Person: KARADAĞ, BÜLENT TANER
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KARADAĞ
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BÜLENT TANER
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Publication Metadata only Evaluation of caregiver burden, somatization and sleep quality in mothers of children with cystic fibrosis(2022-12-08) KARAVUŞ, MELDA; GÖKDEMİR, YASEMİN; ERDEM ERALP, ELA; ERGENEKON, ALMALA PINAR; KARADAĞ, BÜLENT TANER; AYVAZ, İLKNUR; HIDIROĞLU, SEYHAN; Ayvaz İ., Karavuş M., Hıdıroğlu S., Atasoy A., Karagöz D. C. , Baştuğ R. E. , Ladikli Ş. B. , Gökdemir Y., Erdem Eralp E., Ergenekon A. P. , et al.Publication Open 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.Publication Open 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.Publication Metadata 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.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 A qualitative study on awareness, attitudes, behaviors and social adaptation of mothers of children with cystic fibrosis(2023-06-07) AYVAZ, İLKNUR; HIDIROĞLU, SEYHAN; GÖKDEMİR, YASEMİN; ERDEM ERALP, ELA; ERGENEKON, ALMALA PINAR; KARADAĞ, BÜLENT TANER; KARAVUŞ, MELDA; Ayvaz İ., Karavuş M., Hıdıroğlu S., Taşcan D., Atıcı F., Özyıldırım N. Ö., Binatamir R. Y., Gökdemir Y., Erdem Eralp E., Ergenekon A. P., et al.Publication Open Access Parent's report on oral health-related quality of life of children with cystic fibrosis(2022-10-01) PEKER, MEHMET SERTAÇ; GÖKDEMİR, YASEMİN; ERDEM ERALP, ELA; KARADAĞ, BÜLENT TANER; KARGÜL, BETÜL; Sisman H. I. , Peker S., GÖKDEMİR Y., ERDEM ERALP E., KARADAĞ B. T. , KARGÜL B.Background Health-related quality of life (HRQoL) scales are now widely used in children with cystic fibrosis (cwCF) which reflects the course of the disease. In this cross-sectional study, our primary aim was to compare the Pediatric Oral Health-Related Quality of Life (POQL) and Oral Health Score (OHS) between cwCF and healthy group. Our secondary aim was to evaluate the association between Pseudomonas aeruginosa (PA) colonization, pulmonary function test, OHS and POQL in cwCF. Methods The study population (age ranging 6-14) included 55 cwCF followed at the Marmara University Division of Pediatric Pulmonology compared with 50 healthy peers. A survey consisted of general questions (age, sex, etc.) and the POQL instrument were filled by parents. The decayed, missing, and filled teeth for both primary (dft) and permanent dentition (DMFT) was detected according to WHO criteria. Data like current body mass index (BMI z score), colonization status with PA, predicted value for forced expiratory volume in 1 second (FEV1pp), and any hospitalizations during the previous year were obtained from their medical. Differences between the groups were evaluated using Chi-square and Mann-Whitney U test with a significance level set at 0.05. Results There was no significant difference between PA-colonized cwCF and healthy controls in DMFT (p = 0.916). For all domains of POQL (emotional function, social function, role function), scores of cwCF were significantly better than healthy controls (p 0.05). Conclusion Although POQL scores of cwCF were encouraging, dental caries prevention and regular follow-ups should be taken into consideration.Publication Open 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.Publication Open Access The disease-specific clinical trial network for primary ciliary dyskinesia: PCD-CTN(2022-06-01) ERDEM ERALP, ELA; KARADAĞ, BÜLENT TANER; Raidt J., Maitre B., Pennekamp P., Altenburg J., Anagnostopoulou P., Armengot M., Bloemsma L. D. , Boon M., Borrelli M., Brinkmann F., et al.Primary ciliary dyskinesia (PCD) is a rare genetic disorder characterised by impaired mucociliary clearance leading to irreversible lung damage. In contrast to other ram lung diseases like cystic fibrosis (CF), there are only few clinical trials and limited evidence-based treatments. Management is mainly based on expert opinions and treatment is challenging due to a wide range of clinical manifestations and disease severity. To improve clinical and translational research