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Öğe Abdominal pain, nausea, vomiting, and ascites in a 14-year-old girl with systemic lupus erythematosus: Questions(Springer, 2019) Elmas, Ahmet Taner; Tabel, Yilmaz; Selimoglu, Ayse; Kenc, Senay; Kutlu, Ramazan[Abstract Not Available]Öğe Acute kidney injury and peritoneal dialysis in extremely low birth weight newborns(Edizioni Minerva Medica, 2023) Kaya, Huseyin; Gokce, Ismail K.; Turgut, Hatice; Ozdemir, Ramazan; Tabel, YilmazBACKGROUND: In 12.5-56% of extremely low birth weight (ELBW) infants treated in newborn units, acute kidney injury (AKI) develops. Some of these infants may need renal replacement therapy for several reasons including hyperkalemia, hypovolemia and resistant acidosis. METHODS: All ELBW infants who were followed in our hospital between January 2015 and December 2017 and who lived longer than 48 hours were assessed. Patients were followed for AKI and peritoneal dialysis (PD). RESULTS: AKI developed in 25 of 201 ELBW infants. PD was administered to nine patients. PD was initiated at a median of 11 days (2-22 days) for all patients due to hyperkalemia which did not respond to medical treatment. Three of the nine infants who received PD died while dialysis was ongoing. The remaining six patients completed PD successfully. In these patients, the serum potassium value returned to normal in three days, and dialysis was continued for a median of 93 hours (40-172 hours). Dialysis leakage occurred in two patients, and hyperglycemia developed in two patients. On average, diuresis started at the 25(th) hour (8-40(th) hour). CONCLUSIONS: In the renal failure treatment of ELBW infants, PD is the only option which can be used for many units. It was found that in ELBW infants, who had wider peritoneal surface when compared to their body weight, biochemical values recovered rapidly with PD, and diuresis started a short while later in most patients.Öğe An Adolescent Girl with the Recurrent Attacks of Different Type of Thromboses(Galenos Publ House, 2023) Selcuk, Senay Zirhli; Öncül, Yurday; Durmus, Hanim; Sozeri, Betul; Tabel, YilmazIntroduction: Thrombosis is less common in childhood compared to adults and is usually acquired. Here, we present a patient who had recurrent thrombosis in different organs and was diagnosed with lupus secondary antiphospholipid syndrome (APS) when the lupus anticoagulant test was positive in the follow-up, which we treated quickly and effectively considering possible catastrophic prognosis due to kidney involvement in the same week. Case Report: Fifteen-year-old girl who presented to the emergency department with complaints of sensitivity, pain, and swelling in her left leg. Her medical history revealed recurrent thrombosis attacks and development of mental retardation after a seizure at around the age of three, and no underlying disease had been identified to date. Her family history revealed that her aunt had complained of hand swelling after cold exposure. No significant finding was detected in her thrombophilia panel. A thrombophilia panel was conducted, but no significant findings were detected. Due to a positive lupus anticoagulant test, the patient was diagnosed with APS. The diagnosis of systemic lupus erythematosus was also considered secondary to APS after positive results for anti-nuclear antibody (ANA) and dsDNA tests. Due to the recurrent thrombosis attacks and kidney involvement, a possible catastrophic outcome was considered. In addition to the on going heparin, warfarin, and aspirin therapy, high-dose steroids, cyclophosphamide, intravenous immunoglobulin, and 5 sessions of plasmapheresis were administered, and all treatments were met with a positive response. Conclusion: In this case presentation, we wanted to emphasize that despite the difficulties in the differential diagnosis of thrombosis in children and especially the diagnosis of catastrophic antiphospholipid syndrome (CAPS), prompt and effective treatment can be life-saving.