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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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  • PublicationOpen 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, BURCU
    Aim 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.
  • PublicationOpen 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, ÖZDEN
    Multisystemic 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.
  • PublicationMetadata only
    Resting Heart Rate in Children with Crimean-Congo Hemorrhagic Fever: A Tool to Identify Patients at Risk?
    (2014-01-01T00:00:00Z) OFLAZ, MEHMET BURHAN; BOLAT, FATİH; KAYA, ALİ; GÜVEN, AHMET SAMİ; KÜÇÜKDURMAZ, ZEKERİYA; KARAPINAR, HEKİM; GÜLSEVER, OSMAN; Dogan, Melih; Cevit, Omer; İÇAĞASIOĞLU, FÜSUN DİLARA; İÇAĞASIOĞLU, DİLARA FÜSUN
    Objective: We aimed to assess the association between resting heart rate (RHR) and severe infection in children with Crimean-Congo hemorrhagic fever (CCHF). Methods: In all, 121 patients under 18 years of age with a laboratory-confirmed diagnosis of CCHF were enrolled in the study. Patients were classified into two groups based on disease severity (severe group and nonsevere group). RHR was measured by electrocardiography (ECG) on admission. Maximum P-wave duration (Pmax), P-wave dispersion (Pd), QRS duration, corrected QT interval, and QT dispersion were also measured. Results: Mean age was 11.43.9 years and 84 patients were male. Twenty-six patients were classified as severe. Patients in this group had a higher RHR (103.6 +/- 10.4vs. 80.5 +/- 8.1, p=0.001) than those with nonsevere disease. There was no difference in Pmax, Pd, QRS duration, QTcmax, or QTc dispersion. The optimal cutoff value of RHR to predict disease severity was>96 beats per minute (bpm), with 70.6% sensitivity and 50.1% specificity. Bleeding, thrombocytopenia (80x10(9)/L), elevated aspartate transaminase (AST) (>208IU/L), elevated alanine transaminase (ALT) (>87IU/L), elevated lactate dehydrogenase (LDH) (>566IU/L), long activated partial thromboplastin time (aPTT) (>42s), and increased hospitalization days were more frequent in patients with RHR >96bpm. Multivariate logistic regression analysis revealed low platelet count (42s), high LDH (>566IU/L), and elevated RHR (>96bpm) as independent risk factors for severe disease. Conclusions: We conclude that elevated RHR was significantly associated with severe disease in children with CCHF, thus offering the potential to identify patients with increased risk.