Yazar "Turan, Caner" seçeneğine göre listele

Listeleniyor 1 - 20 / 53
  • Küçük Resim Yok
    Öğe
    A 7-Day-Old Male Infant With Carbon Monoxide Poisoning Treated With Hyperbaric Oxygen
    (Lippincott Williams & Wilkins, 2020) Turan, Caner; Yurtseven, Ali; Beyter, Mehmet Baki; Saz, Eylem Ulas
    Objective Children are presented with an unknown intoxication at emergency department (ED) after carbon monoxide (CO) poisoning. Although CO poisoning is well defined in the adult literature, little information exists regarding CO poisoning in childhood, especially in infants. the only diagnostic test for CO poisoning is elevation of the carboxyhemoglobin level in the blood. Case We report the second youngest neonate in literature who was severely poisoned by CO and treated with hyperbaric oxygen at the ED. He present to the ED with fussiness and feeding difficulty. Upon arrival, he was lethargic, hypotonic, and crying weak. He had a high carboxyhemoglobin measurement, and the levels of cardiac markers elevated. He was treated with hyperbaric oxygen and discharged a good clinical condition. Conclusions If there is a baby with unexplained neurologic symptoms and signs, CO poisoning should be considered in the differential diagnosis. Early diagnosis and treatment prevent complications and sequelaes.
  • Küçük Resim Yok
    Öğe
    A comparative evaluation of salivary and serum procalcitonin to identify infants with serious bacterial infections
    (Springer, 2026) Cinarli, Sercan; Yurtseven, Ali; Turan, Caner; Azarsiz, Elif; Kose, Timur; Saz, Eylem Ulas
    Differentiating serious bacterial infections (SBIs) from viral illnesses in infants remains challenging. Although serum procalcitonin (PCT) is a well-established biomarker, its measurement requires invasive blood sampling. This study investigated the correlation between salivary and serum PCT and evaluated the diagnostic accuracy of salivary PCT for identifying SBIs in infants under 1 year of age. This prospective observational study included 160 infants under one 1 year of age presenting to a pediatric emergency department with suspected SBI. Paired serum and saliva samples were collected. Salivary PCT and serum PCT levels were measured. Serum C-reactive protein (CRP), a routinely used inflammatory marker in pediatric emergency practice, was included as a comparator biomarker. Patients were classified into SBI and viral infection groups based on final diagnoses. The diagnostic accuracy of the biomarkers was assessed and compared using receiver operating characteristic (ROC) curve analysis.Of the 160 infants (median age 8 months; 63% male), 11.3% (n = 18) were diagnosed with SBI and 88.7% (n = 142) with viral infections. Median salivary PCT levels were markedly higher in the SBI group than in the viral infection group (69.3 pg/mL vs. <0.01 pg/mL; p < 0.001). The area under the curve (AUC) for diagnosing SBI was 0.92 for salivary PCT, 0.96 for serum PCT, and 0.88 for serum CRP. At a cutoff value of 31.3 pg/mL, salivary PCT demonstrated a sensitivity of 89% and a specificity of 92.3%, with a negative predictive value (NPV) of 98.7%. A weak but statistically significant correlation was found between serum and salivary PCT levels (r = 0.250; p = 0.001). Conclusion: Salivary PCT shows strong correlation with serum PCT and demonstrates high diagnostic accuracy as a non-invasive biomarker for identifying SBIs in infants. Its performance approaches that of serum PCT and exceeds that of serum CRP, highlighting its potential clinical value in reducing the need for invasive blood sampling.
