Browsing by Author "Orhan, Mehmet Fatih"
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Publication Thrombolysis with systemic recombinant tissue plasminogen activator in children: A multicenter retrospective study(Galenos Yayıncılık, 2021-08-18) Zengin, Emine; Sarper, Nazan; Erdem, Arzu Yazal; Al, Işık Odaman; Evim, Melike Sezgin; Yaralı, Neşe; Belen, Burcu; Akçay, Arzu; Yıldırım, Aysen Türedi; Karapınar, Tuba Hilkay; Güneş, Adalet Meral; Gelen, Sema Aylan; Oren, Hale; Olcay, Lale; Baytan, Birol; Gülen, Hüseyin; Öztürk, Gülyüz; Orhan, Mehmet Fatih; Oymak, Yeşim; Akpınar, Sibel; Tüfekci, Özlem; Albayrak, Meryem; Günen, Burçak Tatlı; Canpolat, Aylin; Özbek, Namık; SEZGİN EVİM, MELİKE; MERAL GÜNEŞ, ADALET; Baytan, Birol; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Hematoloji Bilim Dalı.; 0000-0002-4792-269X; 0000-0002-0686-7129; 0000-0002-9375-2855; JGX-6145-2023 ; AAH-1452-2021 ; DVW-8108-2022Objective: This study aimed to evaluate systemic thrombolysis experiences with recombinant tissue plasminogen activator (rtPA). Materials and Methods: Retrospective data were collected from 13 Turkish pediatric hematology centers. The dose and duration of rtPA treatment, concomitant anticoagulant treatment, complete clot resolution (CCR), partial clot resolution (PCR), and bleeding complications were evaluated. Low-dose (LD) rtPA treatment was defined as 0.01-0.06 mg/kg/h and high-dose (HD) rtPA as 0.1-0.5 mg/kg/h. Results: Between 2005 and 2019, 55 thrombotic episodes of 54 pediatric patients with a median age of 5 years (range: 1 day to 17.75 years) were evaluated. These patients had intracardiac thrombosis (n=16), deep vein thrombosis (DVT) (n=15), non-stroke arterial thrombosis (n=14), pulmonary thromboembolism (PE) (n=6), and stroke (n=4). The duration from thrombus detection to rtPA initiation was a median of 12 h (range: 2-504 h) and it was significantly longer in cases of DVT and PE compared to stroke, non-stroke arterial thrombosis, and intracardiac thrombosis (p=0.024). In 63.6% of the episodes, heparin was initiated before rtPA treatment. LD and HD rtPA were administered in 22 and 33 of the episodes, respectively. Concomitant anticoagulation was used in 90% and 36% of the episodes with LD and HD rtPA, respectively (p=0.0001). Median total duration of LD and HD rtPA infusions was 30 h (range: 2-120 h) and 18 h (2-120 h), respectively (p=0.044). Non-fatal major and minor bleeding rates were 12.5% and 16.7% for LD and 3.2% and 25.8% for HD rtPA, respectively. At the end of the rtPA infusions, CCR and PCR were achieved in 32.7% and 49.0% of the episodes, respectively. The most successful site for thrombolysis was intracardiac thrombosis. HD versus LD rtPA administration was not correlated with CCR/PCR or bleeding (p>0.05). Conclusion: Systemic thrombolytic therapy may save lives and organs effectively if it is used at the right indications and the right times in children with high-risk thrombosis by experienced hematologists with close monitoring of recanalization and bleeding.Item Undiagnosed cardiac abnormalities among school-aged children(Uludağ Üniversitesi, 2010-05-21) Karacan, Mehmet; Olgun, Haşim; Orhan, Mehmet Fatih; Altay, Nilgün Demet; Öztürk, Candan Ferai; Karakelleoğlu, Cahit; Ceviz, NaciIntroduction: The aim of this study was to assess the frequency of undiagnosed congenital and acquired heart diseases among school-aged children. Materials and Method: The study population consisted of 4.370 children (2081 boys and 2289 girls) who were chosen from a total school-aged children population of 51,891 students (aged 7-15 years) (10.7±2.4) (8.4%). Results: In this population, a total of 11 (0.25%) children had been diagnosed and treated for structural cardiac abnormalities before the study. In the study period (after an assessment by a questionmaire), cardiac evaluation was needed in 405 (9.3%) children who were invited to the pediatric cardiology unit. Among them, a total of 153 (37.8%) children were admitted for further evaluation, and 21 (13.7%) were diagnosed as having undiagnosed congenital (12.4%) or acquired (1.3%) heart diseases. Five children with congenital heart diseases were treated by surgical or invasive techniques, and penicillin prophylaxis was begun in two patients with rheumatic heart disease. The most frequent congenital heart diseases were atrial septal defect and mitral valve prolapse among the admitted children. Conclusions: Some children still reach school age with undiagnosed congenital or acquired heart diseases. All children should be examined carefully at the time of school registration in order to diagnose and treat congenital and acquired heart diseases in an effort to prevent the occurrence of undesirable events during sports or social activities.