Browsing by Author "Özkan H."

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    Evaluation of micafungin use in children; [Çocuklarda mikafungin kullanımının değerlendirilmesi]
    (Ankara Microbiology Society, 2020) Yeşil E.; Çelebi S.; Sezgin Evim M.; Özer A.; Turan C.; Ti̇Mur D.; Çakir S.Ç.; Bülbül B.; Ener B.; Güneş A.M.; Köksal N.; Özkan H.; Sevinir B.; Düzcan Kilimci D.; Hacimustafaoğlu M.
    Micafungin is recommended especially in patients with liver and kidney failure and in the presence of other side effects due to antifungals apart from its known priority indications such as invasive candidiasis. The aim of this study was to evaluate the children who have received micafungin treatment. In the study, 125 children who were hospitalized in the pediatric wards and intensive care units of our hospital and had used micafungin between November 2016 and January 2019 were analyzed retrospectively. Clinical data, micafungin indication, blood values on the first and fourth days of the treatment, side effects of the drug and efficacy were evaluated. Sixty percent (75/125) of the patients were male and the mean age of all the patients were 58 ± 67 (0-215, 30) months. Approximately half of the cases (48%) had malignancy and 13% of them were premature. Sixty-two percent (n= 37) of the malignencies were hematological (27 acute lymphocytic leukemia, nine acute myeloid leukemia, one myelodysplastic syndrome) and 38% (n= 23) were oncological (six neuroblastoma, four Hodgkin lymphoma, two Non-Hodgkin’s lymphoma, five sarcomas, one hepatoblastoma, five others) malignencies. The major cause of hospitalization was sepsis (53%). The patients had several risk factors like immunosuppressive therapy (n= 68, 54%), neutropenia (n= 61, 49%), central venous catheter (n= 102, 82%), nasogastric tube (n= 63, 50%), endotracheal intubation tube (n= 49, 39%), urinary catheter (n= 14, 11%) and total parenteral nutrition (n= 81, 65%). Thirteen percent (n= 16) of the cases were post-operative patients. Candida species were cultivated in 97 clinical specimens (blood, endotracheal aspirate, sputum, urine, etc.) among 23 (18%) of the patients. Thirteen (10%) of the patients had candidemia and 62% of them were non-albicans strains. In all candidemias, strains were echinocandin susceptible, and blood cultures were negative within four days. When all the patients (n= 125) were evaluated, a significant decrease in C-reactive protein, an increase in sodium, and a decrease in alanine aminotransferase were observed on the fourth day of micafungin treatment (p< 0.05). A total of 39 (31%) patients underwent various antifungal treatments for median seven (1-60) days prior to micafungin treatment. Fourteen (36%) of these 39 patients, had elevated liver function tests (LFT), 10 (26%) of them had hypokalemia, and five (13%) of them had elevated renal function tests. Ten (26%) patients had antifungal-induced hypokalemia previously; and potassium levels were normalized after micafungin treatment (p= 0.0001). The patients for which micafungin treatment was chosen due to elevated liver function tests (n= 47, 38%), whether the antifungal induced or not; alanine aminotransferase and aspartate aminotransferase levels were decreased after micafungin treatment (p= 0.0001 and p= 0.0001, respectively). Nineteen (15%) of the patients have died within the first 30 days of micafungin treatment and one of them had candidemia. No micafungin treatment related significant side effects were observed in any of the patients. Our study showed that micafungin could be a safe and effective option in pediatric cases including newborns with high liver and kidney function tests. © 2020 Ankara Microbiology Society. All rights reserved.
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    Adulthood asthma as a consequence of childhood adversity: A systematic review of epigenetically affected genes
    (Cambridge University Press, 2022) Saygideger Y.; Özkan H.; Baydar O.; Yilmaz O.
