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Öğe Comparison of Three Different Administration Positions for Intratracheal Beractant in Preterm Newborns with Respiratory Distress Syndrome(Elsevier Taiwan, 2016) Karadag, Ahmet; Ozdemir, Ramazan; Degirmencioglu, Halil; Uras, Nurdan; Dilmen, Ugur; Bilgili, Gokmen; Erdeve, OmerBackground: The aim of this study was to compare the efficacy and adverse effects of various intratracheal beractant administration positions in preterm newborns with respiratory distress syndrome. Methods: This study was performed on preterm newborns with respiratory distress syndrome. The inclusion criteria were being between 26 weeks and 32 weeks of gestational age, having a birth weight between 600 g and 1500 g, having received clinical and radiological confirmation for the diagnosis of respiratory distress syndrome (RDS) within 3 hours of life, having been born in one of the centers where the study was carried out, and having fractions of inspired oxygen (FiO(2)) >= 0.40 to maintain oxygen saturation by pulse oximeter at 88-96%. Beractant was administered in four positions to Group I newborns, in two positions to Group II, and in neutral position to Group III. Results: Groups I and II consisted of 42 preterm infants in each whereas Group III included 41 preterm infants. No significant differences were detected among the groups with regards to maternal and neonatal risk factors. Groups were also similar in terms of the following complications: patent ductus arteriosus (PDA), pneumothorax, intraventricular hemorrhage (IVH), chronic lung disease (CLD), retinopathy of prematurity (ROP), necrotising enterocolitis (NEC), death within the first 3 days of life, death within the first 28 days of life, and rehospitalization within 1 month after discharge. Neither any statistically significant differences among the parameters related with surfactant administration, nor any significant statistical differences among the FiO(2) levels and the saturation levels before and after the first surfactant administration among the groups were determined. Conclusion: In terms of efficacy and side effects, no important difference was observed between the recommended four position beractant application, the two position administration, and the neutral position. Copyright (C) 2016, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.Öğe Dexpanthenol therapy reduces lung damage in a hyperoxic lung injury in neonatal rats(Taylor & Francis Ltd, 2016) Ozdemir, Ramazan; Demirtas, Gulsum; Parlakpinar, Hakan; Polat, Alaadin; Tanbag, Kevser; Taslidere, Elif; Karadag, AhmetObjective: Dexpanthenol (Dxp) plays a major role in cellular defense and in repair systems against oxidative stress and inflammatory response and it has not yet been evaluated in treatment of bronchopulmonary dysplasia (BPD). We tested the hypothesis that proposes whether Dxp decreases the severity of lung injury in an animal model of BPD.Methods: Forty rat pups were divided into four groups: control, control+Dxp, hyperoxia and hyperoxia+Dxp. All animals were processed for lung histology and tissue analysis. The degree of lung inflammation, oxidative and antioxidant capacity was assessed from lung homogenates.Results: Lung injury score and alveol diameter increased in the hyperoxia group (p<0.001). Median level of malondialdehyde, total oxidant status and oxidative stress indexes was significantly higher in the hyperoxia group compared to the other groups. The median superoxide dismutase activity in the hyperoxia group was notably less than those of control+Dxp and hyperoxia+Dxp groups (p<0.01). Similarly, lung catalase, glutathione (GSH) peroxidase and reduced GSH activities in the hyperoxia group were significantly lower than other groups. Furthermore, the hyperoxia+Dxp group had lower tumor necrosis factor- and interleukin-1 median levels compared to the hyperoxia group (p=0.007).Conclusion: Dxp treatment results in less emphysematous change as well as decrease in inflammation and oxidative stress markers in an animal model of BPD.