Browsing by Author "SEZGİN EVİM, MELİKE"

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A rare case of recurrence presenting with bilateral exudative retinal detachment in a child with acute lymphoblastic leukemia
(Wiley, 2021-08-16) Yalçınbayır, Özgür; Sezgin Evim, Melike; Uçan Gündüz, Gamze; Güler, Salih; Meral Güneş, Adalet; YALÇINBAYIR, ÖZGÜR; SEZGİN EVİM, MELİKE; UÇAN GÜNDÜZ, GAMZE; GÜLER, SALİH; MERAL GÜNEŞ, ADALET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Hematoloji Anabilim Dalı; 0000-0002-7311-5277; 0000-0002-1219-8304; 0000-0002-5458-1686; 0000-0002-4792-269X; 0000-0002-0686-7129; IYJ-9408-2023; AAH-1452-2021; AAH-6661-2021; DWH-8632-2022; EXD-8400-2022
Aceruloplasminemia in a Turkish adolescent with a novel mutation of cp gene: The first diagnosed case from Turkey
(Ferrata Storti Foundation, 2013-06-12) Güneş, Ahmet; Baytan, Birol; Evim, Melike Sezgin; Güneş, Ahmet; Baytan, Birol; SEZGİN EVİM, MELİKE; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Hematoloji Bölümü; 0000-0002-9375-2855; AAH-1452-2021; KOC-4717-2024; DVW-8108-2022
Acute endocrine and metabolic complications during treatment in childhood acute lymphoblastic leukemia patients: Retrospective study
(Güncel Pediatri, 2023-04-01) Evim, Melike Sezgin; Tobçu, Zeynep; Güler, Salih; Öngen, Yasemin Denkboy; Güneş, Adalet Meral; SEZGİN EVİM, MELİKE; TOBCU, ZEYNEP; GÜLER, SALİH; DENKBOY ÖNGEN, YASEMİN; MERAL GÜNEŞ, ADALET; Uludağ Üniversitesi Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Hematoloji Bilim Dalı; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dal; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Endokrinoloji Bilim Dal; IRI-7023-2023; JJX-6307-2023; JHO-2788-2023; JJP-0399-2023; JGX-6145-2023
Introduction: Acute leukemias are the most common malignancy of childhood, and acute lymphoblastic leukemia (ALL) is the most common subtype. In this study; we aimed to asses to acute endocrine and metabolic complications which occurs during treatment. Newly diagnosed ALL patients were included in the study.Materials and Methods: The endocrine and metabolic complication of 293 patients aged 1-18 years old who were newly diagnosed ALL between January 2007 and December 2017 in Uludag University Faculty, Department of Pediatric Hematology were analyzed. Patients' age, gender, risk groups, leukemia subtypes, and chemotherapy phases at the time of endocrine complications were noted.Results: In total, 250 patients were follow-up with B-ALL and 43 patients with T-ALL. 64% (n=188) of patients were male and 36% (n=105) were female. In our study, 36.4% of patients were in the high risk group but ten of the patients died before the risk group could be determined. During the two-year treatment, We found that 83% of the patients developed at least one endocrine complication. Hyperglycemia, osteoporosis and avascular necrosis were observed more frequently in patients older than 10 years at the time of diagnosis. The difference between the sexes was found only in vitamin D and was lower in girls. In regression analysis, only to be high risk group were found to be effective for the development of endocrine complications.Conclusion: Although the chemotherapeutics used today have prolonged the survival time, they have caused an increase in the incidence of complications. We think that these complications can be reduced by determining the risk factors in advance.
Acute neurologic complications in children with acute lymphoblastic leukemia
(Wiley-blackwell, 2013-09-01) MERAL GÜNEŞ, ADALET; SEZGİN EVİM, MELİKE; Baytan, B.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hemotoloji Anabilim Dalı.; 0000-0002-9375-2855; AAH-1452-2021
Approach to children with thrombocytosis
(Galenos Yayincilik, 2017-12-01) SEZGİN EVİM, MELİKE; Güneş, Adalet Meral; MERAL GÜNEŞ, ADALET; Baytan, Birol; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Hematoloji ve Onkoloji Bilim Dalı.; 0000-0002-9375-2855; AAH-1452-2021
The platelet count above than 450.000 mm3 is defined as thrombocytosis. According to the underlying causes, thrombocytosis is classified as primary (essential) or secondary (reactive) thrombocytosis. In childhood, the most common causes of thrombocytosis are secondary reasons. Secondary thrombcytosis is a self-limited disease. It resolves with under the control of underlying disorder. Secondary trombocytosis usually does not result in tromboembolic event. If trombembolic complication occurs, such cases have got additional risk factors. Primary trombocytosis is grouped under the myeloproliferative disease and is exremely rare in childhood. Tromboembolic events in primary trombocytosis are the most important causes of mortality and morbidity. Some cases with primary thrombocytosis may present with bleeding symptoms.