    There is an accumulating data that shows relation between childhood adversity and vulnerability to chronic diseases as well as epigenetic influences that in turn give rise to these diseases. Asthma is one of the chronic diseases that is influenced from genetic regulation of the inflammatory biomolecules and therefore the hypothesis in this research was childhood adversity might have caused epigenetic differentiation in the asthma-related genes in the population who had childhood trauma. To test this hypothesis, the literature was systematically reviewed to extract epigenetically modified gene data of the adults who had childhood adversity, and affected genes were further evaluated for their association with asthma. PRISMA guidelines were adopted and PubMed and Google Scholar were included in the searched databases, to evaluate epigenetic modifications in asthma-related genes of physically, emotionally or sexually abused children. After retrieving a total of 5245 articles, 36 of them were included in the study. Several genes and pathways that may contribute to pathogenesis of asthma development, increased inflammation, or response to asthma treatment were found epigenetically affected by childhood traumas. Childhood adversity, causing epigenetic changes in DNA, may lead to asthma development or influence the course of the disease and therefore should be taken into account for the prolonged health consequences. © 2022 The Author(s). Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease.
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    Clinical and Demographic Characteristics of Treatment Requiring Retinopathy of Prematurity in Big Premature Infants in Turkiye: Report No. 1 (BIG-ROP Study)
    (S. Karger AG, 2024) Özdek Å.; Ozdemir H.B.; Ozen Tunay Z.; Bayramoglu S.E.; Alyamac Sukgen E.; Klr N.; Koç E.; Ekinci D.Y.; Sayin N.; Ceylan N.A.; Cebeci Z.; Çelik G.; Kizilay O.; Demir S.T.; Yildiz M.; Öztürk T.; Bekmez S.; Eris E.; Çömez A.; Mayali H.; Kabatas E.U.; Satirtav G.; Ögreden T.; Vural A.; Onur I.U.; Yeter D.Y.; Gönc T.; Tanidir S.T.; Akdogan M.; Çelemler P.; Beyazyildiz E.; Beyazyildiz Ö.; Acar D.E.; Özbay E.K.; Özcan Y.; Keles S.; Yildirim M.; Uzun A.; Dikci S.; Sari A.; Kara C.; Petriçli I.S.; Comba Ö.B.S.; Albayrak S.; Ersan B.A.; Bilgin B.; Çeliker H.; Sahin O.; Seymen Z.; Alaluf A.; Kaymak N.Z.; Oral A.Y.; Kerimoglu H.; Ünsal A.I.A.; Hirfanoglu I.M.; Tayman C.; Mert M.K.; Çetinkaya M.; Karatekin G.; Uslu S.; Özkan H.; Tüzün F.; Yildirim T.G.; Yurttutan S.; Dinlen N.F.; Bezirganoglu H.; Altinhan H.; Salihoglu Ö.; Tun G.; Karakurt D.G.; Bas A.Y.; Demiroglu Ö.B.; Aygün C.; Tekgündüz K.S.; Ceylan M.; Özdemir R.; Zübahiroglu U.; Özkiraz S.; Cömert S.; Akcan A.B.
    Introduction: The aim of the study was to analyse the clinical and demographic features of infants with gestational age (GA) of 32-37 weeks and birth weight (BW) of >1,500 g who developed treatment requiring retinopathy of prematurity (ROP). Methods: Data on the infants with a GA of 32-37 weeks and BW >1,500 g who developed treatment requiring ROP (TR-ROP) were collected retrospectively from the 33 ROP centres in Turkiye. GA, BW, type of hospital, neonatal intensive care units (NICUs) level, presence of an ophthalmologist and neonatologist in the same hospital, length of stay in NICU, duration of oxygen therapy, comorbidities, type of ROP, and timing for TR-ROP development were analysed. Results: A total of366 infants were included in the study. Mean GA and BW were 33 1 weeks and 1,896 316 g, respectively. Duration of hospitalization was 3-4 weeks in 46.8% of them. The first ROP examination was performed at postnatal 4-5 weeks in 80.3% of infants, which was significantly later in level 2 and lower NICUs and non-university clinics. At the first ROP examination, any stage of ROP was detected in 90.9% and TR-ROP was detected in 15.3% of the infants. The mean postnatal week of TR-ROP development was 6.16 2.04. Conclusion: Routine ROP screening thresholds need to be expanded in hospitals with suboptimal NICU conditions considering the development of TRROP in more mature and heavier preterm infants. The first ROP examination should be earlier than the fourth postnatal week. 2024 S. Karger AG, Basel. © 2024 S. Karger AG. All rights reserved.