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Aksu B, Afonso AC, Akil I, Alpay H, Atmis B, Aydog O, Bayazıt AK, Bayram MT, Bilge I, Bulut IK, Buyukkaragoz B, Comak E, Demir BK, Dincel N, Donmez O, Durmus MA, Dursun H, Dusunsel R, Duzova A, Ertan P, Gedikbasi A, Goknar N, Guven S, Hacihamdioglu D, Jankauskiene A, Kalyoncu M, Kavukcu S, Kenan BU, Kucuk N, Kural B, Litwin M, Montini G, Morello W, Obrycki L, Omer B, Oner HA, Ozdemir EM, Ozkayin N, Paripovic D, Pehlivanoglu C, Saygili S, Schaefer F, Schaefer S, Sonmez F, Tabel Y, Tas N, Tasdemir M, Teixeira A, Tekcan D, Topaloglu R, Tulpar S, Turkkan ON, Uysal B, Uysalol M, Vitkevic R, Yavuz S, Yel S, Yildirim T, Yildirim ZY, Yildiz N, Yuksel S, Yurtseven E, Yilmaz A. Urine soluble TLR4 levels may contribute to predict urinary tract infection in children: the UTILISE Study. Pediatr Nephrol 2024; 39:483-491. [PMID: 37462743 DOI: 10.1007/s00467-023-06063-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND One of the most common bacterial infections in childhood is urinary tract infection (UTI). Toll-like receptors (TLRs) contribute to immune response against UTI recognizing specific pathogenic agents. Our aim was to determine whether soluble TLR4 (sTLR4), soluble TLR5 (sTLR5) and interleukin 8 (IL-8) can be used as biomarkers to diagnose UTI. We also aimed to reveal the relationship between urine Heat Shock Protein 70 (uHSP70) and those biomarkers investigated in this study. METHODS A total of 802 children from 37 centers participated in the study. The participants (n = 282) who did not meet the inclusion criteria were excluded from the study. The remaining 520 children, including 191 patients with UTI, 178 patients with non-UTI infections, 50 children with contaminated urine samples, 26 participants with asymptomatic bacteriuria and 75 healthy controls were included in the study. Urine and serum levels of sTLR4, sTLR5 and IL-8 were measured at presentation in all patients and after antibiotic treatment in patients with UTI. RESULTS Urine sTLR4 was higher in the UTI group than in the other groups. UTI may be predicted using 1.28 ng/mL as cut-off for urine sTLR4 with 68% sensitivity and 65% specificity (AUC = 0.682). In the UTI group, urine sTLR4 levels were significantly higher in pyelonephritis than in cystitis (p < 0.0001). Post-treatment urine sTLR4 levels in the UTI group were significantly lower than pre-treatment values (p < 0.0001). CONCLUSIONS Urine sTLR4 may be used as a useful biomarker in predicting UTI and subsequent pyelonephritis in children with UTI. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Bagdagul Aksu
- Department of Pediatrics Basic Sciences, Institute of Child Health, Istanbul University, Istanbul, Turkey.
- Division of Pediatric Nephrology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey.
| | - Alberto Caldas Afonso
- Division of Pediatric Nephrology, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ipek Akil
- Division of Pediatric Nephrology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Harika Alpay
- Division of Pediatric Nephrology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Bahriye Atmis
- Pediatric Nephrology, Erzurum Training and Research Hospital, Erzurum, Turkey
- Division of Pediatric Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ozlem Aydog
- Division of Pediatric Nephrology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Aysun Karabay Bayazıt
- Division of Pediatric Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Meral Torun Bayram
- Division of Pediatric Nephrology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ilmay Bilge
- Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Koc University, Istanbul, Turkey
| | - Ipek Kaplan Bulut
- Division of Pediatric Nephrology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Bahar Buyukkaragoz
- Division of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Elif Comak
- Division of Pediatric Nephrology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Belde Kasap Demir
- Division of Pediatric Nephrology, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
- Division of Pediatric Nephrology, Izmir Katip Celebi University Faculty of Medicine, Izmir, Turkey
| | - Nida Dincel
- Division of Pediatric Nephrology, Dr. Behcet Uz Children Diseases Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Osman Donmez
- Division of Pediatric Nephrology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Mehmet Akif Durmus
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hasan Dursun
- Division of Pediatric Nephrology, Okmeydani Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ruhan Dusunsel
- Division of Pediatric Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ali Duzova
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Pelin Ertan
- Division of Pediatric Nephrology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Asuman Gedikbasi
- Department of Rare Diseases, Institute of Child Health, Istanbul University, Istanbul, Turkey
| | - Nilufer Goknar
- Division of Pediatric Nephrology, Bagcilar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sercin Guven
- Division of Pediatric Nephrology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Duygu Hacihamdioglu
- Division of Pediatric Nephrology, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Augustina Jankauskiene
- Clinic of Pediatrics, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Mukaddes Kalyoncu
- Division of Pediatric Nephrology, Faculty of Medicine, Karadeniz Technic University, Trabzon, Turkey
| | - Salih Kavukcu
- Division of Pediatric Nephrology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Bahriye Uzun Kenan
- Division of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nuran Kucuk
- Division of Pediatric Nephrology, Kartal Training and Research Hospital, Istanbul, Turkey
| | - Bahar Kural
- Department of Pediatrics, Health Science University Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Mieczysław Litwin
- Division of Nephrology, Kidney Transplantation and Hypertension, The Children's Memorial Health Institute, Warsaw, Poland
| | - Giovanni Montini
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy
| | - William Morello
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Lukasz Obrycki
- Division of Nephrology, Kidney Transplantation and Hypertension, The Children's Memorial Health Institute, Warsaw, Poland
| | - Beyhan Omer
- Department of Biochemistry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Huseyin Adil Oner