Öğe Diagnostic Contribution of Postmortem Needle Biopsies in Neonates(De Gruyter Open Ltd, 2013) Celiloglu, Ozgu Suna; Celiloglu, Can; Kurnaz, Erdal; Ozdemir, Ramazan; Karadag, AhmetObjective: We examined the contribution of neonatal postmortem needle biopsy in circumstances of autopsy denial where magnetic resonance imaging cannot be performed. Material and Method: 247 postmortem needle biopsy specimens of 76 neonatal cases who died in the neonatal intensive care ward of a tertiary hospital between 2005 and 2010 and where the family did not give permission for an autopsy were retrospectively evaluated. Results: 90 needle biopsy attempts (36.4%) were unsuccessful among the 247 biopsies. Liver needle biopsies were found to yield the most valuable diagnostic contribution. A total of 53 liver biopsies provided clinical information that contributed to the diagnosis. Conclusion: The postmortem needle biopsy should be applied in all cases in which standard biopsy cannot be performed. Success rates and level of information gained by extrahepatic needle organ biopsies in neonates were found to be quite low whereas needle biopsies of the liver yielded valuable results. We believe it is more appropriate to perform percutaneous postmortem biopsies solely on the liver in neonates.Öğe Fludrocortisone therapy in a newborn with cerebral salt wasting due to hypernatremia and severe hyperbilirubinemia(Churchill Livingstone, 2010) Karadag, Ahmet; Tabel, Yilmaz; Dogan, Derya Gumus; Aktas, Mumtaz; Aslan, Mehmet; Dogan, Metin[Abstract Not Available]Öğe Human milk banking and milk kinship: Perspectives of mothers in a Muslim country(Oxford Univ Press, 2015) Karadag, Ahmet; Ozdemir, Ramazan; Ak, Muharrem; Ozer, Ali; Dogan, Derya Gumus; Elkiran, OzlemAim: The present study aims to determine the knowledge, attitudes and views of mothers regarding infant feeding, breast milk, wet-nursing, milk kinship and human milk banks. Methods: This descriptive cross-sectional study was composed of 1042 mothers who delivered at two different hospitals in Turkey. Results: Almost half of the participating mothers, 49.9%, agreed with the establishment of alternative HMBs in Turkey. Only 7.7% of the mothers in this study expressed views in favour of the establishment of Western-style HMBs. Approximately half of the mothers (42.4%) indicated that they were against the establishment of any kind of HMBs in Turkey. Only 9.2% of the mothers in this study stated that they would volunteer to donate their breast milk to the Western-style HMBs, and only 6.9% of the mothers approved obtaining milk from this type of HMB. Finally, 44.2% of the mothers stated that they would donate their breast milk to the alternative HMBs, and 31.9% of the mothers approved obtaining milk from this type of HMB. Conclusion: This is the first study conducted among mothers in a Muslim community about issues such as infant feeding, breast milk, wet-nursing, milk kinship and HMBs. The majority of the mothers in this study are against the establishment of Western-style HMBs, whereas they have a more positive response to an alternative HMB when their religious concerns are relieved.Öğe Jeune Sendromu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2011) Celiloglu, Ozgu Suna; Dogan, Metin; Ak, Muharrem; Dogan, Derya Gumus; Celiloglu, Can; Sigirci, Ahmet; Karadag, AhmetJeune sendromu; diğer adıyla ‘Asfiksik Torasik Displazi’ (ATD) daralmış göğüs kafesi, ekstremite anomalileri, solunum yetmezliği ve kayda değer yenidoğan mortalitesi ile karakterize otozomal resesif kalıtım gösteren nadir bir kondrodisplazidir. Bu sendrom bulunan çocukların çoğu şiddetli solunumsal yetmezlik gösterir ve erken süt çocukluğu döneminde ciddi ventilatör desteğine ihtiyaç duyabilir. Sendromun renal displazi, retinitis pigmentosa, hepatik ve pankreatik fibrozu içerebilen geniş bir klinik spektrumu mevcuttur. Doğum öncesi akondroplazi tanısı bulunan ve doğum sonrası ciddi solunumsal yetmezlik gösteren ve Jeune sendromu tanısı konulan bir hastayı sunduk.Öğe Measuring the primary care physician's knowledge about diagnosis and treatment of cow's milk allergy and adrenaline auto injector usage(Bilimsel Tip Yayinevi, 2014) Topal, Erdem; Catal, Ferhat; Ozdemir, Ramazan; Karadag, Ahmet; Yildirim, Nurdan; Ermistekin, Halime; Sinanoglu, M. SelcukObjective: Cow's milk allergy is the most common form within the food allergy its prevalence increased recent years in children. In this study, we aim to determine the primary care physician's knowledge about diagnosis of cow's milk allergy, treatment and adrenaline auto injector usage. Materials and Methods: One hundred twenty-six voluntary primary care physicians who are working in Malatya city were included in the study. Interview with each participant were carried out and cow's milk allergy form which was prepared previously was filled in. Results: The median age was 42 (26-62), median length of professional experience was 16 (2-39) years and 89 (70.6%) of participant were male gender. The mean examined patient number by primary care physicians was 37.4 (+/- 14.6) for each day and the mean examined patient number whose age was under 3 years was 8.5 (+/- 4.5). Of the 25.4 percent of primary care physicians did not have knowledge about skin prick test, serum specific Ig E level and/or oral challenge test for diagnosis of cow's milk allergy. Although 73% of participant knew the elimination milk and dietary product from infant who was considered to have allergy to cow's milk and mother, only 13.5% of them knew the prescribe hypoallergenic formula for infant with cow's milk allergy. 