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Öğe Anaphylaxis in The Newborn with a Diagnosis of Cutaneous Mastocytosis: Case Report and Literature Review(Galenos Yayincilik, 2017) Tarakci, Nuriye; Konak, Murat; Daye, Munise; Altunhan, Huseyin; Ors, RahmiMastocytosis is carachterized by excessive mast cell accumulation in the skin and/or internal organs. Mastocytosis is divided into two groups; systemic and cutaneous. Symptoms depend on excessive cytokine release and their local and systemic affects. Symptoms may be mild or cause life-threatening anaphylactic reactions. In the literature anaphylactic reactions reported in systemic disease of adult and childhood mastocytosis. We here present an anaphylaxis in the newborn with a diagnosis of cutaneous mastocytosis.Öğe Association Between Cardiothoracic Ratio and Mortality in Neonates with Pneumothorax(Galenos Yayincilik, 2019) Yilmaz, Fatma Hilal; Tarakci, Nuriye Emiroglu; Gultekin, Nazli Dilay; Gultekin, Umit; Altunhan, HuseyinAim: The aim of this study was to determine the effect of a reduction in the cardiothoracic ratio (CTR) on mortality in newborns with pneumothorax. Methods: Newborns with pneumothorax, who were admitted to our neonatal intensive care unit, were included in the study. The cardiothoracic ratio was calculated by dividing the transverse cardiac diameter by maximum internal thoracic diameter. Results: Of 7909 infants admitted to our neonatal intensive care unit from September 2006 to September 2017, a total of 82 (1.03%) newborns had pneumothorax. Patients who died had a lower CTR than surviving patients (0.39 +/- 0.056 and 0.44 +/- 0.048, respectively; p<0.001). It was found that the cut-off value was 0.4, area under the curve (AUC) value was 0.79, sensitivity was 68%, specificity was 87.7%, positive predictive value was 70.8%, and negative predictive value was 86.2%. Low birth weight, preterm birth, low maternal age, presence of respiratory distress syndrome, need for resuscitation at birth, and invasive mechanical ventilation were found to be significantly associated with mortality. However, among overall significant parameters, CTR and implementation of resuscitation at birth were the independent prognostic factors determined by regression analysis (p=0.001 and p=0.036, respectively). Conclusion: A CTR below 0.4% can be considered an important parameter indicating an increased risk of mortality in newborns with pneumothorax.Öğe Can altered colostrum miRNA expression profile after cesarean delivery be a risk factor for autoimmune diseases?(Wiley, 2021) Yerlikaya, Fatma Humeyra; Onmaz, Duygu Eryavuz; Altunhan, Huseyin; Ilhan, MerveProblem The cesarean section (CS) rate has increased significantly in North America, Western Europe, and Latin America. However, it has been reported that the incidence of inflammatory and autoimmune diseases such as asthma and type 1 diabetes increased in parallel with CS in these countries. Our aim was to investigate the expression level of miRNAs associated with inflammatory response and autoimmune diseases in colostrum samples and contribute to elucidating the role of CS in the pathogenesis of immune system-related diseases. Method of study Colostrum samples were taken from voluntary mothers who had 40 normal and 50 cesarean births. miRNAs were extracted from colostrums and detected to miRNA expression profiling (eighty-four miRNAs) by quantitative real-time PCR with the Fluidigm integrated microfluidic circuit technology. Results There was a statistically significant change in the expression levels of 17 miRNAs in the colostrums of mothers who had normal and cesarean delivery (p < .05), and all of miRNAs were upregulated in the colostrums of mothers who have had cesarean delivery. Conclusion Our best knowledge is that the study we conducted was the first to investigate the effect of delivery method (CS or normal) on the miRNA profile of colostrum. Cesarean delivery is a potential risk factor for inflammatory and immune system-related diseases in children due to dysregulation in miRNA expression.