Person: SEVİNİR, BETÜL BERRİN
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SEVİNİR
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BETÜL BERRİN
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Publication Covid-19 infection in children with cancer after the first wave in Turkey: A study of the Turkish pediatric oncology (tpog) and hematology (tphd) societies(Wiley, 2021-11-01) Kebudi, R.; Kurucu, N.; Tugcu, D.; Eker, N.; Ince, D.; Tokuc, G.; Cecen, R. E.; Vural, O.; Demirdag, T.; Koc, A.; Kara, B.; Uzel, H.; Tuncel, D.; Citak, C.; Kartal, I.; Canpolat, C.; Ozguven, A.; Elli, M.; Acipayam, C.; Toret, E.; Karakas, Z.; Turkkan, E.; Kocak, U.; Tufekci, O.; Bay Buyukkapu, S.; Orhan, M.; Albayrak, C.; Albayrak, D.; Sen, H.; Bicakci, Z.; Ozbek, N.; Somer, A.; Kara, A.; Erdem, M.; Sevinir, B.; SEVİNİR, BETÜL BERRİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Onkoloji Anabilim Dalı.; 0000-0001-5291-2923; 0000-0001-7523-7553; 0000-0002-4811-4803; 0000-0001-8081-6760; 0000-0002-1321-4708; 0000-0002-1654-3232; AAD-8047-2020; HPG-6298-2023; I-9081-2013; AAJ-6924-2021; AAA-5354-2021; HLH-1182-2023; AAA-4820-2022; AAZ-4692-2020; O-4389-2018Publication Evaluation of micafungin use in children(Ankara Microbiology, 2020-01-01) Hacimustafaoglu, Mustafa; Yeşil, Edanur; YEŞİL, EDANUR; Çelebi, Solmaz; ÇELEBİ, SOLMAZ; Sezgin Evim, Melike; SEZGİN EVİM, MELİKE; Özer, Arife; Turan, Cansu; TURAN, CANSU; Timur, Demet; TİMUR, DEMET; Çakır, Salih Cağrı; ÇAKIR, SALİH ÇAĞRI; Bülbül, Beyhan; BÜLBÜL, BEYHAN; Ener, Beyza; ENER, BEYZA; Güneş, Adalet Meral; MERAL GÜNEŞ, ADALET; Koksal, Nilgun; Özkan, Hilal; ÖZKAN, HİLAL; Sevinir, Betul; SEVİNİR, BETÜL BERRİN; Düzcan Kilimci, Duygu; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Onkoloji Anabilim Dalı.; 0000-0002-8926-9959; 0000-0003-3146-6391; 0000-0001-5761-4757; 0000-0002-5720-1212; 0000-0002-3232-7652; 0000-0003-4646-660X; AAG-8523-2021; AEZ-2469-2022; GSO-3630-2022; AAH-1570-2021; HJZ-4508-2023; AAE-6201-2021; AAG-8393-2021; JCD-9679-2023Micafungin is recommended especially in patients with liver and kidney failure and in the presence of other side effects due to antifungals apart from its known priority indications such as invasive candidiasis. The aim of this study was to evaluate the children who have received micafungin treatment. In the study, 125 children who were hospitalized in the pediatric wards and intensive care units of our hospital and had used micafungin between November 2016 and January 2019 were analyzed retrospectively. Clinical data, micafungin indication, blood values on the first and fourth days of the treatment, side effects of the drug and efficacy were evaluated. Sixty percent (75/125) of the patients were male and the mean age of all the patients were 58 +/- 67 (0-215, 30) months. Approximately half of the cases (48%) had malignancy and 13% of them were premature. Sixty-two percent (n= 37) of the malignencies were hematological (27 acute lymphocytic leukemia, nine acute myeloid leukemia, one myelodysplastic syndrome) and 38% (n= 23) were oncological (six neuroblastoma, four Hodgkin lymphoma, two Non-Hodgkin's lymphoma, five sarcomas, one hepatoblastoma, five others) malignencies. The major cause of hospitalization was sepsis (53%). The patients had several risk factors like immunosuppressive therapy (n= 68, 54%), neutropenia (n= 61, 49%), central venous catheter (n= 102, 82%), nasogastric tube (n= 63, 50%), endotracheal intubation tube (n= 49, 39%), urinary catheter (n= 14, 11%) and total parenteral nutrition (n= 81, 65%). Thirteen percent (n= 16) of the cases were post-operative patients. Candida species were cultivated in 97 clinical specimens (blood, endotracheal aspirate, sputum, urine, etc.) among 23 (18%) of the patients. Thirteen (10%) of the patients had candidemia and 62% of them were non-albicans strains. In all candidemias, strains were echinocandin susceptible, and blood cultures were negative within four days. When all the patients (n= 125) were evaluated, a significant decrease in C-reactive protein, an increase in sodium, and a decrease in alanine aminotransferase were observed on the fourth day of micafungin treatment (p< 0.05). A total of 39 (31%) patients underwent various antifungal treatments for median seven (1-60) days prior to micafungin treatment. Fourteen (36%) of these 39 patients, had elevated liver function tests (LFT), 10 (26%) of them had hypokalemia, and five (13%) of them had elevated renal function tests. Ten (26%) patients had antifungal-induced hypokalemia previously; and potassium levels were normalized after micafungin treatment (p= 0.0001). The patients for which micafungin treatment was chosen due to elevated liver function tests (n= 47, 38%), whether the antifungalinduced or not; alanine