Browsing by Author "Devrim, I"

Now showing 1 - 5 of 5
  • No Thumbnail Available
    Item
    Cardiovascular risk factors and noninvasive assessment of arterial structure and function in obese Turkish children
    Yilmazer, MM; Tavli, V; Carti, OU; Mese, T; Güven, B; Aydin, B; Devrim, I; Tavli, T
    Obesity is associated with a number of risk factors, such as hyperlipidemia, hyperinsulinemia, hypertension, and early atherosclerosis. Evidence indicates that atherosclerosis begins in childhood and progresses over decades. In this work, we examined the relationship between cardiovascular risk factors and ultrasonographic signs of subclinical atherosclerosis in 77 obese children and adolescents compared to 40 non-obese healthy peers. Carotis intima media thickness (cIMT), carotid artery compliance (CAC), brachial artery flow-mediated dilatation (FMD), and established cardiovascular risk factors were studied. In the obese patients, cIMT was significantly increased (0.57 mm vs 0.45 mm, p < 0.001) whereas CAC (1.84% vs 3.29%, p < 0.001) and FMD (9.67 % vs 14.81%, p < 0.001) were significantly decreased. In multiple linear regression analysis, a relation was observed between cIMT, CAC, brachial FMD on one hand, and body mass index (BMI) on the other. Among the lipid anomalies, only hypertriglyceridemia was found to be positively correlated with cIMT. Additionally, we found a significant association between waist circumference (WC) and FMD. These findings indicate that obesity in children is associated with arterial wall alterations and endothelial dysfunction. In hyperlipidemic situations, only hypertriglyceridemia was found to be positively correlated with cIMT. This finding has consistently indicated TG to be a risk factor for the development of atherosclerosis. To our knowledge this is the first study to determine the relation between FMD and WC, which is used as a parameter of obesity in childhood.
  • No Thumbnail Available
    Item
    Adolescents With Breakthrough COVID-19 Infections Requiring Hospitalization: A Multicenter Retrospective Study
    Bal, ZS; Arslan, SY; Ozenen, GG; Okur, DS; Kiliçaslan,Ö; Demirbuga, A; Turgut, EA; Dalgic, N; Belet, N; Inceli, HB; Elvan-Tuz, A; Kara, TT; Bulbul, B; Demirdag, T; Çakici,Ö; Bal, A; Ergun, D; Altug, U; Arslan, A; Isancli, DK; Torun, SH; Çelik,Ü; Yasar, B; Erbas, IC; Oncel, EK; Akbas, A; Gudeloglu, E; Sen, S; Kacar, P; Dede, E; Petmezci, E; Aksoy, FD; Karbuz, A; Öncel, S; Tezer, H; Devrim, I; Ciftci, E; Hacimustafaoglu, M; Kurugol, Z
    Background Vaccines have the most important role in the battle against the COVID-19 pandemic. With the widespread use of vaccines, COVID-19 has remarkably declined. Adolescents were vaccinated after approvals for this age group, which was later than adults, and a nationwide vaccination program was implemented in August 2021 in Turkey for adolescents >= 12 years of age. Therefore, we aimed to determine the effects of the COVID-19 nationwide adolescent vaccination program on adolescent hospitalizations due to COVID-19 and multisystem inflammatory syndrome in children (MIS-C) by comparing two periods, including the vaccination period (VP) and the pre-VP (PVP). The second aim of this study is to compare the clinical features and disease severity of vaccine-breakthrough COVID-19 hospitalizations with unvaccinated individuals in the VP. Methods A retrospective multicenter study was conducted to determine and compare the number of hospitalizations due to COVID-19 and MIS-C between the VP (September 1, 2021, to August 31, 2022) and PVP (September 1, 2020, to August 31, 2021). We also compared the characteristics, risk factors, and outcomes of breakthrough infections of adolescents aged 12-18, which required hospitalization with the same age group of unvaccinated hospitalized individuals during the VP. Results During the study period, 3967 children (0-18 years) were hospitalized in the PVP and 5143 (0-18 years) in the VP. Of them, 35.4% were adolescents (12-18 years) in the PVP, and this rate was 18.6% in the VP; relative risk was 0.6467 (95% confidence interval [CI]: 0.6058-0.6904; p < 0.001). Patients with breakthrough COVID- 19 were older (201 vs. 175 months, p < 0.001) and less commonly hospitalized for COVID-19 (81.5% vs. 60.4%, p < 0.001, odds ratio [OR]: 0.347 [95% CI: 0.184-0.654]). The majority of these infections were asymptomatic and mild (32% vs.72.9%: p < 0.001, OR: 5.718 [95% CI: 2.920-11.200]), and PICU admission was less frequently required (p = 0.011, OR: 0.188 [95% CI: 0.045-0.793]). Most breakthrough COVID-19 infections occurred within three months after the last vaccine dose (54.2%). Conclusions This study demonstrated a significant decrease in adolescent hospitalizations due to COVID-19 and MIS -C after implementing COVID-19 vaccines in Turkey. Breakthrough cases were less severe and mostly occurred three months after the last dose. This study emphasizes the importance of COVID-19 vaccines and that parents' decisions may be changed, particularly those who hesitate to or refuse vaccination.
