Researcher:
Aktürk, Hacer

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Hacer

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Aktürk

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Aktürk, Hacer

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2020 - 202212

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    Malignancy and lymphoid proliferation in primary immune deficiencies; hard to define, hard to treat
    (Wiley, 2020) Kiykim, Ayca; Eker, Nursah; Surekli, Ozlem; Nain, Ercan; Kasap, Nurhan; Dogru, Omer; Canbolat, Aylin; Somer, Ayper; Koc, Ahmet; Tokuc, Gulnur; Bozkurt, Suheyla; Turkoz, Kemal; Karakoc-Aydiner, Elif; Ozen, Ahmet; Baris, Safa; Aktürk, Hacer; Faculty Member; School of Medicine; 162936
    Background Regarding the difficulties in recognition and management of the malignancies in primary immune deficiencies (PIDs), we aimed to present the types, risk factors, treatment options, and prognosis of the cancers in this specific group. Methods Seventeen patients with PID who developed malignancies or malignant-like diseases were evaluated for demographics, clinical features, treatment, toxicity, and prognosis. Results The median age of malignancy was 12.2 years (range, 2.2-26). Lymphoma was the most frequent malignancy (n = 7), followed by adenocarcinoma (n = 3), squamous cell carcinoma (n = 2), cholangiocarcinoma (n = 1), Wilms tumor (n = 1), and acute myeloid leukemia (n = 1). Nonneoplastic lymphoproliferation mimicking lymphoma was observed in five patients. The total overall survival (OS) was 62.5% +/- 12.1%. The OS for lymphoma was 62.2% +/- 17.1% and found to be inferior to non-PID patients with lymphoma (P = 0.001). Conclusion In patients with PIDs, malignancy may occur and negatively affect the OS. The diagnosis can be challenging in the presence of nonneoplastic lymphoproliferative disease or bone marrow abnormalities. Awareness of susceptibility to malignant transformation and early diagnosis with multidisciplinary approach can save the patients' lives.
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    Liver involvement is rare during COVID-19 infection in children
    (Elsevier, 2021) Polat, Esra; Güven, Şirin; N/A; N/A; N/A; Arıkan, Çiğdem; Aktürk, Hacer; Khalilova, Fidan; Faculty Member; Faculty Member; Doctor; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; School of Medicine; N/A; Koç University Hospital; 240198; 162936; N/A
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    Education of healthcare personnel working with pediatric patients during covid-19 pandemic within the framework of infection control
    (AVES, 2020) Oygar P.D.; Büyükçam A.; Bal Z.Ş.; Dalgıç N.; Bozdemir Ş.E.; Karbuz A.; Çetin B.Ş.; Kara Y.; Çetin C.; Hatipoğlu N.; Uygun H.; Aygün F.D.; Törün S.H.; Okur D.Ş.; Çiftdoğan D.Y.; Kara T.T.; Yahşi A.; Özer A.; Demir S.Ö.; Akkoç G.; Turan C.; Salı E.; Şen S.; Erdeniz E.H.; Kara S.S.; Emiroğlu M.; Erat T.; Gürlevik S.L.; Sütçü M.; Aydın Z.G.G.; Atikan B.Y.; Yeşil E.; Güner G.; Çelebi E.; Efe K.; İşançlı D.K.; Durmuş H.S.; Tekeli S.; Karaarslan A.; Bülbül L.; Almış H.; Kaba Ö.; Keleş Y.E.; Yazıcıoğlu B.; Oğuz Ş.B.; Ovalı H.F.; Doğan H.H.; Çelebi S.; Çakır D.; Karasulu B.; Alkan G.; Gül D.; Küçükalioğlu B.P.; Avcu G.; Kukul M.G.; Bilen M.; Yaşar B.; Üstün T.; Kılıç Ö.; Akın Y.; Cebeci S.O.; Turgut M.; Yanartaş M.S.; Şahin A.; Arslanoğlu S.; Elevli M.; Öz Ş.K.T.; Hatipoğlu H.; Erkum İ.T.; Demirbuğa A.; Özçelik T.; Sarı E.E.; Akkuş G.; Hatipoğlu S.S.; Dinleyici E.Ç.; Hacımustafaoğlu M.; Özkınay F.; Kurugöl Z.; Cengiz A.B.; Somer A.; Tezer H.; Kara A.; N/A; Aktürk, Hacer; Yenidoğan, İrem; Faculty Member; Researcher; School of Medicine; School of Medicine; 162936; 327591
    Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n= 4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic. © 2020, AVES. All rights reserved./ Öz: Giriş: Yeni ortaya çıkan patojenlerin neden olduğu salgınların erken dönemleri sağlık çalışanları için büyük bir risk taşımaktadır. SARS-CoV-2’nin neden olduğu pandemide de durum farklı olmamış, alınan yetersiz önlemler ve kişisel korunma eksikliği nedenleriyle pandemi başlangıcında birçok sağlık çalışanı hayatını kaybetmiştir. Sağlık çalışanlarının koruması ve güvenli ortamda çalışmalarının devamlılığının sağlanması sağlık hizmetlerinin aksamamasının yanında salgının sınırlandırması içinde gereklidir. Kişisel koruyucu ekipmaların kullanımı ile ilgili eğitimlerin verilmesi, gerekli durumlarda güncellenmesi koruyucu ekipmanların sağlanması kadar önemlidir. Gereç ve Yöntemler: Otuz iki farklı merkezde çocuklara sağlık hizmeti veren 4927 sağlık personeli üzerinde anket uygulanmış, kişisel koruyucu ekipman kullanımı konusunda alınan eğitim değerlendirilmiş, yaş, cinsiyet, meslek ve bölgesel farklılıkların eğitim alma üzerine etki edip etmediği değerlendirilmiştir. Bulgular: Otuz iki farklı merkezden 4927 sağlık çalışanın katıldığı çalışmada, 4457 (%91) sağlık çalışanın kişisel koruyucu ekipmaların kullanımı ile ilgili eğitim aldığı saptanmış, yalnızca %36’sının hem teorik hem de uygulamalı eğitim aldığı bulunmuştur. Meslek grupları arasında eğitim alma yönünden fark görülmezken, bölgelere göre eğitim alıp almamada anlamlı fark olduğu saptanmıştır. Sonuç: Tüm bölgelerde sağlık personelinin kişisel korunma konusunda eğitilmesi ve verilen eğitimin denetimi ve sürekliliği kaliteli sağlık hizmetlerinin devamlılığı için gereklidir.
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    Roseola infantum during the COVID-19 pandemic
    (Lippincott Williams and Wilkins, 2022) N/A; Aktürk, Hacer; Bağcı, Mihrimah Selcen; Yiğit, Murat Hüseyin; Khalilova, Fidan; Ünlügedik, Özlem; Asarcıklı, Fikret; Faculty Member; Other; Researcher; Doctor; Other; Doctor; School of Medicine; N/A; School of Medicine; N/A; N/A; N/A; N/A; Koç University Hospital; N/A; Koç University Hospital; Koç University Hospital; 162936; N/A; 327599; N/A; N/A; N/A
    introduction: Roseola infantum is always considered to be among the differential diagnosis of young patients with fever and leukopenia whom to be strictly isolated with the preliminary diagnosis of COVID-19 until otherwise proven during the pandemic. Results: Human herpes virus-6 (HHV-6) polymerase chain reaction (PCR) blood test was performed in 4 of 7 patients with a clinical diagnosis of roseola infantum and all found to be HHV-6 PCR positive. the most striking laboratory finding in all patients was leukopenia. HHV-6 PCR tests were found to be positive. Severe acute respiratory syndrome coronavirus-2 testing were found to be negative in all patients. Conclusion: During the peak of the pandemic, children continued to present with fever because of viral infections other than COVID-19.