Öğe Clinical characteristics and neonatal outcomes of liveborn newborns with hydrops fetalis treated in a tertiary level neonatal intensive care unit(Wiley, 2020) Emiroglu, Nuriye; Yilmaz, Fatma Hilal; Kececi, Ramazan; Yucel, Mehmet; Gultekin, Nazli Dilay; Altunhan, HuseyinBackground This study was performed for examining the neonatal results and aetiological factors of neonates with hydrops fetalis (HF) and determining the factors affecting mortality. Methods The medical records of liveborn neonates with HF who were admitted to a tertiary Neonatal Intensive Care Unit (NICU) in Konya, Turkey, between 2013 and 2019 were reviewed retrospectively. The demographic data, prenatal intervention, clinical findings, and results of the patients were recorded. Results A total of 32.6% of the 46 liveborn HF infants had immune HF (IHF), while 67.4% had nonimmune HF (NIHF); there was prenatal diagnoses in 39 (84.7%) cases. Cordocentesis and blood transfusion (n = 14; 30.4%) were the prenatal diagnosis and treatment interventions with the highest rate. A total of 16 patients (34.7%) received in utero interventional treatment. It was determined that the mean gestational age was not associated with mortality; moreover, birthweight (BW), Apgar score and the need for mechanical ventilation affected mortality. Conclusion The prognosis changes according to different etiologies of HF. However, despite the developments in neonatal care, mortality is still high in HF infants.Öğe Comparison of the Efficacy of Three Natural Surfactants in Preterm Turkish Newborns with Respiratory Distress Syndrome(Galenos Yayincilik, 2021) Yilmaz, Fatma Hilal; Tarakci, Nuriye; Gultekin, Nazli Dilay; Yucel, Mehmet; Kececi, Ramazan; Ozturk, Elif Nur Yildirim; Altunhan, HuseyinAim: To determine the efficacy of three natural surfactant preparations in our community and the short- and long-term results of these on preterm infants. Materials and Methods: This was a retrospective research on 193 premature babies with respiratory distress syndrome (RDS). The patients were divided into three groups, each of which received one of three surfactants: Group 1; beractant (100 mg/kg); group 2; poractant alfa (first dose of 200 mg/kg, recurrent doses of 100 mg/kg); group 3; calfactant (100 mg/kg). The groups were compared according to demographic characteristics, 1- and 5-minute Apgar scores, weight percentiles by gestational week, presence of pulmonary hemorrhage, surfactant dose repetition, air leak, bronchopulmonary dysplasia (BPD), stage of intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), hemodynamically significantpatent ductus arteriosus (hs-PDA) and its medical or surgical treatment, retinopathy of premature (ROP) and its treatment, sepsis, ventilation time (both non-invasive and invasive), free oxygen need time, time to start full enteral feeding, discharge time, and mortality. Results: A total of 193 preterm infants with a mean gestational age of 28.9 +/- 3.1 weeks and mean birth weight of 1,190.4 +/- 504.3 grams were included in this study. The neonates were allocated into three different groups randomly, namely group-1 (n=77), group-2 (n=59), and group-3 (n=57). There were no differences in the clinical and demographic features of the groups. The incidence of pulmonary hemorrhage, surfactant dose repetition, air leak, ventilation time for both non-invasive and invasive, free oxygen need time, hs-PDA and surgical treatment of PDA, BPD, NEC (>= stage II), IVH (>stage III), ROP, time to start full enteral feeding, and discharge time were similar between the study groups. The sepsis and mortality rates were lower in group 3 compared to groups 1 and 2 (p=0.015, p=0.001). Conclusion: In this study, beractant, proctant alfa and calfactant had clinically similar efficacy in patients with RDS.Öğe Comparison of urinary neutrophil gelatinase-associated lipocalin, C-reactive protein and procalcitonin in the diagnosis of late onset sepsis in preterm newborns(Taylor & Francis Ltd, 2013) Ertugrul, Sabahattin; Annagur, Ali; Kurban, Sevil; Altunhan, Huseyin; Ors, Rahmi[Abstract Not Availabe]Öğe A congenital cranial dysinnervation disorder: Mobius' syndrome(Aves, 2017) Albayrak, Hatice Mutlu; Tarakci, Nuriye; Altunhan, Huseyin; Ors, Rahmi; Caksen, HuseyinMbius' syndrome, also known as Mbius' sequence, is a nonprogressive cranial dysinnervation disorder characterized by congenital facial and abducens nerve paralysis. Here, we report a 5-day-old girl who was conceived after in vitro fertilization with poor suck and facial paralysis. She had bilaterally ptosis and lateral gaze limitation, left-sided deviation of the tongue, dysmorphic face, hypoplastic fingers and finger nails on the left hand, and was diagnosed as having Mbius' syndrome. Involvement of other cranial nerves such as three, four, five, nine, 9 and 12, and limb malformations may accompany this syndrome. However, several factors have been proposed for the etiology, some rare cases have also been reported with artificial reproductive technologies. Feeding difficulties and aspiration are the main problems encountered in infancy. The other cranial nerves should be examined further in newborns who present with congenital facial palsy, and other cranial dysinnervation disorders should be considered in the differential diagnosis.