Gürkan Atay

Ümraniye Eğitim ve Araştırma Hastanesi

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Seher Erdoğan

Ümraniye Eğitim ve Araştırma Hastanesi

Ayper Somer

Istanbul University

Selda Hançerlı Törün

Istanbul University

Murat Sütçü

Istinye University

Manolya Kara

Yeditepe University

Hazal Ceren Tuğrul

Sağlık Bilimleri Üniversitesi

Kemal Nişli

Istanbul University

EÇ

Emine Çalışkan

Sağlık Bilimleri Üniversitesi

Betül Sözeri

Ümraniye Eğitim ve Araştırma Hastanesi

AÇ

Agop Çıtak

Acıbadem University Atakent Hospital

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Sağlık Bilimleri Üniversitesi

124

Istanbul University

University of Health Science

Ümraniye Eğitim ve Araştırma Hastanesi

University of Health Sciences

Pediatrics and Genetics

Ministry of Health

Ankara University

Marmara University

Hacettepe University

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Serum albumin level in critically ill pediatric patients

The Annals of Clinical and Analytical Medicine (2021)

Gürkan Atay Seher Erdoğan

Aim: Hypoalbuminemia is a frequent condition among patients admitted to the pediatric intensive care unit (PICU).The aims of the present study were to determine the prevalence of hypoalbuminemia among critically ill pediatric patients and assess its relationship with prognosis.Material and Methods: This was a retrospective observational study evaluating the albumin levels and prognoses recorded among patients admitted to the PICU between May 2017 and December 2018.The patients were categorized into two groups; those with hypoalbuminemia were assigned to Group 1. Results: The study enrolled a total of 126 pediatric patients, of whom 64 (50.8%) were female.One hundred and five (83.3%) patients survived and 21 (16.7%)died.Forty-six (36.5%) patients had hypoalbuminemia.Among the patients assigned to Group 1, the need for mechanical ventilation (MV) was significantly greater (p=0.007),but there was no significant difference between the number of days of MV (p=0.64).Group 1 had significantly greater PRISM scores, significantly longer hospital stays, and a significantly higher mortality rate (p=0.000,p=0.013, and p=0.000, respectively).No significant difference was seen for the number of days spent in the PICU.Prognosis analysis revealed that surviving patients had a higher mean age, less need for MV, shorter hospitalization and MV times, and lower serum total protein and albumin levels.Discussion: We suggest that serum albumin level is an important prognostic marker as it is a simple, specific, and low-cost parameter that is routinely used in most PICUs.

10.4328/acam.20746

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Are serum thrombomodulin and interleukin-8 levels associated with disease severity and mortality in critically ill children with respiratory failure?

TURKISH JOURNAL OF MEDICAL SCIENCES (2024)

Dilan Akgün Ünlü Hazal Ceren Tuğrul Selen Ceren Çakmak Gürkan Atay Seher Erdoğan

Thrombomodulin (TM) is found on endothelial cell surfaces and increases in response to endothelial injury of different organs. Interleukin (IL)-8 regulates pulmonary inflammation. TM and IL-8 are candidate biological markers of acute respiratory distress syndrome (ARDS). The aim of the present study was to compare TM and IL-8 levels in pediatric patients with and without ARDS who received respiratory support and to determine their relationships with prognosis.

Thrombomodulin

10.55730/1300-0144.5896

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Therapeutic plasma exchange (TPE) treatment in COVID-19 related Multisystem inflammatory syndrome in children (MIS-C) who admitted with acute abdomen clinic

Ümraniye Pediatri Dergisi - Journal of Umraniye Pediatrics (2020)

Mücahit Oğuz K Türk Canan Hasbal Akkuş Gürkan Atay Seher Erdoğan

In March 2020, the World Health Organization designated the disease Coronavirus Disease 2019 , which caused by Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), as a pandemic.Prognosis of the disease proceed generally mildly in pediatric cases.Rarely, children have been affected severely and prognosis can be different from adult patients.Since May 2020, reports from different countries documented a presentation in children and this condition has been termed as multisystem inflammatory syndrome in children.This report, we presented an 8-year-old patient who was admitted to the hospital with complaints of fever and abdominal pain, was operated by a pediatric surgeon with the diagnosis of acute appendicitis, was followed up with the multisystemic inflammatory syndrome clinic in pediatric intensive care unit, and received intravenous immunoglobulin, steroid, plasmapheresis treatments and inotropic support.This report, we wanted to emphasize that in the COVID-19 pandemic, there may be hospital applications with different clinical presentations in the childhood age group, and the use of intravenous immunoglobulin and plasmapheresis treatment combination can be a life-saving option, especially in multisystem inflammatory syndrome in children cases requiring intensive care.

