Browsing by Author "Baskin, Esra"

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Abnormal circadian blood pressure regulation in children with nocturnal enuresis
(2016) Yuce, Ozge; Bayrakci, Umut Selda; Gulleroglu, Kaan; Baskin, Esra; 27056252
Introduction: To investigate autonomic nervous system function in enuretic children by performing ambulatory blood pressure monitor (ABPM) for 24h. Methods: Twenty-eight children ranging in age from 6 to 15 years with primary nocturnal enuresis and 27 age-matched healthy controls were enrolled and they get 24h ABPM. Hypertension was defined as standard deviation score (SDS)>1.64 (i.e., >95th percentile) adjusted for gender and height. Urinalysis, urine electrolyte levels, urinary culture, and urinary system ultrasound were carried out in all children. They have also requested to have a diary about daily fluid intake and urine volume. Results: Although the mean 24-h and daytime diastolic blood pressure (BP) did not differ between the groups, systolic BP (SBP) was significantly higher in enuretic children (p<0.05). The mean night-time SBP, DBP values, SDS and BP loads were found to be significantly higher than those in the controls (p<0.01). A lack of nocturnal decrease was more prevalent in the enuretic children compared with the control subjects, the difference was statistically significant for DBP but not for SBP. Patients with elevated night-time BP load was found to have higher frequency of urinary incontinence per week as well as per night when compared with enuretic children with normal night-time BP load (r=0.72, r=0.69, p<0.01, respectively). Conclusion: Subtle abnormalities of circadian BP regulation in enuretic children indicated by a selective elevation of nocturnal SBP, DBP, and MAP, and attenuated nocturnal dipping may reflect sympathetic hyper activation and its possible role in pathogenesis of enuresis.
Acidosis and Hyperkalemia Caused By Losartan and Enalapril in Pediatric Kidney Transplant Recipients
(2014) Sakalli, Hale; Baskin, Esra; Bayrakci, Umut Selda; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-4361-8508; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24447308; B-5785-2018; AAE-1041-2021; AAJ-8097-2021
Objectives: To evaluate the efficacy and safety of losartan and enalapril in pediatric kidney transplant recipients. Materials and Methods: A retrospective review was performed in 31 pediatric kidney transplant recipients who were treated with losartan (50 mg/d, oral) for 1 to 6 months because of mild hypertension and persistent proteinuria. All patients were treated concurrently with enalapril (5 or 10 mg daily, oral), and 12 patients (39%) also were treated with amlodipine (5 or 10 mg daily, oral). Demographic and clinical characteristics of the patients were reviewed. Results: Losartan use was associated with a significant decrease in mean systolic (before losartan was started, 123 +/- 14 mm Hg; before losartan was stopped, 111 +/- 10 mm Hg; P <= .001) and diastolic blood pressure (before losartan was started, 78 +/- 11 mm Hg; before losartan was stopped, 69 +/- 10 mm Hg; P <= .001) and urinary protein excretion (before losartan was started, 51 +/- 45 mg/m(2)/h; before losartan was stopped, 28 +/- 34 mg/m(2)/h; P <= .001). However, losartan therapy was associated with a significant mean increase in serum potassium level (before losartan was started, 4.0 +/- 0.4 mmol/L; before losartan was stopped, 5.7 +/- 0.5 mmol/L; P <= .001) and decrease in pH (before losartan was started, 7.35 +/- 0.0; before losartan was stopped, 7.23 +/- 0.0; P <= .001). Losartan was stopped because of hyperkalemia and acidosis earlier in patients who were on tacrolimus than cyclosporine immunosuppression (tacrolimus, 3 +/- 1 mo; cyclosporine, 4.7 +/- 0.8 mo; P <= .001). Conclusions: Losartan and enalapril may be beneficial in pediatric kidney transplant recipients by decreasing blood pressure and proteinuria, with maintenance of stable graft function, but may be associated with serious adverse events including hyperkalemia and life-threatening acidosis.