  • Küçük Resim Yok
    Öğe
    A Game Changer for Acute Gastroenteritis in the Pediatric Emergency Department: Multiplex Stool PCR Test
    (Wiley, 2025) Barut, Dogan; Turan, Caner; Boluk, Ezgi; Aydemir, Sohret; Yurtseven, Ali; Saz, Eylem Ulas
    Objective: This study evaluated the diagnostic performance of the FilmArray GI Panel multiplex polymerase chain reaction (PCR) compared to conventional stool culture (CSC) and microscopic stool analysis in children with bacterial acute infectious gastroenteritis (AIG) in the emergency department (ED). It also assessed the impact of PCR use on clinical decision-making, antibiotic stewardship, and ED workflow. Methods: A retrospective analysis was conducted in a tertiary pediatric ED. Children diagnosed with AIG who underwent CSC, microscopy, and multiplex PCR were included. Data on demographics, clinical findings, diagnostic results, antibiotic prescriptions, and patient outcomes were collected. Diagnostic performance metrics-sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)-were compared. Results: Among 257 pediatric patients, enteropathogens were detected in 31.9% via CSC and 39.3% via multiplex PCR. PCR showed superior sensitivity (96.2%) and NPV (97.4%) compared to CSC. The median turnaround time for PCR (7.9 h) was significantly shorter than for CSC (47.5 h, p < 0.001). Antibiotic use was significantly lower in PCR-negative cases (p < 0.001), and ED length of stay was also reduced. Conclusion: The FilmArray GI Panel offers improved sensitivity and faster results than conventional methods, enhancing diagnostic accuracy and reducing unnecessary antibiotic use. Its integration in ED protocols can support antimicrobial stewardship and streamline care.
  • Küçük Resim Yok
    Öğe
  • Küçük Resim Yok
    Öğe
    Anjiyotensin Dönüştürücü Enzimlerin (ACE1, ACE2) Genetik Varyantlarının COVID-19 Hastalığının Şiddeti Üzerine Etkisi
    (Erkan YULA, 2025) Yurtseven, Ali; Atik, Tahir; Durmuşalioğlu, Enise Avcı; Turan, Caner; Güngör, Tuğçe Kalın; Akarca, Funda Karbek; Saz, Eylem Ulaş
    Amaç: Bu çalışmada, ACE1 I/D ve ACE2 rs2285666 polimorfizmleri ile COVID-19 şiddeti arasındaki ilişkinin araştırılması amaçlandı. Yöntem: Bu çalışma, Polimeraz zincir reaksiyonu yöntemi ile COVID-19 tanısı konulan 200 hasta üzerinde prospektif, gözlemsel olarak gerçekleştirildi. Çalışmaya alınan olguların demografik ve klinik verileri kaydedilerek, ACE1 I/D ve ACE2 rs2285666 genlerinin genetik analizleri, yeni nesil dizi yöntemi kullanılarak gerçekleştirildi. Vakalar, hastalığın şiddetine göre hafif, orta ve ağır olarak üç gruba ayrıldı. Bulgular: Çalışmaya alınan olguların ortalama yaşı 52 (±27) yıl olup, 116'sı (%58) erkekti. Olguların 120'sinde (%60) en az bir kronik hastalık mevcutken, dörtte birinde düzenli sigara kullanımı vardı. Ağır klinik bulguları olan 52 hasta (%26) yoğun bakım servisinde tedavi edilirken ve bunların 19'u (%9,5) hayatını kaybetti. Kalan %74’lük hafif veya orta şiddette klinik semptomları olan olguların tümü iyileşerek taburcu edildi. Çalışmada ACE1 I/D ve ACE2 rs2285666 gen polimorfizmleri ile COVID-19 şiddeti veya ölüm oranı arasında istatistiksel olarak anlamlı bir ilişki bulunamadı. Sonuç: Bulgular, ACE1 I/D ve ACE2 rs2285666 polimorfizmlerinin COVID-19 şiddetini etkilemediğini göstermektedir. Bu ilişkinin daha kapsamlı bir şekilde anlaşılabilmesi için, farklı etnik grupları içeren ve farklı polimorfizmleri araştıran daha fazla çalışmaya ihtiyaç vardır.
