Araştırma Çıktıları
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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 Time Series Analysis of the Microbiota of Children Suffering From Acute Infectious Diarrhea and Their Recovery After Treatment(FRONTIERS MEDIA SA, 2018-01-01) Dinleyici, Ener C.; Martinez-Martinez, Daniel; Kara, Ates; Karbuz, Adem; Dalgic, Nazan; Metin, Ozge; Yazar, Ahmet S.; Guven, Sirin; Kurugol, Zafer; Turel, Ozden; Kucukkoc, Mehmet; Yasa, Olcay; Eren, Makbule; Ozen, Metehan; Manuel Marti, Jose; Garay, Carlos P.; Vandenplas, Yvan; Moya, AndresGut microbiota is closely related to acute infectious diarrhea, one of the leading causes of mortality and morbidity in children worldwide. Understanding the dynamics of the recovery from this disease is of clinical interest. This work aims to correlate the dynamics of gut microbiota with the evolution of children who were suffering from acute infectious diarrhea caused by a rotavirus, and their recovery after the administration of a probiotic, Saccharomyces boulardii CNCM I-745. The experiment involved 10 children with acute infectious diarrhea caused by a rotavirus, and six healthy children, all aged between 3 and 4 years. The children who suffered the rotavirus infection received S. boulardii CNCM I-745 twice daily for the first 5 days of the experiment. Fecal samples were collected from each participant at 0, 3, 5, 10, and 30 days after probiotic administration. Microbial composition was characterized by 16S rRNA gene sequencing. Alpha and beta diversity were calculated, along with dynamical analysis based on Taylor's law to assess the temporal stability of the microbiota. All children infected with the rotavirus stopped having diarrhea at day 3 after the intervention. We observed low alpha diversities in the first 5 days (p-value <0.05, Wilcoxon test), larger at 10 and 30 days after probiotic treatment. Canonical correspondence analysis (CCA) showed differences in the gut microbiota of healthy children and of those who suffered from acute diarrhea in the first days (p-value <0.05, ADONIS test), but not in the last days of the experiment. Temporal variability was larger in children infected with the rotavirus than in healthy ones. In particular, Gammaproteobacteria class was found to be abundant in children with acute diarrhea. We identified the microbiota transition from a diseased state to a healthy one with time, whose characterization may lead to relevant clinical data. This work highlights the importance of using time series for the study of dysbiosis related to diarrhea.