Yasemin DEMİRBİLEK, Gülen PEHLİVANTÜRK, Zeynep Özge ÖZGÜLER, Emine Alp MEŞE
Yasemin DEMİRBİLEK, Gülen PEHLİVANTÜRK, Zeynep Özge ÖZGÜLER, Emine Alp MEŞE
Our first COVID-19 case in Turkey was a 44-year-old male who referred to the hospital on March 9, 2020. The first related
death occurred on March 17, 2020. Preparedness for the pandemic has been ongoing before the first case was detected. The National
Pandemic Plan was published in 2006. The Pandemic Influenza National Preparedness Plan was available after being updated in light of
experiences gained during the 2009 Influenza A pandemic. Accordingly, Pandemic Coordination Boards and Operation Centers have
been established on the national and provincial levels. This was an adaptable plan to the Novel Coronavirus Disease (COVID-19). We
formed teams to work on a 24/7 basis and established a Scientific Committee at the Public Health Emergency Operation Center within
the General Directorate of Public Health. “COVID-19 Risk Assessment”, “COVID-19 Guideline” and “Case Report Form”, regulations
of personal protective equipment along with need-based guidelines, treatment algorithms, brochures and related documents have been
released. For the case-based follow-up, Public Health Management System (HSYS) is being used. PCR and rapid diagnostic kits are
being used to analyze the samples at the central Microbiology Reference Laboratory and the authorized laboratories in several provinces.
Various preventive measures were implemented including flight restrictions to certain countries, gradually expanded to suspending all
flights and prohibiting the entry of foreign nationals, 14-day isolation and symptom monitoring for those that came from countries
under risk. Persons with chronic diseases have been granted an administrative leave, on campus education at schools and activities of
public rest and entertainment areas were temporarily suspended. The measures have been implemented for penitentiary institutions,
dormitories, nursing homes, public transport and intercity buses, and also weekend curfews are implemented. In accordance with the
pandemic plan, actions have been carried out with a multi-sectoral approach, and preventive measures have been implemented to cover
the society as a whole.
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Eskild PETERSEN, Deniz GÖKENGİN
Eskild PETERSEN, Deniz GÖKENGİN
Background/aim: Coronavirus Infectious Disease 2019 (COVID-19) is now a pandemic spreading in most countries including Turkey.
Materials and methods: The current knowledge of COVID-19 and the virus causing it, SARS-CoV-2, was reviewed. The epidemiology
and control in different countries was compared and the differences discussed.
Results: The population attack rates and case fatality rates vary from country to country with Lombardy in northern Italy reporting
an attack rate in the general population of 0.37% compared to 0.004% in Hong Kong. The differences are caused by different testing
strategies and reporting systems.
Conclusion: Turkey is early in the outbreak. Different control strategies are available with South Korea, Hong Kong and Singapore being
models to follow.
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Ceren ÇETİN, Ateş KARA
Ceren ÇETİN, Ateş KARA
Pandemics have had very important consequences in human history. Lots of people lost their lives and countries have been
intensively affected in terms of socioeconomic problems. Unfortunately, avoidance of pandemics and limiting the spread are still
currently not always possible. Maybe the most important factor for this is the increasing frequency of traveling. Increasing airline
traveling rate also increases the rate of spread. Global organizations like the World Health Organization and United Nations are trying
to play a supreme role over the countries. Pandemics do not have borders; therefore, efforts should be given globally, definition of
pandemic should be established as soon as possible, and protective measures should be shared with countries. If these are not done,
severe health consequences and serious economic problems are inevitable.
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Mustafa HASÖKSÜZ, Selçuk KILIÇ, Fahriye SARAC
Mustafa HASÖKSÜZ, Selçuk KILIÇ, Fahriye SARAC
Coronaviruses (CoVs) cause a broad spectrum of diseases in domestic and wild animals, poultry, and rodents, ranging from
mild to severe enteric, respiratory, and systemic disease, and also cause the common cold or pneumonia in humans. Seven coronavirus
species are known to cause human infection, 4 of which, HCoV 229E, HCoV NL63, HCoV HKU1 and HCoV OC43, typically cause
cold symptoms in immunocompetent individuals. The others namely SARS-CoV (severe acute respiratory syndrome coronavirus),
MERS-CoV (Middle East respiratory syndrome coronavirus) were zoonotic in origin and cause severe respiratory illness and fatalities.
On 31 December 2019, the existence of patients with pneumonia of an unknown aetiology was reported to WHO by the national
authorities in China. This virus was officially identified by the coronavirus study group as severe acute respiratory syndrome coronavirus
2 (SARS-CoV-2), and the present outbreak of a coronavirus-associated acute respiratory disease was labelled coronavirus disease 19
(COVID-19). COVID-19’s first cases were seen in Turkey on March 10, 2020 and was number 47,029 cases and 1006 deaths after 1
month. Infections with SARS-CoV-2 are now widespread, and as of 10 April 2020, 1,727,602 cases have been confirmed in more than
210 countries, with 105,728 deaths.