Acute Rejection and Longterm Graft Survival in Pediatric Renaltransplant Patients
(2018) Baskin, Esra; Gulleroglu, Kaan; Sahin, Vildan; Kazanci, Ozlem; Moray, Gokhan; Haberal, Mehmet; 0000-0003-4361-8508; 0000-0003-1434-3824; 0000-0003-2498-7287; 0000-0002-3462-7632; B-5785-2018; AAJ-8833-2021; AAE-1041-2021; AAJ-8097-2021
Acute Renal Injury in Liver Transplant Patients and Its Effect on Patient Survival
(2014) Kirnap, Mahir; Colak, Turan; Baskin, Esra; Akdur, Aydincan; Moray, Gokhan; Arslan, Gulnaz; Haberal, Mehmet; https://orcid.org/0000-0002-8372-7840; https://orcid.org/0000-0003-4361-8508; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24635816; AAH-9198-2019; AAJ-8554-2021; B-5785-2018; AAA-3068-2021; AAE-1041-2021; AAJ-8097-2021
Objectives: Acute renal injury is a common complication in liver transplant patients. Acute kidney injury is due to nephrotoxic drugs used after liver transplant, infections, and hemorrhage. Though it is generally reversible, it has effects on grafts and patients survival. In this retrospective observational study carried out at a single center, the effects of acute renal disease on liver recipient's survival were investigated. Materials and Methods: Liver transplant recipients of live-donor and deceased-donor transplants between January 2002 and May 2013 were included in this study; there were 310 liver transplant patients (mean age, 28 y; age range, 6 mo-62 y; 165 males, 145 females). The acute kidney disease diagnosis and staging was based on the nephrology department evaluation and daily serum creatinine levels. Patients with acute kidney injury before undergoing liver transplant and those undergoing a transplant for the second time were excluded. Kidney functions were evaluated by the nephrology department 1 week, 3 months, and 1 year after the liver transplant. Results: Acute kidney disease rates in these patients were 5%, 8%, and 12%. Four patients developed chronic kidney failure during follow-up. The mortality rate was higher (18%) in acute renal failure patients compared with those that did not have acute renal failure. The mortality rate was 11% in patients without acute renal failure. Conclusions: Acute renal injury is common after liver transplant and has an effect on mortality.
The Age of the Recipient and the Ratio of CD4/CD8 in Renal Allografts Influences the Prognosis and the Presenting Time of the Polyoma Virus-Associated Nephropathy (PVAN)
(2022) Ozdemir, B. Handan; Akcay, Eda Yilmaz; Ozdemir, F. Nurhan; Baskin, Esra; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0001-6831-9585; AAJ-8097-2021; AAK-1960-2021
Agreement Between Integrated Management of Childhood Illness and Final Diagnosis in Acute Respiratory Tract Infections
(2018) Yalcin, Siddika Songul; Ozdemir, Beril; Ozdemir, Sadriye; Baskin, Esra; 0000-0001-9061-4281; 0000-0003-4361-8508; 29457209; I-9331-2013; B-5785-2018
ObjectiveTo evaluate the agreement between integrated management of childhood illness (IMCI) and final diagnosis in patients presenting with cough at the second and third level health institutions.MethodsThis cross-sectional study included 373 children aged 2-60 mo who presented with cough at the pediatric emergency and outpatient clinics in the Department of Pediatrics. After clinical examination of children, body temperature, respiratory rate, saturation, presence or absence of the chest indrawing, rales, wheezing and laryngeal stridor were recorded. Cases were categorized according to IMCI algorithm regarding the severity using the color code, such as red (urgent treatment), yellow (treatment in the hospital), or green (treatment at home). Final diagnosis after physical examination, laboratory analysis and chest X-ray was compared with the IMCI algorithm.ResultsStudy agreement between IMCI classification and final diagnosis was 74.3% with kappa value 0.55 (moderate agreement). Similar agreement values were detected in both the second and third level health institutions. Health condition and gender did not affect agreement value. Agreement were found to be high in patients <24 mo of age (?=0.67), presence of fever and cough (?=0.54), tachypnea (?=0.93), chest indrawing (?=1.00) and oxygen saturation of <94%(?=0.90).ConclusionsAdding saturation level to the IMCI algorithmic diagnosis may increase agreement between IMCI classification and final diagnosis.
