Person: KARADAĞ, BÜLENT TANER
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KARADAĞ
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BÜLENT TANER
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Publication Metadata only Foreign body aspiration: What is the outcome?(WILEY-LISS, 2002) YILDIZELİ, BEDRETTİN; Karakoc, F; Karadag, B; Akbenlioglu, C; Ersu, R; Yildizeli, B; Yuksel, M; Dagli, EUndiagnosed and retained foreign bodies may result in serious complications such as pneumonia, atelectasis, or bronchiectasis. We reviewed a total of 174 children with foreign body aspiration (FBA). Clinical, radiological, and bronchoscopic findings of these patients were evaluated according to the nature of foreign body and elapsed time from aspiration to diagnosis. Significant differences were noted between patients with organic and inorganic FBA in terms of clinical and radiological findings. Cough, recurrent pneumonia, and fever were the most common presenting symptoms in patients with delayed diagnosis. Long-term follow-up was available for 110 patients for a mean duration of 37.8 +/- 23.7 months (range, 1-88 months). We evaluated the course of recovery after bronchoscopic removal. Organic FBA was of comparable duration as for inorganic FBA, and prolonged follow-up was associated with increased risk of persistent symptoms and bronchiectasis (P < 0.001). The risk of long-term complications increased with increasing elapsed time from aspiration to diagnosis; complications were as high as 60% in children who were diagnosed 30 days after FBA (P = 0.0035). Bronchiectasis was a major complication, found in 25% of patients whose diagnosis was delayed by more than 30 days (P = 0.0001). Three patients with bronchiectasis underwent lobectomy. Patients with persistent asthma-like symptoms such as cough and wheezing required treatment with inhaled corticosteroids and bronchodilators. The positive response to this treatment was thought to be a confirmation of the development of transient bronchial hyperresponsiveness induced by foreign bodies. We conclude that timely diagnosis and appropriate treatment of FBA is important to prevent long-term complications in affected children. (C) 2002 Wiley-Liss, Inc.Publication Metadata only Bronchoscopic evaluation of unexplained recurrent and persistent pneumonia in children(WILEY-BLACKWELL, 2013) KARADAĞ, BÜLENT TANER; Gokdemir, Yasemin; Cakir, Erkan; Kut, Arif; Erdem, Ela; Karadag, Bulent; Ersu, Refika; Karakoc, Faziletd Background: Persistent or recurrent pneumonia in children can pose a significant challenge to paediatricians and respiratory physicians. Aim: The aim of this study is to determine the role of flexible bronchoscopy (FB) in evaluation of recurrent or persistent pneumonia that remain otherwise unexplained by non-invasive diagnostic tests in children. Methods: Retrospective evaluation of patients who underwent FB with an indication of recurrent or persistent pneumonia from 1997 to 2011. Results: Among 2600 FB procedures, 434 (17%) were performed with the indication of recurrent or persistent pneumonia. There were 237 (54%) boys. Median age at presentation was 84 months, and median duration of symptoms was 9 months. FB led to specific diagnosis in 33% of the cases. The most common diseases diagnosed by FB were malacia disorders (n: 32, 7%), aspirated foreign body (n: 30, 7%), endobronchial tuberculosis (n: 20, 5%), congenital airway anomalies (n: 14, 3%), mucus plugs (n: 14, 3%), pulmonary haemosiderosis (n: 12, 3%) and middle lobe syndrome (n: 11, 3%). During FB, only 6% of the patients had minor complications such as transient hypoxia, stridor and tachycardia. Conclusions: In our study, FB proved to be a safe and effective tool in evaluation of children with persistent or recurrent pneumonia. FB is indicated for children with recurrent or persistent pneumonia where the underlying diagnosis remains unclear even after non-invasive diagnostic tests.Publication Metadata only Comparison of Conventional Pulmonary Rehabilitation and High-Frequency Chest Wall Oscillation In Primary Ciliary Dyskinesia(WILEY-BLACKWELL, 2014) KARADAĞ, BÜLENT TANER; Gokdemir, Yasemin; Karadag-Saygi, Evrim; Erdem, Ela; Bayindir, Ozun; Ersu, Refika; Karadag, Bulent; Sekban, Nimet; Akyuz, Gulseren; Karakoc, FaziletBackgroundEnhancement of mucociliary clearance by pulmonary rehabilitation (PR) is advocated in primary