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Öğe Coarctation of the aorta presenting with fever and abdominal pain: a case report(2022) Sütçü, Murat; Soran, Mustafa; Şimşek, Nazmi; Arslan, DeryaAortic coarctation is among the congenital heart disease which can easily be diagnosed in infancy and childhood by means of a deliberate physical examination and echocardiography. Children without a prompt diagnosis are represented with several complications that depend on the severity of coarctation. It is of vital importance to perform stent implantation, balloon dilatation or surgical repair as soon as possible after the diagnosis, because severe complications may emerge in aortic coarctation. The present report delineates the case of a six-year old patient who was presented with fever and abdominal pain, and diagnosed with echocardiography to have aortic coarctation.Öğe Could the COVID-19 infection have a better prognosis than expected in pediatric hematology oncology and bone marrow transplant patients?(AVES, 2021) Öner, Özlem Başoğlu; Aksoy, Başak Adaklı; Yaman, Ayhan; Sütçü, Murat; Erol Çipe, Funda; Atça, Ali Önder; Bozkurt, Ceyhun; Fışgın, TunçCoronavirus disease 2019 (COVID-19) is a pandemic that spread rapidly worldwide (1). So far, very few reports concerning the impact of COVID-19 among patients with pediatric hematologic-oncologic diseases are available (2). We aimed to describe the clinical features, prevalence, treatments, and outcomes in the COVID-19 patient population.Öğe COVID-19 associated multisystemic inflammatory syndrome in 614 children with and without overlap with Kawasaki disease-Turk MIS-C study group(Springer, 2022) Yılmaz Çiftdoğan, Dilek; Ekemen Keleş, Yıldız; Şirvan Çetin, Benhur; Dalgıç Karabulut, Nazan; Sütçü, Murat; Kara, Emine ManolyaMultisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9-12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells × ?L, p = 0.028; platelet count 166 vs. 216 cells × 103/?L, p < 0.001). The median serum procalcitonin levels were statistically higher in patients overlapped with KD (3.18 vs. 1.68 µg/L, p = 0.001). Coronary artery dilatation was statistically significant in patients with overlap with KD (13.4% vs. 6.8%, p = 0.007), while myocarditis was significantly more common in patients without overlap with KD features (2.6% vs 7.4%, p = 0.009). The association between clinical and laboratory findings and overlap with KD was investigated. Age > 12 years reduced the risk of overlap with KD by 66% (p < 0.001, 95% CI 0.217-0.550), lethargy increased the risk of overlap with KD by 2.6-fold (p = 0.011, 95% CI 1.244-5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% (p < 0.001, 95% CI 0.298-0.559).Conclusion: Almost half of the patients with MISC had clinical features that overlapped with KD; in particular, incomplete KD was present. The median age was lower in patients with KD-like features. Lymphocyte and platelet counts were lower, and ferritin and procalcitonin levels were significantly higher in patients with overlap with KD. What is Known: • In some cases of MIS-C, the clinical symptoms overlap with Kawasaki disease. • Compared to Kawasaki disease, lymphopenia was an independent predictor of MIS-C. What is New: • Half of the patients had clinical features that overlapped with Kawasaki disease. • In patients whose clinical features overlapped with KD, procalcitonin levels were almost 15 times higher than normal. • Lethargy increased the risk of overlap with KD by 2.6-fold in MIS-C patients. • Transient bradycardia was noted in approximately 10% of our patients after initiation of treatment.Öğe COVID-19 pandemisinde enfeksiyon kontrol çalışmaları çerçevesinde çocuk hastalarla çalışan sağlık personeli eğitimi(AVES YAYINCILIK, 2020) Oygar, Pembe Derin; Büyükcam, Ayşe; Bal, Zümrüt Şahbudak; Dalgıç, Nazan; Bozdemir, Şefika Elmas; Sütçü, Murat; Gül, Doruk; Hatipoğlu, HalilGiriş: Yeni ortaya çıkan patojenlerin neden olduğu salgınların erken dönemleri sağlık çalışanları için büyük bir risk taşımaktadır. SARS-CoV-2’nin neden olduğu pandemide de durum farklı olmamış, alınan yetersiz önlemler ve kişisel korunma eksikliği nedenleriyle pandemi başlangıcında birçok sağlık çalışanı hayatını kaybetmiştir. Sağlık çalışanlarının koruması ve güvenli ortamda çalışmalarının devamlılığının sağlanması sağlık hizmetlerinin aksamamasının yanında salgının sınırlandırması içinde gereklidir. Kişisel