Browsing by Author "Sahin, G"

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    Retrospective Evaluation of Cases Diagnosed with Ulcerative Colitis
    Ünal, F; Sahin, G; Cebe, A; Ayhan, S; Eren, F; Kasirga, E
    Introduction: Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal canal characterised by remissions and exacerbations. This study aimed to make a retrospective evaluation of clinical and laboratory findings of patients being monitored with a diagnosis of IBD. Materials and Methods: Medical records of 18 patients with a diagnosis of IBD and 7 years of follow-up at our pediatric gastroenterology departments were investigated with respect to demographic data, complaints on presentation and accompanying diseases. Unusual findings from physical examination, endoscopic findings, histopathological findings and the applied treatments were examined. Results: The 18 patients (10 female, 8 male) included in this study had a mean age of 13.6 +/- 2.9 years and the mean time from onset of symptoms to diagnosis was 6.9 +/- 4.5 months. Seventeen patients were diagnosed with ulcerative colitis and 1 patient with intermediate colitis. There was a positive family history of the disease in 2 patients (11%). At the time of diagnosis, the most common complaints on presentation were found to be abdominal pain (100%), bloody diarrhea (94.5%) and tenesmus (44.4%). The most frequent laboratory findings were CRP positivity (89%), increased sedimentation rate (83.3%) and iron-deficient anaemia (77.7%). On colonoscopy, pancolitis involvement (66.6%) was most frequently encountered. Accompanying diseases to IBD were found to be familial Mediterranean fever (FMF) (11%), celiac disease (5.5%) and Heliobacter pylori gastritis (5.5%). One patient (5.5%) who did not respond to medical treatment for pancolitis involvement underwent a colectomy. Discussion: The number of diagnoses of IBD in childhood is gradually increasing. Nonetheless, it can be difficult to define diseases with non-specific symptoms and this may cause a delay in diagnosis. Because of the association of autoimmune diseases with IBD, despite appropriate therapy, diseases with no remission which lead to gastrointestinal inflammation, such as FMF, should be further investigated.
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    Primary polydipsia case presenting with severe malnutrition
    Sahin, GE; Zorlu, P; Çaylan, ND; Uçar, S; Açoglu, EA; Sahin, G
    Primary polydipsia is a clinical status with excessive fluid consumption without any physiological need. A seventeen-month-old male infant with severe malnutrition and developmental retardation was found to have polyuria and polydipsia in the follow-up. The urine density was found to be 1001, Na was found to be 124 mEq/L and the serum and urine osmolarity was found to be low. The patient was diagnosed with primary polydipsia and was treated by gradually water restriction. This case is presented to emphasize that primary polydipsia changes nutritional habits which may lead to malnutrition and developmental retardation.
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    Removal of Cr Ions from Aquatic Solutions Using Olive Leaves as Low-cost Bio-sorbent
    Sahin, G; Aslan, A; Tuzen, M; Sari, A
    Contamination of water by chromium (Cr) creates serious pollution in terms of the environment and public health, since its different forms become released into air, water, soil and residential areas. In the present work, olive leaf powder (OLP) was evaluated as a novel low-cost sorbent due to its various functional groups such as amide, hydroxyl, carboxyl, and carbonyl which are responsible for the bio-removal of chromium ions from aqueous solutions. The chemical functional groups and microstructure of the OLP bio-sorbent were characterized by the Fourier Transform Infrared (FT-IR) spectroscopy and scanning electron microscopy (SEM) techniques. The bio-sorption conditions were optimized as pH 4, contact time 60 min, bio-sorbent dosage 40 g/L, temperature 40 degrees C. The bio-sorption isotherm was well fitted to the Langmuir model, and the predicted maximum bioremoval capacity of the OLP was estimated at 42.4 mg/g under the above-mentioned experimental conditions. The reuse performance of the bio-sorbent was determined after repeated sorption/desorption cycles. The thermodynamic examination showed that the chromium sorption by OLP was endothermic in thermal nature. The kinetic evaluations indicated that the bio-sorption process well followed with the pseudo-second-order model. The overall results demonstrated that the OLP can be thought as a potential bio-sorbent for cleaning of chromium-contaminated water and wastewater due to its advantageous properties such as low cost, availability, renewable nature, and remarkable bio-sorption capacity.
