Browsing by Author "Zengin N."

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    Evaluation of prognostic factors in localized high-grade undifferentiated pleomorphic sarcoma: report of a multi-institutional experience of Anatolian Society of Medical Oncology
    (Springer Science and Business Media B.V., 2016) Ozcelik M.; Seker M.; Eraslan E.; Koca S.; Yazilitas D.; Ercelep O.; Ozaslan E.; Kaya S.; Hacibekiroglu I.; Menekse S.; Aksoy A.; Taskoylu B.Y.; Varol U.; Arpaci E.; Ciltas A.; Oksuzoglu B.; Zengin N.; Gumus M.; Aliustaoglu M.
    Most data on prognostic factors for patients with high-grade undifferentiated pleomorphic sarcoma (HGUPS) is obtained from analyses of soft tissue sarcomas. The purpose of this study was to evaluate the clinicopathologic features and their impact on outcomes specifically in patients diagnosed with HGUPS. In this multicenter trial, we retrospectively analyzed 112 patients who were diagnosed and treated at 12 different institutions in Turkey. We collected data concerning the patients, tumor characteristics, and treatment modalities. There were 69 males (61.6 %) and 43 females (38.4 %). Median age was 56 years (19–90). The most common anatomic site of tumor origin was the upper extremity. Pleomorphic variant was the predominant histological subtype. Median tumor size was 8.2 cm (0.6–30 cm). Tumors were mainly deeply seated (57.1 %). Fifty-seven patients (50.9 %) were stage II and the remainder were stage III at the time of diagnosis. Median follow-up was 30 months (2–160). The primary site of distant metastasis was the lung (73.5 %) and the second most common site was the liver (11.7 %). The 5-year overall survival, distant metastasis-free survival, and local recurrence-free survival rates were 56.3, 53.4, and 67.2 %, respectively. Multivariate analysis showed that Eastern Cooperative Oncology Group (ECOG) performance score of II (p = 0.033), deep tumor location (p = 0.000), and development of distant metastasis (p = 0.004) were negatively correlated with overall survival, and perioperative radiotherapy and negative microscopic margins were significant factors for local control rates (p = 0.000 for each). Deep tumor location (p = 0.003) was the only adverse factor related to distant metastasis-free survival. Deep tumor location, ECOG performance score of II, and development of distant metastasis carry a poor prognostic implication on overall survival. These will aid clinicians in predicting survival and treatment decision. © 2015, International Society of Oncology and BioMarkers (ISOBM).
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    The effect of the gastrectomy on survival in patients with metastatic gastric cancer: A study of ASMO
    (Future Medicine Ltd., 2016) Yazici O.; Özdemir N.; Duran A.O.; Menekşe S.; Nahit Şendur M.A.; Karaca H.; Göksel G.; Arpaci E.; Hacibekiroʇlu I.; Bilgetekin I.; Kaçan T.; Özkan M.; Aksoy S.; Aksoy A.; Çokmert S.; Uysal M.; Elkiran E.T.; Çiçin I.; Büyükberber S.; Zengin N.
    Aim: To investigate the role of surgical resection of primary tumor on overall survival (OS) in advanced gastric cancer patients at the time of diagnosis. Patients & methods: The survival rates of metastatic gastric cancer patients whose gastric primary tumor was resected at time of diagnosis were compared with metastatic gastric cancer patients whose primary tumor was nonresected. Results: The median progression-free survival and OS in operated and nonoperated group were 10 versus 6, 14 versus 9 months, respectively (p < 0.001). In multivariate analysis, gastric resection of primary tumor, Eastern Cooperative Oncology Group performance status, second-line chemotherapy had a significant effect on OS (hazard ratio [HR]: 0.52 [95% CI: 0.38-0.71], HR: 0.57 [95% CI: 0.42-0.78], HR: 1.48 [1.09-2.01]; p ≤ 0.001, p = 0.001 and p = 0.012, respectively). Conclusion: Subpopulations of patients with metastatic gastric cancer might benefit from surgical removal of primary tumor. © 2016 Future Medicine Ltd.
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    Possible complications of martial arts technique
    (BMJ Publishing Group, 2019) Gokalp G.; Berksoy E.; Bardak S.; Demir S.; Demir G.; Bicilioglu Y.; Zengin N.