koruyucu ekipmaların kullanımı ile ilgili eğitimlerin verilmesi, gerekli durumlarda güncellenmesi koruyucu ekipmanların sağlanması kadar önemlidir. Gereç ve Yöntemler: Otuz iki farklı merkezde çocuklara sağlık hizmeti veren 4927 sağlık personeli üzerinde anket uygulanmış, kişisel koruyucu ekipman kullanımı konusunda alınan eğitim değerlendirilmiş, yaş, cinsiyet, meslek ve bölgesel farklılıkların eğitim alma üzerine etki edip etmediği değerlendirilmiştir. Bulgular: Otuz iki farklı merkezden 4927 sağlık çalışanın katıldığı çalışmada, 4457 (%91) sağlık çalışanın kişisel koruyucu ekipmaların kullanımı ile ilgili eğitim aldığı saptanmış, yalnızca %36’sının hem teorik hem de uygulamalı eğitim aldığı bulunmuştur. Meslek grupları arasında eğitim alma yönünden fark görülmezken, bölgelere göre eğitim alıp almamada anlamlı fark olduğu saptanmıştır. Sonuç: Tüm bölgelerde sağlık personelinin kişisel korunma konusunda eğitilmesi ve verilen eğitimin denetimi ve sürekliliği kaliteli sağlık hizmetlerinin devamlılığı için gereklidir.Öğe Education of healthcare personnel working with pediatric patients during covid-19 pandemic within the framework of infection control(AVES, 2020) Oygar, Pembe Derin; Büyükcam, Ayşe; Bal, Zümrüt Şahbudak; Dalgıç, Nazan; Bozdemir, Şefika Elmas; Sütçü, Murat; Gül, Doruk; Hatipoglu, HalilObjective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n= 4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic.Öğe Epidemiological, clinical, and laboratory features of children with COVID-19 in Turkey(FRONTIERS MEDIA SA, 2021) Karbuz, Adem; Akkoç, Gülşen; Bedir Demirdağ, Tuğba; Yılmaz Çiftdoğan, Dilek; Özer, Arife; Çakır, Deniz; Sütçü, Murat; Hatipoğlu, Halil UğurObjectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children. Methods: A retrospective study was conducted by pediatric infectious disease specialists from 32 different hospitals from all over Turkey by case record forms. Pediatric cases who were diagnosed as COVID-19 between March 16, 2020, and June 15, 2020 were included. Case characteristics including age, sex, dates of disease onset and diagnosis, family, and contact information were recorded. Clinical data, including the duration and severity of symptoms, were also collected. Laboratory parameters like biochemical tests and complete blood count, chest X-ray, and chest computed tomography (CT) were determined. Results: There were 1,156 confirmed pediatric COVID-19 cases. In total, male cases constituted 50.3% (n = 582) and females constituted 49.7% (n = 574). The median age of the confirmed cases was 10.75 years (4.5-14.6). Of the total cases, 90 were younger than 1 year of age (7.8%), 108 were 1-3 years of age (9.3%), 148 were 3-6 years of age (12.8%), 298 were 6-12 years of age (25.8%), 233 were 12-15 years of age (20.2%), and 268 cases were older than 15 years of age (23.2%). The most common symptom of the patients at the first visit was fever (50.4%) (n = 583) for a median of 2 days (IQR: 1-3 days). Fever was median at 38.4 degrees C (38.0-38.7 degrees C). The second most common symptom was cough (n = 543, 46.9%). The other common symptoms were sore throat (n = 143, 12.4%), myalgia (n = 141, 12.2%), dyspnea (n = 118, 10.2%), diarrhea (n = 112, 9.7%), stomachache (n = 71, 6.1%), and nasal discharge (n = 63, 5.4%). When patients were classified according to disease severity, 263 (22.7%) patients were asymptomatic, 668 (57.7%) patients had mild disease, 209 (18.1%) had moderate disease, and 16 (1.5%) cases had severe disease. One hundred and forty-nine (12.9%) cases had underlying diseases among the total cases; 56% of the patients who had severe disease had an underlying condition (p < 0.01). The need for hospitalization did not differ between patients who had an underlying condition and those who do not have (p = 0.38), but the need for intensive care was higher in patients who had an underlying condition (p < 0.01). Forty-seven (31.5%) of the cases having underlying conditions had asthma or lung disease (38 of them had asthma). Conclusions: To the best of our knowledge, this is one of the largest pediatric data about confirmed COVID-19 cases. Children from all ages appear to be susceptible to COVID-19, and there is a significant difference in symptomatology and laboratory findings by means of age distribution.