  • No Thumbnail Available
    Item
    Evaluation of Attitudes and Knowledge of Influenza Diagnosis, Treatment and Vaccination Among Pediatric Residents
    Garipçin, P; Keles, YE; Öncel, EK; Kiymet, E; Böncüoglu, E; Özlü, CO; Asrak, HK; Özenen, GG; Ümit, Z; Kara, SS; Sen, S; Aksay, AK; Bal, ZS; Devrim, I; Belet, N; Çiftdogan, DY
    Objective: Influenza virus is common in children, especially in winter, causing hospitalization, admission to the intensive care unit, or even death. There are few studies on the attitudes or knowledge of influenza diagnosis, treatment, and vaccination among pediatricians. This study was planned to determine pediatric residents' attitudes and behaviors about recognizing the influenza virus, making treatment decisions, prophylaxis, and immunization. Material and Methods: This descriptive cross-sectional study was performed from 31 July-1 December 2019 among pediatric residents working in six different hospitals in the Aegean Region by an online survey. Twenty-seven questions were asked regarding articipant's demographic characteristics, recognition of the influenza symptoms, treatment, prophylaxis, and immunization. Results: Two hundred and four (58.5%) of 349 pediatric residents were included in the study, who answered the questionnaire. Among the participants, 72.5% were females, and their mean age was 27.9 +/- 2.1 years, and 59.3% worked as a pediatric residents for less than two years. When the symptoms of influenza were evaluated, the most known symptoms were fever (94.1%), myalgia (81.9%), tiredness (77.0%), headache (70.1%), and cough (68.6%). When oseltamivir treatment indications were questioned, most pediatric residents (82.2%) answered the questions. It was observed that 21.1% of the pediatric residents had the flu vaccine in the current season. According to the state of having chronic diseases, the rate of vaccination in participants was not statistically significant (p= 0.136). Conclusion: In this study, it was determined that pediatric residents' knowledge about influenza awareness, treatment, and immunization was insufficient. It may be beneficial to train pediatric residents about the influenza virus and vaccine before each influenza season.
