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  1. Home
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Browsing by Author "Doğan G."

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    Relationship between duodenal histopathology and strong positive tissue transglutaminase antibodies in children with celiac disease; [Çölyak hastası çocuklarda duodenal histopatoloji ve güçlü pozitif doku transglutaminaz antikorları arasındaki ilişki]
    (Galenos Yayincilik,, 2015) Doğan G.; Ayhan S.; Yılmaz B.; Appak Y.Ç.; Dündar P.E.; Ecemiş T.; Ünal F.; Kasırga E.
    Introduction: In celiac disease (CD) strong positive tissue transglutaminase antibody (TTGA) levels (≥100 U/A) have been shown to almost always indicate villous atrophy. The aim of this study is to determine the sufficiency of ≥100 U/A Ig A type TTGA levels for diagnosis of CD. Materials and Methods: Results from duodenum biopsy performed due to positive TTGA in 197 children were retrospectively examined. IgA TTGA levels had a positive value of >18 U/A. Increases of 5 times or more than this threshold value (≥100 U/A) are accepted as strong positivity. CD diagnosis was made according to ESPGHAN criteria. A modified Marsh stage ≥2 was accepted as significant for CD. Results: Of the cases, 129 were female (65.5%) and 68 were male (34.5%). Duodenum histopathology was compatible with Marsh 0 for 1 case (0.5%), Marsh 2 for 17 cases (8.6%), Marsh 3a for 41 (20.8%), Marsh 3b for 81 (41.4%) and Marsh 3c for 57 (28.9%). The TTGA levels of 64 of the 197 cases (32.5%) were ≥100 U/A. In cases with strong positivity for TTGA the duodenum histology was compatible with Marsh 3 (villous atrophy) for 63 and Marsh 0 (normal histology) for 1 case (type 1 diabetic and asymptomatic for CD). For Marsh 3c TTGA levels ≥100 U/A had a sensitivity of 85.96% (95% CI: 74.2-93.7%), specificity of 89.29% (95% CI: 82.9-93.8%), positive predictive value of 76.56% (95% CI: 64.3-86.2%) and negative predictive value of 93.9% (95% CI: 88.4- 97.3%). Conclusions: This study showed that positive IgA TTGA levels (≥100 U/A) were almost always accompanied by Marsh 3 duodenal histopathological changes. Diagnosis of CD without biopsy may miss certain accompanying diseases, however in some cases with advanced examinations CD may be diagnosed by pediatric gastroenterology specialists without endoscopy. © The Journal of Current Pediatrics, published by Galenos Publishing.
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    Neonatal Cholestasis as Initial Presentation of Portosystemic Shunt: A Case Report
    (Elsevier B.V., 2016) Doğan G.; Düzgün F.; Tarhan S.; Appak Y.Ç.; Kasırga E.
    Congenital intrahepatic portosystemic shunts are rare in children. Portosystemic venous malformations are characterized by extreme clinical variability. We report a full-term 33-day-old male infant presenting with neonatal jaundice. On physical examination, he had generalized icterus and the liver was palpable 3.5 cm below the right costal margin. He had no other symptoms. Laboratory tests showed AST 632 U/L, ALT 198 U/L, total bilirubin 12.1 mg/dL, conjugated bilirubin 10.2 mg/dL, alkaline phosphatase 753 U/L, GGT 47 U/L and glucose 67 U/L. Colour Doppler ultrasonography showed the left portal vein was more dilated than the right portal branch and communication with dilated left hepatic vein. There was no evidence of portal hypertension, heart failure, hepatopulmonary syndrome and encephalopathy during his hospital stay, so he was discharged from the pediatric department and his parents advised to attend monthly follow-up. Congenital portosystemic shunts are rarely observed in the childhood period.1 Depending on anatomic characteristics they may be intrahepatic or extrahepatic.2 Intrahepatic portosystemic shunts (PSS) are observed between the portal vein and hepatic vein or vena cava inferior.3,4 Small shunts may close themselves before the age of 2 years.5 With the increase in use of imaging methods, diagnosing PSS has become easier, with an increase in the number of cases reported.6 Neonatal cholestatis is a frequent complication of PSS.1 We present a case presenting with neonatal cholestasis diagnosed with congenital intrahepatic PSS. © 2016
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    Should we worry about the eyes of celiac patients?
    (SAGE Publications Ltd, 2020) Doğan G.; Şen S.; Çavdar E.; Mayalı H.; Cengiz Özyurt B.; Kurt E.; Kasırga E.
