Browsing by Author "Kilimci D.D."
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Item EPISODE OF ACUTE HEMOLYSIS DUE TO UNDIAGNOSED GLUCOSE-6-PHOSPHATE DEHIDROGENASE DEFICIENCY IN AN ADOLESCENT WITH NEWLY DIAGNOSED TYPE 1 DIABETES MELLITUS: CASE REPORT AND REVIEW OF LITERATURE(Acta Endocrinologica Foundation, 2023) Goren T.A.; Kilimci D.D.; Yigit Y.; Yildirim A.T.; Gulen H.; Ersoy B.Glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency is common in the community. The most important clinical manifestation of G6PD deficiency is acute hemolytic anemia due to oxidative stressors. Diabetes Mellitus (DM) can precipitate hemolysis in patients with G6PD deficiency. Here, we described a 15-year-old male with newly diagnosed type 1 DM (T1DM) and unknown G6PD deficiency who suffered from hemolytic anemia during normalization of blood glucose. On admission, the patient did not have ketoacidosis. After the patient's blood sugars were regulated with insulin therapy, he presented five days later with hemolytic anemia. The cause of hemolytic anemia was G6PD deficiency. The patient had no previous episodes of hemolysis and had no relevant family history. Hypoglycemia did not occur during blood glucose regulation. The return of blood sugar to normal after a long period of hyperglycemia was thought to be the possible cause of hemolysis. In conclusion, G6PD deficiency should be considered when there is an episode of hemolysis in newly diagnosed children and adolescents with T1DM, especially in the absence of ketoacidosis and hypoglycemia. © 2023, Acta Endocrinologica Foundation. All rights reserved.Item Evaluation of Children with Stenotrophomonas maltophilia Bacteremia; [Stenotrophomonas maltophilia Bakteriyemili Çocuk Olguların Değerlendirilmesi](Galenos Publishing House, 2023) Yeşil E.; Çelebi S.; Özaslan Z.; Özer A.; Kilimci D.D.; Hacımustafaoğlu M.Introduction: Stenotrophomonas maltophilia (S. maltophilia) is a resistant gram-negative rod that can often cause serious infections, especially in patients with long hospital stays and using broad-spectrum antibiotics. In this study, clinical data, and mortality-related risk factors of patients with S. maltophilia bacteremia were evaluated. Materials and Methods: Patients with S. maltophilia bacteremia included in this study and evaluated retrospectively, when hospitalized between 2013 and 2018 in our pediatric wards and intensive care units. Results: A total of 67 patients had 100 S. maltophilia bacteremia in 70 different episodes. Sixty percent (n=40) of the cases were male and their median age were 9 months. Sixty-nine percent (n=46) of the cases were admitted in intensive care units. The most common comorbidity was malignancy. All bacteremias were healthcare associated, and 55% (n=55) were catheter-related. In the total of 70 episodes; 57% (n=37) of the patients had central venous catheters, 47% (n=33) were entubated. Fourty-seven percent (n=33) of the patients had broad spectrum antibiotic use over 14 days. In the blood cultures, 98% of S. maltophilia-producing strains were sensitive to trimethoprim-sulfamethoxazole. Ciprofloxacin and trimethoprim-sulfamethoxazole combination therapy had used for treatment. The mortality rate in the first 30 days was 16% (n=11). Mechanical ventilation was found to be significant (p<0.05) as a predisposing factor related to mortality. Conclusion: Stenotrophomonas maltophilia is the causative pathogen in healthcare associated bloodstream infections especially in intensive care unit. In our study, 69% of the cases were admitted in the intensive care unit and mechanical ventilation status increased mortality. © 2023, Galenos Publishing House. All rights reserved.