Assessment of overprotective parenting attitudes and emotional status among mothers in pediatric thalassemia, hemofilia and leukemia patients in Bursa
(Galenos Yayincilik, 2018-01-01) Kantarcıoğlu, Arzu Çirpan; Evim, Melike Sezgin; SEZGİN EVİM, MELİKE; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; AAH-1452-2021
INTRODUCTION: The aim of the current study was to investigate overprotective parenting attitudes and emotional status among thalassemia, hemophilia and leukemia patients' mothers.METHODS: Seventy-four children who were between six to sixteen years old participated in current study. Fifty-two children were in the study group (thalassemia, hemophilia and leukemia patients) and twenty-two children in control group. Brief Symptom Inventory and Parental Attitude Research Instrument (PARI) were used to collect data.RESULTS: According to the results, over protective parenting attitudes in the study group were significantly higher than the control group. When the study group was compared within itself, it was observed that the mothers of the hemophilia had significantly protective attitudes compared to the leukemia patients. The depression, anxiety, negative self-perception, somatization and hostility scores of the study group were significantly higher than the control group. At the same time, there is a positive relationship between over-protective parenting attitudes and anxiety.DISCUSSION and CONCLUSION: Overprotective parenting attitudes can cause some psychopathology and developmental defiency in the childrens' future personal life. Children diagnosed with chronic or serious illness and their family should be evaluated psychologically.
Assessment of patients with von willebrand disease with STH/BAT and PBQ scores
(Galenos Yayıncılık, 2020-01-01) Apak, Fatma Burcu Belen; Ümit, Elif Gülsüm; Zengin, Yağmur; Evim, Melike Sezgin; Ünal, Ekrem; Özbas, Hasan Mücahit; Acıpayam, Can; SEZGİN EVİM, MELİKE; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatrik Hematoloji Onkoloji Anabilim Dalı.; 0000-0002-4792-269X; AAH-1452-2021
Central nervous system fungal infections in children with leukemia: Risk factors and outcome: A multicentric study
(Wiley, 2018-11-01) Karaman, S.; Kebudi, R.; Kızılocak, H.; Karakaş, Z.; Evim, Melike Sezgin; Kaya, Z.; Yaralı, N.; Calışkan, U.; Şahin, B. Karagün; Yılmaz, S.; Karapınar, D. Yilmaz; Unal, E.; Güneş, Adalet Meral; Güzelküçük, Z.; Koçak, U.; Celkan, T.; SEZGİN EVİM, MELİKE; MERAL GÜNEŞ, ADALET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Hematololoji Onkoloji Bölümü; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kemik İliği Nakli Ünitesi; AAH-1452-2021; EXD-8400-2022
Congenital leukemia initially presenting with leukemia cutis
(Galenos Yayincilik, 2012-12-01) Evim, Melike Sezgin; SEZGİN EVİM, MELİKE; Demiral, Meliha; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; AAH-1452-2021
Introduction: Congenital leukemia represents less than 1% of childhood leukemia. Its prognosis is poor. Myeloid form is the most common type, and leukemia cutis has been observed in 25-30% of the patients. These skin lesions are defined as 'blueberry muffin' type which are blue-violaceous and usually multiple and diffuse nodules.Case Report: She had diffuse blue-violaceous nodules since birth. She hospitalized due to sepsis for 35 days. She was referred to our center with the suspicion of immune deficiency. The initial physical findings were severe pallor, diffuse blue-violaceous subcutanose nodules and hepatosplenomegaly. The leucocyte count was found 363 000/mm(3). Acute monositer leukemia (AML-M5) was determined with morphologic and flow cytometric evaluation of the peripheral blood.Conclusion: Congenital leukemia must be thought in differential diagnosis from other underlying disease presenting with blueberry muffin skin lesions.