64.3% of participant knew the prescribe the adrenaline auto injector in case of anaphylaxis due to cow's milk. Knowledge of adrenaline auto injector use, appropriate side for injection and dose were 34%, 34.1% and 30.2%, respectively. There was no significant effect of primary care physicians's age and length of professional experiences on the knowledge of cow's milk allergy and adrenaline autoinjector usage. Conclusion: The knowledge of primary care physician about diagnosis of cow's milk allergy, treatment and adrenaline auto injector usage are insufficient. Therefore it should be useful to training programs about these topics for primary care physician.Öğe Nasal saline as a placebo in a rhinosinusitis study(Dove Medical Press Ltd, 2014) Karadag, Ahmet; Catal, Ferhat[Abstract Not Available]Öğe Nasal saline as a placebo in allergic rhinitis(Wiley, 2017) Catal, Ferat; Karadag, Ahmet[Abstract Not Available]Öğe Nasal saline as a placebo in chronic rhinosinusitis(Elsevier Science Bv, 2014) Karadag, Ahmet; Catal, Ferhat[Abstract Not Available]Öğe A Newborn with Massive Congenital Astroblastoma(Informa Healthcare, 2011) Turkmen, Emine; Raisanen, Jack; Dogan, Metin; Sandikkaya, Ayse; Dogan, Derya Gumus; Sahin, Nurhan; Karadag, Ahmet[Abstract Not Available]Öğe Oropharyngeal continuous positive airway pressure: An alternative to intubation for newborns not applied nasal continuous positive airway pressure(Wolters Kluwer Medknow Publications, 2016) Demirtas, Mehmet Semih; Turgut, Hatice; Ozdemir, Emine; Karadag, Ahmet[Abstract Not Available]Öğe Phototherapy, Hyperbilirubinemia and Genotoxicity in Newborns(Elsevier Science Bv, 2010) Karadag, Ahmet; Demirin, Hilmi; Dogan, Derya Gumus; Aslan, Mehmet; Tatli, Mustafa Mansur[Abstract Not Available]Öğe The Platelet Parameters as Inflammatory Markers in Preschool Children with Atopic Eczema(Clin Lab Publ, 2015) Topal, Erdem; Celiksoy, Mehmet Halil; Catal, Ferhat; Karakoc, Habib Tadayyon Einaddin; Karadag, Ahmet; Sancak, RecepBackground: Mean platelet volume has been frequently used as an inflammatory marker in various diseases associated with inflammation. In this study, we compared platelet parameter levels between preschool children with and without atopic eczema (AE). Methods: Preschool children with AE and age-matched healthy children were included in the study. Complete blood count was assessed in children with AE while platelet parameters were compared between children with and without AE. Results: One hundred twenty eight pediatric patients (78 boys, mean age: 14 months) diagnosed with AE and 128 healthy patients (71 boys, mean age: 12 months) were included in the study. There were no statistically significant differences between the genders (p = 0.375) and ages (p = 0.273) of both groups. WBC (p = 0.952), Hb (p = 0.370), MCV (p = 0.314) and RDW values (p = 0.124), and platelet counts (p = 0.198) of both groups were similar. In the AE group, while the MPV value was found to be higher (p = 0.003), mean PDW value (p = 0.025) and PLT/MPV ratio were found to be lower (p = 0.021). In addition, there was no correlation between the severity of AE and MPV (rho; 0.1, p = 0.257), POW (rho; -0.1, p = 0.269) and PLT/MPV (rho; 0.07, p = 0.432) ratio. Conclusions: In patients with AE, as a sign of inflammation, PDW value and PLT/MPV ratio decrease while MPV value increases. This study has also shown that there is no association between the severity of AE and platelet parameters.