- Division of Pediatric Nephrology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey
| | - Ebru Misirli Ozdemir
- Department of Pediatrics, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Nese Ozkayin
- Division of Pediatric Nephrology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Dusan Paripovic
- Division of Pediatric Nephrology, University Children's Hospital, Belgrade, Serbia
| | - Cemile Pehlivanoglu
- Division of Pediatric Nephrology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Seha Saygili
- Division of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Franz Schaefer
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University, Heidelberg, Germany
| | - Susanne Schaefer
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University, Heidelberg, Germany
| | - Ferah Sonmez
- Division of Pediatric Nephrology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Yilmaz Tabel
- Division of Pediatric Nephrology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Nesrin Tas
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Tasdemir
- Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Koc University, Istanbul, Turkey
- Department of Pediatric Nephrology, Istinye University, Faculty of Medicine, Liv Hospital Ulus, Istanbul, Turkey
| | - Ana Teixeira
- Division of Pediatric Nephrology, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Demet Tekcan
- Division of Pediatric Nephrology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Rezan Topaloglu
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sebahat Tulpar
- Division of Pediatric Nephrology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ozde Nisa Turkkan
- Division of Pediatric Nephrology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Berfin Uysal
- Division of Pediatric Nephrology, Dortcelik Children's Hospital, Bursa, Turkey
- Division of Pediatric Nephrology, Bursa City Hospital, Bursa, Turkey
| | - Metin Uysalol
- Division of Pediatric Emergency, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Renata Vitkevic
- Clinic of Pediatrics, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Sevgi Yavuz
- Division of Pediatric Nephrology, Department of Pediatrics, Kanuni Sultan Suleyman Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sibel Yel
- Division of Pediatric Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Tarik Yildirim
- Department of Pediatrics, Kanuni Sultan Suleyman Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zeynep Yuruk Yildirim
- Department of Pediatrics Basic Sciences, Institute of Child Health, Istanbul University, Istanbul, Turkey
- Division of Pediatric Nephrology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey
| | - Nurdan Yildiz
- Division of Pediatric Nephrology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Selcuk Yuksel
- Division of Pediatric Nephrology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Eray Yurtseven
- Department of Biostatistics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alev Yilmaz
- Department of Pediatrics Basic Sciences, Institute of Child Health, Istanbul University, Istanbul, Turkey
- Division of Pediatric Nephrology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey
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Uzun Kenan B, Demircioglu Kilic B, Akbalık Kara M, Taktak A, Karabay Bayazit A, Yuruk Yildirim ZN, Delibas A, Aytac MB, Conkar S, Kaya Aksoy G, Donmez O, Yel S, Saygili S, Akaci O, Buyukkaragoz B, Alpay H, Bakkaloglu SA. Evaluation of the Claria sharesource system from the perspectives of patient/caregiver, physician, and nurse in children undergoing automated peritoneal dialysis. Pediatr Nephrol 2023; 38:471-477. [PMID: 35562513 PMCID: PMC9106572 DOI: 10.1007/s00467-022-05563-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Automated peritoneal dialysis (APD) is increasingly preferred worldwide. By using a software application (Homechoice with Claria sharesource system (CSS)) with a mod-M added to the APD device, details of the home dialysis treatment become visible for PD nurses and physicians, allowing for close supervision. We aimed to evaluate the perceptions of patients/caregivers, PD nurses, and physicians about the advantages and disadvantages of CSS. METHODS Three different web-based questionnaires for patients/caregivers, nurses, and physicians were sent to 15 pediatric nephrology centers with more than 1 year of experience with CSS. RESULTS Respective questionnaires were answered by 30 patients/caregivers, 22 pediatric nephrologists, and 15 PD nurses. Most of the nurses and physicians (87% and 73%) reported that CSS improved patient monitoring. A total of 73% of nurses suggested that CCS is not well known by physicians, while half of them reported reviewing CSS data for all patients every morning. Sixty-eight percent of physicians thought that CSS helps save time for both patients/caregivers and healthcare providers by reducing visits. However, only 20% of patients/caregivers reported reduced hospital visits. A total of 90% of patients/caregivers reported that being under constant monitoring made them feel safe, and 83% stated that the patient's sleep quality improved. CONCLUSIONS A remote monitoring APD system, CSS, can be successfully applied with children for increased adherence to dialysis prescription by giving shared responsibility and may help increase the patient's quality of life. This platform is more commonly used by nurses than physicians. Its potential benefits should be evaluated in further well-designed clinical studies with larger patient groups. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Bahriye Uzun Kenan
- Department of Pediatric Nephrology, Gazi University School of Medicine, Besevler, Ankara, Turkey
| | | | | | - Aysel Taktak
- Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey
| | | | | | - Ali Delibas
- Mersin University School of Medicine, Mersin, Turkey
| | | | - Secil Conkar
- Ege University School of Medicine, Izmir, Turkey
| | | | - Osman Donmez
- Uludag University School of Medicine, Bursa, Turkey
| | - Sibel Yel
- Erciyes University School of Medicine, Kayseri, Turkey
| | - Seha Saygili
- Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Okan Akaci
- Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Bahar Buyukkaragoz
- Department of Pediatric Nephrology, Gazi University School of Medicine, Besevler, Ankara, Turkey
| | - Harika Alpay
- Marmara University School of Medicine, Istanbul, Turkey
| | - Sevcan A Bakkaloglu
- Department of Pediatric Nephrology, Gazi University School of Medicine, Besevler, Ankara, Turkey.