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    Diagnostic Yield of Upper Gastrointestinal Endoscopy in the Evaluation of Iron Deficiency Anemia in Older Children and Adolescents
    Gulen, H; Kasirga, E; Yildirim, SA; Kader, S; Sahin, G; Ayhan, S
    Iron deficiency anemia (IDA) is frequent in childhood. Inadequate nutrition and gastrointestinal malabsorption are the frequent causes of IDA in children. But reduced iron absorption and insidious blood loss from the gastrointestinal tract has been identified as the most frequent causes of IDA in older children and adolescents. Therefore the authors evaluated the frequency and etiologies of the upper gastrointestinal system pathologies causing IDA in older pediatric population. Patients with known hematological or chronic diseases, heavy menstrual flow, and obvious blood loss were excluded from the study. Forty-four children between the ages of 9.5 and 17.5 years and diagnosed with IDA were enrolled. They underwent upper gastrointestinal endoscopy and biopsy from esophagus, stomach, and duodenum. Mean age and hemoglobin (Hb) levels of study group (32 boys, and 12 girls) were 14.6 +/- 2.0 years and 7.9 +/- 1.8 g/dL, respectively. Only 1 patient had a positive serology testing with anti-tissue transglutaminase and small bowel biopsy correlating with celiac disease. Endoscopy revealed abnormal findings in 25 (56.8%) patients (21 endoscopic antral gastritis, 2 active duodenal ulcers, and 2 duodenal polyps). Helicobacter pylori (HP) infection was identified by using antral histopathological evaluation in 19 of 44 children (43.2%). In 2 of duodenal samples, one patient had celiac disease, and the other one was diagnosed as giardiasis. In conclusion, there are different etiologies resulting in IDA in older children and adolescents. When older children and adolescents are found to have iron deficiency, HP infection and other gastrointestinal pathologies should be ruled out before iron deficiency treatment.
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    The Frequency of Lysosomal Acid Lipase Deficiency in Children With Unexplained Liver Disease
    Kuloglu, Z; Kansu, A; Selbuz, S; Kalayci, AG; Sahin, G; Kirsaclioglu, CT; Demirören, K; Dalgiç, B; Kasirga, E; Önal, Z; Islek, A; Eren, E; Hosnut, FÖ; Urganci, N; Yaman, A; Özkan, T; Bozbulut, E; Dogan, G; Eksi Bozbulut, N; Dogan, G; Durmaz Ugurcan, Ö; Usta, AM; Arslan, D; Akçam, M; Isik, IA; Ecevit, ÇÖ; Usta, Y; Özgür, T; Özçay, F; Balamtekin, N; Öztürk, Y; Balamtekin, N; Öztürk, Y; Cantez, S; Gülerman, F; Üstündag, GH; Emiroglu, HH; Karacabey, N; Comba, A; Erdemir, G; Aydogan, AU; Gökçe, S; Kuyum, P; Gülsan, M; Tosun, MS; Tokgöz, Y; Güven, B; Yüksekkaya, H; Tümgör, G; Eren, M; Baran, M; Gümüs, M; Canan, O; Kocamaz, H; Gerenli, N; Çakir, M; Agin, M; Hizli, S; Dogan, Y; Çeltik, Ç; Deveci, U; Balci Sezer, O
    Objectives: Evidence suggests that lysosomal acid lipase deficiency (LAL-D) is often underdiagnosed because symptoms may be nonspecific. We aimed to investigate the prevalence of LAL-D in children with unexplained liver disease and to identify demographic and clinical features with a prospective, multicenter, cross-sectional study. Methods: Patients (aged 3 months-18 years) who had unexplained transaminase elevation, unexplained hepatomegaly or hepatosplenomegaly, obesity-unrelated liver steatosis, biopsy-proven cryptogenic fibrosis and cirrhosis, or liver transplantation for cryptogenic cirrhosis were enrolled. A Web-based electronic data collection system was used. LAL activity (nmol/punch/h) was measured using the dried blood spot