Person: GÖKDEMİR, YASEMİN
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GÖKDEMİR
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YASEMİN
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Publication Metadata only Health-related quality of life in patients with bronchiolitis obliterans(WILEY, 2020) KARADAĞ, BÜLENT TANER; Atag, Emine; Ikizoglu, Nilay Bas; Ergenekon, Pinar; Kalin, Sevinc; Unal, Fusun; Gokdemir, Yasemin; Eralp, Ela Erdem; Yalcin, Koray; Oktem, Sedat; Ersu, Refika; Karakoc, Fazilet; Karadag, BulentIntroduction Bronchiolitis obliterans (BO) is mainly caused by infections and hematopoietic stem cell transplantation (HSCT). This study aimed to investigate the health-related quality of life (HRQOL) of children with BO compared to the healthy children and also to assess the HRQOL according to the etiology. Methods Postinfectious (group 1) and post-HSCT BO (group 2) patients and healthy children were included in the study. HRQOL was assessed by the Short Form-36 (SF-36) and St George's Respiratory Questionnaire (SGRQ). Correlations between demographic and clinical characteristics, pulmonary function tests, high-resolution chest tomography scores, and HRQOL were assessed. Results Thirty-seven postinfectious and post-HSCT BO patients and 34 healthy children were included in the study. Mean age was 13.8 +/- 0.7 years. Mean forced vital capacity and forced expiratory volume(1)were 60.7 +/- 2.7% predicted, and 49.8 +/- 3.1% predicted, respectively. The SF-36 scores were lower in BO patients compared to healthy children (P < .01). Patients with better lung functions had higher SF-36 scores, but lower SGRQ. The number of inhaled therapies, acute exacerbations, hospitalizations were inversely correlated with SF-36. A positive correlation was found between these parameters and total SGRQ scores (r = .507,P = .02;r = .409,P = .12;r = .326,P = .049, respectively). SF-36 scores were better in group 1 for subscales of physical role functioning and social role functioning compared to group 2. (P = .01,P = .01, respectively). Conclusion The HRQOL of patients with BO measured by SF-36 was low compared to healthy children. SF-36 scores were more affected in post-HSCT BO patients. HRQOL of children with chronic lung disease should be taken into consideration in the management of these patients.Publication Metadata only Comparison of intravenous and non-intravenous antibiotic regimens in eradication of P. aeruginosa and MRSA in cystic fibrosis(WILEY, 2021-12) KARAHASAN, AYŞEGÜL; Mursaloglu, H. Hakan; Akin, Can; Yegit, Cansu Yilmaz; Ergenekon, Almala P.; Uzunoglu, Burcu Suzer; Tastan, Gamze; Gokdemir, Yasemin; Eralp, Ela Erdem; Yagci, Aysegul Karahasan; Karakoc, Fazilet; Karadag, BulentBackground Chronic pulmonary infection is the leading cause of mortality and morbidity in patients with cystic fibrosis (CF). The most common pathogens isolated in CF are Staphylococcus aureus (SA) and Pseudomonas aeruginosa (PA). Chronic infection of PA and methicillin-resistant S. aureus (MRSA) are associated with worse survival and antibiotic eradication treatment is recommended for both. This study compared the outcomes between intravenous (IV) and non-IV antibiotics in eradication of PA and MRSA. Methods This was a single-center retrospective study. All respiratory specimen cultures of 309 CF patients and eradication regimens between 2015 and 2019 were reviewed. Patients received eradication treatment in case of first ever isolation or new isolation after being infection-free >= 1 year. The primary analysis was the comparison of the percentage of successful eradication after receiving IV and non-IV eradication regimens. Demographic and clinical risk factors for eradication failure were also analyzed. Results One hundred and two patients with PA isolations and 48 patients with MRSA were analyzed. At 1 year, 21.6% in PA group and 35.4% in MRSA group were successfully eradicated. There was not any statistically significant difference between IV versus non-IV antibiotic regimens on eradication in either group. Additionally, none of the clinical risk factors was significantly associated with eradication failure in PA and MRSA groups. Conclusion In the eradication of PA and MRSA, IV and non-IV treatment regimens did not show any superiority to one another. Non-parenteral eradication could be a better option considering the cost-effectiveness and the treatment burden of IV treatments due to hospitalization and the need for IV access.