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Yilmaz D, Ekemen Keles Y, Emiroglu M, Duramaz BB, Ugur C, Aldemir Kocabas B, Celik T, Ozdemir H, Bayturan S, Turel O, Erdeniz EH, Cakici O, Cakmak Taskin E, Erbas İC, Genceli M, Sari EE, Caymaz C, Kizil MC, Sutcu M, Demirbuga A, Alkan G, Bagcı Z, Timurtas Dayar G, Ozkan EA, Tekin Yilmaz A, Akca M, Yesil E, Kara SS, Akturk H, Yasar B, Umit Z, Uygun H, Erdem N, Buyukcam A, Karadag Oncel E, Tuter Oz SK, Cetin HS, Anil AB, Yilmaz R, Zengin N, Uzuner S, Albayrak H, Borakay O, Topal S, Arslan G, Yazar A, Ozer A, Kendirli T, Kara EM, Demirkol D, Battal F, Kosker M, Metin Akcan O, Kihtir HS, Gul D, Zararci K, Alakaya M, Kula N, Celik E, Petmezci E, Evren G, Kara Aksay A, Konca C, Sert A, Arslan D, Bornaun H, Tekeli O, Bal A, Sahin IO, Demir S, Sap F, Akyol MB, Tanidir IC, Donmez YN, Ucar T, Coban S, Arga G, Hancerli Torun S, Karpuz D, Celik SF, Varan C, Elmali F, Oncel S, Belet N, Hatipoglu N, Dalgic Karabulut N, Turgut M, Somer A, Kuyucu N, Dinleyici EC, Ciftci E, Kara A. Evaluation of 601 children with multisystem inflammatory syndrome (Turk MISC study). Eur J Pediatr 2023; 182:5531-5542. [PMID: 37782350 DOI: 10.1007/s00431-023-05207-6] [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: 04/05/2023] [Revised: 09/09/2023] [Accepted: 09/15/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE Due to its link with the 2019 coronavirus, the multisystem inflammatory syndrome in children (MISC) has garnered considerable international interest. The aim of this study, in which MISC patients were evaluated multicenter, and the data of the third period of the Turk-MISC study group, to compare the clinical and laboratory characteristics and outcomes of MISC patients who did and did not require admission to an intensive care unit (ICU). METHODS This retrospective multicenter observational study was carried out between June 11, 2021, and January 01, 2022. The demographics, complaints, laboratory results, system involvements, and outcomes of the patients were documented. RESULTS A total of 601 patients were enrolled; 157 patients (26.1%) required hospitalization in the intensive care unit (ICU). Median age was 8 years (interquartile range (IQR) 4.5-11.3 years. The proportion of Kawasaki disease-like features in the ICU group was significantly higher than in the non-ICU group (56.1% vs. 43.2% p = 0.006). The ICU group had considerably lower counts of both lymphocytes and platelets (lymphocyte count 900 vs. 1280 cells × μL, platelet count 153 vs. 212 cells × 103/ μL, all for p< 0.001). C-reactive protein, procalcitonin, and ferritin levels were significantly higher in the ICU group (CRP 164 vs. 129 mg/L, procalcitonin 9.2 vs. 2.2 μg/L, ferritin 644 vs. 334 μg/L, all for p< 0.001). Being between ages 5-12 and older than 12 increased the likelihood of hospitalization in the ICU by four [95% confidence intervals (CI)1.971-8.627] and six times (95% CI 2.575-14.654), respectively, compared to being between the ages 0-5. A one-unit increase in log D-dimer (µg/L) and log troponin (ng/L) was also demonstrated to increase the need for intensive care by 1.8 (95% CI 1.079-3.233) and 1.4 times (95% CI 1.133-1.789), respectively. Conclusion: By comparing this study to our other studies, we found that the median age of MISC patients has been rising. Patients requiring an ICU stay had considerably higher levels of procalcitonin, CRP, and ferritin but significantly lower levels of lymphocyte and thrombocyte. In particular, high levels of procalcitonin in the serum might serve as a valuable laboratory marker for anticipating the need for intensive care. WHAT IS KNOWN • Lymphopenia and thrombocytopenia were an independent predictor factors in patients with MISC who needed to stay in intensive care unit. • The possibility of the need to stay in the intensive care unit in patients with MISC who had Kawasaki disease-like findings was controversial compared with those who did not. WHAT IS NEW • A one-unit increase log D dimer and log troponin was demonstrated to require for intensive care unit by 1.8 and 1.4 times, respectively. • Serum procalcitonin levels had the best performance to predict stay in the intensive care unit stay.
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Affiliation(s)
| | - Yildiz Ekemen Keles
- Health Sciences University Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Gaziler Street Number: 468, 35020, Yenisehir Konak/Izmir, Turkey.
| | | | | | - Cuneyt Ugur
- University of Health Sciences Konya Health Application and Research Center, Konya, Turkey
| | | | - Talyan Celik
- Canakkale On Sekiz Mart University Hospital, Canakkale, Turkey
| | - Halil Ozdemir
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
| | | | - Ozden Turel
- Bezmialem Vakif University Hospital, Istanbul, Turkey
| | | | | | | | | | | | - Emine Ergul Sari
- Health Science University İstanbul Bakırkoy Dr. Sadi Konuk Training and Research Hospital TR, Istanbul, Turkey
| | - Canan Caymaz
- Başakşehir Cam ve Sakura City Hospital, Istanbul, Turkey
| | | | - Murat Sutcu
- İstinye University Hospital, Istanbul, Turkey
| | | | | | - Zafer Bagcı
- University of Health Sciences Konya Health Application and Research Center, Konya, Turkey
| | | | | | | | | | | | | | | | - Belma Yasar
- Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | | | - Hatice Uygun
- Adıyaman Research and Training Hospital, Adiyaman, Turkey
| | | | - Ayse Buyukcam
- Ankara Gulhane Research and Training Hospital, Ankara, Turkey
| | - Eda Karadag Oncel
- Health Sciences University Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Gaziler Street Number: 468, 35020, Yenisehir Konak/Izmir, Turkey
| | | | | | - Ayse Berna Anil
- Health Sciences University Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Gaziler Street Number: 468, 35020, Yenisehir Konak/Izmir, Turkey
- Pediatric Intensive Care, Health Sciences University Tepecik Training and Research Hospital, Izmir, Izmir, Turkey
| | | | | | - Selcuk Uzuner
- Bezmialem Vakif University Hospital, Istanbul, Turkey
| | | | | | - Sevgi Topal
- Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Gazi Arslan
- Dokuz Eylül University Hospital, Izmir, Turkey
| | - Abdullah Yazar
- Necmettin Erbakan University, Meram Hospital, Konya, Turkey
| | - Arife Ozer
- Health Sciences University Van Training and Research Hospital, Van, Turkey
| | - Tanil Kendirli
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
- Pediatric Intensive Care, Ankara University Hospital, Ankara, Turkey
| | | | | | - Fatih Battal
- Canakkale On Sekiz Mart University Hospital, Canakkale, Turkey
| | | | | | | | - Doruk Gul
- İstinye University Hospital, Istanbul, Turkey
| | | | | | - Nilgun Kula
- Antalya Training and Research Hospital, Antalya, Turkey
| | - Elif Celik
- Aydin Adnan Menderes University Hospital, Aydin, Turkey
| | - Ercument Petmezci
- Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | | | - Ahu Kara Aksay
- Health Sciences University Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Gaziler Street Number: 468, 35020, Yenisehir Konak/Izmir, Turkey
| | - Capan Konca
- Adiyaman University Hospital, Adiyaman, Turkey
| | - Ahmet Sert
- Selcuk University Hospital, Konya, Turkey
| | - Derya Arslan
- University of Health Sciences Konya Health Application and Research Center, Konya, Turkey
| | - Helen Bornaun
- Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Onur Tekeli
- Antalya Training and Research Hospital, Antalya, Turkey
| | - Alkan Bal
- Celal Bayar University Hospital, Manisa, Turkey
| | | | - Selcan Demir
- Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Fatih Sap
- Necmettin Erbakan University, Meram Hospital, Konya, Turkey
| | - Mehmet Bedir Akyol
- Health Science University İstanbul Bakırkoy Dr. Sadi Konuk Training and Research Hospital TR, Istanbul, Turkey
| | | | | | - Tayfun Ucar
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
- Pediatric Cardiology, Ankara University Hospital, Ankara, Turkey
| | - Senay Coban
- Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Gul Arga
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
| | | | | | | | - Celal Varan
- Adiyaman University Hospital, Adiyaman, Turkey
| | | | - Selim Oncel
- Kocaeli University Hospital, Kocaeli, Turkey
| | | | - Nevin Hatipoglu
- Health Science University İstanbul Bakırkoy Dr. Sadi Konuk Training and Research Hospital TR, Istanbul, Turkey
| | - Nazan Dalgic Karabulut
- Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | | | - Ayper Somer
- Istanbul University Hospital, Istanbul, Turkey
| | | | | | - Ergin Ciftci
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ates Kara
- Hacettepe University Hospital, Ankara, Turkey
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Misirlioglu M, Yildizdas D, Ekinci F, Ozgur Horoz O, Tumgor G, Yontem A, Talay MN, Kangin M, Tufan E, Kesici S, Yener N, Kinik Kaya HE, Havan M, Tunc A, Akçay N, Sevketoglu E, Durak F, Ozel Dogruoz A, Ozcan S, Perk O, Duyu M, Boyraz M, Uysal Yazici M, Ozturk Z, Çeleğen M, Bukulmez A, Kacmaz E, Cagri Dinleyici E, Dursun O, Koker A, Bayraktar S, Talip Petmezci M, Nabaliyeva A, Agin H, Hepduman P, Akkuzu E, Kendirli T, Ozen H, Topal S, Ödek Ç, Ozkale M, Ozkale Y, Atay G, Erdoğan S, Konca C, Yapici G, Arslan G, Besci T, Yilmaz R, Gumus M, Oto A, Dalkiran T, Mercan M, Çoban Y, Ipek S, Gungor S, Arslankoylu AE, Alakaya M, Sari F, Yucel A, Yazar A. Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey. Front Pediatr 2023; 11:1179721. [PMID: 37601138 PMCID: PMC10436004 DOI: 10.3389/fped.2023.1179721] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/29/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Malnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies. Material and Method In this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined. Results Of the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024). Conclusion Timely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score.
