Publications by authors named "Alkan Bal"

Article Synopsis
  • The study aimed to assess the status of point-of-care ultrasound (POCUS) usage, perceptions, and educational barriers in pediatric emergency departments (PEDs) and pediatric intensive care units (PICUs) in Turkey.
  • The survey revealed that a significant majority of PEDs (84.2%) and all PICUs (100%) utilize POCUS, mainly for thoracic and cardiovascular assessments, but face challenges like lack of equipment, manpower, and training.
  • Participants emphasized the importance of mandatory POCUS training during fellowship programs to enhance usage and improve patient outcomes in pediatric care.
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Introduction: Multisystemic inflammatory syndrome (MIS-C) is a newly described disease manifestation in children associated with the novel coronavirus SARS-CoV-2 infection and can be easily confused with Kawasaki disease with its clinical and laboratory findings. In this study, the clinical findings, organ involvements, similarities, and differences in laboratory and imaging of the children with MIS-C and KD at the time of admission will be revealed in detail, and the treatment methods and follow-up results will be revealed.

Material And Method: Our study was a single-center study and included pediatric patients who were treated with a diagnosis of MIS-C between March 2020 and July 2023 in the pediatric cardiology, pediatric emergency, pediatric infection, and pediatric intensive care clinics at Celal Bayar University and who were treated with a diagnosis of KD (complete/incomplete) between January 2015 and July 2023.

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Article Synopsis
  • Vaccines have significantly reduced COVID-19 hospitalizations among adolescents in Turkey, evidenced by a decline in hospitalizations during the vaccination period compared to pre-vaccination.
  • The study revealed that while there were more total hospitalizations during the vaccination period, the proportion of vaccinated adolescents requiring hospitalization was lower, reflecting the effectiveness of the vaccine.
  • Additionally, breakthrough infections in vaccinated adolescents were generally milder and less severe compared to infections in unvaccinated peers, with many being asymptomatic.
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Pneumonia is a disease caused by bacteria, viruses, and fungi that settle in the alveolar sacs of the lungs and can lead to serious health complications in humans. Early detection of pneumonia is necessary for early treatment to manage and cure the disease. Recently, machine learning-based pneumonia detection methods have focused on pneumonia in adults.

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Although various bacteria and viruses have been identified in the etiology of acute respiratory tract infections (ARI), 90% of acute ARIs that develop in children are of viral origin. The aim of this study was to investigate the seasonal trends and interactions between infectious agents and to determine the risk factors associated with ARI in children aged 1-15 years admitted to the Pediatric Emergency Department of Manisa Celal Bayar University Hospital in the advancing periods of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic. To determine the bacterial and viral agents, samples were taken from 314 patients attending to the hospital with symptoms suggestive for ARI, between 06/01/2021 and 05/31/2022.

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Article Synopsis
  • The study investigates multisystem inflammatory syndrome in children (MISC) related to COVID-19, focusing on comparing clinical and laboratory characteristics of children hospitalized in ICU versus those who were not.
  • Conducted from June 2021 to January 2022, the observational study included 601 patients, with 157 requiring ICU care, revealing significant differences in demographics, lab results, and disease features.
  • Key findings showed that older age groups and higher levels of certain inflammatory markers increased the likelihood of ICU admission, highlighting the severe impact of MISC on children's health.
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This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.

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Background: The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population.

Methods: This was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific antibodies against SARS-CoV-2 were included.

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This study was conducted to investigate the agreement between laboratory hemoglobin (LabHb) measured in venous blood and noninvasive, spectrophotometric hemoglobin (SpHb) measurement and the usability of SpHb measurement in the transfusion decision-making in patients with thalassemia whose hemoglobin (Hb) was monitored by taking blood samples at frequent intervals and who were transfused. Cardiac pulse, oxygen saturation, Pleth variability index (PVI), and SpHb values were measured in patients who came to the hematology outpatient clinic for a control visit and whose Hb levels were planned to be measured. Venous blood samples were taken for LabHb measurement, which we accept as the gold standard.

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Article Synopsis
  • The study aims to evaluate the skills of pediatric healthcare providers in Turkey regarding the recognition of heart rhythm abnormalities and the use of defibrillators, emphasizing the necessity of BLS and ALS training for improved emergency care outcomes.* -
  • Conducted as a cross-sectional survey involving 716 healthcare participants, findings indicated that a majority had received BLS-ALS training, leading to increased confidence and knowledge in performing defibrillation procedures, especially among trained physicians.* -
  • Results showed that non-certified healthcare providers struggled with administering correct doses during cardioversion and defibrillation, highlighting the importance of proper training in improving the effectiveness of emergency interventions in pediatric settings.*
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Article Synopsis
  • The study analyzed pediatric COVID-19 cases across 32 hospitals in Turkey, focusing on the epidemiological, clinical, and laboratory characteristics of the disease in children from March 16 to June 15, 2020.
  • A total of 1,156 cases were confirmed, with a slightly higher proportion of males (50.3%) compared to females (49.7%), and the median age of the patients was 10.75 years; common symptoms included fever (50.4%) and cough (46.9%).
  • The severity of illness varied, with 22.7% asymptomatic, 57.7% experiencing mild symptoms, and 1.5% being classified as severe; 12.9% had
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Background: The most underdeveloped area in the care of critically-ill-children (CIC) is the prehospital period. Appropriate prehospital assessment and life-saving-interventions (LSI) of this population are challenging and require dedicated resources to ensure the best outcomes. We aimed to determine the characteristics and outcomes of CIC transported to the Turkish Pediatric Emergency Departments (EDs).