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İlhami ÇELİK, Esma SAATÇİ, Füsun ÖNER EYÜBOĞLU
İlhami ÇELİK, Esma SAATÇİ, Füsun ÖNER EYÜBOĞLU
Infectious diseases remain as the significant causes of human and animal morbidity and mortality, leading to extensive
outbreaks and epidemics. Acute respiratory viral diseases claim over 4 million deaths and cause millions of hospitalizations in developing
countries every year. Emerging viruses, especially the RNA viruses, are more pathogenic since most people have no herd immunity.
The RNA viruses can adapt to the rapidly changing global and local environment due to the high error rate of their polymerases that
replicate their genomes. Currently, coronavirus disease 2019 (COVID-19) is determined as an infectious disease caused by severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first identified in 2019 in Wuhan. Herein we discuss emerging and
reemerging respiratory viral infections till to SARS-CoV-2.
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Hasan TEZER, Tuğba Bedir DEMİRDAĞ
Hasan TEZER, Tuğba Bedir DEMİRDAĞ
Coronavirus disease (COVID-19) was firstly reported at the end of 2019. The disease rapidly spread all around the world in a
few months and was declared a worldwide pandemic by WHO in March 2020. By April 9, there were 1,436,198 confirmed COVID-19
cases in the world, nearly with 6% mortality rate. This novel infectious disease causes respiratory tract illness that may generally occur as
mild upper respiratory tract disease or pneumonia. In older patients and/or patients with underlying conditions, it may result in acute
respiratory distress syndrome, multi organ failure and even death. According to the current literature, children account approximately for
1%–5% of diagnosed COVID-19 cases. Generally, COVID-19 seems to be a less severe disease for children than adults. Approximately
90% of pediatric patients are diagnosed as asymptomatic, mild, or moderate disease. However, up to 6.7% of cases may be severe. Severe
illness is generally seen in patients smaller than 1 year of age and patients who have underlying disesases. The epidemiological and
clinical patterns of COVID-19 and treatment approaches in pediatric patients still remain unclear although many pediatric reports
are published. This review aims to summarize the current epidemics, clinical presentations, diagnosis, and treatment of COVID-19 in
pediatric patients.
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Abdurrahman TUFAN, Aslıhan AVANOĞLU GÜLER, Marco Matucci CERİNİC
Abdurrahman TUFAN, Aslıhan AVANOĞLU GÜLER, Marco Matucci CERİNİC
In the Wuhan Province of China, in December 2019, the novel coronavirus 2019 (COVID-19) has caused a severe involvement
of the lower respiratory tract leading to an acute respiratory syndrome. Subsequently, coronavirus 2 (SARS-CoV-2) provoked a
pandemic which is considered a life-threatening disease. The SARS-CoV-2, a family member of betacoronaviruses, possesses singlestranded
positive-sense RNA with typical structural proteins, involving the envelope, membrane, nucleocapsid and spike proteins
that are responsible for the viral infectivity, and nonstructural proteins. The effectual host immune response including innate and
adaptive immunity against SARS-Cov-2 seems crucial to control and resolve the viral infection. However, the severity and outcome
of the COVID-19 might be associated with the excessive production of proinflammatory cytokines “cytokine storm” leading to an
acute respiratory distress syndrome. Regretfully, the exact pathophysiology and treatment, especially for the severe COVID-19, is
still uncertain. The results of preliminary studies have shown that immune-modulatory or immune-suppressive treatments such as
hydroxychloroquine, interleukin (IL)-6 and IL-1 antagonists, commonly used in rheumatology, might be considered as treatment
choices for COVID-19, particularly in severe disease. In this review, to gain better information about appropriate anti-inflammatory
treatments, mostly used in rheumatology for COVID-19, we have focused the attention on the structural features of SARS-CoV-2, the
host immune response against SARS-CoV-2 and its association with the cytokine storm.
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Hasan AKDUMAN, Emel OKULU, Fatma Tuba EMİNOĞLU, Tanıl KENDİRLİ, Gaffari TUNÇ, Ebru AZAPAĞASI, Oktay PERK, Ömer EREDEVE, Begüm ATASAY, Saadet ARSLAN
Hasan AKDUMAN, Emel OKULU, Fatma Tuba EMİNOĞLU, Tanıl KENDİRLİ, Gaffari TUNÇ, Ebru AZAPAĞASI,
... Devamını oku
Background/aim: Most inborn metabolic diseases are diagnosed during the neonatal period. The accumulation of toxic metabolites
may cause acute metabolic crisis with long-term neurological dysfunction and death. Renal replacement therapy (RRT) modalities allow
the efficient removal of toxic metabolites. In this study, we reviewed our experience with continuous venovenous hemodiafiltration
(CVVHDF) as RRT for newborns with an inborn metabolic disease.
