Yazar "Kiper, Nural" seçeneğine göre listele
Listeleniyor 1 - 6 / 6
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Evaluation of respiratory function at 6 years of age in patients with cystic fibrosis with frequent pulmonary exacerbations in the first 2 years of life(European Respiratory Soc Journals Ltd, 2023) Tabakci, Sati Ozkan; Cinel, Guzin; Uytun, Salih; Polat, Sanem Eryilmaz; Yalcin, Ebru; Kiper, Nural; Erdal, Meltem Akgul[Abstract Not Availabe]Öğe Multicentric analysis of childhood tuberculosis in Turkey(Turkish J Pediatrics, 2013) Pekcan, Sevgi; Aslan, Ayse Tana; Kiper, Nural; Uysal, Gulnar; Gurkan, Fuat; Patiroglu, Turkan; Ozturk, MustafaOnly a few series of pediatric tuberculosis (TB) have been reported in the last 20 years. The purpose of this study was to evaluate the clinical, radiological, microbiological, and treatment characteristics of childhood TB. A total of 539 children with childhood TB diagnosed over a 12-year period (1994-2005) in 16 different centers in Turkey participated in the study. The medical records of all childhood TB patients were investigated. A total of 539 children (274 males, 265 females) with childhood TB aged 10 days-17 years participated in the study. Age distribution was nearly equal among all age groups. We detected the index case in 39.8% of the patients. More than one index case was detected in 17.3% of the patients. A minimum 15-mm induration is accepted on tuberculin skin test (TST) following Bacillus Calmette-Guerin (BCG) vaccination. The TST was positive in 55.3% of the patients. Acid-fast bacillus smear was positive in 133, and polymerase chain reaction for Mycobacterium tuberculosis was positive in 45 patients. In 75 patients (13.9%), cultures yielded M. tuberculosis. One hundred fifty-one patients (28%) did not present for follow-up, and families of 5 patients (0.9%) discontinued the treatment. Pulmonary TB (n=285) and meningeal TB (n=85) were the most frequent diseases. In 29% of the patients, there was poor adherence to treatment or patients were lost to follow-up. We have demonstrated that household contact screening procedures play a major and important role, especially considering the high ratio of cases with contact index cases. We also recommend that the positive TST values should be reviewed according to the local cut-off data and should be specified in as many countries as possible. In view of the considerably high percentages of patients lost to follow-up and treatment discontinuation observed in our study, we suggest that application of directly observed treatment, short-course (DOTS) is preferable.Öğe Patients with cystic fibrosis who could not receive the CFTR modulator treatment: What did they lose in 1 year?(Wiley, 2023) Uytun, Salih; Cinel, Guzin; Polat, Sanem Eryilmaz; Tabakci, Sati Ozkan; Kiper, Nural; Yalcin, Ebru; Tural, Dilber AdemhanBackgroundCystic fibrosis (CF) is an autosomal recessive disorder caused by CF transmembrane conductance regulator (CFTR) genetic variants. CFTR modulators improve pulmonary function and reduce respiratory infections in CF. This study investigated the clinical and laboratory follow-up parameters over 1 year in patients with CF who could not receive this treatment. MethodsThis retrospective cohort study included 2018 and 2019 CF patient data from the CF registry of Turkey. Demographic and clinical characteristics of 294 patients were assessed, who had modulator treatment indications in 2018 but could not reach the treatment. ResultsIn 2019, patients younger than 18 years had significantly lower BMI z-scores than in 2018. During the 1-year follow-up, forced expiratory volumes (FEV1) and FEV1 z-scores a trend toward a decrease. In 2019, chronic Staphylococcus aureus colonization, inhaled antipseudomonal antibiotic use for more than 3 months, oral nutritional supplement requirements, and oxygen support need increased. ConclusionsPatients who had indications for modulator treatments but were unable to obtain them worsened even after a year of follow-up. This study emphasized the importance of using modulator treatments for patients with CF in our country, as well as in many countries worldwide.Öğe The success of the Cystic Fibrosis Registry of Turkey for improvement of patient care(Wiley, 2022) Asfuroglu, Pelin; Eyuboglu, Tugba Sismanlar; Aslan, Ayse Tana; Gursoy, Tugba Ramasli; Emiralioglu, Nagehan; Yalcin, Ebru; Kiper, NuralBackground Cystic fibrosis (CF) registries play an essential role in improving disease outcomes of people with CF. This study aimed to evaluate the association of newly established CF registry system in Turkey on follow-up, clinical, growth, treatment, and complications of people with this disease. Methods Age at diagnosis, current age, sex, z-scores of weight, height and body mass index (BMI), neonatal screening results, pulmonary function tests, history of meconium ileus, medications, presence of microorganisms, and follow-up were evaluated and compared to data of people with CF represented in both 2017 and 2019 registry data. Results There were 1170 people with CF in 2017 and 1637 in 2019 CF registry. Eight hundred and fourteen people were registered in both 2017 and 2019 of whom z-scores of heights and BMI were significantly higher in 2019 (p = 0.002, p =0.039, respectively). Inhaled hypertonic saline, bronchodilator, and azithromycin usages were significantly higher in 2019 (p =0.001, p = 0.001, p = 0.003, respectively). The percent predicted of forced expiratory volume in 1 sec and forced vital capacity were similar in 2017 and 2019 (88% and 89.5%, p = 0.248 and 84.5% and 87%, p =0.332, respectively). Liver diseases and osteoporosis were significantly higher, and pseudo-Bartter syndrome (PBS) was significantly lower in 2019 (p = 0.011, p = 0.001, p = 0.001, respectively). Conclusions The z-scores of height and BMI were higher, the use of medications that protect and improve lung functions was higher and incidence of PBS was lower in 2019. It was predicted that registry system increased the care of people with CF regarding their follow-up. The widespread use of national CF registry system across the country may be beneficial for the follow-up of people with CF.