Öğe Evaluation of the risk factors for BK virus-associated hemorrhagic cystitis in pediatric bone marrow transplantation patients: Does post-transplantation cyclophosphamide increase the frequency?(Wiley, 2022) Zengin Ersoy, Gizem; Bozkurt, Ceyhun; Adaklı Aksoy, Başak; Başoğlu Öner, Özlem; Aydoğdu, Selime; Çipe, Funda; Sütçü, Murat; Özkaya, Ozan; Tunç, FışgınBackground: BKV-HC is one of the most significant complications of HSCT. This ret -rospective study aimed to determine the frequency of BKV-HC in pediatric patients undergoing HSCT, detect the associated risk factors for the development of BKV-HC, and explore the effects of post-transplantation Cy use.Methods: Three hundred twenty-seven patients (girls: 121, boys: 206) were analyzed according to sex, conditioning regimen, transplantation type, donor relatedness, stem cell source, the presence and grade of aGVHD, CMV co-existence, and Cy use.Results: Multivariate analysis confirmed the prognostic importance of age (OR: 4.865), TBI use, the presence of aGVHD (OR: 2.794), CMV coinfection (OR: 2.261), and Cy use (OR: 27.353). A statistically significant difference was found between the mean BKV-HC follow-up times compared with post-transplantation Cy intake (p< .001). The BKV-HC rate increased as the number of risk factors of the patient increased.Conclusion: BKV-HC is an essential complication of HSCT primarily associated with Cy use, the presence of aGVHD, and donor relatedness. The present study shows that the use of Cy in the post-transplantation period further increases BKV-HC risk in pediatric patients, regardless of dose.Öğe Kidney transplantation in children weighing 15 kilograms or less(SPRINGER, 2021) Özkaya, Ozan; Evrengül, Havva; Eren, Eryiğit; Tokaç, Mehmet; Yaman, Ayhan; Şahin, Taylan; Sütçü, Murat; Dursun, İsmail; Dinçkan, Ayhan[No Abstract Available]Öğe Multisystem inflammatory syndrome in children associated with COVID-19 in 101 cases from Turkey (Turk-MISC study)(2022) Yılmaz Çiftdoğan, Dilek; Ekemen Keleş, Yıldız; Karbuz, Adem; Şirvan Çetin, Benhur; Elmas Bozdemir, Şefika; Sütçü, Murat; Gül, DorukAim: Multisystem inflammatory syndrome in children (MIS-C) may cause shock and even death in children. The aim of this study is to describe the clinical features, laboratory characteristics and outcome of children diagnosed with MIS-C in 25 different hospitals in Turkey. Methods: The retrospective study was conducted between 8 April and 28 October 2020 in 25 different hospitals from 17 cities. Data were collected from patients' medical records using a standardised form. Clinical and laboratory characteristics and outcomes according to different age groups, gender and body mass index percentiles were compared using multivariate logistic regression analysis. Results: The study comprised 101 patients, median age 7 years (interquartile range (IQR) 4.6-9.3); 51 (50.5%) were boys. Reverse-transcriptase polymerase chain reaction (PCR) assay was positive in 21/100 (21%) patients; 62/83 (74.6%) patients had positive serology for SARS-CoV-2. The predominant complaints were fever (100%), fatigue (n = 90, 89.1%), and gastrointestinal symptoms (n = 81, 80.2%). Serum C-reactive protein (in 101 patients, median 165 mg/L; range 112-228), erythrocyte sedimentation rate (73/84, median 53 mm/s; IQR 30-84) and procalcitonin levels (86/89, median 5 ?g/L; IQR 0.58-20.2) were elevated. Thirty-eight patients (37.6%) required admission to intensive care. Kawasaki disease (KD) was diagnosed in 70 (69.3%) patients, 40 of whom had classical KD. Most patients were treated with intravenous immunoglobulin (n = 92, 91%) and glucocorticoids (n = 59, 58.4%). Seven patients (6.9%) died. Conclusion: The clinical spectrum of MIS-C is broad, but clinicians should consider MIS-C in the differential diagnosis when persistent fever, fatigue and gastrointestinal symptoms are prominent. Most patients diagnosed with MIS-C were previously healthy. Immunomodulatory treatment and supportive intensive care are important in the management of cases with MIS-C. Glucocorticoids and intravenous immunoglobulins are the most common immunomodulatory treatment options for MIS-C. Prompt diagnosis and prompt treatment are essential for optimal management.