Öğe Prolonged jaundice in newborns is associated with low antioxidant capacity in breast milk(Taylor & Francis Ltd, 2010) Uras, Nurdan; Tonbul, Alpaslan; Karadag, Ahmet; Dogan, Derya G.; Erel, Ozcan; Tatli, Mustafa M.In breastfeeding newborns who are otherwise healthy, the mechanism of prolonged jaundice remains unclear. The aim of this study was to investigate relations between prolonged jaundice and oxidative parameters in breast milk. Full-term, otherwise healthy newborns with jaundice lasting more than 2 weeks were enrolled prospectively in the study. As a control group, newborns in the same age group but without prolonged jaundice were selected. All newborns in the study were exclusively breastfed. In the newborns with prolonged jaundice, investigations of the etiology of the jaundice included complete blood count, peripheral blood smear, blood typing, direct Coombs test, measurement of serum levels of total and direct bilirubin, tests for liver and thyroid function (TSH, free T4, total T4), urine culture and measurement of urine reducing substances, and determination of glucose 6 phosphate dehydrogenase enzyme levels. Breast milk was collected from the mothers of the newborns in both groups. The antioxidant status of the breast milk was assessed via determination of total antioxidant capacity (TAG). Oxidative stress was also assessed in breast milk by measurement of total oxidation status (TOS) and calculation of the oxidative stress index (OSI). The prolonged jaundice group differed significantly from the control group in terms of mean TAG and OSI (p < 0.001), but not in terms of TOS. In conclusion, in the breast milk of mothers of newborns with prolonged jaundice, oxidative stress was found to be increased, and protective antioxidant capacity was found to be decreased.Öğe Protective effects of dexpanthenol in an experimental model of necrotizing enterocolitis(W B Saunders Co-Elsevier Inc, 2015) Karadag, Ahmet; Ozdemir, Ramazan; Kurt, Ahmet; Parlakpinar, Hakan; Polat, Alaadin; Vardi, Nigar; Taslidere, ElifBackground/purpose: In pathogenesis of necrotizing enterocolitis (NEC), both oxidative stress and inflammation are considerable risk factors. The study was designed to evaluate whether administration of dexpanthenol (Dxp) is able to attenuate intestinal injury through the antioxidant and antiinflammatory mechanisms in a neonatal rat model of NEC. Methods: Forty newborn pups divided into four groups were included in the study: control, control + Dxp, NEC, and NEC + Dxp. NEC was induced by hyperosmolar formula and additionally the pups were exposed to hypoxia/hyperoxia and cold stress. They were sacrificed on postnatal day four, and their intestinal tissues were analyzed biochemically and histopathologically. Results: Dxp caused a significant decrease in intestinal damage as determined by the histological score, villus height and number of goblet cells in NEC groups (p < 0.0001). Tissue malondialdehyde, total oxidant status, and oxidative stress indexes levels were higher in the NEC group than in the control and control + Dxp groups (p < 0.001). These values were reduced in the pups treated with Dxp (p <= 0.004). Superoxide dismutase, glutathione peroxidase, and reduced glutathione activities were significantly reduced in the NEC group compared to the others (p < 0.005). Treatmentwith Dxp significantly reduced elevations in tissue homogenate levels of tumor necrosis factor-alpha and interleukin-1 beta in the NEC + Dxp group (p = 0.002 and p = 0.01, respectively). Conclusions: Dexpanthenol seems to have antiinflammatory and antioxidant properties. Prophylaxis with Dxp has a potential to reduce the severity of intestinal damage in NEC in the animals. (C) 2015 Elsevier Inc. All rights reserved.Öğe Separation anxiety disorder increases among neonatal intensive care unit graduates(Taylor & Francis Ltd, 2012) Karabel, Musemma; Tan, Seda; Tatli, Mustafa Mansur; Yilmaz, Ayse Esra; Tonbul, Alparslan; Karadag, AhmetAim: To evaluate whether separation anxiety disorder (SAD) develops in the later life of the infants, who were separated from their mothers in relation to being in neonatal intensive care unit (NICU). Methods: A group of 57 children, ages over 6 years old who were cared in NICU has been evaluated retrospectively by using the SAD diagnostic scale which is adapted according to DSM-IV. Another age and sex matched 50 children who admitted to the outpatient unit were selected as control group. Results: We found that the scores and incidence of SAD were increased among children who were cared in the NICU and both were correlated with the duration of stay in the NICU. Conclusion: The NICU should be arranged to support the development of the baby. Families should be informed about the necessity of sustaining an early mother-infant interaction. By supporting mother-infant interaction, it will be provided that the baby will establish a more secure relation with his/her mother, develop more healthy and have less behavior problems in the future life.