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Affiliation(s)
- Merve Misirlioglu
- Department of Pediatric Intensive Care, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Dincer Yildizdas
- Department of Pediatric Intensive Care, Faculty of Medicine, Cukurova University, Adana, Türkiye
| | - Faruk Ekinci
- Department of Pediatric Intensive Care, Faculty of Medicine, Cukurova University, Adana, Türkiye
| | - Ozden Ozgur Horoz
- Department of Pediatric Intensive Care, Faculty of Medicine, Cukurova University, Adana, Türkiye
| | - Gokhan Tumgor
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Cukurova University, Adana, Türkiye
| | - Ahmet Yontem
- Department of Pediatric Intensive Care, Faculty of Medicine, Cukurova University, Adana, Türkiye
| | - Mehmet Nur Talay
- Department of Pediatrics, Health Sciences University, Gazi Yasargil Training and Research Hospital, Diyarbakir, Türkiye
| | - Murat Kangin
- Department of Pediatric Intensive Care, Faculty of Medicine, Medipol University, Istanbul, Türkiye
| | - Erennur Tufan
- Department of Pediatric Intensive Care, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Selman Kesici
- Department of Pediatric Intensive Care, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Nazik Yener
- Department of Pediatric Intensive Care, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Türkiye
| | - Hatice Elif Kinik Kaya
- Department of Pediatric Intensive Care, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Türkiye
| | - Merve Havan
- Department of Pediatric Intensive Care, Mersin City Training and Research Hospital, Mersin, Türkiye
| | - Ali Tunc
- Department of Pediatrics, Mersin City Training and Research Hospital, Mersin, Türkiye
| | - Nihal Akçay
- Department of Pediatric Intensive Care, University of Health Sciences Bakirkoy, Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye
| | - Esra Sevketoglu
- Department of Pediatric Intensive Care, University of Health Sciences Bakirkoy, Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye
| | - Fatih Durak
- Department of Pediatric Intensive Care, İzmir Health Sciences University, Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Aysenur Ozel Dogruoz
- Department of Pediatric Intensive Care, İzmir Health Sciences University, Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Serhan Ozcan
- Department of Pediatric Intensive Care, Ankara City Hospital, Ankara, Türkiye
| | - Oktay Perk
- Department of Pediatric Intensive Care, Ankara City Hospital, Ankara, Türkiye
| | - Muhterem Duyu
- Department of Pediatric Intensive Care, Medeniyet University, Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Türkiye
| | - Merve Boyraz
- Department of Pediatric Intensive Care, Medeniyet University, Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Türkiye
| | - Mutlu Uysal Yazici
- Department of Pediatric Intensive Care, Health Sciences University Ankara, Dr. Sami Ulus Obstetrics Child Health and Diseases Training and Research Hospital, Ankara, Türkiye
| | - Zeynelabidin Ozturk
- Department of Pediatric Intensive Care, Health Sciences University Ankara, Dr. Sami Ulus Obstetrics Child Health and Diseases Training and Research Hospital, Ankara, Türkiye
| | - Mehmet Çeleğen
- Department of Pediatric Intensive Care, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Türkiye
| | - Aysegul Bukulmez
- Department of Pediatric Gastroenterology, Faculty of Medicine, Hepatology and Nutrition, Afyonkarahisar Health Sciences University, Afyonkarahisar, Türkiye
| | - Ebru Kacmaz
- Department of Pediatric Intensive Care, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Türkiye
| | - Ener Cagri Dinleyici
- Department of Pediatric Intensive Care, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Türkiye
| | - Oguz Dursun
- Department of Pediatric Intensive Care, Faculty of Medicine, Akdeniz University, Antalya, Türkiye
| | - Alper Koker
- Department of Pediatric Intensive Care, Faculty of Medicine, Akdeniz University, Antalya, Türkiye
| | - Suleyman Bayraktar
- Department of Pediatric Intensive Care, Sultangazi Haseki Training and Research Hospital, Istanbul, Türkiye
| | - Mey Talip Petmezci
- Department of Pediatric Intensive Care, Prof. Dr. Cemil Tascıoglu City Hospital, Istanbul, Türkiye
| | - Aygul Nabaliyeva
- Department of Pediatric Intensive Care, Prof. Dr. Cemil Tascıoglu City Hospital, Istanbul, Türkiye
| | - Hasan Agin
- Department of Pediatric Intensive Care, University of Health Sciences Izmir, Dr. Behcet Uz Child Diseases and Surgery Training and Research Hospital, Izmir, Türkiye
| | - Pinar Hepduman
- Department of Pediatric Intensive Care, University of Health Sciences Izmir, Dr. Behcet Uz Child Diseases and Surgery Training and Research Hospital, Izmir, Türkiye
| | - Emine Akkuzu
- Department of Pediatric Intensive Care, Isparta City Hospital, Isparta, Türkiye
| | - Tanil Kendirli
- Department of Pediatric Intensive Care, Faculty of Medicine, Ankara University, Ankara, Türkiye
| | - Hasan Ozen
- Department of Pediatric Intensive Care, Faculty of Medicine, Ankara University, Ankara, Türkiye
| | - Sevgi Topal
- Department of Pediatric Intensive Care, Erzurum Regional Training and Research Hospital, ErzurumTürkiye
| | - Çağlar Ödek
- Department of Pediatric Intensive Care, Faculty of Medicine, Uludag University, Bursa, Türkiye
| | - Murat Ozkale
- Department of Pediatric Intensive Care, Faculty of Medicine, Baskent University, Adana Dr Turgut Noyan Teaching and Medical Research Center, Adana, Türkiye
| | - Yasemin Ozkale
- Department of Pediatric Intensive Care, Faculty of Medicine, Baskent University, Adana Dr Turgut Noyan Teaching and Medical Research Center, Adana, Türkiye
| | - Gürkan Atay
- Department of Pediatric Intensive Care, Umraniye Training and Research Hospital, Istanbul, Türkiye
| | - Seher Erdoğan
- Department of Pediatric Intensive Care, Umraniye Training and Research Hospital, Istanbul, Türkiye
| | - Capan Konca
- Department of Pediatric Intensive Care, Adiyaman Training and Research Hospital, Adiyaman, Türkiye
| | - Guler Yapici
- Department of Pediatric Intensive Care, Adiyaman Training and Research Hospital, Adiyaman, Türkiye
| | - Gazi Arslan
- Department of Pediatric Intensive Care, Faculty of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Tolga Besci
- Department of Pediatric Intensive Care, Faculty of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Resul Yilmaz
- Department of Pediatric Intensive Care, Faculty of Medicine, Selcuk University, Konya, Türkiye
| | - Meltem Gumus
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Selcuk University, Konya, Türkiye
| | - Arzu Oto
- Department of Pediatric Intensive Care, University of Health Sciences Bursa High Specialization Hospital, Bursa, Türkiye
| | - Tahir Dalkiran
- Department of Pediatric Intensive Care, Necip Fazil City Hospital, Kahramanmaras, Türkiye
| | - Mehmet Mercan
- Department of Pediatrics, Necip Fazil City Hospital, Kahramanmaras, Türkiye
| | - Yasemin Çoban
- Department of Pediatric Intensive Care, Faculty of Medicine, Mugla University, Mugla, Türkiye
| | - Sevcan Ipek
- Department of Pediatric Intensive Care, Faculty of Medicine, Sutcu Imam University, Kahramanmaras, Türkiye
| | - Sukru Gungor
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Sutcu Imam University, Kahramanmaras, Türkiye
| | - Ali Ertug Arslankoylu
- Department of Pediatric Intensive Care, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Mehmet Alakaya
- Department of Pediatric Intensive Care, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Ferhat Sari
- Department of Pediatric Intensive Care, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Türkiye
| | - Aylin Yucel
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Necmettin Erbakan University Meram, Konya, Türkiye
| | - Abdullah Yazar
- Department of Pediatric Intensive Care, Faculty of Medicine, Necmettin Erbakan University Meram, Konya, Türkiye
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3
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Yılmaz D, Üstündağ G, Büyükçam A, Salı E, Çelik Ü, Avcu G, Belet N, Çakmak Taşkın E, Öcal Demir S, Birbilen AZ, Kılıç Ö, Metin Akcan Ö, Tekin Yılmaz A, Aldemir Kocabaş B, Hatipoğlu N, Karbuz A, Çakır D, Sütçü M, Aygün FD, Çelik T, Bayturan Şen S, Dalgıç N, Ümit Z, Kara SS, Karadağ Öncel E, Bolat A, Kılıç Çil M, Turan C, Çakıl Güzin A, Topal S, Esen Besli G, Doğan G, Şahin S, Akın F, Bildirici Y, Timurtaş Dayar G, Ergül Sarı E, Kızmaz İşançlı D, Kara M, Önal P, Aylaç H, Lüleci D, Yaşar B, Dede E, Çağlar A, Akova S, Afat Turgut E, Yazıcı Özkaya P, Kandemir Gülmez T, Ulusoy E, Duyu M, Kara Y, Çeliktaş H, Tekeli O, Çağlar F, Gül D, Oral Cebeci S, Battal F, Bal A, Aygün E, Uysalol M, Arslan G, Özkavaklı A, Kızıl MC, Yazar A, Aygün F, Somer A, Kuyucu N, Dinleyici EÇ, Kara A. A snapshot of pediatric inpatients and outpatients with COVID-19: a point prevalence study from Turkey. Eur J Pediatr 2023:10.1007/s00431-023-04982-6. [PMID: 37140703 PMCID: PMC10157577 DOI: 10.1007/s00431-023-04982-6] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/31/2023] [Accepted: 04/13/2023] [Indexed: 05/05/2023]
Abstract
This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027). Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children.