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3
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Pınarbaşı AS, Dursun I, Gokce I, Çomak E, Saygılı S, Bayram MT, Donmez O, Melek E, Tekcan D, Çiçek N, Yılmaz D, Tabel Y, Yıldırım ZY, Bahat E, Koyun M, Soylu A, Canpolat N, Aksu B, Çelakıl ME, Taşdemir M, Benzer M, Özçelik G, Bakkaloğlu SA, Düşünsel R. Predictors of poor kidney outcome in children with C3 glomerulopathy. Pediatr Nephrol 2021; 36:1195-1205. [PMID: 33130981 DOI: 10.1007/s00467-020-04799-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/13/2020] [Accepted: 09/24/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND C3 glomerulopathy (C3G) is characterized by heterogeneous clinical presentation, outcome, and predominant C3 accumulation in glomeruli without significant IgG. There is scarce outcome data regarding childhood C3G. We describe clinical and pathological features, treatment and outcomes, and risk factors for progression to chronic kidney disease stage 5 (CKD5) in the largest pediatric series with biopsy-proven C3G. METHODS Sixty pediatric patients with C3G from 21 referral centers in Turkey were included in this retrospective study. Patients were categorized according to CKD stage at last visit as CKD5 or non-CKD5. Demographic data, clinicopathologic findings, treatment, and outcome data were compared and possible risk factors for CKD5 progression determined using Cox proportional hazards model. RESULTS Mean age at diagnosis was 10.6 ± 3.0 years and follow-up time 48.3 ± 36.3 months. Almost half the patients had gross hematuria and hypertension at diagnosis. Nephritic-nephrotic syndrome was the commonest presenting feature (41.6%) and 1/5 of patients presented with nephrotic syndrome. Membranoproliferative glomerulonephritis was the leading injury pattern, while 40 patients had only C3 staining. Patients with DDD had significantly lower baseline serum albumin compared with C3GN. Eighteen patients received eculizumab. Clinical remission was achieved in 68.3%. At last follow-up, 10 patients (16.6%) developed CKD5: they had lower baseline eGFR and albumin and higher frequency of nephrotic syndrome and dialysis requirement than non-CKD5 patients. Lower serum albumin and eGFR at diagnosis were independent predictors for CKD5 development. CONCLUSIONS Children with C3G who have impaired kidney function and hypoalbuminemia at diagnosis should be carefully monitored for risk of progression to CKD5. Graphical abstract.
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Affiliation(s)
- Ayşe Seda Pınarbaşı
- Department of Pediatric Nephrology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
| | - Ismail Dursun
- Department of Pediatric Nephrology, Erciyes University, Faculty of Medicine, Kayseri, Turkey.
| | - Ibrahim Gokce
- Department of Pediatric Nephrology, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Elif Çomak
- Department of Pediatric Nephrology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Seha Saygılı
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University, İstanbul, Turkey
| | - Meral Torun Bayram
- Department of Pediatric Nephrology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Osman Donmez
- Department of Pediatric Nephrology, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Engin Melek
- Department of Pediatric Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Demet Tekcan
- Department of Pediatric Nephrology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Neslihan Çiçek
- Department of Pediatric Nephrology, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Dilek Yılmaz
- Department of Pediatric Nephrology, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Yılmaz Tabel
- Department of Pediatric Nephrology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Zeynep Y Yıldırım
- Department of Pediatric Nephrology, Istanbul Faculty of Medicine, Istanbul University, İstanbul, Turkey
| | - Elif Bahat
- Department of Pediatric Nephrology, Faculty of Medicine, Karadeniz Teknik University, Trabzon, Turkey
| | - Mustafa Koyun
- Department of Pediatric Nephrology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Alper Soylu
- Department of Pediatric Nephrology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Nur Canpolat
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University, İstanbul, Turkey
| | - Bağdagül Aksu
- Department of Pediatric Nephrology, University of Health Sciences, Haseki Education and Research Hospital, İstanbul, Turkey
| | - Mehtap Ezel Çelakıl
- Department of Pediatric Nephrology, Faculty of Medicine, Kocaeli University, İzmit, Kocaeli, Turkey
| | - Mehmet Taşdemir
- Department of Pediatric Nephrology, Faculty of Medicine, Koç University, İstanbul, Turkey
| | - Meryem Benzer
- Department of Pediatric Nephrology, Bakırköy Dr Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Gül Özçelik
- Department of Pediatric Nephrology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Sevcan A Bakkaloğlu
- Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ruhan Düşünsel
- Department of Pediatric Nephrology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Yesilkaya S, Acikel C, Fidanci BE, Polat A, Sozeri B, Ayaz NA, Makay BB, Simsek D, Akinci N, Özçelik G, Kavukçu S, Emre S, Donmez O, Delibas A, Yüksel S, Berdeli A, Poyrazoglu H, Saldir M, Fidanci K, Çakar N, Peru H, Bakkaloglu S, Tabel Y, Sari O, Aydogan U, Ozenc S, Basbozkurt G, Unsal E, Kasapcopur Ö, Gok F, Ozen S, Demirkaya E. Development of a medication adherence scale for familial Mediterranean fever (MASIF) in a cohort of Turkish children. Clin Exp Rheumatol 2015; 33:S156-62. [PMID: 26393894 DOI: pmid/26393894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 06/05/2015] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To develop and assess the validity and reliability of an adherence scale concerning medical treatment in paediatric FMF patients. METHODS The Medication Adherence Scale in FMF Patients (MASIF) is a 18-item questionnaire that evaluates adherence to medication in four domains. Validation of the instrument was accomplished in paediatric FMF patients (aged 2-18 years) under medication at least for 6 months. The first step was to build up the scale through qualitative approach (with interviews using semi-structured questions). Validation analyses included assessment of feasibility, face and content validity; construct validity, internal consistency and test-retest reliability. RESULTS One hundred and fifty patients with FMF were enrolled in the study. The mean age of the patients was 11.11±4.02 years and 48.7% of them were male. The MASIF was found to be feasible and valid for both face and content. It correlated with the Morisky Medication Adherence Scale as a gold standard thereby demonstrating good construct validity (r=0.515, p<0.001). Assessment of content validity identified four subscales. The internal consistency, Cronbach's alpha was 0.728. There was a positive and significant correlation between test and retest scores (r=0.843; p<0.001). Also, a significant correlation between parents' and children's reports (r=0.781, p<0.001). CONCLUSIONS Based on these results, the use of this scale to assess and follow up the adherence to treatment in paediatric FMF patients under medical treatment is recommended.
