Researcher:
Demirkol, Demet

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Demet

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Demirkol

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Demirkol, Demet

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2014 - 201915

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Now showing 1 - 10 of 15
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    Management of the critically ill child with the sepsis/hemophagocytic lymphohistiocytosis/macrophage activation syndrome overlap syndrome
    (Georg Thieme Verlag Kg, 2014) Carcillo, Joseph; N/A; Demirkol, Demet; Faculty Member; School of Medicine; 108964
    Hemophagocytic lymphohistiocytosis (HLH) or macrophage activation syndrome (MAS) is a frequently fatal disease, which can result in end-organ damage and death. This condition shares features with sepsis and systemic inflammatory response syndrome. Making a diagnosis of HLH can be challenging since most of the clinical and laboratory features of HLH are quite nonspecific. Timely diagnosis is critical to start therapy before damage by hypercytokinemia becomes irreversible. The treatment for patients with suspected acquired HLH/sepsis/systemic inflammatory response syndrome/multi organ dysfunction syndrome/MAS overlap syndrome should be guided primarily by the severity of signs and symptoms, age of the patient, and underlying conditions. It is critical that the risks of treatment or non-treatment be weighed according to the clinical presentation of each patient. In this article, the authors discuss the diagnostic similarities between sepsis/HLH/MAS and management of the critically ill child with sepsis/HLH/MAS overlap syndrome.
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    Hemolytic uremic syndrome outbreak in Istanbul-Turkey in 2015; outcome and eculizumab experience
    (Springer, 2017) Ağbaş, Ayşe; Göknar, Nilufer; Akıncı, Nurver; Yıldırım, Zeynep Yürük; Benzer, Meryem; Gökçe, İbrahim; Küçük, Nuran; Çalışkan, Salim; Taşdemir, Mehmet; Demirkol, Demet; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 175867; 108964
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    What is the best vascular access site for continuous renal replacement therapy during neonatal period?
    (Springer, 2015) Büyükpastırmacı, Müge; Karacabey, Burçin Nazlı; Aygün, Fatih.; Zeybek, Çiğdem Ayşe; N/A; Demirkol, Demet; Faculty Member; School of Medicine; 108964
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    Diffusion tensor ımaging parameters in children with acute hyperammonemic encephalopathy due to urea cycle enzyme defects and organic acidemia
    (Bentham Science Publ Ltd, 2018) Kurtcan, Serpil; Alkan, Alpay; Toprak, Hüseyin; Tüzün, Ümit; Aralaşmak, Ayşe; N/A; Demirkol, Demet; Faculty Member; School of Medicine; 108964
    Background: Prolonged hyperammonemia, as a result of its toxic effect, may cause irreversible damage in the central nervous system. Objective: We aimed to determine whether there were DTI changes in brains of pediatric subjects with acute hyperammonemic encephalopathy due to Urea Cycle Defects (UCD) and Organic Acidemia (OA). Methods: Eleven children with acute hyperammonemic encephalopathy (UCD, n=5; OA, n=6) and 9 controls were included in study. Routine MRI and diffusion-weighted images at b= 0 s mm(-2) and b= 1000 s mm(-2) were applied. Then, DTI sequence was performed. ADC and FA comparisons of all subjects were performed by nonparametric tests (the Mann-Whitney test, Kruskal-Wallis test). Results: The mean ADCs of the perirolandic cortex (p=0.037), cerebellar white matter (p=0.006), cingulum (p=0.017), temporal and frontal periventricular white matter (p=0.030) (p=0.020), and parietal subcortical white matter (p=0.037) were statistically higher in all subjects than controls. FAs of nucleus caudatus (p=0.034), putamen (p=0.004), perirolandic cortex (p=0.026), corpus callosum genu (p=0.031), temporal periventricular white matter (p=0.003), and occipital periventricular and subcortical white matter (p=0.045, p=0.026) were lower in both subjects with UCD and OA than controls. FAs of splenium of the corpus callosum (p=0.012) in subjects with UCD were lower compared to subjects with OA and the control group. FAs of hippocampus and parietal subcortical white matter in subjects with OA were lower compared to subjects with UCD and the control group (p=0.03 1). Conclusion: On DTI, both UCDs and OAs demonstrated similar DTI changes in same regions compared to controls. These changes in ADC and FA values in both conditions may indicate microstructural damage. In this context, DTI findings may contribute to a better understanding of the underlying pathophysiology of disease.
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    A case with acute baked milk protein-induced enterocolitis syndrome
    (Wiley, 2019) N/A; N/A; N/A; Saçkesen, Cansın; Yılmaz, Özlem; Demirkol, Demet; Faculty Member; Doctor; Faculty Member; School of Medicine; School of Medicine; School of Medicine; 182537; 140706; 108964
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    Outbreak of Shiga toxin-producing Escherichia-coli-associated hemolytic uremic syndrome in Istanbul in 2015: outcome and experience with eculizumab
    (Springer, 2018) Ağbas, Ayşe; Göknar, Nilüfer; Akıncı, Nurver; Yıldırım, Zeynep Yürük; Benzer, Meryem; Gökçe, İbrahim; Candan, Cengiz; Küçük, Nuran; Uzuner, Selçuk; Özçelik, Gül; Sever, Lale; Çalışkan, Salim; Taşdemir, Mehmet; Demirkol, Demet; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 175867; 108964
