Talay, Mehmet Nur
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Dr. Öğr. Üyesi
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Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü
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Current Staff
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Scholarly Output
8
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7
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0
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Article Multisystem Inflammatory Syndrome in Children Treated With Intravenous Immunoglobulin Monotherapy: a Single-Center Retrospective Study(Springer, 2024) Talay, Mehmet Nur; Akar, Asuman; Talay, Mehmet Nur; Gul, Ozlem; Tas, Muhammed; Semdinoglu, Ayten; Yakut, NurhayatBackgroundMultisystem inflammatory syndrome in children (MIS-C) is one of the complications of SARS-CoV-2 infection. This study aims to evaluate the clinical and laboratory characteristics, as well as treatment results, of MIS-C patients who received intravenous immunoglobulin (IVIG) monotherapy.MethodsThis retrospective study included patients diagnosed with MIS-C. Demographic data, organ involvements at the admission, laboratory evaluations for diagnosis, treatment, and follow-up were recorded. We evaluated outcomes by the length of the intensive care unit stay, the total hospitalization period, complications, and mortality.ResultsA total of 95 patients diagnosed with MIS-C were evaluated. The mean age was 118.8 (+/- 52.5) months. 76.8% of the patients had four or more organ systems involved. Seventy-nine patients (83%) were hospitalized in the pediatric intensive care unit (PICU) for a mean of 4.59 days. Seventy-seven (81%) patients received IVIG. A second dose of IVIG was administered to 66.3% of patients. All patients received vitamin D and C supplementation. Six patients who had cardiac involvement or cerebral infarction were treated with plasmapheresis. No patients received steroids. There was no mortality at the end of the follow-up.ConclusionsFavorable outcomes may be obtained with IVIG monotherapy in MIS-C patients. More clinical trials are needed to establish the role of supportive treatments like vitamin D and C in MIS-C management.Article Retrospective Investigation of Children Presented With Febrile Convulsion(2024) Talay, Mehmet Nur; Talay, Mehmet Nur; Solmaz, MuratAim: In this study, we aimed to determine the characteristics of patients admitted with the diagnosis of febrile convulsion (FC) and to evaluate the most common diagnosis and the most frequent months of presentation. Materials and Methods: A total of 172 children who were admitted to the pediatric emergency unit in the last one year due to FC and were admitted for observation were included in the study. The age range of the children included in the study was 5 months - 6 years (72 months). Patients were analyzed in terms of age, gender, diagnosis at presentation, type of FC, month of presentation, whether brain tomography was performed, sodium level, CRP level, white blood cell (WBC) count, and glucose level. SPSS (Statistical Package for Social Sciences) for Windows 22.0 program was used for statistical analysis. Results: The median age of the patients was 20 (11-34) months and 58.7% were male. Upper respiratory tract infections were the most common cause of convulsions with 72.7%. Acute gastroenteritis followed with 20.9%. Simple febrile convulsion was present in 89.5% of cases. Brain tomography was required in 33.1% of the patients admitted due to FC. The most common month of presentation was November with 16.3%. Mean WBC level was 13.4±6.0 (x103 /µL), mean CRP level was 24.2±35.3 (mg/L), mean Glucose level was 117±29.8 (mg/dL), mean Sodium level was 137±13.9 (mmol/L). Conclusion: In the management of this condition, which is uncomplicated and has no long-term effects in most patients, it is important to avoid unnecessary examinations and to provide accurate information to families.Article Evaluation of the Results of the Patients Who Underwent Plasmapheresis in the Pediatric Intensive Care Unit(Tubitak Scientific & Technological Research Council Turkey, 2024) Talay, Mehmet Nur; Orhan, Ozhan; Kangin, Murat; Turanli, Ese Eda; Ozbek, Mehmet NuriBackground/aim: Therapeutic plasma exchange (TPE) is an extracorporeal treatment method that removes large molecular weight substances from plasma. In our study, we aimed to retrospectively examine the indications and procedural methods of the patients who had undergone TPE, and the complications that occurred during the procedure. Materials and methods: Forty-one patients who were monitored in thePICU of Gazi Ya & scedil;argil Training and Research Hospital and had indications for TPE between 2017 and 2021 were included in the