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    Down Syndrome Patients in the Pediatric Emergency Department
    (2022) Aydın, Hilal; Bucak, İbrahim Hakan; Kılıç, Fedli Emre; Tanrıverdi, Hüseyin; Geyik, Mehmet
    Objective: The purpose of this study was to evaluate Down syndrome (DS) cases presenting to the pediatric emergency department and to compare them with DS cases with clinical presentations for routine check-ups. Method: DS patients presenting to the pediatric emergency department of a tertiary hospital between 01.10.2018 and 31.03.2019 (group 1) and DS patients presenting for routine clinical check-ups (group 2) were included in the study. Patients’ demographic data (age and gender), weight, height ad head circumference measurements, and data for general health were examined. Results: Forty-one patients (13 girls, 28 boys) with a mean age of 50.24±48.4 (1-163) months were enrolled in group 1, and 49 cases (17 girls, 32 boys) with a mean age of 52.94±50.1 (1-168) months in group 2. Cases in group 1 had higher rates of heart disease (p=0.004), drug use for heart disease (p=0.038), thyroid disease (0.001), and drug use for thyroid disease (p=0.001) compared to group 2, while engagement in sporting activity was significantly higher among cases in group 2 (p=0.32) than in group 1. There was no difference between the groups in terms of anthropometric measurements. Conclusion: DS cases presenting to the pediatric emergency department differ from DS cases presenting for routine check-ups in terms of general health status and accompanying diseases. Pediatric practitioners can be more knowledgeable about cases with DS who are admitted to the emergency department.
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    Facilitated Subcutaneous Immunoglobulin Treatment Increases the Quality of Life and Decreases the Number of Infections and Hospitalizations in Children with Primary Immunodeficiencies
    (Karger, 2024) Erbas Acici, Nida; Topyildiz, Ezgi; Ayguen, Ayse; Geyik, Mehmet; Edeer Karaca, Neslihan; Aksu, Guzide; Kutukculer, Necil
    Introduction: Immunoglobulin replacement therapy is an effective lifelong treatment modality used in patients with primary immunodeficiency to prevent and/or reduce the incidence of serious infections. Facilitated subcutaneous immunoglobulin (fSCIG) was developed to combine the advantages of intravenous immunoglobulin (IVIG) and subcutaneous immunoglobulin (SCIG) and is the latest method of immunoglobulin G (IgG) administration. In this study, switching to fSCIG administration in primary immunodeficiency patients receiving regular IVIG or SCIG therapy was evaluated, and serum IgG trough levels, frequency of infections, frequency and duration of hospitalizations, duration of absence from school/work, and quality of life were determined. Methods: In this study, fifteen patients with primary immunodeficiency who were previously receiving IVIG or SCIG treatment, followed by fSCIG, were evaluated retrospectively. Age, diagnosis, current complications, mean IgG value, frequency of infection, frequency of hospitalization, and duration of absenteeism from school and work were recorded during and before fSCIG treatment. At the beginning of fSCIG treatment, at 6th and 12th months, The Quality of Life Scale was also evaluated in patients and parents. Results: The most common indications for initiation of fSCIG treatment were the difficulty of access to the hospital and the long transfusion periods. No systemic adverse reactions were reported except for redness, swelling, and mild pain on the injection site. The median IgG values for the last 1 year were 529.6 mg/dL for IVIG (n = 9), 876.2 mg/dL for SCIG (n = 6) and 856.7 mg/dL for fSCIG (n = 15, all patients) treatment. The frequency of infections and the number of hospitalizations decreased significantly in the fSCIG group compared to both previous treatment modalities. There was a significant increase in the quality of life score of the patients and their families when compared with previous treatment modalities. Conclusion: fSCIG is an effective treatment method and is well tolerated in patients with immunodeficiency. It provides stable immunoglobulin levels and excellent protection against infections and offers the patients the possibility of home-based therapy.
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    Factors effecting natural course of egg allergy
    (Edra Spa, 2024) Senol, Handan Duman; Geyik, Mehmet; Topyldz, Ezgi; Aygun, Ayse; Gulen, Figen; Demir, Esen
    Background. There is limited data about the natural course of egg allergy in the literature. We aimed to analyze the factors that can affect the tolerance or persistence of egg allergy. Methods. A total number of 126 IgE-mediated egg allergic patient who had data about tolerance gaining were included in the study. Demographic and laboratory data were recorded retrospectively. Kaplan -Meier curves was used for estimation of resolution and the factors related to resolution by Cox regression model. Results. Among 126 patients, 81 (64.2%) had gained tolerance with a median survival time of 48 months (min: 12 -max: 121). Tolerance was gained in 22.2% (n = 28) of these patients in the first 2 years of life, in 46.8% (n = 49) in 2-6 years, 3.1% (n = 4) between 7-12 years. In univariate analysis, baseline sIgE level was < 8.2 (Hazard ratio: 2.193; 95%CI 1.309-3.674; p = 0.003), no history of anaphylaxis (at initiation or during OFC) (Hazard ratio: 11.292; 95%CI 2.766-46.090; p = 0.001) and baseline egg SPT < 11 mm (Hazard ratio: 2.906; 95%CI 1.424-5.930, p = 0.003) were found to be related to earlier resolution of egg allergy. In multivariate analysis, only anaphylaxis was significantly related to later resolution (Hazard ratio: 6.547; 95%CI 15.8027.434; p = 0.01). Conclusions. Higher levels of egg sIgE, skin prick test induration and anaphylaxis at onset or during oral food challenge, can give hint about persistence of egg allergy.