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Öğe Anthropometric and Biochemical Assessment of Nutritional Status in Pediatric Cancer Patients(Taylor & Francis Inc, 2015) Ilhan, Inci Erguhan; Sari, Neriman; Yesil, Sule; Eren, Tuba; Tacyildiz, NurdanChildren are at greater risk for malnutrition due to increased needs of nutrients to obtain appropriate growth, and they exhibit elevated substrate needs due to cancer and its treatment. This study aimed to report anthropometric and biochemical evaluation of nutritional status in children with cancer at initial presentation and during treatment. A prospective, controlled study was performed in the pediatric oncology department of a tertiary care center. Control group consisted of the siblings of patients. Weight, height, body mass index, triceps skinfold thickness, and serum levels of total protein, albumin, prealbumin, serum lipids, trace minerals, C-reactive protein (CRP), and vitamins were compared in patients and controls at initial presentation and at 6th month after the onset of treatment. According to weight for height, the frequency of malnutrition was 16% at initial presentation and 22% at 6th month. Triceps skinfold thickness was significantly thinner in patients than controls at both measurements. Patients had lower levels of prealbumin, albumin, iron, folate, zinc, and vitamin C and higher levels of ferritin, vitamin B-12, and copper. Serum CRP levels were significantly higher in cancer patients at initial presentation and seemed to be correlated with copper levels. Compared with other patients, malnourished patients had significantly higher levels of vitamin B-12 at 6th month. Results of the current study demonstrate that trace minerals, vitamins, and anthropometric measures may yield important clues for nutritional status and disease activity in pediatric oncology patients. However, validation and updating these potential markers warrant further trials on larger series.Öğe Effects of Oral Health Care Education on the Severity of Oral Mucositis in Pediatric Oncology Patients(Kare Publ, 2020) Kostak, Melahat Akgun; Semerci, Remziye; Eren, Tuba; Kocaaslan, Esra Nur; Yildiz, FilizOBJECTIVE Oral mucositis is undoubtedly the most common painful complication of cancer treatment, especially chemotherapy and adversely affects the quality of life children. This study aimed to examine the effects of oral health care education on the severity of oral mucositis in pediatric oncology patients. METHODS The semi-experimental and longitudinal study was carried out with 30 children aged eight to 18 years and their mothers in the pediatric oncology clinics at a university hospital. Data were collected with Survey Form, World Health Organization Oral Mucositis Index, and Children's International Mucositis Evaluation Scale. Children and mothers in the intervention group received oral health care education before chemotherapy. Children's oral health was assessed before chemotherapy (0th day) and following chemotherapy 7th, 14th, and 21st days. Data were analyzed with descriptive statistics, Mann-Whitney U test, Friedman Test. RESULTS The socio-demographic characteristics of the children did not affect children's oral mucositis severity. It was determined a significant difference in the severity of oral mucositis between the control and intervention group (p<0.05). Oral mucositis's degree and scores were lower in the intervention groups than the control group on the 7th day of chemotherapy. CONCLUSION The findings obtained in this study suggest that oral health care education is an effective method to reduce the severity of oral mucositis in pediatric oncology patients. It is recommended that oral health care education should be given to children and their parents from the beginning of hospitalization.