Esra özer - Academia.edu (original) (raw)

Papers by Esra özer

Research paper thumbnail of Macrophage Activation Syndrome in Children with Systemic Juvenile Idiopathic Arthritis Successfully Treated with Megadose Methyl Prednisolone Therapy

Journal of Pediatric Research, Jun 19, 2015

Re cei ved/Ge liş ta ri hi: 18.02.2015 Ac cep ted/Ka bul ta ri hi: 10.04.2015 ABS TRACT ÖZET Macr... more Re cei ved/Ge liş ta ri hi: 18.02.2015 Ac cep ted/Ka bul ta ri hi: 10.04.2015 ABS TRACT ÖZET Macrophage activation syndrome (MAS) is the most common serious and fatal complication of systemic juvenile idiopathic arthritis (SJIA). MAS is most commonly seen in SJIA and there are no true estimates of its incidence. Although it has been considered a rare complication, it is probably more common than it is thought. In the last sixteen years, 240 patients were diagnosed with JIA in our institute. Out of the 240 patients, 16 were diagnosed with SJIA; and four of these 16 SJIA patients had MAS. There is no consensus on the treatment of MAS. Four cases of MAS diagnosed in our institution were administered intravenous mega-dose methylprednisolone (MDMP) as induction therapy successfully without any serious adverse effects. To the best of authors' knowledge, MDMP as a treatment modality in MAS therapy is reported for the first time. Herein, we report the clinical and laboratory data of our cases who received MDMP and evaluate our clinical experience reviewing the literature.

Research paper thumbnail of Comparison of oral and intravenous fluid therapy in newborns with hypernatremic dehydration

The Journal of Maternal-Fetal & Neonatal Medicine, 2013

To evaluate the efficacy and complications of oral and intravenous fluid therapy in newborns with... more To evaluate the efficacy and complications of oral and intravenous fluid therapy in newborns with hypernatremic dehydration. A total of 75 term and near-term (>35 weeks) neonates with hypernatremic dehydration (Na ≥ 150 mmol/L) were included in this retrospective study. The patients were divided into two groups according to therapy approach for rehydration (breast milk-oral formula and intravenous fluid). The decline in sodium concentration (<0.5 mmol/L/h was regarded as safe drop) and complications were analyzed. The mean gestational age, birth weight and age at admission were 38.9 ± 1.4(36-42) weeks, 3341 ± 504 (2500-4500) gram and 4.3 ± 2.6 (1-17) day, respectively. Fever (61.8%) and jaundice (39.4%) were the most common presenting signs. Forty-four (58.6%) of the infants were treated with breast milk and/or oral formula (group 1) and 31 (41.4%) of the infants were treated with IV fluid (group 2). In group 1 and group 2, respectively, mean % weight loss, 5 and 7.5; median serum sodium at admission, 153 and 152 mmol/L; median change in sodium at 12 hours, 7 and 11 mmol/L; and median change in sodium at 24 hours, 10 and 15 mmol/L. The decline in sodium concentration was more safely in group 1 than group 2 at both 12 and 24 hours of rehydration. One patient had convulsion associated with cerebral edema in group 2. Otherwise no complication was observed in both groups. Enteral route for fluid replacement may be safe and effective and may be an alternative to intravenous fluid therapy in newborns with hypernatremic dehydration when clinical situation is stable.

Research paper thumbnail of Traditional methods used in the care of babies of mothers in Muğla province

Ortadoğu tıp dergisi, Sep 1, 2019

Gelenekler, kuşaktan kuşağa ve toplumdan topluma geçen kültür mirasları, alışkanlıklar, bilgiler,... more Gelenekler, kuşaktan kuşağa ve toplumdan topluma geçen kültür mirasları, alışkanlıklar, bilgiler, töreler ve davranışlardır. Bebek bakımıyla ilgili bazı geleneklerde kundaklama gibi güncel tıbbi bilgiyle çelişen uygulamalar bulunmaktadır. Bu tür geleneksel uygulamaların eğitim sonrası büyük ölçüde azaldığı gözlenmektedir. Buna karşılık, ülkemizde bebek tuzlama gibi bazı yan etkileri ciddi sorunlara neden olan geleneksel uygulamaların pek çok yörede hala yaygın olarak uygulandığı bilinmektedir. Çocuk hekimlerinin görev yaptıkları bölgelerdeki halkın geleneklerini tanıması ve eğitici rol üstlenmesi çocuk sağlığının geliştirilmesi açısından önem arz etmektedir. Çalışmamızda Muğla ilimizde bebek bakımındaki geleneksel uygulamaların araştırılması amaçlanmıştır. Hastanemiz Çocuk Sağlığı ve Hastalıkları polikliniğine başvuran 305 anneye bebek bakımındaki geleneksel uygulamalara yönelik olarak anket uygulanmıştır. En sık gözlenen geleneksel uygulama %59,9 ile bebek tuzlama olmuştur. Annelerin eğitim süresiyle geleneksel uygulamalar arasında anlamlı ilişki olduğu görülmüştür. Sonuç olarak annelerin eğitilmesinin bebek bakımında zararlı olma potansiyeli olan geleneksel uygulamaları azaltabileceği kanısına varılmıştır.