  • No Thumbnail Available
    Item
    Antibiotic associated diarrhea in outpatient pediatric antibiotic therapy
    Basaranoglu, ST; Karaaslan, A; Sali, E; Çiftçi, E; Aydin, ZGG; Kocabas, BA; Kaya, C; Bayturan, SS; Kara, SS; Çiftdogan, DY; Çay, Ü; Aktürk, HG; Çelik, M; Ozdemir, H; Somer, A; Diri, T; Yazar, AS; Sütçü, M; Tezer, H; Oncel, EK; Kara, M; Çelebi, S; Parlakay, AÖ; Karakaslilar, S; Arisoy, ES; Tanir, G; Kara, TT; Devrim, I; Erat, T; Aykaç, K; Kaba, Ö; Güven, S; Yesil, E; Yilmaz, AT; Durmus, SY; Çaglar, I; Günay, F; Özen, M; Dinleyici, EÇ; Kara, A
    BackgroundAntibiotic-associated diarrhea is one of the most frequent side effects of antimicrobial therapy. We assessed the epidemiological data of antibiotic-associated diarrhea in pediatric patients in our region.MethodsThe prospective multi-center study included pediatric patients who were initiated an oral antibiotic course in outpatient clinics and followed in a well-established surveillance system. This follow-up system constituded inclusion of patient by the primary physician, supply of family follow-up charts to the family, passing the demographics and clinical information of patient to the Primary Investigator Centre, and a close telephone follow-up of patients for a period of eight weeks by the Primary Investigator Centre.ResultsA result of 758 cases were recruited in the analysis which had a frequency of 10.4% antibiotic-associated diarrhea. Among the cases treated with amoxicillin-clavulanate 10.4%, and cephalosporins 14.4% presented with antibiotic-associated diarrhea. In the analysis of antibiotic-associated diarrhea occurrence according to different geographical regions of Turkey, antibiotic-associated diarrhea episodes differed significantly (p = 0.014), particularly higher in The Eastern Anatolia and Southeastern Anatolia. Though most commonly encountered with cephalosporin use, antibiotic-associated diarrhea is not a frequent side effect.ConclusionThis study on pediatric antibiotic-associated diarrhea displayed epidemiological data and the differences geographically in our region.
  • No Thumbnail Available
    Item
    Antifungal consumption, indications and selection of antifungal drugs in paediatric tertiary hospitals in Turkey: Results from the first national point prevalence survey
    Çaglar, I; Devrim, I; Özdemir, H; Sahbudak, Z; Sönmez, G; Buyukcam, A; Gulhan, B; Kara, A; Aygun, DF; Bayram, N; Celebi, S; Çetin, B; Nepesov, MI; Yilmaz, AT; Kepenekli, E; Çiftdogan, DY; Acar, MK; Yayla, BC; Okumus, C; Ecevit, Z; Hatipoglu, N; Kuyucu, N; Kosker, M; Sen, S; Karbuz, A; Sutcu, M; Duramaz, BB; Özen, M; Çiftçi, E; Alabaz, D; Kurugol, Z; Kara, A; Kanik, S; Kilic, O; Oncel, S; Somer, A; Tapisiz, A; Belet, N; Akcan, ÖM; Türel, Ö; Ozkaya, A; Tezer, H; Cengiz, AB; Ince, E; Camcioglu, Y; Kocabas, E; Arisoy, ES; Salman, N
    Objectives: The aim of this point prevalence survey was to evaluate the consumption, indications and strategies of antifungal therapy in the paediatric population in Turkey. Methods: A point prevalence study was performed at 25 hospitals. In addition to general data on paediatric units of the institutes, the generic name and indication of antifungal drugs, the presence of fungal isolation and susceptibility patterns, and the presence of galactomannan test and high-resolution computed tomography (HRCT) results were reviewed. Results: A total of 3338 hospitalised patients were evaluated. The number of antifungal drugs prescribed was 314 in 301 patients (9.0%). Antifungal drugs were mostly prescribed in paediatric haematology and oncology (PHO) units (35.2%), followed by neonatal ICUs (NICUs) (19.6%), paediatric services (18.3%), paediatric ICUs (PICUs) (14.6%) and haematopoietic stem cell transplantation (HSCT) units (7.3%). Antifungals were used for prophylaxis in 147 patients (48.8%) and for treatment in 154 patients (50.0%). The antifungal treatment strategy in 154 patients was empirical in 77 (50.0%), diagnostic-driven in 29 (18.8%) and targeted in 48 (31.2%). At the point of decision-making for diagnostic-driven antifungal therapy in 29 patients, HRCT had not been performed in 1 patient (3.4%) and galactomannan test results were not available in 12 patients (41.4%). Thirteen patients (8.4%) were receiving eight different antifungal combination therapies. Conclusion: The majority of antifungal drugs for treatment and prophylaxis were prescribed in PHO and HSCT units (42.5%), followed by ICUs. Thus, antifungal stewardship programmes should mainly focus on these patients within the availability of diagnostic tests of each hospital. (C) 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.