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Affiliation(s)
- Dilek Yılmaz
- Department of Pediatric Infectious Diseases, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Turkey
| | - Gülnihan Üstündağ
- Pediatric Infectious Disease Clinic, Health Science University İzmir Tepecik Training and Research Hospital, Konak 35020, İzmir, Turkey.
| | - Ayşe Büyükçam
- Pediatric Infectious Disease Clinic, Health Science University Gülhane Training and Research Hospital, Ankara, Turkey
| | - Enes Salı
- Pediatric Infectious Disease Clinic, Health Science University Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Ümit Çelik
- Pediatric Infectious Disease Clinic, Adana City Hospital, Adana, Turkey
| | - Gülhadiye Avcu
- Department of Pediatric Infectious Diseases, Ege University Faculty of Medicine, İzmir, Turkey
| | - Nurşen Belet
- Department of Pediatric Infectious Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Esra Çakmak Taşkın
- Pediatric Infectious Disease Clinic, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Sevliya Öcal Demir
- Pediatric Infectious Disease Clinic, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ahmet Ziya Birbilen
- Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Pediatric Emergency Clinic, Gaziantep, Turkey
| | - Ömer Kılıç
- Department of Pediatric Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Özge Metin Akcan
- Department of Pediatric Infectious Diseases, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Ayşe Tekin Yılmaz
- Pediatric Infectious Disease Clinic, Eskişehir City Hospital, Eskişehir, Turkey
| | - Bilge Aldemir Kocabaş
- Pediatric Infectious Disease Clinic, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Nevin Hatipoğlu
- Pediatric Infectious Disease Clinic, Health Science University İstanbul Bakırköy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Adem Karbuz
- Pediatric Infectious Disease Clinic, Cemil Taşçıoğlu City Hospital, İstanbul Prof. Dr, Istanbul, Turkey
| | - Deniz Çakır
- Pediatric Infectious Disease Clinic, Health Science University Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Murat Sütçü
- Department of Pediatric Infectious Diseases, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Fatma Deniz Aygün
- Department of Pediatric Infectious Diseases, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Taylan Çelik
- Department of Pediatric Infectious Diseases, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Semra Bayturan Şen
- Department of Pediatric Infectious Diseases, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Nazan Dalgıç
- Pediatric Infectious Disease Clinic, Health Science University Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Zühal Ümit
- Pediatric Infectious Disease Clinic, Manisa City Hospital, Manisa, Turkey
| | - Soner Sertan Kara
- Department of Pediatric Infectious Diseases, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Eda Karadağ Öncel
- Pediatric Infectious Disease Clinic, Health Science University İzmir Tepecik Training and Research Hospital, Konak 35020, İzmir, Turkey
| | - Ahmet Bolat
- Pediatrics Clinic, Health Science University Gülhane Training and Research Hospital, Ankara, Turkey
| | - Merve Kılıç Çil
- Pediatric Infectious Disease Clinic, Adana City Hospital, Adana, Turkey
| | - Caner Turan
- Department of Pediatric Emergency Medicine, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ayşe Çakıl Güzin
- Department of Pediatric Infectious Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Sevgi Topal
- Pediatric Intensive Care Unit, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Gülser Esen Besli
- Pediatric Emergency Clinic, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Gizem Doğan
- Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Pediatrics Clinic, Gaziantep, Turkey
| | - Sabiha Şahin
- Department of Pediatric Emergency Medicine, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Fatih Akın
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Yaşar Bildirici
- Pediatrics Clinic, Eskişehir City Hospital, Eskişehir, Turkey
| | - Gülperi Timurtaş Dayar
- Pediatric Infectious Disease Clinic, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Emine Ergül Sarı
- Pediatrics Clinic, Health Science University İstanbul Bakırköy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Didem Kızmaz İşançlı
- Pediatric Infectious Disease Clinic, Cemil Taşçıoğlu City Hospital, İstanbul Prof. Dr, Istanbul, Turkey
| | - Manolya Kara
- Department of Pediatric Infectious Diseases, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Pınar Önal
- Department of Pediatric Infectious Diseases, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Hakan Aylaç
- Department of Pediatrics, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Duygu Lüleci
- Department of Pediatrics, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Belma Yaşar
- Pediatric Infectious Disease Clinic, Health Science University Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Elif Dede
- Department of Pediatric Infectious Diseases, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Aykut Çağlar
- Department of Pediatric Emergency Medicine , Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Sevgi Akova
- Pediatric Emergency Clinic, Health Science University Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Elif Afat Turgut
- Pediatric Infectious Disease Clinic, Adana City Hospital, Adana, Turkey
| | - Pınar Yazıcı Özkaya
- Department of Pediatric Intensive Care, Ege University Faculty of Medicine, İzmir, Turkey
| | | | - Emel Ulusoy
- Department of Pediatric Emergency Medicine, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Muhterem Duyu
- Pediatric Intensive Care Unit, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Yalçın Kara
- Department of Pediatric Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Hüseyin Çeliktaş
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Onur Tekeli
- Pediatric Infectious Disease Clinic, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatma Çağlar
- Pediatric Emergency Clinic, Health Science University İstanbul Bakırköy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Doruk Gül
- Department of Pediatrics, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Sinem Oral Cebeci
- Department of Pediatric Emergency Medicine, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Fatih Battal
- Department of Pediatrics, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Alkan Bal
- Department of Pediatric Emergency Medicine, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Emre Aygün
- Pediatrics Clinic, Health Science University Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Metin Uysalol
- Department of Pediatric Emergency Medicine, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Gazi Arslan
- Department of Pediatric Intensive Care, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ayberk Özkavaklı
- Pediatrics Clinic, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Mahmut Can Kızıl
- Department of Pediatric Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Abdullah Yazar
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Fatih Aygün
- Department of Pediatric Intensive Care, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseases, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Necdet Kuyucu
- Department of Pediatric Infectious Diseases, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Ener Çağrı Dinleyici
- Department of Pediatric Intensive Care, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Ateş Kara
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
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4
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Sık G, Inamlık A, Akçay N, Kesici S, Aygun F, Kendırlı T, Atay G, Sandal O, Varol F, Ozkaya PY, Duyu M, Bırbılen AZ, Ozcan S, Arslan G, Kangın M, Bayraktar S, Altug U, Anıl AB, Havan M, Yetımakman AF, Dalkıran T, Zengın N, Oto A, Kıhtır HS, Gırgın Fİ, Telhan L, Yıldızdas D, Yener N, Yukselmıs U, Alakaya M, Kılınc MA, Celegen M, Dursun A, Battal F, Sarı F, Ozkale M, Topal S, Kocaoglu C, Yazar A, Alacakır N, Odek C, Yaman A, Cıtak A. Mortality risk factors among critically ill children with MIS-C in PICUs: a multicenter study. Pediatr Res 2023:10.1038/s41390-023-02518-0. [PMID: 36813951 PMCID: PMC9946280 DOI: 10.1038/s41390-023-02518-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/21/2022] [Accepted: 01/09/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND This study evaluated of clinical characteristics, outcomes, and mortality risk factors of a severe multisystem inflammatory syndrome in children admitted to a the pediatric intensive care unit. METHODS A retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 41 PICUs in Turkey. The study population comprised 322 children diagnosed with multisystem inflammatory syndrome. RESULTS The organ systems most commonly involved were the cardiovascular and hematological systems. Intravenous immunoglobulin was used in 294 (91.3%) patients and corticosteroids in 266 (82.6%). Seventy-five (23.3%) children received therapeutic plasma exchange treatment. Patients with a longer duration of the PICU stay had more frequent respiratory, hematological, or renal involvement, and also had higher D-dimer, CK-MB, and procalcitonin levels. A total of 16 patients died, with mortality higher in patients with renal, respiratory, or neurological involvement, with severe cardiac impairment or shock. The non-surviving group also had higher leukocyte counts, lactate and ferritin levels, and a need for mechanical ventilation. CONCLUSIONS In cases of MIS-C, high levels of D-dimer and CK-MB are associated with a longer duration of PICU stay. Non-survival correlates with elevated leukocyte counts and lactate and ferritin levels. We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality. IMPACT MIS-C is a life-threatening condition. Patients need to be followed up in the intensive care unit. Early detection of factors associated with mortality can improve outcomes. Determining the factors associated with mortality and length of stay will help clinicians in patient management. High D-dimer and CK-MB levels were associated with longer PICU stay, and higher leukocyte counts, ferritin and lactate levels, and mechanical ventilation were associated with mortality in MIS-C patients. We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality.