  • Küçük Resim Yok
    Öğe
    Benign acute childhood myositis associated with influenza A/B in the paediatric emergency department and the efficacy of early-onset oseltamivir
    (Wiley, 2022) Turan, Caner; Yurtseven, Ali; Cicek, Candan; Keskin, Gulsum; Saz, Eylem Ulas
    Aim To investigate the association of benign acute childhood myositis (BACM) with respiratory viruses. Also, we aimed to assess the effect of antiviral treatment on the improvement and complications. Methods This study was conducted at an urban-academic emergency department during four influenza-seasons (2016-2019), retrospectively. Demographics, clinical findings, laboratories, metabolic disease analyses and serological features were extracted from the medical records. Treatments, complications and outcomes were also recorded. Results A total of 114 children were included. The median age was 7.0 (min 1.25-max 17) years and 78.9% were male. The most common symptoms were leg pain (91.2%), anorexia (54.4%), fever (45.6%), sore throat (42.1%) and walking difficulty (32.5%). On admission, the median creatine phosphokinase level was 3332 IU/L (range, 1634-50 185), median aspartate aminotransferase 107 U/L (range, 38-1798). In the multiplex polymerase chain reaction analysis, 40.4% influenza B, 36.8% influenza A, 7.8% adenovirus, 7.8% parainfluenza virus, 5.3% rhinovirus, 5.3% respiratory syncytial virus and 1.8% Mycoplasma pneumoniae were detected. Rhabdomyolysis was developed in 6.7% and acute renal failure was seen in two patients. Oseltamivir was given in 44 (38.6%) patients who had influenza A/B. Metabolic disease screening tests were performed in 33.3% of patients and metabolic diseases were detected in 4 (3.5%) patients. The median recovery time was lower in patients with oseltamivir treatment (4 (min 2-max 5) - 5 (min 3-max 10) days) (P < 0.001). Conclusion Rhabdomyolysis is more common in BACM due to the influenza A virus. The early use of oseltamivir treatment was significantly associated with a shorter recovery time.
  • Küçük Resim Yok
    Öğe
    Cerrahi Tedavi Yapılamayan ve Erken Antibiyoterapiye Yanıt Veren Septik Sakroileit Olgusu
    (2019) Turan, Benay; Erseven, Eren; Ümit, Zühal; Turan, Caner; Yurtseven, Ali; Bal, Zümrüt Şahbudak; Saz, Eylem Ulaş
    …
  • Küçük Resim Yok
    Öğe
    Characteristics and outcomes of critically ill children transported by ambulance in a Turkish prehospital system: a multicenter prospective cohort study
    (Turkish J Pediatrics, 2021) Saz, Eylem Ulas; Turan, Caner; Anil, Murat; Bal, Alkan; Gokalp, Gamze; Yilmaz, Hayri Levent; Tekin, Deniz
    Background. The most underdeveloped area in the care of critically-ill-children (CIC) is the prehospital period. Appropriate prehospital assessment and life-saving-interventions (LSI) of this population are challenging and require dedicated resources to ensure the best outcomes. We aimed to determine the characteristics and outcomes of CIC transported to the Turkish Pediatric Emergency Departments (EDs). The frequency and distribution of LSI administered by prehospital providers on route and in the EDs were also investigated. Methods. This prospective study was conducted at 4 metropolitan cities and 9 tertiary pediatric EDs between August 2014-August 2015. A survey based study evaluated all CC who were brought by ambulance to the participant EDs. CIC were defined as a patient who requires LSI or needs intensive care admission for any reason. Patient demographics, clinical features, reason for transport, performed procedures in the ambulance or ED were sought. Finally, the short-term outcomes of transported CIC and transport-associated risks were analyzed. Results. During the study period, a total 2094 children were brought by ambulance to all participant EDs. Only 227 (10.8%) of them were critically-ill. Emergency Medical Services (EMS) providers were less likely to perform procedures in CIC if they were staffed with paramedics (p<0.001). Most procedures were performed on children aged one or older (p<0.001). No procedure was performed in the ambulance for nearly one fourth of patients who received LSI in the EDs. If the EMS did not have a physician, prehospital providers were less likely to provide immediate LSIs (p<0.001). CIC were more likely referred from secondary/tertiary care hospitals. The short-term mortality rate was higher if the ambulance was staffed by only paramedics. Conclusion. This study demonstrated that Turkish prehospital pediatric emergency care is deficient. We offer a clinical overview of pediatric emergencies to aid EMS directors, policymakers, and ED directors in planning the care of CIC.