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 Open Access An unusual case of childhood sarcoidosis(SOC ARGENTINA PEDIATRIA, 2013-10-01) KARADAĞ, BÜLENT TANER; Gokdemir, Yasemin; Ersu, Refika; Karadag, Bulent; Karakoc, Fazilet; Kiyan, Gursu; Kaya, Handan; Kasapcopur, Ozgur; Erdem, Ela; Dagli, ElifSarcoidosis is a systemic granulomatous disease of unknown etiology that may affect many systems, mainly lungs. Most of the patients present at stages I and II lung involvement. Pulmonary infiltrates without hilar lymphadenopathy (state III) rarely occurs. Extrapulmonary organ involvement is common in pediatric sarcoidosis. The aim of this report is to present an unusual case of childhood sarcoidosis with stage III lung involvement without any extrapulmonary organ involvement. A 7-year-old girl presented with the complaints of malaise, fatigue, weight loss and dyspnea. There was patchy, bilateral ground glass view at high resolution computer tomography. Video assisted thoracoscopic lung biopsy was performed and histopathological examination showed nonnecrotising epitheloid-cell granulomas with giant cells. She did not have any hilar or extrapulmonary organ involvement and pulmonary sarcoidosis at stage III was diagnosed. Sarcoidosis should be considered in the differential diagnosis of children with interstitial lung disease.Publication Open Access COVID-19 disease characteristics in different pediatric age groups(2022-01-01) ŞENYÜREK, BETÜL; BORAN, PERRAN; KEPENEKLİ KADAYİFCİ, EDA; YAKUT, NURHAYAT; KARAHASAN, AYŞEGÜL; AYDINER, ELİF; MEMİŞOĞLU, ASLI; GÖKDEMİR, YASEMİN; ERDEM ERALP, ELA; KARADAĞ, BÜLENT TANER; KEPENEKLİ KADAYİFCİ E., YAKUT N., Ergenc Z., Aydiner O., Sarinoglu R. C., KARAHASAN A., Karakoc-Aydiner E., MEMİŞOĞLU A., GÖKDEMİR Y., ERDEM ERALP E., et al.Introduction: Little is known about the COVID-19 disease characteristics and differences between different pediatric age groups. This study aimed to investigate the disease characteristics according to age groups. Methodology: We conducted a retrospective, single-center study of pediatric COVID-19 in a tertiary care hospital in Turkey. The patients were divided into three groups: 15 days-24 months old (Group 1), 25-144 months old (Group 2), and 145-210 months old (Group 3) according to age. Results: A total of 139 pediatric patients with COVID-19 were examined. Twenty-nine patients (20.9%) were in Group 1, 52 (37.4%) were in Group 2, 58 (41.7%) were in Group 3. Thirty-nine patients (28.1%) were hospitalized. The most common symptoms were cough (55.4%) and fever (51.8%). The median chest X-ray (CXR) score of hospitalized patients was 1 (min 0-max 7), and the median CXR score of outpatients was 1 (min 0-max 6). Fever was significantly more frequent in Group 1, and chest pain was more frequent in Group 3. Group 1 had significantly higher WBC, lymphocyte, thrombocyte counts, AST, LDH, D-dimer, and Troponin T levels but lower hemoglobin, total protein, and albumin levels. The treatment included antibiotics, oseltamivir, hydroxychloroquine, and supportive therapy. Only one patient (0.7%) received noninvasive mechanical ventilatory support. Conclusions: As we know the clinical course of COVID-19 in children is less severe than in adults. We also found significant differences in both clinical and laboratory findings between different pediatric age groups which supports the theory that disease pathogenesis is highly variable according to age.Publication Metadata only Flexible bronchoscopy as a valuable tool in the evaluation of infants with stridor(SPRINGER, 2013) KARADAĞ, BÜLENT TANER; Erdem, Ela; Gokdemir, Yasemin; Unal, Fusun; Ersu, Refika; Karadag, Bulent; Karakoc, FaziletThe aim is to determine clinical characteristics, flexible bronchoscopy (FB) findings including associated airway abnormalities and other conditions, treatment modalities and long term follow-up of children with congenital stridor. Medical records of children, who underwent FB for the evaluation of stridor between 1 January 2004 and 31 December 2009 were retrospectively reviewed. Demographic characteristics, symptoms and physical examination findings at presentation, FB findings, follow-up data including the time to resolution of symptoms and treatment modalities, presence of associated conditions were assessed. 109 children were enrolled to the study. Laryngomalacia was the most common etiology for stridor. Laryngomalacia was isolated in 37 patients and 54 patients had secondary airway lesions (SALs). Diagnoses other than laryngomalacia such as subglottic hemangioma, subglottic web, isolated tracheomalacia were found in 18 patients. In 90 % of patients, stridor resolved before 3 years of age without any surgical intervention and there was no significant difference in terms of the persistence of stridor between patients with isolated laryngomalacia and associated SALs. Duration of stridor was significantly longer in both patients with neurological abnormalities and reflux symptoms. Surgical procedure was performed in 19 of the patients. There is a high incidence of SALs in patients with laryngomalacia. FB is helpful for identifying anomalies requiring surgical treatment.