Öğe Antibodies to Borna Disease Virus in Children with Attention Deficit-Hyperactivity Disorder Borna disease virus serology in Attention Deficit-Hyperactivity Disorder(Universitatsverlag Ulm Gmbh, 2009) Ozcan, Ozlem; Gungor, Serdal; Helps, Chris R.; Turan, Nuri; Tabel, Yilmaz; Saget, Hasan; Yilmaz, HueseyinBorna disease virus (BDV) causes behavioral disorders in rats infected in the newborn period. We investigated BDV serology in children with attention deficit hyperactivity disorder (ADHD). Method: Ninety-nine children with ADHD (mean age: 8.7 +/- 2.5) and 104 control children (mean age: 8.4 +/- 2.8) were included in the study. All sera were investigated using the Enzyme-Linked Immunosorbent Assay (ELISA) method for BDV antibodies. Results: The rate of sero-positivity was 2% (2 of 99) in ADHD and 3.8% (4 of 104) in the control group. There was no significant difference between ADHD and control group for BDV sero-positivity. Conclusion: Our results do not support a role of BDV infections in the pathogenesis of ADHD.Öğe Association between RAS gene polymorphisms (ACE I/D, AGT M235T) and Henoch-Schonlein purpura in a Turkish population(Hindawi Ltd, 2013) Nalbantoglu, Sinem; Tabel, Yilmaz; Mir, Sevgi; Serdaroglu, Erkin; Berdeli, AfigHenoch-Schonlein purpura (HSP) is a small-vessel vasculitis of autoimmune hypersensitivity, and renin-angiotensin system (RAS) regulates vascular homeostasis and inflammation with activation of cytokine release. Thus, we aimed to investigate the association between HSP and ACE I/D and AGT M235T polymorphisms. Genotyping was determined by allele specific PCR and PCR-RFLP. We obtained a significant difference in genotype distribution (p = 0.003) and allele frequencies (p < 0.001) of ACE I/D polymorphism between patients and controls, while no significant association was detected in genotype distribution (p > 0.05) and allele frequencies (p > 0.05) of the AGT M235T polymorphism. Risk assessment showed significant risk for HSP in the subjects both with the ID + DD genotype (p = 0.019, OR: 2.288, 95% CI: 1.136-4.609) and D allele (OR: D vs. I: 2.0528, 95% CI: 1.3632-3.0912, p = 0.001) while no significant risk was obtained for HSP in the subjects both with the MT + TT genotype (p = 0.312, OR: 1.3905, 95% CI: 0.7326-2.6391) and T allele (OR: T vs. M: 1.065, 95% CI: 0.729-1.557, p = 0.743). Furthermore, when patients were stratified by the presence of certain systemic complications of HSP, no significant association was detected with ACE I/D, and AGT M235T polymorphisms. Our findings suggest that ACE I/D polymorphism is significantly associated with HSP susceptibility.Öğe Blood pressure is normal, but is the heart?(Springer, 2018) Celik, Serkan Fazli; Karakurt, Cemsit; Tabel, Yilmaz; Elmas, Taner; Yologlu, SaimThere is no detailed strain analysis of cardiac functions in treated hypertensive pediatric patients. The aim of this study was to evaluate the cardio-protective effects of different drug classes in treated pediatric hypertensive patients. Sixty non-obese-treated hypertensive patients with preserved left ventricular (LV) systolic function and 45 age-, sex-, and body mass index-matched healthy subjects underwent clinical evaluation, including 24-h ambulatory blood pressure monitoring, standard echocardiographic examination, tissue Doppler imaging, and two-dimensional Speckle Tracking Echocardiography. The patients were divided into two subgroups based on the effects of the drugs on the Renin Angiotensin Aldosterone System. The subgroup hypertension (HT) 1 received angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and HT 2 subgroup received calcium channel blocker, beta-blocker, or diuretics. There was no difference between the two groups and subgroups with respect to clinical, demographic, ABPM, ventricular volumes, ejection fraction, and tissue Doppler imaging (TDI) parameters. For patients and controls, respectively, global longitudinal strain was - 18.70 +/- 3.41 versus - 21.01 +/- 3.82 (P < 0.001), and global radial strain was 40.6 +/- 9.8 versus 54.8 +/- 12.8 (P = 0.004). Peak LV twist and peak LV torsion were not significantly different. The patient subgroup analyses with each other revealed no difference in systolic and diastolic myocardial deformation properties. Strain parameters were reduced in all treated hypertensive children compared to normotensive children, and the various cardiac mechanic parameters were similarly abnormal no matter what type of antihypertensive agent was used.