  • Küçük Resim Yok
    Öğe
    Characteristics of pediatric COVID-19 patients admitted to the emergency department and factors associated with pneumonia
    (Wolters Kluwer Medknow Publications, 2022) Yurtseven, Ali; Turan, Caner; Ozenen, Gizem Guner; Isik, Halit; Bal, Zumrut; Sertoz, Ruchan; Saz, Eylem
    OBJECTIVES: Coronavirus disease 2019 (COVID-19) that causes a respiratory illness, continues to be a global pandemic. In this study, we purpose to identify the features of children with COVID-19 and the factors affecting disease severity. METHODS: This is a retrospective, observational study was conducted on patients who presented with suspicion of COVID-19 from April 1, 2020, to March 31, 2021, at a tertiary care medical center in Turkey. The characteristics of 640 children who were confirmed to have COVID-19 by real-time reverse transcription-polymerase chain reaction were retrieved from medical records. RESULTS: The mean age of the cases was 10 & PLUSMN; 6 years, and 56% of them were male. Seasonal difference did not affect the number of cases. The majority of the cases (n = 501, 78%) were infected by family members. Fever (67%) and cough (38%) were common complaints. The mean duration of fever was 1.9 +/- 1.1 days. One-fourth of the cases were asymptomatic, 462 (72%) had mild upper respiratory tract infections, and 18 (3%) had pneumonia. Patients with pneumonia were more likely to have comorbidities and had a longer fever duration (both P < 0.001). Fever, cough, and respiratory distress were more common in patients with pneumonia (P = 0.010, P = 0.023, and P < 0.001, respectively). The mean C-reactive protein (CRP) value of the patients with pneumonia was significantly higher than that of the others (P < 0.001). A total of 70 (11%) complicated patients were hospitalized, 5 of them requiring intensive care admission. All hospitalized patients were discharged with recovery. CONCLUSIONS: Although pediatric COVID-19 patients tended to have a mild disease, some children with comorbidities can still develop a severe illness. CRP value is a useful indicator in the diagnosis of COVID-19 pneumonia. Furthermore, the prevalence rate of COVID-19 did not decrease with hot seasons.
  • Küçük Resim Yok
    Öğe
    Cisplatin ototoxicity in children: risk factors and its relationship with polymorphisms of DNA repair genes ERCC1, ERCC2, and XRCC1
    (Springer, 2019) Turan, Caner; Kantar, Mehmet; Aktan, Cagdas; Kosova, Buket; Orman, Mehmet; Bilgen, Cem; Kirazli, Tayfun
    Purpose We aimed to investigate the cisplatin-related hearing toxicity and its possible relationship with polymorphic variants in DNA repair genes, ERCC1, ERCC2, and XRCC1. Methods Fifty patients treated with cisplatin in the past were included in the study. There were 29 females and 21 males; mean age 13.4 +/- 6.0 years). the polymorphism in DNA repair genes was studied using primer and probes in Light Cycler device after DNA isolation was carried out with PCR technique. the polymorphisms and clinical risk factors were evaluated using Chi square test and logistic regression modelling. Results the patients had hearing loss in 44%. For ERCC1 gene, the patients with hearing loss had 50% of GG (wild type), 40.9% of AG and 9.1% of AA genotypes, while the patients without hearing loss had 28.6% of GG, 53.5% of AG, and 17.9% of AA genotypes. For ERCC2 gene, the patients with hearing loss had 18.2% of GG (wild type), 40.9% of TG, and 40.9% of TT genotypes, while the patients without hearing loss had 10.7% of GG 39.3% of TG, and 50% of TT genotypes. For XRCC1 gene, the patients with hearing loss had 18.2% of CC (wild type), 59.1% of CT, and 22.7% of TT genotypes, while the patients without hearing loss had 35.7% of CC, 50% of CT, and 14.3% of TT genotypes. There was no statistically significant association among the groups (p = 0.24). Conclusion We did not find a relationship between DNA repair gene polymorphisms and hearing toxicity of cisplatin.