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 Metadata only Long-term respiratory outcomes of post-op congenital lung malformations(WILEY, 2021) KARADAĞ, BÜLENT TANER; Dincel, Alican; Yilmaz Yegit, Cansu; Ergenekon, Almala Pinar; Erdem Eralp, Ela; Gokdemir, Yasemin; Kiyan, Gursu; Karadag, BulentBackground Congenital lung malformations (CLM) are rare disorders and surgical intervention is the definitive treatment. Our aim is to evaluate the long-term lung function of patients with CLM after surgery compared to healthy children. Methods Sixteen children with CLM (M/F: 9/7) and 30 age-matched, healthy controls (M/F: 13/17) were included in the study. Demographic data were recorded and both groups were compared by spirometry and the nitrogen-based Lung Clearance Index (LCI). Results Mean +/- SD age of the patients was 12.0 +/- 5.4 years. The mean forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and forced expiratory flow between 25% and 75% of force expiration (FEF25-75) predicted was, 86.68 +/- 16.65, 88.00 +/- 14.58, 97.44 +/- 9.89, and 79.00 +/- 26.41, respectively in the patient group. Patients with CLM had significantly lower values in FEV1, FVC, FEF25-75 than healthy controls (P = 0.002, P 0.007, P 0.045). While the mean LCI2,5% value in patients' group was 8.33 +/- 1.52, it was 7.28 +/- 0.80 in healthy controls (P = 0.023). Strong inverse correlation between LCI and FEV1, FEV1/FVC was detected in the patient group (P = 0.023; r: -0.581, P 0.017; r: -0.606 respectively). Conclusion This study revealed that, in long-term follow-up, patients who had surgery because of CLM have impairment in the pulmonary function compared to healthy children and LCI may be more accurate in detecting airway diseases early than spirometry.Publication Metadata only Comparison of conventional chest physiotherapy and oscillatory positive expiratory pressure therapy in primary ciliary dyskinesia(WILEY, 2020) KARADAĞ, BÜLENT TANER; Bingol, Ibrahim; Gokdemir, Yasemin; Yilmaz-Yegit, Cansu; Ergenekon, Pinar; Atag, Emine; Bas Ikizoglu, Nilay; Erdem Eralp, Ela; Evkaya, Ayca; Gencer, Kardelen; Saygi, Evrim K.; Karakoc, Fazilet; Ersu, Refika; Karadag, BulentBackground Chest physiotherapy (CP) is a recommended treatment modality in primary ciliary dyskinesia (PCD). Objective Primary aim was to compare the efficacy and safety of the conventional chest physiotherapy (CCP) and oscillatory positive expiratory pressure therapy (OPEPT). Secondary aims were to compare the exacerbation rate, time until the first exacerbation, patient compliance and comfort between the two CP methods. Methods This is a 6 month randomized, controlled crossover trial. Patients >6 years of age with PCD were randomized into two groups, first group was assigned to OPEPT (Acapella (R)) for 3 months while second group was assigned to CCP. Groups were crossed over to the other modality after a 15-day washout period. Pulmonary function tests (PFTs) and compliance were monitored by monthly clinic visits. Results There was a significant increase in FEV1, FEF25-75, and PEF values (p = .018,p = .020, andp = .016, respectively) in the OPEPT group and in FVC values (p = .007) in CCP group compared to baseline. However PFT increase at 3rd month was not superior to each other with both physiotherapy methods. Median acute pulmonary exacerbation rate and time period until the first exacerbation were similar in both groups (p = .821,p = .092, respectively). Comfort and effectiveness of OPEPT was higher than CCP according to patients (p = .029 andp = .042, respectively). There were no adverse effects with either therapy. Conclusions OPEPT was as effective as CCP in PCD patients. OPEPT was more comfortable and effective than CCP according to patients. OPEPT might be an efficient alternative method for airway cleareance in PCD patients.Publication Metadata only Other risk factors associated with mortality in moderate and severe cystic fibrosis patients(TURKISH PEDIATRICS ASSOC, 2012-12-15) KARADAĞ, BÜLENT TANER; Gokdemir, Yasemin; Erdem, Ela; Akpinar, Ihsan Nuri; Ersu, Refika; Karadag, Bulent; Karakoc, FaziletAim: Severe pulmonary disease is responsible for over 80% of deaths associated with cystic fibrosis. Our aim was to evaluate the other risk factors associated with mortality in patients with cystic fibrosis who have moderate and severe lung disease. Material and Method: Among 200 patients with cystic fibrosis who were followed up in our clinic, 35 patients with moderate and severe lung disease (%FEV1 predicted <= 60) were included in the study. Demographic data, pulmonary function tests, high resolution thorax tomography, modified Bhalla score, blood gas analysis and nutritional status of the patients were evaluated. Results: Requirement for respiratory support was 31.4% in moderate and severe lung disease. Lower pulmonary function, requirement for non invasive ventilation, presence of diabetes mellitus, a SaO(2) value of <95, a value of pCO(2) >50 mm Hg and requirement for frequent IV antibiotics were significantly related with increased mortality. Conclusions: This is a single centre study conducted in patients with cystic fibrosis who had moderate and severe lung disease and who had not received lung transplantation. We evaluated the clinical outcome and other factors that were associated with mortality. (Turk Arch Ped 2012; 47:267-71)