method and classified as LAL-D(<0.02), intermediate (0.02-0.37) or normal (>0.37). Asecond dried blood spot sample was obtained from patients with intermediate LAL activity for confirmation of the result. Results: A total of 810 children (median age 5.6 years) from 795 families were enrolled. The reasons for enrollment were unexplained transaminase elevation (62%), unexplained organomegaly (45%), obesity-unrelated liver steatosis (26%), cryptogenic fibrosis and cirrhosis (6%), and liver transplantation for cryptogenic cirrhosis (<1%). LAL activity was normal in 634 (78%) and intermediate in 174 (21%) patients. LAL-D was identified in 2 siblings aged 15 and 6 years born to unrelated parents. Dyslipidemia, liver steatosis, and mild increase in aminotransferases were common features in these patients. Moreover, the 15-year-old patient showed growth failure and microvesicular steatosis, portal inflammation, and bridging fibrosis in the liver biopsy. Based on 795 families, 2 siblings in the same family were identified as LAL-D cases, making the prevalence of LAL-D in this study population, 0.1% (0.125%-0.606%). In the repeated measurement (76/174), LAL activity remained at the intermediate level in 38 patients. Conclusions: Overall, the frequency of LAL-D patients in this study (0.1%) suggests that LAL-D seems to be rare even in the selected high-risk population.
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    Regorafenib Treatment for Recurrent Glioblastoma Beyond Bevacizumab-Based Therapy: A Large, Multicenter, Real-Life Study
    Tünbekici, S; Yuksel, HC; Acar, C; Sahin, G; Orman, S; Majidova, N; Coskun, A; Seyyar, M; Dilek, MS; Kara, M; Disli, AK; Demir, T; Kolkiran, N; Sahbazlar, M; Demirciler, E; Kus, F; Aytac, A; Menekse, S; Yucel, H; Biter, S; Koseci, T; Unsal, A; Ozveren, A; Sevinc, A; Goker, E; Gürsoy, P
    Background/Objectives: In the REGOMA trial, regorafenib demonstrated an overall survival advantage over lomustine, and it has become a recommended treatment for recurrent glioblastoma in guidelines. This study aimed to evaluate the effectiveness and safety of regorafenib as a third-line treatment for patients with recurrent glioblastoma who progressed while taking bevacizumab-based therapy. Methods: This retrospective, multicenter study in Turkey included 65 patients treated between 2021 and 2023 across 19 oncology centers. The main inclusion criteria were histologically confirmed isocitrate dehydrogenase (IDH)-wildtype glioblastoma, progression after second-line bevacizumab-based treatment, and an Eastern Cooperative Oncology Group (ECOG) performance status score of <= 2. Patients received regorafenib 160 mg once daily for the first 3 weeks of each 4-week cycle. Results: The median age of the patients was 53 years (18-67 years), with a median progression-free survival of 2.5 months (95% Confidence Interval: 2.23-2.75) and a median overall survival of 4.1 months (95% CI: 3.52-4.68). The median overall survival was improved in patients who received subsequent therapy after regorafenib treatment compared with those who did not (p = 0.022). Progression-free survival was longer in patients with ECOG 0-1 than in those with ECOG 2 (p = 0.042). The safety profile was consistent with that of the REGOMA trial, with no drug-related deaths observed. Conclusions: Regorafenib shows good efficacy and safety as a third-line treatment for recurrent glioblastoma after bevacizumab-based therapy. This study supports the use of regorafenib and emphasizes the need for further randomized studies to validate its role and optimize treatment strategies.
