Öz
Balık yağının yapısal ve fonksiyonel birçok faydasından dolayı günümüzde ailelerce çocuklara yaygın olarak kullandırılmaktadır. Balık yağının çocuklarda zihinsel gelişim üzerinde olumlu etkisi bazı çalışmalarda gösterilmiş olsa da çocukluk çağında kullanımının gerekliliği konusunda net bir görüş yoktur. Yan etkileri yeterince aydınlatılmamış olup bazı çalışmalarda balık yağı kullanımının kanamaya yatkınlığa neden olduğu gösterilmiştir.
Bu olgu, günümüzde takviyeler arasında çocuklar için sıklıkla tercih edilen balık yağının neden olduğu uzamış benign pediatrik epistaksisin dikkat çekici bir sunumudur. Takviyenin (balık yağı) kesilmesinin ardından hastanın durumu önemli ölçüde düzelmiştir. Bu deneyimimizden yola çıkarak bu tür ürünlerin de kullanımının standart bir değerlendirmeye tabi olması gerektiğine, yan etkileri de olabileceğinden dolayı başlanmasına hekimlerce karar verilmesi ve ayrıca yan etkileri olabileceğinden başalanan hastalarda yakından izlem gerektiğini düşünüyoruz.
Anahtar Kelimeler
Balık yağı bening pediatrik epistaksis kanama omega yağ asitleri
Kaynakça
- 1. Leaf, A., and Weber, P.C. (1988) Cardiovascular Effects of n-3 Fatty Acids,N. Engl. J. Med. 318, 549–557.
- 2. İncesoy Özdemir, S , Akça, H , Bahçeci, O , Bulut, B . (2021). Çocuk Acil Servisine Epistaksis ile Başvuran Olguların Klinik ve Laboratuvar Değerlendirmesi . Türkiye Çocuk Hastalıkları Dergisi , 15 (1) , 1-5 . DOI: 10.12956/tchd.813262
- 3. Brown NJ, Berkowitz RG. Epistaxis in healthy children requiring hospital admission. Int J Pediatr Otorhinolaryngol 2004;68:1181-4.
- 4. Yengil E, Çevik C. Burun Kanamasına Birinci Basamakta Yaklaşım. Smyrna Tıp Dergisi 2014; 1: 45-50.
- 5. Damrose JF, Maddalazzo J. Pediatric epistaxis. Laryngoscope 2006; 116: 387– 93. 11. Patel N, Maddalozzo J, Billings KR. An update on management of pediatric epistaxis. Int J Pediatr Otorhinolaryngol 2014; 78: 1400-4.
- 6. Information Use and Needs of Complementary Medicines Users. Available online: https://www.nps.org.au/__data/assets/pdf_file/0010/66619/Complementary_Medicines_Report_-_ConsuCCon.pdf (accessed on 18 September 2016).
- 7. Barnes, P.M.; Bloom, B.; Nahin, RL Complementary and alternative medicine use among adults and children: United States, 2007. Natl. Health Stat. Report. 2008, 10, 1–23. [Google Scholar].
- 8. ESPGHAN Committee on Nutrition, Agostoni C, Braegger C, Decsi T, Kolacek S, Mihatsch W, Moreno LA, Puntis J, Shamir R, Szajewska H, Turck D, van Goudoever J. Supplementation of N-3 LCPUFA to the diet of children older than 2 years: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2011 Jul;53(1):2-10. doi: 10.1097/MPG.0b013e318216f009. PMID: 21694531.
- 9. Ryan AS, Astwood JD, Gautier S, Kuratko CN, Nelson EB, Salem N. Effects of long-chain polyun-saturated fatty acid supplementation on neurodevel-opment in childhood: A review of human studies. Pos-tagland Leukot Essent Fatty Acids 2010;82:305–314.
- 10. Nestel, P.; Clifton, P.; Colquhoun, D.; Noakes, M.; Mori, T.A.; Sullivan, D.; Thomas, B. Indications for omega-3 long chain polyunsaturated fatty acid in the prevention and treatment of cardiovascular disease. Heart Lung Circ. 2015, 24, 769–779. [Google Scholar] [CrossRef] [PubMed].