Öğe Effects of Virtual Reality on Pain During Venous Port Access in Pediatric Oncology Patients: A Randomized Controlled Study(Sage Publications Inc, 2021) Semerci, Remziye; Kostak, Melahat Akgun; Eren, Tuba; Avci, GulcanPurpose: Needle procedures are one of the most distressing practices for pediatric oncology patients. Virtual reality (VR) is a distraction method which offers an extremely realistic and interactive virtual environment and helps reduce needle-related pain and distress. The aim of this study was to evaluate the effects of VR method on pain during venous port access in pediatric oncology patients aged 7 to 18 years. Method: Children who had cancer and were between the ages of 7 and 18 years and undergoing a port-a-cath access were randomly assigned through blocked randomization to either the VR intervention group or control group. A commercially available VR headset was fitted to children in the intervention group. Immediately after the port access, pain scores were obtained from children's self-reports and parents' proxy reports, using the Wong-Baker FACES Pain Rating Scale. Results: Descriptive characteristics of the children (n = 71) showed a homogeneous distribution between groups. During the procedure, children in the control group (n = 36; 5.03 +/- 3.35) experienced more pain than the children in VR group (n = 35; 2.34 +/- 2.76; p < .001). Proxy reports of the parents in the experimental group (1.77 +/- 2.46) were found to be lower than those in the control group (4.67 +/- 2.56; p < .001). Conclusions/Implications for Practice: VR method is effective for reducing pain during venous port access in pediatric oncology patients. VR should be used as a distraction method during venous port access.Öğe Identification of Substance Abuse Among Children in a Pediatric Emergency Department(Galenos Yayincilik, 2020) Ciftdemir, Nukhet Aladag; Eren, Tuba; Karal, YaseminAim: Illicit substance use is a worldwide important public health problem with increasing substance abuse rates and decreasing starting age. In this study, our aim was to determine the complaints of the patients in pediatric emergency department (PED) admission in order to increase awareness about substance abuse. Materials and Methods: The data of this cross-sectional study was gathered from those patients admitted to a PED with complaints of substance abuse and patients without a history of substance abuse, but with a positive urine drug test. A screening urine test was used for the qualitative determination of drug substances. If positive, a quantitative liquid chromatography integrated mass/mass spectrometry test was ordered for confirmation. Results: A total of 17 patients presented to the emergency department. The most frequent symptoms were unstable cognitive conditions and tachycardia. Laboratory analyses showed high creatine kinase-MB. Synthetic cannabinoids were the most frequently detected substance in urine screening and confirmation tests. Twenty-nine percent of patients were hospitalized and no mortality was observed. Conclusion: The use of illegal substances has increased in teenagers. Emergency department doctors must be informed and trained regarding substance abuse since patients frequently presented to the emergency department with cognitive malfunctions. Also, it should be remembered that patients may present with symptoms concerning various organ systems.Öğe Inherited Variants is a Genetic Determinant of Mercaptopurine/Methotrexate Intolerance in Children With Acute Lymphoblastic Leukemia(2022) Atli, Emine Ikbal; Eker, Damla; Atlı, Engin; Demir, Selma; Yalçıntepe, Sinem; Gürkan, Hakan; Eren, TubaObjectives: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children with distinctive features across its different subtypes. Although the etiology of ALL has not been fully elucidated, it has been shown that the onset of ALL is partly due to genetic factors. Genes related to drug transport, metabolism, detoxification and DNA repair could influence the cytotoxic effects associated with chemotherapy, including those involved in the transport (e.g., ABCB1, ABCC2, MTHFR and SLCO1B3), and transporter of folate (SLC19A1) of MTX and 6-MP. Likewise, genes involved in DNA-binding transcription factor activity and RNA polymerase II cis-regulatory region sequence-specific DNA binding (NR3C1) and DNA repair (TYMS) have previously been linked with cytotoxicity of 6-MP and/or MTX. Methods: In the current study, we therefore aimed to assess