Therapeutic plasma exchange

2019-20 coronavirus outbreak

Acute abdomen

10.14744/upd.2020.03522

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Anaphylaxis during puncture of a hepatic hydatid cyst

Northern Clinics of Istanbul (2022)

Gürkan Atay Seher Erdoğan Hazal Ceren Tuğrul Seyma Melisa Su Dur

Although hydatid cyst infects many organs, it most commonly involves liver, lungs, and central nervous system. The goal of hydatid cyst treatment is to completely eliminate the parasite and to prevent recurrences with minimal mortality and morbidity. The procedure of puncture, aspiration, injection of a scolicidal, and reaspiration (PAIR) of a cyst has been introduced as an alternative to surgical method since it is less invasive and less morbid and is associated with a shorter hospital stay and a lower cost. Herein, we report an 11-year-old girl who developed anaphylaxis during the puncture of a hepatic hydatid cyst. The patient who developed anaphylaxis during the PAIR procedure was administered intravenous adrenaline, methyl prednisolone, and antihistaminic medication. She was intubated and provided assisted ventilation using a mechanic ventilator. The child was extubated 4 h after her admission to the pediatric intensive care unit. During follow-up, the contents of her hepatic hydatid cysts were aspirated through a catheter, followed by their irrigation with 20% sodium chloride and re-aspiration. Then, 97% ethyl alcohol was injected into the cyst cavity to make it collapse. The goal of this report was to draw attention to the rare occurrence of anaphylaxis during the PAIR procedure and to stress that clini-cians should be vigilant for this complication.

Albendazole

Hydatid cyst

10.14744/nci.2022.58260

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Ciddi Hastalığı Olan Çocuklarda Tigesiklin Kurtarma Tedavisi

Çocuk Enfeksiyon Dergisi/Journal of Pediatric Infection (2018)

Manolya Kara Murat Sütçü Hacer Aktürk Özden Türel Selda Hançerlı Törün

Objective: Tigecycline has a wide spectrum antimicrobial activity including multi-drug resistant and extended drug resistant nosocomial Gram-negative bacteria.Although its pediatric use has not been approved, clinicians are sometimes obligated to choose tigecycline as salvage therapy.In this study, we present our clinical experience regarding tigecycline use in children. Material and Methods:This was a retrospective study of children who had been given tigecycline therapy at least 48 consecutive hours of duration in the pediatric departments of two tertiary-centers from January 2011 to March 2016.Results: Twenty four patients (13 female, 54.2%) with median age of 96 months (1-192) were enrolled.Tigecycline was started for ventilator associated pneumonia (n= 10, 41.7%), blood stream infection (n= 7, 29.2%), catheter related infection (n= 1, 4.2%), complicated skin soft tissue intection (n= 1, 4.2%) and emprically (n= 5, 20.8%).The most common isolated pathogen was Acinetobacter baumannii (n= 13, 54.2%).Other pathogens were Klebsiella spp.(n= 4, 16.6%), methicilline resistant Staphylococcus aureus, (n= 1, 42%) and Leptospira spp.(n= 1, 4.2%).All of the patients had tigecycline combination therapy.The most common combination was tigecycline + colistin (n= 10, 41.7%).Two patients (8.3%) had mild adverse events.The mortality rate was 45.8%.There was negative correlation between the age of patients and mortality rate (p= 0.006). Conclusion:Tigecycline may be used in critically ill children as salvage therapy with considerably mild side effects.

