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Öğe Evaluation of the 10 Warning Signs in Primary and Secondary Immunodeficient Patients(Frontiers Media Sa, 2022) Eldeniz, Fadime Ceyda; Gul, Yahya; Yorulmaz, Alaaddin; Guner, Sukru Nail; Keles, Sevgi; Reisli, IsmailObjectivesTen warning signs of primary immunodeficiency (PID) were suggested by the Jeffrey Modell Foundation (JMF), to increase physician awareness of PID. These warning signs have not yet been evaluated for patients with secondary immunodeficiency (SID). This study investigated whether the 10 warning signs used for the diagnosis of PID were also sufficient for the diagnosis of SID, and explored the possibility of additional signs. MethodsThis prospective study was conducted between June and December 2020. The mothers of 162 patients with PID and SID, and mothers of 200 healthy children, were asked to complete a questionnaire about family and personal history in addition to the warning signs of PID developed by the JMF. A JMF score was created by giving one point for each Yes answer for the 10 warning signs of PID. Medical records of the patients were evaluated for possible additional warning signs for PID and SID. ResultsThe JMF scores of the PID (3.36 +/- 1.65) and SID (3.72 +/- 1.12) groups were significantly higher than the scores of the control group (0.34 +/- 0.61) (p < 0.05). A sign for immunological evaluation in two patients without warning signs in the PID group was found to be chronic diarrhea. In addition to the 10 JMF warning signs, we found that consanguinity and a family history of tuberculosis were statistically significant in our PID group, compared with the SID and control groups. ConclusionsThe JMF warning signs are important for early diagnosis of PID. Our study showed that these signs may also be used for the early diagnosis of SID in patients and, according to our results, in addition to the 10 JMF signs for PID, parental consanguinity, chronic diarrhea, and a family history of tuberculosis may also be considered warning signs for the early diagnosis of PID.Öğe Primer immün yetmezlikli çocuklarda tanımlayıcı öykü özelliklerinin araştırılması(Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, 2021) Eldeniz, Fadime Ceyda; Reisli, İsmailAmaç: ÇalıĢmanın amacı; primer immün yetmezlik (PĠY) tanısında kullanılan 10 uyarıcı iĢaretin tanıda yeterli olup olmadığını belirlemek, PĠY erken tanısı için uyarıcı olabilecek bu 10 uyarıcı iĢarete eklenebilecek baĢka iĢaretlerin olma olasılığını araĢtırmak ve literatüre katkı sağlamaktır. Yöntem: Bu çalıĢma Haziran 2020 ile Aralık 2020 tarihleri arasında prospektif olarak gerçekleĢtirilmiĢtir. ÇalıĢmaya, Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Çocuk Alerji ve Ġmmünoloji Polikliniğinde takipli primer veya sekonder immün yetmezlik tanılı 162 hastanın aileleri alınmıĢtır. Bu ailelere Jeffrey Model Vakfı’nın geliĢtirdiği PĠY uyarıcı iĢaretlerini içeren sorularla birlikte özgeçmiĢ ve soygeçmiĢ özelliklerini içeren sorulardan oluĢan bir anket uygulanmıĢtır. Aynı anket tanımlanmıĢ bir primer/sekonder immün yetmezliği olmayan (sağlıklı) 200 çocuğun ailesine uygulanmıĢ ve böylece kontrol grubu oluĢturulmuĢtur. Ġstatistiksel analizler için SPSS programı kullanıldı ve p<0,05 olması anlamlı kabul edildi. Bulgular: Katılımcıların 98’i (%27,1) PĠY, 64’ü (%17,7) sekonder immün yetmezlik (SĠY) grubunda yer alırken; kontrol grubu 200 (%55,2) katılımcıdan oluĢuyordu. PĠY grubunun (3,36±1,65) ve SĠY grubunun JMF puanları (3,72±1,12); kontrol grubunun JMF puanından (0,34±0,61) anlamlı derecede yüksekti, (p<0,05). JMF uyarıcı iĢaretleri değerlendirildiğinde, literatürden farklı olarak, intravenöz antibiyotik gereksinimi (%82,7) ve yılda ikiden fazla alt solunum yolu enfeksiyonu geçirme öyküsünden (%64,3) sonra üçüncü uyarıcı iĢaret olarak etkisiz veya iki aydan daha uzun süreli oral antibiyotik kullanımı bulunmuĢtur (%45,9). JMF'in 10 uyarıcı iĢaretine ilave olarak bizim PĠY grubumuzda, SĠY ve kontrol gruplarına göre ebeveyn akrabalığı, Bacillus Calmette-Guérin (BCG) aĢısı sonra lenfadenopati ve ailede tüberküloz öyküsünü istatistiksel olarak anlamlı bulduk. Sonuç: PĠY’lerin erken tanısında JMF uyarıcı iĢaretleri önemlidir. Ancak değiĢik toplumlarda ek uyarı iĢaretlerine gereksinim olduğu kanaatindeyiz. ÇalıĢmamıza göre PĠYÖğe Reactivation of Tuberculosis and COVID-19 in Pediatric Patients(Georg Thieme Verlag Kg, 2023) Unal, Gokcen; Pekcan, Sevgi; Akcan, Ozge Metin; Keles, Sevgi; Yilmaz, Asli Imran; Eldeniz, Fadime Ceyda; Caglar, Hanife TugceObjective Mycobacterium tuberculosis is an immobile aerobic bacillus that causes tuberculosis (TB) disease. We aimed to evaluate the association between coronavirus disease 2019 (COVID-19), COVID-19-related drugs, TB reactivation, and TB incidence during the pandemic.Methods Eight patients who were diagnosed as having TB in Meram Medical Faculty, Necmettin Erbakan University between March 1, 2020, and December 31, 2021, at the beginning of the pandemic, were enrolled in this study. The presence of COVID-19 infection was confirmed using COVID-19 antibody tests and the patients' COVID-19 history. We evaluated the demographic data, laboratory findings, imaging tests, and pathology results of all patients. Results We checked all our patients with TB using COVID-19 antibodies (immunoglobulin [Ig]G thorn IgM) or polymerase chain reaction. Seven of the eight patients were female (87.5%). The median age was 16 years. Family screening of all patients was negative, and they had bacillus Calmette-Guerin vaccine scars. Two patients had chronic diseases. One was diagnosed as having primary ciliary dyskinesia in our department (patient no. 8) and the second was under follow-up by the rheumatology department with a diagnosis of juvenile idiopathic rheumatoid arthritis.Conclusion There has been an increase in the incidence of TB in children, especially in adolescents, during the pandemic period. This may be due to the pathogenic structure of the COVID-19 virus with an unknown mechanism. In addition, lifestyle changes and changes in health care policies during the pandemic may have caused this. Further research should be performed on this topic.