    [No abstract available]
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    How important is the damage to the liver after lower limb ischemia-reperfusion? An experimental study in a rat model
    (Baycinar Medical Publishing, 2020) Gökalp G.; Eygi B.; Kiray M.; Açikgöz B.; Berksoy E.; Bicilioğlu Y.; Zengin N.; Işcan S.; Gökalp O.; Gürbüz A.
    Background: The aim of this study was to compare the effect of lower extremity ischemia reperfusion on the liver and the effect of ischemiareperfusion on the liver itself in a rat model. Methods: Thirty Sprague-Dawley male rats were randomly divided into three groups including 10 in each group: sham (Group 1), lower limb ischemia-reperfusion (Group 2), and liver ischemia-reperfusion (Group 3). In Group 2, one hour of left lower limb ischemia was performed. In Group 3, one hour of ischemia in the liver was performed, followed by 24 hours of reperfusion. After reperfusion, the liver tissues were removed, and the groups were evaluated biochemically and histologically. Results: The liver malondialdehyde levels were significantly higher in Groups 2 and 3 than in the sham group (p<0.001). In Group 2, the malondialdehyde levels were significantly higher than in Group 3 (p=0.019). The glutathione levels in the liver were significantly lower in Groups 2 and 3 than in the sham group (p<0.001). However, the glutathione levels were significantly higher in Group 2 than in Group 3 (p=0.005). In the histological evaluation, although the liver damage score was higher in Group 3 than in Group 2 (p=0.015), there was no significant difference between the two groups in TUNEL(+) cell number (p>0.05). Conclusion: Reperfusion injury in the liver after lower limb ischemiareperfusion is as important as ischemia-reperfusion injury which is specifically induced in the liver. This should be taken into account, particularly in reperfusion surgeries following vascular trauma or in cases of leg tourniquets to stop bleeding after lower limb vascular trauma. © 2020 All right reserved by the Turkish Society of Cardiovascular Surgery.
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    The skills of defibrillation practice and certified life-support training in the healthcare providers in Turkey
    (Wiley-Hindawi, 2021) Derinoz-Guleryuz O.; Uysal-Yazici M.; Udurgucu M.; Karacan C.; Akça H.; Ongun E.A.; Ekinci F.; Duman M.; Akça-Çaglar A.; Vatansever G.; Bilen S.; Uysalol M.; Akcan-Yıldız L.; Saz E.U.; Bal A.; Piskin E.; Sahin S.; Kurt F.; Anil M.; Besli E.; Alakaya M.; Gültekingil A.; Yılmaz R.; Temel-Koksoy O.; Kesici S.; Akcay N.; Cebisli E.; Emeksiz S.; Kılınc M.A.; Köker A.; Çoban Y.; Erkek N.; Gurlu R.; Eksi-Alp E.; Apa H.; Kalkan G.; Azapagası E.; Yener N.; Sarac-Sandal O.; Horoz O.O.; Öztürk A.; Tuygun N.; Özdemir İ.; Göktuğ A.; Gökulu G.; Gümüs S.; Teksam O.; Turan C.; Zengin N.; Kardeş H.; Bozan G.; Ünal B.; Bardak S.; Arslanköylü A.E.; Yorulmaz A.; Celegen M.; Sevketoglu E.; Dursun O.; Perk O.; Başpınar O.; Akgul F.