Öğe Blood pressure is normal, but is the heart?(Sprınger, 233 sprıng st, new york, ny 10013 usa, 2018) Celik, Serkan Fazli; Karakurt, Cemsit; Tabel, Yilmaz; Elmas, Taner; Yologlu, SaimThere is no detailed strain analysis of cardiac functions in treated hypertensive pediatric patients. The aim of this study was to evaluate the cardio-protective effects of different drug classes in treated pediatric hypertensive patients. Sixty non-obese-treated hypertensive patients with preserved left ventricular (LV) systolic function and 45 age-, sex-, and body mass index-matched healthy subjects underwent clinical evaluation, including 24-h ambulatory blood pressure monitoring, standard echocardiographic examination, tissue Doppler imaging, and two-dimensional Speckle Tracking Echocardiography. The patients were divided into two subgroups based on the effects of the drugs on the Renin Angiotensin Aldosterone System. The subgroup hypertension (HT) 1 received angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and HT 2 subgroup received calcium channel blocker, beta-blocker, or diuretics. There was no difference between the two groups and subgroups with respect to clinical, demographic, ABPM, ventricular volumes, ejection fraction, and tissue Doppler imaging (TDI) parameters. For patients and controls, respectively, global longitudinal strain was - 18.70 +/- 3.41 versus - 21.01 +/- 3.82 (P < 0.001), and global radial strain was 40.6 +/- 9.8 versus 54.8 +/- 12.8 (P = 0.004). Peak LV twist and peak LV torsion were not significantly different. The patient subgroup analyses with each other revealed no difference in systolic and diastolic myocardial deformation properties. Strain parameters were reduced in all treated hypertensive children compared to normotensive children, and the various cardiac mechanic parameters were similarly abnormal no matter what type of antihypertensive agent was used.Öğe Case Study of Bardet-Biedl Syndrome with Fetal Lobulation and Focal Segmental Glomerulosclerosis(Galenos Yayincilik, 2008) Tabel, Yilmaz; Akin, Like Mungan; Karadag, Nese; Akinci, AyflehanBardet-Biedl syndrome is a genetic autosomal recessive disease characterized by abdominal obesity, mental retardation, dysmorphic extremities, retinal dystrophy or pigmentary retinopathy, hypogonadism or hypogenitalism, and kidney involvement. Patients with renal involvement may present with both structural and functional abnormalities. Here, we present a 15-year-old male with Bardet-Biedl syndrome who has both fetal lobulation, a rare type of structural abnormality, and focal segmental glomerulosclerosis, having not been reported before.Öğe The causes of death-censored graft loss among kidney transplant recipients(2024) Ciftci, Felat; Simsek, Arife; Piskin, Turgut; Unal, Bulent; Dogan, Sait Murat; Ulutas, Ozkan; Tabel, YilmazAim: This study presents the causes of death-censored graft loss among kidney transplant recipients. Materials and Methods: Medical records of the patients, who had undergone kidney transplantation at a tertiary center between November 2010 and December 2018, were retrospectively reviewed. Death-censored graft loss was described as an irreversible graft failure signified by return to long-term dialysis (or re-transplantation). Inclusion criteria were: patients who had undergone kidney transplantation, and subsequently lost their first graft, and a follow-up of more than one year after kidney transplantation. Results: Of 269 kidney transplant recipients, 33 recipients with a mean age of 33.54 ± 15.37 years (17 male and 16 female) were included in the study. The rate of death-censored graft loss was 12.26%. Of graft failures, 3.03% occurred in the hyperacute phase, 18.18% in the acute phase, and 78.78% in the chronic phase. Chronic allograft nephropathy was the leading cause of graft failure (48.48%). Other causes were medical problems (18.18), immunological problems (18.18%) and surgical complications (15.15%). Conclusion: Identification of the true causes of graft failure described under the heading chronic allograft nephropathy is noteworthy. Comprehensive biochemical, physiological, pathological, immunological, and