Person: KIYAN, GÜRSU
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KIYAN
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GÜRSU
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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 Metadata only Efficacy of standardized tracheostomy training with a simulation model for healthcare providers: A study by ISPAT team(WILEY) ERDEM ERALP, ELA; Uyan, Zeynep S.; Atag, Emine; Ergenekon, Almala P.; Gokdemir, Yasemin; Gokler, Ozan; Ay, Pinar; Ikizoglu, Nilay Bas; Cenk, Muruvvet; Eralp, Ela Erdem; Sivrikaya, Ulufer; Girit, Saniye; Cakir, Erkan; Kilic, Ayse A.; Yazan, Hakan; Oksay, Sinem Can; Hepkaya, Evrim; Kiyan, Gursu; Karadag, Bulent; Karakoc, Fazilet; Oktem, SedatIntroduction Tracheostomy care in children may be challenging, due to lack of knowledge of healthcare providers (HCPs). The aim of this study was to determine the level of knowledge of HCP who follow patients with tracheostomy and to increase this level with theoretical training and training in a simulation laboratory. Materials and Methods ISPAT (IStanbul PAediatric Tracheostomy), a multidisciplinary team for tracheostomy care was established and a training program was prepared. Participants were subjected to theoretical and practical pretests which evaluated their knowledge levels and skills for care, follow-up, and treatment of a patient with tracheostomy. After the theoretical and practical training given to the participants with a simulation model, theoretical and practical posttests were applied. Results Fifty-one HCP from nine tertiary pediatric clinics in Istanbul were enrolled in the training program. Only six (11.8%) of them had received standardized training programs previously. Regarding the theoretical tests, seven of the 33 questions were indicated as essential. The knowledge level of the participants based on the essential questions significantly increased after the training (p < 0.05 for all of the essential questions). The total number of correct answers and correct answers of three subheadings also significantly increased after the practical training (p < 0.001 for all). Ninety-five percent of the participants assessed the course as good or excellent in general. Conclusion Training in a simulation laboratory in combination with theoretical education can improve the knowledge and skills of the HCP enabling improved care of children with a tracheostomy.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 Pediatric flexible bronchoscopy in the intensive care unit: A multicenter study(WILEY, 2021) ERGENEKON, ALMALA PINAR; Atag, Emine; Unal, Fusun; Yazan, Hakan; Girit, Saniye; Uyan, Zeynep Seda; Ergenekon, Almala Pinar; Yayla, Esra; Mertturk, Edanur; Telhan, Leyla; Meral, Ozge; Kucuk, Hanife Busra; Gunduz, Mehmet; Gokdemir, Yasemin; Eralp, Ela Erdem; Kiyan, Gursu; Cakir, Erkan; Ersu, Refika; Karakoc, Fazilet; Oktem, SedatIntroduction Flexible bronchoscopy (FB) is frequently used for assessment and treatment of patients with respiratory diseases. Our aim was to investigate the contribution of FB to diagnosis and therapy in children admitted to the intensive care units (ICU) and to evaluate the safety of FB in this vulnerable population. Methods Children less than 18 years of age who underwent FB in the five neonatal and pediatric ICUs in Istanbul between July 1st, 2015 and July 1st, 2020 were included to the study. Demographic and clinical data including bronchoscopy indications, findings, complications, and the contribution of bronchoscopy to the management were retrospectively reviewed. Results One hundred and ninety-six patients were included to the study. The median age was 5 months (range 0.3-205 months). The most common indication of FB was extubation failure (38.3%), followed by suspected airway disease. Bronchoscopic assessments revealed at least one abnormality in 90.8% patients. The most common findings were airway malacia and the presence of excessive airway secretions (47.4% and 35.7%, respectively). Positive contribution of FB was identified in 87.2% of the patients. FB had greater than 1 positive contribution in 138 patients and 80.6% of the patients received a new diagnosis. Medical therapy was modified after the procedure in 39.8% and surgical interventions were pursued in 40% of the patients. Therapeutic lavage was achieved in 18.9%. There were no major complications. Conclusion Flexible bronchoscopy is a valuable diagnostic and therapeutic tool in neonatal and pediatric ICUs and is not associated with major complications.Publication Open Access An adolescent with idiopathic pleuroparenchymal fibroelastosis. Case report(SOC ARGENTINA PEDIATRIA, 2018-02-01) KARADAĞ, BÜLENT TANER; Atag, Emine; Ikizoglu, Nilay Bas; Gokdemir, Yasemin; Eralp, Ela Erdem; Kiyan, Gursu; Yilmazbayhan, Dilek; Karadag, BulentIdiopathic pleuroparenchymal fibroelastosis (IPPFE) is a rare disorder recently included in rare idiopathic interstitial pneumonias according to the updated American Thoracic Society/European Respiratory Society classification. IPPFE is characterized by pleural and subpleural parenchymal fibrosis causing volume loss predominantly in the upper lung lobes. Age of onset is variable, IPPFE mainly occurs in third and fourth decades. We present a 16 year old patient with a 2-year history of exertional dyspnea, nonproductive cough and weight loss. On physical examination, auscultation revealed diminished breath sounds on the upper lobes. Chest radiograph showed apical pleural thickening and volume loss. Computerized tomographic scan (CT) of chest revealed ground glass densities and tubular bronchiectasis predominantly in upper lobes bilaterally, with interlobular septal thickening of the pleura and enlarged mediastinal lymph nodes. Thoracoscopic lung biopsy was performed and histological evaluation showed subpleural fibrosis and elastic staining demonstrated fragmented elastic fiber deposition in the subpleural area and adjacent pulmonary parenchyma suggesting IPPFE. To our knowledge this is the first case in childhood. Therefore, pediatricians should be aware of this disease for the diagnosis and appropriate management.