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Affiliation(s)
- Guntulu Sık
- Department of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey.
| | - Aysegul Inamlık
- grid.411117.30000 0004 0369 7552Department of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Nihal Akçay
- grid.414177.00000 0004 0419 1043Department of Pediatric Intensive Care, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Selman Kesici
- grid.14442.370000 0001 2342 7339Department of Pediatric Intensive Care, Hacettepe University, Ankara, Turkey
| | - Fatih Aygun
- grid.506076.20000 0004 1797 5496Department of Pediatric Intensive Care, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Tanıl Kendırlı
- grid.7256.60000000109409118Department of Pediatric Intensive Care, Ankara University, Ankara, Turkey
| | - Gurkan Atay
- grid.417018.b0000 0004 0419 1887Department of Pediatric Intensive Care, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Ozlem Sandal
- Department of Pediatric Intensive Care, Dr Behcet Uz Child Disease and Surgery Training and Research Hospital, Izmir, Turkey
| | - Fatih Varol
- grid.414850.c0000 0004 0642 8921Department of Pediatric Intensive Care, Sancaktepe Şehit Prof. MD İlhan Varank Training and Research Hospital, İstanbul, Turkey
| | - Pınar Yazıcı Ozkaya
- grid.8302.90000 0001 1092 2592Department of Pediatric Intensive Care, Ege University, Izmir, Turkey
| | - Muhterem Duyu
- Department of Pediatric Intensive Care, Goztepe Prof. MD Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ahmet Ziya Bırbılen
- Department of Pediatric Intensive Care, Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Gaziantep, Turkey
| | - Serhan Ozcan
- grid.449874.20000 0004 0454 9762Department of Pediatric Intensive Care, Ankara Yıldırım Beyazıt University, Ankara Children’s Hospital, Ankara, Turkey
| | - Gazi Arslan
- grid.21200.310000 0001 2183 9022Department of Pediatric Intensive Care Unit, Dokuz Eylül University, Izmir, Turkey
| | - Murat Kangın
- Department of Pediatric Intensive Care, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Suleyman Bayraktar
- grid.413752.60000 0004 0419 1465Department of Pediatric Intensive Care, Sultangazi Haseki Training and Research Hospital, Istanbul, Turkey
| | - Umit Altug
- Department of Pediatric Intensive Care, Sanlıurfa Training and Research Hospital, Sanlıurfa, Turkey
| | - Ayşe Berna Anıl
- Department of Pediatric Intensive Care, Tepecik Training and Research Hospital, Izmır Katip Çelebi University, Izmir, Turkey
| | - Merve Havan
- Department of Pediatric Intensive Care, Mersin City Hospital, Mersin, Turkey
| | - Ayse Filiz Yetımakman
- grid.411105.00000 0001 0691 9040Department of Pediatric Intensive Care, Kocaeli University, Kocaeli, Turkey
| | - Tahir Dalkıran
- Department of Pediatric Intensive Care, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Neslihan Zengın
- grid.411688.20000 0004 0595 6052Department of Pediatric Intensive Care, Manisa Celal Bayar Unıversity, Manisa, Turkey
| | - Arzu Oto
- Department of Pediatric Intensive Care, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Hasan Serdar Kıhtır
- grid.413819.60000 0004 0471 9397Department of Pediatric Intensive Care, Antalya Training and Research Hospital, Antalya, Turkey
| | - Feyza İnceköy Gırgın
- grid.16477.330000 0001 0668 8422Department of Pediatric Intensive Care, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Leyla Telhan
- grid.411781.a0000 0004 0471 9346Department of Pediatric Intensive Care, Medipol University, Istanbul, Turkey
| | - Dincer Yıldızdas
- grid.98622.370000 0001 2271 3229Department of Pediatric Intensive Care, Cukurova University, Adana, Turkey
| | - Nazik Yener
- grid.411049.90000 0004 0574 2310Department of Pediatric Intensive Care, Samsun 19 Mayıs University, Samsun, Turkey
| | - Ufuk Yukselmıs
- grid.414850.c0000 0004 0642 8921Department of Pediatric Intensive Care, Kartal Dr Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Alakaya
- grid.411691.a0000 0001 0694 8546Department of Pediatric Intensive Care, Mersin University, Mersin, Turkey
| | - Mehmet Arda Kılınc
- Department of Pediatric Intensive Care, Basaksehir Cam ve Sakura City Hospital, Istanbul, Turkey
| | - Mehmet Celegen
- Department of Pediatric Intensive Care, Afyonkarahisar Tarining and Research Hospital, Afyon, Turkey
| | - Adem Dursun
- grid.513116.1Department of Pediatric Intensive Care, Kayseri City Hospital, Kayseri, Turkey
| | - Fatih Battal
- grid.412364.60000 0001 0680 7807Department of Pediatric Intensive Care, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Ferhat Sarı
- grid.14352.310000 0001 0680 7823Department of Pediatric Intensive Care, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Murat Ozkale
- grid.411548.d0000 0001 1457 1144Department of Pediatric Intensive Care, Dr Turgut NOYAN Hospital, Baskent University, Adana, Turkey
| | - Sevgi Topal
- Department of Pediatric Intensive Care, Erzurum Bölge Training and Research Hospital, Erzurum, Turkey
| | - Celebi Kocaoglu
- Department of Pediatric Intensive Care, Konya City Hospital, Konya, Turkey
| | - Abdullah Yazar
- grid.411124.30000 0004 1769 6008Department of Pediatric Intensive Care, Necmettin Erbakan University, Konya, Turkey
| | - Nuri Alacakır
- grid.411693.80000 0001 2342 6459Department of Pediatric Intensive Care, Trakya University, Edirne, Turkey
| | - Caglar Odek
- grid.34538.390000 0001 2182 4517Department of Pediatric Intensive Care, Bursa Uludağ University, Bursa, Turkey
| | - Ayhan Yaman
- grid.508740.e0000 0004 5936 1556Department of Pediatric Intensive Care, Istınye University Liv Hospital, Istanbul, Turkey
| | - Agop Cıtak
- grid.411117.30000 0004 0369 7552Department of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
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Gençeli M, Akcan ÖM, Erdoğan KN, Kiliç AO, Yazar A, Akin F, Güneş M, Şap F, Oflaz MB, Feyzioğlu B. Clinical and Laboratory Evaluations of Patients Diagnosed as Having Multisystem Inflammatory Syndrome Associated with Coronavirus Disease 2019 in Children: A Single Center Experience from Konya. J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1758745] [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: 11/28/2022]
Abstract
Abstract
Objective Multisystem inflammatory syndrome in children (MIS-C), characterized by fever, inflammation, and multiorgan dysfunction, was newly defined after severe acute respiratory syndrome coronavirus 2 infection. The clinical spectrum of MIS-C can be classified as mild, moderate, and severe. We aimed to evaluate demographics, clinical presentations, laboratory findings, and treatment modalities of patients with MIS-C according to clinical severity.
Methods We performed a retrospective study of patients who were diagnosed as having MIS-C between September 2020 and October 2021 in the Necmettin Erbakan University Meram Faculty of Medicine, Turkey.
Results A total of 48 patients (24 females and 24 males) with a median age at diagnosis of 10.3 years (range: 42 months–17 years) were enrolled, the most common clinical severity of MIS-C was moderate. The common presentations of patients were fever (97%), nonpurulent conjunctivitis (89.6%), rashes (81.3%), fatigue (81.3%), strawberry tongue (79.2%), and myalgia (68.8%). The most common laboratory findings were lymphopenia (81.2%), thrombocytopenia (54.1%), elevated D-dimer levels (89.5%), C-reactive protein (CRP; 100%), procalcitonin (97%), erythrocyte sedimentation rate (87.5%), ferritin (95.8%), interleukin 6 (IL-6) (86.1%), and probrain natriuretic peptide (pro-BNP) (97%). High levels of CRP, procalcitonin, pro-BNP, and urea were associated with the severity of MIS-C (p < 0.05). Fifteen of the patients were found to have pulmonary involvement. Ascites were the most common finding on abdominal ultrasonography (11 patients) and were not seen in a mild form of the disease. During the study period, two patients died.
Conclusion It is important to make patient-based decisions and apply a stepwise approach in treating patients with MIS-C due to the increased risk of complications and mortality.
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Affiliation(s)
- Mustafa Gençeli
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Özge Metin Akcan
- Division of Pediatric Infectious Diseases, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Kübra Nur Erdoğan
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Ahmet Osman Kiliç
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Abdullah Yazar
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Fatih Akin
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Muhammed Güneş
- Division of Pediatric Cardiology, Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Fatih Şap
- Division of Pediatric Cardiology, Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Mehmet Burhan Oflaz
- Division of Pediatric Cardiology, Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Bahadır Feyzioğlu
- Division of Medical Virology, Department of Medical Microbiology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
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6
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Gençeli M, Metin Akcan Ö, Pekcan S, Akin F, Özdemir M, Kiliç AO, Yazar A. Outcomes of COVID-19 Infections in children: A single-center retrospective study. Pediatr Pulmonol 2022; 57:2533-2539. [PMID: 35855567 PMCID: PMC9349843 DOI: 10.1002/ppul.26070] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 07/01/2022] [Accepted: 07/06/2022] [Indexed: 12/15/2022]
Abstract
The COVID-19 pandemic is an important cause of morbidity and mortality, which has had a negative impact worldwide. Our aim was to describe clinical findings and outcomes of severe acute respiratory syndrome (SARS)-CoV-2 viral infection and COVID-19 cared for at a large pediatric tertiary care hospital during the first year of the pandemic. Patients aged 1 month to 18 years who were diagnosed as having COVID-19 between March 2020 and April 2021 were included. The files of patients diagnosed with COVID-19 were reviewed retrospectively. Results: Four hundred sixty seven children were included in the study. There were 34 (7.3%) patients under 1 year of age, 111 (23.8%) between 1 and 5 years, 98 (30.4%) between 5 and 10 years, 142 (30.4%) between 11 and 15 years, and 82 (17.6%) age over 15 years. Fever (88.2%), vomiting (32.4%), and diarrhea (29.4%) in patients aged under 1 year, sore throat (36.6%) in patients aged 11-15 years, and dysgeusia (11%), anosmia (14.6%), headache (18.3%), malaise (40.8%), myalgia (28%), and shortness of breath (17.1%) in those aged over 15 years were found to be significantly more common in comparison with the other age groups (p < 0.05). Thirty-five (7.5%) patients were asymptomatic, 365 (78.1%) had mild disease, 35 (7.5%) were moderate, 27 (5.8%) were severe, and five (1.07%) were critical. Leukocyte count, erythrocyte sedimentation rate, ferritin, and C-reactive protein values were significantly higher in hospitalized patients. Three patients died during the study period (0.64%). While SARS-CoV-2 infection may be asymptomatic and COVID-19 usually has a mild clinical course, some children have severe disease or mortality.
