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    Central line-associated bloodstream infection outbreak related to Ralstonia pickettii-contaminated saline in a pediatric hematopoietic stem cell transplant center
    (Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü, 17.10.2024) Çelen, Safiye Suna; Zhumatayev, Suleimen; Yalçın, Koray; Kara, Emine Manolya; Sutcu, Murat; Karasu, Gulsun; Yesilipek, M.Akif
    Background. Ralstonia pickettii is an aerobic Gram-negative non-fermentative bacillus. It is an opportunistic pathogen that has recently prompted nosocomial outbreaks. Although it has low virulence, it can cause a wide range of invasive diseases in immunosuppressive patients. The characteristics of R. pickettii-related central line-associated bloodstream infection (CLABSI) outbreak in pediatric hematopoietic stem cell transplant (HSCT) recipients are presented in this study. Materials and Methods. This was a single-center, retrospective analysis conducted at Bahcesehir University Goztepe Medicalpark Hospital . The clinical and laboratory characteristics of twelve children with Ralstonia-related CLABSIs were analyzed. Results. Of the twelve patients with R. pickettii growth, seven were female. The median age was 12.1 (2-17) years. Autologous HSCT was performed in two of the patients and allogeneic HSCT was performed in ten patients for both malignant and non-malignant diseases. In the conditioning regimens, all patients were given myeloablative therapy. Clinical sepsis was the most common presentation. As a result of the investigations, R. pickettii growth was observed in saline solutions. All cases were successfully treated with the appropriate antibiotic regimen and the bacteria was not found in repeat cultures. Catheter removal was required in two patients. Mortality was not observed in any patient as the outcome of the infection episode. Conclusion. The detection and control of the infectious source are critical in pediatric HSCT patients with severe immunosuppression, as medical equipment-related outbreaks can be life-threatening.
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    EXPERIENCES OF PARENTS WHO CONCEIVED SAVIOR SIBLINGS FOR BEING HEMATOPOIETIC STEM CELL DONORS TO THEIR SICK CHILDREN AND SUCCESSFULLY COMPLETED THE PROCESS: A QUALITATIVE STUDY
    (Springernature, 2023) Eker, Ibrahim; Ozdemir, Hamide Nur Cevik; Yilmaz, Firat; Yesilipek, Akif; Kupesiz, Alphan; Uygun, Vedat; Karasu, Gulsun
    [Abstract Not Available]
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    Impact of Replacing Low Dose Cyclophosphamide with Fludarabine in Children with Acute Myeloid Leukemia Undergoing Transplantation During First Complete Remission
    (Akad Doktorlar Yayinevi, 2023) Uygun, Vedat; Karasu, Gulsun; Yalcin, Koray; Ozturkmen, Seda; Daloglu, Hayriye; Celen, Safiye Suna; Hazar, Volkan
    Busulfan (BU)-based myeloablative conditioning is a standard conditioning regimen for children with AML; however, it is not clear yet which combination of cyclophosphamide (CY) and fludarabine (FLU) is most effective. We performed a study to compare the results of BUCY120 and BU-FLU in pediatric patients with AML in CR1 undergoing allo-HSCT from matched sibling donors. With the combination of BU, 15 patients were given 120 mg/kg of CY, and 12 patients were given 150 mg/m2 of FLU, respectively, in the condition regimen. Patients treated with BUFLU relapsed less than those treated with BUCY120 (p= 0.03). Moreover, these patients engrafted platelets earlier than the BUCY120 administered patients (p= 0.03). The frequency of complications in both groups was comparable. There was no significant difference in survival analysis between the groups. BUFLU has a low toxicity profile, making it a reasonable choice for children with AML in CR1 with low risk and a lower relapse frequency compared to BUCY120.
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    Newborn screening for sickle cell anemia in Antalya, Türkiye
    (Turkish J Pediatrics, 2023) Ozturk, Zeynep; Kupesiz, O. Alphan; Karasu, Gulsun; Uygun, Vedat; Oygur, Nihal; Yesilipek, M. Akif
    Background. In a screening study conducted on adults, the prevalence of sickle cell traits in Antalya was found to be 0.24%. Since no screening studies have been conducted in the neonatal period in our region, the exact incidence has not been determined. In this study, we aim to report our experience of neonatal screening for sickle cell disease in Antalya, Turkiye.Methods. During a 14-month period, 2562 heel prick blood samples, taken on filter paper from Akdeniz University Hospital, Antalya Education and Research Hospital and Antalya Ataturk State Hospital and four other healthcare centers, were studied using the high pressure liquid chromatography method. Blood samples were studied using the 'Sickle Cell Short Program' test method on a Bio Rad Variant device.Results. In the study, no patients with sickle cell disease were identified. Four newborns who were sickle cell carriers (0.15%) and two newborns who were Hemoglobin D carriers (0.08 %), were found. Conclusion.Considering the efficiency and cost calculations made as a result of the data obtained from our study, it was concluded that sickle cell screening would not be effective in newborns. It seems more effective and economical to screen the children of parents, who are found to be at risk for Hemoglobin S carriage as a result of premarital tests.
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    PRE-TRANSPLANTATION VITAMIN D DEFICIENCY INCREASES ACUTE GRAFT-VERSUS-HOST DISEASE AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION IN THALASSEMIA MAJOR PATIENTS
    (Springernature, 2023) Uygun, Vedat; Daloglu, Hayriye; Ozturkmen, Seda; Yalcin, Koray; Karasu, Gulsun; Yesilipek, Akif
    [Abstract Not Available]