Öğe Congenital hydrocephalus as a rare cause of severe type 1 plasminogene deficiency(Aves, 2013) Annagur, Ali; Altunhan, Huseyin; Ozbek, Orhan; Ozturk, Banu Turgut; Ors, RahmiSevere type I plasminogen deficiency is a rarely seen autosomal recessive disease that causes chronic inflammation in mucous membranes, primarily eye membranes. The most commonly encountered clinical manifestation is ligneous conjunctivitis. In these patients, congenital occlusive hydrocephaly may rarely be observed. In this report, we presented a newborn who had hydrocephaly in the prenatal period and presence of severe plasminogen deficiency was detected after birth. We found that the same disease was present in two children of the family and in the aunt of the newborn and discussed this situation. It should be kept in mind that plasminogen deficiency may also be present in cases with occlusive hydrocephaly and especially in newborns with the diagnosis of ligneous conjunctivitis and with familial history of ligneous conjunctivitis.Öğe EFFECTS OF PHOTOTHERAPY ON SERUM PARAOXONASE ACTIVITY AND TOTAL ANTIOXIDANT CAPACITY IN NEWBORN JAUNDICE(Nobel Ilac, 2014) Kurban, Sevil; Annagur, Ali; Altunhan, Huseyin; Mehmetoglu, Idris; Ors, Rahmi; Erdem, Said Sami; Yerlikaya, Fatma HumeyraObjective: Phototherapy is an efficient and commonly used form of therapy for the treatment of neonatal hyperbilirubinemia. Paraoxonase 1 (PON1) is an anti oxidative enzyme, which eliminates lipid peroxides. The aim of our study was to investigate the effect of phototherapy on serum PON1 activity and total antioxidant capacity (TAC) in hyperbilirubinemic full-term newborns. Material and Method: The study was performed on 40 full-tenn newborns between 3 to 15 days of age exposed to phototherapy. SerumPON1 activity and TAC levels of the babies were determined before and after phototherapy by spectrophotometric assays. Results: We have found that PON1 activity was not significantly affected by phototherapy whereas TAC levels were decreased significantly after phototherapy (p<0.001). Conclusion: Our findings demonstrated that phototherapy has no direct effect on PON1 activity. Also, decreased TAC levels might have resulted from increased oxidative stress which may lead to consumption of antioxidant molecules.Öğe Evaluation of blood flow velocity to determine the effect of fortifiers on intestinal hemodynamics(Bayrakol Medical Publisher, 2020) Emiroglu, Nuriye; Altunhan, HuseyinAim: This study aimed to evaluate the effects of human milk fortifier (HMF) formulas on feeding intolerance and intestinal hemodynamics using superior mesenteric artery blood flow velocity (SMA-BFV). Material and Method: The study was conducted on 36 infants born at a gestational age ranging from 26 to 326 weeks. Doppler-ultrasound (USG) was used to measure SMA-BFV. Demographic characteristics, the amount of gastric residue, and the number of stool passages were recorded for each of the patients in this study. Results: The superior mesenteric artery peak systolic velocity (SMA-PSV) increment after HMF was statistically significant (P=0.0011). A statistically significant increase was found in the amount of gastric residue and a significant decrease was found in the number of stool passages after the addition of HMF (p=0.0001 and p=0.034, respectively). Discussion: The use of HMF to achieve appropriate feeding and growth in preterm infants leads to an increase in SMA-BFV, a reduction in the number of stool passages, and an increase in the amount of gastric residue. It does not adversely affect intestinal hemodynamics.Öğe Evaluation of Oral Prostaglandin E1 in Management of Ductus Dependent Congenital Heart Disease(Cukurova Univ, Fac Medicine, 2012) Altunhan, Huseyin; Annagur, Ali; Ertugrul, Sabahattin; Konak, Murat; Sap, Fatih; Karaaslan, Sevim; Ors, RahmiPurpose: Intravenous prostaglandin E1 (PGE1) infusion is a treatment which has been proven to be effective in ductus dependent congenital heart disease. However, PGE1 is very expensive, needed continuous infusion and its supply is difficult by every center. When its long term use is necessary, these problems become more important. The aim of this study was to show whether oral PGE1could keep the ductus open or not till the supply of intravenous PGE1. Method: Ten patients, who were admitted to newborn intensive care unit with the diagnosis of ductus dependent congenital heart disease and received oral PGE1 till the supply of intravenous PGE1, were evaluated. The PO2 with the arterial