genetÖğe Celiac disease in children with urolithiasis(Turkish J Pediatrics, 2012) Menekse, Engin; Selimoglu, Mukadder Ayse; Temel, Ismail; Tabel, Yilmaz; Gurgoze, MetinThere are a few studies suggesting a relationship between celiac disease (CD) and kidney disease, but no study has investigated CD in patients with urolithiasis. In this study, we aimed to determine the prevalence of CD in infants and children with urolithiasis. One hundred and eighty-seven infants and children (4 months-17 years) with urolithiasis, and 278 age- and sex-matched healthy children were included. CD was screened using tissue transglutaminase (tTG) immunoglobulin (Ig) A. Seropositive cases, whose parents gave consent, underwent upper gastrointestinal system endoscopy for duodenal biopsy. Seven (3.7%) among those with urolithiasis and one (0.3%) among controls were positive for tTG IgA (p=0.008). Six of the urolithiasis group and one from the control group underwent upper gastrointestinal endoscopy. Intestinal biopsy revealed Marsh-Oberhuber type 1 intestinal lesions in two children. The other five had normal histology. Biopsy-proven CD was detected in two (1%) children with urolithiasis. The prevalence of biopsy-proven CD among all cases was 0.4%. When children were evaluated with respect to age factor, it was found that seropositivity in children younger and older than two years was not different (4% vs. 3.6%; p=0.880). In this first study investigating CD prevalence in children with urolithiasis, we found a higher seropositivity for CD in children with urolithiasis compared to controls, but in terms of biopsy-proven CD, no difference was found.Öğe The Change in the Renal Pelvis Anterior-Posterior Diameter Between Prevoiding and Postvoiding Status, and Its Correlation With Vesicoureteral Reflux(Lippincott Williams & Wilkins, 2020) Akdulum, Ismail; Akyuz, Melih; Gurun, Enes; Ozturk, Mehmet; Tabel, Yilmaz; Sigirci, AhmetIn this study, our aim was to evaluate the significance of the change in renal pelvis anterior-posterior diameter (RPAPD) before and after micturition between vesicoureteral reflux (VUR)-positive and -negative patients to whom had voiding cystourethrography (VCUG) was performed. In this study, 69 children, age ranging from 0 to 12 years, were included. Before the VCUG imaging, the RPAPD was measured first with a full bladder and then after urination via ultrasound (US). The differences between in RPAPD measurements were noted and values compared made among VUR-positive and -negative children. Data distribution was inhomogeneous, and the Wilcoxon Sign Rank test was utilized instead of Student t test. There was no statistically significant difference in prevoiding and postvoiding RPAPD in VUR (+) and VUR (-) patients (P = 0.672). There was no statistically significant relation between VUR and the presence of hydronephrosis (P = 0.126). Vesicoureteral reflux is more common in patients with urinary tract infections (UTI) (P = 0.001). There was no statistically significant relationship between prevoiding and postvoiding RPAPD change and VUR diagnosis (P = 0,164). Ultrasound is the modality of choice for urinary system evaluation. Diagnosis of hydronephrosis via US is not sufficient in predicting VUR; however, indirect findings may reveal the diagnosis. A decrease in RPAPD in postvoiding US evaluation may not rule out the VUR diagnosis for this reason further imaging modalities, such as VCUG, should be taken into consideration for the patients with clinical suspicion.Öğe Clinical and Demographic Characteristics of Children with Urolithiasis: Single-Center Experience from Eastern Turkey(Karger, 2009) Tabel, Yilmaz; Akin, Ilke Mungan; Tekin, SerapObjective: To evaluate the clinical and demographic findings of children with urolithiasis in eastern Turkey. Methods: We retrospectively reviewed the medical records of 67 children with urolithiasis for clinical and laboratory data. Results: Mean age at the time of diagnosis was 39.1 +/- 41.2 months. Complaints at admission were: urinary tract infection (29.9%), macroscopic hematuria (26.9%), abdominal or flank pain (19.4%), spontaneous passing of the stone (8.9%), growth and developmental delay (7.5%), and non-specific