Analysis of Hpse2 Gene Mutations in Children with Non-neurogenic Neurogenic Bladder and Urofacial (ochoa) Syndrome
(2014) Bulum, Burcu; OzCakar, Z. Birsin; Duman, Duygu; Cengiz, Filiz Basak; Burgu, Berk; Cakar, Nilgun; Baskin, Esra; Soygur, Tarkan; Ekim, Mesiha; Tekin, Mustafa; Yalcinkaya, Fatos; https://orcid.org/0000-0003-4361-8508; B-5785-2018
Association Between Heat Shock Protein-72 Gene Polymorphism and Chronic Renal Failure in Children
(2014) Gulleroglu, Kaan; Baskin, Esra; Kantar, Asli; Sahin, Feride; https://orcid.org/0000-0003-1434-3824; https://orcid.org/0000-0003-4361-8508; https://orcid.org/0000-0001-7308-9673; F-3294-2013; B-5785-2018; AAC-7232-2020
Association Between Vitamin D Deficiency and Anemia in Pediatric Kidney Transplant Recipients
(2022) Avci, Begum; Baskin, Esra; Gulleroglu, Kaan; Yilmaz, Aysun Caltik; Karakaya, Emre; Moray, Gokhan; Haberal, Mehmet; 0000-0003-1434-3824; 0000-0002-3462-7632; 0000-0002-4879-7974; 0000-0003-0774-4419; 35570598; AAJ-8833-2021; AAJ-8097-2021; AAD-5466-2021; AAD-1877-2021
Objectives: The association between vitamin D deficiency and anemia is known. Vitamin D deficiency and anemia are common in kidney transplant recipients. We examined the relationship between vitamin D levels and anemia in pediatric kidney transplant recipients. Materials and Methods: We reviewed retrospectively the data of 75 pediatric kidney transplant recipients (0-18 years of age). Patients were evaluated in 3 groups according to serum 25-hydroxyvitamin D levels (<20, 20-30, and >30 ng/mL) in the first year posttransplant: group 1 was the vitamin D deficiency group, group 2 was the vitamin D insufficiency group, and group 3 was normal vitamin D level group, respectively. Groups were compared in terms of anemia parameters, calcium, phosphorus, alkaline phosphatase, and parathyroid hormone levels, as well as infection, rejection, and graft loss status. All patients included in the study were grouped as those with anemia and without anemia, and the 2 groups were compared in terms of vitamin D levels, serum parathyroid hormone values, estimated glomerular filtration rate, and infection, rejection, and graft loss status. Results: There were 41 patients (54.7%) in group 1, 24 patients (32%) in group 2, and 10 patients (13%) in group 3. There were 65 patients (86.7%) with vitamin D deficiency/insufficiency. When groups were compared, the hematocrit level was found to be lower in groups 1 and 2 (P < .05) and ferritin level was found to be lower in group 1 (P < .05). Anemia was present in 20 patients (26.6%): 61% of patients with anemia had vitamin D deficiency and 33% had vitamin D insufficiency (P > .05). In total, 94% of patients with anemia had vitamin D deficiency/insufficiency. Conclusions: Vitamin D deficiency/insufficiency is common in pediatric kidney transplant recipients. Vitamin D levels should be measured, especially in all kidney transplant recipients with persistent anemia. Thus, risk factors associated anemia can be reduced by treating the deficiency/insufficiency.