study. Laboratory parameters were checked before and after the TPE procedure. In addition to these, patients' diagnosis, weight, type of procedure and type of device, where the procedure was performed, duration of the procedure, amount of blood and plasma processed, complications, number of procedures, and death during the procedure or independent of the procedure were evaluated. Results: The median age was 93.0 (14.0-167.0) months. Hemolytic uremic syndrome (HUS) was the most common TPE indication with nine patients. The most common complication related to TPE was fever (11 patients), while no complication was observed in 18 patients. When laboratory results were evaluated according to American Society for Apheresis (ASFA) categories, a significant improvement was observed in the values of platelet, AST, ALT, LDH, urea, and creatinine in ASFA1 after TPE. No significant improvement was observed in ASFA2 (p > 0.05). In ASFA3, a significant improvement was observed in INR, AST, ALT, LDH, total bilirubin, creatinine, pH, and lactate values after TPE (p < 0.05). Five patients died from ASFA1, one from ASFA2, and three patients from ASFA3. Conclusion: Since significant adjustments are observed in clinical and laboratory values in sepsis-MOF, which is in the ASFA3 category, we believe that it should be evaluated in the ASFA2 or ASFA1 category in the early treatment of these diseases. In addition, we think that MIS -C cases, which have not been in any category according to ASFA, should be included in the ASFA2 or ASFA3 category, considering our TPE results.Article Our Treatment Experience in Poisoning With Calcium Channel Blockers: a Series of Twelve Cases(Briefland, 2024) Talay, Mehmet Nur; Orhan, Ozhan; Ozbek, Mehmet Nuri; Kangin, Murat; Turanli, Ese EdaBackground: Intoxications with cardiovascular system drugs constitute a small percentage of all poisoning cases. Calcium Channel Blockers (CCBs) are the most common drug poisoning in this group. Objectives: We aimed to evaluate the effectiveness of treatments for CCB poisoning and add to the current body of literature by outlining the clinical treatments we employ for bradyarrhythmia, hypotension, and resistant vasodilation resulting from CCB poisoning, as well as sharing our clinical insights in this field. Methods: Twelve patients, ranging in age from 1 month to 18 years, were admitted to the Tertiary Paediatric Intensive Care Unit (PICU) for treatment of medication poisoning related to the CCB group. Patients who ingested several drugs that caused CCB were not allowed to participate in the trial. Results: Twelve patients were followed up in the PICU due to poisoning with CCB group drugs. Of the patients, 7 were male and 5 were female. Five of the patients had taken CCB medication with the purpose of committing suicide, and 7 of them accidentally. All of the patients who received CCB to commit suicide had taken verapamil. Five patients whose hypotension and bradycardia continued were administered inotropes. In addition to PI, calcium gluconate, intravenous lipid, glucagon, insulin, bicarbonate, and methylene blue were given as therapy to our symptomatic patients. Plasmapheresis was applied to a patient who was hospitalized in the PICU due to a sudden loss of consciousness. Conclusions: In the management of patients with CCB poisoning, the use of hyperinsulinemia euglycemia, intravenous lipid emulsion treatment, glucagon treatments, and treatments including methylene blue and extracorporeal life support should be considered in cases of resistant hypotension, bradycardia, and coma in the early period.Article Methemoglobinemia and acute ıntravascular hemolysis after naphthalene poisoning in a pediatric patient(SciELO Argentina, 2023) Orhan, Özhan; Talay, Mehmet NurPoisoning by naphthalene is uncommon in children. It is a type of poisoning brought on by ingesting, inhaling, or coming into touch with naphthalene-containing substances on the skin. Patients typically present with an initial onset of dark brown urine, watery diarrhea, and bile vomit. The signs include fever, tachycardia, hypotension, and low pulse oximetry readings even with oxygen support. Hemolytic anemia, methemoglobinemia, renal failure, and hyperbilirubinemia are all detected in blood tests. Erythrocyte transfusion, ascorbic acid, methylene blue, and N-acetylcysteine (NAC) therapies are provided to inpatients in addition to symptomatic treatment. We present a 23-month-old male patient who developed methemoglobinemia and acute ıntravascular hemolysis, who was followed up in the intensive care unit for five days due to naphthalene intoxication. Although naphthalene poisoning is very rare, it should be known that it has fatal consequences, and more care should be taken in its use and sale