  • Küçük Resim Yok
    Öğe
    Clinical characteristics and outcomes of pediatric methylphenidate intoxication: a five-year single-center study
    (Bmc, 2026) Yildiz, Piril; Yurtseven, Ali; Turan, Caner; Atalay, Burcu Vural; Saz, Eylem Ulas
    Background Methylphenidate is widely prescribed for attention-deficit/hyperactivity disorder, and its use has increased substantially in recent years. Although generally considered safe within therapeutic ranges, supratherapeutic ingestion may result in various systemic adverse effects. This study aimed to evaluate the demographic and clinical characteristics of children presenting with overdose ingestion and to identify potential factors associated with symptom development. Methods We conducted a retrospective review of patients younger than 18 years who presented to a tertiary pediatric emergency department between January 1, 2020, and December 31, 2024, due to overdose ingestion. Demographic characteristics, psychiatric history, ingested dose, mode of exposure, clinical findings, emergency department course, and factors potentially associated with adverse effects were analyzed. Results Thirty-two patients were included; 72% were female, and ingestion was intentional in 84%. The mean ingested dose was 5.7 mg/kg. Clinical symptoms developed in 41% of patients. The most frequent findings were tachycardia (38%), mild hypertension (34%), agitation (22%), and seizures (16%). Although most cases were mild and resolved within 12 h of observation, one toddler developed neuropsychiatric manifestations requiring close monitoring with full recovery within 48 h. No statistically significant association was observed between age, sex, gastrointestinal decontamination status, or reported ingested dose and the development of clinical symptoms (p > 0.05). Conclusions Pediatric methylphenidate intoxication is generally mild, but severe neuropsychiatric and cardiovascular effects may occur. Careful clinical monitoring remains essential. Trial registration Not applicable.
  • Küçük Resim Yok
    Öğe
    The Comparison of Children Who Were Diagnosed with COVID-19 in the First and the Second Waves of the SARS-CoV-2 Pandemic
    (Aves, 2021) Turan, Caner; Basa, Elif Gokce; Elitez, Duygu; Yilmaz, Ozlem; Gumus, Ece; Anil, Murat
    Objective: To compare the clinical and laboratory findings and short-term outcomes of those children diagnosed with COVID-19 in the first and second waves of the SARS-CoV-2 pandemic. Methods: A retrospective study was conducted at a suburban community hospital during a 1-year period. All children who were less than 18 years of age and confirmed with COVID-19 were included in the study population. The demographics, clinical features, laboratories, treatments given, hospitalizations, and outcomes were analyzed. Results: A total of 198 patients were enrolled; median age was 9.3 years. One-hundred four patients were diagnosed with COVID-19 disease in the first wave and 94 (47.5%) patients were diagnosed in the second wave of the pandemic. Those patients who were diagnosed with COVID-19 in the first wave of the pandemic were significantly younger than those in the second wave (medians: 2.7 years vs. 15 years respectively, P <.001). Intra-familial contact was detected in 66.4% vs. 33.6% in the first and second waves of the pandemic, respectively (P <.001). Asymptomatic patients were higher in the second wave than in the first wave (P <.001). Additionally, moderate-to-critically ill patients were significantly higher in the first wave than in the second wave (P <.001). The rate of multisystem inflammatory syndrome (MIS-C) cases was 0.32% in this study. Conclusion: In children, COVID-19 disease affected older children, there was less intra-familial contact and the severity of the disease was milder in the second wave of the pandemic in comparison to the first wave. MIS-C was encountered in the second wave of the pandemic.
