Person: KARADAĞ, BÜLENT TANER
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KARADAĞ
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BÜLENT TANER
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Publication Open Access Respiratory outcome of spinal muscular atrophy type 1 patients treated with nusinersen(2022-01-01) ERGENEKON, ALMALA PINAR; ÖZTÜRK THOMAS, GÜLTEN; ÜNVER, OLCAY; TÜRKDOĞAN, DİLŞAD; KARADAĞ, BÜLENT TANER; ERDEM ERALP, ELA; ERGENEKON A. P., YILMAZ YEĞİT C., Cenk M., GÖKDEMİR Y., ERDEM ERALP E., ÖZTÜRK G., ÜNVER O., Coskun O. K., Saygi E. K., TÜRKDOĞAN D., et al.Background Respiratory failure is the leading cause of mortality in spinal muscular atrophy type 1 (SMA1) children. The current study aims to evaluate the effect of nusinersen treatment on respiratory outcome of the patients with SMA1. Methods In this retrospective, single-center study, 52 SMA1 patients treated with nusinersen were included in the analysis. Patients were divided into two groups based on their age at the time of their first nusinersen treatment (Group 1: 6 months). Respiratory outcome on the 180th day of treatment is defined as the type of ventilation support (spontaneous breathing, noninvasive ventilation (NIV), and tracheostomized or intubated on invasive mechanical ventilation). Demographic data, respiratory outcome, and Children\"s Hospital of Philadelphia Infant Test of Neuromuscular Disorders scores were obtained from medical records. Results On the 180th day of treatment, 46 of the 52 (88.4%) children were alive. Prevalence of the mortality was similar in both groups (P = 0.65). The comparison of respiratory outcome in patients between group 1 and group 2 was as follows: spontaneous breathing, 7 (43.7%) versus 4 (13.3%) (P = 0.03); NIV = 16 h/day. There were significant improvements in Children\"s Hospital of Philadelphia Infant Test of Neuromuscular Disorders scores of the patients at day 180 in comparison with the baseline (P < 0.001). Conclusions Early initiation of nusinersen treatment in SMA1 patients may alter the disease\"s natural course.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 An unusual case of chylothorax complicating childhood tuberculosis(WILEY, 2008) KARADAĞ, BÜLENT TANER; Cakir, Erkan; Gocmen, Basar; Uyan, Zeynep Seda; Oktem, Sedat; Kiyan, Gursu; Karakoc, Fazilet; Ersu, Refika; Karadag, Bulent; Dagli, Tolga; Dagli, ElifEndobronchial tuberculosis (EBTB) and chylothorax are rare clinical disorders. The concurrence of these two disorders as manifestations of childhood pulmonary tuberculosis has not been reported. We report a 4-month-old boy presenting with chylothorax as the initial presentation of tuberculosis that has been successfully treated with octreotide, antituberculosis drugs and steroid therapy.Publication Metadata only Cumulative Antimicrobial Susceptibility Data of Pseudomonas Aeruginosa Isolates from Cystic Fibrosis Patients: 4-Year Experience(GEORG THIEME VERLAG KG, 2021) KARAHASAN, AYŞEGÜL; Fidan, Ebru; Alci, Gamze; Koldas, Seda Sevilay; Gokdemir, Yasemin; Karadag, Bulent; Eralp, Ela Erdem; Yagci, Aysegul KarahasanObjective Pseudomonas aeruginosa is the most important cause of lung infection among cystic fibrosis (CF) patients, and to reduce the severity of the infection, facility-specific cumulative antibiograms could help clinicians in empirical treatment. Methods Respiratory samples of CF patients between January 2015 and December 2018 were scanned through Laboratory Operating System retrospectively. Demographical data of patients, culture results, and antibiotic susceptibilities are recorded using Microsoft Excel 2010. Cumulative antibiogram data were obtained according to the CLSI M39A4 document. Results The number of registered patients has increased in 4 years from 154 to 253. The mean age of patients varied from 9 to 11.7 (range, 2-42). The ratio of patients with a positive culture for P. aeruginosa increased from 32 to 40%, and the mean patients' age decreased from 16.6 to 11.1 (p < 0.05). A total number of 4,146 respiratory samples were analyzed. Sputum samples consisted of 42.5% (n: 1,767) of the samples with a 58.4% isolation rate of P. aeruginosa (n: 1,034). A notable increase of resistance was seen almost all antimicrobials tested by years. The ratio of multidrug-resistant (MDR) P. aeruginosa was 4.1, 10.2, 4.5, and 8.6% in 2015, 2016, 2017, and 2018. Conclusion Antimicrobial resistance is a challenging problem in CF patients, and surveillance should be done regularly.Publication Open Access Prevalence and course of disease after lung resection in primary ciliary dyskinesia: a cohort & nested case-control study(BMC, 2019-12) KARADAĞ, BÜLENT TANER; Kouis, Panayiotis; Goutaki, Myrofora; Halbeisen, Florian S.; Gioti, Ifigeneia; Middleton, Nicos; Amirav, Israel; Barbato, Angelo; Behan, Laura; Boon, Mieke; Emiralioglu, Nagehan; Haarman, Eric G.; Karadag, Bulent; Koerner-Rettberg, Cordula; Lazor, Romain; Loebinger, Michael