    Aim of the study: Successful cardiopulmonary resuscitation and early defibrillation are critical in survival after in- or out-of-hospital cardiopulmonary arrest. The scope of this multi-centre study is to (a) assess skills of paediatric healthcare providers (HCPs) concerning two domains: (1) recognising rhythm abnormalities and (2) the use of defibrillator devices, and (b) to evaluate the impact of certified basic-life-support (BLS) and advanced-life-support (ALS) training to offer solutions for quality of improvement in several paediatric emergency cares and intensive care settings of Turkey. Methods: This cross-sectional and multi-centre survey study included several paediatric emergency care and intensive care settings from different regions of Turkey. Results: A total of 716 HCPs participated in the study (physicians: 69.4%, healthcare staff: 30.6%). The median age was 29 (27-33) years. Certified BLS-ALS training was received in 61% (n = 303/497) of the physicians and 45.2% (n = 99/219) of the non-physician healthcare staff (P <.001). The length of professional experience had favourable outcome towards an increased self-confidence in the physicians (P <.01, P <.001). Both physicians and non-physician healthcare staff improved their theoretical knowledge in the practice of synchronised cardioversion defibrillation (P <.001, P <.001). Non-certified healthcare providers were less likely to manage the initial doses of synchronised cardioversion and defibrillation: the correct responses remained at 32.5% and 9.2% for synchronised cardioversion and 44.8% and 16.7% for defibrillation in the physicians and healthcare staff, respectively. The indications for defibrillation were correctly answered in the physicians who had acquired a certificate of BLS-ALS training (P =.047, P =.003). Conclusions: The professional experience is significant in the correct use of a defibrillator and related procedures. Given the importance of early defibrillation in survival, the importance and proper use of defibrillators should be emphasised in Certified BLS-ALS programmes. Certified BLS-ALS programmes increase the level of knowledge and self-confidence towards synchronised cardioversion-defibrillation procedures. © 2021 John Wiley & Sons Ltd
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    Retinal microvascular and perfusional disruption in paediatric COVID-19: A case-control optical coherence tomography angiography study
    (Elsevier B.V., 2021) Zengin N.; Güven Y.Z.
    Purpose: To investigate the short-term effect of coronavirus 2019 (COVID-19) on the retinal capillary network and choroid in children. Materials and methods: This prospective, cross-sectional, case-control study included 19 recovered COVID-19 pediatric patients and 20 healthy children. Macular thickness, choroidal thickness, vessel density (VD), perfusion density (PD), and foveal avascular zone (FAZ) values were obtained. Central vessel and perfusion densities were measured at the central 6-mm area, and the values were compared among three subgroups according to location. Results: The mean ages of patients and controls were 12. 42 ± 3.3 years and 13.35 ± 1.2 years, respectively. Significant differences were observed between the two groups in terms of inner, outer, and full VD, as well as inner and full PD. No significant differences in center VD and PD were observed between groups. Although it was not evident in analysis of choroidal values, inflammatory sites were thickened. FAZ area significantly differed between groups (p < 0.05). Conclusions: Retinal microvascularity was impaired in the acute phase of disease in recovered COVID-19 patients aged 10–15 years. However, the microvascularity impairment was subclinical. The choroid was thickened because of inflammation during the acute phase of disease. pediatric COVID-19 patients should undergo follow up via optical coherence tomography angiography to detect subclinical and asymptomatic retinal changes. Long-term follow-up studies are needed to validate these findings. © 2021
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    Serum Vitamin D Levels in Relation to Development of Multisystem Inflammatory Syndrome in Pediatric COVID-19
    (Georg Thieme Verlag, 2022) Zengin N.; Bal A.; Goren T.A.; Bayturan S.S.; Alkan F.; Akcali S.
    Objective The aim of the study is to evaluate vitamin D (vit D) levels in children with and without development of multisystem inflammatory syndrome in children (MIS-C) after coronavirus disease 2019 (COVID-19) and also between those with severe and moderate MIS-C. Methods This comprises retrospective data of 68 patients including 34 patients with MIS-C and admitted into the pediatric intensive care unit (MIS-C group) and 34 patients without MIS-C (non-MIS-C group) were analyzed for their presenting characteristics, serum vit D levels, ventilatory needs, and prognostic scores. Results Vit D levels were significantly lower in patients with versus without MIS-C [9 (2-18) vs. 19 (10-43) ng/mL, p <0.001], and also in patients with severe versus moderate MIS-C [7.5 (2-17) vs. 9 (5-18) ng/mL, p = 0.024]. Vit D deficiency (levels <12 ng/mL) was more common in the MIS-C versus non-MIS-C group (79.4 vs. 11.8%, p <0.001) and in severe versus moderate MIS-C (92.9 vs. 70.0%, p <0.001). The severe versus moderate MIS-C was associated with significantly higher levels of procalcitonin [7.6 (0.9-82) vs. 1.7 (0.2-42) ng/mL, p = 0.030] and troponin [211 (4.8-4,545) vs. 14.2 (2.4-3,065) ng/L, p = 0.008] and higher likelihood of reduced ejection fraction (75.0 vs. 15.4%, p = 0.004). Conclusion Our findings indicate the higher prevalence of vit D deficiency in pediatric COVID-19 patients with versus without MIS-C, as well as in those with severe versus moderate MIS-C. Higher troponin and procalcitonin levels and dyspnea at presentation seem also to be risk factors for severe MIS-C, more pronounced cardiac dysfunction, and poorer prognosis. © 2022 Georg Thieme Verlag. All rights reserved.
