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 Natural Alkaloids as Potential Anti-Coronavirus Compounds(2020-12-01T00:00:00Z) Topçu, Gülaçtı; Şenol, Halil; Alim Toraman, Gülbahar Özge; Altan, Vecdi Melih; TOPÇU, GÜLAÇTI; ŞENOL, HALIL; ALİM TORAMAN, GÜLBAHAR ÖZGE; ALTAN, VECDİ MELİHCoronaviruses are causative agents of the last three epidemics/pandemic; Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) and the last one Severe Acute Respiratory Syndrome-Cov-2 (SARS-CoV-2). Although meta-analysis of treatment studies against these three coronaviruses found no clear benefit of any spesific regimen, currently, remdesivir and favipiravir are promising potential therapies for SARS-CoV-2. On the other hand, since natural products have always played a crucial role in drug discovery and development process against various diseases, many groups in the world, are now trying to find new or repurposed natural or naturally originated drugs against viruses and coronaviruses. Secondary metabolites of the plants, particularly alkaloids and terpenoids have been exhibited strong antimicrobial and anticancer activities besides synthetic drugs and other natural compounds (nucleosides and nucleotides and bacterial and fungi originated ones). The first isolated secondary metabolites have been converted into important drugs since 1800’s such as morphine, codeine, cocaine, and quinine have alkaloid skeleton as well as some of the recent anticancer drugs vinblastine, vincristine, taxol, etc. This review includes the last two decades of publications about natural alkaloids rather than their plant extracts which showed some promising results against coronaviruses. Marine organisms are also another rich source to discover new lead drugs, however they were excluded in the present review article.