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    PublicationOpen Access
    Macrophage activation syndrome in a child with juvenile idiopathic arthritis secondary to SARS-CoV-2
    (Oxford University Press (OUP), 2021) Aktürk, Hacer; Tanyıldız, Murat; Erbey, Mehmet Fatih; Taşdemir, Mehmet; Çelikyurt, Aydın; Gönen, Emel; Bilge, İlmay; Faculty Member; Koç University Hospital; Faculty Member; Doctor; Faculty Member; School of Medicine; Koç University Hospital; N/A; N/A; 206213; N/A; N/A; N/A; 198907
    Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused a pandemic affecting many countries and millions of people. Physicians have encountered some rare and challenging cases related to SARS-CoV-2, a novel virus with still many unknowns. In order to share our experience of a such clinical picture, we present here a child with SARS-CoV-2-induced macrophage activation syndrome in the setting of juvenile idiopathic arthritis.
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    PublicationOpen Access
    Immune monitoring of a child with autoimmune hepatitis and type 1 diabetes during COVID-19 infection
    (Lippincott Williams and Wilkins (LWW), 2020) Yüksel, Muhammed; Aktürk, Hacer; Arıkan, Çiğdem; Researcher; Faculty Member; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; Koç University Hospital; N/A; N/A; 240198
    Immunocompromised patients may be at increased risk to develop COVID-19 during the 2019 β-coronavirus infection. We present the unique opportunity we had to monitor the liver, IL-6 and immune cell course before, during and after COVID-19 in a boy with autoimmune hepatitis (AIH) and type 1 diabetes (T1D). CD4+and CD8+T cells frequencies decreased because of prednisolone, followed by a plateauing increase whereas CD19+CD20+B cell increased strongly and was unaffected by COVID-19 infection. Moreover, the percentage of activated CD8+T cells expressing HLA-DR (CD8+HLA-DR+) increased during COVID-19 and subsided after its clearance. Total regulatory T cells (Tregs: CD4+CD25+CD127lowFOXP3+) remained stable. Although activated Tregs (CD4+CD45RA-FOXP3high) strongly increased upon prednisolone, it decreased afterwards. Furthermore, regulatory B cells (Bregs: CD19+CD20+CD24highCD38high) declined sharply owing to prednisolone. Serum IL-6 remained undetectable at all times. We demonstrated for the first time immune monitoring in a child with AIH and T1D before, during and after COVID-19. We hypothesize that continuing with low level of prednisolone without azathioprine may have abrogated activated Tregs, Bregs and IL-6 production and therefore permitting the activation of CD8+T cells, clearing the virus.
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    PublicationOpen Access
    SARS-CoV-2 seropositivity among pediatric health care personnel just after the first peak of pandemic: a nationwide surveillance in Turkey
    (Elsevier, 2021) Oygar, P.D.; Büyükçam, A.; Bal, Z.S.; Dalgıç, N.; Bozdemir, S.E.; Karbuz, A.; Çetin, B.S.; Kara, Y.; Çetin, C.; Hatipoğlu, N.; Uygun, H.; Aygün, F.D.; Torun, S.H.; Okur, D.S.; Çiftdoğan, D.Y.; Kara, T.T.; Yahşi, A.; Özer, A.; Demir, S.O.; Akkoç, G.; Turan, C.; Salı, E.; Şen, S.; Erdeniz, E.H.; Kara, S.S.; Emiroğlu, M.; Erat, T.; Gürlevik, S.L.; Sütçü, M.; Aydın, Z.G.G.; Atıkan, B.Y.; Yeşil, E.; Güner, G.; Çelebi, E.; Efe, K.; İsançlı, D.K.; Durmuş, H.S.; Tekeli, S.; Karaaslan, A.; Bülbül, L.; Almış, H.; Kaba, O.; Keleş, Y.E.; Yazıcıoğlu, B.; Oğuz, S.B.; Ovalı, H.F.; Doğan, H.H.; Çelebi, S.; Çakır, D.; Karasulu, B.; Alkan, G.; Gül, D.; Küçükalioğlu, B.P.; Avcu, G.; Kukul, M.G.; Bilen, M.; Yaşar, B.; Üstün, T.; Kılıç, O.; Akın, Y.; Cebeci, S.O.; Buçak, I.H.; Yanartaş, M.S.; Şahin, A.; Arslanoğlu, S.; Elevli, M.; Çoban, R.; Öz, S.K.T.; Hatipoğlu, H.; Erkum, I.T.; Turgut, M.; Demirbuğa, A.; Özçelik, T.; Çiftci, D.; Sarı E.E.; Akkuş, G.; Hatipoğlu, S.S.; Dinleyici, E.Ç.; Hacımustafaoğlu, M.; Özkınay, F.; Kurugöl, Z.; Cengiz, A.B.; Somer, A.; Tezer, H.; Kara, A.; Aktürk, Hacer; Yenidoğan, İrem; Faculty Member; Researcher; School of Medicine; Koç University Hospital