10.5578/ced.201801

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Ergenlerde, aktif ve pasif sigara içiminin solunum fonksiyon testleri üzerine etkisi

Pediatric Practice and Research (2021)

Meliha Sevim Gürkan Atay Abdullah Yağci .M Topuz Osman Arslan

Amaç: Bu çalışmanın amacı ergenlerde aktif ve pasif sigara içiminin solunum fonksiyonları üzerine etkisini belirlemektir. Gereç ve yöntem: Bu çalışma, Haziran 2013-2015 tarihleri arasında, Ankara Eğitim ve Araştırma Hastanesi Çocuk Polikliniğine başvuran ergenler dahil edildi. Olguların ve ailelerinin sosyodemografik özelliklerini içeren anket formu ebeveynler tarafından dolduruldu. Olgular, aktif sigara içenler, pasif sigara içenler ve hiç içmeyenler olmak üzere üç gruba ayrıldı. Tüm olguların volumetrik spirometre ile solunum fonksiyon testleri yapıldı. Bulgular: Çalışmaya alınan toplam 222 ergenin yaş aralığı 11-17 yaş (median:15 yaş) olup 102’si (%45,9) erkek ve 120’si (%54,1) kızdı. Aktif sigara içenler %29,7 [n= 66, median 16 yaş, 42 erkek (%64) ve 24 kız (%36)], pasif sigara içenler %55,4 [n= 123, median 14 yaş, 52 (%42,3) erkek ve 71 kız (%57,7)] ve hiç içmeyenler %14,9 [n=33, median 14 yaş, 8 erkek (%24,2) ve 25 kız (%75,8)] idi. Pasif sigara içenlerin FEF25-75 ve FEV1 değerleri aktif sigara içenlere göre farklı bulunmadı. Ancak, hiç içmeyenlerle karşılaştırıldığında anlamlı daha düşüktü (sırası ile p=0,049; p=0,003). Pasif sigara içen grubun FVC değerleri aktif sigara içen ve hiç sigara içmeyen gruba göre anlamlı olarak düşük saptandı (sırası ile, p=0,020; p=0,010). Sonuç: Ergenlik döneminde sigara içme oranı yüksek saptandı (%29,7). Pasif sigara içen grubun solunum fonksiyon testlerinin anlamlı düşük çıkması, sigaraya maruziyet oranının, maruziyet tipinden (aktif/pasif) daha etkili bir faktör olduğu kanısını ortaya koymuştur.

10.21765/pprjournal.886067

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Kritik Çocuk Hastalarda Sürekli Renal Replasman Tedavisi

Çocuk Dergisi / Journal of Child (2022)

Gürkan Atay

Amaç: Çocuk yoğun bakım ünitelerinde sürekli renal replasman tedavisi (SRRT), şiddetli akut böbrek hasarının tedavisi ve/veya sıvı dengesi, asitbaz ve metabolik düzensizlikte sıklıkla kullanılmaktadır. Bu tedavinin uygulamasında; kateter seçiminden, kullanılan antikoagülasyon yöntemine kadar çeşitli teknik zorluklarla karşılaşılmakta ve komplikasyonlar görülebilmektedir. Bu çalışmayı yapmaktaki amacımız, SRRT endikasyonları ve komplikasyonlarını değerlendirmek, kullanılan iki farklı antikoagülasyon yöntemini karşılaştırarak deneyimlerimizi paylaşmaktır. Gereç ve Yöntem: Bu çalışmada, bir üniversite hastanesinin 3.basamak çocuk yoğun bakım ünitesinde (ÇYBÜ) Ekim 2020 ile Eylül 2021 tarihleri arasında Sürekli Renal Replasman Tedavisi uygulanan hastaların verileri geriye dönük olarak değerlendirildi. Bulgular: Hastaların ortanca yaşı 120 ay (2-204) ve 16’sı kızdı (%47,1). Sürekli renal replasman tedavisi uygulanan 22 (%64,7) hastada bölgesel sitrat antikoagülasyonu, 12 (%35,3) hastada ise heparin antikoagülan kullanıldı. SRRT endikasyonları sırasıyla, akut böbrek yetmezliği (11, %32,4), sıvı yüklenmesi (9, %26,5), metabolik asidoz /elektrolit bozukluğu (7, %20,6), tümör yıkım sendromu (5, %14,7), hiperamonyemi (1, %2,9), intoksikasyon (1, %2.9) idi. Sitrat kullanılan grupta filtre tipinden bağımsız devre ömrü ortalama 50,1±22 saat iken heparin grubunda bu süre ortalama 28,5±16,6 saat olarak bulundu (p=0,01). Serum kalsiyum düzeyi sitrat grubunda heparin grubuna göre anlamlı olarak daha yüksek tespit edildi (p=0,005). Sonuç: Bölgesel sitrat antikoagülasyon kullanımı filtre ömrünü uzatmaktadır. Bu durumun karşılaşılabilecek teknik problemleri ve iş yükünü azalttığını, maliyete belirgin katkı sağladığını düşünmekteyiz.