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Affiliation(s)
- Sirzat Yesilkaya
- Gulhane Military Medical Academy, Department of Family Medicine, Ankara, Turkey
| | - Cengizhan Acikel
- Gulhane Military Medical Faculty, Department of Biostatistics, Ankara, Turkey
| | - Berna Eren Fidanci
- Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey, Turkey
| | - Adem Polat
- Gulhane Military Medical Faculty, Department of Pediatrics, Ankara, Turkey
| | - Betül Sozeri
- Ege University Faculty of Medicine, Pediatric Rheumatology, Izmir, Turkey
| | - Nuray Aktay Ayaz
- Kanuni Sultan Suleyman Research and Training Hospital, Pediatric Nephrology-Rheumatology, Istanbul, Turkey
| | - Balahan Bora Makay
- Dokuz Eylul University Hospital, Department of Pediatrics, İzmir, Turkey
| | - Dogan Simsek
- Gulhane Military Medical Faculty, Department of Pediatrics, Ankara, Turkey
| | - Nurver Akinci
- Sisli Etfal Education and Research Hospital, Department of Pediatrics, Istanbul, Turkey
| | - Gul Özçelik
- Sisli Etfal Education and Research Hospital, Department of Pediatrics, Istanbul, Turkey
| | - Salih Kavukçu
- Dokuz Eylul University Hospital, Department of Pediatrics, İzmir, Turkey
| | - Sevinc Emre
- Istanbul University, Department of Pediatrics, Istanbul, Turkey
| | - Osman Donmez
- Uludag University Medical Faculty, Dept. of Pediatric Rheumatology, Bursa, Turkey
| | - Ali Delibas
- Akdeniz University, Department of Pediatrics, Mersin, Turkey
| | - Selcuk Yüksel
- Pamukkale University Medical Faculty, Dept. of Paediatrics, Denizli, Turkey
| | - Afig Berdeli
- Ege University Faculty of Medicine, Pediatric Rheumatology, Izmir, Turkey
| | - Hakan Poyrazoglu
- Erciyes University Medical Faculty, Department of Paediatrics, Kayseri, Turkey
| | - Mehmet Saldir
- Gulhane Military Medical Faculty, Department of Pediatrics, Ankara, Turkey
| | - Kursat Fidanci
- Gulhane Military Medical Faculty, Department of Pediatrics, Ankara, Turkey
| | - Nilgun Çakar
- Ministry of Health Dıskapı Children's Hospital, Paediatric Nephrology, Ankara, Turkey
| | - Harun Peru
- Selcuk University, Department of Paediatrics, Ankara, Turkey
| | | | - Yilmaz Tabel
- Inonu University, Paediatric Nephrology, Malatya, Turkey
| | - Oktay Sari
- Gulhane Military Medical Academy, Department of Family Medicine, Ankara, Turkey
| | - Umit Aydogan
- Gulhane Military Medical Academy, Department of Family Medicine, Ankara, Turkey
| | - Salim Ozenc
- Gulhane Military Medical Academy, Department of Family Medicine, Ankara, Turkey
| | - Gokalp Basbozkurt
- Gulhane Military Medical Faculty, Department of Pediatrics, Ankara, Turkey
| | - Erbil Unsal
- Dokuz Eylul University Hospital, Department of Pediatrics, İzmir, Turkey
| | | | - Faysal Gok
- Gulhane Military Medical Faculty, Paediatric Rheumatology Unit, Ankara, Turkey
| | - Seza Ozen
- Hacettepe University, Paediatric Nephrology and Rheumatology Unit, Ankara, Turkey
| | - Erkan Demirkaya
- Gulhane Military Medical Faculty, Paediatric Rheumatology Unit, Ankara; and Gulhane Military Medical Academy, FMF Arthritis Vasculitis and Orphan disease Research in Paediatric Rheumatology, Ankara, Turkey.
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Yesilkaya S, Acikel C, Fidanci BE, Sozeri B, Ayaz NA, Akıncı N, Kavukçu S, Özçelik G, Aydogan U, Ozenç S, Emre S, Donmez O, Delibaş A, Yüksel S, Berdelli A, Poyrazoğlu H, Saldır M, Çakar N, Peru H, Bakkaloğlu S, Tabel Y, Sarı O, Polat A, Basbozkurt G, Unsal E, Kasapcopur O, Gok F, Ozen S, Demirkaya E. Developing of a new scale for assessing the adherence to colchicine treatment in pediatric patients with FMF. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599882 DOI: 10.1186/1546-0096-13-s1-p109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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6
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Donmez O, Akaci O, Albayrak N, Altas A. Safety and Effectiveness of a 2009 H1N1 Vaccine in Chronic Kidney Disease Children. ACTA ACUST UNITED AC 2014; 128:341-4. [DOI: 10.1159/000368410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 08/04/2014] [Indexed: 11/19/2022]
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Erol FS, Cakin H, Ozturk S, Donmez O, Kaplan M. Free floating ventricular shunt catheter between lateral ventricles: a case report of an unusual ventriculoperitoneal shunt complication. Turk Neurosurg 2013; 23:821-3. [PMID: 24310472 DOI: 10.5137/1019-5149.jtn.6351-12.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Ventriculoperitoneal (VP) shunt proximal tip disconnection is rarely seen as a shunt complication. Shunt dysfunction and hydrocephaly can develop due to this disconnection. Presented here is a case of a disconnection of the ventricular catheter from the shunt valve, which passed between both lateral ventricles by free floating in the brain CT. The patient was operated on for hydrocephaly. The dysfunctional shunt valve and peritoneal catheter were removed and a new VP shunt system was implemented. Although some publications report that the ventricular catheter can be disconnected from the shunt valve, can adhere to the intraventricular structures, and can be a source of infection, no studies similar to the current case were found in the literature reporting a free floating ventricular catheter between the lateral ventricles.