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Objective: To analyze the change in quality indicators due to the use of high-flow nasal cannula therapy as a non-invasive ventilation method in children with respiratory distress/failure in a non-invasive ventilation device-free pediatric intensive care unit.

Methods: Retrospective chart review of children with respiratory distress/failure admitted 1 year before (period before high-flow nasal cannula therapy) and 1 year after (period after high-flow nasal cannula therapy) the introduction of high-flow nasal cannula therapy. We compared quality indicators as rate of mechanical ventilation, total duration of mechanical ventilation, rate of re-intubation, pediatric intensive care unit length of stay, and mortality rate between these periods.

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Objective: The purpose of the study is to compare the outcomes of pediatric trauma patients with motor vehicle crashes (MVCs) and motor vehicle versus pedestrian crashes (MPCs) at a level 1 pediatric trauma center in the United States and a pediatric trauma center in Turkey.

Methods: The medical records of all pediatric MVC and MPC subjects presenting to the emergency departments (EDs) of a level 3 hospital in Turkey (Izmir Tepecik Training and Research Hospital [ITTRH]) and a level 1 pediatric trauma center in the United States (Children's Medical Center Dallas [CMCD]) over a 1-year period were reviewed. Data that were collected include patient demographics, prehospital report (mechanism of injury, mode of transportation), injury severity score (ISS), abbreviated injury scale score, Glasgow Coma Scale score, ED length of stay, ED interventions, ED and hospital disposition, and mortality.

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The aim of the study was to determine whether the B-type natriuretic peptide (BNP) plasma level predicted the severity of bronchiolitis without additional pathology in children admitted to an emergency department (ED). A total of 232 children (mean age: 7.7±1.

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Objective: The aim of the present study was to compare the pediatric appendicitis score (PAS), the Alvarado score (AS), white blood cell count (WBC), absolute neutrophil count (ANC), C-reactive protein (CRP) level, procalcitonin level, and ultrasound (US) data, with the appendectomy decisions of pediatric surgeons diagnosing acute appendicitis (AA) in a real-life setting; this was a top-level, high-volume pediatric emergency department (PED) in a developing country.

Methods: The study was conducted prospectively between January 2012 and June 2013 in the PED of the Tepecik Teaching and Research Hospital in Izmir, Turkey. The study was observational in nature; no attempt was made to influence indications for exploration or the timing thereof.

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Oral methanol intoxication is common, but dermal intoxication is rare. We report a previously healthy 19-month-old female infant admitted to the emergency department (ED) with vomiting and tonic-clonic seizure. On physical examination, she was comatose and presented signs of decompensated shock with Kussmaul breathing.

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Objective: To evaluate the prognostic significance of microalbuminuria in critically ill children.

Design: Prospective study.

Setting: PICU of a teaching hospital.

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Objective: This study describes a single-center experience on percutaneously performed partial omentectomy procedure in pediatric peritoneal dialysis (PD) patients who showed early catheter dysfunction and required catheter replacement due to catheter flow obstruction.

Materials And Methods: We performed a retrospective review of clinical outcomes from pediatric PD patients who underwent percutaneous catheter replacement by pediatric nephrologists between November 1995 and December 2012. Partial omentectomy was performed in those patients in whom omental or adhesion trapping to the catheter tip was seen.

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Background: Although short-term renal allograft survival in children has improved over the years, long-term graft outcomes remain unclear. In this study we report the characteristics and other variables that impact long-term kidney graft survival in children.

Material And Methods: Records of 61 pediatric kidney transplant recipients (mean age: 14±3 years) performed at our institution between 1995 and 2011 were evaluated.

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The objective of this study was to determine the effect of circumcision on the frequency of urinary tract infection (UTI), growth development, and the nutrition status in infants with antenatal hydronephrosis (AH). The data were collected prospectively between 1998 and 2010. Infants with a fetal pelvis diameter of >5 mm identified with antenatal ultrasound were followed-up.

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Renal osteodystrophy (ROD) is a multifactorial disorder of bone metabolism in chronic kidney disease (CKD). As CKD progresses, ensuing abnormalities in vitamin D metabolism and parathyroid hormone (PTH) secretion result in distortions in trabecular microarchitecture, thinning of the cortical shell, and increased cortical porosity. The recently described Sagliker syndrome (SS) might be an exaggerated version of ROD and is a very striking and prominent feature of secondary hyperparathyroidism in patients with end-stage renal disease (ESRD).

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The aim of this retrospective study was to evaluate our neonatal intensive care unit (NICU) patients' characteristics treated with acute peritoneal dialysis (PD) and their risk factors for mortality. We also wanted to share our experience of the application of PD in neonates who required less than 60 mL of dwell volume and their PD-related problems, as well as special solutions for these problems. This study included 27 infants treated in our NICU between February 2008 and December 2011.

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