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Öğe Can mean platelet volume have predictive value in premature retinopathy?(Turgut Özal Tıp Merkezi Dergisi, 2016) Korkmaz, Levent; Baştuğ, Osman; Karaca, Çagatay; Özdemir, Ahmet; Korkut, Sabriye; Güneş, Tamer; Öztürk, Adnan; Kurtoğlu, SelimAbstract Aim: Retinopathy of prematurity, a proliferative vitreoretinopathy resulting from the vascular disorder of the retina, is the most frequent cause of blindness in childhood. In the pathogenesis of the disease, in particular, there are stages developing diametrically opposite to each other (the first phase vasoobliteration, the second phase neovascularization) helped our thoughts of the disease to form. Premature retinopathy is quite an important problem in newborn units not only as far as its consequences but also its follow-up and management. Our controlled clinical study aims to present a simple method that will facilitate the follow-up of the disease while guiding clinicians in predicting the prognosis of the disease. Material and Methods: In our case-controlled study we have assessed 64 preterm cases at the risk of premature retinopathy, considering both the 46 preterm cases having been realized at the follow-up to need laser photocoagulation, and the first and second stage of the disease, in terms of thrombocytes, which play an important part in the transport and storage of vascular endothelial growth factor. Results: No statistically significant difference was found between the control and laser groups in terms of the thrombocyte count and mean platelet volume values during the first stage of the disease (p>0.05). During the second stage of the disease, while no difference was detected between the control and laser groups in terms of the thrombocytes count, (p=0.98, p>0.05), Significant differences were found in mean platelet volume values (p=0.001, p<0.05). Conclusion: In our study we have obtained data to facilitate clinicians’ treatment and follow-up of the cases at the risk of mean platelet volume values reflecting the elevated vascular endothelial growth factor levels in the stage of neovascularization, which constitutes the basis of our study. Keywords: Premature Retinopathy; Platelet; Mean Platelet Volume.Öğe Comparison of subclinical neuronal injury by measuring neuron-specific enolase in patients with severe aortic stenosis treated with transcatheter aortic valve replacement or sutureless aortic valve replacement(2021) Yilmaz, Ahmet Seyda; Kahraman, Fatih; Erkan, Hakan; Korkmaz, Levent; Akyuz, Ali RızaAim: Severe aortic valve stenosis (SAVS) which causes angina pectoris, syncope, arrhythmias, and sudden cardiac death, may be treated with transcatheter aortic valve replacement (TAVR) or sutureless aortic valve replacement (SU-AVR). We aimed to predict subclinical neuronal injury (SNI) by measuring neuron-specific enolase (NSE) in patients who underwent the TAVR and the SU-AVR.Materials and Methods: This clinical trial was carried out between January 2015 and January 2017. A total of 53 patients who had severe aortic valve stenosis (SAVS) and underwent TAVR and SU-AVR were included. The Serum NSE level was measured just before and 24 hours after the procedure. Demographic variables, neurologic assessment findings, clinical and echocardiographic data, carotid ultrasounds reports, and laboratory findings were recorded.Results: A total of 53 patients were included the study. The mean age was 78.4±8.6 and 20 were man (37.7%). The mean age of the TAVR group was significantly higher than the SU-AVR group (82.9±4.7 vs 71.5±8.7, p0.001). The NSE level was significantly higher in the SUAVR group compared to the TAVR group after the procedure (21.15±10.25 vs 35.32±12.64, p0.001). Differences between before and after the procedure the National Institutes of Health Stroke Scale (NIHSS), demographic and echocardiographic variables were similar between the two groups.Conclusion: Serum NSE level was significantly higher in the SU-AVR group than the TAVR group Therefore, we may consider the SNI rate is higher as well. In patients who are at higher risk for neurological damage or have neurologic disease, TAVR may be a better treatment option instead of SUAVR.