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Affiliation(s)
- Fatih Serhat Erol
- Firat University, Faculty of Medicine, Department of Neurosurgery, Elazig, Turkey
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8
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Demirkaya E, Acikel C, Basbozkurt G, Gul A, Kasapcopur O, Aydog O, Erdem H, Duzova A, Kisacik B, Kasifoglu T, Erken E, Tunca M, Sayarlioglu M, Yuksel S, Yildiz F, Donmez O, Berdeli A, Senel S, Ayaz NA, Polat A, Sozer B, Tabel Y, Akar S, Onat AM, Ozkaya O, Emre S, Akinca N, Ozcelik G, Yavuz S, Yesilkaya S, Gok F, Poyrazoglu HM, Direskeneli H, Bakkaloglu S, Erten S, Tufan A, Goker B, Kavukcu S, Cakar N, Saldir M, Delibas A, Makay B, Kısaarslan A, Unsal SE, Ozdogan H, Topaloglu R, Ozen S. PReS-FINAL-2213: Validation of inadequate drug response and definition of colchicum resistance in FMF. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044079 DOI: 10.1186/1546-0096-11-s2-p203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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9
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Yesilkaya S, Acıkel C, Eren Fidanci B, Sozeri B, Aktay Ayaz N, Akıncı N, Ozcelik G, Kavukcu S, Aydogan Ü, Ozenc S, Emre S, Donmez O, Yuksel S, Delibas A, Berdelli A, Poyrazoglu H, Saldir M, Cakar N, Peru H, Bakkaloglu S, Tabel Y, Sari O, Polat A, Basbozkurt G, Unsal E, Gok F, Kasapcopur O, Ozen S, Demirkaya E. PReS-FINAL-2204: Developing of a new scale for assessing the adherence to colchicines treatment in pediatric patients with FMF. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044573 DOI: 10.1186/1546-0096-11-s2-p194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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10
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Demirkaya E, Acikel C, Tufan A, Kucuk A, Berdeli A, Gul A, Onat AM, Delibas A, Duzova A, Dinc A, Yavascan O, Kasapcopur O, Makay B, Goker B, Sozeri B, Kisacik B, Comak E, Unsal E, Erken E, Gunal E, Baskin E, Yalcinkaya F, Yildiz F, Gok F, Basbozkurt G, Ozcelik G, Demircin G, Poyrazoglu H, Erdem H, Direskeneli H, Ozer H, Ozdogan H, Simsek I, Dursun I, Gokce I, Tunca M, Gurgoze M, Cakar N, Akinci N, Ayaz N, Donmez O, Ozkaya O, Topaloglu R, Kavukcu S, Yuksel S, Akar S, Bakkaloglu S, Emre S, Senel S, Erten S, Yavuz S, Kalman S, Kasifoglu T, Kalyoncu U, Tabel Y, Ekinci Z, Ozen S. PW01-025 – Definition of colchicine resistance in FMF. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952434 DOI: 10.1186/1546-0096-11-s1-a78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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11
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Zincircioglu SB, Kaplan MA, Isikdogan A, Cil T, Karadayi B, Dirier A, Kucukoner M, Inal A, Yildiz I, Aggil F, Donmez O, Urakci Z, Pekkolay Z, Firat U. Contribution of low-molecular weight heparin addition to concomitant chemoradiotherapy in the treatment of glioblastoma multiforme. J BUON 2012; 17:124-127. [PMID: 22517705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE Glioblastoma multiforme (GBM) is the most common brain tumor in adults and has a very aggressive course. Median survival is as short as 2 years with standard treatment (chemoradiotherapy followed by adjuvant temozolomide). The purpose of this study was to determine the contribution of low molecular weight heparin (LMWH) addition to concomitant chemoradiotherapy in the treatment of GBM. METHODS All patients with newly diagnosed GBM between March 2004-May 2009 were evaluated. After surgical intervention (total, subtotal resection or only biopsy) all of them were treated with concomitant chemoradiotherapy (2 Gy daily, 5 days a week, 30 fractions, total tumor dose 60 Gy; and 75 mg/m² temozolomide, 7 days a week), followed by adjuvant temozolomide (6 cycles, 150-200 mg/m², 5 days every 28 days), with or without LMWH (4000 IU/day, 7 days a week, concomitant with radiotherapy) because of risk of thrombosis. The primary endpoint was the determination of progression-free survival (PFS) and overall survival (OS); secondary endpoints were 1- and 2-year OS survival. RESULTS 30 patients (13 patients in the group non receiving LMWH (LMWH-) and 17 patients in the group receiving LMWH (LMWH+)) were included in the study. Median age was 54 years (range 24-75). Median PFS was 57 and 38 weeks in LMWH+ and LMWH- groups, respectively (p=0.068). Median OS was 69 and 44 weeks (p=0.095), 1-year OS survival 84.6 and 41.2% (p=0.016), and 2-year OS survival 38.5 and 5.9% in LMWH+ and LMWH-, respectively (p=0.061). No significant difference was noted between the two groups for grade 3-4 toxicity (p>0.05). CONCLUSION Better PFS, OS and 2-year OS survival were obtained in present study with the addition of LMWH to concomitant chemoradiation for GBM but without statistical significance. One-year OS survival was statistically significant favoring the LMWH group. The addition of LMWH did not increase temozolomide toxicity.
