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    Evaluation of disease outcome with demographic,clinical and laboratory features of childhood-onset systemic lupus erythematosus: Single center experience
    (2020) Akbalik Kara, Mehtap; Demircioglu Kilic, Beltinge; Turkut Yilmaz, Asli; Buyukcelik, Mithat; Balat, Ayse
    Aim: To report demographic, clinical and laboratory findings with clinical outcome in childhood-onset systemic lupus erythematosus (cSLE)Material and Methods: Charts of all children with cSLE followed at pediatric rheumatology clinic of Gaziantep University between 2000-2016 were reviewed. Demographic data, history, age at diagnosis, physical examination, laboratory investigations, diagnostic criteria, follow-up duration and all therapeutic regimens were noted. The pediatric adaptation of the Systemic Lupus International Collaborating Clinics American College of Rheumatology Damage Index (PedSDI) has been used to evaluate the disease outcome.Results: The study population was consisted of 39 patients, 31 girls and 8 boys who were under 18 years at the time of diagnosis. Female: male ratio was 4.7:1. The mean age at disease onset was 10.5±4.56 years, and the mean follow-up duration was 26.4± 17.8 months. At the end of the follow-up period, fifteen patients (38.5%) had accrued damage (PedSDI≥1). We observed that renal, neuropsychiatric and musculoskeletal damage was the most frequent types of damage (38.5%). The damage score was higher in patients having increased number of diagnostic criteria at presentation (p:0.001).Conclusion: Although our study showed less damage index than patients from other countries, it has been well known that the damage accrual in SLE is higher in long term period, and mean follow-up period of our patients is lower than previous reports. We conclude that damage mainly affects renal, neurophyschiatric and musculoskeletal systems, and increased number of diagnostic criteria at presentation may cause much more damage.
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    Kidney disease profile and encountered problems during follow-up in Syrian refugee children: a multicenter retrospective study
    (Springer, 2022) Balat, Ayse; Kilic, Beltinge Demircioglu; Aksu, Bagdagul; Kara, Mehtap Akbalik; Buyukcelik, Mithat; Agbas, Ayse; Eroglu, Fehime Kara
    Background Children are one of the most vulnerable groups in conflict zones, especially those with chronic diseases. This study aimed to investigate kidney disease profiles and problems during follow-up in a population of Syrian refugee children residing in Turkey. Methods Syrian refugee children aged between 0 and 18 years were included in the study. Demographic data, diagnosis, particular interventions due to nephrological problems, and problems encountered during follow-up were obtained from all participating pediatric nephrology centers. Results Data from 633 children from 22 pediatric nephrology centers were included. Mean age of the children was 94.8 +/- 61.7 months and 375 were male (59%). 57.7% had parental consanguinity and 23.3% had a close relative(s) with kidney disease. The most common kidney diseases were congenital anomalies of the kidney and urinary tract (CAKUT) (31.0%), glomerular disease (19.9%), chronic kidney disease (CKD) (14.8%), and urolithiasis (10.7%). Frequent reasons for CAKUT were nonobstructive hydronephrosis (23.0%), vesico-ureteral reflux (18.4%), and neurogenic bladder (15.8%). The most common etiology of glomerular diseases was nephrotic syndrome (69%). Ninety-four children had CKD, and 58 children were on chronic dialysis. Six children had kidney transplantation. Surgical intervention was performed on 111 patients. The language barrier, lack of medical records, and frequent disruptions in periodic follow-ups were the main problems noted. Conclusions CAKUT, glomerular disease, and CKD were highly prevalent in Syrian refugee children. Knowing the frequency of chronic diseases and the problems encountered in refugees would facilitate better treatment options and preventive measures.