Browsing by Author "Ilhan, O"

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    Efficacy and Safety of Intravenous Colistin in Very Low Birth Weight Preterm Infants
    Ilhan, O; Bor, M; Ozdemir, SA; Akbay, S; Ozer, EA
    BackgroundGiven the severity and high mortality of multidrug-resistant Gram-negative bacilli (MDR-GNB) infections, the use of colistin will increase in patients with MDR-GNB infection.ObjectiveThis study aims to assess the efficacy and safety of intravenous colistin in very low birth weight (VLBW; birth weight <1500g) preterm infants.MethodsWe retrospectively analyzed the medical records of patients who received colistin between June 2016 and December 2017. The patients were assigned to two groups: the VLBW group and the non-VLBW group. Both groups were evaluated for response to treatment and adverse effects.ResultsIn total, 66 infants who received colistin therapy were included; of these, 28 infants were VLBW. All of our patients received standard colistin treatment of 5mg/kg per day in three doses and the median duration of colistin treatment was 14days. No significant differences were observed between the groups with respect to the efficacy of colistin (defined as showing microbiological clearance in control cultures and the absence of mortality during treatment) (89.3 vs 86.8%, p>0.99). Serum magnesium and potassium levels were significantly lower in the VLBW group than in the non-VLBW group during colistin therapy (magnesium, 1.30 vs 1.70mg/dL, p<0.001; potassium, 3.6 vs 4.6mEq/L, p<0.001). Acute kidney injury was observed in four infants in the VLBW group and one in the non-VLBW group, without significant differences (p=0.15).ConclusionsColistin administration appears to be efficacious in VLBW infants; however, renal function tests and serum electrolytes should be monitored more closely in these infants during treatment.
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    Evaluation of 2015-2016 MOTAKK HBV DNA and HCV RNA External Quality Assessment National Program Results
    Karatayli, E; Soydemir, E; Aksoy, ZB; Kizilpinar, M; Altay Koçak, A; Karatayli, SC; Yurdcu, E; Yildirim, U; Güriz, H; Bozdayi, G; Yurdaydin, C; Ilhan, O; Yildirim, Y; Bozdayi, AM; Oguz, AY; Baris, A; Alp, A; Aksözek, A; Sayiner, A; Karagul, A; Ordu, A; Istanbullu, A; Otlu, B; Aridogan, B; Aksu, B; Buruk, CK; Karahan, C; Güney, Ç; Toksöz, D; Yildirim, D; Çolak, D; Daglar, DE; Findik, D; Kas, E; Çaliskan, E; Zeyrek, FY; Arslan, F; Demir, F; Milletli, F; Kibar, F; Özdinçer, F; Dündar, G; Arslan, H; Agca, H; Aliskan, HE; Güdücüoglu, H; Fidan, I; Akyar, I; Afsar, I; Kaleli, I; Dönmez, I; Yanik, K; Midilli, K; Çubukçu, K; Özdemir, M; Acar, M; Yalinay, M; Kuskucu, MA; Bakici, MZ; Aydin, N; Yilmaz, N; Çeken, N; Ziyade, N; Yilmaz, N; Özgümüs, OB; Gitmisoglu, Ö; Demirgan, R; Kesli, R; Güçkan, R; Sertöz, R; Akgün, S; Aksaray, S; Tezcan, S; Kaygusuz, S; Gökahmetoglu, S; Mese, S; Bayik, SA; Akçali, S; Gürcan, S; Karsligil, T; Us, T; Özekinci, T; Pilgir, T; Aslan, U; Dinç, U; Coskun, USS; Çetinkol, Y; Keskin, Y; Ayaydin, Z; Toraman, ZA
    MOTAKK, as a national external quality control program has been launched to evaluate the molecular detection of viral infections including HBV DNA and HCV RNA in molecular microbiology diagnostic laboratories in Turkey. This program is prepared in compliance with ISO 17043:2010 (Conformity assessment general requirements for proficiency testing) standards, and aims to take the place of external quality control programs from abroad, contributing to standardization and accuracy of molecular diagnostic tests in our country. The aim of this study was to evaluate 2015 and 2016 results of the MOTAKK External Quality Control Program for HBV DNA and HCV RNA viral load. The calls were announced on the web page of MOTAKK (www.motakk.org). The quality control samples were sent to participating laboratories in 2015 and 2016. Main stocks were prepared from patients with