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Öğe Congenital Heart Disease and COVID-19: A Single-Center Experience(Briefland, 2022) Oncul, Mehmet; Karakurt, Cemsit; Elkiran, Ozlem; Gozukara, Harika GozdeBackground: Coronavirus disease 2019 (COVID-19) has been infecting children since December 2019 and has caused a severe epidemic and millions of deaths worldwide. COVID-19 has severe clinical effects and is more complicated to manage in patients with underlying diseases, such as congenital heart disease (CHD), past surgical operations, arrhythmia, and end-organ damage. Objectives: This study aimed to evaluate the clinical course, follow-up, and treatment process of patients with CHD and COVID-19 in Inonu University Faculty of Medicine, Department of Pediatrics, Turkey during March 2020-February 2021. Methods: This retrospective study was performed on patients with CHD and COVID-19 in the Department of Pediatrics at Inonu University Faculty of Medicine during March 2020-February 2021, selected by making full count sampling. Admission complaints, clinical findings, biochemical parameters, echocardiography results, hospitalization times, treatments, and clinical follow-up findings were retrieved from patients' files. Results: 11 patients with underlying CHD and COVID-19 were evaluated retrospectively during the study. Ten patients were hospitalized and treated due to COVID-19. Treatment of seven of these patients continued in the intensive care unit (ICU), and five were followed up under a mechanical ventilator. Two patients died during follow-up in the ICU. Conclusions: The clinical course of COVID-19 is severe, and the mortality rate is high in patients with serious diseases, such as underlying CHD. Therefore, COVID-19 in patients with CHD requires more serious and careful follow-up.Öğe Effect of Piracetam and Iron Treatment on Heart Rate Variability in Patients With Breath-Holding Spell(Elsevier Science Inc, 2024) Oncul, Mehmet; Elkiran, Ozlem; Karakurt, Cemsit; Gungor, Serdal; Maras, Serdar Akin; Bag, Harika Gozde GozukaraBackground: Breath-holding spells are a benign condition primarily seen in 3% to 5% of healthy children aged between six months and five years. Although no specific treatment is recommended due to its benign nature, iron and piracetam are used in severe or recurrent cases. We planned to compare the heart rate variability (HRV) before and after treatment with 24 -hour Holter monitoring in patients receiving iron and piracetam treatment and investigate the treatment's effectiveness. Methods: Twenty-five patients who applied to the outpatient clinic between 2013 and 2015 due to breath-holding spells were included in the study. The patients who received piracetam and iron therapy and underwent 24 -hour rhythm Holter monitoring were evaluated retrospectively. Results: Fourteen (56%) of these patients were evaluated as having cyanotic-type and 11 (44%) patients were assessed as having pale -type breath-holding spells. A significant difference was found only between hourly peak heart rate and total power in the group receiving iron treatment. Significant differences were also found among the minimum heart rate, mean heart rate, the standard deviation of RR intervals, the mean square root of the sum of the squares of their difference between adjacent RR intervals, spectpow, and low frequency before and after the treatment in the patients who started piracetam treatment ( P < 0.05). Conclusions: Our study is critical as it is the first to investigate the effects of treatment options on various HRV in patients with breath-holding spells. There were statistically significant changes in HRV parameters in patients receiving piracetam, and the number of attacks decreased significantly. Piracetam treatment contributes positively to the breath-holding spell with regard to efficacy and HRV, therefore it can be used to treat breath-holding spells. (c) 2024 Elsevier Inc. All rights reserved.Öğe Effects of total parenteral nutrition on renal function in preterm neonate(Turkish Pediatrics Assoc, 2012) Tabel, Yilmaz; Oncul, Mehmet; Akin, Ilke Mungan; Karabulut, Aysun Bay; Elmas, Ahmet TanerAim: The aim of this study was to establish serum sistatine C, urine beta(2) microglobulin, gluthatione-S -transferase pi and N-acetyle beta-D glucosaminidase levels in order to evaluate the effect of total parenteral nutrition on renal function in premature infants. In addition, we aimed to compare the renal functions between premature infants receiving total parenteral nutrition and control groups receiving enteral feeding. Material and Method: A hundred four premature infants with a gestational age between 28 and 34 weeks were included in the study. The parenteral nutrition group consisted of 50 infants (male/female; 23/27 and mean weight 1258 +/- 212.3 g) and the enteral nutrition group consisted of 54 infants (male/female; 20/34 and mean weight 1608 +/- 206.1 g). In the parenteral nutrition group; total parenteral group nutrition was initiated on the 3rd day in the enteral nutrition group, minimal enteral nutrition was started on a mean of 6.3 +/- 2.4 days and total enteral nutrition was started on a mean of 24.5 +/- 6.3 days. Breastmilk was given orally or by orogastric/nasogastric tube at first day of life in the enteral group. On the 3rd and 30th day Of life, blood samples of all patients were obtained for evaluating biochemical