Browsing by Author "Kuyucu N."

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    Comparison of two different regimens of combined interferon-α2a and lamivudine therapy in children with chronic hepatitis B infection
    (2006) Kansu A.; Doǧanci T.; Akman S.A.; Artan R.; Kuyucu N.; Kalayci A.G.; Dikici B.; Dalgiç B.; Selimoǧlu A.; Kasirga E.; Özkan T.B.; Kuloǧlu Z.; Aydoǧdu S.; Boşnak M.; Ertekin V.; Tanir G.; Haspolat K.; Girgin N.; Yaǧci R.V.
    Aim: To evaluate the efficacy of two regimens of combined interferon-α2a (IFN-α2a) and lamivudine (3TC) therapy in childhood chronic hepatitis B. Methods: A total of 177 patients received IFN-α2a, 9 million units (MU)/m2 for 6 months. In group I (112 patients, 8.7±3.5 years), 3TC (4 mg/kg/day, max 100 mg) was started simultaneously with IFN-α2a, in group II (65 patients, 9.6±3.8 years) 3TC was started 2 months prior to IFN-α2a. 3TC was continued for 6 months after antiHBe seroconversion or stopped at 24 months in non-responders. Results: Baseline alanine aminotransferase (ALT) was 134.2±34.1 and 147.0±45.3; histological activity index (HAI) was 7.4±2.7 and 7.1±2.3; and HBV DNA levels were above 2,000 pg/ml in 76% and 66% of patients in groups I and II, respectively (P>0.005). Complete response was 55.3% and 27.6% in groups I and II, respectively (P<0.01). AntiHBe seroconversion was higher and earlier, and HBV DNA clearance was earlier in group I (P<0.05). HBsAg clearance was 12.5% and 4.6% and antiHBs seroconversion was 9.8% and 6.2% in groups I and II, respectively (P>0.05). Breakthrough occurred in 17.9% and 24.6%; breakthrough times were 15.9±4.6 and 14.1±5.1 months; and relapse rates were 6.8% and none in groups I and II, respectively (P>0.05, P>0.05, P>0.05). Responders had higher HAI (HAI>6) and higher pre-treatment ALT than non-responders. Conclusion: Simultaneous 3TC+IFN-α2a yields a higher response and earlier antiHBe seroconversion and viral clearance than consecutive combined therapy. Relapse rate is low. Predictors of response are high basal ALT and high HAI scores. 3TC can be administered for 24 months without any side effect and breakthrough rate is comparable with previous studies. © 2006 International Medical Press.
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    Antifungal consumption, indications and selection of antifungal drugs in paediatric tertiary hospitals in Turkey: Results from the first national point prevalence survey
    (Elsevier Ltd, 2018) Çağlar İ.; Devrim İ.; Özdemir H.; Şahbudak Z.; Sönmez G.; Buyukcam A.; Gulhan B.; Kara A.; Aygun D.F.; Bayram N.; Celebi S.; Çetin B.; Nepesov M.İ.; Yilmaz A.T.; Kepenekli E.; Çiftdogan D.Y.; Acar M.K.; Yayla B.C.; Okumuş C.; Ecevit Z.; Hatipoglu N.; Kuyucu N.; Kosker M.; Sen S.; Karbuz A.; Sutcu M.; Duramaz B.B.; Özen M.; Çiftçi E.; Alabaz D.; Kurugol Z.; Kara A.; Kanik S.; Kilic O.; Oncel S.; Somer A.; Tapisiz A.; Belet N.; Akcan Ö.M.; Türel Ö.; Ozkaya A.; Tezer H.; Cengiz A.B.; İnce E.; Camcioglu Y.; Kocabas E.; Arisoy E.S.; 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. © 2018 International Society for Chemotherapy of Infection and Cancer
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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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    Evaluation of 601 children with multisystem inflammatory syndrome (Turk MISC study)