  • Küçük Resim Yok
    Öğe
    Comparison of heated humidified high-flow nasal cannula flow rates (1-L center dot kg center dot min(-1) vs 2-L center dot kg center dot min (-1)) in the management of acute bronchiolitis
    (Wiley, 2019) Yurtseven, Ali; Turan, Caner; Erseven, Eren; Saz, Eylem Ulas
    ObjectiveWe aimed to compare the heated humidified high-FLow nasal cannula (HHHFNC) flow rate of 1-Lkgmin(-1) (1L) with 2-Lkgmin (-1) (2L) in patients with severe bronchiolitis presenting to the pediatric emergency department. Study designWe performed a study in which all patients were allocated to receive these two flow rates. The primary outcome was admitted as treatment failure, which was defined as a clinical escalation in respiratory status. Secondary outcomes covered a decrease of respiratory rate (RR), heart rate (HR), the clinical respiratory score (CRS), rise of peripheral capillary oxygen saturation (SpO(2)), and rates of weaning, intubation, and intensive care unit (ICU) admission. ResultsOne hundred and sixty-eight cases (88 received the 1-L flow rate and 80, the 2-L flow rate) were included in the analyses. Treatment failure was 11.4% (10 of 88) in the 1-L group, and 10% (8 of 80) in the 2-L group (P=.775). Significant variation in the intubation rate or the ICU admission rate was not determined. At the 2nd hour, the rate of weaning (53.4% vs 35%; P=.017), the falling down of the CRS (-2.1 vs -1.5; P<.001), RR (-15.2 vs -11.8; P<.001), and HR (-24.8 vs -21.2; P<.001), and the increase of SpO (2) (4.8 vs 3.6; P<.001) were significantly more evident in the 1-L group. ConclusionHHHFNC with the 1-Lkgmin(-1) flow rate, which provides a more frequent earlier effect, reached therapy success as high as the 2-Lkgmin (-1) flow rate in patients with severe acute bronchiolitis.
  • Küçük Resim Yok
    Öğe
    Diagnostic role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in pediatric syncope in the emergency department: a prospective study
    (Springer, 2026) Dedeoglu, Sinem; Turan, Caner; Dogan, Eser; Kanmaz, Seda; Seker Gezici, Muazzez; Azarsiz, Elif; Saz, Eylem Ulas
    Cardiac syncope in children is a critical risk and demands a prompt, accurate diagnosis. This study aimed to elucidate the diagnostic efficacy and clinical relevance of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in distinguishing between cardiac and non-cardiac syncope in children. A prospective study was conducted in a tertiary pediatric emergency department (ED), enrolling patients who were diagnosed with syncope. Conventional cardiac biomarkers, serum NT-proBNP, telecardiography, and 12-lead electrocardiography were performed. All patients underwent echocardiography, while TILT testing and 24-h Holter monitoring were performed by a pediatric cardiologist in a subset of patients. Electroencephalography (EEG) was performed after cardiac syncope had been ruled out and the patient had been evaluated by a pediatric neurologist. Overall, 197 patients and 50 healthy children were included. Cardiac etiology was identified in 8.6% of patients, while vasovagal, idiopathic, neurologic, orthostatic, and psychogenic syncope accounted for 27.9%, 28.9%, 15.2%, 5.6%, and 7.6% of cases, respectively. The TILT test was performed on only 19.8% of patients, and 46.2% were positive. The median serum NT-proBNP levels were 437.4 ng/L, 44.5 ng/L, and 37.1 ng/L in children with cardiac syncope, non-cardiac syncope, and healthy children (p < 0.001, p = 0.008, and p = 0.971, respectively). The optimum diagnostic cut-off point for cardiac syncope in 7-18-year-old children was 145.0 ng/L, the AUROC was 0.761 (95% CI:0.589-0.934), sensitivity 64.3%, specificity 98.2%, PPV 75.0%, and NPV 97.1%.
  • Küçük Resim Yok
    Öğe
    Differentiation of MIS-C Cases According to Disease Severity: Early Indicators and Clinical Approaches
    (Galenos Publ House, 2025) Ay, Oguzhan; Gungor, Tugce Kalin; Turan, Caner; Yurtseven, Ali; Avcu, Gulhadiye; Bal, Zumrut Sahbudak; Levent, Refit Erturk
    Objective: This study aims to identify key clinical and laboratory indicators that differentiate between severe and mild presentations of Multisystem Inflammatory Syndrome in Children (MIS-C), facilitating early recognition and application of targeted treatment strategies. Method: A retrospective, single-center analysiswas conducted, reviewing clinicaldata of patientswith MIS-C to identify factors associated with disease severity. The study assessed demographic, clinical, laboratory, and echocardiographic parameters, comparing patients with severe MIS-C (requiring inotropic support or prolonged intensive care unit stay) to those with mild MIS-C. Statistical analyses were performed to determine significant intergroup differences. Results: The group with severe MIS-C exhibited a longer duration of fever, presence of shock, tachycardia, and hypotension. Inflammatory markers such as lymphopenia, hypoalbuminemia, and elevated ferritin levels were significantly more pronounced in the severe MIS-C group. Elevated N-terminal pro-B-type natriuretic peptide and troponin levels were also significantly associated with severe MIS-C, indicating myocardial involvement. Echocardiographic findings of reduced ejection fraction and valve insufficiency were significant indicators of worsening clinical conditions. Coronavirus disease 2019 polymerase chain reaction and serological tests were not useful in differentiating between severe and mild forms of MIS-C. Conclusion: Early recognition of clinical features of MIS-C and classification based on disease severity can guide clinicians in diagnosis and treatment of MIS-C. Prolonged fever, shock, elevation of specific inflammatory, and cardiac markers, and echocardiographic abnormalities should raise suspicion for severe disease, prompting rapid intervention and tailored treatment strategies to improve patient outcomes and reduce potential mortality and longterm sequelae.