Congenital malformation in children with acute leukemia: Single center report
(Bursa Uludağ Üniversitesi, 2021-04-01) Güler, Salih; Temuroglu, Aytul; Evim, Melike Sezgin; Baytan, Birol; Güneş, Adalet Meral; GÜLER, SALİH; TEMUROĞLU, AYTÜL; SEZGİN EVİM, MELİKE; Baytan, Birol; MERAL GÜNEŞ, ADALET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Hematoloji Anabilim Dalı; 0000-0002-8943-6585; 0000-0002-2398-0959; 0000-0002-4792-269X; 0000-0002-0686-7129; JHO-2788-2023; GES-3112-2022; AAH-1452-2021; DVW-8108-2022; JGX-6145-2023
Introduction:Leukemia is a multifactorial disease. Some genetic syndromes is well known related to leukemia. We evaluated non-syndromic malformation and leukemia relation.Materials and Methods: 288 patients diagnosed with acute leukemia are included the study. 201 patients with non-malign hematologic disease are accepted as a control. Syndromic children were excluded both group. All children were examined according to ICD-10th, Chapter XVII for congenital malformation. The type and number of malformations were compared both group.Results: There were no differences between leukemia and control group in terms of age at diagnosis, gender, consanguinity between parents, parents age at birth, family history of cancer and pregnancies of mother. Congenital malformations were more observed in leukemic population (p<0.001). The most common malformation in the control group was on the skin. Whereas the most common malformation in leukemic children was seen in the circulatory system, second region was skin. Having circulatory system malformation explained 12.53 high of the leukemia risk.Conclusions: Malformations were more common in leukemic children. We found that having a circulatory system malformation significantly increased the risk of leukemia. But the risk was very high previous study. This related to we evaluated echocardiography result which is common use for basal test.
Different kinetics and risk factors for isolated extramedullary relapse after allogeneic hematopoietic stem cell transplantation in children with acute leukemia
(Elsevier, 2021-08-20) Hazar, Volkan; Öztürk, Gülyüz; Yalçın, Koray; Uygun, Vedat; Aksoylar, Serap; Küpesiz, A.; Bozkaya, İkbal Ok; Karagün, Barbaros Şahin; Bozkurt, Ceyhun; İleri, Talia; Atay, Didem; Koçak, Ülker; Karasu, Gülsün Tezcan; Yeşilipek, Akif; Gökçe, Müge; Kansoy, Savas; Kintrup, Gulen Tüysüz; Karakukcu, Musa; Okur, Fatma Visal; Ertem, Mehmet; Kaya, Zühre; Gürsel, Orhan; Yaman, Yöntem; Özbek, Namık; Antmen, Bülent; Tüfekci, Özlem; Albayrak, Canan; Aksoy, Başak Adakli; Sezgin, Gülay; Albayrak, Davut; Evim, Melike Sezgin; Zengin, Emine; Pekpak, Esra; SEZGİN EVİM, MELİKE; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0002-4792-269X; AAH-1452-2021
Relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the most frequent cause of post-transplantation mortality. Isolated extramedullary (EM) relapse (iEMR) after HSCT is relatively rare and not well characterized, particularly in pediatric patients. We retrospectively analyzed 1527 consecutive pediatric patients with acute leukemia after allo-HSCT to study the incidence, risk factors, and outcome of iEMR compared with systemic relapse. The 5 -year cumulative incidence of systemic relapse (either bone marrow [BM] only or BM combined with EMR) was 24.8%, and that of iEMR was 5.5%. The onset of relapse after allo-HSCT was significantly longer in EM sites than in BM sites (7.19 and 5.58 months, respectively; P =.013). Complete response (CR) 2 +/active disease at transplantation (hazard ratio [HR], 3.1; P <.001) and prior EM disease (HR, 2.3; P =.007) were independent risk factors for iEMR. Chronic graft-versus-host disease reduced the risk of systemic relapse (HR, 0.5; P=.043) but did not protect against iEMR. The prognosis of patients who developed iEMR remained poor but was slightly better than that of patients who developed systemic relapse (3 -year overall survival, 16.5% versus 15.3%; P =.089). Patients experiencing their first systemic relapse continued to have further systemic relapse, but only a minority progressed to iEMR, whereas those experiencing their iEMR at first relapse developed further systemic relapse and iEMR at approximately similar frequencies. A second iEMR was more common after a first iEMR than after a first systemic relapse (58.8% versus 13.0%; P =.001) and was associated with poor outcome. iEMR has a poor prognosis, particularly after a second relapse, and effective strategies are needed to improve outcomes. (C) 2021 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