chronic hepatitis B and C who had viral load detection with reference methods according to WHO reference materials for viral load studies to improve quality control sera. From these main stocks, samples with different viral loads were prepared from dilutions of plasma with HBV, HCV, HAV, HIV, Parvovirus B19 and CMV negative serologic markers. Quality control samples were sent to the participating laboratories along with the negative samples in the cold chain. The laboratories accomplished the related tests within 2-3 weeks and entered their results on the MOTAKK web page. These results were analysed according to ISO 13528 (Statistical methods for use in proficiency testing by interlaboratory comparison) and scoring reports were created by a software developed by MOTAKK and sent to participating labs. Each laboratory evaluated their own results in comparison with the other laboratory results, reassessed the tests via observing the distance from the mean result and the reference values. The number of laboratories participating in the HBV DNA and HCV RNA external quality control program was 70-73 in 2015-2016. Participants were able to comply with the program tools, registering, entering results and receiving the results reports problem. In HBV panel, 72.6-89.1% and 84.7-90.3% of the participant laboratories were in 1 standard deviation (SD) in 2015-2016, respectively. In HCV panel, 70.8-89.1% and 84.7-90.3% of the participant laboratories were in 1 SD in 2015-2016, respectively. A national external quality control program for HBV DNA and HCV RNA in Turkey has been prepared for the first time with this project and implemented successfully. All the data provided in the MOTAKK external quality control program final report, compensate all the data provided by the quality control program final reports from abroad; additionally, the report allows comparison of used technologies and commercial products.
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    CLINICAL CHARACTERISTICS, POST-TREATMENT ASSESSMENT AND PROGNOSTIC FACTORS AFFECTING PATIENT SURVIVAL OF PATIENTS AT 65 YEARS OF AGE OR OLDER WITH HODGKIN LYMPHOMA: A RETROSPECTIVE MULTICENTER STUDY FROM TURKEY
    Berber, I; Erkurt, MA; Keklik, M; Dogu, MH; Terzi, H; Pala, C; Sari, HI; Sencan, M; Sivgin, S; Hacioglu, S; Altuntas, F; Aydogdu, I; Ilhan, O
    Introduction: During the last three decades, major advances have been made in the therapy of Hodgkin's lymphoma. However, despite these advances, Hodgkin's lymphoma has a poor prognosis in the elderly. The proportion of Hodgkin's lymphoma patients aged > 60 ranges in the different reports between 15% and 35%. This study aimed to examine clinical characteristics, treatment outcomes and prognostic factors affecting patient survival in Hodgkin's lymphoma patients aged 65 years or older. Material methods: Hodgkin's lymphoma patients at 65 years of age and older managed within last 5 years in a total of 5 centers in Turkey were retrospectively assessed. Results: The median age of a total of 32 patients was 71 (65-83) years. Elderly patients presented more frequently with B symptoms, elevated sedimentation rate, mixed cellularity histologic subtype and comorbid disease. Less frequent were bulky disease, bone marrow involvement, and the application of autologous stem cell transplantation. The nodular lymphocyte predominant subtype and lymphocyte rich subtype were not observed at all. Eastern Cooperative Oncology Group, ferritin, total protein, and histological type were significant predictors affecting survival (p<0.05). Conclusions: Hodgkin's lymphoma is a more fatal disease in 65 years of age or older, when compared to the young population. Tumor biology, older age itself, and other factors related to comorbidity probably contribute to the worse outcome of elderly patients. Further large-scale studies are needed to better investigate the factors that were significant predictors of patient survival.