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Affiliation(s)
- S B Zincircioglu
- Department of Radiation Oncology, Dicle University, Diyarbakir, Turkey
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12
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Topaloglu R, Baskın E, Bahat E, Kavukcu S, Cakar N, Donmez O, Guven AG, Calıskan S, Erdogan O, Yalcınkaya F. Hereditary renal tubular disorders in Turkey: demographic, clinical, and laboratory features. Clin Exp Nephrol 2010; 15:108-13. [PMID: 21103902 DOI: 10.1007/s10157-010-0367-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 10/12/2010] [Indexed: 02/05/2023]
Affiliation(s)
- Rezan Topaloglu
- Department of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey.
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13
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Soylemezoglu O, Ozkaya O, Ozen S, Bakkaloglu A, Dusunsel R, Peru H, Cetinyurek A, Yildiz N, Donmez O, Buyan N, Mir S, Arisoy N, Gur-Guven A, Alpay H, Ekim M, Aksu N, Soylu A, Gok F, Poyrazoglu H, Sonmez F. Henoch-Schönlein nephritis: a nationwide study. Nephron Clin Pract 2009; 112:c199-204. [PMID: 19439991 DOI: 10.1159/000218109] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Accepted: 11/24/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIM The aim of this retrospective study was to evaluate the presentation, clinical and pathological manifestations and outcome of the Henoch-Schönlein purpura (HSP) nephritis in children. METHODS Clinical and laboratory data of 443 children with HSP nephritis aged between 3 and 16 years from 16 pediatric nephrology reference centers were analyzed retrospectively. The biopsy findings were graded according to the classification developed by the International Study of Kidney Disease in Children (ISKDC). RESULTS Renal biopsy was performed in 179 of the patients with HSP nephritis. The most common presenting clinical finding in patients who were biopsied was nephrotic range proteinuria (25%) which was followed by nephritic-nephrotic syndrome (23.5%). The biopsy findings according to the ISKDC were as follows: class I: 8.3%; II: 44.1%; III: 36.3%; IV: 6.7%; V: 3.3%; VI: 1.1%. All of the patients who developed end-stage renal disease had nephritic-nephrotic syndrome at presentation. Of 443 patients, 87.2% had a favorable outcome and 12.8% had an unfavorable outcome. The overall percentage of children who developed end-stage renal disease at follow-up was 1.1%. Logistic regression analysis did not show any association of initial symptoms and histology with outcome. CONCLUSION In the presented cohort, the presence of crescents in the first biopsy or presenting clinical findings did not seem to predict the outcome of HSP nephritis in children. We conclude that children with HSP nephritis even with isolated microscopic hematuria and/or mild proteinuria should be followed closely.
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Affiliation(s)
- O Soylemezoglu
- Gazi University, Department of Pediatric Nephrology, Ankara, Turkey
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14
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Berdeli A, Mir S, Yavascan O, Serdaroglu E, Bak M, Aksu N, Oner A, Anarat A, Donmez O, Yildiz N, Sever L, Tabel Y, Dusunsel R, Sonmez F, Cakar N. NPHS2 (podicin) mutations in Turkish children with idiopathic nephrotic syndrome. Pediatr Nephrol 2007; 22:2031-40. [PMID: 17899208 DOI: 10.1007/s00467-007-0595-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2007] [Revised: 07/10/2007] [Accepted: 07/13/2007] [Indexed: 10/22/2022]
Abstract
The podocin (NPHS2) gene encodes podocin protein, which has an important role in glomerular ultrafiltration and controlling slit membrane permeability. The detection of an NPHS2 mutation affects the treatment plan for children with nephritic syndrome (NS). The frequency and spectrum of podocin mutations in the Turkish population have remained largely unknown. The aim of this study was to screen for podocin mutations in Turkish patients with steroid-resistant NS (SRNS) and to compare it with other published series. There were 295 children with SRNS, originating from Turkey, included in this study. Forty-one patients (13.8%) had familial NS and 254 patients (86.2%) had sporadic NS. Mutation analysis was performed in all eight exons of the NPHS2 gene with the direct DNA sequencing method. There were 53 different pathogenetic NPHS2 mutations detected, including 37 novel mutations. The mutation detection rate was 24.7% for all patients, 29.2% for familial, and 24% for sporadic SRNS. The most common mutated exon was exon 5 (52 allele). The presence of mutations in exon 4 was found to increase the risk of end-stage renal disease (ESRD). Among patients with mutations, the rates of renal failure and/or ESRD (26%) were significantly higher than in those without mutations (12.6%). The mean time of progression to renal failure and ESRD in patients with mutations (1.8 +/- 2.5 years) was significantly shorter than in patients without mutations (3.7 +/- 4.0 years). Additionally, in patients with heterozygote mutations, fewer cases (13.6%) progressed to renal failure and/or ESRD than in with patients who had homozygote/compound heterozygote mutations (31.3%). In conclusion, podocin mutations are responsible for some of both familial and sporadic SRNS cases in Turkey. The mutations in this gene should be searched for in every child after presentation with the first episode of NS.
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Affiliation(s)
- Afig Berdeli
- Department of Molecular Genetics, Ege University Faculty of Medicine, Izmir, Turkey.