  • Küçük Resim Yok
    Öğe
    The Effects of Prehospital Care on Outcome in Pediatric Diabetic Ketoacidosis
    (2020) Turan, Caner; Yurtseven, Ali; Basa, Elif Gökçe; Saz, Eylem Ulaş
    Objective: Despite the guidelines, significant variations can be encountered in initial therapy for pediatric diabetic ketoacidosis (DKA) in the prehospital setting. These variations occur mostly in fluid administration, insulin dosing, route of administration, and other aspects of the initial resuscitation and stabilization. The aim was to identify the effect of transport care on outcomes in children with DKA admitted to the emergency department (ED). Methods: Patients admitted to a tertiary-care pediatric ED between 2015-2019 with a diagnosis of DKA were retrospectively identified. Details of pre-pediatric ED care, including transport modality, patient demographics, clinical features, laboratory evaluation, fluid therapy, insulin dosing, and short-term outcome were recorded. Results: The study cohort included 147 episodes of DKA in 136 patients aged 9 months-21 years. Emergency Medical Service (EMS) transported only 37.4% of cases. EMS utilization rate was significantly higher (p=0.003) in severe cases, most of whom were >10 years (p=0.04). During transport 85% received intravenous fluid bolus. Use of fluids other than normal saline was significantly higher when transport time was >30 minutes (p=0.001). Acute kidney injury and cerebral edema developed in 21.7% and 7.4% of episodes, respectively. These complications were more common in the EMS transport group. Pediatric intensive care admission rate was also higher in the EMS compared to the non-EMS group (p=0.01) Conclusion: Parents did not call the ambulance for most cases although a higher complication rate occurred in EMS patients. EMS providers and referral facilities should improve their knowledge of pediatric DKA.
  • Küçük Resim Yok
    Öğe
    The Effects of Prehospital Care on Outcome in Pediatric Diabetic Ketoacidosis
    (2020) Turan, Caner; Yurtseven, Ali; Basa, Elif Gökçe; Saz, Eylem Ulaş
    Objective: Despite the guidelines, significant variations can be encountered in initial therapy for pediatric diabetic ketoacidosis (DKA) in the prehospital setting. These variations occur mostly in fluid administration, insulin dosing, route of administration, and other aspects of the initial resuscitation and stabilization. the aim was to identify the effect of transport care on outcomes in children with DKA admitted to the emergency department (ED). Methods: Patients admitted to a tertiary-care pediatric ED between 2015-2019 with a diagnosis of DKA were retrospectively identified. Details of pre-pediatric ED care, including transport modality, patient demographics, clinical features, laboratory evaluation, fluid therapy, insulin dosing, and short-term outcome were recorded. Results: the study cohort included 147 episodes of DKA in 136 patients aged 9 months-21 years. Emergency Medical Service (EMS) transported only 37.4% of cases. EMS utilization rate was significantly higher (p=0.003) in severe cases, most of whom were >10 years (p=0.04). During transport 85% received intravenous fluid bolus. Use of fluids other than normal saline was significantly higher when transport time was >30 minutes (p=0.001). Acute kidney injury and cerebral edema developed in 21.7% and 7.4% of episodes, respectively. These complications were more common in the EMS transport group. Pediatric intensive care admission rate was also higher in the EMS compared to the non-EMS group (p=0.01) Conclusion: Parents did not call the ambulance for most cases although a higher complication rate occurred in EMS patients. EMS providers and referral facilities should improve their knowledge of pediatric DKA.