    Background: understanding SARS-CoV-2 seroprevalence among health care personnel is important to ex-plore risk factors for transmission, develop elimination strategies and form a view on the necessity and frequency of surveillance in the future. Methods: we enrolled 4927 health care personnel working in pediatric units at 32 hospitals from 7 different regions of Turkey in a study to determine SARS Co-V-2 seroprevalence after the first peak of the COVID-19 pandemic. A point of care serologic lateral flow rapid test kit for immunoglobulin (Ig)M/IgG was used. Seroprevalence and its association with demographic characteristics and possible risk factors were analyzed. Results: SARS-CoV-2 seropositivity prevalence in health care personnel tested was 6.1%. Seropositivity was more common among those who did not universally wear protective masks (10.6% vs 6.1%). Having a COVID-19-positive co-worker increased the likelihood of infection. The least and the most experienced personnel were more likely to be infected. Most of the seropositive health care personnel (68.0%) did not suspect that they had previously had COVID-19. Conclusions: health surveillance for health care personnel involving routine point-of-care nucleic acid testing and monitoring personal protective equipment adherence are suggested as important strategies to protect health care personnel from COVID-19 and reduce nosocomial SARS-CoV-2 transmission.
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    PublicationOpen Access
    A single-center report of COVID-19 disease course and management in liver transplanted pediatric patients
    (Wiley, 2021) Yüksel, Muhammed; Aktürk, Hacer; Mızıkoğlu, Özlem; Toroslu, Ertuğ; Arıkan, Çiğdem; Researcher; Faculty Member; Researcher; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; 240198
    Background: in 2019, SARS-CoV-2 causing COVID-19 emerged. Severe COVID-19 symptoms may evolve by virtue of hyperactivation of the immune system. Equally, immunocompromised patients may be at increased risk to develop COVID-19. However, treatment guidelines for children following liver transplantation are elusive. Methods: as a liver transplantation center, we diagnosed and followed up 10 children (male/female: 8/2) with a median age of 8.5 years (IQR: 5.2-11.0), with COVID-19 post-liver transplant between March 2019 and December 2020. COVID-19 diagnosis was based on PCR test and or florid X-ray findings compatible with COVID-19 in the absence of other cause. We retrospectively collected clinical and laboratory data from electronic patient records following written consent from patients/parents. Results: nine patients were diagnosed as definitive (PCR positive) with one patient being diagnosed as probable COVID-19. Seven patients recovered without any support whereas three were admitted for non-invasive oxygenation. Lymphopenia and/or high levels of serum IL-6 were detected in four patients. Six patients mounted anti-SARS-CoV-2 antibodies at median 30 days (IQR: 26.5-119.0) following COVID-19 diagnosis. Antibiotic therapy, favipiravir, anakinra, and IVIG were used as treatment in 4,1,1 and 2 patients, respectively. Furthermore, we kept the tacrolimus with or without everolimus but stopped MMF in 2 patients. Importantly, liver allograft function was retained in all patients. Conclusions: we found that being immunocompromised did not affect disease severity nor survival. Stopping MMF yet continuing with tacrolimus was an apt treatment modality in these patients.