- 11. Calder, P. Long-chain n-3 fatty acids and inflammation: Potential application in surgical and trauma patients. Br. J. Med. Biol. Res. 2003, 36, 433–446. [Google Scholar] [CrossRef].
- 12. Fetterman, J.W., Jr.; Zdanowicz, M.M. Therapeutic potential of n-3 polyunsaturated fatty acids in disease. Am. J. Health Syst. Pharm. 2009, 66, 1169–1179. [Google Scholar] [CrossRef] [PubMed].
- 13. Miller, P.E.; Van Elswyk, M.; Alexander, D.D. Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: A meta-analysis of randomized controlled trials. Am. J. Hypertens. 2014, 27, 885–896. [Google Scholar] [CrossRef] [PubMed].
- 14. Flaten, H.; Høstmark, A.; Kierulf, P.; Lystad, E.; Trygg, K.; Bjerkedal, T.; Osland, A. Fish-oil concentrate: Effects on variables related to cardiovascular disease. Am. J. Clin. Nutr. 1990, 52, 300–306. [Google Scholar] [PubMed].
- 15. Paniccia R, Priora R, Liotta AA, Abbate R. Platelet function tests: a comparative review. Vasc Health Risk Manag. 2015;11:133-148. Published 2015 Feb 18. doi:10.2147/VHRM.S44469
- 16. Hamblin TJ. What about the bleeding time?. Br Med J (Clin Res Ed). 1985 Jul 13;291(6488):91. https://doi.org/10.1136/bmj.291.6488.91.
- 17. Russeau AP, Vall H, Manna B. Bleeding Time. [Updated 2020 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537233/
- 18. Saynor, R., Verel, D. Effect of a fish oil on blood lipids and coagulation. Thromb. Haemostas. 1981;46:65 (Abstr.).
- 19. Larson M.K., Tormoen G.W., Weaver L.J. et al. Exogenous modification of platelet membranes with the omega-3 fatty acids EPA and DHA reduces platelet procoagulant activity and thrombus formation. Am J Physiol Cell Physiol. 2013; 304: C273-C279.
- 20. Pryce R, Bernaitis N, Davey AK, et al. The Use of Fish Oil with Warfarin Does Not Significantly Affect either the International Normalised Ratio or Incidence of Adverse Events in Patients with Atrial Fibrillation and Deep Vein Thrombosis: A Retrospective Study. Nutrients 2016;8(9):578.
- 21. Larson M.K., Shearer G.C., Ashmore J.H. et al. Omega-3 fatty acids modulate collagen signaling in human platelets. Prostaglandins Leuko Essent Fatty Acids. 2011; 84: 93-98.
- 22. Role of FishOil in Post-CardiotomyBleeding: A Summary of the Basic ScienceandClinicalTrials. Carr JA. AnnThoracSurg. 2018 May;105(5):1563-1567. doi: 10.1016/j.athoracsur.2018.01.041. Epub 2018 Apr 5. Review.
- 23. Meredith D.S., Kepler C.K., Huang R.C., et al. The effect of omega-3 fatty-acid supplements on perioperative bleeding following posterior spinal arthrodesis. Eur Spine J. 2012; 21: 2659-2663.
- 24.Bays HE. Safety considerations with omega-3 fatty acid therapy. Am J Cardiol. 2007 Mar 19;99(6A):35C-43C. doi: 10.1016/j.amjcard.2006.11.020. Epub 2006 Nov 28. PMID: 17368277.
- 25. https://www.healthline.com/nutrition/fish-oil-side-effects#section11
- 26. TEMD dislipidemi tanı ve tedavi kılavuzu. Türkiye Endokrinoloji ve Metabolizma Derneği. Ankara: BAYT Bilimsel Araştırmalar Basın Yayın ve Tanıtım Ltd. Şti; 2018.