R.; Maitre, Bernard; Mazurek, Henryk; Morgan, Lucy; Nielsen, Kim Gjerum; Omran, Heymut; Ozcelik, Ugur; Price, Mareike; Pogorzelski, Andrzej; Snijders, Deborah; Thouvenin, Guillaume; Werner, Claudius; Zivkovic, Zorica; Kuehni, Claudia E.; Yiallouros, Panayiotis K.Background Lung resection is a controversial and understudied therapeutic modality in Primary Ciliary Dyskinesia (PCD). We assessed the prevalence of lung resection in PCD across countries and compared disease course in lobectomised and non-lobectomised patients. Methods In the international iPCD cohort, we identified lobectomised and non-lobectomised age and sex-matched PCD patients and compared their characteristics, lung function and BMI cross-sectionally and longitudinally. Results Among 2896 patients in the iPCD cohort, 163 from 20 centers (15 countries) underwent lung resection (5.6%). Among adult patients, prevalence of lung resection was 8.9%, demonstrating wide variation among countries. Compared to the rest of the iPCD cohort, lobectomised patients were more often females, older at diagnosis, and more often had situs solitus. In about half of the cases (45.6%) lung resection was performed before presentation to specialized PCD centers for diagnostic work-up. Compared to controls (n = 197), lobectomised patients had lower FVC z-scores (- 2.41 vs - 1.35, p = 0.0001) and FEV1 z-scores (- 2.79 vs - 1.99, p = 0.003) at their first post-lung resection assessment. After surgery, lung function continued to decline at a faster rate in lobectomised patients compared to controls (FVC z-score slope: - 0.037/year Vs - 0.009/year, p = 0.047 and FEV1 z-score slope: - 0.052/year Vs - 0.033/year, p = 0.235), although difference did not reach statistical significance for FEV1. Within cases, females and patients with multiple lobe resections had lower lung function. Conclusions Prevalence of lung resection in PCD varies widely between countries, is often performed before PCD diagnosis and overall is more frequent in patients with delayed diagnosis. After lung resection, compared to controls most lobectomised patients have poorer and continuing decline of lung function despite lung resection. Further studies benefiting from prospective data collection are needed to confirm these findings.Publication Metadata only Late diagnosis of foreign body aspiration in children with chronic respiratory symptoms(ELSEVIER IRELAND LTD, 2007) KARADAĞ, BÜLENT TANER; Karakoc, F.; Cakir, E.; Ersu, R.; Uyan, Z. S.; Colak, B.; Karadag, B.; Kiyan, G.; Dagli, T.; Dagli, E.Background: Children with undiagnosed and retained foreign bodies (FBs) may present with persistent respiratory symptoms. Delayed diagnosis is an important problem in developing countries and several factors affect the delay. Objectives: To investigate, the incidence of clinically unsuspected foreign body aspiration (FBA) in our flexible bronchoscopy procedures, the causes resulting in late diagnosis of FBA, and the incidence of the complications of FBA according to elapsed time between aspiration and diagnosis. Methods: We reviewed the records of all the patients who underwent flexible bronchoscopy between 1997 and 2004 in our clinic. Patients with FBA were identified and their medical records were reviewed. Results: During the study period, 654 children underwent flexible bronchoscopy; 32 cases (4.8%) of FBA were identified. Median age of patients was 29.5 months at presentation with a median symptomatic period of 3 months. None of the patients had a history of FBA. The most common misdiagnosis was bronchitis. Flexible bronchoscopy was performed to these patients within 1 week following presentation. In 87% of the patients (n = 28), FBs were in organic nature. Patients were followed up for 21.0 months after removal of the FBs. Fifty-three percent (n = 17) of the patients had a complete remission after bronchoscopic removal of the FBs. However, nine (28.8%) patients had chronic respiratory problems and six patients (18.8%) developed bronchiectasis. Conclusions: Atypical or prolonged respiratory symptoms should alert the physician and clinical and radiological findings should be carefully evaluated for a possible FBA. Delay in diagnosis and treatment of FBA should be avoided to prevent complications. (C) 2006 Elsevier Ireland Ltd. All rights reserved.Publication Open Access Key paediatric messages from the 2017 European Respiratory Society International Congress(EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2018-04) KARADAĞ, BÜLENT TANER; Grigg, Jonathan; Barben, Jurg; Everard, Mark L.; Hall, Graham; Karadag, Bulent; Moeller, Alexander; Nenna, Raffaella; Priftis, Kostas N.; Rottier, Robbert J.; Terheggen-Lagro, Suzanne W. J.; Midulla, FabioIn this article, the group chairs of the Paediatric Assembly of the European Respiratory Society (ERS) highlight some of the most interesting findings presented at the 2017 ERS International Congress, which was held in Milan, Italy.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.