blood gas analysis and SO2 levels with pulse oxymeter at skin were recorded before and after the administration of oral and intravenous PGE1. Results: The mean oral PGE1 initiation age was 5.5 hours (0.5-25), and mean administration period was 28 hours (18-46). It was observed that the PO2 and SO2 levels of patients measured 2 hours after the initiation of oral PGE1 were significantly increased compared to the levels before initiation of PGE1. The improvement in PO2 and SO2 levels continued till the initiation of intravenous PGE1. It was also observed that the PO2 and SO2 levels of patients measured 2 hours after the initiation of intravenous PGE1 were slightly increased compared to levels before initiation of intravenous PGE1. Conclusion: Although intravenous PGE1 is more effective than oral PGE1 in short term usage, oral PGE1 is also sufficiently effective in keeping the dustus open. For this reason until the intravenous PGE1 is supplied oral PGE1 may be used as an alternative treatment choice. We think that in long term use oral PGE1, which is cheaper and easy to use, could be used instead of intravenous PGE1 without need of admission to hospital and opening intravenous line. However for this further studies are needed to confirm this assumption.Öğe From the Symptoms of an Undiagnosed Mother to the Infant with Congenital Myotonic Dystrophy(Derman Medical Publ, 2017) Gultekin, Nazli Dilay; Yilmaz, Fatma Hilal; Altunhan, Huseyin; Ors, RahmiCongenital myotonic dystrophia (CMD) is a disorder with a wide clinical spectrum, characterized by hypotonia, respiratory failure, and nutritional challenges in the neonatal period. Although familial history is important in the diagnostic process, diagnosing the infant in the neonatal period may, conversely, lead the mother, or rarely the father, to be diagnosed. Here, a male infant presenting with hypotonicity and respiratory failure in the neonatal period was diagnosed with CMD through genetic testing by looking at the complaints of fatigue, muscle pain, and hypersomnia in the mother. As in our case, it should be kept in mind that CMD can be diagnosed at an early stage only by focusing on the familial history in hypotonic infants.Öğe Giant maxillofacial teratoma in a newborn(Bayrakol Medical Publisher, 2019) Yilmaz, Fatma Hilal; Gultekin, Nazli Dilay; Emiroglu, Nuriye Tarakci; Altunhan, Huseyin[Abstract Not Availabe]Öğe Hyperpyrexia Associated with Congenital Long QT Syndrome(Cukurova Univ, Fac Medicine, 2014) Tarakci, Nuriye; Konak, Murat; Altunhan, Huseyin; Alp, Hayrullah; Ors, RahmiCongenital long QT syndrome (CLQTS) is a genetic disorder presented with prolonged QT interval. In these patients, risk of sudden cardiac death due to ventricular tachyarrhythmias is high. Bradycardia may exhibit as a result of intrauterine fetal atrioventricular block, sinus bradycardia, tachycardia in these patient. Prolonged QT interval and multisystem involvement such as sensorineural hearing loss, muscle paralysis, immune deficiency, syndactyly have been reported in these patient. We have detected hyperpyrexia without clinical immunodeficiency and infection in our patient. To our knowledge, our patient is the first case in the literatureÖğe Intrauterine volvulus that had been misunderstood as an antenatal mesenteric cyst(Elsevier Taiwan, 2019) Gultekin, Nazli Dilay; Salihoglu, Ozgul; Alptekin, Ahmet; Yilmaz, Fatma Hilal; Altunhan, Huseyin[Abstract Not Availabe]Öğe Is perinatal arterial ischemic stroke common?(Springer, 2020) Caksen, Huseyin; Koseoglu, Fatma Tuba; Guven, Ahmet Sami; Altunhan, Huseyin; Acikgozoglu, Saim[Abstract Not Availabe]Öğe Is there a relationship between causative microorganisms and hearing loss in neonatal sepsis?(Wiley, 2021) Yilmaz, Fatma Hilal; Emiroglu, Nuriye; Oflaz, Mehmet Burhan; Yucel, Mehmet; Kececi, Ramazan; Arbag, Hamdi; Altunhan, HuseyinBackground The aim of the present study was to determine the possible relationship between cultured microorganisms and hearing loss in infants admitted to the neonatal intensive care unit (NICU) who could not pass a standard hearing test. Method The medical records of infants treated at the NICU were retrospectively evaluated. The patients were first divided into two groups, and group 1 was divided into two subgroups: Group 1 included patients with hearing loss accompanied by proven sepsis caused by either gram-negative (group 1A) or gram-positive (group 1B) bacteria, and group 2 included patients with clinical sepsis. The groups were compared with potential risk factors related to hearing loss. Results Between January 2014 and January 2019, the cases of 3,800 infants