    Purpose: In this article, we evaluate subfoveal choroidal thickness in celiac patients with respect to adherence to the gluten-free diet and nonadherence to the gluten-free diet, comparing with age and sex matched healthy controls using spectral-domain optical coherence tomography. Materials and Methods: A case-control study among 42 celiac patients and 42 healthy participants was conducted in the Department of Pediatric Gastroenterology. Celiac patients of our policlinics compliant with spectral-domain optical coherence tomography examination enrolled in the study. Celiac patients had been asked verbally about their adherence to gluten-free diet, were evaluated according to negative or positive EmA and anti-TG2 for defining adherence, and were divided into two groups (adherence to gluten-free diet and nonadherence to gluten-free diet). Results: Subfoveal choroidal thickness was thinner in EmA (+) or anti-TG2 (+) eyes than EmA(−) or anti-TG2 (−) eyes in celiac patients, but it was not statistically significant. The mean subfoveal choroidal thickness values in eyes with celiac disease, whose diagnosis time was longer than 60 months, were thinner than shorter group. Longer duration of gluten-free diet was associated with adherence difficulty and thinner choroidal thickness (r = −0.15, p = 0.34). Adherence to gluten-free diet was 88.2% for children below the age of 60 months and 57.1% for children older than 60 months. Conclusion: In conclusion, in addition to other extraintestinal manifestations of celiac disease, diagnosis time longer than 60 months in pediatric celiac patients, nonadherence to the gluten-free diet, and antibody positivity should be focused on during ophthalmologic examination and choroid measurement. © The Author(s) 2019.
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    A rare case of ascites: Eosinophilic gastroenteritis
    (Galenos Publishing House, 2020) Doğan G.; Düzgün F.; Yılmaz Ö.; Ayhan S.; Gülen H.; Kasırga E.
    Eosinophilic gastroenteropathies are rare disorders. An 18-year-old girl presented to the hospital with abdominal pain and distension. Abdominal tenderness and grade 2 ascites, serious peripheral eosinophilia and high immunoglobulin E level were found. Laparoscopic antrum biopsy showed subserosal eosinophilic infiltration. Eosinophilic gastroenteropathy was suspected, diet elimination was given, no steroid treatment was used. © Copyright 2020 by Ege University Faculty of Medicine, Department of Pediatrics and Ege Children's Foundation
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    Nutritional interventions improve quality of life of caregivers of children with neurodevelopmental disorders
    (Taylor and Francis Ltd., 2021) Ayça S.; Doğan G.; Yalın Sapmaz Ş.; Erbay Dündar P.; Kasırga E.; Polat M.
    Introduction: Children with neurodevelopmental disorders are at high risk for malnutrition. We aimed to investigate the impact of nutritional interventions to children with neurodevelopmental disorders and the quality of life of caregivers. Materials/Method: This is a prospective interventional study of 91 children with neurodevelopmental disorders. The children were separated into two groups: the intervention group and control group. The intervention group was selected from among children who had not been evaluated for nutrition and feeding problems by a pediatric gastroenterologist or dietician for the past one year. Children in the intervention group were called for follow-up visits and their nutritional intervention and anthropometric measurements were initiated by a pediatric gastroenterologist and dietician, at one month, three months, six months, and one year. The WHOQoL-BREF quality of life scale was completed by the caregivers of the children at baseline and at one year. Results: The intervention group had increased malnutrition (p < 0.001) and gastrointestinal system pathologies such as dysphagia (p < 0.001), constipation (p = 0.02), gastroesophageal reflux (p = 0.03) at baseline. After the nutritional intervention, 77.7% of the intervention group gained weight and 55.5% reached the target weight. The quality of life scale scores at baseline were lower among caregivers of the intervention group; however, they reached those of the control group after the nutritional intervention. Conclusion: Close multidisciplinary nutrition monitoring enables children with neurodevelopmental disorders to thrive appropriately and improves the quality of life of caregivers. © 2019 Informa UK Limited, trading as Taylor & Francis Group.
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    Evaluation of the Knowledge, Attitudes and Behaviors of Pregnant Women on Tetanus Vaccination; [Gebelerin Tetanos Aşısıyla İlgili Bilgi, Tutum ve Davranışlarının Değerlendirilmesi]
    (DOC Design and Informatics Co. Ltd., 2022) Çınar G.; Akdemir-Kalkan İ.; Yılmaz-Karadağ F.; Hocaoğlu M.; Deniz S.; Işık M.E.; Gülten E.; Erdem-Kıvrak E.; Tüzün T.; Torun A.; Ünlü G.; Uygun-Kızmaz Y.; Akgül F.; Arslan E.; Dindar K.; Doğan G.; Sarı S.; Bayındır Z.; Sarıcaoğlu E.M.; Kaplan-Atalay E.; Cavnar A.M.; Haliloğlu E.N.