Öğe Serum Interleukin-6 Levels in the Differential Diagnosis of Sepsis and Transient Tachypnea of Newborn(Aves Yayincilik, Ibrahim Kara, 2010) Uras, Nurdan; Karadag, Ahmet; Tonbul, Alparslan; Mete, Emin; Kara, Semra; Karabel, Musemma; Tatli, Mustafa MansurObjective: The aim of this study was to evaluate the role of serum interleukin-6 (IL-6) levels in the differentiation of neonatal bacterial sepsis and TTN. Material and Methods: The hospital records of 58 newborn infants with respiratory distress who were above 35 weeks of gestational age were investigated. Patients were divided into two groups. The infection group consisted of patients with proven sepsis and clinical sepsis and the other was the UN group. Clinical findings and white blood cell count, serum C-reactive protein (CRP), IL-6 levels and the ratio of immature neutrophils to total neutrophils count (UT) were recorded and compared between the two groups. Results: Serum CRP and IL-6 levels were found higher than the normal limits in both of the groups. However there was no significant difference between them. Duration of respiratory distress was longer and I/T ratio significantly higher in the infection group than the UN group. The combination of IL-6 and I/T ratio yielded a sensitivity of 80%, a specificity of 48%, a positive predictive value of 44.7%, and a negative predictive value of 80% Conclusion: The I/T ratio and IL-6 may contribute to the early diagnosis of sepsis with respiratory symptoms in newborn infants but IL-6 alone cannot distinguish between TIN and sepsis.Öğe Subclinical hypoxia of infants with intrauterine growth retardation determined by increased serum S100B protein levels(Tubitak Scientific & Technological Research Council Turkey, 2011) Kirmemis, Ozlem; Tatli, Mustafa Mansur; Tayman, Cuneyt; Koca, Cemile; Karadag, Ahmet; Uras, Nurdan; Dilmen, UgurAim: To test the hypothesis that serum S100B levels could be useful in detecting neurological damage in infants with intrauterine growth retardation (IUGR). Materials and methods: The study group consisted of infants with IUGR and the control group consisted of age-matched healthy infants. S100B protein levels were measured after birth and compared between groups. Results: For this study, 43 infants with IUGR and 25 infants as a control group were recruited. Gender, gestational age, type of delivery, and maternal age of the groups were statistically insignificant, with the exception of the mean birth weights (2120 +/- 450 g in the IUGR group and 3096 +/- 570 g in the control group (P < 0.001), respectively). S100B protein levels of the IUGR infants (1.13 +/- 0.54) were significantly higher than those of the control group (0.45 +/- 0.13) (P < 0.001). IUGR infants treated with antenatal steroids showed lower S100B levels than IUGR infants that did not receive antenatal steroid treatments (P < 0.05). The study group infants were divided into 2 groups, for growth retardation (GR) that was asymmetric (n = 15) and symmetric (n = 28). The asymmetric and symmetric GR infants' S100B levels were 1.14 +/- 0.47 pg/mL and 1.21 +/- 0.34 pg/mL, respectively, and no significant differences were found between the 2 groups in terms of S100B levels (P = 0.32). Conclusion: The results of this study favor the opinion that there is an existing intrauterine hypoxia causing hypoxic brain tissue damage in IUGR infants, even when followed up with modern obstetrical screening protocols. Measurements of S100B may be useful in the prediction of outcome in these infants.Öğe Surgical Management of Immature Teratoma Involving the Oral Cavity and Orbit in a Neonate(Lippincott Williams & Wilkins, 2014) Firat, Cemal; Aytekin, Ahmet Hamdi; Akatli, Ayse Nur; Karadag, Ahmet; Samdanci, EmineTeratomas are congenital germ cell tumors composed of elements from 1 or more of the embryonic germ layers and contain tissues usually foreign to the anatomic site of origin. In the head and neck region, these lesions are rare, and 90% of head and neck teratomas present during the neonatal and infantile periods. Besides, in neonates, it carries serious risk for respiratory distress as well as feeding problems due to oral cavity and airway obstruction. Here, an unusual case of intraoral teratoma involving the orbit in a newborn who underwent immediate surgical excision successfully is described.
