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Öğe ALLERJİK HASTALIĞI OLAN ÇOCUKLARDA TAMAMLAYICI VE ALTERNATİF TIP KULLANIMI(2020) Sezer Efe, Yağmur; ÖZBEY, Harun; CANER, Nuray; Bayat, Meral; TAHAN, Fulya; Cansever, MuratBu çalışma, alerjik hastalığı olan çocuklarda kullanılan tamamlayıcı ve alternatif tıp (TAT) uygulamalarını belirlemek amacıyla yapılmıştır. Araştırmanın örneklemini bir üniversite hastanesinin çocuk allerji polikliniğinde 1 Temmuz-31 Aralık 2019 tarihleri arasında takip edilen çocukların anneleri (n=150) oluşturmaktadır. Veriler, Çocuk ve Ebeveyn Tanıtım Formu ve Tamamlayıcı Bakım Uygulamalarının Kullanımına İlişkin Form ile toplanmıştır. Araştırmaya katılan annelerin %46.0’ının TAT kullandığı ve bunların %39.7’sinin tedaviye destek sağlamak amacıyla TAT kullandıkları, %88.7’sinin TAT kullanımı hakkında sağlık personelini bilgilendirmediği saptanmıştır. TAT kullanan ebeveynlerin %36.4’ünün TAT yöntemi olarak doğal/bitkisel ürünleri tercih ettikleri saptanmıştır. Kızlarında alerjik hastalık olan (p≤0.001) ve tanıya ilişkin eğitim alan (p≤0.001) ebeveynlerin daha fazla TAT kullandıkları saptanmıştır. Bu doğrultuda TAT kullanımının hasta değerlendirmesinde araştırılması ve ebeveynlerin kullandıkları TAT uygulamaları konusunda sağlık personelini bilgilendirmeleri için teşvik edilmesi önerilebilir.Öğe ALLERJİK HASTALIĞI OLAN ÇOCUKLARDA TAMAMLAYICI VE ALTERNATİF TIP KULLANIMI(2020) Sezer Efe, Yağmur; ÖZBEY, Harun; Caner, Nuray; Bayat, Meral; TAHAN, Fulya; Cansever, MuratBu çalışma, alerjik hastalığı olan çocuklarda kullanılan tamamlayıcı ve alternatif tıp (TAT) uygulamalarını belirlemek amacıyla yapılmıştır. Araştırmanın örneklemini bir üniversite hastanesinin çocuk allerji polikliniğinde 1 Temmuz-31 Aralık 2019 tarihleri arasında takip edilen çocukların anneleri (n=150) oluşturmaktadır. Veriler, Çocuk ve Ebeveyn Tanıtım Formu ve Tamamlayıcı Bakım Uygulamalarının Kullanımına İlişkin Form ile toplanmıştır. Araştırmaya katılan annelerin %46.0’ının TAT kullandığı ve bunların %39.7’sinin tedaviye destek sağlamak amacıyla TAT kullandıkları, %88.7’sinin TAT kullanımı hakkında sağlık personelini bilgilendirmediği saptanmıştır. TAT kullanan ebeveynlerin %36.4’ünün TAT yöntemi olarak doğal/bitkisel ürünleri tercih ettikleri saptanmıştır. Kızlarında alerjik hastalık olan (p≤0.001) ve tanıya ilişkin eğitim alan (p≤0.001) ebeveynlerin daha fazla TAT kullandıkları saptanmıştır. Bu doğrultuda TAT kullanımının hasta değerlendirmesinde araştırılması ve ebeveynlerin kullandıkları TAT uygulamaları konusunda sağlık personelini bilgilendirmeleri için teşvik edilmesi önerilebilir.Öğe Group 3 innate lymhoid cells are absent in DOCK8-defective HIES patients(Amer Assoc Immunologists, 2018) Eken, Ahmet; Okus, Fatma Zehra; Patiroglu, Turkan; Erdem, Serife; Karakukcu, Musa; Cansever, Murat; Donmez-Altuntas, Hamiyet[Abstract Not Available]Öğe ILC3 deficiency and generalized ILC abnormalities in DOCK8-deficient patients(Wiley, 2020) Eken, Ahmet; Cansever, Murat; Okus, Fatma Zehra; Erdem, Serife; Nain, Ercan; Azizoglu, Zehra Busra; Haliloglu, YesimBackgroundDedicator of cytokinesis 8 (DOCK8) deficiency is the main cause of the autosomal recessive hyper-IgE syndrome (HIES). We previously reported the selective loss of group 3 innate lymphoid cell (ILC) number and function in a Dock8-deficient mouse model. In this study, we sought to test whether DOCK8 is required for the function and maintenance of ILC subsets in humans. MethodsPeripheral blood ILC1-3 subsets of 16 DOCK8-deficient patients recruited at the pretransplant stage, and seven patients with autosomal dominant (AD) HIES due to STAT3 mutations, were compared with those of healthy controls or post-transplant DOCK8-deficient patients (n = 12) by flow cytometry and real-time qPCR. Sorted total ILCs from DOCK8- or STAT3-mutant patients and healthy controls were assayed for survival, apoptosis, proliferation, and activation by IL-7, IL-23, and IL-12 by cell culture, flow cytometry, and phospho-flow assays. ResultsDOCK8-deficient but not STAT3-mutant patients exhibited a profound depletion of ILC3s, and to a lesser extent ILC2s, in their peripheral blood. DOCK8-deficient ILC1-3 subsets had defective proliferation, expressed lower levels of IL-7R, responded less to IL-7, IL-12, or IL-23 cytokines, and were more prone to apoptosis compared with those of healthy controls. ConclusionDOCK8 regulates human ILC3 expansion and survival, and more globally ILC cytokine signaling and proliferation. DOCK8 deficiency leads to loss of ILC3 from peripheral blood. ILC3 deficiency may contribute to the susceptibility of DOCK8-deficient patients to infections.