prior associations for 17 selected genetic variants in 5 genes, in a large cohort of 41 ALL patients treated with mercaptopurine (6-MP) and methotrexate (MTX) combination therapy or mono-therapy of whom detailed clinical toxicity datas were available. Results: Among the 17 variants in 5 genes evaluated according to the results of our study, the polymorphisms in rs2893881 (G/A) in ARID5B were closely related to therapy toxicity. To our knowledge, the effect of ARID5B variants on childhood ALL has not been studied in Turkey. Several genome-wide and candidate gene association studies have reported strong associations between ARID5B SNPs and risk of ALL and toxicity to therapeutic drugs in different populations. Conclusion: Finally, one of the most significant findings from this study is that ARID5B germline SNPs related to ALL treatment toxicity. To our knowledge, this is the first report to describe the relationship between ARID5B and ALL treatment response in the context of a preliminary ALL clinical trial. Further investigation of ARID5B variation in line with different ALL treatment regimens is required to improve its value as a prognostic marker.Öğe Is Immunosuppressive and Thrombolytic Therapy Really Effective in a Patient With Intracardiac Thrombosis and Pulmonary Artery Aneurysm due to Behcet's Disease?(Turkish League Against Rheumatism, 2019) Aladag Ciftdemir, Nukhet; Gokalp, Selman; Eren, TubaBehcet's disease (BD) is a rare, multisystemic, chronic vasculitic disorder with unknown etiology. Intracardiac thrombus formation and pulmonary artery aneurysm in BD are very rare. The treatment protocol in patients with vascular involvement, particularly those with pulmonary artery aneurysm accompanied by thrombosis, have not been clearly defined. In this article, we report an exceptional case, who had been treated unsuccessfully with a combination of anti-inflammatory/immunosuppressive therapy and thrombolytic agents, to discuss the poor prognosis of pulmonary artery aneurysm accompanying intracardiac thrombosis in juvenile BD.Öğe The Journey to the Pediatric Intensive Care Unit Following Vaccine Refusal(Springer, 2019) Ciftdemir, Nukhet Aladag; Duran, Ridvan; Eren, Tuba; Aslan, Mustafa Torehan[Abstract Not Available]Öğe KAPOSIFORM HEMANGIOENDOTHELIOMA AND REFRACTORY KASABACH-MERRITT PHENOMENON TREATED WITH SIROLIMUS(Wiley, 2023) Eren, Tuba; Cakir, Fatma Betul[Abstract Not Available]Öğe Life experiences of adolescents with cancer in Turkey: a phenomenological study(Pakistan Medical Assoc, 2019) Kostak, Melahat Akgun; Semerci, Remziye; Eren, Tuba; Avci, Gulcan; Savran, FilizObjective: To explore life experiences of adolescents after cancer diagnosis. Method: The phenomenological qualitative study was conducted at the paediatric oncology clinic of a university hospital in Edirne, Turkey, from March 15 to April 1, 2016, and comprised semi-structured interviews with adolescents aged 10-18 years diagnosed with different types of cancer. Data was analysed using Colaizzi's method. Results: Of the 12 adolescents, 7(58.3%) were boys and 5(41.7%) were girls. The overall mean age was 14.92 +/- 2.19. Mean duration of life post-diagnosis was 2.87 +/- 2.94 years (range: 1-11 years), and all (100%) of them had undergone chemotherapy. More adolescents experienced shock, sadness, fear, anxiety, curiosity and uncertainty when they learned their diagnosis. Changes related to family included missing their siblings and parents, and feelings of guilt, anger, and sibling jealousy. Adolescents stated that they missed their schools and friends, feared stigmatisation, abandonment and changes related to future. They wanted a stress-free life, to have an occupation, to continue school, and to be independent. Conclusion: Cancer changed adolescents' relationships with family and peers, and their feelings and thoughts regarding future. It is important that health professionals, especially nurses, recognise and understand such changes to provide quality care.