    (Springer Science and Business Media Deutschland GmbH, 2023) Yilmaz D.; Ekemen Keles Y.; Emiroglu M.; Duramaz B.B.; Ugur C.; Aldemir Kocabas B.; Celik T.; Ozdemir H.; Bayturan S.; Turel O.; Erdeniz E.H.; Cakici O.; Cakmak Taskin E.; Erbas İ.C.; Genceli M.; Sari E.E.; Caymaz C.; Kizil M.C.; Sutcu M.; Demirbuga A.; Alkan G.; Bagcı Z.; Timurtas Dayar G.; Ozkan E.A.; Tekin Yilmaz A.; Akca M.; Yesil E.; Kara S.S.; Akturk H.; Yasar B.; Umit Z.; Uygun H.; Erdem N.; Buyukcam A.; Karadag Oncel E.; Tuter Oz S.K.; Cetin H.S.; Anil A.B.; Yilmaz R.; Zengin N.; Uzuner S.; Albayrak H.; Borakay O.; Topal S.; Arslan G.; Yazar A.; Ozer A.; Kendirli T.; Kara E.M.; Demirkol D.; Battal F.; Kosker M.; Metin Akcan O.; Kihtir H.S.; Gul D.; Zararci K.; Alakaya M.; Kula N.; Celik E.; Petmezci E.; Evren G.; Kara Aksay A.; Konca C.; Sert A.; Arslan D.; Bornaun H.; Tekeli O.; Bal A.; Sahin I.O.; Demir S.; Sap F.; Akyol M.B.; Tanidir I.C.; Donmez Y.N.; Ucar T.; Coban S.; Arga G.; Hancerli Torun S.; Karpuz D.; Celik S.F.; Varan C.; Elmali F.; Oncel S.; Belet N.; Hatipoglu N.; Dalgic Karabulut N.; Turgut M.; Somer A.; Kuyucu N.; Dinleyici E.C.; Ciftci E.; Kara A.
    Purpose: Due to its link with the 2019 coronavirus, the multisystem inflammatory syndrome in children (MISC) has garnered considerable international interest. The aim of this study, in which MISC patients were evaluated multicenter, and the data of the third period of the Turk-MISC study group, to compare the clinical and laboratory characteristics and outcomes of MISC patients who did and did not require admission to an intensive care unit (ICU). Methods: This retrospective multicenter observational study was carried out between June 11, 2021, and January 01, 2022. The demographics, complaints, laboratory results, system involvements, and outcomes of the patients were documented. Results: A total of 601 patients were enrolled; 157 patients (26.1%) required hospitalization in the intensive care unit (ICU). Median age was 8 years (interquartile range (IQR) 4.5–11.3 years. The proportion of Kawasaki disease-like features in the ICU group was significantly higher than in the non-ICU group (56.1% vs. 43.2% p = 0.006). The ICU group had considerably lower counts of both lymphocytes and platelets (lymphocyte count 900 vs. 1280 cells × μL, platelet count 153 vs. 212 cells × 103/ μL, all for p< 0.001). C-reactive protein, procalcitonin, and ferritin levels were significantly higher in the ICU group (CRP 164 vs. 129 mg/L, procalcitonin 9.2 vs. 2.2 μg/L, ferritin 644 vs. 334 μg/L, all for p< 0.001). Being between ages 5–12 and older than 12 increased the likelihood of hospitalization in the ICU by four [95% confidence intervals (CI)1.971–8.627] and six times (95% CI 2.575–14.654), respectively, compared to being between the ages 0–5. A one-unit increase in log d-dimer (µg/L) and log troponin (ng/L) was also demonstrated to increase the need for intensive care by 1.8 (95% CI 1.079–3.233) and 1.4 times (95% CI 1.133–1.789), respectively. Conclusion: By comparing this study to our other studies, we found that the median age of MISC patients has been rising. Patients requiring an ICU stay had considerably higher levels of procalcitonin, CRP, and ferritin but significantly lower levels of lymphocyte and thrombocyte. In particular, high levels of procalcitonin in the serum might serve as a valuable laboratory marker for anticipating the need for intensive care. What is Known: • Lymphopenia and thrombocytopenia were an independent predictor factors in patients with MISC who needed to stay in intensive care unit. • The possibility of the need to stay in the intensive care unit in patients with MISC who had Kawasaki disease-like findings was controversial compared with those who did not. What is New: • A one-unit increase log D dimer and log troponin was demonstrated to require for intensive care unit by 1.8 and 1.4 times, respectively. • Serum procalcitonin levels had the best performance to predict stay in the intensive care unit stay. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.