findings (8.9%). A family history of urolithiasis was positive in 50.7% of patients. Metabolic screening could be performed in 47 (70.1%) of patients due to socioeconomic problems and revealed hypercalciuria in 59.6%, infectious stone in 17%, cystinuria in 6.4%, hyperuricosuria in 10.6%, hyperoxaluria 4.3%, and hypocitruria in 2.1%. Stone analysis of patients (26.9%) revealed calcium oxalate in 38.9%, calcium phosphate in 22.2%, uric acid in 16.7%, cystine in 11.2%, struvite in 5.6% and mixed content in 5.6%. Conclusion: We believe early diagnosis with detailed metabolic screening and appropriate treatment and follow-up procedures and the contribution of urolithiasis to end-stage renal disease can be avoided. Copyright (C) 2009 S. Karger AG, BaselÖğe Clinical and Imaging Findings in Childhood Posterior Reversible Encephalopathy Syndrome(Iranian Child Neurology Soc, 2018) Gungor, Serdal; Kilic, Betul; Tabel, Yilmaz; Selimoglu, Ayse; Ozgen, Unsal; Yilmaz, Sezai; Sigirci, AhmetObjective Posterior reversible encephalopathy syndrome (PRES) is characterized by typical radiologic findings in the posterior regions of the cerebral hemispheres and cerebellum. The symptoms include headache, nausea, vomiting, visual disturbances, focal neurologic deficits, and seizures. The aim of this study is to evaluate the clinical and radiological features of PRES in children and to emphasize the recognition of atypical features. Materials & Methods We retrospectively examined 23 children with PRES from Mar 2010-Apr 2015 in Inonu University Turgut Ozal Medical Center in Turkey. We compared the clinical features and cranial MRI findings between underlying diseases of PRES. Results The most common precipitating factors were hypertension (78.2%) and medications, namely immunosuppressive and antineoplastic agents (60.8%). Manifestations included mental changes (100%), seizures (95.6%), headache (60.8%), and visual disturbances (21.7%) of mean 3.6 (range 1-10) days' duration. Cranial magnetic resonance imaging (MRI) showed bilateral occipital lesions in all patients, associated in 82.6% with less typical distribution of lesions in frontal, temporal or parietal lobes, cerebellum, corpus callosum, basal ganglia, thalamus, and brain stem. Frontal involvement was predominant, observed in 56.5% of patients. Clinical recovery was followed by radiologic resolution in all patients. Conclusion PRES is often unsuspected by the clinician, thus radiologists may be the first to suggest this diagnosis on an MRI obtained for seizures or encephalopathy. Atypical MRI finding is seen quite often. Rapid diagnosis and treatment are required to avoid a devastating outcome.Öğe Clinical Features of Children With Henoch-Schonlein Purpura Risk Factors Associated With Renal Involvement(Iranian Soc Nephrolgy, 2012) Tabel, Yilmaz; Nano, Filiz Callak; Dogan, Derya Gumus; Elmas, Ahmet TanerIntroduction. This study aimed to evaluate renal involvement and factors affecting the prognosis in patients with Henoch-Schonlein purpura (HSP). Materials and Methods. The outcomes of 107 children diagnosed with HSP who had been followed up for at least 6 months were reviewed. Results. Renal involvement was observed in 26.1% of the patients. The mean age of the patients with renal involvement was 8.8 +/- 4.0 years as compared to 7.1 +/- 2.9 years in the patients without renal involvement (P = .02). The risk of renal involvement was found to be significantly higher in the patients who were 10 years old and over (P < .001). In the group with renal involvement, the frequency of scrotal involvement was significantly higher than that of the group without renal involvement (P = .02). The mean serum immunoglobulin A level of the patients with renal involvements was significantly higher (P = .04) and the mean serum complement C3 levels was significantly lower (P = .04) than those of the patients without renal involvement. None of the patients with renal involvement reached end-stage kidney failure. No significant relationship was observed between the development of renal involvement and early steroid treatment. Conclusions. This study proposes that in old children with HSP, elevated serum immunoglobulin A levels, decreased serum complement C3 levels, and scrotal involvement are associated with renal involvement. We failed to find any effect of steroid treatment on development of renal involvement.