Öğe The evaluation of our newborns cases operated due to necrotizing enterocolitis(2017) Korkmaz, Levent; Bastug, Osman; Daar, Ghaniya; Korkut, Sabriye; Halis, Hulya; Ozdemir, Ahmet; Ceylan, Mahir; Gunes, Tamer; Ozturk, Mehmet Adnan; Kurtoglu, SelimAim: This study aimed to investigate the characteristics of newborns operated due to necrotizing enterecolitis (NEC) in newborn intensive care unit and to evaluate the mortality of these patients. Material and Methods: The research was designed retrospectively. The study included 39 patients operated due to NEC in our newborn intensive care unit between January 2010 and December 2015 and their characteristic factors and prognosis were evaluated. Results: The average gestational age and weight at birth of the newborns were 31.5±3.7 weeks, 1861±817 g respectively. There were significant differences between the newborns who died and survived in respect to birth weight, age at the time of operation, presence of antenatal steroid application, hypoxic ischemic encephalopathy, intestinal presence of perforation, blood culture positivity (p<0.05 for all comparisons). Conclusion: NEC is the most common life-threatening gastrointestinal emergency experienced by premature infants cared for in the newborn intensive care unit. It is thought that the most important ethiologic factors are prematurity, hypoxia and enteral nutrition. At the same time, it is a devastating gastrointestinal disease that is associated with severe sepsis, intestinal perforation, and significant morbidity and mortality. Its mortality and morbidity rates have been reduced due to developments in newborn intensive care. However, mortality rate is still high among newborns operated due to NEC. For these reasons our thought is that promptly arranged operation time can help to reduce the frequency of mortalityÖğe The evaluation of our newborns cases operated due to necrotizing enterocolitis(2017) Korkmaz, Levent; Baştuğ, Osman; Daar, Ghaniya; Korkut, Sabriye; Halis, Hülya; Özdemir, Ahmet; Ceylan, Mahir; Güneş, Tamer; Öztürk, Mehmet Adnan; Kurtoğlu, SelimAbstract:Aim: This study aimed to investigate the characteristics of newborns operated due to necrotizing enterecolitis (NEC) in newborn intensive care unit and to evaluate the mortality of these patients. Material and Methods: The research was designed retrospectively. The study included 39 patients operated due to NEC in our newborn intensive care unit between January 2010 and December 2015 and their characteristic factors and prognosis were evaluated. Results: The average gestational age and weight at birth of the newborns were 31.5±3.7 weeks, 1861±817 g respectively. There were significant differences between the newborns who died and survived in respect to birth weight, age at the time of operation, presence of antenatal steroid application, hypoxic ischemic encephalopathy, intestinal presence of perforation, blood culture positivity (p<0.05 for all comparisons). Conclusion: NEC is the most common life-threatening gastrointestinal emergency experienced by premature infants cared for in the newborn intensive care unit. It is thought that the most important ethiologic factors are prematurity, hypoxia and enteral nutrition. At the same time, it is a devastating gastrointestinal disease that is associated with severe sepsis, intestinal perforation, and significant morbidity and mortality. Its mortality and morbidity rates have been reduced due to developments in newborn intensive care. However, mortality rate is still high among newborns operated due to NEC. For these reasons our thought is that promptly arranged operation time can help to reduce the frequency of mortality.Öğe Evaluation of our newborns with galactosemia(Turgut Özal Tıp Merkezi Dergisi, 2016) Korkmaz, Levent; Öztürk, Mehmet Adnan; Kardaş, Fatih; Daar, Ghaniya; Bastuğ, Osman; Akın, Mustafa Ali; Korkut, Sabriye; Özdemir, Ahmet; Aşcıoğlu, Mustafa Erhan; Güneş, Tamer; Kendirci, Mustafa; Kurtoğlu, SelimAbstract Objective: In this study, we aimed to help clinicians in the recognition and follow-up of galactosemia by emphasizing that this disease may manifest with different clinical pictures in the neonatal period Materials and Methods: This retrospective uncontrolled study included 19 patients diagnosed with galactosemia and followed-up between January 1994 and January 2014. Five of them had been previously diagnosed. Reductant agents in urine were evaluated using Benedict test, while galactose-1-phosphate uridyltransferase (GALT) was measured with kinetic, enzymatic, colorimetric measurement method. GALT mutation analysis was performed with the Tetraprimer Amplification Refractory Mutation System-Polymerase Chain Reaction (ARMS-PCR) method. Galactose and free galactose were studied with the modified Diepenbrock colorimetric microassay method. Results: Eight (42.1%) of the patients were female and 11 (57.9%) male. Time of the suspicion for galactosemia was found as 11.5±6.3 days, while one patient (5.3%) had a familial