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    The Pediatric Tracheostomy Practice During COVID-19 Pandemic at a PICU; [COVID-19 Pandemi Sürecinde Çocuk Yoğun Bakımda Pediyatrik Trakeostomi Deneyimi]
    (Galenos Publishing House, 2022) Zengin N.; Bal A.; Cankorur O.O.; Tanrıverdi H.İ.
    Introduction: To evaluate pediatric tracheostomies performed at a tertiary care pediatric intensive care unit (PICU) before and after the Coronavirus disease-2019 (COVID-19) pandemic. Methods: A total of 57 pediatric tracheostomy patients performed at a tertiary care PICU were included. Prognostic scores including pediatric risk of mortality 2, pediatric index of mortality 2 and pediatric logistic organ dysfunction scores, the family education process and time to home discharge were evaluated according to time of tracheostomy (pre-pandemic vs. after pandemic) and responsible surgeon (pediatric surgeon vs. otolaryngologist). MedCalc® Statistical Software version 19.7.2 (MedCalc Software Ltd, Ostend, Belgium; https: //www.medcalc.org; 2021) was used for statistical analysis. Results: A non-significant tendency for higher rate of pediatric surgery-based tracheostomies was noted after the pandemic (76.0 vs. 24.0%, p=0.134). No significant difference was noted between tracheostomies performed before vs. after the COVID-19 pandemic and those performed by otolaryngologists vs. pediatric surgeons in terms of prognostic scores and time to home discharge. Conclusion: Our findings emphasize the maintenance of high quality patient care for pediatric tracheostomy patients in accordance with standardized tracheostomy protocols and policies during the pandemic period with no significant difference between tracheostomies performed before and after the COVID-19 pandemic and those performed by pediatric surgeons vs. otolaryngologists in terms of prognostic scores and time to home discharge. © 2022, Galenos Publishing House. All rights reserved.
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    COVID-19 disease in children presenting to the pediatric emergency department: A multicenter study with 8886 cases from Turkey
    (W.B. Saunders, 2022) Duman M.; Şık N.; Tekşam Ö.; Akça H.; Kurt F.; Çağlar A.A.; Yıldız L.A.; Taşar M.A.; Fidancı İ.; Yayla B.C.C.; Yılmaz D.; Güngör E.; Demir Ş.; Çokuğraş H.; Cebeci S.O.; Önal P.; Saz E.U.; Yurtseven A.; Uysalol M.; Yıldız R.; Gümüş S.; Bal A.; Bayturan S.Ş.; Zengin N.; Atik S.; Çiftdoğan D.Y.; Berksoy E.; Çiçek A.; Şahin S.; Kızıl M.C.; Kara Y.; Apa H.; Ulusoy E.; Kara A.A.; Yesil E.; Erdem M.; Turan C.; Arslanoglu S.; Duyu M.; Besli G.E.; Arslan G.; Oflu A.T.; Çeleğen M.; Buldu E.; Pişkin İ.E.; Kardeş H.; Yılmaz H.L.; Yıldızdaş D.; Gökulu G.; Çay P.; Özer U.; Güleryüz O.D.; Çolak Ö.; Güneysu S.T.