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Affiliation(s)
- Mustafa Gençeli
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Özge Metin Akcan
- Departments of Pediatric Infectious Diseases, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Sevgi Pekcan
- Departments of Pediatric Pulmonology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Fatih Akin
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Mehmet Özdemir
- Departments of Medical Microbiology, Division of Medical Virology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Ahmet Osman Kiliç
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Abdullah Yazar
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
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7
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Kılıç AO, Akın F, Yazar A, Metin Akcan Ö, Topcu C, Aydın O. Zonulin and claudin-5 levels in multisystem inflammatory syndrome and SARS-CoV-2 infection in children. J Paediatr Child Health 2022; 58:1561-1565. [PMID: 35638118 PMCID: PMC9347651 DOI: 10.1111/jpc.16033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/31/2022] [Accepted: 04/25/2022] [Indexed: 12/22/2022]
Abstract
AIM SARS-CoV-2 infection in children is generally asymptomatic or mild; however, it can lead to a life-threatening clinical condition, multisystem inflammatory syndrome in children (MIS-C), days or weeks after the infection. Increased intestinal permeability isa possible triggering factor at the onset of the hyperinflammation associated with MIS-C. Zonulin and claudin-5 are involved in intestinal permeability. In this study, we aimed to investigate serum zonulin and claudin-5 levels in SARS-CoV-2 infection and MIS-C disease. METHODS The study group consisted of children diagnosed with MIS-C or SARS-CoV-2 infection who presented to a university hospital paediatric emergency or infectious diseases departments. The control group included well patients seen at the General Pediatrics units for routine follow-up. Serum zonulin and claudin-5 levels were measured at the time of diagnosis. RESULTS Fifteen patients were included in the MIS-C group, 19 in the SARS-CoV-2 infection group and 21 in the control group. The mean zonulin level in the MIS-C group was significantly higher than in the control group (P < 0.001). Mean Claudin-5 levels were Psignificantly lower in the SARS-CoV-2 infection group than in the control group (P < 0.001). CONCLUSION These results indicate that increased intestinal permeability may be involved in the pathogenesis of SARS-CoV-2 infection and MIS-C disease. Larger clinical trials are needed to clarify the role of serum zonulin and claudin-5 on intestinal permeability in MIS-C and SARS-CoV-2 infection in children.
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Affiliation(s)
- Ahmet O Kılıç
- Department of Pediatrics, Meram Medical FacultyNecmettin Erbakan UniversityKonyaTurkey
| | - Fatih Akın
- Department of Pediatrics, Meram Medical FacultyNecmettin Erbakan UniversityKonyaTurkey
| | - Abdullah Yazar
- Department of Pediatrics, Meram Medical FacultyNecmettin Erbakan UniversityKonyaTurkey
| | - Özge Metin Akcan
- Department of Pediatrics, Meram Medical FacultyNecmettin Erbakan UniversityKonyaTurkey
| | - Cemile Topcu
- Department of Biochemistry, Meram Medical FacultyNecmettin Erbakan UniversityKonyaTurkey
| | - Orkun Aydın
- Department of PediatricsDr. Sami Ulus Maternity and Children's Health and Diseases Training and Research HospitalAnkaraTurkey
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8
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Erden S, Akbaş İleri B, Sadıç Çelikkol Ç, Nalbant K, Kılınç İ, Yazar A. Serum B12, homocysteine, and anti-parietal cell antibody levels in children with autism. Int J Psychiatry Clin Pract 2022; 26:8-13. [PMID: 33823740 DOI: 10.1080/13651501.2021.1906906] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Indexed: 10/21/2022]
Abstract
AIMS To compare vitamin B12, homocysteine, and anti-parietal cell antibody (APCA) levels between children with ASD and controls, paired in terms of age, sex, and socioeconomic level. METHODS The research group consisted of 69 children, 36 with ASD and 33 controls. The severity of ASD was determined using the Childhood Autism Rating Scale (CARS). Serum vitamin B12, homocysteine and human anti-parietal cell levels were analysed using enzyme-linked immunosorbent assay. RESULTS The serum vitamin B12 and homocysteine levels in children with ASD were lower than in the control group, but there was no significant difference in terms of APCA levels. CONCLUSIONS Deficiencies in micronutrients, such as B12, may play a role in the pathogenesis and clinical symptoms of autism. However, it is believed that these parameters should be analysed in a wider population to clarify their effect on the aetiology of ASD.KEY POINTWe hypothesised that low levels of vitamin B12 and homocysteine levels reported in previous studies might be associated with APCA levels.The homocysteine and B12 levels were found to be significantly lower in children with ASD. There was no significant difference in serum APCA levels.No significant relationship was found between B12 levels and APCA.Given all these findings, it can be stated that vitamin B12 deficiency is not associated with an absorption-related mechanism due to the presence of APCA.Deficiencies in micronutrients, such as B12, may play a role in the pathogenesis and clinical symptoms of autism.In future studies, it will be beneficial to investigate other mechanisms that may cause vitamin B12 deficiency.
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Affiliation(s)
- Semih Erden
- Department of Child and Adolescent Psychiatry, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Betül Akbaş İleri
- Department of Child and Adolescent Psychiatry, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Çağla Sadıç Çelikkol
- Department of Child and Adolescent Psychiatry, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Kevser Nalbant
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İbrahim Kılınç
- Department of Biochemistry, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Abdullah Yazar
- Department of Child Health and Diseases, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
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9
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Türe E, Yazar A, Akın F, Topcu C, Aydın A, Balasar M, Ataş B. Early kidney injury in immunoglobulin A vasculitis: Role of renal biomarkers. Pediatr Int 2021; 63:1218-1222. [PMID: 33423326 DOI: 10.1111/ped.14600] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 12/07/2020] [Accepted: 01/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND We aimed to determine whether urine kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) can be used as early noninvasive biomarkers of kidney injury in immunoglobulin A vasculitis. METHODS Patients who were diagnosed with immunoglobulin A vasculitis were included in the study. Urine samples were collected for determination of urine KIM-1 and NGAL levels. The control group consisted of age-matched healthy children. RESULTS Sixty-one patients who were diagnosed with immunoglobulin A vasculitis were included in the study; 37.7% of these patients were determined to have renal involvement. Median KIM-1 was found to be significantly higher in the patient group (69.59 pg/mL) than the control group (40.84 pg/mL) (P = 0.001). Median NGAL was determined to be statistically significantly higher in the patient group (59.87 ng/mL) compared with the control group (44.87 ng/mL) (P = 0.013). In 23.6% of the patients without renal involvement at admission renal involvement developed within the following 6 months. When median KIM-1 and NGAL at admission of these patients were compared with the control group, they were determined to be statistically significantly higher (P = 0.001, P = 0.003). CONCLUSIONS The fact that our patients with late-term nephropathy had no hematuria and / or proteinuria and that KIM-1 and NGAL levels were determined to be high indicates that these biomarkers might be potentially reliable, noninvasive and early determinants of kidney injury.
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Affiliation(s)
- Esra Türe
- Department of Pediatric Emergency, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Abdullah Yazar
- Department of Pediatric Emergency, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Fatih Akın
- Department of Pediatric Emergency, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Cemile Topcu
- Department of Medical Biochemistry, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Arif Aydın
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Balasar
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Bülent Ataş
- Department of Pediatric Nephrology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
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Abstract
Aims We aimed to evaluate the effectivity and safety of botulinum toxin A (BT-A) to reduce sialorrhea in children with hypersalivation due to neurological diseases. Methods Patients who had a complaint of severe sialorrhea were included in the study. Drooling severity of the patients was evaluated using the classification of Thomas-Stonell and Greenberg. The frequency of aspiration before and after the procedure was recorded. The 24-hour saliva amount and mean duration of two consecutive aspirations were recorded. BT-A was injected into the bilateral parotid and submandibular glands by a otorhinolaryngologist under the guidance of ultrasound guidance (USG). Results When patients' mean drooling severity scores, drooling frequency scores, mean duration of two consecutive aspirations, and amount of saliva collected before and after procedure were compared, a statistical significance was observed. One-year hospital records before after and injection were examined and it was observed that after BT-A injection, hospital visits were statistically significantly low (P = 0.017). Conclusion BT-A injection into salivary glands is well tolerated, is minimally invasive, has low complication rates and should be performed into both parotid and submandibular glands under USG. Although there is still no consensus on the ideal dose and frequency of injections, it is thought that a dose of 1U/kg/gland can be used with safety in pediatric age groups and the dimensions of the salivary glands and quantitative measurements of the amount of saliva should be utilized. Larger studies involving more patients are required in order to constitute a standard injection protocol.
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Affiliation(s)
- E Ture
- Department of Pediatric Emergency, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - A Yazar
- Department of Pediatric Emergency, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - M A Dundar
- Department of -Otolaryngology -Head and Neck Surgery, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - S Bakdik
- Department of Radiodiagnostic, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - F Akin
- Department of Pediatric Emergency, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - S Pekcan
- Department of Pediatric Pulmonology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
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Kılıç AO, Türe E, Yazar A, Akın F, Reisli İ. Simulation Based Endotracheal Intubation Education for Residents of Pediatrics. Eurasian J Emerg Med 2021. [DOI: 10.4274/eajem.galenos.2020.35693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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12
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Dağlı HY, Akcan ÖM, Pekcan S, Gençeli M, Özdemir HS, Uğurlu B, Özbek ÜS, Parlatan H, Akın F, Yazar A, Kılıç AO, Özdemir M, Taşbent FE. Uncommon Presentation of COVID-19 in Pediatric Patients: Anosmia. J PEDIAT INF DIS-GER 2021. [DOI: 10.1055/s-0041-1723974] [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: 10/22/2022]
Abstract
Abstract
Objective The novel coronavirus disease 2019 (COVID-19) infection was declared as a pandemic by the World Health Organization on March 11, 2020. Although the complaint of anosmia is well described in adult patients, there is limited knowledge in pediatric patients. We aim to evaluate the epidemiological characteristics and clinical findings of children with anosmia in COVID-19-positive pediatric patients.