history of galactosemia. The most common findings were nutritional intolerance (n=17, 89.5%), hypotonia (n=17, 89.5%) and organomegaly (n=15, 78.9%). The most commonly seen genetic disorder was GALT enzyme deficiency (n=12, 85.7%) and the most common mutation was the Q188R mutation (n=8, 66.6%). Conclusion: Galactosemia is a life threatening, but treatable disease with early diagnosis as well as being one of the metabolic diseases which cause confusion when clinically nonspecific findings are observed. Besides these clinical and laboratory findings, early diagnosis can be established by keeping in mind that galactosemia may present in infants having these findings. Keywords: Galactosemia; Neonate; Clinical And Laboratory Findings.Öğe Evaluation of our newborns with galactosemia(Turgut Özal Tıp Merkezi Dergisi, 2016) Korkmaz, Levent; Öztürk, Mehmet Adnan; Kardaş, Fatih; Daar, Ghaniya; Baştuğ, Osman; Kendirci, Mustafa; Akın, Ali; Korkut, Sabriye; Özdemir, Ahmet; Asçioğlu, Mustafa ErhanAbstract Objective: In this study, we aimed to help clinicians in the recognition and follow-up of galactosemia by emphasizing that this disease may manifest with different clinical pictures in the neonatal period Materials and Methods: This retrospective uncontrolled study included 19 patients diagnosed with galactosemia and followed-up between January 1994 and January 2014. Five of them had been previously diagnosed. Reductant agents in urine were evaluated using Benedict test, while galactose-1-phosphate uridyltransferase (GALT) was measured with kinetic, enzymatic, colorimetric measurement method. GALT mutation analysis was performed with the Tetraprimer Amplification Refractory Mutation System-Polymerase Chain Reaction (ARMS-PCR) method. Galactose and free galactose were studied with the modified Diepenbrock colorimetric microassay method. Results: Eight (42.1%) of the patients were female and 11 (57.9%) male. Time of the suspicion for galactosemia was found as 11.5±6.3 days, while one patient (5.3%) had a familial history of galactosemia. The most common findings were nutritional intolerance (n=17, 89.5%), hypotonia (n=17, 89.5%) and organomegaly (n=15, 78.9%). The most commonly seen genetic disorder was GALT enzyme deficiency (n=12, 85.7%) and the most common mutation was the Q188R mutation (n=8, 66.6%). Conclusion: Galactosemia is a life threatening, but treatable disease with early diagnosis as well as being one of the metabolic diseases which cause confusion when clinically nonspecific findings are observed. Besides these clinical and laboratory findings, early diagnosis can be established by keeping in mind that galactosemia may present in infants having these findings. Keywords: Galactosemia; Neonate; Clinical And Laboratory Findings.Öğe The importance and effectiveness of cardiac screening in early diagnosis of critical congenital heart diseases(2021) Alan, Cumali; Korkmaz, LeventAim: Cardiac screening test for early diagnosis of critical congenital heart disease (CCHD) is recommended by our ministry of health in newborns. We wanted to investigate the effectiveness of the pulse-oximetry screening test recommended by the ministry of health in our neonatal intensive care unit. Our study is planned to find an answer to this question regarding the subject matter. Materials and Methods: Our study was planned retrospectively in cases followed up in our neonatal intensive care unit and obstetrics and gynecology clinic. Our study cases were accepted to the neonatal service of our hospital starting from 01/10/2015 in the 30-month period. Patients admitted from the neonatal and obstetrics / gynecology services were included in the study. Saturation measurements of these cases were made at the earliest 6th hour after birth. The test was considered positive, if saturation was <90 % in the right hand or the saturation was 90-94 % plus the right hand and any of the lower extremities saturation difference was greater than 3 % in three measurements performed at one hour intervals. Pulse-oximetry screening test was performed in all cases included in the study. SPSS 21.0 (Chicago, Illinois) was used for statistical analysis. Results: A total of 12,504 cases were included in our study. Considering the exclusion criteria, some of our cases were excluded from the study, and CCHD was detected in 45 of the 12,223 cases accepted by ECHO examination. 