    Background: This study aims to identify epidemiological and clinical characteristics of patients and report our experience with eculizumab treatment during an outbreak of hemolytic uremic syndrome (HUS) caused by Shiga toxin-producing Escherichia coli (STEC) in Istanbul in 2015. Methods: Thirty-two children (21 females, median age 3.25 years) were included in this study. Demographic, clinical and laboratory data, and treatment details were retrospectively collected. Renal outcomes were assessed at last follow-up visit. To assess the effect of eculizumab on prognosis of STEC-HUS, subgroup analysis was performed on patients who required dialysis. Results: A high number of cases occurred within a certain region of Istanbul. Stool samples were cultured from 21 patients (65%), and enteroaggregative E. coli (EAEC; n = 7) and enterohemorrhagic E. coli (EHEC; n = 3) strains were detected. Rates of dialysis treatment, neurological manifestations, and death were 59%, 25%, and 3%, respectively. Mean follow-up duration was 8.6 ± 2.6 months (range 3–12 months). None of the patients (n = 25) was on dialysis at the final visit. The complete renal recovery rate was 54%. Nine patients were treated with eculizumab. At final follow-up visit, no differences in estimated glomerular filtration rate, proteinuria level, or hypertension incidence were observed between patients treated with eculizumab and those not treated with eculizumab. Conclusions: An outbreak of EAEC occurred in a specific region of Istanbul. Livestock markets were suspected as the source. Evidence for beneficial effects of eculizumab on renal outcome was not clear in this cohort.
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    Continuous venovenous hemodiafiltration in the treatment of maple syrup urine disease
    (Karger, 2016) Sık, Güntülü; Topal, Nilüfer; Çitak, Agop; Zeybek, Çiğdem; Tüten, Abdulhamit; N/A; N/A; Demirkol, Demet; Bilge, İlmay; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 108964; 198907
    Background: The study aims to define the efficacy of continuous renal replacement therapy in acute metabolic decompensation treatment of maple syrup urine disease (MSUD). Methods: All the neonates, infants and children who have had life threatening conditions due to MSUD and were treated with continuous venovenous hemodiafiltration (CVVHDF) were analyzed retrospectively. Results: Fourteen patients underwent 15 sessions of CVVHDF (age range 15 days to 87 months, mean 40.8 +/- 31.4 months). One patient required additional CVVHDF 1 week after cessation of CVVHDF. Twenty seven percent (n = 4) of the patients were intubated and mechanically ventilated. Twelve patients responded to treatment and dramatic neurological improvement was observed within 24 h. Two of the 14 patients required 36 h of CVVHDF for neurological improvement. The mean duration of CVVHDF was 20.2 +/- 8.6 (9-36) h. The mean leucine level was 1,648 +/- 623.8 (714-2,768) mu mol/l before and was 256.5 +/- 150.6 (117-646) mu mol/l at the end of treatment. No mortality was observed. Conclusion: Continuous hemodiafiltration is an effective and safe method in correcting metabolic disturbances in MSUD. (C) 2016 S. Karger AG, Basel
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    Co-existence of type 3 hereditary angioedema and polycystic ovary syndrome
    (Wiley, 2019) Birben, E.; Soyer, Uysal O.; Yilmaz, O.; Sackesen, C.; Balkancı, Uğur Berkay; Demirkol, Demet; Yeşiltepe Mutlu, Rahime Gül; Undergraduate Student; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; N/A; 108964; 153511
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    Life-saving treatment for medically refractory hyperammonemia: continuous renal replacement therapy
    (Springer, 2015) Karacabey, BN; Zeybek, CA; Cesur, Y; N/A; N/A; N/A; N/A; Demirkol, Demet; Faculty Member; School of Medicine; 108964
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    Non-invasive ventilation practices in children across Europe
    (WILEY, 2018) Mayordomo-Colunga, Juan; Pons-Odena, Marti; Medina, Alberto; Rey, Corsino; Milesi, Christophe; Kallio, Merja; Wolfler, Andrea; Garcia-Cusco, Mireia; Garcia-Lopez, Milagros; Rimensberger, Peter; N/A; Demirkol, Demet; Faculty Member; School of Medicine; 108964
    ObjectivesTo describe the diversity in practice in non-invasive ventilation (NIV) in European pediatric intensive care units (PICUs). Working hypothesisNo information about the use of NIV in Pediatrics across Europe is currently available, and there might be a wide variability regarding the approach. Study designCross-sectional electronic survey. MethodologyThe survey was distributed to the ESPNIC mailing list and to researchers in different European centers. ResultsOne hundred one units from 23 countries participated. All respondent units used NIV. Almost all PICUs considered NIV as initial respiratory support (99.1%), after extubation (95.5% prophylactically, 99.1% therapeutically), and 77.5% as part of palliative care. Overall NIV use outside the PICUs was 15.5% on the ward, 20% in the emergency department, and 36.4% during transport. Regarding respiratory failure cause, NIV was delivered in pneumonia (97.3%), bronchiolitis (94.6%), bronchospasm (75.2%), acute pulmonary edema (84.1%), upper airway obstruction (76.1%), and in acute respiratory distress syndrome (91% if mild, 53.1% if moderate, and 5.3% if severe). NIV use in asthma was less frequent in Northern European units in comparison to Central and Southern European PICUs (P=0.007). Only 47.7% of the participants had a written protocol about NIV use. Bilevel NIV was applied mostly through an oronasal mask (44.4%), and continuous positive airway pressure through nasal cannulae (39.8%). If bilevel NIV was required, 62.3% reported choosing pressure support (vs assisted pressure-controlled ventilation) in infants; and 74.5% in older children. ConclusionsThe present study shows that NIV is a widespread technique in European PICUs. Practice across Europe is variable.