Materials and methods: Patients diagnosed with an inborn metabolic disease and who received CVVHDF treatment at our neonatal
intensive care unit between January 2014 and December 2017 were included in this study. Their demographic and clinical data were
collected, and the efficacy and safety of CVVHDF was evaluated.
Results: A total of nine continuous RRT (CRRT) sessions as CVVHDF were performed in eight newborns with a diagnosis of urea cycle
defect (n = 5), maple syrup urine disease (n = 2), or methylmalonic acidemia (n = 1). The mean age at admission was 10 ± 8.6 days
(range: 3–28 days). The mean plasma levels of ammonium were 1120 ± 512.6 mg/dL and 227.5 ± 141.6 mg/dL before and at the end
of the treatment, respectively. Plasma levels of leucine were 2053.5 ± 1282 μmol/L and 473.5 ± 7.8 μmol/L before and at the end of the
treatment, respectively. The CVVHDF duration was 32.3 ± 11.1 h (median: 37 h; range: 16–44 h), and the mean length of hospitalization
was 14.6 ± 12.9 days. The mean duration of CVVHDF was 32.3 ± 11.1 h (range: 16–44 h). Circuit clotting was the most common
observed complication (37.5%) and the survival rate was 50%. Among surviving patients, two developed severe and two developed mild
mental and motor retardation.
Conclusion: CVVHDF is a CRRT modality that can be used to treat newborns with an inborn metabolic disease. Early diagnosis,
commencement of specific medical therapy, diet, and extracorporeal support, if needed, are likely to result in improved short and longterm
outcomes.
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Ekrem ÜNAL, Ebru YILMAZ, Alper ÖZCAN, Bilgen IŞIK, Musa KARAKÜKCÜ, Cüneyt TURAN, Hülya AKGÜN, Figen ÖZTÜRK, Abdulhakim COŞKUN, Mehmet Akif ÖZDEMİR, Türkan PATIROĞLU
Ekrem ÜNAL, Ebru YILMAZ, Alper ÖZCAN, Bilgen IŞIK, Musa KARAKÜKCÜ, Cüneyt TURAN,
... Devamını oku
Background/aim: Non-Wilms renal tumors (NWRTs) are rarely encountered in children. The aim of this study is to determine the
treatment strategies, prognosis, outcomes, and survival of children with NWRTs at Erciyes University in Kayseri, Turkey.
Materials and methods: Medical records of all patients (n = 20) treated for NWRTs over a 23-year period (1995–2018) were reviewed
retrospectively.
Results: There was male predominance (female/male: 7/13); the median age at diagnosis was 3.2 years old (0.1–13.5 years old). The
major histological groups included mesoblastic nephroma (MBN), (n: 5, 25%), malignant rhabdoid tumor (MRT), (n: 5, 25%), renal
cell carcinoma, (n: 3, 15%), inflammatory myofibroblastic tumor (n: 2, 10%), multilocular cystic renal tumors (n: 2, 10%), metanephric
adenoma (n: 1, 5%), renal neuroblastoma (n: 1, 5%), and bilateral renal Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET)
(n: 1, 5%). All of the patients with NWRTs had radical nephrectomy except the child with bilateral renal ES/PNET. Six children died
because of progressive disease; the mortality rate was 30% (n: 6).
Conclusion: We have made the first report of bilateral renal involvement of ES/PNET in the English medical literature. Physicians
dealing with pediatric renal masses should be alert to the high mortality rate in children with MRT, MBN, and ES/PNET and they
should design substantial management plans for NWRTs.
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Dan ZHAO, Jun LI, Rui YANG, Guang Hong XU
Dan ZHAO, Jun LI, Rui YANG, Guang Hong XU
Background/aim: Hypertension is an important risk factor for cognitive impairment. This study explored whether elderly patients with stage I hypertension (HPs) and normotensive patients (NPs) showed differences in the recovery of postoperative attention network
function according to the attentional network test (ANT) performance.
Materials and methods: Of 110 patients screened, 25 HPs and 25 NPs completed this study. The Mini-Mental State Examination
(MMSE) was applied to all participants before the operation and the ANT (on days 2 and 7) after the operation. All participants
completed 1 day preoperatively and the ANT on postoperative days (PODs) 2 and 7.
Results: Compared with NPs, HPs had significantly lower alerting network effect scores and more difficulty resolving conflict on POD
7. However, no significant difference was observed between the groups on POD 2. Orienting network performance was similar between
the groups at all time points. Significant differences in alerting and executive control network performances were observed between
PODs 2 and 7 in each group.
Conclusion: HPs showed selective cognitive impairment at different time points following elective hip or knee arthroplasty. Compared
with NPs, during the first postoperative week, HPs were more likely to experience delayed recovery of alerting and executive control
network function, but not orienting network function.
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