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    Guideline on Pregnancy and Diabetes by the Society of Specialists in Perinatology (PUDER), Turkey
    Bayram, M; Biri, AA; Büyükbayrak, EE; Daglar, HK; Ercan, F; Erzincan, SG; Esmer, AC; Inan, C; Kanit, H; Kara, O; Katlan, DC; Nas, T; Öcal, E; Sagsöz, N; Sanhal, CY; Sahin, G; Timur, H; Turhan, U; Türkmen, GG; Türkyilmaz, G; Yanik, FFB; Yüksel, MA
    Diabetes mellitus (DM) is the most common endocrinologic problem in pregnancy. In Turkey, the reported prevalance is between 1.9-27.9%, with an average of 7.7%. While some of these cases are pregestational diabetes (PGDM), about 90% are detected during the pregnancy for the first time and diagnosed as gestational diabetes (GDM). Diabetes in pregnancy confers serious risks regarding the fetus, newborn and the mother. Therefore, we offer GDM screening for all pregnant women preferantially between 24-28 weeks of gestation. Either one-step 75-g oral glucose tolerance test (OGTT) or two-step 50-g glucose challenge test and 100-g OGTT may be used for the screening and diagnosis. In pregnancies with high-risk for DM, screening should be performed earlier, if possible, in the first antenatal visit. When GDM is diagnosed, maternal glycemic control is tried to be achieved by diet and exercise program, and if necessary, by using insulin. The use of metformin or glyburide in pregnancy is also possible. In women with the diagnosis of DM before pregnancy, preconceptional control of plasma glucose levels is of utmost importance in order to prevent adverse pregnancy outcomes. In pregnancies with GDM regulated by diet and exercise, pregnancy follow-up may be performed as in the low risk group without any pregnancy complications. If maternal or fetal distress is not observed, delivery is planned between 39+0 -40+6 weeks. Although caesarean section is recommended when estimated fetal weight is 4500 g or more, the mode of delivery may be decided more appropriately on a case-by-case basis.
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    Cross-sectional study: long term follow-up care for pediatric cancer survivors in a developing country, Turkey: current status, challenges, and future perspectives
    Incesoy Özdemir, S; Taçyildiz, N; Varan, A; Kebudi, R; Zülfikar, B; Celkan, T; Sahin, G; Çorapçioglu, F; Keskin Yildirim, Z; Pinarli, FG; Olgun, N; Sari, N; Dagdemir, A; Özyörük, D; Eren, T; Çakir, FB; Adakli Aksoy, B; Bozkurt, C; Güler, E; Özgüven, AA; Erbey, F; Berber, M; Dinçaslan, H; Ünal, E; Kantar, M
    Aim: The main purpose of this study is to determine the current status of long-term follow-up (LTFU) for childhood cancer survivors and the challenges of LTFU for pediatric cancer survivors at pediatric oncology institutions in Turkey. Material and methods: A questionnaire was e-mailed to the directors of 33 pediatric oncology centers (POCs) registered in the Turkish Pediatric Oncology Group (TPOG). Of these 33 active TPOG institutions, 21 participated in the study and returned their completed questionnaires. Results: Only 1 of the 21 participating centers had a separate LTFU clinic. The remaining centers provided LTFU care for childhood cancer survivors at the pediatric oncology outpatient clinic. Of these centers, 17 (80.9%) reported difficulty in transition from the pediatric clinic to the adult clinic, 14 (66.6%) reported insufficient care providers, and 12 (57.1%) reported insufficient time and transportation problems. As neglected late effects, 16 (76.1%) centers reported psychosocial and getty job problems and 11 (52.3%) reported sexual and cognitive problems. None of the centers had their own LTFU guidelines for their daily LTFU practice. Conclusion: This study was the first to gain an overview of the needs of POCs and the gaps in survivorship services in Turkey. The results from this study will help to develop a national health care system and national guidelines for pediatric cancer survivors.
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    Correlations among enthesitis, clinical, radiographic and quality of life parameters in patients with ankylosing spondylitis
    Rezvani, A; Bodur, H; Ataman, S; Kaya, T; Bugdayci, DS; Demir, SE; Koçyigit, H; Altan, L; Ugurlu, H; Kirnap, M; Gür, A; Kozanoglu, E; Akinci, A; Tekeoglu, I; Sahin, G; Bal, A; Sivrioglu, K; Yazgan, P; Aydin, G; Hepgüler, S; Ölmez, N; Sendur, ÖF; Yener, M; Altay, Z; Ayhan, F; Durmus, O; Duruöz, MT; Günendi, Z; Nacir, B; Öken, Ö; Toktas, H; Delialioglu, SÜ; Evcik, D; Sertpoyraz, FM
    Objectives. To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). Methods. A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Results. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 +/- 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Conclusions. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS.