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Döven SS, Tezol Ö, Yeşil E, Durak F, Mısırlıoğlu M, Alakaya M, Karahan F, Kıllı İ, Akça M, Erdoğan S, Can M, Delibaş A. The 2023 Türkiye-Syria earthquakes: analysis of pediatric victims with crush syndrome and acute kidney Injury. Pediatr Nephrol 2024:10.1007/s00467-024-06307-7. [PMID: 38358551 DOI: 10.1007/s00467-024-06307-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND On February 6th, 2023, two consecutive earthquakes struck southeastern Türkiye with magnitudes of 7.7 and 7.6, respectively. This study aimed to analyze the clinical and laboratory findings, as well as management of pediatric victims with Crush Syndrome (CS) and Acute Kidney Injury (AKI). METHODS The study included pediatric earthquake victims who were presented to Mersin University Hospital. Clinical and laboratory characteristics of the patients were collected retrospectively. RESULTS Among 649 patients, Crush injury (CI), CS and AKI was observed in 157, 59, and 17 patients, respectively. White blood cell count (12,870 [IQR: 9910-18700] vs. 10,545 [IQR: 8355-14057] /µL, P < 0.001), C-reactive protein (51.27 [IQR: 14.80-88.78] vs. 4.59 [1.04-18.25] mg/L, P < 0.001) and myoglobin levels (443.00 [IQR: 198.5-1759.35] vs. 17 [11.8-30.43] ng/ml) were higher in patients with CS, while their sodium (IQR: 134 [131-137] vs. 136 [134-138] mEq/L, P < 0.001) levels were lower compared to non-CS patients. An increase in myoglobin levels was identified as an independent risk factor for developing CS (OR = 1.017 [1.006-1.027]). Intravenous fluid replacement was administered to the patients with CS at a dose of 4000 cc/m2/day. Hypokalemia was observed in 51.9% of the CS patients on the third day. All patients with AKI showed improvement and no deaths were reported. CONCLUSIONS Hyponatremia and increase in inflammation markers associated with CS may be observed. An increase in myoglobin levels was identified as a risk factor for CS. Hypokalemia may be seen as a complication of vigorous fluid therapy during hospitalization.
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Affiliation(s)
- Serra Sürmeli Döven
- Faculty of Medicine, Department of Pediatric Nephrology, Mersin University, Mersin, Türkiye.
| | - Özlem Tezol
- Faculty of Medicine, Department of Pediatrics, Mersin University, Mersin, Türkiye
| | - Edanur Yeşil
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Mersin University, Mersin, Türkiye
| | - Fatma Durak
- Faculty of Medicine, Department of Pediatrics, Mersin University, Mersin, Türkiye
| | - Merve Mısırlıoğlu
- Faculty of Medicine, Department of Pediatric Intensive Care, Mersin University, Mersin, Türkiye
| | - Mehmet Alakaya
- Faculty of Medicine, Department of Pediatric Intensive Care, Mersin University, Mersin, Türkiye
| | - Feryal Karahan
- Faculty of Medicine, Department of Pediatric Hematology, Mersin University, Mersin, Türkiye
| | - İsa Kıllı
- Faculty of Medicine, Department of Pediatric Surgery, Mersin University, Mersin, Türkiye
| | - Mehtap Akça
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Mersin University, Mersin, Türkiye
| | - Semra Erdoğan
- Faculty of Medicine, Department of Biostatistics and Medical Informatics, Mersin University, Mersin, Türkiye
| | - Mevlüt Can
- Faculty of Medicine, Department of Pediatric Nephrology, Mersin University, Mersin, Türkiye
| | - Ali Delibaş
- Faculty of Medicine, Department of Pediatric Nephrology, Mersin University, Mersin, Türkiye
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Demir E, Adım F, Döğen ME, Aydoğdu A, Yeşil E, Mermer S, Başer B, Ürel Demir G. EXTL3-Associated Immunoskeletal Dysplasia with Neurodevelopmental Abnormalities: A Lethal Phenotype. Pediatr Allergy Immunol Pulmonol 2023; 36:147-149. [PMID: 38010729 DOI: 10.1089/ped.2023.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background: Immunoskeletal dysplasia with neurodevelopmental abnormalities (ISDNA) caused by Exostosin-Like Glycosyltransferase 3 (EXTL3) biallelic mutations is a very rare syndrome with only 16 cases reported in the literature. Skeletal dysplasia, neurodevelopmental delay, immunodeficiency, liver, and kidney cysts are the most common findings of this syndrome. Case Presentation: Here, we report on a patient who exhibited a lethal phenotype with clinical characteristics of this syndrome and had a homozygous pathogenic mutation in EXTL3 gene. Conclusions: ISDNA should be kept in mind in the differential diagnosis of patients presenting with neuro-immuno-skeletal dysplasia phenotype.
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Affiliation(s)
- Engin Demir
- Division of Pediatric Gastroenterology, Department of Pediatrics, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Filiz Adım
- Department of Pediatrics, Mersin City Training and Research Hospital, Mersin, Turkey
| | | | - Ayşe Aydoğdu
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Edanur Yeşil
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Serdar Mermer
- Department of Medical Genetics, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Burak Başer
- Department of Medical Genetics, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Gizem Ürel Demir
- Division of Pediatric Genetics, Department of Pediatrics, Mersin City Training and Research Hospital, Mersin, Turkey
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Karahan F, Ünal S, Tezol Ö, Sürmeli Döven S, Durak F, Alakaya M, Mısırlıoğlu M, Yeşil E, Kıllı İ, Kurt H, Altunköprü G. Thromboprophylaxis in pediatric patients with earthquake-related crush syndrome: a single centre experience. Pediatr Surg Int 2023; 39:248. [PMID: 37584864 DOI: 10.1007/s00383-023-05540-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE Injuries increase the risk of venous thromboembolism (VTE). However, the literature on the management of anticoagulant therapy in pediatric patients with crush injury is limited. In this study, we aimed to share our experience about anticoagulant thromboprophylaxis in pediatric patients with earthquake-related crush syndrome. METHODS This study included patients who were evaluated for VTE risk after the Turkey-Syria earthquake in 2023. Since there is no specific pediatric guideline for the prevention of VTE in trauma patients, risk assessment for VTE and decision for thromboprophylaxis was made by adapting the guideline for the prevention of perioperative VTE in adolescent patients. RESULTS Forty-nine patients [25 males and 24 females] with earthquake-related crush syndrome had participated in the study. The median age of the patients was 13.5 (8.8-15.5) years. Seven patients (14.6%) who had no risk factors for thrombosis were considered to be at low risk and did not receive thromboprophylaxis. Thirteen patients (27.1%) with one risk factor for thrombosis were considered to be at moderate risk and 28 patients (58.3%) with two or more risk factors for thrombosis were considered to be at high risk. Moderate-risk patients (n = 8) and high-risk patients aged < 13 years (n = 11) received prophylactic enoxaparin if they could not be mobilized early, while all high-risk patients aged ≥ 13 years (n = 13) received prophylactic enoxaparin. CONCLUSION With the decision-making algorithm for thyromboprophylaxis we used, we observed a VTE rate of 2.1% in pediatric patients with earthquake-related crush syndrome.
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Affiliation(s)
- Feryal Karahan
- Faculty of Medicine, Department of Pediatric Hematology, Mersin University, Mersin, Turkey
| | - Selma Ünal
- Faculty of Medicine, Department of Pediatric Hematology, Mersin University, Mersin, Turkey
| | - Özlem Tezol
- Faculty of Medicine, Department of Pediatrics, Mersin University, Mersin, Turkey.
| | - Serra Sürmeli Döven
- Faculty of Medicine, Department of Pediatric Nephrology, Mersin University, Mersin, Turkey
| | - Fatma Durak
- Faculty of Medicine, Department of Pediatrics, Mersin University, Mersin, Turkey
| | - Mehmet Alakaya
- Faculty of Medicine, Department of Pediatric Intensive Care, Mersin University, Mersin, Turkey
| | - Merve Mısırlıoğlu
- Faculty of Medicine, Department of Pediatric Intensive Care, Mersin University, Mersin, Turkey
| | - Edanur Yeşil
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Mersin University, Mersin, Turkey
| | - İsa Kıllı
- Faculty of Medicine, Department of Pediatric Surgery, Mersin University, Mersin, Turkey
| | - Hakan Kurt
- Faculty of Medicine, Department of Pediatrics, Mersin University, Mersin, Turkey
| | - Gül Altunköprü
- Faculty of Medicine, Department of Pediatrics, Mersin University, Mersin, Turkey
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Yeşil E, Hacımustafaoğlu M, Çelebi S, Özer A, Düzcan Kilimci D, Eren H, Özakın C. Evaluation of Children with Ralstonia pickkettii Bacteraemia. J Pediatr Inf 2023. [DOI: 10.5578/ced.20239904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Yeşil E, Hacımustafaoğlu M, Çelebi S, Özer A, Düzcan Kilimci D, Eren H, Özakın C. Evaluation of Children with Ralstonia pickkettii Bacteraemia. J Pediatr Inf 2023. [DOI: 10.5578/ced.20239918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Tanır Basaranoğlu S, Karaaslan A, Salı E, Çiftçi E, Gayretli Aydın ZG, Aldemir Kocabaş B, Kaya C, Şen Bayturan S, Kara SS, Yılmaz Çiftdoğan D, Çay Ü, Gundogdu Aktürk H, Çelik M, Ozdemir H, Somer A, Diri T, Yazar AS, Sütçü M, Tezer H, Karadag Oncel E, Kara M, Çelebi S, Özkaya Parlakay A, Karakaşlılar S, Arısoy ES, Tanır G, Tural Kara T, Devrim İ, Erat T, Aykaç K, Kaba Ö, Güven Ş, Yeşil E, Tekin Yılmaz A, Yaşar Durmuş S, Çağlar İ, Günay F, Özen M, Dinleyici EÇ, Kara A. Antibiotic associated diarrhea in outpatient pediatric antibiotic therapy. BMC Pediatr 2023; 23:121. [PMID: 36932373 PMCID: PMC10024443 DOI: 10.1186/s12887-023-03939-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/02/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Antibiotic-associated diarrhea is one of the most frequent side effects of antimicrobial therapy. We assessed the epidemiological data of antibiotic-associated diarrhea in pediatric patients in our region. METHODS The prospective multi-center study included pediatric patients who were initiated an oral antibiotic course in outpatient clinics and followed in a well-established surveillance system. This follow-up system constituded inclusion of patient by the primary physician, supply of family follow-up charts to the family, passing the demographics and clinical information of patient to the Primary Investigator Centre, and a close telephone follow-up of patients for a period of eight weeks by the Primary Investigator Centre. RESULTS A result of 758 cases were recruited in the analysis which had a frequency of 10.4% antibiotic-associated diarrhea. Among the cases treated with amoxicillin-clavulanate 10.4%, and cephalosporins 14.4% presented with antibiotic-associated diarrhea. In the analysis of antibiotic-associated diarrhea occurrence according to different geographical regions of Turkey, antibiotic-associated diarrhea episodes differed significantly (p = 0.014), particularly higher in The Eastern Anatolia and Southeastern Anatolia. Though most commonly encountered with cephalosporin use, antibiotic-associated diarrhea is not a frequent side effect. CONCLUSION This study on pediatric antibiotic-associated diarrhea displayed epidemiological data and the differences geographically in our region.
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Affiliation(s)
- Sevgen Tanır Basaranoğlu
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, 06100, Turkey
| | - Ayşe Karaaslan
- Department of Pediatric Infectious Diseases, Istanbul Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Enes Salı
- Department of Pediatric Infectious Diseases, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
| | - Ergin Çiftçi
- Department of Pediatric Infectious Diseases, Ankara University, Ankara, Turkey
| | | | - Bilge Aldemir Kocabaş
- Department of Pediatric Infectious Diseases, Antalya Akdeniz University, Antalya, Turkey
| | - Cemil Kaya
- Department of Pediatrics, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
| | - Semra Şen Bayturan
- Department of Pediatric Infectious Diseases, Manisa Celal Bayar University, Manisa, Turkey
| | - Soner Sertan Kara
- Department of Pediatric Infectious Diseases, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Dilek Yılmaz Çiftdoğan
- Department of Pediatric Infectious Diseases, Saglik Bilimleri University, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ümmühan Çay
- Department of Pediatric Infectious Diseases, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Hacer Gundogdu Aktürk
- Department of Pediatric Infectious Diseases, Istanbul Zeynep Kamil Women and Children Training and Research Hospital, Istanbul, Turkey
| | - Melda Çelik
- Department of Pediatric Infectious Diseases, Ankara Kecioren Training and Research Hospital, Ankara, Turkey
| | - Halil Ozdemir
- Department of Pediatric Infectious Diseases, Ankara University, Ankara, Turkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseases, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Tijen Diri
- Department of Pediatrics, Istanbul Acıbadem Atakent Hospital, Istanbul, Turkey
| | - Ahmet Sami Yazar
- Department of Pediatrics, Istanbul Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Murat Sütçü
- Department of Pediatric Infectious Diseases, Konya Training and Research Hospital, Konya, Turkey
| | - Hasan Tezer
- Department of Pediatric Infectious Diseases, Ankara Gazi University, Ankara, Turkey
| | - Eda Karadag Oncel
- Department of Pediatric Infectious Diseases, Saglik Bilimleri University, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Manolya Kara
- Department of Pediatric Infectious Diseases, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Solmaz Çelebi
- Department of Pediatric Infectious Diseases, Bursa Uludag University, Bursa, Turkey
| | - Aslınur Özkaya Parlakay
- Department of Pediatric Infectious Diseases, Ankara Yildirim Beyazit University, Ankara, Turkey
| | | | - Emin Sami Arısoy
- Department of Pediatric Infectious Diseases, Kocaeli University, Kocaeli, Turkey
| | - Gönül Tanır
- Department of Pediatric Infectious Diseases, Ankara Doktor Sami Ulus Women and Children Training and Research Hospital, Ankara, Turkey
| | - Tuğçe Tural Kara
- Department of Pediatric Infectious Diseases, Hatay State Hospital, Hatay, Turkey
| | - İlker Devrim
- Department of Pediatric Infectious Diseases, Izmir Doktor Behcet Uz Children's Hospital, İzmir, Turkey
| | - Tuğba Erat
- Department of Pediatric Infectious Diseases, Ankara University, Ankara, Turkey
| | - Kübra Aykaç
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, 06100, Turkey
| | - Özge Kaba
- Department of Pediatric Infectious Diseases, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Şirin Güven
- Department of Pediatrics, Istanbul Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Edanur Yeşil
- Department of Pediatric Infectious Diseases, Bursa Uludag University, Bursa, Turkey
| | - Ayşe Tekin Yılmaz
- Department of Pediatric Infectious Diseases, Kocaeli University, Kocaeli, Turkey
| | - Sevgi Yaşar Durmuş
- Department of Pediatric Infectious Diseases, Ankara Doktor Sami Ulus Women and Children Training and Research Hospital, Ankara, Turkey
| | - İlknur Çağlar
- Department of Pediatric Infectious Diseases, Izmir Doktor Behcet Uz Children's Hospital, İzmir, Turkey
| | - Fatih Günay
- Department of Pediatrics, Ankara University, Ankara, Turkey
| | - Metehan Özen
- Department of Pediatric Infectious Diseases, Istanbul Acıbadem Atakent Hospital, Istanbul, Turkey
| | | | - Ateş Kara
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, 06100, Turkey.
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Erbaş İC, Keleş YE, Erdeniz EH, Yılmaz AT, Yeşil E, Çakıcı Ö, Akça M, Ulu NK, Dinç F, Çiftdoğan DY, Öncel S, Kuyucu N, Tapısız A, Belet N. Evaluation of possible COVID-19 reinfection in children: A multicenter clinical study. Arch Pediatr 2023; 30:187-191. [PMID: 36804354 PMCID: PMC9902289 DOI: 10.1016/j.arcped.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/17/2022] [Accepted: 01/07/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Although it was originally unknown whether there would be cases of reinfection of coronavirus disease 2019 (COVID-19) as seen with other coronaviruses, cases of reinfection were reported from various regions recently. However, there is little information about reinfection in children. METHODS In this study, we aimed to investigate the incidence and clinical findings of reinfection in pediatric patients who had recovered from COVID-19. We retrospectively evaluated all patients under 18 years of age with COVID-19 infection from a total of eight healthcare facilities in Turkey, between March 2020 and July 2021. Possible reinfection was defined as a record of confirmed COVID-19 infection based on positive reverse transcription-polymerase chain reaction (RT-PCR) test results at least 3 months apart. RESULTS A possible reinfection was detected in 11 out of 8840 children, which yielded an incidence of 0.12%. The median duration between two episodes of COVID-19 was 196 (92-483) days. When initial and second episodes were compared, the rates of symptomatic and asymptomatic disease were similar for both, as was the severity of the disease (p = 1.000). Also, there was no significant difference in duration of symptoms (p = 0.498) or in hospitalization rates (p = 1.000). Only one patient died 15 days after PCR positivity, which resulted in a 9.1% mortality rate for cases of reinfection in pediatric patients. CONCLUSION We observed that children with COVID-19 were less likely to be exposed to reinfection when compared with adults. Although the clinical spectrum of reinfection was mostly similar to the first episode, we reported death of a healthy child during the reinfection.
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Affiliation(s)
- İrem Ceren Erbaş
- Division of Pediatric Infectious Disease, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey.
| | - Yıldız Ekemen Keleş
- Division of Pediatric Infectious Disease, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Emine Hafize Erdeniz
- Division of Pediatric Infectious Disease, Faculty of Medicine, On Dokuz Mayıs University, Samsun, Turkey
| | - Ayşe Tekin Yılmaz
- Division of Pediatric Infectious Disease, Eskişehir State Hospital, Eskişehir, Turkey
| | - Edanur Yeşil
- Division of Pediatric Infectious Disease, Mersin State Hospital, Mersin, Turkey
| | - Özlem Çakıcı
- Division of Pediatric Infectious Disease, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Mehtap Akça
- Division of Pediatric Infectious Disease, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Nursel Kara Ulu
- Division of Pediatric Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Fatih Dinç
- Division of Virology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Dilek Yılmaz Çiftdoğan
- Division of Pediatric Infectious Disease, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Selim Öncel
- Division of Pediatric Infectious Disease, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Necdet Kuyucu
- Division of Pediatric Infectious Disease, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Anıl Tapısız
- Division of Pediatric Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nurşen Belet
- Division of Pediatric Infectious Disease, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
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Yeşil E, Sezer Ç, Çelebi S, Turan C, Bülbül B, Hacımustafaoğlu M. Evaluation of Children with Tuberculosis: A 10-year Retrospective Study. jcp 2022. [DOI: 10.4274/jcp.2022.71542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Oygar PD, Büyükçam A, Sahbudak Bal Z, Dalgıç N, Bozdemir ŞE, Karbuz A, Çetin BŞ, Kara Y, Çetin C, Hatipoğlu N, Uygun H, Aygün FD, Hançerli Törün S, Şener Okur D, Yılmaz Çiftdoğan D, Tural Kara T, Yahşi A, Özer A, Öcal Demir S, Akkoç G, Turan C, Salı E, Şen S, Erdeniz EH, Kara SS, Emiroğlu M, Erat T, Aktürk H, Laçinel Gürlevik S, Sütçü M, Gayretli Aydın ZG, Yıldız Atikan B, Yeşil E, Güner Özenen G, Çelebi E, Efe K, Kizmaz Isancli D, Selver Durmuş H, Tekeli S, Karaaslan A, Bülbül L, Almış H, Kaba Ö, Ekemen Keleş Y, Yazıcıoğlu B, Bahtiyar Oğuz S, Ovalı HF, Doğan HH, Çelebi S, Çakir D, Karasulu B, Alkan G, Yenidoğan İ, Gül D, Parıltan Kücükalioğlu B, Avcu G, Kukul MG, Bilen M, Yaşar B, Üstün T, Kılıç Ö, Akın Y, Oral Cebeci S, Bucak İH, Sarı Yanartaş M, Şahin A, Arslanoglu S, Elevli M, Çoban R, Tuter Öz SK, Hatipoğlu H, Erkum İT, Turgut M, Demirbuğa A, Özçelik T, Çiftçi D, Sarı EE, Akkuş G, Hatipoğlu SS, Dinleyici EC, Hacimustafaoğlu M, Özkınay F, Kurugöl Z, Cengiz AB, Somer A, Tezer H, Kara A. Evaluation of vaccination status of health care workers for recommended vaccines and their acceptance of SARS-CoV-2 vaccines. Hum Vaccin Immunother 2022; 18:2044707. [PMID: 35714279 PMCID: PMC9248937 DOI: 10.1080/21645515.2022.2044707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Introduction Health care workers (HCWs) are disproportionately exposed to infectious diseases and play a role in nosocomial transmission, making them a key demographic for vaccination. HCW vaccination rates are not optimal in many countries; hence, compulsory vaccination policies have been implemented in some countries. Although these policies are effective and necessary under certain conditions, resolving HCWs’ hesitancies and misconceptions about vaccines is crucial. HCWs have the advantage of direct contact with patients; hence, they can respond to safety concerns, explain the benefits of vaccination, and counter antivaccine campaigns that escalate during pandemics, as has been observed with COVID-19. Method A short survey was carried out in May–June 2020 on the vaccination status of HCWs working with pediatric patients with COVID-19. The survey inquired about their vaccination status (mumps/measles/rubella [MMR], varicella, influenza, and diphtheria/tetanus [dT]) and willingness to receive hypothetical future COVID-19 vaccines. The respondents were grouped according to gender, age, occupation, and region. Results In total, 4927 HCWs responded to the survey. Most were young, healthy adults. The overall vaccination rates were 57.8% for dT in the past 10 years, 44.5% for MMR, 33.2% for varicella, and 13.5% for influenza. Vaccination rates were the highest among physicians. The majority of HCWs (81%) stated that they would be willing to receive COVID-19 vaccines. Conclusion Although vaccination rates for well-established vaccines were low, a majority of HCWs were willing to receive COVID-19 vaccines when available. Education and administrative trust should be enhanced to increase vaccination rates among HCWs.
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Oygar PD, Büyükçam A, Bal ZŞ, Dalgıç N, Bozdemir ŞE, Karbuz A, Çetin BŞ, Kara Y, Çetin C, Hatipoğlu N, Uygun H, Aygün FD, Törün SH, Okur DŞ, Çiftdoğan DY, Kara TT, Yahşi A, Özer A, Demir SÖ, Akkoç G, Turan C, Salı E, Şen S, Erdeniz EH, Kara SS, Emiroğlu M, Erat T, Aktürk H, Gürlevik SL, Sütçü M, Aydın ZGG, Atikan BY, Yeşil E, Güner G, Çelebi E, Efe K, İşançlı DK, Durmuş HS, Tekeli S, Karaaslan A, Bülbül L, Almış H, Kaba Ö, Keleş YE, Yazıcıoğlu B, Oğuz ŞB, Ovalı HF, Doğan HH, Çelebi S, Çakır D, Karasulu B, Alkan G, Yenidoğan İ, Gül D, Küçükalioğlu BP, Avcu G, Kukul MG, Bilen M, Yaşar B, Üstün T, Kılıç Ö, Akın Y, Cebeci SO, Bucak IH, Yanartaş MS, Şahin A, Arslanoğlu S, Elevli M, Çoban R, Öz ŞKT, Hatipoğlu H, Erkum İT, Turgut M, Demirbuğa A, Özçelik T, Çiftçi D, Sarı EE, Akkuş G, Hatipoğlu SS, Dinleyici EÇ, Hacımustafaoğlu M, Özkınay F, Kurugöl Z, Cengiz AB, Somer A, Tezer H, Kara A. SARS-CoV-2 seropositivity among pediatric health care personnel after the first peak of the pandemic: nationwide surveillance in Turkey. Int J Infect Dis 2021; 113:184-189. [PMID: 34592441 PMCID: PMC8474801 DOI: 10.1016/j.ijid.2021.09.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/31/2021] [Accepted: 09/22/2021] [Indexed: 11/19/2022] Open
Abstract
Background Understanding SARS-CoV-2 seroprevalence among health care personnel is important to explore risk factors for transmission, develop elimination strategies and form a view on the necessity and frequency of surveillance in the future. Methods We enrolled 4927 health care personnel working in pediatric units at 32 hospitals from 7 different regions of Turkey in a study to determine SARS Co-V-2 seroprevalence after the first peak of the COVID-19 pandemic. A point of care serologic lateral flow rapid test kit for immunoglobulin (Ig)M/IgG was used. Seroprevalence and its association with demographic characteristics and possible risk factors were analyzed. Results SARS-CoV-2 seropositivity prevalence in health care personnel tested was 6.1%. Seropositivity was more common among those who did not universally wear protective masks (10.6% vs 6.1%). Having a COVID-19-positive co-worker increased the likelihood of infection. The least and the most experienced personnel were more likely to be infected. Most of the seropositive health care personnel (68.0%) did not suspect that they had previously had COVID-19. Conclusions Health surveillance for health care personnel involving routine point-of-care nucleic acid testing and monitoring personal protective equipment adherence are suggested as important strategies to protect health care personnel from COVID-19 and reduce nosocomial SARS-CoV-2 transmission.
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Özdemir A, Yeşil E, Brown MA. Iatrogenic injury of the airways. Pediatr Pulmonol 2021; 56:1252-1253. [PMID: 33587830 DOI: 10.1002/ppul.25145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Ali Özdemir
- Department of Pediatrics, Pediatric Pulmonary Section, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Edanur Yeşil
- Department of Pediatrics, Pediatric Infectious Disease Section, Mersin City Training and Research Hospital, Mersin, Turkey
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Oygar PD, Büyükçam A, Şahbudak Bal Z, Dalgıç N, Bozdemir ŞE, Karbuz A, Çetin BŞ, Kara Y, Çetin C, Hatipoğlu N, Uygun H, Aygün FD, Hançerli Törün S, Şener Okur D, Yılmaz Çiftdoğan D, Tural Kara T, Yahşi A, Özer A, Öcal Demir S, Akkoç G, Turan C, Salı E, Şen S, Erdeniz EH, Kara SS, Emiroğlu M, Erat T, Aktürk H, Laçinel Gürlevik S, Sütçü M, Gayretli Aydın ZG, Atikan BY, Yeşil E, Güner G, Çelebi E, Efe K, Kızmaz İşançlı D, Durmuş HS, Tekeli S, Karaarslan A, Bülbül L, Almış H, Kaba Ö, Ekemen Keleş Y, Yazıcıoğlu B, Bahtiyar Oğuz Ş, Ovalı HF, Doğan HH, Çelebi S, Çakır D, Karasulu B, Alkan G, Yenidoğan İ, Gül D, Parıltan Küçükalioğlu B, Avcu G, Kukul MG, Bilen M, Yaşar B, Üstün T, Kılıç Ö, Akın Y, Oral Cebeci S, Turgut M, Sarı Yanartaş M, Şahin A, Arslanoğlu S, Elevli M, Tüter Öz ŞK, Hatipoğlu H, Erkum İT, Demirbuğa A, Özçelik T, Ergül Sarı E, Akkuş G, Hatipoğlu SS, Dinleyici EÇ, Hacımustafaoğlu M, Özkınay F, Kurugöl Z, Cengiz AB, Somer A, Tezer H, Kara A. Education of Healthcare Personnel Working with Pediatric Patients During COVID-19 Pandemic within the Framework of Infection Control. J Pediatr Inf 2020. [DOI: 10.5578/ced.202061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n= 4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic.
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Oygar PD, Büyükçam A, Şahbudak Bal Z, Dalgıç N, Bozdemir ŞE, Karbuz A, Çetin BŞ, Kara Y, Çetin C, Hatipoğlu N, Uygun H, Aygün FD, Hançerli Törün S, Şener Okur D, Yılmaz Çiftdoğan D, Tural Kara T, Yahşi A, Özer A, Öcal Demir S, Akkoç G, Turan C, Salı E, Şen S, Erdeniz EH, Kara SS, Emiroğlu M, Erat T, Aktürk H, Laçinel Gürlevik S, Sütçü M, Gayretli Aydın ZG, Atikan BY, Yeşil E, Güner G, Çelebi E, Efe K, Kızmaz İşançlı D, Durmuş HS, Tekeli S, Karaarslan A, Bülbül L, Almış H, Kaba Ö, Ekemen Keleş Y, Yazıcıoğlu B, Bahtiyar Oğuz Ş, Ovalı HF, Doğan HH, Çelebi S, Çakır D, Karasulu B, Alkan G, Yenidoğan İ, Gül D, Parıltan Küçükalioğlu B, Avcu G, Kukul MG, Bilen M, Yaşar B, Üstün T, Kılıç Ö, Akın Y, Oral Cebeci S, Bucak İH, Turgut M, Sarı Yanartaş M, Şahin A, Arslanoğlu S, Elevli M, Tüter Öz ŞK, Hatipoğlu H, Erkum İT, Demirbuğa A, Özçelik T, Ergül Sarı E, Akkuş G, Hatipoğlu SS, Dinleyici EÇ, Hacımustafaoğlu M, Özkınay F, Kurugöl Z, Cengiz AB, Somer A, Tezer H, Kara A. COVID-19 Pandemisinde Enfeksiyon Kontrol Çalışmaları Çerçevesinde Çocuk Hastalarla Çalışan Sağlık Personeli Eğitimi. J Pediatr Inf 2020. [DOI: 10.5578/ced.70235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n= 4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic.
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Yeşil E. Pakistan’da Pnömonide Amoksisilinin Randomize Araştırılması*. J Pediatr Inf 2020. [DOI: 10.5578/ced.202037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Yeşil E, Çelebi S, Sezgin Evim M, Özer A, Turan C, Timur D, Çakır SÇ, Bülbül B, Ener B, Güneş AM, Köksal N, Özkan H, Sevinir B, Düzcan Kilimci D, Hacımustafaoğlu M. [Evaluation of Micafungin Use in Children]. MIKROBIYOL BUL 2020; 54:120-134. [PMID: 32050883 DOI: 10.5578/mb.68832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Micafungin is recommended especially in patients with liver and kidney failure and in the presence of other side effects due to antifungals apart from its known priority indications such as invasive candidiasis. The aim of this study was to evaluate the children who have received micafungin treatment. In the study, 125 children who were hospitalized in the pediatric wards and intensive care units of our hospital and had used micafungin between November 2016 and January 2019 were analyzed retrospectively. Clinical data, micafungin indication, blood values on the first and fourth days of the treatment, side effects of the drug and efficacy were evaluated. Sixty percent (75/125) of the patients were male and the mean age of all the patients were 58 ± 67 (0-215, 30) months. Approximately half of the cases (48%) had malignancy and 13% of them were premature. Sixty-two percent (n= 37) of the malignencies were hematological (27 acute lymphocytic leukemia, nine acute myeloid leukemia, one myelodysplastic syndrome) and 38% (n= 23) were oncological (six neuroblastoma, four Hodgkin lymphoma, two Non-Hodgkin's lymphoma, five sarcomas, one hepatoblastoma, five others) malignencies. The major cause of hospitalization was sepsis (53%). The patients had several risk factors like immunosuppressive therapy (n= 68, 54%), neutropenia (n= 61, 49%), central venous catheter (n= 102, 82%), nasogastric tube (n= 63, 50%), endotracheal intubation tube (n= 49, 39%), urinary catheter (n= 14, 11%) and total parenteral nutrition (n= 81, 65%). Thirteen percent (n= 16) of the cases were post-operative patients. Candida species were cultivated in 97 clinical specimens (blood, endotracheal aspirate, sputum, urine, etc.) among 23 (18%) of the patients. Thirteen (10%) of the patients had candidemia and 62% of them were non-albicans strains. In all candidemias, strains were echinocandin susceptible, and blood cultures were negative within four days. When all the patients (n= 125) were evaluated, a significant decrease in C-reactive protein, an increase in sodium, and a decrease in alanine aminotransferase were observed on the fourth day of micafungin treatment (p<0.05). A total of 39 (31%) patients underwent various antifungal treatments for median seven (1-60) days prior to micafungin treatment. Fourteen (36%) of these 39 patients, had elevated liver function tests (LFT), 10 (26%) of them had hypokalemia, and five (13%) of them had elevated renal function tests. Ten (26%) patients had antifungal-induced hypokalemia previously; and potassium levels were normalized after micafungin treatment (p= 0.0001). The patients for which micafungin treatment was chosen due to elevated liver function tests (n= 47, 38%), whether the antifungalinduced or not; alanine aminotransferase and aspartate aminotransferase levels were decreased after micafungin treatment (p= 0.0001 and p= 0.0001, respectively). Nineteen (15%) of the patients have died within the first 30 days of micafungin treatment and one of them had candidemia. No micafungin treatment related significant side effects were observed in any of the patients. Our study showed that micafungin could be a safe and effective option in pediatric cases including newborns with high liver and kidney function tests.
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Affiliation(s)
- Edanur Yeşil
- Uludag University Faculty of Medicine, Department of Pediatric Infectious Diseases, Bursa, Turkey
| | - Solmaz Çelebi
- Uludag University Faculty of Medicine, Department of Pediatric Infectious Diseases, Bursa, Turkey
| | - Melike Sezgin Evim
- Uludag University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | - Arife Özer
- Uludag University Faculty of Medicine, Department of Pediatric Infectious Diseases, Bursa, Turkey
| | - Cansu Turan
- Uludag University Faculty of Medicine, Department of Pediatric Infectious Diseases, Bursa, Turkey
| | - Demet Timur
- Uludag University Faculty of Medicine, Department of Medical Mycology, Bursa, Turkey
| | - Salih Çağrı Çakır
- Uludag University Faculty of Medicine, Department of Neonatology, Bursa, Turkey
| | - Beyhan Bülbül
- Uludag University Faculty of Medicine, Department of Pediatric Infectious Diseases, Bursa, Turkey
| | - Beyza Ener
- Uludag University Faculty of Medicine, Department of Medical Mycology, Bursa, Turkey
| | - Adalet Meral Güneş
- Uludag University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | - Nilgün Köksal
- Uludag University Faculty of Medicine, Department of Neonatology, Bursa, Turkey
| | - Hilal Özkan
- Uludag University Faculty of Medicine, Department of Neonatology, Bursa, Turkey
| | - Betül Sevinir
- Uludag University Faculty of Medicine, Department of Pediatric Oncology, Bursa, Turkey
| | - Duygu Düzcan Kilimci
- Celal Bayar University Faculty of Medicine, Department of Pediatric Endocrinology, Manisa, Turkey
| | - Mustafa Hacımustafaoğlu
- Uludag University Faculty of Medicine, Department of Pediatric Infectious Diseases, Bursa, Turkey
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Yeşil E, Hacımustafaoğlu M. Anesthesia/Surgery and Vaccination. J Pediatr Inf 2019. [DOI: 10.5578/ced.201953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Yeşil E, Hacımustafaoğlu M. Anestezi/Cerrahi Operasyon ve Aşılama. J Pediatr Inf 2019. [DOI: 10.5578/ced.201962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
Invasive candidiasis is a common and serious infection in premature newborns. Preventing and treating fungal infections is very important to improve the prognosis of premature infants. Fluconazole and amphotericin B are used as the first choice in the treatment of invasive fungal infections of the newborns. In some cases, fluconazole and amphotericin B cannot be used due to nephrotoxicity, hepatotoxicity or resistant strains. Micafungin, which is among recently developed echinocandins, is the drug of choice in these cases. The use of micafungin in newborns is new and there is a limited experience about the effect of high dose usage in the central nervous system. The aim of this study was to evaluate the electronic files of patients who used micafungin for the treatment of culture-proven or possible invasive fungal infection during their hospital stay in the neonatal intensive care unit during a 24-month period (2016-2017) in the third-level intensive care unit. A total of 15 patients (10 premature and 5 term babies) were included in the study. The mean birth weight of the patients was 1732 ± 999 g and the mean gestational age was 32.2 ± 5.8 weeks. All patients had long-term intensive care and increased risk of invasive candidiasis infection. Central venous catheterization and multiple antibiotics usage were the most common risk factors in these patients. The other risk factors included intubation, total parenteral nutritional use and surgical procedure application. Candida species were isolated from the cultures of four patients. Candida species isolated from patients were Candida albicans, Candida glabrata, Candida catenulata, Candida parapsilosis. The mean time for onset of micafungin was 29.9 ± 16.6 days. Mean duration of micafungin therapy was 22.4 ± 11.2 days. Eight patients received amphotericin B, three patients received fluconazole therapy and four patients did not receive any antifungal therapy before the onset of micafungin. None of these patients had an abnormal kidney or liver function tests due to micafungin use. As a conclusion, high dose (10 mg/kg/day) micafungin is a safe and effective treatment choice both in the treatment of neonatal culture proven or probable invasive candida infections that were caused by refractory Candida strains, and in the case of nephrotoxicity and hepatotoxicity.
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Affiliation(s)
- Salih Çağrı Çakır
- Uludag University Faculty of Medicine, Department of Neonatology, Bursa, Turkey
| | - Solmaz Çelebi
- Uludag University Faculty of Medicine, Department of Pediatric Infectious Disease, Bursa, Turkey
| | - Hilal Özkan
- Uludag University Faculty of Medicine, Department of Neonatology, Bursa, Turkey
| | - Nilgün Köksal
- Uludag University Faculty of Medicine, Department of Neonatology, Bursa, Turkey
| | - Bayram Ali Dorum
- Uludag University Faculty of Medicine, Department of Neonatology, Bursa, Turkey
| | - Edanur Yeşil
- Uludag University Faculty of Medicine, Department of Pediatric Infectious Disease, Bursa, Turkey
| | - Mustafa Hacımustafaoğlu
- Uludag University Faculty of Medicine, Department of Pediatric Infectious Disease, Bursa, Turkey
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