admitted to the NICU were reviewed. Of 3,548 living babies, the Auditory Brainstem Response (ABR) test showed that 35 infants (0.98%) were diagnosed with hearing loss. In 12 infants with hearing loss, microbial growth in the blood cultures was detected, whereas in the remaining 23, the blood cultures were negative. Of the cases with microbial growth, five were gram negative and seven were gram positive. In the comparison of groups 1A, 1B, and 2, there were statistically significant differences in terms of risk factors such as low birth weight (p = .048), neonatal hospitalization time (p = .001), free oxygen support (p = .001), intraventricular bleeding (p = .001), loop diuretic use (p = .001), and blood transfusion (p = .048). Conclusion The relationship between hearing loss and microorganisms causing sepsis could not be determined in this research.Öğe Lneonatal meningitis due to streptoccocus dysgalactiae subspecies equisimilis: a case report and literature review(Derman Medical Publ, 2018) Tarakci, Nuriye; Yilmaz, Fatma Hilal; Gultekin, Nazli Dilay; Altunhan, Huseyin; Ors, RahmiStreptococcus dysgalactiae subsp. equisimilis (SDSE) was firstly reported as a toxon among human streptococcal pathogens in the year 1996. Diseases caused by SDSE may vary from milder skin involvements including wound infection, erysipelas, and cellulitis to life-threatening clinical pictures as streptococcal toxic shock syndrome and necrotizing fasciitis. We describe a case of SDSE sepsis and meningitis in a 2-day-old newborn. He was referred to our intensive care unit (ICU) with fever, respiratory distress, seizures, peripheral cyanosis, and somnolence. SDSE grew out of the CSF and blood cultures obtained on admission to the ICU. SDSE cases reported in the literature are frequently older patients with an underlying disease. Also, SDSE may cause serious neonatal infections.Öğe Management of Patent Ductus Arteriosus in Preterm Patients Who Were Given Surfactant(Bayrakol Medical Publisher, 2020) Yilmaz, Fatma Hilal; Emiroglu, Nuriye; Oflaz, Mehmet Burhan; Gultekin, Nazli Dilay; Yucel, Mehmet; Kececi, Ramazan; Altunhan, HuseyinAim: Respiratory distress syndrome (RDS) and perinatal asphyxia are known to be risk factors in hemodynamically significant Patent Ductus Arteriosus (hsPDA). In this study, we aimed to reveal scientific data in respiratory distressed preterm infants in the light of the current literature and to discuss the management of PDA in babies born at 33d weeks of gestation and up to 33d weeks which we have treated and followed in our unit. Materials and Methods: The medical records of premature infants treated at Necmettin Erbakan University Neonatal Intensive Care Unit (NICU) between January 2016 and January 2019 were retrospectively evaluated. Results: Between January 2016 and January 2019, 476 patients born prior to 33d gestational weeks were admitted to our unit.. PDA was detected in 149 of these patients because of RDS due to the surfactants. In 112 (75.1%) of these patients, the PDA closed spontaneously within the first week of life. Thirty-seven (24.8%) patients developed hs-PDA. The incidence of premature retinopathy (ROP), bronchopulmonary dysplasia (BPD), and late neonatal sepsis morbidity was significantly elevated during the hospitalization (p=0.05, p=0.01, p=0.06). Invasive mechanical ventilation, non-invasive mechanical ventilation, and free oxygen requirement times were found to be longer (p= 0.0001, p= 0.004, p= 0.014). Complete enteral nutrition and discharge times were longer in the treated group (p= 0.03, p= 0.002). We identified the presence of Small for Gestational Age (SGA) (r = 0.30 p = 0.04) and low birth weight (r = 0.99 p = 0.02) in logistic regression analysis of the factors affecting the PDA as meaningful results. Discussion: The presence of hs-PDA in infants with RDS is directly proportional to the birth week and weight, the presence of SGA reduces the frequency of hs-PDAs, the presence of hs-PDA is associated with ROP, BPD, and late sepsis. The presence of hs-PDA has been found to be correlated with prolonged respiratory support and delayed discharge.Öğe Mosaic trisomy 14 and aorta-pulmonary window association: A case report(Turkish Soc Cardiology, 2019) Yilmaz, Fatma Hilal; Oflaz, Mehmet Burhan; Tarakci, Nuriye; Baysal, Tamer; Altunhan, HuseyinTrisomy 14 mosaicism is a rare chromosomal abnormality with distinct and recognizable clinical features. Congenital heart anomalies can accompany in this syndrome. To the best of our knowledge, this is the first case of mosaic trisomy 14 with an aortopulmonary window to be described in the literature.