Effects of 6 months all treatment on psychosocial development and emotional status in children aged 1 to 3 years
(Galenos Yayincilik, 2012-04-01) SEZGİN EVİM, MELİKE; Kantarcıoğlu, Arzu; MERAL GÜNEŞ, ADALET; Güneş, Adalet Meral; Baytan, Birol; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0002-9375-2855
Introduction: The aim of the current study was to evaluate possible effects of cancer treatment on psychosocial development and emotional state among children who was diagnosed as acute lymphoblastic leukemia (ALL) before hospitalization and six months after treatment process.Materials and Methods: Twelve patients aged 1 to 3 years were screened before and six months after treatment. AGTE (Ankara Developmental Screening Inventory) and BITSEA (Brief Infant Toddler Social Emotional Assessment) were used for evaluating psychosocial development and social emotional status respectively. Spending time with play, peer groups and physical activity were evaluated twice and investaged with respect to possible relationship with psychosocial development.Results: According the current study results; six months after the diagnosis of ALL, children's social emotional problems were increased, competence was decreased, fine motor and social development-self care ability were regressed.Conclusions: In early develomental stage, even 6 months after the diagnosis, ALL is a risk factor for psychosocial development and emotional state. Social isolation due to neutropenia seems to have important side effect on the behaviour. In the future studies there is a great need of longidutional research as if that side effect will be permanent. In the mean time during the hospitalization and isolation process, children need environmental stimulations. Care givers should be informed and guided about the ways which support development. If needed, children should be directed to special education programs.
Elevated vitamin b12 levels
(Galenos Yayincilik, 2014-12-01) MERAL GÜNEŞ, ADALET; SEZGİN EVİM, MELİKE; Evim, Melike Sezgin; Tuten, Rahime; Baytan, Birol; Güneş, Adalet Meral; Yakansik, Selin; Baytan, Birol; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0002-9375-2855; AAH-1452-2021
Vitamin B12 is essential to all cells in the body. Both high levels and low levels of vitamin B 12 are significant. High serum cobalamin (vitamin B 12) levels are found particularly in hematological disorders, solid tumors, autoimmune diseases, renal diseases and infectious diseases; and this elevation is associated with prognosis in some of these diseases. High levels of serum vitamin B 12 should be taken into consideration and more studies should be performed on this issue.
Evaluation of micafungin use in children
(Ankara Microbiology, 2020-01-01) Hacimustafaoglu, Mustafa; Yeşil, Edanur; YEŞİL, EDANUR; Çelebi, Solmaz; ÇELEBİ, SOLMAZ; Sezgin Evim, Melike; SEZGİN EVİM, MELİKE; Özer, Arife; Turan, Cansu; TURAN, CANSU; Timur, Demet; TİMUR, DEMET; Çakır, Salih Cağrı; ÇAKIR, SALİH ÇAĞRI; Bülbül, Beyhan; BÜLBÜL, BEYHAN; Ener, Beyza; ENER, BEYZA; Güneş, Adalet Meral; MERAL GÜNEŞ, ADALET; Koksal, Nilgun; Özkan, Hilal; ÖZKAN, HİLAL; Sevinir, Betul; SEVİNİR, BETÜL BERRİN; Düzcan Kilimci, Duygu; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Onkoloji Anabilim Dalı.; 0000-0002-8926-9959; 0000-0003-3146-6391; 0000-0001-5761-4757; 0000-0002-5720-1212; 0000-0002-3232-7652; 0000-0003-4646-660X; AAG-8523-2021; AEZ-2469-2022; GSO-3630-2022; AAH-1570-2021; HJZ-4508-2023; AAE-6201-2021; AAG-8393-2021; JCD-9679-2023
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.