Öğe Unfinished battle with childhood tuberculosis: Is it curable with less drugs and shorter duration?(2013) Cinel, Güzin; Kiper, Nural; Pekcan, Sevgi; Koyun, Mustafa; Köse, Mehmet; Çobanoğlu, Nazan; Tana Aslan, Ayşe; Yalçın, Ebru; Doğru, Deniz; Özçelik, Uğur; Göçmen, AyhanGiriş: Etkili tedavi rejimleriyle mortalitesi tüm dünyada azalmış olsa da tüberküloz halen global bir sağlık problemidir. Tedaviye uyumsuzluk, ilaç direnci, tedavi başarısızlığı ve relaps tüberküloz tedavisi sırasında sık karşılaşılan problemlerdir. İntermittan tedavi rejimlerinin, özellikle kaynakları sınırlı bölgelerde, tedavi maliyetini ve tedavinin yan etkilerini azalttığı, hastanın tedaviye uyumunu artırdığı bilinmektedir; ayrıca çocuk hastalarda da her gün verilen tedavi kadar etkili olduğu gösterilmiştir. Bu çalışmada, hastanemizde pulmoner ve ekstrapulmoner tüberküloz tanısı almış çocuk hastalara iki ilaçla verilen 6 ve 9 aylık intermittan tüberküloz tedavi rejimlerinin sonuçları karşılaştırılmıştır. Materyal ve Metod: Hastanemizde 1986 ile 2001 yılları arasında akciğer, lenf nodu, iskelet sistemi, plevral, abdominal, miliyer, perikardiyal, deri ve böbrek tüberkülozu nedeniyle intermittan antitüberküloz tedavi alan 115 hasta retrospektif olarak değerlendirilmiştir. Elli bir hastaya 15 gün süreyle izoniazid ve rifampisin tedavisi sonrası 9 ay süreyle aynı ilaçlarla ve aynı dozlarda haftada iki gün intermittan tedavi verilmiştir. Altmış dört hastaya ise aynı tedavi rejimi 6 ay süreyle uygulanmıştır. Bulgular: Tedavinin ilk ayında 1. gruptaki (9 aylık intermittan tedavi) pulmoner tüberkülozlu hastaların %75'inde, 2. gruptaki (6 aylık intermittan tedavi) pulmoner tüberkülozlu hastaların %79'unda klinik düzelme gözlendi. Pulmoner tüberkülozlu hastalarda ilk 6 ayda, grup 1'de %81'inde, grup 2'de %86'sında radyolojik düzelme görüldü. Klinik ve radyolojik düzelme zamanları karşılaştırıldığında iki grup arasında anlamlı bir farklılık saptanmadı (p 0.05). Benzer sonuçlar ekstrapulmoner tüberkülozlu hastalarda da gözlendi (p 0.05). Hastalar 7 ay ile 15 yıl arasında takip edildi. Hiçbir olguda erken relaps gözlenmedi. Dokuz aylık intermittan tedavi alan (grup 1) 4 hastada, tedavi kesildikten iki yıl sonra geç relaps görüldü. Sonuç:Çocukluk çağı pulmoner ve menenjit dışı ekstrapulmoner tüberkülozda, iki ilaçla 6 aylık intermittan tedavi, 9 aylık intermittan tedavi kadar etkilidir.Öğe Unfinished battle with childhood tuberculosis: is it curable with less drugs and shorter duration?(Turkish Assoc Tuberculosis & Thorax, 2013) Cinel, Guzin; Kiper, Nural; Pekcan, Sevgi; Koyun, Mustafa; Kose, Mehmet; Cobanoglu, Nazan; Aslan, Ayse TanaIntroduction: Tuberculosis is still a global health problem all over the world despite its mortality has been decreased with effective treatment regimens. Poor treatment adherence, acquired drug resistance, treatment failure and relapse are the major problems during the course of the tuberculosis treatment. Intermittent regimens have the advantages of reducing the side effects and the cost of the therapy and increasing the adherence, especially in resource-limited areas; and have been documented to be as effective as daily regimen in the paediatric population. In this study, we compared the results of 6-month and 9-month intermittent-therapy regimens with two drugs, given to the children with pulmonary and extrapulmonary tuberculosis at our hospital. Materials and Methods: One hundred and fifteen patients with pulmonary and extrapulmonary tuberculosis other than meningitis, who had been given intermittent anti-tuberculosis therapy between 1986 and 2001, were evaluated retrospectively. Fifty one patients were given isoniazid and rifampin daily for 15 days, followed by the same drugs and doses twice weekly for a total of 9-months. Also, 64 patients were treated with the same regimen for a total of 6-months. Results: Clinical recovery was observed in 75% and 79% of pulmonary tuberculosis patients at the first month of therapy in group 1 (9-month group) and group 2 (6-month group), respectively. Radiological recovery was noted between 0-6 months in 81% of the patients in group 1 and 86% of the patients in group 2. According to the clinical and radiological recovery times, no significant difference was detected between the two groups (p>0.05). Similar results had been observed in extrapulmonary tuberculosis (p>0.05). Follow-up periods ranged from 7 months to 15 years. There was no case of early relapse. Late relapse was noted in 4 patients, who had been received 9-month therapy (group 1). Conclusion: Six-month intermittent therapy with two drugs is as efficacious as 9-month intermittent-therapy in childhood pulmonary and extrapulmonary tuberculosis, other than meningitis.