Öğe Inherited prothrombotic risk factors in children with hereditary angioedema(2019) Cansever, Murat; Ozcan, Alper; Ozkul, Yusuf; Patiroglu, TurkanAim: Hereditary angioedema is characterized with recurrent mucocutaneous angioedema, abdominal pain, edema of larynx and extremities. Dermal vascular thrombosis and systemic coagulation may occur in patients with hereditary angioedema due to inhibition of activated factor XII, thrombin and plasmin. Aim of this study was to screen patients with HAE for prothrombotic genetic risk factors before treatment.Material and Methods: Ten patients with hereditary angioedema who were followed up at our clinic were included in our study. The type and frequency of attack, use of prophylaxis and family history of hereditary angioedema were questioned and prothrombotic risk factors were studied.Results: Among the 10 included patients, five of them were male (50%) and five were female (50%). Four patients had abdominal edema (40%), four patients had edema of hands, feet and face (40%). One patient (10%) had heterozygous factor V G1691A mutation, another one had also heterozygous protrombin G20210A mutation. The heterozygous methylene tetrahydrofolate reductase (MTHFR) mutation were identified in seven patients (70%) and homozygous MTHFR mutation were found two patients (20%).Conclusion: In patients with hereditary angioedema, evaluation of protrombotic risk factors was crucial to estimate attack frequency-severity and treatment related thrombosis risk.Keywords: Hereditary angioedema; prothrombotic risk factors; C1 inhibitor; thrombosis.Öğe A pilot study about subcutaneous administration of 10% immunoglobulin in patients with primary immune deficiencies: Single center experience(2017) Cansever, Murat; Kut Bektas, Fulya; Patıroğlu, TürkanAbstract:Aim: In this study, we aimed to see the safety, protectivity and adverse events of rapid infusion subcutaneous immunoglobulin (SCIG) therapy in our patients for one year duration. Material and methods: 10 patients diagnosed with primary immune deficiency and receiving regular intravenous immunoglobulin (IVIG) were randomly included to the study, then their IVIG replacement therapy changed as rapidly infused SCIG in same monthly dose. Patients were evaluated in different times for following aspects; serum IgG levels, frequency of infections, side effects, local reactions, and improvement of life quality. IgG levels of patients were measured at the beginning, 3, 6, and 12 months of SCIG replacement treatment. Results: Local reactions were high at the beginning, then decreased with recurrent infusions. Any severe systemic reactions were not observed in patients. Less infection rate was seen in four patients who were not receiving IVIG regularly before with good compliance in all patients. Infection frequency remained same in 4patients. Increased levels of IgG were achieved eight of the patients at end of the 6months and their levels remained as stable at the end of a year. Conclusion: Our study showed that rapid SCIG therapy in same monthly dose with IVIG is as effective as IVIG for preventing infections without any worse systemic reactions.Öğe A pilot study about subcutaneous administration of 10% immunoglobulin in patients with primary immune deficiencies: Single center experience(2017) Cansever, Murat; Bektas Kut, Fulya; Patiroglu, TurkanAim: In this study, we aimed to see the safety, protectivity and adverse events of rapid infusion subcutaneous immunoglobulin (SCIG) therapy in our patients for one year duration. Material and methods: 10 patients diagnosed with primary immune deficiency and receiving regular intravenous immunoglobulin (IVIG) were randomly included to the study, then their IVIG replacement therapy changed as rapidly infused SCIG in same monthly dose. Patients were evaluated in different times for following aspects; serum IgG levels, frequency of infections, side effects, local reactions, and improvement of life quality. IgG levels of patients were measured at the beginning, 3, 6, and 12 months of SCIG replacement treatment. Results: Local reactions were high at the beginning, then decreased with recurrent infusions. Any severe systemic reactions were not observed in patients. Less infection rate was seen in four patients who were not receiving IVIG regularly before with good compliance in all patients. Infection frequency remained same in 4patients. Increased levels of IgG were achieved eight of the patients at end of the 6months and their levels remained as stable at the end of a year. Conclusion: Our study showed that rapid SCIG therapy in same monthly dose with IVIG is as effective as IVIG for preventing infections without any worse systemic reactionsÖğe Retrospective evaluation of patients with humoral immune deficiency(2018) Patıroğlu, Türkan; Cansever, MuratAbstract:Aim: Patients, who were being followed up for the last 10 years by Pediatric Immunology unit of the Faculty of Medicine at Erciyes University, were evaluated retrospectively in order to contribute toward the early diagnosis and the treatment of patients with humoral immunodeficiency. Material and Methods: 412 patients with humoral immunodeficiency were evaluated retrospectively. Patients’ age, gender, consanguineous marriages, family history of immune deficiency or similar diseases were studied at the time