10.26650/jchild.2022.1017478

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Evaluation of the effect of therapeutic plasma exchange on serum cytokine levels in pediatric intensive care unit

Therapeutic Apheresis and Dialysis (2025)

Selen Ceren Çakmak Hazal Ceren Tuğrul Dilan Akgün Ünlü Rasit Alkan Albayrak Gürkan Atay

Abstract Introduction Therapeutic plasma exchange (TPE) is crucial for saving lives when used appropriately. This study aimed to assess TPE's impact on tumor necrosis factor‐like weak inducer of apoptosis (TWEAK) protein and IL‐6 levels in critically ill pediatric patients. Methods Conducted between May 2022 and December 2022, the study observed pediatric intensive care unit (PICU) patients undergoing TPE, recording demographics, lab results, TWEAK, and IL‐6 levels pre‐ and post‐procedure. Results Of 41 patients, 53.7% were male, 51.2% had underlying conditions, and 39% showed sepsis symptoms. IL‐6 levels significantly rose post‐TPE ( p : 0.006), while TWEAK protein levels dropped ( p : 0.030). Positive correlations were found between interleukin‐6 (IL‐6) pre‐TPE and ventilation duration, ferritin levels ( p <0.05), and TWEAK pre‐TPE and organ failure indicators, D‐Dimer levels ( p <0.05). Prognosis showed no significant difference in IL‐6/TWEAK levels ( p >0.05). Conclusion Serum IL‐6 and TWEAK can indicate disease severity and inflammation level, but may not predict prognosis accurately. Clinical Trial Registration Our study has clinical study registration number B.10.1.TKH.4.34.H.GP.0.01/154 of the University of Health Sciences Ümraniye Training and Research Hospital.

10.1111/1744-9987.14246

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Intrapancreatic Peristaltic Duodenal Duplication Cyst; Presenting with Acute Pancreatitis and Intraabdominal Bleeding

International Journal Of Medical Science And Clinical Invention (2022)

Sevinç Kalın Zeliha Akış Yıldız Canan Hasbal Akkuş Seher Erdoğan Gürkan Atay

Congenital anomalies and variations should be kept in mind when evaluating diseases in the pediatric patient group. A 12 years old girl presented with findings of acut abdomen. Clinical and laboratory data were consistent with acute pancreatitis. Imaging findings showed a peristaltic cystic tissue with a thick wall and central lumen in the head of the pancreas. In the operation, it was shown that this cystic lesion was associated with the accessory pancreatic duct and had no duodenal connection. In the pathology report, the presence of duodenal intestinal tissue compatible with a duplication cyst located in the head of the pancreas was proven. By sharing this rare case, keeping in mind the underlying congenital anomalies in any pathology in children and emphasizing the importance of ultrasonographic dynamic real-time examination in abdominal imaging.

Lumen (anatomy)

Pathognomonic

10.18535/ijmsci/v9i09.03

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Methaemoglobinemia Developing Following Lidocain Use

İstanbul medical journal (2020)

Seher Erdoğan Gürkan Atay Tuğçe Bozkurt Hüsniye İşcan

Methemoglobinemi, iki değerli hemoglobin demirinin okside olup üç değerli

10.4274/imj.galenos.2020.22308

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