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Öğe Aplazia Kutis Konjenita Tip VI (Bart Sendromu) Olgusu(2019) Gökçe, İsmail Kürşad; Guliyeva, Lale; Turgut, Hatice; Kaya, Hüseyin; Yılmaz, Ercan; Özdemir, RamazanBart sendromu (aplazia kutis konjenita tip VI olarak ta adlandırılır) aplazia kutis konjenita, epidermolizis bülloza ve distrofik tırnaklarla karakterize genetik bir hastalıktır. Lokalize cilt defektlerine intrauterin dönemde oluşabilen büllöz lezyonların neden olduğu düşünülmektedir. Biz doğumdan hemen sonra her iki ayak bileği ve ayak sırtında cilt defektleri saptanan bir olgu sunduk. Hastamızda postnatal üçüncü günde basıya maruz kalan bölgelerde büllöz lezyonlar gelişti. Aile öyküsü ve tırnaklardaki distrofik değişikliklerle Bart sendromu tanısı aldı. Takip eden günlerde konservatif tedavi (topikal kremler ve ıslak gazlı bez) ile cilt lezyonlarında düzelme izlendi. Hasta postnatal 30. günde taburcu edildi. Klinik kontrollere getiril- meyen hastanın postnatal 57 günlükken öldüğü öğrenildiÖğe Demographic characteristics of cases diagnosed with cleft palate(2020) Kaya, Hüseyin; Guliveya, Lale; Özdemir, Ramazan; Gökçe, İsmail Kürşad; Deveci, Mehmet FatihAbstract: Aim: The aim of this study is to retrospectively evaluate the cleft palate cases in our neonatal clinic and to examine the associated clinical features, predisposing factors, accompanying anomalies, additional fidings, treatment approaches and follow-up results. Material and Methods: The study included babies that were diagnosed with cleft palate in our Neonatal Intensive Care Unit between January 2014 and December 2018. The etiological risk factors, demographic characteristics, clinical features and concomitant malformations of the patients included in the study were retrospectively recorded from the patient fies and the database system of our hospital. Results: A total of 70 cleft palate patients were observed over a fie year period. Of these, 30 (42.9%) were female and 40 (57.1%) were male. The mean gestational age was 38 ± 2.9 weeks and the mean birth weight was 2845 ± 700 grams. 77.1% of the patients were found to additionally have cleft lips. 27 patients (38.5%) had cardiac defects, 18 (25.7%) had central nervous system anomalies and 4 (5.7%) had hypothyroidism. 24 (34.3%) of the parents were consanguineous. The median age at the time of the initial operation was 13 months for cleft palate cases and 5 months for cleft lip cases. Conclusion: As a result, treatment and follow-up of patients with cleft palate defect requires a multidisciplinary approach. These patients should undergo a thorough examination and evaluation. Since many syndromes or malformations may accompany the palate defects, these cases should be investigated with respect to genetic disease and other system anomalies.Öğe The effect of feeding with own mother’s milk on bronchopulmonary dysplasia in very low birth weight infants(2019) Gökçe, İsmail Kürşad; Deveci, Mehmet FatihAbstract: Aim: The aim was to evaluate to investigate the attitudes and behaviors of mothers who provide toilet training to their children. Material and Methods: A qualitative study was conducted with focus group interviews. This study was conducted with 24 mothers who provided toilet training to their healthy children between May and July 2017. Three focus group interviews were conducted within the scope of the study. Each group consisted of eight mothers. Semi-structured questions were used in focus interviews. These questions include “How did you know your child is ready for toilet training?”, “Are there any special practices you have done to make your child feel more comfortable with the toilet? Can you explain?” Voice recording was performed during the interviews. The data collected with voice recordings were evaluated by content analysis method, and then the main themes and sub themes of the study were formed. Results: It was determined that 45.8% of the mothers were aged between 28 and 31, 33.3% of them were primary school graduate, 50% of the children to whom toilet training was given, were determined to be aged between 2, 5 and 3. Three main themes and seven sub-themes were identified in this study. These include: 1-Decision time (behaviors of the child, age of the child, effect of family elders), 2-Facilitation activities (forming a suitable environment, encouraging) and 3-Reaction of the mother in interim incontinence(unresponsiveness, negative reaction). Conclusion: The majority of the mothers started toilet training according to the child’s age and readiness signs, used facilitation activities and generally did not react harshly to incontinence.