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    PublicationOpen Access
    Catheter-related bloodstream infection caused by Burkholderia cepacia in a pediatric oncology patient
    (Association for Increasing the Visibility of Scientific Research (ACVCS), 2022) Özen, Mehmet Ali; Aktürk, Hacer; Sözmen, Banu Oflaz; Asarcıklı, Fikret; Erbey, Mehmet Fatih; Kandemir, Oğuzhan; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; Koç University Hospital; 293404; N/A; N/A; N/A; 206213; N/A
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    PublicationOpen Access
    COVID-19 associated multisystemic inflammatory syndrome in 614 children with and without overlap with Kawasaki disease-Turk MIS-C study group
    (Springer, 2022) Çiftdoğan, Dilek Yılmaz; Keleş, Yıldız Ekemen; Çetin, Benhur Şirvan; Karabulut, Nazan Dalgıç; Emiroğlu, Melike; Bağcı, Zafer; Büyükçam, Ayşe; Erdeniz, Emine Hafize; Arga, Gül; Yeşil, Edanur; Çakıcı, Özlem; Karbuz, Adem; Bal, Zümrüt Şahbudak; Kara, Soner Sertan; Özer, Arife; Akcan, Özge Metin; Bozdemir, Şefika Elmas; Anıl, Ayşe Berna; Uygun, Hatice; Kılıç, Ömer; Torun, Selda Hancerli; Ümit, Zuhal; Sütcü, Murat; Özmen, Berfin ÖzgÖkce; Asrak, Hatice Karaoğlu; Alkan, Gülsüm; Aksay, Ahu Kara; Uğur, Cüneyt; Birbilen, Ahmet Ziya; Duramaz, Burcu Bursal; Özkan, Esra Akyüz; Burakay, Özgür; Arslan, Sema Yıldırım; Öncel, Eda Karadağ; Celik, Serkan Fazlı; Kılıç, Ahmet Osman; Özen, Seval; Sarıkaya, Remzi; Demirkol, Demet; Arslan, Gazi; Türel, Özden; Sert, Ahmet; Sarı, Ergül; Orbak, Zerrin; Şahin, İrfan Oğuz; Varan, Celal; Öz, Sadiye Kübra Tuter; Durak, Fatih; Oflaz, Mehmet Burhan; Kara, Manolya; Karpuz, Derya; Petmezci, Mey Talip; Hatipoğlu, Nevin; Öncel, Selim; Turgut, Mehmet; Elmalı, Ferhan; Somer, Ayper; Kuyucu, Necdet; Dinleyici, Ener Cağrı; Kurugöl, Zafer; Çiftci, Ergin; Kara, Ateş; Aktürk, Hacer; Faculty Member; Koç University Hospital
    Multisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9-12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells x mu L, p = 0.028; platelet count 166 vs. 216 cells x 10(3)/mu L, p < 0.001). The median serum procalcitonin levels were statistically higher in patients overlapped with KD (3.18 vs. 1.68 mu g/L, p = 0.001). Coronary artery dilatation was statistically significant in patients with overlap with KD (13.4% vs. 6.8%, p = 0.007), while myocarditis was significantly more common in patients without overlap with KD features (2.6% vs 7.4%, p = 0.009). The association between clinical and laboratory findings and overlap with KD was investigated. Age > 12 years reduced the risk of overlap with KD by 66% (p < 0.001, 95% CI 0.217-0.550), lethargy increased the risk of overlap with KD by 2.6-fold (p = 0.011, 95% CI 1.244-5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% (p < 0.001, 95% CI 0.298-0.559). Conclusion: Almost half of the patients with MISC had clinical features that overlapped with KD; in particular, incomplete KD was present. The median age was lower in patients with KD-like features. Lymphocyte and platelet counts were lower, and ferritin and procalcitonin levels were significantly higher in patients with overlap with KD.