    Background: The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population. Methods: This was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific antibodies against SARS-CoV-2 were included. Demographics, presence of chronic illness, symptoms, history of contact with SARS-CoV-2 PCR-positive individuals, laboratory and radiologic investigations, clinical severity, hospital admissions, and prognosis were recorded. Results: A total of 8886 cases were included. While 8799 (99.0%) cases resulted in a diagnosis of SARS-CoV-2 with PCR positivity, 87 (1.0%) patients were diagnosed with MIS-C. Among SARS-CoV-2 PCR-positive patients, 51.0% were male and 8.5% had chronic illnesses. The median age was 11.6 years (IQR: 5.0–15.4) and 737 (8.4%) patients were aged <1 year. Of the patients, 15.5% were asymptomatic. The most common symptoms were fever (48.5%) and cough (30.7%) for all age groups. There was a decrease in the rate of fever as age increased (p < 0.001); the most common age group for this symptom was <1 year with the rate of 69.6%. There was known contact with a SARS-CoV-2 PCR-positive individual in 67.3% of the cases, with household contacts in 71.3% of those cases. In terms of clinical severity, 83 (0.9%) patients were in the severe-critical group. There was hospital admission in 1269 (14.4%) cases, with 106 (1.2%) of those patients being admitted to the pediatric intensive care unit (PICU). Among patients with MIS-C, 60.9% were male and the median age was 6.4 years (IQR: 3.9–10.4). Twelve (13.7%) patients presented with shock. There was hospital admission in 89.7% of these cases, with 29.9% of the patients with MIS-C being admitted to the PICU. Conclusion: Most SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups. © 2022 Elsevier Inc.
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    A Comparison Study in Children with Lower Respiratory Tract Infections: Chest X-ray and Lung Ultrasound
    (Galenos Publishing House, 2023) Gürbüz N.; Zengin N.; Karaburun N.C.; Düzgün F.; Bal A.
    Aim: Lower respiratory tract infections (LRTIs) are one of the leading causes of mortality and morbidity in children. Chest X-rays, which are frequently used in diagnosis, cause ionizing radiation exposure and a loss of time. We aimed to compare the diagnostic accuracy of chest radiography (CR) and lung ultrasonography (US) in patients with LRTIs. Materials and Methods: This study was designed as methodological research. Of the 62 patients evaluated in our study, four refused to participate, and eight were excluded from the study due to their underlying chronic diseases. All 50 remaining patients (between the ages of 0-18 years) were evaluated with a preliminary LRTI diagnosis. Lung US was performed by a 3rd-year pediatric resident who had six hours of online US training. CR was taken after lung US. Results: The mean age of the 50 cases included in this study was five years and three months; 35 of the 50 patients (70%) had a clinical diagnosis of pneumonia, 15 (30%) of them had a clinical diagnosis of bronchiolitis. Statistically significant interobserver agreement was found between US and CR [Kappa value 0.772, 95% confidence interval (0.590-0.925) (p=0.000)]. The sensitivity of lung US was 95%, and its specificity was 85.7% when CR was accepted as the gold standard. Conclusion: Our study demonstrates that lung US can be used instead of CR to diagnose and follow-up pediatric cases with LRTIs. © 2023 Galenos Publishing House. All Rights Reserved.
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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.
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    The Effect of Therapeutic Hypothermia on Prognosis in Patients Receiving Continuous Renal Replacement Therapy
    (Mary Ann Liebert Inc., 2024) Evren G.; Zengin N.
    Continuous renal replacement therapy (CRRT) is a commonly used therapeutic modality in the pediatric intensive care unit (PICU) for the treatment of severe acute kidney injury, as well as for addressing metabolic abnormalities, fluid-electrolyte imbalances, and acid-base disorders. According to reports, therapeutic hypothermia treatment has demonstrated the ability to decrease cellular metabolism, oxygen consumption, formation of free radicals, cell death, and inflammatory signals. The study encompassed all individuals who underwent CRRT at both Manisa City Hospital and Manisa Celal Bayar University Hospital throughout the period from February 2021 to November 2022. A total of 14 patients who received CRRT were subjected to a warming procedure utilizing an external blanket and an external heater attached to the CRRT venous return line, resulting in the attainment of a body temperature exceeding 36̊C. Therapeutic hypothermia was implemented on 12 patients to maintain their body temperature within the range of 32–35̊C. The study population exhibited a median age of 24.5 months, with males comprising 61.5% of the sample. A therapeutic hypothermia treatment was administered to a cohort of 12 patients. The patients who had therapeutic hypothermia exhibited a significantly reduced vasoactive-inotropic score (p = 0.038). Patients who did not receive therapeutic hypothermia exhibited a prolonged need for mechanical ventilation (p = 0.020). The duration of stay in the PICU for patients who underwent therapeutic hypothermia was shown to be considerably shorter compared to those who did not receive therapeutic hypothermia (p = 0.047). The potential efficacy of moderate therapeutic hypothermia appears promising, particularly in the context of patients who are receiving CRRT for severe sepsis and acute respiratory distress syndrome. This is attributed to the anti-inflammatory properties and hypometabolic effects associated with this intervention. To the best of our current understanding, this study represents the initial investigation showcasing the effectiveness of combining therapeutic hypothermia with CRRT in the pediatric population. © Mary Ann Liebert, Inc.