aminotransferase and aspartate aminotransferase levels were decreased after micafungin treatment (p= 0.0001 and p= 0.0001, respectively). Nineteen (15%) of the patients have died within the first 30 days of micafungin treatment and one of them had candidemia. No micafungin treatment related significant side effects were observed in any of the patients. Our study showed that micafungin could be a safe and effective option in pediatric cases including newborns with high liver and kidney function tests.Publication Healthcare-associated infections in the department of pediatric hematology-oncology; a single center evaluation(Galenos Publishing House, 2024-04) Özdel, Zeynep Gizem Ergün; Çelebi, Solmaz; Güneş, Adalet Meral; Evim, Melike Sezgin; Sevinir, Betül Berrin; Baytan, Birol; Demirkaya, Metin; Köse, Serdal Kenan; Çetin, Benhur; Çelik, Taylan; Salı, Enes; Hacımustafaoğlu, Mustafa; ERGÜN ÖZDEL, ZEYNEP GİZEM; ÇELEBİ, SOLMAZ; MERAL GÜNEŞ, ADALET; SEZGİN EVİM, MELİKE; SEVİNİR, BETÜL BERRİN; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi; H-2691-2017Introduction: With advances in the treatment of Pediatric Hematology -Oncology (PHO) patients, the survival of patients are increasing day by day. However, Healthcare -Associated Infections (HAI) is still a significant cause of mortality and morbidity in this group of patients. This study aimed to evaluate the rates of HAI in patients who were hospitalized in Uludag University Medical Faculty PHO Clinic during the 4 -year study period. Materials and Methods: HAI was diagnosed according to the CDC (Center for Disease Control and Prevention) 2008 criteria. We recorded the number of patients admitted, the number of patients with HAI, the total number of HAI episodes, and the length of stay in hospital. We calculated HAI rate and HAI density (per 1000 patient -days). Results: During the four years, 3069 hospitalizations were recorded in 607 PHO patients (5.05 admissions per patient). 38.6% of the patients were female, and 61.4% male. The mean age was 100.8 +/- 63.6 months. The mean duration of hospitalization was 14 +/- 17.16 days. A total of 232 HAI episodes were recorded in 141 hospitalizations. HAI rate was 7.5%, and HAI density was 5.36/1000 patient -days. Conclusion: The HAI rates in our PHO unit were comparable to those of developed countries and lower than those of developing countries and prior results from our country.Publication Evaluation of the lag time between onset of symptoms and diagnosis in childhood cancers(Galenos Publ House, 2023-12-01) Kalay, Gülşah; Sevinir, Betül Berrin; Demirkaya, Metin; Aygüneş, Utku; Ertekin, Mehtap; SEVİNİR, BETÜL BERRİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatrik Onkoloji Anabilim Dalı; 0000-0002-3232-7652; DSK-0178-2022Introduction: Our aim was to evaluate the lag time between the first onset of symptoms and the final diag-nosis in children with lymphoma and solid tumors.Materials and Methods: This study was carried out by retrospectively scanning the records of 759 patients admitted to the Pediatric Oncology Department of Uludag University between January 2005 and December 2014. Demographic data of the patients, first complaints, the time to apply to a physician after the first complaint, the first application center were determined, lag time to the center that established the oncologic diagnosis, the final diagnosis, time to diagnosis at the last center, total time elapsed from the first onset of complaints to the establishment of diagnosis and the last health state of the patient were obtained from the hospital records.Results: The patients diagnosed with cancer firstly applied to a physician median 15 days. The physicianwho saw the patient for the first time referred to him/her to the center that established the final diagnosis after a median of 8 days. The median time to final diagnosis was 10 days minimum 1 days and totaly 55 days at the last center. In patients whose first symptom is fever, abdominal pain and seizures and In patients with a definitive diagnosis of germ cell tumor, neuroblastoma, kidney tumor and liver tumor, the time to the first admission was shorter than 15 days. In patients whose first symptom was a headache, and abdominal mass; in patients and central nervous system (CNS), and eyes, and in patients with the final diagnosis of CNS tumor germ cell tumor and retinoblastoma, the lag times for referrals were significantly shorter than 8 days. In patients whose first symptom was headache, nausea and vomiting, fatigue-weight loss, and visual disturbances and in patients with the final diagnosis of CNS tumors and neuroendocrine tumors, the time to diagnosis was significantly shorter than 10 days.Conclusion: Delays in diagnosis are common in children with cancer. A sustained effort should