Öğe Long-term prognosis of Henoch-Schonlein nephritis in children(Amer Acad Pediatrics, 2008) Oner, Ayse; Erdogan, Ozlem; Eren, Tuba; Demircin, Gulay; Bulbul, Mehmet; Baysun, Sahika; Arda, Nilufer[Abstract Not Available]Öğe Papular-Purpuric Gloves and Socks Syndrome(Aves Yayincilik, Ibrahim Kara, 2016) Ciftdemir, Nukhet Aladag; Eren, Tuba; Duran, Ridvan; Acunas, BetulPapular-purpuric gloves and socks syndrome is characterized by focal acral purpuric petechial eruptions. There are various causative agents related to this condition. In most cases, parvovirus B19 has been implicated as the etiological factor. In this report, we present the case of an 11-year-old female patient with papular-purpuric gloves and socks syndrome having petechial and erythematous lesions only on her feet and legs. Acute parvovirus B19 infection was confirmed by serological tests. The purpose of this report is to emphasize the presence of atypical presentation of this syndrome in children.Öğe Papüler Purpurik Eldiven Çorap Sendromu(2016) Duran, Rıdvan; Çiftdemir, Nükhet Aladağ; Acunaş, Betül; Eren, TubaPapüler-purpurik eldiven çorap sendromu el ve ayaklarda fokal purpurik peteşiyal döküntülerle karakterizedir. Çeşitli etkenler sebep olabilir. Parvovirus B19 olguların çoğunda etyolojik faktördür. Sadece ayak ve bacaklarında peteşiyal döküntü ve eritemi olan eldiven- çorap sendromlu 11 yaşında bir kız hasta sunduk. Serolojik testlerle akut parvovirus B19 enfeksiyonu kanıtlandı. Çocuklarda bu sendromun atipik seyirli olabileceğini vurgulamayı amaçladıkÖğe Primary renal neuroblastoma mimicking Wilms’ tumor(2021) Akçaer, Vedat; Eren, Tuba; Taştekin, Ebru[Abtract Not Available]Öğe A Rare Cause of Torticollis: Grisel Syndrome(Oxford Univ Press, 2018) Ciftdemir, Nukhet Aladag; Eren, Tuba; Ciftdemir, MertPainful torticollis in children requires specific attention. Grisel syndrome is diagnosed on suspicion in patients with recent or history of ongoing upper respiratory tract infections and in patients with restriction of movement or deformity following oto-rhino-laryngologic surgery. Pediatricians should be aware of this condition because early diagnosis and intervention are critical for prognosis in Grisel syndrome.Öğe Successful Desensitization of a Patient with Possible IgE-Mediated Anaphylactic Reaction to FVIII/VWF Concentrate(Mary Ann Liebert, Inc, 2019) Beken, Burcin; Celik, Velat; Ozdemir, Pinar Gokmirza; Eren, Tuba; Yazicioglu, MehtapBackground: Type 3 von Willebrand disease (VWD) is a severe bleeding disorder with a prevalence of 1:1 million live births. There are several von Willebrand factor (VWF) replacement products used in the treatment of acute bleeding episodes or as prophylaxis. Patients who receive multiple transfusions have an increased risk of developing antibodies against these products. These antibodies can lead to life-threatening anaphylactic reactions. Previous studies have identified immune complex formation and complement activation as the trigger for anaphylaxis, rather than IgE. IgE-mediated anaphylaxis against VWF concentrates has not yet been published. Case: A 4-year-old female patient with type 3 VWD was referred to our hospital because of an anaphylactic reaction during FVIII/VWF concentrate (Immunate (R)) infusion. She had previously received FVIII/VWF concentrate (Haemate P (R)) infusions 8 times without any complications. She did not have antibodies against VWF and FVIII, and serum IgA level was normal. Since she needed factor replacement therapy as a result of a growing hematoma on her scalp, we performed skin prick and intradermal tests 2 days after the reaction. The prick test, with FVIII/VWF (Immunate), was negative, but the intradermal test was positive. We administered a 12-step desensitization protocol with FVIII/VWF concentrate (Immunate) successfully without any reactions. Conclusion: Anaphylactic reaction to factor replacement products is a major problem for patients with VWD, especially type 3 VWD requiring multiple factor infusions. We achieved a successful desensitization with FVIII/VWF concentrate in a patient who had an anaphylactic reaction during the infusion of this product. Our patient is important since she represents the first case of IgE-mediated anaphylaxis against VWF concentrate reported in the literature.
