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GÖKDEMİR, YASEMİN

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Author: YILMAZ YEĞİT, CANSU × Subject: Klinik Tıp (MED) ×

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Now showing 1 - 5 of 5
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    PublicationOpen Access
    Improvements in body mass index of children with cystic fibrosis following implementation of a standardized nutritional algorithm: A quality improvement project
    (2023-03-01) GÖKDEMİR, YASEMİN; ERDEM ERALP, ELA; ERGENEKON, ALMALA PINAR; YILMAZ YEĞİT, CANSU; KARADAĞ, BÜLENT TANER; GÖKDEMİR Y., ERDEM ERALP E., ERGENEKON A. P., YILMAZ YEĞİT C., Yanaz M., Mursaloglu H., Uzunoglu B., Kocamaz D., Tastan G., Filbrun A., et al.
    BackgroundA collaboration between the University of Michigan (UM) Cystic Fibrosis Center (CFC) and Marmara University (MU) CFC was initiated in MU through conducting Quality Improvement projects (QIP). The global aim was to improve nutritional status of children with CF (cwCF), with a specific aim to increase the mean BMI percentile (BMIp) for cwCF by 10 percentile points in 12 months. MethodsBody mass index (BMI) percentiles of cwCF were categorized as: nutritionally adequate (BMIp >= 50%); at risk (BMIp 25%-49%); urgently at risk (BMIp 10%-25%); critically at risk (BMIp < 10%). Appropriate interventions were made according to BMIp category every three months. Forced expiratory volume in one-second percent predicted (FEV1pp), and health-related quality of life (HRQoL) were evaluated. ResultsOne hundred and eight-two cwCF with a mean age of 9.1 +/- 4.3 years were included in the project. Baseline BMIp increased from 25.6 to 37.2 at the 12th month (p < 0.001). In the critically at-risk group BMIp increased from 3.6 to 20.5 (p < 0.001), in the urgently at risk group from 15.9 to 30.8 (p < 0.001), in the at risk group from 37.0 to 44.2 (p < 0.079) and in the nutritionally adequate group the increase was from 66.8 to 69.5 (p < 0.301). FEV1pp also improved significantly, from 81.3 +/- 20.6 to 85.9 +/- 20.8 (p < 0.001). Physical functioning, eating problems, and respiratory symptoms domains of the HRQoL evaluation improved (p < 0.05). ConclusionThis project has led to significant improvements in BMIp, FEV1pp and HRQoL of cwCF; similar projects could easily be implemented by centers in other developing countries.
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    PublicationOpen Access
    Depression, anxiety, and sleep quality of caregivers of children with spinal muscular atrophy
    (2023-03-01) ERGENEKON, ALMALA PINAR; YILMAZ YEĞİT, CANSU; SELÇUK, MERVE; KARABULUT, ŞEYDA; ÖZTÜRK THOMAS, GÜLTEN; ERDEM ERALP, ELA; ÜNVER, OLCAY; KARADAĞ, BÜLENT TANER; GÖKDEMİR, YASEMİN; ERGENEKON A. P., Gumus Z., YILMAZ YEĞİT C., Cenk M., Gulieva A., Kalyoncu M., SELÇUK M., KARABULUT Ş., ÖZTÜRK G., ERDEM ERALP E., et al.
    BackgroundThe aim of this study was to evaluate the prevalence of anxiety, depression, sleep, and associated factors in caregivers of children with spinal muscular atrophy (SMA). Materials and MethodsBeck Depression Inventory (BDI), the State-Trait Anxiety Inventory-State (STAI-S), the State-Trait Anxiety Inventory-Trait (STAI-T), and Pittsburgh Sleep Quality Index (PSQI) were used to assess the anxiety, depression, and sleep quality of the caregivers of children with SMA. Higher scores indicated worse outcome for all three questionnaires. ResultsFifty-six caregivers of children with SMA were included in the study. Median age of children was 6 (3.2-10) years and mean age of the caregivers was 37.0 +/- 6.5 years. Median scores of the BDI, STAI-S, STAI-T, and PSQI were 12 (7.2-17), 35.5 (31-44), 40.5 (35-48), and 7.0 (5.0-10.0), respectively. There was a positive correlation between BDI and PSQI scores (p < 0.05). There was a negative correlation between the age of the caregivers and PSQI, BDI, STAI-T scores (p = 0.01, r = -0.341; p = 0.006, r = -0.364; p = 0.003, r = -0.395, respectively). There was a negative correlation between the age of the patients and the PSQI scores of the caregivers (p = 0.01, r = -0.33). There was a negative correlation between BDI scores and household income (p = 0.01, r = -0.34). ConclusionCaregivers of children with SMA had elevated depression and anxiety levels and they also had decreased sleep quality. Economic and social support resources are needed to help caregivers of those children.
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    PublicationMetadata only
    The utility of risk assessment tools for acute pulmonary embolism in children
    (2022-09-01) ERGENEKON, ALMALA PINAR; YILMAZ YEĞİT, CANSU; SELÇUK, MERVE; TRUE, ÖMER; ERDEM ERALP, ELA; GÖKDEMİR, YASEMİN; KARADAĞ, BÜLENT TANER; ERGENEKON A. P. , YILMAZ YEĞİT C., Cenk M., Gulieva A., Kalyoncu M., SELÇUK M., DOĞRU Ö., ERDEM ERALP E., GÖKDEMİR Y., Karakoc F., et al.
