Goal: 08 - İnsana Yakışır İş ve Ekonomik Büyüme
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İnsana Yakışır İş ve Ekonomik Büyüme
İstikrarlı, kapsayıcı ve sürdürülebilir ekonomik büyümeyi, tam ve üretken istihdamı ve herkes için insana yakışır işleri desteklemek
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Publication Open Access Multisystem inflammatory syndrome in children associated with COVID-19 in 101 cases from Turkey (Turk-MISC study)(2022-02-01T00:00:00Z) Yilmaz Ciftdogan, Dilek; Ekemen Keles, Yildiz; Karbuz, Adem; ÇETİN, BENHUR ŞİRVAN; Elmas Bozdemir, Sefika; KEPENEKLİ KADAYİFCİ, EDA; Metin Akcan, Ozge; Ozer, Arife; Erat, Tugba; Sutcu, Murat; Buyukcam, Ayse; BELET, NURŞEN; Erdeniz, Emine Hafize; Dalgic Karabulut, Nazan; Hancerli Torun, Selda; ÖNCEL, SELİM; ORBAK, Zerrin; TÜREL, Özden; GAYRETLİ AYDIN, ZEYNEP GÖKÇE; KILIÇ, ÖMER; Yahsi, Aysun; Kara Aksay, Ahu; Ergenc, Zeynep; Petmezci, Mey Talip; OFLAZ, MEHMET BURHAN; Sarikaya, Remzi; Otar Yener, Gulcin; Ozen, Seval; Gul, Doruk; ARSLAN, GAZİ; Kara, Soner Sertan; Demirkol, Demet; YAZICI ÖZKAYA, PINAR; YOZGAT, YILMAZ; Varan, Celal; Kara, Manolya; ARGA, GÜL; YAKUT, NURHAYAT; Kilic, Ahmet Osman; ÇAKICI, ÖZLEM; Kucuk, Mehmet; Kaba, Ozge; KARAOĞLU ASRAK, HATİCE; BURSAL DURAMAZ, BURCU; Dalkiran, Tahir; Berna Anil, Ayse; TURĞUT, MEHMET; KARAPINAR, BÜLENT; Somer, Ayper; ELMALI, FERHAN; DİNLEYİCİ, ENER ÇAĞRI; ÇİFTCİ, ERGİN; KARA, ATEŞ; TÜREL, ÖZDEN; YOZGAT, YILMAZ; BURSAL DURAMAZ, BURCUAim Multisystem inflammatory syndrome in children (MIS-C) may cause shock and even death in children. The aim of this study is to describe the clinical features, laboratory characteristics and outcome of children diagnosed with MIS-C in 25 different hospitals in Turkey. Methods The retrospective study was conducted between 8 April and 28 October 2020 in 25 different hospitals from 17 cities. Data were collected from patients- medical records using a standardised form. Clinical and laboratory characteristics and outcomes according to different age groups, gender and body mass index percentiles were compared using multivariate logistic regression analysis. Results The study comprised 101 patients, median age 7 years (interquartile range (IQR) 4.6-9.3); 51 (50.5%) were boys. Reverse-transcriptase polymerase chain reaction (PCR) assay was positive in 21/100 (21%) patients; 62/83 (74.6%) patients had positive serology for SARS-CoV-2. The predominant complaints were fever (100%), fatigue (n = 90, 89.1%), and gastrointestinal symptoms (n = 81, 80.2%). Serum C-reactive protein (in 101 patients, median 165 mg/L; range 112-228), erythrocyte sedimentation rate (73/84, median 53 mm/s; IQR 30-84) and procalcitonin levels (86/89, median 5 mu g/L; IQR 0.58-20.2) were elevated. Thirty-eight patients (37.6%) required admission to intensive care. Kawasaki disease (KD) was diagnosed in 70 (69.3%) patients, 40 of whom had classical KD. Most patients were treated with intravenous immunoglobulin (n = 92, 91%) and glucocorticoids (n = 59, 58.4%). Seven patients (6.9%) died. Conclusion The clinical spectrum of MIS-C is broad, but clinicians should consider MIS-C in the differential diagnosis when persistent fever, fatigue and gastrointestinal symptoms are prominent. Most patients diagnosed with MIS-C were previously healthy. Immunomodulatory treatment and supportive intensive care are important in the management of cases with MIS-C. Glucocorticoids and intravenous immunoglobulins are the most common immunomodulatory treatment options for MIS-C. Prompt diagnosis and prompt treatment are essential for optimal management.Publication Open Access COVID-19 associated multisystemic inflammatory syndrome in 614 children with and without overlap with Kawasaki disease-Turk MIS-C study group(2022-02-01T00:00:00Z) ÇİFTDOĞAN, DİLEK YILMAZ; Keles, Yildiz Ekemen; ÇETİN, BENHUR ŞİRVAN; Karabulut, Nazan Dalgic; EMİROĞLU, MELİKE; Bagci, Zafer; Buyukcam, Ayse; Erdeniz, Emine Hafize; ARGA, GÜL; Yesil, Edanur; ÇAKICI, ÖZLEM; Karbuz, Adem; ŞAHBUDAK BAL, ZÜMRÜT; Kara, Soner Sertan; Ozer, Arife; AKCAN, ÖZGE METİN; Bozdemir, Sefika Elmas; ANIL, AYŞE BERNA; Uygun, Hatice; KILIÇ, ÖMER; Torun, Selda Hancerli; Umit, Zuhal; Sutcu, Murat; Ozmen, Berfin Ozgokce; KARAOĞLU ASRAK, HATİCE; Alkan, Gulsum; Aksay, Ahu Kara; Ugur, Cuneyt; Birbilen, Ahmet Ziya; BURSAL