Öğe Mortality related factors on hypoxic ischemic encephalopathic patients treated with therapeutic hypothermia: an 11-year single-center experience.(2022) Deveci, Mehmet Fatih; Turgut, Hatice; Alagöz, Meral; Kaya, Hüseyin; Gökçe, İsmail Kürşad; Özdemir, RamazanBackground/aim: Hypoxic-ischemic encephalopathy (HIE) is a condition that may cause multiple organ dysfunction and has a high rate of mortality and morbidity. Therapeutic hypothermia is the only proven treatment that decreases the sequel and mortality rate of neonates that are born after 36 weeks of pregnancy and have moderate-severe HIE. Material and method: Our study was a single-center, retrospective study that includes newborns (gestational age ? 36 weeks) who underwent therapeutic hypothermia due to hypoxic-ischemic encephalopathy between 2010 and 2020. We evaluated 125 patients who were diagnosed with moderate to severe HIE and received therapeutic hypothermia. Demographic and clinical data were obtained from electronic medical records and patient files. The patients were separated into two groups as exitus group (n = 39) and discharged group (n = 86). We aimed to evaluate factors affecting mortality. Results: We determined that the median resuscitation times were longer in the delivery room [retrospectively, 10th minutes (0–30) vs. 1 min (0–20), p < 0.05], the tenth min APGAR scores were lower [respectively, 4 (0–7) vs. 6 (3–10), p < 0.05], and the median pH value in the first blood gas taken was lower [respectively, 6.87 (6.4–7.14) vs. 6.90 (6.58–7.12), p < 0.05] in the exitus group. We also determined that multiple organ dysfunction is seen more often in the exitus group. Conclusion: This study demonstrated that the depth of acidosis in the blood gas, multiple organ dysfunction, and the existence of earlyonset seizures are the signs of poor prognosis. Therefore, physicians need to be aware of such prognostic factors to follow these patients more closely in terms of possible complications and to inform their parents.Öğe Yenidoğan Yoğun Bakım Ünitesinde Takip Edilen Özofagus Atrezili Olguların Değerlendirilmesi: 10 Yıllık Tek Merkez Deneyimi(2022) Deveci, Mehmet Fatih; Alagöz, Meral; Gökçe, İsmail Kürşad; Özdemir, RamazanAmaç: Özofagusun en sık görülen konjenital anomalisi olan özofagus atrezisi (ÖA), embriyonik dönemdeki fizyolojik gelişimin normal olarak tamamlanmamasından dolayı oluşmaktadır. Prematürite, düşük doğum ağırlığı ve eşlik eden anomaliler mortaliteyi artırmaktadır. Biz bu çalışmamızda; ÖA’lı olgulardaki 10 yıllık deneyimimizi ve bu hastalardaki mortalite ile ilişkili faktörleri değerlendirmeyi amaçladık. Yöntem: Ocak 2011-Aralık 2020 tarihleri arasında takip ettiğimiz ÖA’lı olgularımızı retrospektif olarak inceledik. Hastaların demografik özellikleri ve klinik izlem bilgilerini analiz ederek, mortalite ile ilişkili faktörleri değerlendirdik. Bulgular: Toplam 23 ÖA’lı olgumuzdan 9’unun (%39,1) eksitus olduğunu tespit ettik. Eksitus olan hastaların ortanca gebelik haftası ve ortanca doğum ağırlığının eksitus olmayan hastalara göre istatistiksel olarak daha düşük olduğunu bulduk [33 hafta (28-38), 37 hafta (29-40) sırasıyla (p=0,003)] [1290 gram (875- 2600), 2535 gram (1150-2900) sırasıyla (p=0,005)]. Hastaları, Spitz sınıflaması Okamoto modifikasyonuna göre gruplandırdık. Sağkalım oranları; grup 1’de %88,9, grup 2’de %50, grup 3’te %33,3 ve grup 4’te %66,7 idi. Sonuç: Düşük doğum ağırlığı ve majör kardiyak anomali ÖA’lı olgularda mortalite ile ilişkilidir. Hekimlerin mortalite ile ilişkili faktörleri iyi bilmesi ve risk sınıflaması ile sağkalım öngörüsü yapması; hasta yönetiminde faydalı olacaktır.Öğe Yenidoğanda Kateter İlişkili Enfeksiyonlar(İnönü Üniversitesi Tıp Fakültesi, 2020) Oğuzalp, S. Şeyma; Gökçe, İsmail KürşadYENİDOĞANDA SANTRAL VENÖZ KATETERLER VE KATETER İLİŞKİLİ KAN DOLAŞIM ENFEKSİYONLARININ ÖNLENMESİÖğe Yenidoğanın Geçici Takipnesi(İnönü Üniversitesi Tıp Fakültesi, 2020) Karakuş, Gürkan; Gökçe, İsmail Kürşad