ciliary dyskinesia (PCD). Our primary aim was to compare the efficacy and safety of postural drainage, percussion and vibration [conventional PR (CPR)], and high frequency chest wall oscillation (HFCWO) by studying change in pulmonary function. Our secondary aim was to evaluate patient preferences regarding the two methods. MethodsThis was a controlled randomized crossover study. PCD patients between the ages of 7 and 18 years were assigned to two groups, first group performed airway clearance with CPR at hospital for 5 days and after a 2-day washout period HFCWO was applied to the same group at home. HFCWO was applied first to the other group and then these patients were hospitalized for CPR. The primary outcome measure of the study was pulmonary function test (PFT). The secondary outcomes were pulse arterial oxygen saturation (SpO(2)) and the perceived efficiency and comfort level. ResultsPFT values of patients increased significantly after both PR methods (before/after): CPR: FVC: 77.014.1/81.8 +/- 13.0 (P=0.002); FEV1: 72.9 +/- 14.8/78.7 +/- 13.5 (P=0.001); PEF: 73.8 +/- 14.5/82.5 +/- 14.5 (P=0.001); FEF25-75: 68.6 +/- 27.6/74.9 +/- 29.3 (P=0.007). HFCWO: FVC: 75.1 +/- 15.3/80.3 +/- 13.9 (P=0.002); FEV1: 71.4 +/- 16/77.4 +/- 14.6 (P=0.001); PEF: 70.9 +/- 18.0/78.3 +/- 17.7 (P=0.002); FEF25-75: 70.5 +/- 23.4/76.4 +/- 25.6 (P=0.006). There were no significant differences in % predicted FVC, FEV1, PEF, and FEF25-75 increased values with CPR and HFCWO. HFCWO was found more comfortable (P=0.04). Two PR methods were found efficient and no desaturation occurred during PR. ConclusionsPFTs were significantly increased after both PR methods. There were no differences in PFTs and SpO(2) between the CPR and HFCWO groups. Both PR methods were found efficient. HFCWO was found more comfortable. HFCWO may be an option in patients with chronic pulmonary disease and low adherence to PR. Pediatr Pulmonol. 2014; 49:611-616. (c) 2013 Wiley Periodicals, Inc.Publication Metadata only Flexible bronchoscopy as a valuable tool in the evaluation of persistent wheezing in children(ELSEVIER IRELAND LTD, 2009) KARADAĞ, BÜLENT TANER; Cakir, Erkan; Ersu, Refika Hamutcu; Uyan, Zeynep Seda; Oktem, Sedat; Karadag, Bulent; Yapar, Okan; Pamukcu, Ozge; Karakoc, Fazilet; Dagli, ElifBackground: Persistent wheezing is a common problem in early childhood and leads to a diagnostic dilemma, excessive investigations, drug administration and additional cost. Objective: To determine the efficacy and the safety of FOB in children with persistent wheezing despite bronchodilator and inhaled steroid therapy. Methods: Patients with persistent wheezing that lasted at least 6 weeks and did not respond to bronchodilator and inhaled steroid therapy and to whom flexible bronchoscopy was performed were included to the study. Results: Between 1997 and 2009; 113 patients were enrolled to the study. Sixty-three percent of the children were male. Median age was 14 months at presentation and median duration of symptoms was 5 months. Bronchoscopy revealed pathological findings in 48% of the patients. Thirty-eight patients had malacia disorders, 14 had foreign body aspiration and two had external compression of airways which were later diagnosed as vascular ring. Major and minor complications were not seen in 92% of the patients while transient hypoxia was seen in 6%, stridor in 1% and tachycardia in 1% of the patients. Conclusion: Flexible bronchoscopy provided rapid and definitive diagnosis for our patients with persistent wheezing without any major complications. This study is one of the largest studies concerning persistent wheezing. Early bronchoscopic evaluation can reduce cost by providing rapid and accurate diagnosis and preventing unnecessary investigations and drug administration. Flexible bronchoscopy is a safe procedure and should be considered in the evaluation of children with persistent wheezing. (C) 2009 Elsevier Ireland Ltd. All rights reserved.Publication Metadata only Caregiver burden in children with cystic fibrosis and primary ciliary dyskinesia(WILEY, 2019) KARADAĞ, BÜLENT TANER; Coskun, Ozge Kenis; Atalay, Kardelen Gencer; Erdem, Ela; Karadag-Saygi, Evrim; Gokdemir, Yasemin; Karadag, BulentIntroduction Caregiver burden impacts both the social and economic framework of society. Cystic fibrosis (CF) causes significant caregiver burden, but the current data is