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    Comparison of early characteristics of multisystemic inflammatory syndrome and Kawasaki disease in children and the course of Kawasaki disease in the pandemic
    (BioMed Central Ltd, 2024) Alkan F.; Bircan O.; Bal A.; Bayturan S.; Zengin N.; Coskun S.
    Introduction: Multisystemic inflammatory syndrome (MIS-C) is a newly described disease manifestation in children associated with the novel coronavirus SARS-CoV-2 infection and can be easily confused with Kawasaki disease with its clinical and laboratory findings. In this study, the clinical findings, organ involvements, similarities, and differences in laboratory and imaging of the children with MIS-C and KD at the time of admission will be revealed in detail, and the treatment methods and follow-up results will be revealed. Material and method: Our study was a single-center study and included pediatric patients who were treated with a diagnosis of MIS-C between March 2020 and July 2023 in the pediatric cardiology, pediatric emergency, pediatric infection, and pediatric intensive care clinics at Celal Bayar University and who were treated with a diagnosis of KD (complete/incomplete) between January 2015 and July 2023. MIS-C diagnosis was made according to the Turkish Ministry of Health COVID-19 guidelines. Sociodemographic characteristics, clinical, laboratory, and echocardiography findings, treatments given, and clinical course of all patients included in the study were evaluated. Results: The median age was 30 months (7–84) in KD and 96 months (6-204) in MIS-C, and it was significantly higher in the MIS-C group (p = 0.000). Symptom duration was significantly longer in the MIS-C group (p = 0.000). In terms of clinical features, gastrointestinal syndrome findings (nausea, vomiting, abdominal pain) and respiratory findings (dyspnea) were significantly higher in the MIS-C group (p = 0.007, p = 0.000, p = 0.002, respectively). Regarding cardiovascular system involvement, coronary involvement was significantly higher in the KD group. However, valvular involvement, left ventricular systolic dysfunction, and pericardial effusion were significantly higher in the MIS-C group (p = 0.000, p = 0.001, p = 0.003, p = 0.023, respectively). In terms of laboratory findings, white blood cell count was higher in KD (p = 0.000), absolute lymphocyte count, platelet level, blood sodium, and albumin levels were lower in MIS-C group (p = 0.000, p = 0.000, p = 0.000, p = 0.000, p = 0.003, respectively), ferritin and troponin levels were significantly higher in MIS-C group. These results were statistically significant (p = 0.000, p = 0.000, respectively). D-dimer and fibrinogen levels were high in both groups, and no significant statistical difference was detected between the two groups. There was no significant difference between the two groups regarding the length of hospitalization and mortality, but steroid use was significantly higher in the MIS-C group (p = 0.000). Conclusion: In conclusion, this study has demonstrated the similarities and differences between MIS-C and KD regarding clinical findings, organ involvement, and laboratory and imaging results. The results of our study have important implications in terms of contributing to the data in the existing literature on these two diseases and for the correct diagnosis and better management of pediatric patients presenting with these disorders. What is known: Multisystemic inflammatory syndrome (MIS-C) is a newly described disease manifestation in children associated with the novel coronavirus SARS-CoV-2 infection and can be easily confused with Kawasaki disease with its clinical and laboratory findings. What is new: Although MIS-C and KD have many similarities, their symptoms, disease processes, possible complications, and treatment regimens may differ. © The Author(s) 2024.