36 of these 45 cases were suspected of CCHD with a physical examination and 41 with the pulse-oximetry screening test and were referred to the pediatric cardiology outpatient clinic. Pulse-oximetry screening test was positive in all 36 cases with CCHD determined by physical examination, but physical examination was found negative in 5 of 41 cases where pulse-oximetry screening test was positive. The 4 CCHD patients in the study could not be determined either by physical examination or by the pulse-oximetry screening test. Conclusion: Physical examination alone does not have sufficient sensitivity and specificity. Pulse-oximetry screening test is more effective than physical examination in detecting neonatal cases with CCHD. Therefore, the appropriate combination of physical examination and pulse-oximetry screening test in the detection of CCHD cases may provide an advantage to physicians in early diagnosis.Öğe Maternal hypoparathyroidism related transient normocalcemic hyperparathyroidism in newborns: case report(2017) Kurtoglu, Selim; Ozdemir, Ahmet; Korkmaz, LeventMaternal hypoparathyroidism causes enlargement in fetal parathyroid glands and hyperparathyroidism. This kind of neonatal hyperparathyroidism may lead tohypercalcemia. Normocalcemia may be observed in some cases. This temporary presentation of hyperparathyroidism generally recovers in a few days after birth as the infant takes enough amount of calcium and phosphorus. Especially significant intrauterine growth retardation and mortality rates are high in infants born from mothers with poorly controlled or untreated hypoparathyroidism. Contrary to the severe hyperparathyroidism of the newborn, these infants often have low birth weight, suppressed or normal serum calcium levels and normal or a little high serum phosphorus levels. The reasons for this difference between the two groups are unknown. In this article, literature was examined by presenting the case of an infant who had transient normocalcemic hyperparathyroidism and the mother who had thyrodectomy and hypoparathyroid symptoms and inadequate treatment during pregnancy.Öğe Our newborn cases with brachial plexus palsy and its prognosis relation with clavicle fracture: A single-center retrospective study(2019) Korkmaz, Levent; Daar, GhaniyaAim: The aim of the study was to present clinical and demographic characteristics of the newborns born in our hospital via normal vaginal delivery and diagnosed with obstetric brachial plexus palsy (OBPP). Material and Methods: Our study was planned as a retrospective single-center study. In our study, newborns born with normal vaginal route were included in Malatya Training and Research Hospital between October 1, 2015 and March 15, 2018. In this period, a total of 5288 newborns were born and 68 of these cases had the pathology of OBPP. Results: Of 68 patients with OBPP, 37 were girls, 31 were boys and mean birth weight was 3,888 gr. The right arm of 38 cases and the left arm of 31 cases were found to develop OBPP. According to the Narakas classification, 39 cases of them (57.3%) were stage I, 21 (30.8%) were stage II, 6 (8.8%) were stage IIU, and 2 of the cases (2.9%) were evaluated as stage IV. Discussion: In our study, the mean frequency of OBPP was close to the world average. Even, it was lower comparing to some European countries. However, the frequency of clavicular fracture was higher comparing to the literature. This gave the impression that the clavicle fracture could be considered as a protecting factor for the development of OBPP. Conclusion: Although OBPP is a common congenital complication in newborns, its frequency in Turkey is parallel to the world average. The main reasons for this OBPP outcome can be due to increasing the number of highly skilled obstetricians in this field and women are currently performing most of the deliveries in a hospital setting even they are not under follow-up. In addition, the protective effect of clavicle fracture on OBPP was also observed in our study.Öğe Prematüre retinopatisinde mean platelet volüm'un prediktif değeri olabilir mi?(2016) Korkmaz, Levent; Baştuğ, Osman; Karaca, Çağatay; Özdemir, Ahmet; Korkut, Sabriye; Güneş, Tamer; Öztürk, Adnan; Kurtoğlu, SelimÖz:Amaç: Prematüre retinopatisi retinanın damarsal bozukluğu sonucu oluşan proliferatif vitreoretinopati olup çocuklardaki körlüklerin sık nedenlerindendir. Özellikle hastalık patogenezinde, birbirinin zıttı olarak gerçekleşen fazların (birinci faz-vasoobliteration, ikinci faz-neovascularization) olduğunun bulunması prematüre retinopatisi hakkındaki düşüncelerin şekillenmesine yardımcı olmuştur. Prematüre retinopatisi yenidoğan ünitelerinde sonuçları açısından olduğu kadar takibi ve tedavisi açısından da oldukça önemli bir problemdir. Biz kontrollü klinik çalışmamızda, hem hastalığın takibinde kolaylık