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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 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 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 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 Evaluation of therapeutic and prophylactic platelet transfusion practices in a neonatal intensive care unit(2019) Korkut, Sabriye; Bozkaya, Davut; Tayman, CuneytAim: To investigate the causes of thrombocytopenia requiring platelet transfusion (PT), clinical factors influencing the decision to give PT, and the frequency of major hemorrhage post-PT in a neonatal intensive care unit (NICU). Material and Methods: This retrospective cross-sectional study included neonates who underwent PT at least once in the NICU during a 4-month period. Demographic characteristics, postnatal age at time of PT, number of PTs, thrombocytopenia etiology, and occurrence of major hemorrhage were analyzed. PT threshold was <20x103 /µL in group 1; 20x103 /µL – 49x103 /µL in group 2; and >503 /µL in group 3. Results: Thirty-seven (4.9%) of the 751 patients admitted to the NICU during the study period received PT. These 37 patients received a total of 133 PTs. The most common etiology of thrombocytopenia requiring PT was sepsis (83.5%), followed by NEC (9.8%). Of the 133 PTs, 7 were administered for early-onset thrombocytopenia and 126 for late-onset thrombocytopenia. All patients in group 1 (n=56) had severe thrombocytopenia only with no additional morbidity; patients in group 2 (n=72) had thrombocytopenia accompanied by severe morbidity and/or major hemorrhage, coagulopathy, or extremely low birth weight (ELBW); patients in group 3 (n=4) received PT due to thrombocytopenia and preoperative preparation, coagulopathy, or major hemorrhage. Seven of the 133 PTs (5.3%) were therapeutic and the other 126 (94.7%) were prophylactic. Existing major hemorrhage persisted after 6 of the 7 therapeutic PTs. Major hemorrhage occurred after only 1 prophylactic PT. Conclusion: It was identified bacterial sepsis and NEC as the two most common clinical indications for PT. In general, prophylactic PT was not followed by major hemorrhage, whereas recurrent major hemorrhage occurred after therapeutic PT. Therefore, randomized controlled studies are needed to determine a safe PT threshold value based on a scoring system for predicting the risk of major hemorrhage.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 A study of longitudinal measurements in the screening for osteopenia of prematurity(2018) Korkut, Sabriye; Kurtoglu, SelimAim: To investigate the biochemical parameters and bone “speed of sound” (SoS) values used in the screening for osteopenia of prematurity (OP). Material and Methods: Serial measurements of tibial bone SoS and concomitant serum calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP) levels of preterm infants in postnatal week 1, 3, and 6 were studied retrospectively. Results: Fifty premature infants ≤ 35 weeks of gestational age were included in the study. A positive correlation was detected between serum P levels and SoS values at 1st and 6th week (r = 0.55, P = 0.0001 and Rho = 0.67, P = 0.0001, respectively). SoS values in postnatal week 3 were correlated with SoS values in week 1 and week 6 (Rho = 0.67, P = 0.0001 and Rho = 0.65, P = 0.0001, respectively). Serum Ca, P, and ALP levels measured in postnatal week 1 and 3 were not predictive of the subsequent risk of osteopenia. The SoS value in week 3 (≤ 2940 m/s) was predictive of the risk of osteopenia in week 6, with sensitivity of 85% and specify of 73% (Area under the curve [AUC] = 0.80, p = 0.001). Conclusions: Serum P levels were correlated with bone SoS values. Bone SoS measurements in postnatal week 3 rather than biochemical parameters was predictive of the risk of osteopenia in postnatal week 6. For this reason, screening for osteopenia can be started at postnatal week 3 in newborn units where quantitative ultrasonography (QUS) is used.