Association Between Vitamin D Deficiency and Anemia in Pediatric Renal Transplant Recipients
(2022) Avci, Begum; Baskin, Esra; Gulleroglu, Kaan; Yilmaz, Aysun Caltik; Karakaya, Emre; Moray, Gokhan; Haberal, Mehmet; 0000-0003-1434-3824; 0000-0002-5375-379X; 0000-0002-3462-7632; 0000-0002-4879-7974; AAJ-8833-2021; GYU-5220-2022; AAJ-8097-2021; AAD-5466-2021
The Beneficial Impact of D3 Vitamin on the Decline of Rejection, Epithelial-Mesenchymal Transition (EMT), And Interstitial Fibrosis Among Pediatric Renal Transplant Patients
(2022) Akcay, Eda Yilmaz; Ozdemir, B. Handan; Baskin, Esra; Ozdemir, F. Nurhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0001-6831-9585; AAJ-8097-2021; AAK-1960-2021
BK Polyomavirus Infection and Risk Factors in Pediatric Patients Undergoing Kidney Transplant
(2022) Avci, Begum; Baskin, Esra; Gulleroglu, Kaan; Ecevit, Zafer; Soy, Ebru Ayvazoglu; Moray, Gokhan; Haberal, Mehmet; 35570612
Objectives: BK polyomavirus infection is a critical complication affecting graft survival after kidney transplant. We aimed to determine the frequency, the effect on graft function, and the risk factors of BK polyomavirus infection in pediatric kidney transplant patients. Materials and Methods: We retrospectively reviewed data of 144 pediatric patients (female/male: 67/77; 0-18 years of age) who received kidney transplants in the past 10 years at our center. Demographic/laboratory data, kidney failure etiologies, donor types, and immunosuppressive treatments were recorded. Patients were grouped as those with and without BKV infection, with groups compared in terms of transplant age, sex, kidney failure etiology, donor type, immunosuppressive treatments, presence of ureteral stents, acute rejection episodes, accompanying viral infections, glomerular filtration rate, and graft loss rate. Results: Twelve patients (8.3%) had BK polyomavirus infection. All 12 patients had viruria (8.3%), 8 (5.5%) had viremia, and 4 (2.8%) had BK polyomavirus nephropathy. Two patients (1.4%) had graft loss because of BK polyomavirus nephropathy. When patients with and without infection were compared, no significant differences were found in terms of sex, transplant age, donor type, presence of a ureteral stent, acute rejection, graft loss, or immunosuppressive treatment (P > .05). Rates of congenital anomalies of the kidney and urinary tract were 30.3% and 66.6% in those without and with BK polyomavirus infection, respectively (P < .05). The group positive for BK polyomavirus had a significantly higher incidence of cytomegalovirus infection versus the group without infection (P < .05). Glomerular filtration rate values at years 1 and 3 were similar between groups (P > .05). Conclusions: Frequency of BK polyomavirus nephropathy in pediatric patients undergoing kidney transplant in our center was consistent with data from other centers. Graft loss can be prevented by early detection and treatment through close periodic control and adequate evaluation of risk factors.
Can We Differentiate Pyelonephritis and Cystitis without 99mTc-Dimercaptosuccinic Acid Scan in Children?
(2015) Kilicaslan, Buket; Noyan, Aytul; Cengiz, Nurcan; Sariturk, Cagla; Parmaksiz, Gonul; Baskin, Esra
Purpose: Urinary tract infection is one of the most common infections in childhood. Because of the long term sequelae, differentiation of pyelonephritis from cystitis is important. The aim of this study is to determine the value of biomarkers such as C-reactive protein and procalcitonin and whether preferred to predict pyelonephritis in children without 99mTc-Dimercaptosuccinic Acid scan. Material and Methods: Fifty children aged 3 months to 16 years with a first urinary tract infection were included in this retrospective observational study. The medians, sensitivity, specificity, and cut-off values of serum C - reactive protein and procalcitonin to predict pyelonephritis were determined. Results: Thirty-two (64%) patients were diagnosed with pyelonephritis and 18 (36%) were diagnosed with cystitis. The cut-off value for C - reactive protein was 34 mg/L to predict pyelonephritis, with 69% sensitivity and 61% specificity. The cut-off value for procalcitonin was 0.23 ng/mL to predict pyehlonephritis, with 69% sensitivity and 66% specificity. In combination, these biomarkers were 63% sensitive and 78% specific to predict pyelonephritis. Conclusion: Using a combination of procalcitonin and C-Reactive Protein is preferred to predict pyelonephritis in children, instead of the 99mTc-Dimercaptosuccinic Acid scan. Because of its disadvantages, the 99mTc-Dimercaptosuccinic Acid scan should be avoided in children.
