hastası enteral beslenme formülası almadı. Antropometrik parametreleri (boy, kilo, vücut kitle indeksi, triseps, subskapular ve suprailiak deri kıvrım kalınlığı), serum albümin, prealbumin, transferrin düzeyleri ve lipid profilleri tanı anında ve 3. ayda ölçüldü. Bulgular: 3 ayın sonunda enteral beslenme alan grupta subskapular ve suprailiak deri kıvrım kalınlıklarında tanı anındaki ölçülerle karşılaştırıldığımızda belirgin bir artış saptadık (p=0.01 ve p=0.014 sırasıyla). Prealbümin ve albümin değerlerinde enteral beslenme desteğinin 3. ayında artış saptandı (p=0.005 ve p=0.006, sırasıyla). Enteral beslenme alan grubunun % 69.2’inde tedavi sonunda ağırlık persentil artışı görüldü. Üçüncü ayda, albümin ve suprailiak deri kıvrım kalınlıkları değerleri enteral beslenme grubunda, kontrol grubuna göre yüksek idi (p=0.012 ve p=0.017, sırasıyla). Üçüncü ayda kontrol grubunun antropometrik ve biyokimyasal parametrelerinde tanı anı ile karşılaştırıldığında anlamlı bir değişiklik görülmedi. Tartışma: Bu çalışma enteral beslenme formülası alan kanserli çocuklarda antropometrik ve biyokimyasal parametrelerde iyileşme göstermektedir.

Dermatopathic lymphadenitis associated with human papilloma virus infection and verruca vulgaris.

Here we present a pediatric case of human papilloma virus associated with dermatopathic lymphadenitis (DL). A 5-year-old boy presented to the pediatric oncology clinic with swelling of the neck and warts on his lower jaw. His blood chemistry and complete blood count were normal, as was chest x-ray. HIV, EBV, CMV, and parvovirus serologies were negative. The patient was investigated for malignancy and lymphoma but no association was found. Histopathologic examination of the lymph node and the lesion revealed DL and verruca vulgaris, respectively. DL represents a benign form of reactive lymph node hyperplasia and described in patients with HIV and EBV infections. It is a rare entity described in patients with human papilloma virus infection. To our knowledge, this is the first report of DL in a patient with human papilloma virus infection.