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    Coincidence of Nemaline Myopathy and Agenesis of Corpus Callosum in a Newborn Infant: Case Report
    Akbay, S; Ozer, E; Ilhan, O; Kanar, B; Memur, S; Diniz, G; Cavusoglu, D; Dündar, NO
    The diagnosis of the hypotonia during neonatal period is difficult. In the neonatal period, acute illnesses and systemic diseases such as sepsis, congestive heart failure and inborn errors of metabolism should be considered in the differential diagnosis of the patients. Congenital disorders that affect nervous system can be the reason of hypotonia. Nemaline myopathy (NM) is a rare congenital myopathy, characterized with slowly progressive or nonprogressive muscle weakness and the inclusions known as nemaline rods characterized by rod-shaped structures (nemaline bodies) in muscle biopsy specimens. The disease can be presented with hypotonia, feeding problems, repeated respiratory infections, and arthrogryposis. Also, agenesis of corpus callosum (ACC) can result in an interhemispheric disconnection , neurologic problems such as mental retardation, and seizures. Unfortunately, there is no curative treatment for both of them. Herein, we report an infant who was admitted with generalized muscle weakness at the neonatal period and diagnosed as ACC with NM.
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    Evolution of clinical characteristics of patients with paroxysmal nocturnal hemoglobinuria treated with eculizumab in turkey: a multicenter retrospective analysis
    Karadag, FK; Yenerel, MN; Yilmaz, M; Uskudar, H; Ozkocaman, V; Tuglular, TF; Erdem, F; Unal, A; Ayyildiz, O; Ozet, G; Comert, M; Kaya, E; Ayer, M; Salim, O; Guvenc, B; Ozdogu, H; Mehtap, O; Sonmez, M; Guler, N; Hacioglu, S; Aydogdu, I; Bektas, O; Toprak, SK; Kaynar, L; Yagci, M; Aksu, S; Tombak, A; Karakus, V; Yavasoglu, I; Onec, B; Ozcan, MA; Undar, L; Ali, R; Ilhan, O; Saydam, G; Sahin, F
    Paroxysmal nocturnal hemoglobinuria (PNH) is a rare X-linked genetic disorder. On the contrary to its name, it is a multisystemic disease and various symptoms other than hemoglobinuria could be occurred. It could be life threatening especially because of thromboembolic events. In the last decade, a terminal complement inhibition with eculizumab approved with promising results for PNH patients. We conducted this study to evaluate the long term experience of eculizumab therapy from Turkey for the first time. Our cohort included 138 patients with PNH treated with eculizumab between January 2008 and December 2018 at 28 centers in Turkey. Laboratory and clinical findings at the time of diagnosis and after eculizumab therapy were recorded retrospectively. The median age was 39 (range 18-84) years and median granulocyte PNH clone size was 74% (range 3.06-99.84%) at the time of diagnosis. PNH with bone marrow failure syndrome was detected in 49 patients and the rest of 89 patients had classical PNH. Overall 45 patients (32.6%) had a history of any prior thrombotic event before eculizumab therapy and only 2 thrombotic events were reported during the study period. Most common symptoms are fatigue (75.3%), hemoglobinuria (18.1%), abdominal pain (15.2%) and dysphagia (7.9%). Although PNH is commonly related with coombs negativity, we detected coombs positivity in 2.17% of patients. Seven months after the therapy, increased hemoglobin level was seen and remarkably improvement of lactate dehydrogenase level during the treatment was occurred. In addition to previous studies, our real life data support that eculizumab is well tolerated with no serious adverse events and improves the PNH related findings.
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    Evaluation of Patients with PNH Treated By Eculizumab: Real World Data from Turkey
    Karadag, FK; Yenerel, MN; Mehmet, Y; Teke, HU; Ozkocaman, V; Tuglular, T; Erdem, F; Unal, A; Ayyildiz, O; Ozet, G; Ozkan, M; Kaya, E; Ayer, M; Salim, O; Güvenç, B; Ozdogu, H; Mehtap, Ö; Sönmez, M; Güler, N; Hacioglu, SK; Aydogdu, I; Bektas, O; Toprak, SK; Kaynar, L; Yagci, M; Aksu, S; Tombak, A; Karakus, V; Yavasoglu, I; Öneç, B; Özcan, MA; Ündar, L; Ali, R; Ustun, C; Ilhan, O; Saydam, G; Sahin, F