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15
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Schaefer F, Feneberg R, Aksu N, Donmez O, Sadikoglu B, Alexander SR, Mir S, Ha IS, Fischbach M, Simkova E, Watson AR, Möller K, von Baum H, Warady BA. Worldwide variation of dialysis-associated peritonitis in children. Kidney Int 2007; 72:1374-9. [PMID: 17882152 DOI: 10.1038/sj.ki.5002523] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Peritonitis is the most common cause of dialysis failure in children on chronic peritoneal dialysis. We performed a prospective study of 501 peritonitis episodes in 44 pediatric dialysis centers located in 14 countries that examined peritonitis etiology, efficiency of opinion-based management guidelines, and final outcomes. Culture-negative incidence varied significantly from 11% in North America to 67% in Mexico. Argentina and North America had the highest rate of Gram-negative episodes. Pseudomonas-based peritonitis was eightfold more common in the United States than in Europe, and correlated with the frequency of exit site cleansing and topical mupirocin administration. Significant regional variation in antibiotic susceptibility was noted for the first generation cephalosporins and aminoglycosides. Initial response rates to standardized empiric antibiotic treatment did not differ between regions; however, final outcomes were significantly less favorable in Eastern Europe. The wide regional variation in culture-negative peritonitis, and the distribution and antibiotic susceptibilities of causative bacteria needs to be taken into consideration when the guidelines for empiric therapy of pediatric dialysis-associated peritonitis are revised.
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Affiliation(s)
- F Schaefer
- Division of Pediatric Nephrology, University of Heidelberg, Heidelberg, Germany.
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16
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Warady BA, Feneberg R, Verrina E, Flynn JT, Müller-Wiefel DE, Besbas N, Zurowska A, Aksu N, Fischbach M, Sojo E, Donmez O, Sever L, Sirin A, Alexander SR, Schaefer F. Peritonitis in children who receive long-term peritoneal dialysis: a prospective evaluation of therapeutic guidelines. J Am Soc Nephrol 2007; 18:2172-9. [PMID: 17582162 DOI: 10.1681/asn.2006101158] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
In children who are on chronic peritoneal dialysis, peritonitis is the primary complication compromising technique survival, and the optimal therapy of peritonitis remains uncertain. An Internet-based International Pediatric Peritonitis Registry was established in 47 pediatric centers from 14 countries to evaluate the efficacy and safety of largely opinion-based peritonitis treatment guidelines in which empiric antibiotic therapy was stratified by disease severity. Among a total of 491 episodes of nonfungal peritonitis entered into the registry, Gram-positive organisms were cultured in 44%, Gram-negative organisms were cultured in 25%, and cultures remained negative in 31% of the episodes. In vitro evaluation revealed 69% sensitivity of Gram-positive organisms to a first-generation cephalosporin and 80% sensitivity of Gram-negative organisms to a third-generation cephalosporin. Neither the risk factors assumed by the guidelines nor the choice of empiric therapy was predictive of either the early treatment response or the final functional outcome of the peritonitis episodes. Overall, 89% of cases achieved full functional recovery, a portion after relapsing peritonitis (9%). These data serve as the basis for new evidence-based guidelines. Modification of empiric therapy to include aminoglycosides should be considered.
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Affiliation(s)
- Bradley A Warady
- Pediatric Nephrology, Children's Mercy Hospital, Kansas City, MO 64108, USA.
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17
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Ozen S, Bakkaloglu A, Dusunsel R, Soylemezoglu O, Ozaltin F, Poyrazoglu H, Kasapcopur O, Ozkaya O, Yalcinkaya F, Balat A, Kural N, Donmez O, Alpay H, Anarat A, Mir S, Gur-Guven A, Sonmez F, Gok F. Childhood vasculitides in Turkey: a nationwide survey. Clin Rheumatol 2006; 26:196-200. [PMID: 16586044 DOI: 10.1007/s10067-006-0266-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Revised: 02/22/2006] [Accepted: 02/23/2006] [Indexed: 10/24/2022]
Abstract
AIM The aims of this study were to evaluate the characteristics of childhood vasculitides and to establish the first registry in Turkey, an eastern Mediterranean country with a white population. PATIENTS AND METHODS A questionnaire was distributed to the main referral centers asking for the registration of the Henoch-Schönlein purpura (HSP) patients in the last calendar year only and 5 years for other vasculitides. Demographic, clinical, and laboratory data were assessed. RESULTS Vasculitic diseases were registered from 15 pediatric centers. These centers had a fair representation throughout the country. In the last calendar year, incidences were as follows: HSP 81.6%, Kawasaki disease (KD) 9.0%, childhood polyarteritis nodosa (C-PAN) 5.6%, Takayasu arteritis (TA) 1.5%, Wegener's granulomatosis 0.4%, and Behçet disease 1.9%. There was no clear gender dominance. The mean age was 11.05+/-4.89 years. Acute phase reactants were elevated in almost all, highest figures being in C-PAN. Renal involvement was present in 28.6% of HSP and 53% of the C-PAN patients. Abdominal aorta was involved in all TA patients. Among the C-PAN patients, 25% had microscopic PAN with necrotizing glomerulonephritis; antineutrophil cytoplasmic antibody was positive in those who were studied. Among the patients, 12.5% and 15% had classic PAN and cutaneous PAN, respectively. The remaining majority were classified as systemic C-PAN diagnosed with biopsies and/or angiograms demonstrating small to midsize artery involvement. The overall prognosis was better than reported in adult series. CONCLUSION This is the largest multicenter study defining the demographic data for childhood vasculitides. The distribution of childhood vasculitides was different in our population where KD is much less frequent, whereas HSP constitutes an overwhelming majority. C-PAN was more frequent as well.
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Affiliation(s)
- Seza Ozen
- Department of Pediatrics, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey.