of complaints and diagnosis. Results: Humoral immune deficiency was found among 412 out of 536 (76.8%) patients, who were being followed up because of primary immune deficiency. Although the average age of patients at the time of diagnosis was 48.9±4.6 months, the average age was 28.6±33.4 months at the start of complaints. Transient hypogammaglobinemia of infancy was observed the most among patients (50.5%), followed by IgA deficiency (28.4% ), hypogammaglobinemia (6.8%), IgA +IgM deficiency (3.6%), IgG subclass deficiency (3.2%), Common variable immunodeficiency (2.4%), Bruton disease (1.2%), and hyper IgM syndrome (0.5%) respectively. IVIG replacements were given regularly to patients who were diagnosed with either hypogammaglobinemia, CVID, Bruton disease and hyper IgM. Conclusions: In patients with recurrent infections, we need to certainly consider immune deficiency diseases first. Also, we need to be aware of the fact that humoral immune deficiency would relatively be diagnosable and treatable in most of these diseases. Finally,we need to educate the public about the role of marriages among relatives in order to decrease the frequency of these diseases.Öğe Retrospective evaluation of patients with humoral immune deficiency(2018) Cansever, Murat; Patiroglu, TurkanAim: Patients, who were being followed up for the last 10 years by Pediatric Immunology unit of the Faculty of Medicine at Erciyes University, were evaluated retrospectively in order to contribute toward the early diagnosis and the treatment of patients with humoral immunodeficiency. Material and Methods: 412 patients with humoral immunodeficiency were evaluated retrospectively. Patients’ age, gender, consanguineous marriages, family history of immune deficiency or similar diseases were studied at the time of complaints and diagnosis. Results: Humoral immune deficiency was found among 412 out of 536 (76.8%) patients, who were being followed up because of primary immune deficiency. Although the average age of patients at the time of diagnosis was 48.9±4.6 months, the average age was 28.6±33.4 months at the start of complaints. Transient hypogammaglobinemia of infancy was observed the most among patients (50.5%), followed by IgA deficiency (28.4% ), hypogammaglobinemia (6.8%), IgA +IgM deficiency (3.6%), IgG subclass deficiency (3.2%), Common variable immunodeficiency (2.4%), Bruton disease (1.2%), and hyper IgM syndrome (0.5%) respectively. IVIG replacements were given regularly to patients who were diagnosed with either hypogammaglobinemia, CVID, Bruton disease and hyper IgM. Conclusions: In patients with recurrent infections, we need to certainly consider immune deficiency diseases first. Also, we need to be aware of the fact that humoral immune deficiency would relatively be diagnosable and treatable in most of these diseases. Finally,we need to educate the public about the role of marriages among relatives in order to decrease the frequency of these diseases.Öğe Review of patients hospitalized due to indirect hyperbilirubinemia: A retrospective, observational study(2019) Cansever, Murat; Ozdemir, AhmetAim: The aim of our study to identify characteristics of patients admitted to our hospital due to indirect hyperbilirubinemia and to determine risk factors for indirect hyperbilirubinemia. Material and Methods: The study included 130 patients (gestational age≥36 weeks) who admitted to newborn clinic with the diagnosis of indirect hyperbilirubinemia. In all patients, risk factors, peripheral venous serum samples, complete blood count and biochemical parameters before and after phototherapy were assessed. The phototherapy and exchange transfusion decisions were made according to total serum bilirubin (TSB) levels proposed by Turkish Neonatology Association. Result: In patients included, mean gestational age was 38.54±0.95 weeks (range: 36-41) while mean birth weight was 3241.53±414.60 g (range: 2020-4400). Of the patients, 71 (54.6%) were boys. Time of presentation was 3.56±1.2 days while total bilirubin level was 21.31±3.83 mg/dL. No underlying cause was detected in 71 patients while there was dehydration in 30 (23.0%), ABO incompatibility in 41 (31.5%) and Rh incompatibility in 20 patients (15.3%). Mean phototherapy duration was 69.78±20.36 hours (range: 48-120). Seven patients received intravenous immunoglobulin (IVIG) therapy. Of these, there was Rh incompatibility in 4 patients and ABO incompatibility in 3 patients. Overall, 6 patients underwent exchange transfusion. In 3 patients, exchange transfusion was required despite IVIG therapy. The hemoglobin, MCV and total bilirubin levels were 15.89±2.92 g/dL, 105.51±6.59 fL and 21.31±3.83 mg/dL before therapy whereas 14.07±2.90 g/dL, 101.41±8.15 fL and 11.33±2.18 mg/dl after therapy, respectively. Conclusion: Based on our results, the most common cause of hyperbilirubinemia is idiopathic jaundice ((most probably physiological jaundice or breast milk jaundice) in newborns; followed by ABO incompatibility.