DURAMAZ, BURCU; Ozkan, Esra Akyuz; Burakay, Ozgur; Arslan, Sema Yildirim; Oncel, Eda Karadag; Celik, Serkan Fazli; Kilic, Ahmet Osman; Ozen, Seval; Sarikaya, Remzi; Demirkol, Demet; ARSLAN, GAZİ; TÜREL, Özden; SERT, AHMET; Sari, Ergul; ORBAK, Zerrin; Sahin, Irfan Oguz; Varan, Celal; Akturk, Hacer; Oz, Sadiye Kubra Tuter; Durak, Fatih; OFLAZ, MEHMET BURHAN; Kara, Manolya; Karpuz, Derya; Petmezci, Mey Talip; Hatipoglu, Nevin; ÖNCEL, SELİM; TURĞUT, MEHMET; ELMALI, FERHAN; Somer, Ayper; KUYUCU, NECDET; DİNLEYİCİ, ENER ÇAĞRI; KURUGÖL, NURİ ZAFER; ÇİFTCİ, ERGİN; KARA, ATEŞ; BURSAL DURAMAZ, BURCU; TÜREL, ÖZDENMultisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9-12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells × μL, p = 0.028; platelet count 166 vs. 216 cells × 103/μL, p < 0.001). The median serum procalcitonin levels were statistically higher in patients overlapped with KD (3.18 vs. 1.68 µg/L, p = 0.001). Coronary artery dilatation was statistically significant in patients with overlap with KD (13.4% vs. 6.8%, p = 0.007), while myocarditis was significantly more common in patients without overlap with KD features (2.6% vs 7.4%, p = 0.009). The association between clinical and laboratory findings and overlap with KD was investigated. Age > 12 years reduced the risk of overlap with KD by 66% (p < 0.001, 95% CI 0.217-0.550), lethargy increased the risk of overlap with KD by 2.6-fold (p = 0.011, 95% CI 1.244-5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% (p < 0.001, 95% CI 0.298-0.559). Conclusion: Almost half of the patients with MISC had clinical features that overlapped with KD; in particular, incomplete KD was present. The median age was lower in patients with KD-like features. Lymphocyte and platelet counts were lower, and ferritin and procalcitonin levels were significantly higher in patients with overlap with KD.Publication Open Access Time Series Analysis of the Microbiota of Children Suffering From Acute Infectious Diarrhea and Their Recovery After Treatment(2018-06-12) Dinleyici, Ener C.; MARTINEZ-MARTINEZ, Daniel; KARA, ATEŞ; KARBUZ, Adem; DALGIC, Nazan; METIN, Ozge; YAZAR, Ahmet S.; GUVEN, Sirin; Kurugol, Zafer; Turel, Ozden; KUCUKKOC, Mehmet; YASA, Olcay; Eren, Makbule; Ozen, Metehan; MANUEL MARTI, Jose; GARAY, Carlos P.; VANDENPLAS, Yvan; MOYA, Andres; TÜREL, ÖZDENGut microbiota is closely related to acute infectious diarrhea, one of the leading causes of mortality and morbidity in children worldwide. Understanding the dynamics of the recovery from this disease is of clinical interest. This work aims to correlate the dynamics of gut microbiota with the evolution of children who were suffering from acute infectious diarrhea caused by a rotavirus, and their recovery after the administration of a probiotic, Saccharomyces boulardii CNCM I-745. The experiment involved 10 children with acute infectious diarrhea caused by a rotavirus, and six healthy children, all aged between 3 and 4 years. The children who suffered the rotavirus infection received S. boulardii CNCM I-745 twice daily for the first 5 days of the experiment. Fecal samples were collected from each participant at 0, 3, 5, 10, and 30 days after probiotic administration. Microbial composition was characterized by 16S rRNA gene sequencing. Alpha and beta diversity were calculated, along with dynamical analysis based on Taylor's law to assess the temporal stability of the microbiota. All children infected with the rotavirus stopped having diarrhea at day 3 after the intervention. We observed low alpha diversities in the first 5 days (p-value < 0.05, Wilcoxon test), larger at 10 and 30 days after probiotic treatment. Canonical correspondence analysis (CCA) showed differences in the gut microbiota of healthy children and of those who suffered from acute diarrhea in the first days (p-value < 0.05, ADONIS test), but not in the last days of the experiment. Temporal variability was larger in children infected with the rotavirus than in healthy ones. In particular, Gammaproteobacteria class was found to be abundant in children with acute diarrhea. We identified the microbiota transition from a diseased state to a healthy one with time, whose characterization may lead to relevant clinical data. This work highlights the importance of using time series for the study of dysbiosis related to diarrhea.