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Kilic SS, Donmez O, Sloan EA, Elizondo LI, Huang C, André JL, Bogdanovic R, Cockfield S, Cordeiro I, Deschenes G, Fründ S, Kaitila I, Lama G, Lamfers P, Lücke T, Milford DV, Najera L, Rodrigo F, Saraiva JM, Schmidt B, Smith GC, Stajic N, Stein A, Taha D, Wand D, Armstrong D, Boerkoel CF. Association of migraine-like headaches with Schimke immuno-osseous dysplasia. Am J Med Genet A 2005; 135:206-10. [PMID: 15884045 DOI: 10.1002/ajmg.a.30692] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Schimke immuno-osseous dysplasia (SIOD) is characterized by spondyloepiphyseal dysplasia, nephropathy, and T-cell deficiency. SIOD is caused by mutations in the putative chromatin remodeling protein SMARCAL1. We report an 8-year-old boy with SIOD and recurrent, severe, refractory migraine-like headaches. Through a retrospective questionnaire-based study, we found that refractory and severely disabling migraine-like headaches occur in nearly half of SIOD patients. We have also found that the vasodilator minoxidil provided symptomatic relief for one patient. We hypothesize that these headaches may arise from an intrinsic vascular, neuroimmune, or neurovascular defect resulting from loss of SMARCAL1 function.
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Affiliation(s)
- Sara Sebnem Kilic
- Department of Pediatrics, Division of Immunology, Uludag University Medical Faculty, Görükle-Bursa, Turkey
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Bakkaloglu SA, Ekim M, Sever L, Noyan A, Aksu N, Akman S, Elhan AH, Yalcinkaya F, Oner A, Kara OD, Caliskan S, Anarat A, Dusunsel R, Donmez O, Guven AG, Bakkaloglu A, Denizmen Y, Soylemezoglu O, Ozcelik G. Chronic peritoneal dialysis in Turkish children: a multicenter study. Pediatr Nephrol 2005; 20:644-51. [PMID: 15717162 DOI: 10.1007/s00467-004-1773-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2004] [Revised: 11/10/2004] [Accepted: 11/11/2004] [Indexed: 11/25/2022]
Abstract
Chronic peritoneal dialysis (CPD) has been utilized in the treatment of children since 1989 in Turkey. The aims of this study were to summarize our experience with CPD in children and to establish a pediatric registry data system in Turkey. Standard questionnaires were sent to all pediatric CPD centers. 514 patients treated between 1989 and 2002 in 12 pediatric centers were enrolled in the study. Reflux nephropathy was the most common (18.1%) cause of renal failure. Mean age at dialysis initiation was 10.1+/-4.6 years. Mean duration of dialysis was 24.1+/-20.5 months. Continuous ambulatory peritoneal dialysis (CAPD) was the first CPD modality for 476 (92.6%) patients, 142 of whom switched to automated peritoneal dialysis (APD) during follow-up. Currently, 47.3% of the patients are still on CPD, 15.4% were transplanted, 13.2% switched to hemodialysis, 16.7% died. The patient and technique survivals were 90% and 95% at one year and 70% and 69% at five years, respectively. The survival was significantly shorter in the youngest age group (0-24 months) compared to those in older age groups (p=0.000). We herein report the first results of the TUPEPD study providing information on demographic data and survival of pediatric CPD patients. As opposed to clear recommendations in favor of APD, there is a clear preponderance of CAPD in our pediatric CPD population. That vesicoureteral reflux (VUR) is still the leading cause of renal failure is a distressing finding. Remarkably lower survival rates and transplantation ratios are as striking and distressing as the high incidence of VUR among the causes of ESRD. We conclude that we must make a great effort to achieve better results and to change these undesirable events.
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Affiliation(s)
- Sevcan A Bakkaloglu
- Department of Pediatric Nephrology, Gazi University School of Medicine, Besevler, 06500, Ankara, Turkey.
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Sever MS, Erek E, Vanholder R, Ozener C, Yavuz M, Kayacan SM, Ergin H, Apaydin S, Cobanoglu M, Donmez O, Erdem Y, Lameire N. Lessons learned from the Marmara disaster: Time period under the rubble. Crit Care Med 2002; 30:2443-9. [PMID: 12441752 DOI: 10.1097/00003246-200211000-00007] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the effect of the time period under the rubble on morbidity and mortality of the crush-syndrome patients after the catastrophic Marmara earthquake that struck northwestern Turkey in August 1999. DESIGN Observational study. SETTING Consecutive admissions to emergency and intensive care units of 35 reference hospitals that treated the renal victims. METHODS Analysis of questionnaires obtained from these hospitals. PATIENTS A total of 539 of 639 crush-syndrome patients whose time under the rubble was identified in the questionnaires. RESULTS Mean time under the rubble was 11.7 +/- 14.3 hrs (median, 8 hrs; interquartile range, 6 hrs; range, 0.5-135 hrs). The highest number of patients was entrapped within the 5-8 hrs time stratum, and by the end of 48 hrs, 97% of the victims had been rescued. Nondialyzed victims spent a longer duration under the rubble than dialyzed ones (15.9 +/- 23.1 hrs [median, 7 hrs; interquartile range, 8.5 hrs] vs. 10.3 +/- 9.5 hrs [median, 8 hrs; interquartile range, 6 hrs), p <.001)]. Likewise, in the strata of longer time under the rubble, the percentage of survivors was higher (p =.07). Time under the rubble correlated positively with the number of amputated extremities (p <.001) and admission platelet count (p <.001), and it correlated negatively with admission serum albumin (p <.001). The victims entrapped for >50 hrs (n = 6) were characterized by lower figures of admission blood urea nitrogen (p =.04), serum creatinine (p =.003), hemodialysis sessions, and duration of hemodialysis support (p =.005, for both analyses) compared with victims whose time under the rubble was shorter. CONCLUSION Rescue efforts should continue at least for 5 days after the disaster. Time under the rubble is not an adverse prognostic indicator of survival or renal dysfunction for the patients of crush syndrome, probably because only the victims with mild or moderate injuries can survive under the rubble for longer durations.
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