Methods Patients diagnosed with COVID-19 infection at 1 month to 18 years of age, who admitted to Meram Faculty of Medicine of Necmettin Erbakan University between March and June 2020, were retrospectively reviewed, and the patients who had anosmia or developed anosmia during follow-up were then included in the study. The diagnosis was established by polymerase chain reaction (PCR).
Results A total of 71 patients were diagnosed with COVID-19 and 14 (19.7%) of them had anosmia. Mean patient age was 14.07 (range: 10–16) years. Six of our 14 (42.8%) patients had anosmia at the time of diagnosis and anosmia developed in the follow-up among eight patients. The mean duration of anosmia in our patients was 6.9 ± 3.8 days. Recovery time was 1 to 4 days in four patients (28.5%), 5 to 8 days in four patients (28.5%), and 9 to 14 days in six patients (42.8%).
Conclusion In this article, it was emphasized that anosmia can be the sole manifestation or concomitant with other symptoms in children with COVID-19 disease. Care and attention is important to identify COVID-19 patients at an early stage of the disease and limit the spread of the virus.
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Affiliation(s)
- Hatice Y. Dağlı
- Department of Pediatrics, Faculty of Medicine, Necmettin Erbakan University Meram, Konya, Turkey
| | - Özge M. Akcan
- Department of Pediatric Infectious Diseases, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Sevgi Pekcan
- Department of Pediatric Pulmonology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Mustafa Gençeli
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Hüseyin S. Özdemir
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Betül Uğurlu
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Ümmü S. Özbek
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Havva Parlatan
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Fatih Akın
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Abdullah Yazar
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Ahmet O. Kılıç
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Mehmet Özdemir
- Division of Medical Virology, Department of Medical Microbiology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Fatma E. Taşbent
- Department of Medical Microbiology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
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Atas B, Bulut M, Sap F, Yazar A, Akin F, Poyraz N, Tokgoz H. Paediatric systemic lupus erythematosus: A single referral centre experience. J PAK MED ASSOC 2021; 71:136-139. [PMID: 33484540 DOI: 10.5455/jpma.61641] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In this study, the clinical and laboratory findings, management and follow-up of 32 children with paediatric systemic lupus erythematosus (pSLE) were evaluated to determine the prognostic factors in pSLE. Of the 32 patients, 25 (78.1%) were females. Age at onset of symptoms and diagnosis in the patients were 147.6 ± 49 months and 154.3 ± 48 months, respectively. The most common symptom on admission were joint problems, seen in 25 (78.1%) patients. Haematological alterations were seen in 25 (78.1%) cases during follow-up. Lupus nephritis was diagnosed in 10 (31.2%) patients. Malar rash was seen in a total of 12 (37.5%) patients during follow up, however it had been noted in five (15.6%) patients on admission. Antinuclear antibody and anti-dsDNA were positive in all patients and 31 (96.8%) patients, respectively. Decreased complement 3 and 4 levels were noted in 23 (71.8%) patients. Antiphospholipid antibody was studied in 27 patients and it was found to be positive in 13 (48.1%) patients. In conclusion, based on our findings, we would like to emphasize that pSLE has a large and remarkable clinical and laboratory findings.
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Affiliation(s)
- Bulent Atas
- Department of Pediatrics, Pediatric Nephrology and Rheumatology Unit, Necmettin Erbakan University, Konya, Turkey
| | - Mustafa Bulut
- Department of Pediatrics, Necmettin Erbakan University, Konya, Turkey
| | - Fatih Sap
- Department of Pediatrics, Necmettin Erbakan University, Konya, Turkey
| | - Abdullah Yazar
- Department of Pediatrics, Necmettin Erbakan University, Konya, Turkey
| | - Fatih Akin
- Department of Pediatrics, Necmettin Erbakan University, Konya, Turkey
| | - Necdet Poyraz
- Department of Radiology, Necmettin Erbakan University, Konya, Turkey
| | - Huseyin Tokgoz
- Department of Pediatrics, Necmettin Erbakan University, Konya, Turkey
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Kılıç AO, Akın F, Yazar A, Çokbiçer A, Doğan M, Energin VM. A Rare Complication during Salmonella sp. Infection in a 4-Year-Old Child: Acute Pancreatitis. J PEDIAT INF DIS-GER 2020. [DOI: 10.1055/s-0040-1714711] [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: 10/23/2022]
Abstract
Abstract
Objective We aimed to report a rare complication of acute pancreatitis which developed during Salmonella infection.
Methods We report a 4-year-old girl with pancreatitis that occurred after salmonella gastroenteritis.
Discussion Salmonella sp. infections cause serious mortality and morbidity worldwide. Salmonella transmission is mostly fecal oral from contaminated water and foods. Acute pancreatitis expresses the acute inflammatory process of the pancreas. Inflammation of the pancreas associated with bacterial, viral, and fungal agents can lead to acute pancreatitis. There are limited data regarding the frequency of infections leading to pancreatitis. Here, a pediatric case with pancreatitis that occurred after salmonella gastroenteritis is reported.
Conclusion Acute pancreatitis due to S. sp. infection is very rare in children. Pancreatitis should be considered in patients with gastroenteritis with typical abdominal pain.
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Affiliation(s)
- Ahmet O. Kılıç
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Fatih Akın
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Abdullah Yazar
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Abdülkerim Çokbiçer
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Metin Doğan
- Department of Medical Microbiology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Vesile M. Energin
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
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15
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Türe E, Yazar A. Retrospective Evaluation of Return Visits to the Paediatric Emergency Department. Eurasian J Emerg Med 2020. [DOI: 10.4274/eajem.galenos.2019.68926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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16
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Üskent N, Ayla S, Mandel NM, Ozkan M, Teomete M, Baloglu H, Aydıncer C, Yergok H, Dogan E, Berk B, Yazar A. Prognostic significance of tumour tissue NeuGcGM3 ganglioside expression and predictive value of circulating tumour cell count monitoring in patients receiving racotumomab immunotherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Yazar A, Akın F, Akça ÖF, Eklioğlu BS, Türe E, Coşkun F, Atabek ME. The effect of attention deficit/hyperactivity disorder and other psychiatric disorders on the treatment of pediatric diabetes mellitus. Pediatr Diabetes 2019; 20:345-352. [PMID: 30652399 DOI: 10.1111/pedi.12819] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 07/26/2018] [Revised: 11/01/2018] [Accepted: 12/17/2018] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Psychiatric diagnoses of patients with type 1 diabetes mellitus (T1DM), the severity of attention deficit/hyperactivity disorder (ADHD) symptoms of the patients and their primary caregivers, and the effects of these factors on treatment were investigated. METHODS Sixty-one patients with T1DM were included in the study along with their parents. Psychiatric diagnoses of the patients were determined using a semistructured psychiatric interview, and their depression and ADHD symptom severities were evaluated with self-report scales. The ADHD symptom severities of the parents were evaluated using self-report scales. The relationships among the psychiatric symptoms and the hemoglobin A1c (HbA1c), fasting blood glucose (FBG), and postprandial blood glucose (PBG) levels of the patients were investigated. RESULTS HbA1c levels were found to correlate with the hyperactivity levels of children and the number of diagnoses they had. FBG and PBG values of patients diagnosed with ADHD were found to be higher than in those who did not have ADHD. HbA1c, FBG, and PBG values of the patients who had any disruptive behavior disorder were found to be higher than in those who did not. ADHD total scores, gender (being female), having diagnoses of ADHD or depression were found to be predictive of HbA1c levels according to the regression analyses. No relationship between the clinical findings of the children and their parents' ADHD levels was found. CONCLUSIONS The findings of this study implicate that children with T1DM should be evaluated in terms of ADHD which could have negative effects on the treatment.
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Affiliation(s)
- Abdullah Yazar
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Fatih Akın
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Ömer F Akça
- Department of Child and Adolescent Psychiatry, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Beray S Eklioğlu
- Department of Pediatric Endocrinology and Diabetes, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Esra Türe
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Fatma Coşkun
- Department of Child and Adolescent Psychiatry, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet E Atabek
- Department of Pediatric Endocrinology and Diabetes, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
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Abstract
AbstractThe aim of this study is to evaluate temperature measurement methods in children. Body temperatures of 3 to 18 years old patients were measured with a tympanic infrared thermometer, a noncontact infrared skin thermometer and with a temporal artery thermometer. While the specificity of temporal artery and noncontact thermometers were good in determination of temperatures above 37.5°C, their sensitivities were low. Positive predictive value and negative predictive value for both thermometers were sufficient. Both specificity and sensitivity of both thermometers were determined to be good at temperature values above ≥ 38°C. It is thought that noncontact and temporal artery thermometers can be used for screening in pediatric emergency departments.
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Affiliation(s)
- Abdullah Yazar
- Department of Pediatric Emergency, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Esra Türe
- Department of Pediatric Emergency, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
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Yazar A, Yorulmaz A, Türe E, Akın F, Sert A. Down Sendromlu hastalarda subklinik hipotiroidizm ve hematolojik parametreler arasındaki ilişki. FAMILY PRACTICE AND PALLIATIVE CARE 2018. [DOI: 10.22391/fppc.422181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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20
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Akın F, Türe E, Çaksen H, Odabaş D, Yazar A. Mean Platelet Volume and Neutrophil-to-Lymphocyte Ratio May Be Used as Predictors in Febrile Seizures. J PEDIAT INF DIS-GER 2018. [DOI: 10.1055/s-0038-1668534] [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
AbstractFebrile seizure (FS) is the most frequent seizure disorder in childhood, associated with rapid onset of high fever. Our study aims are (1) to determine if the levels of mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR) are risk factors for FS and to (2) assess the usefulness of these markers as predictors to distinguish the subgroups of FS. This prospective study includes children with FS, acute febrile illness (AFI) without seizure, and control group. Complete blood count was performed on all participants. The following data were obtained: white blood cell count (WBC), platelet count, MPV, hemoglobin (Hb), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), and NLR. MPV, WBC, ANC, and NLR were significantly increased in patients with AFI and FS compared with controls (p < 0.05). When patients with FS and AFI were compared, only WBC was increased significantly in patients with FS (p < 0.05). WBC, ANC, and NLR were significantly increased in patients with complex FS compared with simple (p < 0.05). Our findings showed that WBC, MPV, ANC, and NLR were higher in children with FS than in the control group. Additionally WBC, ANC, and NLR were found to be higher in children with CFS than in those with simple febrile seizure. Based on the study results, we suggest that only WBC may be used as predictors in children with FS.