    Background and Aim Pulmonary embolism (PE) is a potentially life-threatening disease in children. The objective of the study is to evaluate the utility of adult-based pulmonary embolism rule-out criteria (PERC), Pediatric PE Model, and D-dimer in the diagnosis of PE in children. Material and Methods The study consisted of patients under 18 years of age who were consulted to the Pediatric Pulmonology Clinic for the evaluation of PE. Patients were divided into two groups based on the confirmation of PE. The group with the presence of PE (n = 20) consisted of children who were diagnosed with PE. The group with the absence of PE (n = 28) consisted of children with clinically suspected PE but negative diagnostic imaging. Adult validated clinical decision PERC rule and Pediatric PE Model were retrospectively applied to the patients. Results In the study, PERC demonstrated a sensitivity of 60% and a specificity of 46% for the diagnosis of PE in children. When PE Model was evaluated for the children, it was found a 50% sensitivity and 75% specificity. Combining PE Model and PERC rule with D-dimer did not increase the specificity and sensitivity. Smoking was found to be relevant for PE in the childhood. Twenty-five percent of the patients had a genetic tendency for PE. All of the patients had an underlying disease as well. Conclusion None of the current risk assessment tools (PE Model, PERC, D-dimer) were found to be accurate in predicting PE. Further larger population studies are still required to develop a better diagnostic approach.
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    PublicationOpen Access
    Çocuklarda fleksibl bronkoskopi- marmara çocuk göğüs hastalıkları deneyimi
    (2022-05-01) ERGENEKON, ALMALA PINAR; ŞAHİN, ECENUR; YILMAZ YEĞİT, CANSU; ERDEM ERALP, ELA; GÖKDEMİR, YASEMİN; KARADAĞ, BÜLENT TANER; Ergenekon A. P., Şahin E., Yılmaz Yeğit C., Yanaz M., Guliyeva A., Kalyoncu M., Selçuk M., Erdem Eralp E., Gökdemir Y., Karadağ B. T.
    Amaç: Fleksibl bronkoskopinin pediatrik hastalarda tanı ve/veya tedavi amaçlı kullanımı yeni endikasyon alanlarıyla son yıllarda oldukça artış göstermiştir. Bu çalışmada amacımız Çocuk Göğüs Hastalıkları kliniğimizde 5 yıllık sürede gerçekleştirdiğimiz 732 fleksibl bronkoskopi işlemi ile ilgili deneyimimizi sunmaktır. Gereç ve Yöntem: 2016-2021 yılları arasında fleksibl bronkoskopi işlemi uygulanan 18 yaş altı çocuklar çalışmaya dahil edildi. Hastaların tıbbi kayıtları incelendi ve demografik özellikleri, bronkoskopi endikasyonları, bronkoskopi bulguları, komplikasyonlar ve bronkoalveoler lavaj sonuçları kayıt edildi. Bulgular: Hastaların ortanca yaşı 5 yıl idi. Fleksibl bronkoskopinin en sık endikasyonu tekrarlayan alt solunum yolu enfeksiyonu (%29,6), ikinci en sık neden kronik öksürük (%16,4) idi. Fleksibl bronkoskopi yapılan hastaların 49’unda (%6,7) immun yetmezlik, 42’sinde (%5,7) malignite mevcuttu. Bronkoskopik değerlendirmeler 250 (%34,2) hastada normal hava yolu anatomisi ortaya koyarken, 482 (%65,8) hastada en az bir patolojik bulgu saptadı. En sık görülen bulgular 268 (%36,6) hastada havayolu sekresyonları artışı ile 66 (%9) hastada bronkomalazi idi. Hastaların 111’inde (%20,8) mikrobiyolojik üreme mevcuttu. Haemophilus influenzae en sık bulunan bakteri idi. Hiçbir hastada majör komplikasyon gözlenmedi. Sonuç: Fleksibl bronkoskopi, tekrarlayan alt solunum yolu enfeksiyonu olan hastalarda bronkoalveoler lavaj kültür sonuçları ile uygun antibiyotik tedavisinin verilebilmesi açısından çok önemlidir. Stridoru olan hastalarda laringomalazi veya ikincil hava yolu lezyonlarının; persistan hışıltı ve kronik öksürüğü olan hastalarda bronkomalazinin kesin tanısı için önemli bir araçtır.
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    PublicationMetadata only
    Nöromusküler hastalık tanılı çocuklarda solunum bulguları ve solunum sisteminin değerlendirilmesinde kullanılan testler
    (Türkiye Klinikleri Yayınevi, 2023-09-01) YILMAZ YEĞİT, CANSU; GÖKDEMİR, YASEMİN; Yılmaz Yeğit C., Gökdemir Y., Karakoc F.
    Nöromusküler hastalık tanılı çocuklar, solunum sistemi komplikasyonları açısıdan oldukça riskli bir gruptur. Morbidite ve mortaliteden de büyük ölçüde solunum sistemi komplikasyonları sorumludur. Solunum kaslarında zayıflık, inefektif öksürük, eşlik edebilen skolyoz ve göğüs deformitesi ve artmış aspirasyon riski gibi pek çok neden solunum fonksiyonlarını olumsuz etkilemektedir. Klinik değerlendirmenin yanında, solunum fonksiyon testleri, uyku çalışmaları ve solunumsal kas gücünün değerlendirildiği testler, riskli hastaların erken belirlenmesi ve gerekli müdahalelerin yapılması açısından oldukça önemlidir. Nöromusküler hastalık tanılı tüm çocuklar, düzenli olarak çocuk göğüs hastalıkları hekimi tarafından takip edilmelidir.