scarce. In the case of primary ciliary dyskinesia (PCD), even less is known. This study aims to compare the caregiver burden of the parents of patients with CF and PCD. Methods Patients with CF and PCD between the ages of 6 to 13 and their parents were included. Patients' clinical information and parents' demographics were recorded. Caregiver burden was measured with Zarit Caregiver Burden Scale (ZCB), while the quality of life (QOL) was measured with CFQOL-revised (CFQOL-R) and PCD QOL questionnaire as the patients' age and diagnosis indicated. Results A total of 63 patients, 44 with CF (69%) and 85 caregivers (35 mothers, 6 fathers, and 22 mother-father dyads) participated in the study. Caregiver burden was significantly higher in mothers of the CF group with a mean ZCB of 30.5 +/- 10.7 when compared to the PCD group with a mean ZCB of 21.93 +/- 8.26 (P = .006). This was similar in fathers with mean ZCB of 27.5 +/- 9.21 in the CF group and 20.36 +/- 7.43 in the PCD group (P = .03). In correlation analyses, mothers' caregiver burden moderately and inversely correlated with CFQOL-R subscales in the CF population. Conclusion Caregiver burden is significantly higher in the CF population when compared to PCD. It is correlated with pulmonary functions and QOL in patients with CF.Publication Metadata only Mucoid impaction: An unusual form of allergic bronchopulmonary aspergillosis in a patient with cystic fibrosis(WILEY-LISS, 2006) KARADAĞ, BÜLENT TANER; Cakir, E.; Uyan, Z. S.; Hamutcu Ersu, R.; Karadag, B.; Karakoc, F.; Dagli, E.We reported a child with cystic fibrosis (CF) who developed mucoid impaction related to allergic bronchopulmonary aspergillosis (ABPA). This is the first reported case of mucoid impaction related to ABPA in CF described to date in the literature. The case was successfully treated by corticosteroids and itraconazole therapy, but relapsed 6 months later. During exacerbation therapy, cataract formation complicated the corticosteroid treatment. We want to emphasize that 6-months therapy may be inadequate for the treatment of ABPA, and it is important to monitor for possible complications of corticosteroids therapy.Publication Metadata only Prevalence of sleep-disordered breathing and associated risk factors in primary school children in urban and rural environments(SPRINGER HEIDELBERG, 2021) KARADAĞ, BÜLENT TANER; Gokdemir, Yasemin; Civelek, Ersoy; Cakir, Banu; Demir, Ahmet; Kocabas, Can Naci; Ikizoglu, Nilay Bas; Karakoc, Fazilet; Karadag, Bulent; Ersu, RefikaIntroduction Sleep-disordered breathing (SDB) in primary school children is a significant problem, yet its prevalence is not well known outside large urban settings. Information on the burden and risk factors of SDB in children could be used to improve resource allocation when providing care across a large country. The objectives of this study were to assess the prevalence of SDB among school-aged children comparing rural and urban settings, and to investigate associated risk factors. Methods In this cross-sectional study, a random sample of primary school students in Turkey were selected from urban and rural areas and data were collected using the Pediatric Sleep Questionnaire, asthma, and allergic rhinitis questionnaires completed by the parents. Results Questionnaires were collected from a total of 139 schools from 58 provinces. A total of 11,013 students were contacted, and 9045 (73%) completed the study. There was no difference in the prevalence of SDB between rural and urban settings (16% vs. 15%,p = 0.612). Multivariate logistic regression analysis revealed that current wheezing, current rhinoconjunctivitis, being overweight, parental snoring, and current mold at home were significant risk factors for SDB in both rural and urban children. Current tobacco smoke exposure (OR = 1.48, 95%CI = 1.19-1.85), near roadway air pollution exposure (OR = 1.40, 95%CI = 1.108-1.791), and mold at home in the first year of life (OR = 1.68, 95%CI = 1.26-2.23) were associated with SDB in urban children. History of maternal/paternal adenotonsillectomy was a significant predictor of SDB in the rural setting (OR = 1.63, 95%CI = 1.12-2.39). Conclusion The prevalence of SDB is high in children living in both settings but associated risk factors may vary. Children residing in rural areas should also be screened for sleep-disordered breathing during routine health visits.