parameters and cystatin C and urine samples were obtained for evaluation of N-acetyl beta-D glucosaminidase, gluthatione-S-transferase pi, beta(2) microglobulin, sodium, creatinin levels, density and pH of the urine. The study was approved by the ethics commite (2008/16). Results: When we compared the patients who received total parenteral nutrition and enteral nutrition on the 3rd and 30th days, serum cystatin C, urinary beta(2) microglobulin, gluthatione-S-transferase pi and N-acetyl- beta-D glucosaminidase excretions were similar on the 3rd day however were significantly higher on the 30th day in samples of the patients receiving total parenteral nutrition (p<0.05 for each parameter on each day). Conclusions: This study shows that total parenteral nutrition in premature infants can have adverse effects on glomerular and tubular functions of the kidney which can be manifested at an early time with cystatin C, beta(2) microglobulin, gluthatione-S-transferase pi and N-acetyl beta-D glucosaminidase. (Turk Arch Ped 2012; 47: 247-52)Öğe Evaluation of Renal Functions in Preterm Infants With Respiratory Distress Syndrome(John Wiley & Sons Inc, 2014) Tabel, Yilmaz; Oncul, Mehmet; Elmas, Ahmet Taner; Gungor, SerdalBackground: The aim of this prospective study was to evaluate urinary glutathione S transferases p (GST-pi), beta-2-microglobulin (B2-MG), and N-acetyl-beta-D-glucosaminidase (NAG) levels as markers revealing the effect of respiratory distress syndrome (RDS) on renal function in preterm infants. Methods: The study was performed with 76 preterm infants whose gestational ages were between 28 and 32 weeks. Twenty-six preterm infants with RDS (cases) and 50 preterm infants without RDS (controls) enrolled in the study. Blood and urine samples were obtained on postnatal (PN) day 3 and 30. Urinary GSTp levels were measured by enzyme-linked immunosorbent assay (ELISA), and urinary B2-MG levels were determined by nephelometric method. Results: There was no significant difference in urinary B2-MG and GST-pi levels between RDS and non-RDS groups on PN day 3 (P > 0.05 for each). However, preterm infants with RDS had significantly higher urinary B2-MG and GSTp levels than the control group on PN day 30 (P = 0.0001 and P = 0.031, respectively). Urinary NAG levels were higher in RDS group than those of the controls on both PN day 3 and 30, but these findings were not statistically significant (P > 0.05, for each). Conclusion: Preterm infants with RDS had increased levels of both GST-p and B2-MG levels on PN day 30, suggesting subclinical tubular dysfunction, probably secondary to hypoxic stress. (C) 2014 Wiley Periodicals, Inc.Öğe An evaluation of risk factors, clinical features, and follow-up findings of patients with infective endocarditis(2021) Oncul, Mehmet; Karakurt, Cemsit; Elkiran, OzlemAim: Infective endocarditis (IE) is a serious infection of the endocardial layer of the heart and the endothelial layer of the aorta, which usually is caused by bacteria or fungal microorganisms, requiring early diagnosis and treatment. Congenital heart diseases (CHD) and acquired valvular diseases are risk factors for IE. Advances in life-saving medical interventions such as intensive care, immunosuppressive treatments and the more frequent use of implanted prosthetic materials have increased the risk of IE. The aim of this retrospective study is to evaluate the underlying risk factors, clinical and laboratory findings, microbiological profiles, treatments, and follow-up of patients diagnosed with IE in our clinic. Material and Methods: In this retrospective study, risk factors, clinical features, laboratory findings, microbiological characteristics, echocardiographic features and medical treatment results and complications of 7 patients who admitted to Inonu University Faculty of Medicine Pediatric Cardiology Department a diagnosed with IE, between 2013-2019 were evaluated. Results: Seven patients who were diagnosed with IE were detected from the hospital data system. When the predisposing causes were examined, we found that 3 patients had mitral insufficiency due to rheumatic heart disease, and 3 patients had CHD. None of our patients had a history of intervention before infective endocarditis. Bacteria grew in blood cultures of all patients. The most grown microorganisms were Staphylococci. Surgical treatment, valve repair or replacement therapy, was applied to three patients. A patient, who had aortic coarctation and mycotic aneurysm developing based on infective endarteritis, died on the 5th day due to aneurysm rupture while waiting for surgery under antibiotic pressure. Conclusion: Despite advancing treatment modalities, the mortality rate is about 25%, which is still too high. The most common bacterial infections that cause IE are Streptococci and Staphylococcal infections. Since mortality and morbidity rates are too high in IE, in case of suspicion, necessary laboratory tests and blood cultures should be taken, and treatment should be started immediately.Öğe Spontaneous Coronary Artery Dissection in Children with Duchenne Muscular Dystrophy(Kare Publ, 2022) Oncul, Mehmet; Karakurt, Cemsit; Elkiran, Ozlem; Hidayet, Siho; Maras, Serdar Akin[Abstract Not Available]Öğe URINE ACUTE KIDNEY INJURY BIOMARKERS IN PRETERM NEONATES WITH RESPIRATORY DISTRESS SYNDROME(Oxford Univ Press, 2013) Tabel, Yilmaz; Oncul, Mehmet; Elmas, Ahmet[Abstract Not Available]