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Affiliation(s)
- Fatih Akın
- Department of Pediatric Emergency, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Esra Türe
- Department of Pediatric Emergency, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Hüseyin Çaksen
- Department of Pediatric Neurology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Dursun Odabaş
- Department of Pediatric Emergency, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Abdullah Yazar
- Department of Pediatric Emergency, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
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Akın F, Yazar A, Doğan M. Determining the Infectious Pathogens and Their Resistance to Antibiotics in a Pediatric Intensive Care Unit. J PEDIAT INF DIS-GER 2017. [DOI: 10.1055/s-0037-1607236] [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: 10/18/2022]
Abstract
Introduction Nosocomial infections are one of the main causes of morbidity and mortality. It is important to know the common infectious pathogens and their resistance profiles in intensive care units (ICUs) to determine appropriate treatment protocols. The aim of this study was to determine the epidemiological profile of microorganisms isolated in a pediatric ICU (PICU) and to determine antibiotic resistance in isolated strains.
Materials and Methods This retrospective study was performed at the Meram Medical Faculty Hospital, Necmettin Erbakan University, Konya, Turkey. A total of 1,502 bacteria that were isolated from various specimens from children who were hospitalized in PICUs between January 2014 and December 2015 were included in this study to determine the isolated bacteria diversity and susceptibility to various antibiotics.
Results Staphylococcus spp. was the most frequently isolated microorganism followed by Escherichia coli and Klebsiella spp., respectively. The sites where pathogens were isolated were as follows: 616 blood, (41%), 445 urine (29.6%), 60 sputum (4%), 44 cerebrospinal fluid (2.9%), 25 wound swab (1.6%), 20 tracheal aspirate (1.3%), and 26 others (1.7%). The carbapenem resistance rate was 40.8% among Pseudomonas aeruginosa isolates. Among 60 Acinetobacter baumannii isolates tested, 62% were resistant to carbapenems. Sensitivity rates of A. baumannii isolates to tigecycline and colistin were as high as 98 and 96%, respectively. Meropenem and colistin resistance rates to Klebsiella spp. were 16.2 and 15%, respectively.
Conclusion In conclusion, it is essential to identify the infectious pathogens and their resistance to antibiotics especially in ICUs where infections with multidrug-resistant bacteria are frequent. Studies on this issue should be performed at appropriate time intervals.
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Affiliation(s)
- Fatih Akın
- Department of Pediatrics, Meram Medical Faculty Hospital, Necmettin Erbakan University, Konya, Turkey
| | - Abdullah Yazar
- Department of Pediatrics, Meram Medical Faculty Hospital, Necmettin Erbakan University, Konya, Turkey
| | - Metin Doğan
- Department of Medical Microbiology, Meram Medical Faculty Hospital, Necmettin Erbakan University, Konya, Turkey
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Sert A, Yazar A, Odabas D. Efficacy of a diazepam at preventing febrile seizure recurrence after febrile illness. Brain Dev 2010; 32:887. [PMID: 20627633 DOI: 10.1016/j.braindev.2010.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 05/05/2010] [Indexed: 11/28/2022]
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Abstract
The 2009 flu outbreak in humans, known as H1N1 influenza A, refers to influenza A due to a new H1N1 strain called swine-origin influenza virus A. The signs and symptoms of novel influenza A (H1N1) virus infection are similar to those of seasonal influenza, and specific diagnostic testing is required to distinguish novel influenza A (H1N1) virus from seasonal influenza virus. It results in various degrees of infection, ranging from mild to severe to fatal. For the treatment of swine-origin influenza virus A oseltamivir and zanamivir are effective in most cases. Influenza A (H1N1) pneumonia in the newborn has not been yet reported in the literature. To our knowledge, this is the first report of a neonate of pneumonia in which influenza A (H1N1) virus was isolated.
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Affiliation(s)
- Ahmet Sert
- Department of Pediatrics, Konya Training and Research Hospital, Konya, Turkey.
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Gotzmann M, Hehen T, Germing A, Lindstaedt M, Yazar A, Laczkovics A, Mumme A, Mugge A, Bojara W. Short-term effects of transcatheter aortic valve implantation on neurohormonal activation, quality of life and 6-minute walk test in severe and symptomatic aortic stenosis. Heart 2009; 96:1102-6. [DOI: 10.1136/hrt.2009.180661] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Abstract
BACKGROUND Although thromboembolic complications are common in adult patients with malignant diseases, cerebral venous sinus thrombosis has been rarely described in cancer afflicted pediatric and adolescent population. CASE HISTORY A 16-year-old adolescent girl referred for complaints of pain and swelling on her left leg. On physical examination, a solid tibial mass was discovered. After the diagnosis of Ewing sarcoma with a tru-cut biopsy, chemotherapy protocol consisting of cisplatin, ifosfamide, adriamycine, and vincristine was started. During the first course of the treatment, the patient expressed headache, diplopia, and ptosis. Contrast-enhanced magnetic resonance (MR) images and MR angiography showed superior sagittal and transverse sinus thromboses. After anticoagulant therapy, the thromboses disappeared within 1.5 months. She received her chemotherapy protocol with the anticoagulant prophylaxis. After a follow-up period of 12 months, she is still in a good neurological recovery without any sequel. CONCLUSION Children and adolescents with cancer should be monitored closely for thrombotic complications. We discuss this uncommon case to draw attention to the importance of early diagnosis and adequate treatment of intracranial thrombosis in childhood cancer, and we review the relevant literature.
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Affiliation(s)
- Ekrem Unal
- Meram Faculty of Medicine, Department of Pediatrics, Selcuk University, 42080, Konya, Turkey.
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Yazar A, Ustüner Z, Sakar B, Kaytan Sağlam E, Camlica H, Aykan F. Adjuvant chemoradiation for patients with adenocarcinoma of the pancreas: an expirence of single institute. Med Oncol 2007; 24:384-7. [PMID: 17917086 DOI: 10.1007/s12032-007-0032-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 11/30/1999] [Accepted: 05/01/2007] [Indexed: 02/05/2023]
Abstract
Only a small percentage of patients with pancreatic cancer have limited disease suitable for curative resection. Even with surgery, patients often have poor long-term survival due to relapse of the disease. There are controversies about the adjuvant treatment of these patients. We reported the survival of resected pancreatic cancer from a single institute. About 128 consecutive patients who had complete resection of the pancreatic ductal adenocarcinoma were evaluated, retrospectively. Chemoradiotherapy (45 Gy plus 5-fluorouracil) was given to 63 patients. Fifty-five patients declined to take chemoradiotherapy or with poor performance status were observed without additional treatment. Eight patients took only chemotherapy and two patients took only radiotherapy. The median survival of chemoradiotherapy group was significantly higher than the observation group (13 months vs. 4 months, respectively; P < 0.001). In multivariate analyses the most important factors improving survival were the application of chemoradiation (P < 0.001), low-level serum LDH (P = 0.026), good performance status (P = 0.033) and low serum CA19-9 (P = 0.037). Although adjuvant chemoradiotherapy has a significant survival benefit when compared with the observation group, the survival data are still poor for pancreatic cancer. Therefore, we need more effective additional or adjuvant treatment modalities.
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Affiliation(s)
- A Yazar
- Department of Medical Oncology, Acibadem Hospital, Halit Ziya Usakligil Cad 1, Bakirkoy, Istanbul, Turkey.
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Lindstaedt M, Spiecker M, Lawo T, Yazar A, Mügge A, Bojara W, Germing A. [Angiographic assessment of functionally insignificant left main coronary artery stenoses: reliability compared to intracoronary pressure measurement]. Dtsch Med Wochenschr 2006; 131:2134-8. [PMID: 16991027 DOI: 10.1055/s-2006-951340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 10/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Left main coronary artery disease (LMCA) is still a widely accepted indication for coronary artery bypass surgery. Intermediate LMCA disease, however, often cannot be evaluated reliably on the basis of clinical and angiographic information alone. The deferral of surgical revascularization based on fractional flow reserve (FFR) measurements has been shown to be safe and feasible when taking an FFR value of (3) 0.75 as cutoff. This study was performed to compare the accuracy of visual angiographic assessment of intermediate LMCA stenoses by experienced interventional cardiologists with functional assessment by FFR in a patient population with excellent long-term outcome after deferral of surgery on the basis of FFR measurements. PATIENTS AND METHODS 24 of 51 consecutive patients with intermediate LMCA disease were deferred from surgery based on an FFR value of > or = 0.75. Each angiogram was retrospectively reviewed independently by three experienced interventional cardiologists. Reviewers were blinded to initial FFR results, clinical data, and clinical outcome and asked to classify each lesion as SIGNIFICANT (FFR < 0.75), NOT SIGNIFICANT (FFR > or = 0.75), or UNSURE if the observer was unable to make a decision based on the angiogram. RESULTS Mean follow-up was 29 +/- 13.6 months. No death or myocardial infarction was observed, event-free survival was 69 %. When taking the "unsure" classifications into consideration the individual reviewers achieved correct lesion classification with respect to FFR results on average in 58 % to 82 % of cases. Interobserver variability resulted in only 46 % of cases in concordant lesion classification (3 agreements or 2 agreements and 1 "unsure" evaluation). The number of concordant agreements between the individual pairs of reviewers did not exceed the rate of coincidental agreements that could be expected to result from simple guessing (mean KAPPA coefficient 0.04). More than 50 % of patients with excellent long-term outcome after deferral of surgery would potentially have undergone operative revascularization if consensual decision making had been solely based on angiographic lesion assessment. CONCLUSION The functional significance of intermediate or equivocal LMCA lesions should not be based on visual assessment alone, even when performed by experienced interventional cardiologists.
