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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item 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 BedirObjective: 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.Item Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections(BAISHIDENG PUBLISHING GROUP INC, 2016-01-01) McFarland, Lynne Vernice; Ozen, Metehan; Dinleyici, Ener Cagri; Goh, ShanAntibiotic-associated diarrhea (AAD) and Clostridum difficile infections (CDI) have been well studied for adult cases, but not as well in the pediatric population. Whether the disease process or response to treatments differs between pediatric and adult patients is an important clinical concern when following global guidelines based largely on adult patients. A systematic review of the literature using databases PubMed (June 3, 1978-2015) was conducted to compare AAD and CDI in pediatric and adult populations and determine significant differences and similarities that might impact clinical decisions. In general, pediatric AAD and CDI have a more rapid onset of symptoms, a shorter duration of disease and fewer CDI complications (required surgeries and extended hospitalizations) than in adults. Children experience more community-associated CDI and are associated with smaller outbreaks than adult cases of CDI. The ribotype NAP1/027/BI is more common in adults than children. Children and adults share some similar risk factors, but adults have more complex risk factor profiles associated with more co-morbidities, types of disruptive factors and a wider range of exposures to C. difficile in the healthcare environment. The treatment of pediatric and adult AAD is similar (discontinuing or switching the inciting antibiotic), but other treatment strategies for AAD have not been established. Pediatric CDI responds better to metronidazole, while adult CDI responds better to vancomycin. Recurrent CDI is not commonly reported for children. Prevention for both pediatric and adult AAD and CDI relies upon integrated infection control programs, antibiotic stewardship and may include the use of adjunctive probiotics. Clinical presentation of pediatric AAD and CDI are different than adult AAD and CDI symptoms. These differences should be taken into account when rating severity of disease and prescribing antibiotics.Item Gut immune homeostasis: the immunomodulatory role of Bacillus clausii, from basic to clinical evidence(TAYLOR \& FRANCIS LTD, 2022-01-01) Wong-Chew, Rosa Maria; de Castro, Jo-Anne A.; Morelli, Lorenzo; Perez, Marcos; Ozen, MetehanIntroduction The gut microbiota affects the development of the gut immune system in early life. Perturbations to microbiota structure and composition during this period can have long-term consequences on the health of the individual, through its effects on the immune system. Research in the last few decades has shown that probiotic administration can reverse these effects in strain- and environment-specific ways. Bacillus clausii (B. clausii) has been in use for many decades as a safe and efficacious probiotic, but its mode of action has not yet been completely elucidated. Areas covered In this review, we discuss how the gut immune system works, the factors that affect its functioning, and the plethora of research highlighting its role in various diseases. We also discuss the known modes of action of Bacillus probiotics, and highlight the preclinical and clinical evidence that reveal how B. clausii acts to bolster gut defense. Expert opinion We anticipate that the treatment and/or prevention of dysbiosis will be central to managing human health and disease in the future. Discovering the pathophysiology of autoimmune diseases, infections, allergies, and some cancers will aid our understanding of the key role played by microbial communities in these diseases.Item Probiotics added to maternal nutrition affect infantile colic symptoms and fecal microbiota profile: a single-blind randomized controlled study(Korean Pediatric Soc, 2022-01-01) Karaahmet, Aysu Yildiz; Dolgun, Gulumser; Ozen, MetehanBackground: Infantile colic has a multifactorial etiology