Öğe Nasopharyngeal meningococcal carriage among children and adolescents in Turkey in 2018: an unexpected high serogroup x carriage(PubMed Central, 2021) Kızıl, Mahmut Can; Kılıç, Ömer; Ceylan, Mehmet; Iseri Nepesov, Merve; Karbuz, Adem; Kurugöl, Zafer; Sütçü, MuratMeningococcal carriage studies and transmission modeling can predict IMD epidemiology and used to define invasive meningococcal disease (IMD) control strategies. In this multicenter study, we aimed to evaluate the prevalence of nasopharyngeal Neisseria meningitidis (Nm) carriage, serogroup distribution, and related risk factors in Turkey. Nasopharyngeal samples were collected from a total of 1267 children and adolescents and were tested with rt-PCR. Nm carriage was detected in 96 participants (7.5%, 95% CI 6.1-9.0), with the peak age at 13 years (12.5%). Regarding age groups, Nm carriage rate was 7% in the 0-5 age group, was 6.9%in the 6-10 age group, was 7.9% in the 11-14 age group, and was 9.3% in the 15-18 age group. There was no statistically significant difference between the groups (p > 0.05). The serogroup distribution was as follows: 25% MenX, 9.4% MenA, 9.4% MenB, 2.1% MenC, 3.1% MenW, 2.1% for MenY, and 48.9% for non-groupable. The Nm carriage rate was higher in children with previous upper respiratory tract infections and with a high number of household members, whereas it was lower in children with antibiotic use in the last month (p < 0.05 for all). In this study, MenX is the predominant carriage strain. The geographical distribution of Nm strains varies, but serogroup distribution in the same country might change in a matter of years. Adequate surveillance and/or a proper carriage study is paramount for accurate/dynamic serogroup distribution and the impact of the proposed vaccination.Öğe Rhabdomyolysis after BNT162b2 mRNA Covid-19 vaccine in an adolescent male(Malawi Medical Journal, 2022) Sütçü, Murat; Gül, Doruk; Atik, Fatih; Kara, Emine ManolyaPfizer-BioNTech COVID-19 (BNT162b2) conferred a high level of protection against Covid-19 with a proven short-term safety profile. Although cases of vaccine-associated myopericarditis have been reported, the existence of rhabdomyolysis without myocarditis has not yet been published. A 16-year-old, healthy male patient, who did not use any herbal or illegal drugs before, was admitted with muscle pain that developed after the second dose of BNT162b2 vaccine. Cardiac examination and heart enzymes were normal and the patient had significantly higher creatinine kinase levels. The patient, whose enzymes returned to normal with only force hydration therapy, recovered without complications. Reporting the side effects of the vaccine, which has a short history of application to large populations, is of vital importance in the conduct of vaccine development studies and in identifying the risky group in terms of side effects. © 2022 The College of Medicine and the Medical Association of Malawi.Öğe SARS-CoV-2 seropositivity among pediatric health care personnel after the first peak of the pandemic: nationwide surveillance in Turkey(Elsevier, 2021) Oygar, Pembe Derin; Büyükcam, Ayşe; Şahbudak Bal, Zümrüt; Dalgıç, Nazan; Bozdemir, Şefika Elmas; Sütçü, Murat; Gül, Doruk; Hatipoğlu, Halil UğurBackground: Understanding SARS-CoV-2 seroprevalence among health care personnel is important to explore risk factors for transmission, develop elimination strategies and form a view on the necessity and frequency of surveillance in the future. Methods: We enrolled 4927 health care personnel working in pediatric units at 32 hospitals from 7 different regions of Turkey in a study to determine SARS Co-V-2 seroprevalence after the first peak of the COVID-19 pandemic. A point of care serologic lateral flow rapid test kit for immunoglobulin (Ig)M/IgG was used. Seroprevalence and its association with demographic characteristics and possible risk factors were analyzed. Results: SARS-CoV-2 seropositivity prevalence in health care personnel tested was 6.1%. Seropositivity was more common among those who did not universally wear protective masks (10.6% vs 6.1%). Having a COVID-19-positive co-worker increased the likelihood of infection. The least and the most experienced personnel were more likely to be infected. Most of the seropositive health care personnel (68.0%) did not suspect that they had previously had COVID-19. Conclusions: Health surveillance for health care personnel involving routine point-of-care nucleic acid testing and monitoring personal protective equipment adherence are suggested as important strategies to protect health care personnel from COVID-19 and reduce nosocomial SARS-CoV-2 transmission. © 2021 The Author(s)
