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Öğe Clinical and Demographic Characteristics of Children with Urolithiasis: Single-Center Experience from Eastern Turkey(Karger, 2009) Tabel, Yilmaz; Akin, Ilke Mungan; Tekin, SerapObjective: To evaluate the clinical and demographic findings of children with urolithiasis in eastern Turkey. Methods: We retrospectively reviewed the medical records of 67 children with urolithiasis for clinical and laboratory data. Results: Mean age at the time of diagnosis was 39.1 +/- 41.2 months. Complaints at admission were: urinary tract infection (29.9%), macroscopic hematuria (26.9%), abdominal or flank pain (19.4%), spontaneous passing of the stone (8.9%), growth and developmental delay (7.5%), and non-specific findings (8.9%). A family history of urolithiasis was positive in 50.7% of patients. Metabolic screening could be performed in 47 (70.1%) of patients due to socioeconomic problems and revealed hypercalciuria in 59.6%, infectious stone in 17%, cystinuria in 6.4%, hyperuricosuria in 10.6%, hyperoxaluria 4.3%, and hypocitruria in 2.1%. Stone analysis of patients (26.9%) revealed calcium oxalate in 38.9%, calcium phosphate in 22.2%, uric acid in 16.7%, cystine in 11.2%, struvite in 5.6% and mixed content in 5.6%. Conclusion: We believe early diagnosis with detailed metabolic screening and appropriate treatment and follow-up procedures and the contribution of urolithiasis to end-stage renal disease can be avoided. Copyright (C) 2009 S. Karger AG, BaselÖğe Effects of total parenteral nutrition on renal function in preterm neonate(Turkish Pediatrics Assoc, 2012) Tabel, Yilmaz; Oncul, Mehmet; Akin, Ilke Mungan; Karabulut, Aysun Bay; Elmas, Ahmet TanerAim: The aim of this study was to establish serum sistatine C, urine beta(2) microglobulin, gluthatione-S -transferase pi and N-acetyle beta-D glucosaminidase levels in order to evaluate the effect of total parenteral nutrition on renal function in premature infants. In addition, we aimed to compare the renal functions between premature infants receiving total parenteral nutrition and control groups receiving enteral feeding. Material and Method: A hundred four premature infants with a gestational age between 28 and 34 weeks were included in the study. The parenteral nutrition group consisted of 50 infants (male/female; 23/27 and mean weight 1258 +/- 212.3 g) and the enteral nutrition group consisted of 54 infants (male/female; 20/34 and mean weight 1608 +/- 206.1 g). In the parenteral nutrition group; total parenteral group nutrition was initiated on the 3rd day in the enteral nutrition group, minimal enteral nutrition was started on a mean of 6.3 +/- 2.4 days and total enteral nutrition was started on a mean of 24.5 +/- 6.3 days. Breastmilk was given orally or by orogastric/nasogastric tube at first day of life in the enteral group. On the 3rd and 30th day Of life, blood samples of all patients were obtained for evaluating biochemical parameters and cystatin C and urine samples were obtained for evaluation of N-acetyl beta-D glucosaminidase, gluthatione-S-transferase pi, beta(2) microglobulin, sodium, creatinin levels, density and pH of the urine. The study was approved by the ethics commite (2008/16). Results: When we compared the patients who received total parenteral nutrition and enteral nutrition on the 3rd and 30th days, serum cystatin C, urinary beta(2) microglobulin, gluthatione-S-transferase pi and N-acetyl- beta-D glucosaminidase excretions were similar on the 3rd day however were significantly higher on the 30th day in samples of the patients receiving total parenteral nutrition (p<0.05 for each parameter on each day). Conclusions: This study shows that total parenteral nutrition in premature infants can have adverse effects on glomerular and tubular functions of the kidney which can be manifested at an early time with cystatin C, beta(2) microglobulin, gluthatione-S-transferase pi and N-acetyl beta-D glucosaminidase. (Turk Arch Ped 2012; 47: 247-52)Öğe Epidemiologic and clinical characteristics of neonates with late-onset COVID-19: 1-year data of Turkish Neonatal Society(Springer, 2022) Akin, Ilke Mungan; Kanburoglu, Mehmet Kenan; Tayman, Cuneyt; Oncel, Mehmet Yekta; Imdadoglu, Timucin; Dilek, Mustafa; Yaman, AkanThe literature on neonates with SARS-CoV-2 is mainly concerned with perinatal cases, and scanty data are available about environmentally infected neonates. To fill knowledge gaps on the course and prognosis of neonatal cases, we analyzed 1-year data from the Turkish Neonatal Society in this prospective cohort study of neonates with postnatal transmission. Data from 44 neonatal intensive care units (NICUs), of neonates with positive RT-PCR results at days 5-28 of life, were extracted from the online registry system and analyzed. Of 176 cases, most were term infants with normal birth weight. Fever was the most common symptom (64.2%), followed by feeding intolerance (25.6%), and cough (21.6%). The median length of hospitalization was 9 days, with approximately one quarter of infants receiving some type of ventilatory support. Myocarditis (5.7%) was the most common complication during follow-up. Among the clinical findings, cough (odds ratio [OR]: 9.52, 95% confidence interval [CI]: 4.17-21.71), tachypnea (OR: 26.5, 95% CI: 9.59-73.19), and chest retractions (OR: 27.5, 95% CI: 5.96-126.96) were associated with more severe clinical disease. Also, there were significant differences in the C-reactive protein level, prothrombin time (PT), partial thromboplastin time, international normalized ratio, and days in the NICU (p = 0.002, p = 0.012, p = 0.034, p = 0.008, and p < 0.001, respectively) between patients with mild-moderate and severe-critical presentations. A PT above 14 s was a significant predictor of severe/critical cases, with a sensitivity of 64% and specificity of 73%. Conclusions: Our data showed that late-onset COVID-19 infection in neonates who need hospitalization can be severe, showing associations with high rates of ventilatory support and myocarditis. Cough, tachypnea, and retractions on admission suggest a severe disease course.Öğe A Multicentered Study on Epidemiologic and Clinical Characteristics of 37 Neonates With Community-acquired COVID-19(Lippincott Williams & Wilkins, 2020) Kanburoglu, Mehmet Kenan; Tayman, Cuneyt; Oncel, Mehmet Yekta; Akin, Ilke Mungan; Can, Emrah; Demir, Nihat; Arayici, SemaBackground: Coronavirus disease 2019 (COVID-19) primarily affects adults and spares children, whereas very little is known about neonates. We tried to define the clinical characteristics, risk factors, laboratory, and imagining results of neonates with community-acquired COVID-19. Methods: This prospective multicentered cohort study included 24 neonatal intensive care units around Turkey, wherein outpatient neonates with COVID-19 were registered in an online national database. Full-term and premature neonates diagnosed with COVID-19 were included in the study, whether hospitalized or followed up as ambulatory patients. Neonates without severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) via reverse transcriptase-polymerase chain reaction testing or whose mothers had been diagnosed with COVID-19 during pregnancy were excluded. Results: Thirty-seven symptomatic neonates were included. The most frequent findings were fever, hypoxemia, and cough (49%, 41%, 27%, respectively). Oxygen administration (41%) and noninvasive ventilation (16%) were frequently required; however, mechanical ventilation (3%) was rarely needed. Median hospitalization was 11 days (1-35 days). One patient with Down syndrome and congenital cardiovascular disorders died in the study period. C-reactive protein (CRP) and prothrombin time (PT) levels were found to be higher in patients who needed supplemental oxygen (0.9 [0.1-8.6] vs. 5.8 [0.3-69.2]p= 0.002, 11.9 [10.1-17.2] vs. 15.2 [11.7-18.0]p= 0.01, respectively) or who were severe/critical (1.0 [0.01-8.6] vs. 4.5 [0.1-69.2]p= 0.01, 11.7 [10.1-13.9] vs. 15.0 [11.7-18.0]p= 0.001, respectively). Conclusions: Symptomatic neonates with COVID-19 had high rates of respiratory support requirements. High CRP levels or a greater PT should alert the physician to more severe disease.Öğe REVERSIBLE POSTERIOR LEUCOENCEPHALOPATHY IN AN 11 YEAR-OLD MALE CHILD WITH LUPUS NEPHRITIS(Marmara Univ, Fac Medicine, 2010) Tabel, Yilmaz; Akin, Ilke Mungan; Gungor, Serdal; Karakurt, Cemsit; Ozgen, UnsalSystemic lupus erythematosus is a chronic inflammatory disease characterized by highly diverse clinical manifestations. The major organ system involvements in childhood systemic lupus erythematosus are similar to those found in adults. Recognizing and reversing secondary causes of central nervous system abnormalities in patients with systemic lupus erythematosus are essential for preventing long-term neurologic disability or death. In this manuscript, we present an 11 year-old male followed up in our clinic, who had the very rare involvement and complications of systemic lupus erythematosus in childhood. He developed a reversible posterior leucoencephalopathy after the first dose of cyclophosphamide, but cyclophosphamide therapy was not stopped as there was no clear evidence in the literature related to the role of this drug in reversible posterior leucoencephalopathy. The patient has now recovered.