Can We Identify "at-risk" Children and Adolescents for Poor Transplant Outcomes in the Psychosocial Evaluation Before Solid Organ Transplantation? The Reliability and Validity Study of Pediatric Transplant Rating Instrument (P-TRI) in Turkish Pediatric Renal Transplant Patients
(2023) Taner, Hande Ayraler; Sari, Burcu Akin; Baskin, Esra; Karakaya, Jale; Gulleroglu, Kaan Savas; Kazanci, Nafia Ozlem; Haberal, Mehmet; 36447352
BackgroundThis study aims to translate the Pediatric Transplant Rating Instrument (P-TRI) to conduct a validity and reliability study on Turkish children and define a cutoff value of this scale. MethodA total of 151 pediatric kidney transplant patients were included in the study. The files of the patients were reviewed by two clinicians, and the scale was filled for inter-rater reliability. One of the clinicians filled the scale again after one month for intra-rater reliability. Glomerular filtration rate (GFR) and creatinine values were used for predictive validity. A GFR below Correlation of P-TRI with GFR (r = .252, p = .003) and creatinine (r = -.249, p = .002) was performed, and the internal consistency of the scale items as measured by Cronbach's alpha coefficient was found to be 0.825. When the test was performed again, the intra-class correlation coefficient was found as .922 for intra-rater reliability and as .798 for inter-rater reliability. For both creatinine and GFR, the best cutoff point for the total score was found to be 66.5. ConclusionsPatients who received P-TRI above 66.5 could be at risk in the post-transplant period. Identification of these patients before transplantation and following these young people more closely will aid in the prevention of serious consequences. The reliability and validity scores are satisfactory for use in transplantation clinics for psychosocial evaluation and compliance in Turkish pediatric renal transplantation patients.
Clinical And Mutational Spectrum Of Children With Autosomal Recessive And Autosomal Dominant Polycystic Kidney Disease
(2021) Baskin, Esra
The Clinical Characteristics of Pediatric Non-Infectious Uveitis in Two Tertiary Referral Centers in Turkey
(2019) Yalcindag, F. Nilufer; Gungor, Sirel Gur; Degirmenci, Mehmet Fatih Kagan; Sezenoz, Almila Sarigul; Ozcaklar, Zeynep Birsin; Baskin, Esra; Yalcinkaya, Fatma Fatos; Atilla, Huban; 31687865
Purpose: To report the manifestations, patterns of disease, treatment strategies and outcomes in pediatric patients with noninfectious uveitis. Methods: Demographic information of 76 cases was recorded. Symptoms, anatomic location, laterality, visual acuity (VA), intraocular pressure, associated systemic diseases, therapeutic strategies, side effects, complications were reviewed. Results: Thirty-one patients were diagnosed as uveitis on routine surveillance because of underlying systemic disease. The most common anatomic location was intermediate uveitis (34.2%). Juvenile idiopathic arthritis (JIA) was the most common underlying systemic disease (25%). Glaucoma was the most common complication (7.7%). The patients with refractory uveitis received adalimumab (26.5%), infliximab (4.6%) and tocilizumab (3.1%). The mean first-year VA was between 20/32 and 20/20 in 116/140 eyes. Conclusion: Most pediatric noninfectious uveitis cases have bilateral intermediate uveitis. JIA was the most common systemic association. The first-year VA was good in most eyes which may be due to early use of corticosteroid-sparing agents.
CLINICAL IMPACT OF COMPLEMENT DEPOSITION FINDINGS ON BIOPSIES IN ACUTE REJECTION EPISODES OF PEDIATRIC RENAL TRANSPLANT PATIENTS
(2020) Gulleroglu, Kaan; Baskin, Esra; Ozdemir, B. Handan; Yilmaz, Aysun Caltik; Soy, Ebru H. Ayvazoglu; Moray, Gokhan; Haberal, Mehmet A.
