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Öğe Analysis of urine biomarkers for early determination of acute kidney injury in non septic and non asphyxiated critically ill preterm neonates(The Journal of Maternal-Fetal & Neonatal Medicine, 2016) Karadağ, Ahmet; Elmas, Taner; Tabel, Yılmaz; Özdemir, Ramazan; Otlu, Hüsniye GülObjective: We designed the present study to test the hypothesis that urinary biomarkers might predict acute kidney injury (AKI) development in non-septic and non-asphyxiated critically ill preterm infants. We evaluated urine (u) sistatin–C (uCys-C), kidney injury molecule–1 (uKIM–1) and neutrophil gelatinase associate lipocaline (uNGAL) as markers of AKI. Methods: Sixty-four preterm infants with gestational age between 28 and 32 weeks were included in this study. Biomarkers were measured on day of life (DOL) 1, 3, and 7. Results: uNGAL levels in the AKI group were significantly higher than in no-AKI group on DOL 1, 3 and 7 (p ¼ 0.016, p ¼ 0.007 and p ¼ 0.0014, respectively). Conclusions: uNGAL is sensitive, early, and noninvasive AKI biomarkers, increasing significantly in non-septic and non-asphyxiated critically ill preterm neonates.Öğe Blood pressure is normal, but is the heart?(Sprınger, 233 sprıng st, new york, ny 10013 usa, 2018) Celik, Serkan Fazli; Karakurt, Cemsit; Tabel, Yilmaz; Elmas, Taner; Yologlu, SaimThere is no detailed strain analysis of cardiac functions in treated hypertensive pediatric patients. The aim of this study was to evaluate the cardio-protective effects of different drug classes in treated pediatric hypertensive patients. Sixty non-obese-treated hypertensive patients with preserved left ventricular (LV) systolic function and 45 age-, sex-, and body mass index-matched healthy subjects underwent clinical evaluation, including 24-h ambulatory blood pressure monitoring, standard echocardiographic examination, tissue Doppler imaging, and two-dimensional Speckle Tracking Echocardiography. The patients were divided into two subgroups based on the effects of the drugs on the Renin Angiotensin Aldosterone System. The subgroup hypertension (HT) 1 received angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and HT 2 subgroup received calcium channel blocker, beta-blocker, or diuretics. There was no difference between the two groups and subgroups with respect to clinical, demographic, ABPM, ventricular volumes, ejection fraction, and tissue Doppler imaging (TDI) parameters. For patients and controls, respectively, global longitudinal strain was - 18.70 +/- 3.41 versus - 21.01 +/- 3.82 (P < 0.001), and global radial strain was 40.6 +/- 9.8 versus 54.8 +/- 12.8 (P = 0.004). Peak LV twist and peak LV torsion were not significantly different. The patient subgroup analyses with each other revealed no difference in systolic and diastolic myocardial deformation properties. Strain parameters were reduced in all treated hypertensive children compared to normotensive children, and the various cardiac mechanic parameters were similarly abnormal no matter what type of antihypertensive agent was used.Öğe Blood pressure is normal, but is the heart?(Springer, 2018) Celik, Serkan Fazli; Karakurt, Cemsit; Tabel, Yilmaz; Elmas, Taner; Yologlu, SaimThere is no detailed strain analysis of cardiac functions in treated hypertensive pediatric patients. The aim of this study was to evaluate the cardio-protective effects of different drug classes in treated pediatric hypertensive patients. Sixty non-obese-treated hypertensive patients with preserved left ventricular (LV) systolic function and 45 age-, sex-, and body mass index-matched healthy subjects underwent clinical evaluation, including 24-h ambulatory blood pressure monitoring, standard echocardiographic examination, tissue Doppler imaging, and two-dimensional Speckle Tracking Echocardiography. The patients were divided into two subgroups based on the effects of the drugs on the Renin Angiotensin Aldosterone System. The subgroup hypertension (HT) 1 received angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and HT 2 subgroup received calcium channel blocker, beta-blocker, or diuretics. There was no difference between the two groups and subgroups with respect to clinical, demographic, ABPM, ventricular volumes, ejection fraction, and tissue Doppler imaging (TDI) parameters. For patients and controls, respectively, global longitudinal strain was - 18.70 +/- 3.41 versus - 21.01 +/- 3.82 (P < 0.001), and global radial strain was 40.6 +/- 9.8 versus 54.8 +/- 12.8 (P = 0.004). Peak LV twist and peak LV torsion were not significantly different. The patient subgroup analyses with each other revealed no difference in systolic and diastolic myocardial deformation properties. Strain parameters were reduced in all treated hypertensive children compared to normotensive children, and the various cardiac mechanic parameters were similarly abnormal no matter what type of antihypertensive agent was used.