  • Küçük Resim Yok
    Öğe
    Efficacy and Safety Study of the Revised Ege Pediatric Status Epilepticus Protocol (r-EPSEP)
    (Sage Publications Inc, 2025) Turan, Benay; Kanmaz, Seda; Turan, Caner; Yazici, Pinar; Simsek, Erdem; Yurtseven, Ali; Serin, Hepsen Mine
    Purpose To assess the efficacy and safety of an updated institutional treatment protocol for convulsive status epilepticus (CSE).Methods A single-center, retrospective cohort study was designed to investigate the effectiveness of a protocolized approach for the treatment of pediatric convulsive status epilepticus. The revised Ege Pediatric Status Epilepticus Protocol (r-EPSEP) consists of first-line therapy (step 1 and step 2 with benzodiazepines), second-line therapy (step 3 and 4 with levetiracetam /diphenylhydantoin / valproic acid), and third-line therapy (step 5 with midazolam infusion, and step 6 with propofol or thiopental sodium infusion). The success rates of each therapy line of the r-EPSEP were defined with clinical termination of convulsive status epilepticus.Results The convulsive status epilepticus cohort consisted of 293 children treated with the r-EPSEP. The cumulative success rates of each therapy line were as follows; first-line with 55.2%, second-line with 82.9%, and third-line with 96.9%. Benzodiazepine-resistant convulsive status epilepticus was defined in 131 children (44.7%) with convulsive status epilepticus. The r-EPSEP provided successful termination of refractory convulsive status epilepticus in 66 of 75 children (88%) with 3 therapy categorizations: (1) second-line therapy in 29 patients (38.6%), (2) midazolam infusion in 31 (41.3%), and (3) propofol or thiopental infusion in 6 (8%). Super-refractory convulsive status epilepticus evolved in 9 children (12%). A favorable neurologic outcome was defined in 74.7% of children with Modified Rankin Scores at the discharge time of children from the intensive care unit.Conclusion The timeline-based protocol (r-EPSEP) provided considerable success rates in terminating status epilepticus episodes at predefined time points of each therapy line with a favorable early neurologic outcome.
  • Küçük Resim Yok
    Öğe
    Familial Mediterranean Fever Mimicking Wilson's Disease: A Case Report
    (Galenos Yayincilik, 2018) Turan, Caner; Karakoyun, Miray; Ecevit, Cigdem Omur; Yilmaz, Funda; Aydogdu, Sema
    Wilson's disease (hepatolenticular degeneration) is an autosomal recessive defect in cellular copper transport. Impaired biliary copper excretion leads to an accumulation of copper mostly in the liver, brain and cornea. Familial Mediterranean Fever (FMF) is an autosomal recessive autoimmune disease as a result of a mutation in the MEFV gene encoding pyrin protein characterized by recurring fever and polyserositis attacks. In this report, we describe a Turkish female child with cholestatic hepatitis of unknown etiology who was later diagnosed with typical FMF.
  • Küçük Resim Yok
    Öğe
    Familial Mediterranean Fever Mimicking Wilson’s Disease: A Case Report
    (2018) Turan, Caner; Karakoyun, Miray; Ecevit, Çiğdem Ömür; Barbet, Funda Yılmaz; Aydoğdu, Sema
    Wilson’s disease (hepatolenticular degeneration) is an autosomal recessive defect in cellular copper transport. Impaired biliary copper excretion leads to an accumulation of copper mostly in the liver, brain and cornea. Familial Mediterranean Fever (FMF) is an autosomal recessive autoimmune disease as a result of a mutation in the MEFV gene encoding pyrin protein characterized by recurring fever and polyserositis attacks. in this report, we describe a Turkish female child with cholestatic hepatitis of unknown etiology who was later diagnosed with typical FMF.