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Affiliation(s)
- M Lindstaedt
- Medizinische Klinik II, Universitätsklinik Bergmannsheil, Bochum.
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Yazar A, Büyükafpar K, Polat G, Pata C, Kanýk A, Tiftik EN, Bağdatoğlu O. The urinary 5-hydroxyindole acetic acid and plasma nitric oxide levels in irritable bowel syndrome: a preliminary study. Scott Med J 2005; 50:27-9. [PMID: 15792386 DOI: 10.1177/003693300505000111] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 11/17/2022]
Abstract
BACKGROUND AND AIMS Postprandial increase of 5-hydroxytryptamine (5-HT) has been implicated in irritable bowel syndrome (IBS). There is evidence that nitric oxide (NO) may act as a mediator of 5-HT-evoked secretions in the colon. Our aim is to investigate the role of urinary 5-hydroxyindole acetic acid (5-HIAA) and plasma NO levels (with diarrhoea) in IBS patients. METHODS Nineteen (with constipation) IBS patients (group 1), 22 IBS patients (group 2) and 18 healthy controls (group 3) were included in the study. The diagnosis of IBS was made according to the Rome I Criteria. The urine was collected for determination of 5-HIAA and venous blood was collected from each subject for the measurement of plasma NO levels. RESULTS The levels of urinary 5-HIAA mmol/day and plasma NO mmol/l of group 1 (22.4 +/- 2.2 and 29.4 +/- 2 respectively) were significantly higher than group 3 (14.2 +/- 2.3 and 21.3 +/- 2.1 respectively) (p = 0.036 and p = 0.019 respectively). The NO level of group 1 was also significantly higher than group 2 (21.8 +/- 1.9) (p = 0.021). The 5-HIAA level of group 1 was higher than group 2 (15.2 +/- 2.1) and the difference was marginally significant (p = 0.055). There was no difference between group 2 and group 3 with respect to 5-HIAA and NO levels. CONCLUSIONS The results of this preliminary study lend support to the involvement of 5-HT in some symptomatology of diarrhoea predominant IBS. Furthermore, NO may be one of the effector mediators of the 5-HT-induced symptoms in these patients.
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Affiliation(s)
- A Yazar
- Department of Internal Disease, Faculty of Medicine, Mersin University, Turkey.
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Aydiner A, Kiyik M, Cikrikcioglu S, Kosar F, Gurses A, Turna A, Yazar A, Dilege S, Goksel T, Cakan A. The combination of gemcitabine and cisplatin as neoadjuvant chemotherapy for early stage non-small cell lung carcinoma (NSCLC): an interim analysis of a phase II trial. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. Aydiner
- Istanbul Univ, Institute of Oncology, Istanbul, Turkey; Yedikule Chest Disease Hosp, Istanbul, Turkey; Ege Univ, Izmir, Turkey
| | - M. Kiyik
- Istanbul Univ, Institute of Oncology, Istanbul, Turkey; Yedikule Chest Disease Hosp, Istanbul, Turkey; Ege Univ, Izmir, Turkey
| | - S. Cikrikcioglu
- Istanbul Univ, Institute of Oncology, Istanbul, Turkey; Yedikule Chest Disease Hosp, Istanbul, Turkey; Ege Univ, Izmir, Turkey
| | - F. Kosar
- Istanbul Univ, Institute of Oncology, Istanbul, Turkey; Yedikule Chest Disease Hosp, Istanbul, Turkey; Ege Univ, Izmir, Turkey
| | - A. Gurses
- Istanbul Univ, Institute of Oncology, Istanbul, Turkey; Yedikule Chest Disease Hosp, Istanbul, Turkey; Ege Univ, Izmir, Turkey
| | - A. Turna
- Istanbul Univ, Institute of Oncology, Istanbul, Turkey; Yedikule Chest Disease Hosp, Istanbul, Turkey; Ege Univ, Izmir, Turkey
| | - A. Yazar
- Istanbul Univ, Institute of Oncology, Istanbul, Turkey; Yedikule Chest Disease Hosp, Istanbul, Turkey; Ege Univ, Izmir, Turkey
| | - S. Dilege
- Istanbul Univ, Institute of Oncology, Istanbul, Turkey; Yedikule Chest Disease Hosp, Istanbul, Turkey; Ege Univ, Izmir, Turkey
| | - T. Goksel
- Istanbul Univ, Institute of Oncology, Istanbul, Turkey; Yedikule Chest Disease Hosp, Istanbul, Turkey; Ege Univ, Izmir, Turkey
| | - A. Cakan
- Istanbul Univ, Institute of Oncology, Istanbul, Turkey; Yedikule Chest Disease Hosp, Istanbul, Turkey; Ege Univ, Izmir, Turkey
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Karagol H, Derin D, Yazar A, Basaran M, Bavbek SE, Onat H. A single institution experience: Paclitaxel/ifosfamide/cisplatin (TIP) chemotherapy in refractory or recurrent germ cell tumors. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - D. Derin
- Institute of Oncology, Istanbul, Turkey
| | - A. Yazar
- Institute of Oncology, Istanbul, Turkey
| | | | | | - H. Onat
- Institute of Oncology, Istanbul, Turkey
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Yazar A, Fritz MK, Lindstaedt M, M�gge A, Laczkovics AM, Perrey C, Bojara W. Physiologic assessment of coronary lesions: Coronary pressure measurement for the optimisation of the coronary revascularisation management. Thorac Cardiovasc Surg 2004. [DOI: 10.1055/s-2004-816579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Büyükafşar K, Yazar A, Düşmez D, Oztürk H, Polat G, Levent A. Effect of trapidil, an antiplatelet and vasodilator agent on gentamicin-induced nephrotoxicity in rats. Pharmacol Res 2001; 44:321-8. [PMID: 11592868 DOI: 10.1006/phrs.2001.0864] [Citation(s) in RCA: 26] [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] [Indexed: 11/22/2022]
Abstract
This study was carried out to evaluate the effect of trapidil, an antiplatelet and vasodilator drug, on the nephrotoxicity by an aminoglycoside, gentamicin, in rats. Forty female Wistar rats were divided into six different groups. One group served as a control group and the other groups were treated as follows: gentamicin (50 mg kg(-1) twice daily)-treated, gentamicin plus trapidil (4 or 20 mg kg(-1) daily)-treated and only trapidil-treated (4 or 20 mg kg(-1) daily) groups. Serum urea, creatinine and nitrite/nitrate levels were measured. Moreover, histopathological as well as electron microscopic examinations were performed. At a lower dose (4 mg kg(-1)) trapidil did not prevent the development of renal tubular damage by gentamicin. However, a higher dose of trapidil (20 mg kg(-1)) inhibited the ability of gentamicin to increase the levels of creatinine and urea. Furthermore, both light and electron microscopic evaluation confirmed the nephroprotective effect of the higher dose of trapidil. The level of the stable nitric oxide (NO) metabolite, nitrite, was also increased by trapidil. In conclusion, trapidil at a higher dose may protect against gentamicin nephrotoxicity. The mechanism underlying trapidil nephroprotection is not known, but may result from the antagonism of platelet-derived growth factor (PDGF), vasodilatation, inhibition of trombosit aggregation, and/or NO release.
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Affiliation(s)
- K Büyükafşar
- Department of Pharmacology, Medical Faculty, Mersin University, Turkey.
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Pata C, Konica K, Yazar A. The role of colchicine in Helicobacter pylori prevalence and gastric mucosal changes in Behçet's Disease. J Rheumatol 2001; 28:2144. [PMID: 11824425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Pata C, Konca K, Yazar A. The role of colchicine in Helicobacter pylori prevalence and gastric mucosal changes in Behçet's disease. J Rheumatol 2001; 28:1938. [PMID: 11508610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Abstract
OBJECTIVE Scientific evidence of functional interface between the immune and sensory motor systems of the gut and respiratory systems has been reported. In recent studies excess prevalence of bronchial hyper-responsiveness has been shown among patients with irritable bowel syndrome (IBS). The purpose of our study was to investigate the possible relationship between IBS and asthma. METHODS One hundred thirty-three patients with IBS (108 women, 25 men) and 137 control subjects (105 women, 32 men) were included in this study. Both for IBS and the control group, the mean ages were 41.64+/-9.45 yr and 39.94+/-10.62 yr, respectively. Patients more than 50 yr old, with any organic GI disease, acute respiratory system infection, current or ex-smokers, and patients using drugs affecting smooth muscle and autonomic nervous system were not included in the study. Respiratory symptoms were questioned and pulmonary function tests were performed for every subject. RESULTS There were 45 (33.8%) and eight (5.8%) subjects with respiratory symptoms in IBS and control groups, respectively (p < 0.0001). Twenty-one (15.8%) patients from the IBS group and two (1.45%) patients from the control group had the diagnosis of asthma according to history, clinical, and PFT findings. There was no statistical difference between two groups with respect to percentage of forced vital capacity and forced expiratory volume in 1 s-to-forced vital capacity. The difference between the two groups in forced expiratory volume in 1 s, flow after 50% of the vital capacity has been exhaled, peak expiratory flow rate, and maximal mid-expiratory flow rate was statistically significant (p < 0.01). CONCLUSION We found that the prevalence of asthma was more common in the IBS group than in controls. Our finding supports the speculation that asthma and IBS may share common pathophysiological processes.
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Affiliation(s)
- A Yazar
- Department of Internal Medicine, Mersin University Faculty of Medicine, Turkey
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