Öğe Clinicopathological Analysis of Our Ten-Year Pediatric Percutaneous Kidney Biopsies(Galenos Publ House, 2022) Selcuk, Senay Zirhli; Elmas, Ahmet Taner; Akpolat, Nusret; Tabel, YilmazIntroduction: Our aim in this study is to evaluate the data of native and transplant kidney biopsies in our tertiary pediatric nephrology center in terms of demographics and clinico-pathology, to determine biopsy indications and to evaluate the compatibility of indication and histopathological diagnosis. Materials and Methods: In our study, the files and biopsy results (a total of 134 biopsy results) of 126 pediatric patients aged 1-17 years who were followed up in our Pediatric Nephrology clinic and underwent percutaneous kidney biopsy between 2011 and 2021 were evaluated retrospectively. All patients' age, gender, biopsy adequacy, compliance with the indication and histopathological diagnosis, and follow-up status were recorded. Results: Of 126 patients who underwent kidney biopsy, 62 (49.2%) were male; 64 (50.8%) were girls; mean age was 9.5 +/- 4.1 years. The most common biopsy indication was nephrotic syndrome (32.5%). Immunoglobulin A nephropathy (IgAN) was the most common histopathological diagnosis (23%). The concordance between clinical preliminary diagnosis and histopathological diagnosis was as high as 82.6%. Conclusion: The high rate of compatibility between the histopathological diagnosis and our preliminary diagnoses should not question the necessity of pathological evaluation, and even all kinds of examinations should be used to reach the most accurate diagnosis with the contribution of genetic studies.Öğe Comparison of Urinary Tract Dilatation and Society of Fetal Urology systems in the detection of vesicourethral reflux and renal scar(Int Scientific Information Inc, 2021) Dogan, Gulec Mert; Sigirci, Ahmet; Cengiz, Aslinur; Tasolar, Sevgi Demiroz; Yildiz, Turan; Tabel, Yilmaz; Elmas, Ahmet TanerPurpose: The presence and degree of hydronephrosis is very important in the management of many diseases of the urinary tract. In this study, we aim to compare the sensitivity and specificity of 2 classification systems that are used for hydronephrosis grading in ultrasound, for reflux and scar detection. The classification systems were the Society of Fetal Urology (SFU) and Urinary Tract Dilatation (UTD). Material and methods: Ultrasounds and dimercaptosuccinic acid scintigraphies (DMSA) of all patients who underwent voiding cystourethrogram (VCUG) due to urinary tract infection were examined retrospectively. DMSA was accepted for scar detection and VCUG for reflux detection as reference methods. SFU classification was used for hydronephrosis in ultrasound reports, and UTD classification was made over the reports. Sensitivity, specificity, and positive and negative predictive values of UTD and SFU classification systems for reflux and scar detection were calculated, and these 2 systems were compared. Results: 103 (39%) of the patients were male and 162 (61%) were female. Pathologies were detected in 192 (35%) of 530 kidneys in ultrasound. In 110 (42%) of the children, reflux was detected in VCUG. Scars in DMSA were detected in only 16% (44) of 266 kidneys. Sensitivity, positive and negative predictive values of the UTD classification system were statistically significantly higher than the SFU system for scar and reflux detection (p < 0.01). Conclusions: If we use the UTD system in ultrasounds of patients with urinary tract infections, children reported as UTD 0 may not need VCUG, which reduces radiation exposure to children and the cost of the diagnostic interventions.