Browsing by Author "Koksal, Yavuz"

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    Pediatric Neutropenic Patients Care in Turkey
    (AVES YAYINCILIK, IBRAHIM KARA, 2019-01-01) Aydin, Zeynep Gokce Gayretli; Buyukcam, Ayse; Kara, Ates; Karbuz, Adem; Soysal, Ahmet; Tapisiz, Anil Aktas; Parlakay, Aslinur Ozkaya; Somer, Ayper; Caliskan, Ayse Bahar Budan; Kocabas, Bilge Aldemir; Okur, Dicle Sener; Ciftdogan, Dilek Yilmaz; Arisoy, Emin Sami; Kocabas, Emine; Ciftci, Ergin; Erduran, Erol; Vardar, Fadil; Tanir, Gonul; Sensoy, S. Gulnar; Bayhan, Gulsum Iclal; Devrim, Ilker; Celik, Melda; Ozen, Metehan; Kosker, Muhammet; Erguven, Muferret; Dalgic, Nazan; Hatipoglu, Nevin; Oz, Fatma Nur; Belet, Nursen; Akcan, Ozge Metin; Ceylan, Ozgur; Siraneci, Rengin; Bozdemir, Sefika Elmas; Ozkasap, Serdar; Celebi, Solmaz; Celik, Umit; Camcioglu, Yildiz; Kara, Aybuke Akaslan; Kupeli, Begul; Gulhan, Belgin; Albayrak, Eda; Erdeniz, Emine Hafize; Yasa, Emine Olcay; Turkkan, Emine; Tezer, Hasan; Sutcu, Murat; Bayram, Nuri; Hatipoglu, Sami; Oncel, Selim; Celik, Taylan; Torun, Yasemin Altuner; Koksal, Yavuz; Cay, Ummuhan; Kara, Ahu; Yoruk, Mustafa Asim; Demirdag, Tugba Bedir
    Objective: Infection is a common complication in children with malignancies. There is no consistent guidance for environmental infection control and isolation precautions for neutropenic patients (NP). There are differences between centers. The aim of this questionnaire study was to determine these differences in Turkey. Material and Methods: A multicenter-descriptive questionnaire was conducted on 36 centers from different geografical locations of Turkey. Bone marrow transplantation units were excluded. Each center was contacted at least three-times. Questionnaire was answered by two different doctors from each center. Results: Thirty-six centers including 20 (55.5\%) University Hospitals, 12 (\%33.3) Research Hospitals, three (8.3\%) State Hospital and one Private University Hospital participated in this survey. 94.3\% of the centers had a bed capacity of 50 beds and over. Twenty-one (58.3\%) centers had pediatric infection ward that followed febrile NP. All centers had an infection control committee. 25\% (9/36) of the centers always followed pediatric neutropenic fever patients in a single room. 66.6\% (24/36) of the centers had toilet in all patients' room. The door features of patients' room included mostly (94.1\%, 32/34) manually opened door. Ten (27.7\%) centers had hepa filter system, five of them had positive-negative pressure room. Thirteen (38.2\%, 13/34) centers prefered hickmann catheter for accessing a patient's central line. Training was given for catheteter care in all centers. Sixteen (44.4\%) centers had determined policies about keeping toys in patient rooms. Visitor restrictions were performed in all centers. None of the centers allowed plants or flowers in hospital rooms. There was a neutropenic diet specific for pediatric NP provided in twenty-seven centers (75\%). Conclusion: The prevention and control of infection contributes to the improvement of the prognosis of patients with hematological malignancies. Physicians must be aware of the infection risks and take precautions for infectious complications through the neutropenic period and standard protocols should be established and implemented for patients with hematological malignancies.
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    Somatic POLE mutations cause an ultramutated giant cell high-grade glioma subtype with better prognosis
    (OXFORD UNIV PRESS INC, 2015-01-01) Erson-Omay, E. Zeynep; Caglayan, Ahmet Okay; Schultz, Nikolaus; Weinhold, Nils; Omay, S. Bulent; Ozduman, Koray; Koksal, Yavuz; Li, Jie; Harmanci, Akdes Serin; Clark, Victoria; Carrion-Grant, Geneive; Baranoski, Jacob; Caglar, Caner; Barak, Tanyeri; Coskun, Suleyman; Baran, Burcin; Kose, Dogan; Sun, Jia; Bakircioglu, Mehmet; Gunel, Jennifer Moliterno; Pamir, M. Necmettin; Mishra-Gorur, Ketu; Bilguvar, Kaya; Yasuno, Katsuhito; Vortmeyer, Alexander; Huttner, Anita J.; Sander, Chris; Gunel, Murat
    Background. Malignant high-grade gliomas (HGGs), including the most aggressive form, glioblastoma multiforme, show significant clinical and genomic heterogeneity. Despite recent advances, the overall survival of HGGs and their response to treatment remain poor. In order to gain further insight into disease pathophysiology by correlating genomic landscape with clinical behavior, thereby identifying distinct HGG molecular subgroups associated with improved prognosis, we performed a comprehensive genomic analysis. Methods. We analyzed and compared 720 exome-sequenced gliomas (136 from Yale, 584 from The Cancer Genome Atlas) based on their genomic, histological, and clinical features. Results. We identified a subgroup of HGGs (6 total, 4 adults and 2 children) that harbored a statistically significantly increased number of somatic mutations (mean = 9257.3 vs 76.2, P = .002). All of these ``ultramutated{''} tumors harbored somatic mutations in the exonuclease domain of the polymerase epsilon gene (POLE), displaying a distinctive genetic profile, characterized by genomic stability and increased C-to-A transversions. Histologically, they all harbored multinucleated giant or bizarre cells, some with predominant infiltrating immune cells. One adult and both pediatric patients carried homozygous germline mutations in the mutS homolog 6 (MSH6) gene. In adults, POLE mutations were observed in patients younger than 40 years and were associated with a longer progression-free survival. Conclusions. We identified a genomically, histologically, and clinically distinct subgroup of HGGs that harbored somatic POLE mutations and carried an improved prognosis. Identification of distinctive molecular and pathological HGG phenotypes has implications not only for improved classification but also for potential targeted treatments.