Scopus İndeksli Açık & Kapalı Erişimli Yayınlar

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    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.
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    Low-Dose Antibiotic Prophylaxis Induces Rapid Modifications of the Gut Microbiota in Infants With Vesicoureteral Reflux
    (2021) Morello, William; D'Amico, Federica; Serafinelli, Jessica; Turroni, Silvia; Abati, Isabella; Fiori, Jessica; Baskin, Esra; Yalcinkaya, Fatos; Jankauskiene, Augustina; Pennesi, Marco; Zurowska, Aleksandra; Becherucci, Francesca; Drozdz, Dorota; Mekahli, Djalila; Krzemien, Grazyna; La Scola, Claudio; Taranta Janusz, Katarzyna; Mehls, Otto; Schaefer, Franz; Candela, Marco; Montini, Giovanni; 34222145
    Background and Objectives: Maturation of the gut microbiota (GM) in infants is critically affected by environmental factors, with potential long-lasting clinical consequences. Continuous low-dose antibiotic prophylaxis (CAP) is the standard of care for children with vesicoureteral reflux (VUR), in order to prevent recurrent urinary tract infections. We aimed to assess short-term GM modifications induced by CAP in infants. Methods: We analyzed the GM structure in 87 infants (aged 1-5 months) with high-grade VUR, previously exposed or naive to CAP. Microbial DNA was extracted from stool samples. GM profiling was achieved by 16S rRNA gene-based next-generation sequencing. Fecal levels of short- and branched-chain fatty acids were also assessed. Results: 36/87 patients had been taking daily CAP for a median time of 47 days, while 51/87 had not. In all patients, the GM was predominantly composed by Bifidobacteriaceae and Enterobacteriaceae. Subgroup comparative analysis revealed alterations in the GM composition of CAP-exposed infants at phylum, family and genus level. CAP-exposed GM was enriched in members of Enterobacteriaceae and Bacteroidetes, especially in the genera Bacteroides and Parabacteroides, and showed a trend toward increased Klebsiella, often associated with antibiotic resistance. In contrast, the GM of non-CAP children was mostly enriched in Bifidobacterium. No differences were found in fatty acid levels. Conclusions: In infants with VUR, even a short exposure to CAP definitely alters the GM composition, with increased relative abundance of opportunistic pathogens and decreased proportions of health-promoting taxa. Early low-dose antibiotic exposure might bear potential long-term clinical risks.