Health related quality of life, depression, anxiety and self-concept in childhood all survivors in Turkey
(Wiley, 2015-11-01) Güneş, Adalet Meral; Asut, Çiğdem; Evim, M. Sezgin; Baytan, B.; Kantarcıoğlu, A. Çirpan; MERAL GÜNEŞ, ADALET; SEZGİN EVİM, MELİKE; Asut, Çiğdem; Kantarcıoğlu, A. Çirpan; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Bölümü; 0000-0002-9375-2855; AAH-1452-2021; EXD-8400-2022; EMY-5372-2022; DVW-8108-2022; CWP-8532-2022
Healthcare-associated infections in the department of pediatric hematology-oncology; a single center evaluation
(Galenos Publishing House, 2024-04) Özdel, Zeynep Gizem Ergün; Çelebi, Solmaz; Güneş, Adalet Meral; Evim, Melike Sezgin; Sevinir, Betül Berrin; Baytan, Birol; Demirkaya, Metin; Köse, Serdal Kenan; Çetin, Benhur; Çelik, Taylan; Salı, Enes; Hacımustafaoğlu, Mustafa; ERGÜN ÖZDEL, ZEYNEP GİZEM; ÇELEBİ, SOLMAZ; MERAL GÜNEŞ, ADALET; SEZGİN EVİM, MELİKE; SEVİNİR, BETÜL BERRİN; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi; H-2691-2017
Introduction: With advances in the treatment of Pediatric Hematology -Oncology (PHO) patients, the survival of patients are increasing day by day. However, Healthcare -Associated Infections (HAI) is still a significant cause of mortality and morbidity in this group of patients. This study aimed to evaluate the rates of HAI in patients who were hospitalized in Uludag University Medical Faculty PHO Clinic during the 4 -year study period. Materials and Methods: HAI was diagnosed according to the CDC (Center for Disease Control and Prevention) 2008 criteria. We recorded the number of patients admitted, the number of patients with HAI, the total number of HAI episodes, and the length of stay in hospital. We calculated HAI rate and HAI density (per 1000 patient -days). Results: During the four years, 3069 hospitalizations were recorded in 607 PHO patients (5.05 admissions per patient). 38.6% of the patients were female, and 61.4% male. The mean age was 100.8 +/- 63.6 months. The mean duration of hospitalization was 14 +/- 17.16 days. A total of 232 HAI episodes were recorded in 141 hospitalizations. HAI rate was 7.5%, and HAI density was 5.36/1000 patient -days. Conclusion: The HAI rates in our PHO unit were comparable to those of developed countries and lower than those of developing countries and prior results from our country.
Hepatosplenic fungal infections in children with leukemia-risk factors and outcome: A multicentric study
(Lippincott Williams & Wilkins, 2019-05-01) Celkan, Tiraje; Kızılocak, Hande; Evim, Melike; Güneş, Adalet Meral; Özbek, Namık Y.; Yaralı, Neşe; Ünal, Ekrem; Patıroğlu, Türkan; Karapınar, Deniz Yılmaz; Sarper, Nazan; Zengin, Emine; Karaman, Serap; Koçak, Ülker; Kürekçi, Emin; Özdemir, Canan; Tuğcu, Deniz; Uysalol, Ezgi; Dikme, Gürcan; Adaletli, İbrahim; Kuruoğlu, Sebuh; Kebudi, Rejin; SEZGİN EVİM, MELİKE; MERAL GÜNEŞ, ADALET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Hematoloji-Onkoloji Bilim Dalı; AAH-1452-2021; JGX-6145-2023
Background: Invasive fungal infections, including hepatosplenic fungal infections (HSFI), cause significant morbidity and mortality in children with leukemia. There are not enough data to support for the best approach to diagnosis of HSFI in children, nor for the best treatment. Procedure: In this multicentric study, we assessed the demographic data, clinical and radiologic features, treatment, and outcome of 40 children with leukemia and HSFI from 12 centers. Results: All cases were radiologically diagnosed with abdominal ultrasound, which was performed at a median of 7 days, of the febrile neutropenic episode. Mucor was identified by histopathology in 1, and Candida was identified in blood cultures in 8 patients. Twenty-two had fungal infection in additional sites, mostly lungs. Nine patients died. Four received a single agent, and 36 a combination of antifungals. Conclusions: Early diagnosis of HSFI is challenging because signs and symptoms are usually nonspecific. In neutropenic children, persistent fever, back pain extending to the shoulder, widespread muscle pain, and increased serum galactomannan levels should alert clinicians. Abdominal imaging, particularly an abdominal ultrasound, which is easy to perform and available even in most resource-limited countries, should be recommended in children with prolonged neutropenic fever, even in the absence of localizing signs and symptoms.
Incidence and management of thromboembolism in patients with acute leukemia
(Springer India, 2023-03-29) Temuroğlu, Aytuel; Güler, Salih; GÜLER, SALİH; Evim, Melike Sezgin; SEZGİN EVİM, MELİKE; Güneş, Adalet Meral; MERAL GÜNEŞ, ADALET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Hemotoloji Anabilim Dalı.