    Objective: Tetanus, a vaccine-preventable disease, still has the potential to threaten human health. Immunization, especially in pregnant women, is critical as it protects both mother and baby. This study aims to evaluate the tetanus immunization status of pregnant women, their approach to the vaccine, and the factors affecting these. Methods: A 19-item questionnaire was applied to pregnant women from all over Turkey who applied to the hospital for any reason and agreed to participate. Results: A total of 5000 pregnant women from seven geographical regions, aged between 15 and 44 (mean 28±5.7) and whose gestational age was between 8 and 40 weeks (mean 22.07±8.5), participated in the study. %88.2 of them did not get vaccinated in their current pregnancy, and %23.2 of them didn’t plan to get vaccinated. When the reasons for not being vaccinated were questioned, %28.6 and %15.4 of them were afraid of side effects and harming the baby, respectively. In addition, %23.9 of them thought they didn’t need to be vaccinated, and %7.1 of them stated that the vaccine didn’t provide any protection. In univariate analysis, regions, age, gestational week, and the number of pregnancies resulting in delivery were found as factors that statistically significantly affected getting vaccinated, but in multivariate analysis, gestational week, education until secondary school, being followed by a family physician, history of more than three pregnancies, and being vaccinated in a previous pregnancy was found as an independent factor. Conclusions: Neonatal tetanus should be prevented not only because of its high mortality but also, the sequelae, and it can be prevented, minimized, or even completely eradicated by vaccination of pregnant women. For this purpose, every pregnant woman should be informed, and education and counseling support should be provided for vaccination against tetanus. © 2022, DOC Design and Informatics Co. Ltd.. All rights reserved.
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    A snapshot of pediatric inpatients and outpatients with COVID-19: a point prevalence study from Turkey
    (Springer Science and Business Media Deutschland GmbH, 2023) Yılmaz D.; Üstündağ G.; Büyükçam A.; Salı E.; Çelik Ü.; Avcu G.; Belet N.; Çakmak Taşkın E.; Öcal Demir S.; Birbilen A.Z.; Kılıç Ö.; Metin Akcan Ö.; Tekin Yılmaz A.; Aldemir Kocabaş B.; Hatipoğlu N.; Karbuz A.; Çakır D.; Sütçü M.; Aygün F.D.; Çelik T.; Bayturan Şen S.; Dalgıç N.; Ümit Z.; Kara S.S.; 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 M.C.; Yazar A.; Aygün F.; Somer A.; Kuyucu N.; Dinleyici E.Ç.; Kara A.
    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. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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    Eligibility of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) modulator therapies: cohort of cystic fibrosis registry of Türkiye
    (Turkish National Pediatric Society, 2025) Erdal M.A.; Büyükşahin H.N.; Şen V.; Kılınç A.A.; Çokuğraş H.; Doğan G.; Yılmaz A.İ.; Ünal G.; Serbes M.; Altıntaş D.U.; Arık E.; Keskin Ö.; Özaslan M.M.; Karcıoğlu O.; Köse M.; Başaran A.E.; Çakır E.P.; Canıtez Y.; Özdemir A.; Harmancı K.; Uytun S.; Polat S.E.; Hangül M.; Yüksel H.; Özcan G.; Korkmaz P.; Kılıç M.; Aydın Z.G.G.; Çaltepe G.; Can D.; Doğru S.; Öztürk G.K.; Süleyman A.; Topal E.; Özsezen B.; Hızal M.; Demirdöğen E.; Ogun H.; Börekçi Ş.; Yazan H.; Şen H.S.; Demir A.D.; Çakır E.; Eyüboğlu T.Ş.; Emiralioğlu N.; Pekcan S.; Özçelik U.; Doğru D.
    Background. Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) variants are essential for determining eligibility for CFTR modulator drugs (CFTRms). In contrast to Europe and the USA, the treatment eligibility profile of cystic fibrosis (CF) patients in Türkiye is not known. In this study we aimed to determine the eligibility of CF patients in Türkiye for the CFTRms. Methods. The Cystic Fibrosis Registry of Türkiye (CFrT) data was used to determine the age of patients in the year 2021 and the genetic variants they were carrying. Age-and CFTR-variant appropriate modulator therapies were determined using the Vertex® algorithm. Results. Among a total of 1930 registered patients, CTFR gene analysis was performed on a total of 1841 (95.4%) patients. Mutations were detected in one allele in 10.7% (198 patients), and in both alleles in 79% (1455 patients) of patients. A total of 855 patients (51.7% for whom at least 1 mutation was detected) were eligible for the drugs. The most appropriate drug among genotyped patients was found to be elexacaftor/tezacaftor/ivacaftor for 486 patients (26.4%), followed by ivacaftor for 327 patients (17.7%) and lumacaftor/ivacaftor for 42 patients (2%). Conclusions. Only half of patients registered in CFrT were eligible for CFTRms, which is a significant difference from the CFTR variant profile seen in USA and Europe. However, access to treatment is hampered for some patients whose genes are not analysed. Further studies in CF populations, where rare mutations are relatively more common, will contribute to the field of CFTR modulator treatments for such rare mutations. © 2025 The Author(s).

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