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Öğe Comparison of Liver Transplant Outcomes in Biliary Atresia Patients, Considering Whether They Underwent the Kasai Procedure Beforehand: A Single Center Analysis of 72 Patients(Elsevier Inc., 2023) Demir, H.B.; Umman, V.; Gümüs, T.; Tunalı, S.; Barut, D.; Karakoyun, M.; Akarca, U.S.Background: This study examines the results of liver transplantation (LT) in patients with biliary atresia, considering whether they underwent the Kasai procedure beforehand. LT and determine postoperative and long-term graft outcomes. Methods: This single-center, retrospective study included 72 pediatric patients diagnosed with postpartum biliary atresia who underwent LT between 2010 and 2022. We included patients who underwent LT either after or without the Kasai procedure and compared the demographic data of the patients with various factors, such as the Pediatric End-Stage Liver Disease scores and laboratory values. Results: The study included 72 patients, with 39 of them being female (54.2%) and 33 of them being male (45.8%). Of the 72 patients in the study, 47 (65.3%) had undergone the Kasai procedure, and 25 (34.7%) had not. The preoperative and postoperative month 1 bilirubin values were lower in patients who underwent the Kasai procedure and were higher in postoperative months 3 and 6. Preoperative bilirubin values, postoperative month 3 bilirubin values, and preoperative albumin values were higher in patients who developed mortality (P <.05). Cold ischemia time was longer in patients who developed mortality (P <.05). Conclusions: Our study showed a higher mortality rate in patients who underwent the Kasai procedure. The results also showed that LT was more effective in children, as patients with Kasai had higher mean bilirubin values and higher preoperative albumin values than patients without Kasai. © 2023 Elsevier Inc.Öğe The Comparison of Reported Ingested Paracetamol Dose with Serum Blood Concentrations and Their Relationship with N-Acetylcysteine Administration: A Retrospective Study of 117 Patients(Galenos Publishing House, 2023) Turan, C.; Yurtseven, A.; Basa, E.G.; Ergin, F.; Uçar, M.; Karakoyun, M.; Saz, E.U.Introduction: We aimed to compare the patient reported ingested and blood paracetamol concentrations (BPC) and to investigate the indications for N-acetylcysteine (NAC) administration in referred patients. Methods: This is a retrospective study of acute paracetamol intoxications (API) at the tertiary paediatric emergency department (ED) between June 2015-June 2019. We evaluated the demographics, cause of intoxications, reported doses (mg/kg), BPCs (8/4/12/16 and/or 24th hours). Indications of antidote usage and referral to ED were accepted as BPC >150 mg/kg. Results: Overall, we reviewed 117 cases of acute API. The mean age was 8.97 (±6.0) years, and 68.3% were female. The reported ingested of paracetamol (RIP) median dose was 2725 mg (mean 138±51.9 mg/kg). Adolescents had a significantly higher RIP than that of younger subjects (p<0.001). BPC was performed in 88.9% of the patients at the 4th, 8th, 12th, 16th and 24th hour in 11.1%, 9.4%, 3.5% and 3.5% of cases, respectively. Although, only 34/66 of the referred cases had a RIP dose >150 mg/kg, physicians at the first healthcare facility tended to administer activated charcoal (90.9%), gastric lavage (68%) and intravenous NAC (48%). The referring healthcare facility physicians-initiated NAC particularly for patients who reported ingesting >150 mg/kg (p=0.001). Conclusion: RIP doses should not be used to determine the need for NAC. The antidote should be used in centres where BPCs are not available or in a group of patients who cannot be transferred to a referral centre within the first eight hours. © 2023, Galenos Publishing House. All rights reserved.Öğe Evaluation of candidemia in children at a university hospital: A retrospective cohort(John Wiley and Sons Inc, 2023) Guner Ozenen, G.; Sahbudak Bal, Z.; Avcu, G.; Ozkaya Yazici, P.; Karakoyun, M.; Metin, D.Y.; Hilmioglu Polat, S.Background: Candidemia is a life-threatening infection in hospitalied children. This study aimed to evaluate candidemia's demographic and clinical characteristics and identify the risk factors and outcomes of Candida albicans (CA) and non-albicans Candida (NAC) spp. Methods: A retrospective cohort was designed to evaluate paediatric patients with candidemia between January 2008 and December 2020. Results: A total of 342 episodes in 311 patients were evaluated. The median age of the patients was 2.1 years (1 month–17 years and 6 months), and 59.6% were male. The prevalence of NAC (67.5%) candidemia was higher than that of CA (32.5%). The most commonly isolated Candida species was Candida parapsilosis (43.3%), followed by C. albicans (32.5%), Candida glabrata (6.1%) and Candida tropicalis (5.0%). The length of hospital stay prior to the positive culture and the total length of hospital stay were longer in the NAC group (p =.003 and p =.006). The neutrophil count was lower in the NAC group (p =.007). In the multivariate analysis, total parenteral nutrition, antifungal prophylaxis and a history of coagulase-negative staphylococci (CoNS) culture positivity in the past month were risk factors for developing candidemia due to NAC (p values were.003,.003 and.045). C. albicans and C. parapsilosis fluconazole resistance were 9.5% and 46.6%, respectively. The rates of amphotericin B resistance were 1.1% and 7.6% in C. albicans and C. parapsilosis, respectively. Mortality (14-day and 30-day) rates did not differ between the groups. Conclusions: A history of CoNS culture positivity in the past month, total parenteral nutrition, and antifungal prophylaxis increases the risk of NAC candidemia. © 2023 Wiley-VCH GmbH.Öğe Expression levels of peroxiredoxins in small intestinal mucosa of children with celiac disease(Wiley, 2018) Kose, F. Aydin; Pabuccuoglu, A.; Karakoyun, M.; Aydogdu, S.