be made to raise the level of awareness of childhood cancer among parents and to sensitize all physicians, especially those who treat pediatric patients infrequently, about the warning signs of the disease.Publication Clinical and laboratory follow up of pediatric craniopharyngioma cases(Bursa Uludag Universitesi, 2020-12-01) Sobu, Elif; Eren, Erdal; Sevinir, Betul; Taşkapılıoğlu, M. Özgür; Tarim, Omer; EREN, ERDAL; Sevinir, Betul; SEVİNİR, BETÜL BERRİN; Tarım, Ömer; TARIM, ÖMER FARUK; Bursa Uludağ Üniveristesi/Tıp Fakültesi; 0000-0002-1684-1053; 0000-0002-3232-7652; 0000-0001-5472-9065; 0000-0002-5322-5508; GSN-9730-2022; JPK-3909-2023; AAH-1570-2021INTRODUCTION: The aim of this study was to evaluate the clinical and laboratory findings and follow up of endocrine status of pediatric craniopharyngioma cases.MATERIALS and METHODS: The patients diagnosed with craniopharyngioma between January 2010-December 2017 were included in this study. Demographic and clinical findings were retrospectively examined from medical records of Uludag University Medical Faculty Pediatric Endocinology Department. Statistical analyses were performed using the SPSS software version 21.RESULTS: We identified a total of 28 patients with craniopharyngioma during this period. The age of the patients ranged from 60 to 207 months, with a median age of 138.5 months. Fifty-three percent (n=15) of cases were male and forty-seven percent (n=13) of the cases were female. The most common presenting complaints were headache, visual impairment, and short stature in decreasing order. Tumor size was greater than 3 cm in 71% (n: 20) of patients at the time of diagnosis. When the endocrine status of the patients were examined in the preoperative period, it was determined that 17% (n: 5) of the cases had growth hormone deficiency, 14% (n: 4) had hypothyroidism, 10% (n: 3) had cortisol deficiency, and 7.1% (n: 2) had diabetes insipidus. In the postoperative period, panhypopituitarism developed in 89.3% (n: 25) of the cases.CONCLUSIONS: Craniopharyngiomas are slow-growing tumors, the tumor is usually diagnosed late and reaches large sizes. Late diagnosis and large tumor size often lead to more serious endocrine losses. Failure to thrive and progressive weight gain are stimulating findings for early diagnosis of pituitary masses.Publication Retrospective evaluation of hemophagocytic lymphohistiocytosis cases treated(Galenos Yayıncılık, 2020-04-01) Temuroğlu, Aytül; Evim, Melike Sezgin; Sevinir, Betül; Baytan, Birol; Güler, Salih; Güneş, Adalet Meral; TEMUROĞLU, AYTÜL; SEZGİN EVİM, MELİKE; SEVİNİR, BETÜL BERRİN; Baytan, Birol; GÜLER, SALİH; MERAL GÜNEŞ, ADALET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Hematoloji ve Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Hematoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Onkoloji Anabilim Dalı.; 0000-0002-8943-6585; 0000-0002-3232-7652; 0000-0002-9375-2855; AAH-1570-2021; AAH-1452-2021; GES-3112-2022; DVW-8108-2022; JHO-2788-2023; JGX-6145-2023INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a rare inflammatory syndrome resulting from uncontrolled proliferation in the monocyte / macrophage system. It is divided into two classes as familial (primary) and secondary. Since the rate of consanguineous marriage in our country is high with 29.2%, the frequency of HLH is also increasing. Secondary HLH can be seen at any age, but its true incidence is unknown. It can accompany malignancies, infections and inflammatory processes. Major clinical findings are persistent high fever, cytopenia, splenomegaly and / or hepatomegaly. The first finding is usually fever. The goal of treatment is to stop abnormal inflammation and treat the underlying cause.MATERIALS and METHODS: We retrospectively reviewed 15 patients diagnosed and treated in our clinic between 2010 and 2019. Statistical analysis was performed with kruskal-wallis test.RESULTS: The median age of diagnosis of 15 patients diagnosed and treated in our clinic was 18 months (1 month-17 years). The female to male ratio was 6/9. Fever was seen in all patients, hepatosplenomegaly was 80%. The mean ferritin value was 33.927 +/- 51.461 mu / 1 (964-201.074). In our patient group, consanguineous marriage rate was 53% (n = 8) and it was high and the factor was EBV in all patients who developed secondary to infection. 33% (n 5) of the cases were primary and 67% (n = 10) were secondary. 40% (n = 4) of secondary cases had malignancy in etiology, 50% (n = 5) infection and 10% (n = 1) metabolic disease.CONCLUSIONS: HLH is important for early diagnosis in cases with persistent high fever, hepatosplenomegaly and high ferritin conditions in our country. In cases presenting with HLH, malignancy should not be forgotten in etiology besides primary causes.