Öğe Crush Syndrome of Children in Kahramanmaraş Earthquake: A Single Center Experience in Malatya(Aves, 2024) Selcuk, Senay Zirhli; Elmas, Ahmet Taner; Tabel, YilmazObjective: Natural disasters cause enormous environmental, economic, and human losses. Children are the most vulnerable group and face severe consequences. While the primary cause of post -traumatic death is direct injury, the secondary cause is crush syndrome (CS). In this study, we aimed to share our experience in the management of children with CS during disasters by evaluating the clinical and laboratory outcomes of a group of 26 paediatric patients. Materials and Methods: Age, weight, length of time under rubble, laboratory results, and characteristics of crush injuries were assessed in 26 paediatric patients admitted to the emergency department after the earthquake. Diagnostic criteria for CS were established and the need for dialysis, hyperbaric oxygen or amputation and its determinants were assessed. Results: Crush syndrome was observed in 10 of the 26 patients. Significant differences in creatinine, aspartate aminotransferase, alanine aminotransferase, creatine kinase, hematocrit, pH, HCO3, and myoglobin levels were observed between patients with and without CS. None of the individuals rescued from the rubble within the first 6 hours had symptoms associated with CS. These 10 patients who developed CS were rescued within the first 48 hours of the earthquake, while 2 siblings were rescued after 81 hours and did not develop CS. Conclusion: The fact that the children were rescued from the rubble after 81 hours without developing CS shows the importance of patience in rescue operations. In addition, the very cold weather conditions during this earthquake may have prevented the development of dehydration and acute kidney injury and reduced the possibility of CS.Öğe Determination of reference values for urinary neutrophil gelatinase-associated lipocalin in premature infants(Informa Healthcare, 2014) Elmas, Ahmet Taner; Tabel, Yilmaz; Ipek, SevcanBackground: The aim of this study is to determine the reference values of urinary neutrophil gelatinase-associated lipocalin (uNGAL) in healthy very preterm infants. Method: The study was performed on 30 preterm infants whose gestational ages (GA) were between 28 and 34 weeks. They were divided into three groups according to the GA as group 1: GA 28-29 weeks, group 2: 30-32 weeks and group 3: 33-34 weeks. Blood and urine samples were obtained on postnatal (PN) days 1 and 7. uNGAL was measured by ELISA. Results: There were 10 preterm infants for each group. The median values of uNGAL on PN Days 1 were 19.80 (8.6-25.7) ng/ml, 9.25 (1.42-30.3) ng/ml, and 7.95 (1.60-27.8) ng/ml in group 1, group 2 and group 3, respectively. Multivariate linear regression analysis showed that uNGAL values are not associated with GA, birth weight, and gender in preterm infants on PN Days 1 and 7. Conclusion: Our study indicated that normal values of uNGAL concentrations in healthy very preterm infants, and older children or adults are similar preterm infants.Öğe The Devastating Turkey-Syria Earthquake from the Perspective of Pediatric Nephrology(Galenos Publ House, 2023) Taner, Sevgin; Tabel, Yilmaz; Bakkaloglu, Sevcan A.Kahramanmaras was hit by two major earthquakes nine hours apart on February 6th, 2023, with magnitudes of 7.8 and 7.5 on the Richter scale, respectively. Ten other cities were also devastatingly affected by these earthquakes. More than 50 thousand people died in Turkey. The occurrence of two severe earthquakes on the same day in such a wide geographical area caused significant challenges. This disaster, with its devastating effects, focused attention on the significance of establishing a national and comprehensive emergency disaster plan prior to any disaster. Additionally, it highlighted the necessity of preparing a well-organized healthcare team capable of providing prompt and appropriate fluid replacement for pediatric patients in the early stages of a disaster. This is a crucial issue which must be addressed prior to major disasters. Another very important issue in this tragic disaster was the condition of chronically ill pediatric patients. Indeed, an emergency response is important not only for disaster victims, but also for those patients with chronic diseases in need of uninterrupted medical care. It is vital that individuals of all ages, as well as personnel from all sectors, receive the appropriate education, awareness, and knowledge on what actions to take, where to go, and where to gather in such situations.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)