Thromboembolic events (TE) in childhood are relatively rare but, serious complications of acute leukemia. The aim was to define the incidence and risk factors of thrombosis in children with leukemias. The electronic files of pediatric denovo/relapsed acute leukemia patients aged below 18 years, treated between 2011 and 2021 were retrospectively evaluated for thrombotic attacks. Thirty out of 469 patients developed 35 thrombotic events. The median age at the time of the TE was 11.8 (2-17.6) years, and the median time from diagnosis to TE was 9 (0-58) months. The frequency of TE was found at 7.4% ( n = 35/469). When catheter related (n = 13) events, superficial venous events (n = 10), and arterial central nervous system thrombosis (n = 1) were excluded, the frequency of TE was decreased to 2.3% (n = 11/469). Children older than 10 years old (13.8%; n = 21/152) had significantly higher thromboembolic events than the others (4.4%; n = 14/317) (p = 0.03). The majority of attacks were symptomatic 66% (n = 23/35). The most common complaints were local pain, swelling, and redness 52% (n = 12/23). The majority of attacks in patients with relapsed (75%; 6/8) and newly diagnosed acute lymphoblastic leukemia (40%; 10/25%) developed during the induction phase. Thrombosis recurred in 13.3% (n = 4/30) of cases more than once. Thrombotic attacks were successfully treated with low molecular weight heparin 60% (n = 21/35), and recombinant tissue plasminogen activator 17% (n = 6/35). None of the children were lost due to thrombosis. Thrombosis is an important complication during acute leukemia treatment.Successful results are obtained with early diagnosis and treatment attempts by creating awareness.
Investigation of the relationship between maternal & neonatal vitamin b12 deficiency and neonatal hyperbilirubinemia: A prospective controlled study
(Galenos Yayınevi, 2023-04-01) Turan, Meltem; Özkan, Hilal; Evim, Melike Sezgin; Köksal, Nilgün; TURAN, MELTEM; ÖZKAN, HİLAL; SEZGİN EVİM, MELİKE; Köksal, Nilgün; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Neonatoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Hematoloji Anabilim Dalı.; 0000-0002-1690-1511; 0000-0001-5454-5119; 0000-0002-4792-269X; 0000-0002-6067-3886; IQJ-3996-2023; JJY-3921-2023; IRI-7023-2023; JGS-7600-2023
Introduction: The aim in this study was to investigate the role of vitamin B12 deficiency in neonatal hyperbilirubinemia.Materials and Methods: Term newborns who were breastfed and with hyperbilirubinemia were included in this prospective study. Those with hyperbilirubinemia were assigned to a patient group, and those without hyperbilirubinemia were assigned to a control group. The vitamin B12 levels of all newborns and their mothers were checked.Results: A total of 154 newborns were included in the study. Vitamin B12 deficiency was significantly higher in the patient group in comparison to the control group. Similarly, vitamin B12 levels of mothers were significantly lower in the patient group. The mean bilirubin level and phototherapy need were found to be significantly higher in patients with vitamin B12 deficiency.Conclusion: This study showed that vitamin B12 deficiency in the mother is related to vitamin B12 deficiency in the newborn, which significantly leads to neonatal hyperbilirubinemia.
Juvenile myelomonocytic leukemia in Turkey: A retrospective analysis of 65 patients
(Ferrata Storti Foundation, 2017-06-26) Tüfekçi, O.; Koçak, U.; Kaya, Z.; Yenicesu, I.; Albayrak, C.; Albayrak, D.; Bengoa, S. Yılmaz; Patiroğlu, T.; Karakukcu, M.; Ünal, E.; İnce, E. Unal; Ileri, T.; Ertem, M.; Celkan, T.; Özdemir, G. N.; Sarper, N.; Kaçar, D.; Yaralı, N.; Özbek, N. Y.; Küpesiz, A.; Karapınar, T.; Vergin, C.; Calışkan, U.; Tokgoz, H.; Evim, Melike Sezgin; Baytan, B.; Güneş, Adalet Meral; Karapınar, D. Yılmaz; Karaman, S.; Uygun, V.; Karasu, G.; Yeşilipek, M. A.; Koç, A.; Erduran, E.; Atabay, B.; Öniz, H.; Ören, H.; SEZGİN EVİM, MELİKE; Baytan, B.; MERAL GÜNEŞ, ADALET; Uludağ Üniversitesi; JGX-6145-2023; DVW-8108-2022; AAH-1452-2021