Clinical impact of complement deposition findings on biopsies in acute rejection episodes of pediatric renal transplant patients
(2021) Gulleroglu, Kaan; Baskin, Esra; Ozdemir, Handan; Moray, Gokhan; Haberal, Mehmet; 0000-0003-1434-3824; 0000-0002-3462-7632; 34508854; AAJ-8833-2021; AAJ-8097-2021
Introduction: Rejection is the most important problem for renal graft function and survival. Complement system plays a key role in immune responses from host to graft. It was demonstrated that complement system activation is related with renal fibrosis. We evaluate clinical impact of complement deposition findings on biopsies in acute rejection episodes of pediatric renal transplant patients. Method: Demographics of the patients, graft functions, acute rejection episodes and graft loss were recorded from data files of 165 pediatric renal transplant patients. Findings of 98 renal biopsies were retrospectively evaluated. Results: Thirty three patients with kidney transplant had 44 acute rejection episodes (32 pure cellular acute rejection episodes / 1 pure humoral acute rejection episode / 11 combined acute cellular and acute humoral rejection episodes) proven by biopsy. C1q staining was positive in 7 biopsies, C3 staining in 15 biopsies and, C4d staining in 15 biopsies. 26 patients had graft fibrosis. All patients with a rejection history had a significant decrease in GFR value during follow-up. Patients who did not have fibrotic changes in first biopsy had same level of deterioration of GFR when compared with patients who had fibrotic changes in first biopsy. Conclusion: We could not demonstrate a significant relation between complement deposition and renal fibrosis, and between complement deposition and GFR values. Our data demonstrated that graft outcomes and graft loss after acute rejection episodes cannot be predicted only with complement deposition on graft or only with graft fibrosis.
Comparison Between Oscillometric and Auscultatory Blood Pressure Measurement in Children and Adolescents
(2018) Duzova, Ali; Baskin, Esra; Cakar, Nilgun; Soylemezoglu, Oguz; Yalcinkaya, Fatos; Hayran, Mutlu; 0000-0003-4361-8508; 0000-0002-1853-0101; AAB-7692-2021; B-5785-2018; AAI-1121-2020; AAI-7277-2020
Comparison of Clinical Features and Laboratory Findings of Coronavirus Disease 2019 and Influenza A and B Infections in Children: A Single-Center Study
(2021) Siddiqui, Meraj; Gultekingil, Ayse; Bakirci, Oguz; Uslu, Nihal; Baskin, Esra; https://orcid.org/0000-0002-5739-6590; https://orcid.org/0000-0001-7955-5735; 34015895; ABF-7609-2022; AAR-9945-2020
Background: As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is crucially important for pediatricians to be aware of the differences in demographic and clinical features between COVID-19 and influenza A and B infections. Purpose: This study analyzed and compared the clinical features and laboratory findings of COVID-19 and influenza A and B infections in children. Methods: This retrospective study evaluated the medical data of 206 pediatric COVID-19 and 411 pediatric seasonal influenza A or B patients. Results: COVID-19 patients were older than seasonal influenza patients (median [interquartile range], 7.75 [2-14] years vs. 4 [2-6] years). The frequency of fever and cough in COVID-19 patients was lower than that of seasonal influenza patients (80.6% vs. 94.4%, P<0.001 and 22.8 % vs. 71.5%, P<0.001, respectively). Ageusia (4.9%) and anosmia (3.4%) were present in only COVID-19 patients. Leukopenia, lymphopenia, and thrombocytopenia were encountered more frequently in influenza patients than in COVID-19 patients (22.1% vs. 8.5%, P=0.029; 17.6% vs. 5.6%, P=0.013; and 13.2% vs. 5.6%, P=0.048, respectively). Both groups showed significantly elevated monocyte levels in the complete blood count (70.4% vs. 69.9%, P=0.511). Major chest x-ray findings in COVID-19 patients included mild diffuse ground-glass opacity and right lower lobe infiltrates. There were no statistically significant intergroup differences in hospitalization or mortality rates; however, the intensive care unit admission rate was higher among COVID-19 patients (2.4% vs. 0.5%, P=0.045). Conclusion: In this study, pediatric COVID-19 patients showed a wide range of clinical presentations ranging from asymptomatic/mild to severe illness. We found no intergroup differences in hospitalization rates, oxygen requirements, or hospital length of stay; however, the intensive care unit admission rate was higher among COVID-19 patients.