sağlayacak hem de hastalığın prognozunun tahmin edilmesinde klinisyenlere yol gösterecek basit bir yöntemi gündeme getirmek istedik. Gereç ve Yöntemler: Biz vaka kontrollü çalışmamızda, ROP riski altındaki 64 preterm olguyu, takipleri sonucu lazer fotokoagülasyon ihtiyacı duyulmuş 46 preterm olgu ile hastalığın birinci ve ikinci fazlarını göz önünde bulundurarak, bu fazlarda önemli rol oynayan vasküler endotelyal growth faktörün taşınması ve depolanmasında rol oynayan trombositler açısından değerlendirdik. Bulgular: Hastalığın birinci fazında, trombosit sayıları ve ortalama trombosit hacmi değerleri açısından kontrol ve lazer grupları arasında istatistiksel bir fark bulunmadı (p>0.05). Hastalığın İkinci fazında da kontrol ve lazer grupları arasında trombosit sayıları açısından istatsitiksel bir fark bulunmazken (p=0.98, p>0.05), aynı fazdaki ortalama trombosit hacmi değerleri açısından ise anlamlı fark bulundu (p=0.001, p<0.05). Sonuç: Çalışmamızda, hastalığın temelini oluşturan neovaskülarizasyon fazında (faz-2), artmış vasküler endotelyal büyüme faktör düzeylerini yansıtan ortalama trombosit volüm değerleri açısından risk altındaki olguların tedavi ve takibinde hekimlere kolaylık sağlayabilecek veriler elde edildi.Öğe Subacute sclerosing panencephalitis relationship between clinical stage and diffusion weighted imaging findings(J Magn Reson Imaging, 2006) Alkan, Alpay; Korkmaz, Levent; Sığırcı, Ahmet; Kutlu, Ramazan; Yakıncı, Mehmet Cengiz; Erdem, Gülnur; Yoloğlu, SaimTo investigate the relationship between clinical stages and apparent diffusion coefficient (ADC) changes in the brain of patients with subacute sclerosing panencephalitis (SSPE). Materials and Methods: A total of 18 patients with stage II (N 11) and III (N 7) SSPE and 11 age-matched controls underwent routine MRI and diffusion-weighted imaging (DWI). The ADC values were automatically calculated. Seven distinct neuroanatomic structures (frontal, parieto-occipital, and cerebellar white matter; deep white matter; thalamus; basal ganglia; and brainstem) were selected for analysis in the patient and control groups. Results: Hyperintensities in the periventricular and subcortical white matters on T2-weighted images and ADC maps were detected in 63.6% of patients with stage II and in all patients with stage III. There were significant differences between stage II and III patients and also between patients and control group in ADC values that obtained from all locations. The highest mean ADC values were calculated in stage III patients. Although MRI and DWI findings were normal in four patients with stage II disease, ADC values were significantly increased when compared with controls. Conclusion: The stage of disorder may be independent of DWI appearance during the early stage (stages I and II), even though the brain is affected. Therefore, DWI and ADC values supplemental to routine MRI should also be utilized for lesion detection and definition to enhance diagnostic accuracy in patients with SSPE.Öğe Subakut sklerozan panensefalitte kraniyal manyetik rezonans görüntüleme yöntemlerinin klinik bulgular ile korelasyonu(İnönü Üniversitesi, 2004) Korkmaz, LeventSSPE, çocukluk çağı ve erken adölesan dönemde görülen erken ilerleyici nörolojik bir hastalıktır. Nedeni kronik detektif kızamık virüsüdür. Postmortem beyin biyopsilerinde histopatolojik olarak astroglioz, nöronal kayıp, dentritik dejenerasyon, demiyelinizasyon, nörofibriler yumak, enflematuvar hücre inflemasyonu görülmesi hastalığı gösterir. Hastalarda genelde davranış değişiklikleri, myoklonus, demans, görsel bozukluklar, piramidal ve ekstrapiramidal bulgular görülür. Hastalık hızla ilerleyerek genelde 1-3 yıl içinde ölümle sonlanır. Tanı temel karakteristik bulgulara ek olarak, karakteristik EEG deşarjları ve plazma ve BOS’ta artmış kızamık antikor titresinin bulunmasıdır. SSPE’de başlangıçta asimetrik veya Unilateral lezyon ağırlıklı olarak oksipital, oksipitopariyetal veya temporal lokalizasyondadır. CT ve MRG ile' klinik semptomatoloji ve patolojik değişiklikler arasında ilişkinin düşük olması dikkat çeker. Hastalığın tedavisi henüz bulunamamıştır. Oral isoprinosine ve intraventriküler interferon alfa hastaların hayatını uzatabilen halen kullanılmakta olan en iyi tedavi olarak kabul edilmektedir. Biz bu çalışmada, subakut sklerozan panensefalitli (SSPE) hastalarda kraniyal manyetik rezonans görüntüleme yöntemleri ile hastalığın klinik ve prognozunu değerlendirdik, j Gereç ve yöntem: Tüm hastalar T2 ağırlıklı MRG ve difüzyon MRG ile değerlendirildi. Klinik evrelendirmede Jabbour ve arkadaşlarının SSPE evrelemesi kullanıldı.