and facilitate development of new treatments, the clinical trial network for PCD (PCD-CTN) was founded in 2020 under the framework of the European Reference Network (ERN)-LUNG PCD Core. Applications from European PCD sites interested in participating in the PCD-CTN were requested. Inclusion criteria consisted of patient numbers, membership of ERN-LUNG PCD Core, use of associated standards of care, experience in PCD and/or CF clinical research, resources to run clinical trials, good clinical practice (GCP) certifications and institutional support. So far, applications from 22 trial sites in 18 European countries have been approved, including >1400 adult and >1600 paediatric individuals with PCD. The PCD-CTN is headed by a coordinating centre and consists of a steering and executive committee, a data safety monitoring board and committees for protocol review, training and standardisation. A strong association with patient organisations and industrial companies are further cornerstones. All participating trial sites agreed on a code of conduct. As CTNs from other diseases have demonstrated successfully, this newly formed PCD-CTN operates to establish evidence-based treatments for this orphan disease and to bring new personalised treatment approaches to patients.Publication Open Access Ki̇sti̇k fi̇brozi̇s ve ki̇sti̇k fi̇brozi̇s dişI hastalardan İzole edi̇len achromobacter türleri̇ İle İlgi̇li̇ retrospekti̇f anali̇z(2022-12-01) KARAHASAN, AYŞEGÜL; KARADAĞ, BÜLENT TANER; ERDEM ERALP, ELA; GÖKDEMİR, YASEMİN; Karahasan A., Gökdemir Y., Karadağ B. T., Erdem Eralp E.Achromobacter türleri Gram negatif, katalaz, oksidaz ve sitrat pozitif, fermentatif olmayan bakterilerdir. Toplum kökenli ya da hastane kaynaklı enfeksiyonlara sebep olabilmektedir. Hem immünokompetan hem de immün yetmezlikli kişilerde enfeksiyonlara sebep olabilmekle birlikte kistik fibrozis (KF) hastalarını enfekte etmeleri durumunda, KF hastalarının akciğer fonksiyonlarını kötüleştirdiğinden ve daha sık pulmoner alevlenmeye neden olduğundan bu hasta grubunda özellikle önem taşımaktadır. Bu retrospektif çalışmada, Marmara Üniversitesi Eğitim ve Araştırma Hastanesi’nde 2017-2021 yıllarında Achromobacter türleri izole edilen hastaların verileri analiz edilmiştir. Altta yatan hastalıkların varlığına göre Achromobacter türlerinin izolasyon sıklığı, hastalara ait demografik veriler ve antimikrobiyal duyarlılık sonuçları irdelenmiştir. İzolatların tür düzeyinde tanımlaması, matriks ile desteklenmiş lazer desorpsiyon/iyonizasyon uçuş zamanı kütle spektrometresi (MALDITOF MS, VITEK MS, BioMérieux, Fransa) ile yapılmıştır. Antimikrobiyal duyarlılık testleri, disk difüzyon metodu ile çalışılmıştır. İstatistiksel analizler için SPSS (Statistical Package for Social Sciences) for Windows 24.0 programı kullanılmıştır. Toplam 148 hastadan 318 Achromobacter izolatı elde edilmiştir. Hastaların %29.7’si kistik fibrozis (KF); %70.3’ü ise KF dışı hastalar olmasına rağmen izolatların %51.6’sı KF hastalarına aittir (P=0.63). En sık gönderilen örnek türü, solunum yollarına ait örnekler olup (%78), KF hastalarında gönderilen örneklerin tümü solunum örneği iken; KF dışı hastalarda bu oran %54.5’tir (P<0.05). Solunum yolu örneklerini %10 oranında idrar, %5.7 kan ve %6.3 diğer örnekler takip etmiştir. Hastaların 47’sinde (%31’inde) tekrarlayan Achromobacter üremesi saptanmıştır. Hasta başına tekrarlayan örnek sayısı 4.6 (2-28) olup KF hasta grubunda 22 hastada (%50), KF dışı hasta grubunda 25 hastada (%32.5) tekrarlayan izolasyon olmuştur. Tüm izolatlarda, KF izolatlarında ve diğer izolatlarda direnç oranları sırasıyla piperasilin/tazobaktam için %25.6, %30.4 ve %21.9; meropenem için %40.0, %61.1 ve %18.0 (P<0.05);trimetoprim/sülfametaksazol için %44.7, %68.2 ve %12.5 (p<0.05) olarak belirlenmiştir. Achromobacter hakkındaki çalışmalar oldukça kısıtlı olmakla birlikte, son yıllarda görülme sıklığı artmaktadır; bu bakteri hakkında daha fazla bilgiye ve araştırmaya ihtiyaç vardır. Çalışmamız verileri, literatüre katkıda bulunarak Achromobacter türlerinde artan antimikrobiyal direncin önemine dikkat çekmektedir.