Öz
Fish oil is a widely used reinforcer for children by families nowadays due to its many structural and functional benefits. Although its positive effects on children’s mental development have been demonstrated widespread in some studies, there is no clear view about the necessity of its use in childhood. Besides the side effects of this promising supplement have not been fully illuminated, its use may cause susceptibility to bleeding, as mentioned in many different literature studies. The present case is a remarkable presentation of a prolonged benign pediatric epistaxis caused by fish oil, often preferred among supplements and used for children today. The patient’s condition improved significantly following the discontinuation of the reinforcement (fish oil). We submit our case to emphasize that the use of such products should also be subject to a standard assessment, based on our clinical experience. We suggest that only physicians decide to initiate fish oil in patients who needed it; more importantly, we also consider that they must monitor them closely as it can have side effects.
Anahtar Kelimeler
Fish oil Benign pediatric epistaxis Bleeding Omega fatty acids
Kaynakça
- 1. Leaf, A., and Weber, P.C. (1988) Cardiovascular Effects of n-3 Fatty Acids,N. Engl. J. Med. 318, 549–557.
- 2. İncesoy Özdemir, S , Akça, H , Bahçeci, O , Bulut, B . (2021). Çocuk Acil Servisine Epistaksis ile Başvuran Olguların Klinik ve Laboratuvar Değerlendirmesi . Türkiye Çocuk Hastalıkları Dergisi , 15 (1) , 1-5 . DOI: 10.12956/tchd.813262
- 3. Brown NJ, Berkowitz RG. Epistaxis in healthy children requiring hospital admission. Int J Pediatr Otorhinolaryngol 2004;68:1181-4.
- 4. Yengil E, Çevik C. Burun Kanamasına Birinci Basamakta Yaklaşım. Smyrna Tıp Dergisi 2014; 1: 45-50.
- 5. Damrose JF, Maddalazzo J. Pediatric epistaxis. Laryngoscope 2006; 116: 387– 93. 11. Patel N, Maddalozzo J, Billings KR. An update on management of pediatric epistaxis. Int J Pediatr Otorhinolaryngol 2014; 78: 1400-4.
- 6. Information Use and Needs of Complementary Medicines Users. Available online: https://www.nps.org.au/__data/assets/pdf_file/0010/66619/Complementary_Medicines_Report_-_ConsuCCon.pdf (accessed on 18 September 2016).
- 7. Barnes, P.M.; Bloom, B.; Nahin, RL Complementary and alternative medicine use among adults and children: United States, 2007. Natl. Health Stat. Report. 2008, 10, 1–23. [Google Scholar].
- 8. ESPGHAN Committee on Nutrition, Agostoni C, Braegger C, Decsi T, Kolacek S, Mihatsch W, Moreno LA, Puntis J, Shamir R, Szajewska H, Turck D, van Goudoever J. Supplementation of N-3 LCPUFA to the diet of children older than 2 years: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2011 Jul;53(1):2-10. doi: 10.1097/MPG.0b013e318216f009. PMID: 21694531.
- 9. Ryan AS, Astwood JD, Gautier S, Kuratko CN, Nelson EB, Salem N. Effects of long-chain polyun-saturated fatty acid supplementation on neurodevel-opment in childhood: A review of human studies. Pos-tagland Leukot Essent Fatty Acids 2010;82:305–314.
- 10. Nestel, P.; Clifton, P.; Colquhoun, D.; Noakes, M.; Mori, T.A.; Sullivan, D.; Thomas, B. Indications for omega-3 long chain polyunsaturated fatty acid in the prevention and treatment of cardiovascular disease. Heart Lung Circ. 2015, 24, 769–779. [Google Scholar] [CrossRef] [PubMed].
- 11. Calder, P. Long-chain n-3 fatty acids and inflammation: Potential application in surgical and trauma patients. Br. J. Med. Biol. Res. 2003, 36, 433–446. [Google Scholar] [CrossRef].
