Cemalettin Gunes

Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study

AIM Mean platelet volume (MPV) in the healthy population has not been studied before. Therefore, the aim of the study was to measure MPV in normal subjects in a large cohort of Turkish adults. METHODS A total of 2298 subjects with a mean age of 50 (age range 18 to 92) were interviewed. Subjects who had smoking habit, diabetes, hypertension, coronary artery disease, dyslipidemia, chronic obstructive pulmonary disease, cancer, chronic use of any drugs including antiplatelets, heavy drinkers, metabolic syndrome, ejection fraction <55%, creatinine >1.4 in men and >1.1 in women, abnormal liver function tests and an abnormal TSH were excluded in a in a stepwise manner. Complete blood counts were done on the same day within 6 hours by a CELL-DYN 3700 SL analyzer (Abbott Diagnostics). RESULTS Three hundred twenty-six participants (204 females (63%) and 122 males (37%) with a mean age of 41 ± 16) constituted the final healthy cohort. Mean MPV of the cohort was 8.9 ± 1.4 fL. There was no significant difference among age groups regarding MPV. CONCLUSION Ninety-five percent of the individuals had a MPV between 7.2 and 11.7 fL. A patient having a MPV beyond this range should be evaluated carefully especially for occlusive arterial diseases.

Vitamin D status in children with attention‐deficit–hyperactivity disorder

Attention‐deficit–hyperactivity disorder (ADHD), one of the most common psychiatric disorders of childhood, has an early onset, affecting 2–18% of children worldwide. The etiopathogenesis of ADHD is obscure. In recent studies, a low level of vitamin D has been found in association with many disorders as well as in neuropsychiatric diseases. The aim of this study was therefore to investigate serum vitamin D level in pediatric ADHD patients.

The Relationship Between Internet Addiction and Body Mass Index in Turkish Adolescents

The purpose of this study was to investigate Internet use patterns and Internet addiction among adolescents and to examine the correlation between Internet addiction and eating attitudes and body mass index (BMI). The study was conducted among 1,938 students, aged between 14 and 18 years. The Internet Addiction Test (IAT), the Eating Attitudes Test (EAT), and a sociodemographic query form were used to collect data. According to the IAT, 12.4% of the study sample met the criteria for Internet addiction. A significant positive correlation between BMI and the IAT (r=0.307; p<0.01) and weekly Internet use (r=0.215; p<0.01) was found. Nine students with Internet addiction (3.8%) and 90 with average Internet use (5.3%) were found to have a possible eating disorder (p>0.05). No relationship was found between the EAT and the IAT and duration of weekly Internet use. Linear regression analysis revealed a significant independent association of the IAT with BMI (r=0.235; p<0.001). These results indicate an association between Internet addiction and BMI. Further studies are needed to describe the causality of this association.

The Scintigraphic Findings of Gastroesophageal Reflux in Children is Related to Body Weight

Background Gastroesophageal reflux disease (GERD) is the most common cause of children admissions to pediatric gastroenterology unit and affects about 30% of pediatric population. Body weight and height percentiles of children with GERD and their relationship between presence and the severity of reflux on scintigraphic images were studied. Methods Patients who underwent reflux scintigraphy between 2005 - 2012 were retrospectively reviewed. Among 200 patients, 49 patients were involved that their ages were ranging from 0 to 18 years old and body weight and height percentiles were recorded. Accurately 37 MBq (1 mCi) 99mTc-MAA in 100 - 150 mL of milk was ingested by the patient. Presence, number, duration and level of reflux were evaluated on the dynamic images. Presences of reflux within last ten minute were also recorded. Region-of-interests were drawn on esophagus and stomach and reflux ratio (RR) was calculated. Results The ratio of the presence of reflux which occurred within the last ten minutes was significantly higher in children with low body weight percentile. High-level reflux frequency was higher in these children than in normal’s. Presence of reflux which occurred within the last ten minutes was related with low body weight percentile. Conclusions If reflux is shown within the last ten minutes and there is high level of reflux, the clinician should be warned about possible low body weight percentile in the future and scintigraphic study should be a guide or a reference for the assessment of more effective treatment methods.

An extremely rare cause of bruising in children: autoerythrocyte sensitization syndrome.

Autoerythrocyte sensitization syndrome (ASS)—also known as Gardner-Diamond syndrome—is an autoimmune vasculopathy associated with sensitization to phosphatidylserine, a phosphoglyceride of red blood cell membranes [1]. The syndrome was first described in 1955 by Gardner and Diamond in 4 female patients [2]. ASS is typically seen in adult females; however, pediatric and male patients have also been described [2-4]. The disease usually develops after psychic stress. It is characterized by development of painful edematous skin lesions that progress to ecchymoses during the following 24 h [5]. The diagnosis of ASS is confirmed via an autoerythrocyte sensitization test [2]. Herein we report ASS in a previously healthy 7-year-old boy.

A case of isolated thrombocytopenia due to cobalamin deficiency

The most common form of isolated thrombocytopenia is idiopathic thrombocytopenic purpura (ITP) in childhood. Hence, pediatricians consider a possible diagnosis of ITP in patients with isolated thrombocytopenia who are admitted to hospital with complaints of skin findings such as petechiae, purpura, and ecchymosis. It is well known that cobalamin deficiency may also cause thrombocytopenia together with anemia and leukopenia in children. However, isolated thrombocytopenia due to cobalamin deficiency has rarely been reported in literature. In this case report, we present a 7-year-old female patient with isolated thrombocytopenia that was improved by cyanocobalamin therapy.

A case of bronchogenic cyst admitted by recurrent pulmonary infection

Bronkojenik kist embriyonik foregutun anormal tomurcuk- lanmasi sonucu gelisen ender rastlanan bir bozukluktur. Bazen dogumda solunum sikintisina neden olurken bazen de eriskin doneme kadar asemptomatik kalabilir. Basiya bagli klinik bulgular yenidogan ve sut cocuklugu donemindeki en onemli yakinmalardir. Burada tekrarlayan akciger enfeksiyo- nu nedeniyle izlenen 9 aylik bronkojenik kist olgusu sunul- mustur. Tekrarlayan akciger enfeksiyonu etiyolojisinde bron- kojenik kistin de goz onunde bulundurulmasi gerektigini vurgulamak istedik. Bronchogenic cyst is a rare disorder that result from abnor- mal budding of embrionic foregut. While it sometimes cau- ses to respiratory distress at birth, it may also remain asymptomatic until adulthood. Clinical symptoms due to compression are most frequent complaints in neonatal and infancy period. Herein, a nine month old case of bronchoge- nic cyst followed for recurrent pulmonary infections was presented. We would like to emphasize that the bronchoge- nic cyst should be considered on etiology of recurrent pul- monary infections.