- 12. Fetterman, J.W., Jr.; Zdanowicz, M.M. Therapeutic potential of n-3 polyunsaturated fatty acids in disease. Am. J. Health Syst. Pharm. 2009, 66, 1169–1179. [Google Scholar] [CrossRef] [PubMed].
- 13. Miller, P.E.; Van Elswyk, M.; Alexander, D.D. Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: A meta-analysis of randomized controlled trials. Am. J. Hypertens. 2014, 27, 885–896. [Google Scholar] [CrossRef] [PubMed].
- 14. Flaten, H.; Høstmark, A.; Kierulf, P.; Lystad, E.; Trygg, K.; Bjerkedal, T.; Osland, A. Fish-oil concentrate: Effects on variables related to cardiovascular disease. Am. J. Clin. Nutr. 1990, 52, 300–306. [Google Scholar] [PubMed].
- 15. Paniccia R, Priora R, Liotta AA, Abbate R. Platelet function tests: a comparative review. Vasc Health Risk Manag. 2015;11:133-148. Published 2015 Feb 18. doi:10.2147/VHRM.S44469
- 16. Hamblin TJ. What about the bleeding time?. Br Med J (Clin Res Ed). 1985 Jul 13;291(6488):91. https://doi.org/10.1136/bmj.291.6488.91.
- 17. Russeau AP, Vall H, Manna B. Bleeding Time. [Updated 2020 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537233/
- 18. Saynor, R., Verel, D. Effect of a fish oil on blood lipids and coagulation. Thromb. Haemostas. 1981;46:65 (Abstr.).
- 19. Larson M.K., Tormoen G.W., Weaver L.J. et al. Exogenous modification of platelet membranes with the omega-3 fatty acids EPA and DHA reduces platelet procoagulant activity and thrombus formation. Am J Physiol Cell Physiol. 2013; 304: C273-C279.
- 20. Pryce R, Bernaitis N, Davey AK, et al. The Use of Fish Oil with Warfarin Does Not Significantly Affect either the International Normalised Ratio or Incidence of Adverse Events in Patients with Atrial Fibrillation and Deep Vein Thrombosis: A Retrospective Study. Nutrients 2016;8(9):578.
- 21. Larson M.K., Shearer G.C., Ashmore J.H. et al. Omega-3 fatty acids modulate collagen signaling in human platelets. Prostaglandins Leuko Essent Fatty Acids. 2011; 84: 93-98.
- 22. Role of FishOil in Post-CardiotomyBleeding: A Summary of the Basic ScienceandClinicalTrials. Carr JA. AnnThoracSurg. 2018 May;105(5):1563-1567. doi: 10.1016/j.athoracsur.2018.01.041. Epub 2018 Apr 5. Review.
- 23. Meredith D.S., Kepler C.K., Huang R.C., et al. The effect of omega-3 fatty-acid supplements on perioperative bleeding following posterior spinal arthrodesis. Eur Spine J. 2012; 21: 2659-2663.
- 24.Bays HE. Safety considerations with omega-3 fatty acid therapy. Am J Cardiol. 2007 Mar 19;99(6A):35C-43C. doi: 10.1016/j.amjcard.2006.11.020. Epub 2006 Nov 28. PMID: 17368277.
- 25. https://www.healthline.com/nutrition/fish-oil-side-effects#section11
- 26. TEMD dislipidemi tanı ve tedavi kılavuzu. Türkiye Endokrinoloji ve Metabolizma Derneği. Ankara: BAYT Bilimsel Araştırmalar Basın Yayın ve Tanıtım Ltd. Şti; 2018.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | İç Hastalıkları |
| Bölüm | Vaka Takdimi |
| Yazarlar | |
| Yayımlanma Tarihi | 22 Eylül 2022 |
| Kabul Tarihi | 8 Mart 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 4 Sayı: 3 |
Chief Editors
Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Turkey
Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Turkey
E-mail: medrecsjournal@gmail.com
Publisher:
Medical Records Association (Tıbbi Kayıtlar Derneği)
Address: Düzce / Türkiye
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