Research paper thumbnail of Konjenital Lenfanjiektazinin Neden Olduğu Dirençli Şilöz Asidin Propanolol İle Tedavisi: Olgu Sunumu

Chylous ascites is a rare clinical condition occurring as the result of the extravasation of the ... more Chylous ascites is a rare clinical condition occurring as the result of the extravasation of the chyle into the peritoneal cavity and caused by numerous factors. The most common cause of underlying pathologies are lymphatic vessel disorders. Owing to the lack of the therapeutic and diagnostic standards, individual therapy seems to be extremely important. Octreotide administration, total parenteral nutrition and a diet rich in medium-chain triglycerides constitute first step of the treatment, but surgical intervention may be performed in case of failure of the medical treatment. In literature, there is only one neonate with refractory generalized lymphangiectasia who is treated with propranolol. A newborn baby was admitted to our clinic after delivery due to nonimmune hydropsfetalis and he was diagnosed as lymphangiectasia with lymphoscintigraphy. Herein, we describe the use of propranolol in the therapy of lymphangiectasia in an infant with refractory chylous ascites.

Research paper thumbnail of A newborn with Dubowitz syndrome: a case report

Journal of Dr. Behcet Uz Children s Hospital, 2014

Dubowitz syndrome was first reported in 1965 by Victor Dubowitz. Dubowitz syndrome is a rare auto... more Dubowitz syndrome was first reported in 1965 by Victor Dubowitz. Dubowitz syndrome is a rare autosomal recessive disorder characterized by microcephaly, short stature, abnormal faces, eczematous skin eruption, and mild to severe mental retardation. In this review, we describe a female newborn with microcephaly, micrognathia, high narrow, syndactyly, clinodactyly, ventricular septal defect, poor feeding and sacral dimple. Here, we heard the requirement to report this case because of rarity.

Research paper thumbnail of Assessment of hemodynamic changes in preterm infants with respiratory distress syndrome

Anatolian journal of cardiology, 2017

Research paper thumbnail of Scrotal Hematoma as a Sign of Subcapsular Liver Hematoma in a Preterm Infant

Pediatrics & Neonatology, 2017

Research paper thumbnail of Sleeping Disorders in lnfancy

The Journal of Tepecik Education and Research Hospital, 2003

Süt çocukluğu döneminde uyku bozuklukları çok sayıda ailenin ortak yakınmasıdır. Ailelerin sosyal... more Süt çocukluğu döneminde uyku bozuklukları çok sayıda ailenin ortak yakınmasıdır. Ailelerin sosyal yaşantısını olumsuz yönde etkileyen bu durum, büyük ölçüde ailenin sosyokültürel yapısı ile ilişkilidir. Bu çalışmada, süt çocukluğu döneminde uyku bozukluğuna neden olan faktörlerin araştırılması amaçlanmıştır. Yöntem: Hastanemiz Çocuk Sağlığı ve Hastalıkları Kliniklerine en az 6 aydır süregelen, uyku bozukluğu ile başvuran, organik patolojisi bulunmayan, doğum ağırlığı 2500 g üzerinde, zamanında doğmuş 6-24 ay arası 40 olgu ve aynı özelliklere sahip 70 kontrol olgu çalışma grubu olarak alınmıştır. Uyku bozukluğu üzerine etkili olan faktörler ile ilgili veriler olguların annelerine uygulanan anket formlarından elde edilmiştir. Bulgular: Uyku bozukluğu ile getirilen bebek/erde, uyku süresinin kontrol grubu ile yakınlık gösterdiği, gece uyanma sıklığının ise anlamlı olarak artmış olduğu görüldü (p=O.OOO). Buna karşın her iki grup arasında olgu yaşı, doğum ağırlığı, anne ve baba yaşı, anne sütü ile beslenme süresi, ek gıda/ara başlangıç yaşı, ailedeki kişi ve kardeş sayısı ve anne eğitimi süresi yönünden anlamlı fark bulunmadı. Ancak kontrol grubunda babaların daha yüksek tahsil/i olduğu gözlendi (p=0.008). Uyutulurken obje kullanımı, aydınlık ortamda uyuma yüzdesi ve saliayarak uyutma kontrol grubunda çalışma grubuna göre anlamlı derecede yüksek idi (sırasıyla p=O.OOO, p=0.04, p=0.004). Kundakla uyutma çalışma grubunda daha sık kullanılan bir yöntem olarak bulundu (p=O.Oll). Buna karşın uyutu/madan önceki beslenme özellikleri ve çocuğun uyuduğu yerin her iki grup için farklılık göstermediği dikkati çekti. Sonuç: Süt çocukluğu dönemindeki uyku bozukluklarının geceleri sık uyanma ile karakterize olduğu ve bebeğin uyutu/ma biçimi yanısıra ebeveyn/erin tutumu ve uyuma ortamı ile ilişkili olabileceği kanısına varılmıştır.

Research paper thumbnail of The mechanical properties and stiffness of aorta in obese children

The Turkish journal of pediatrics

Obesity in children has also been associated with the development of early cardiovascular abnorma... more Obesity in children has also been associated with the development of early cardiovascular abnormalities. The aim of this study was to investigate the relationship between aortic stiffness and some risk factors in obese children. Sixty obese children and 60 age- and sex-matched healthy controls were assessed. The mechanical property parameters were measured or computed: lumen diastolic and systolic diameters, aortic strain and elastic modules. Compared to controls, obese children had altered stiffness values of the aorta, whereas strain was not different. Compared to controls, obese children had higher systolic and diastolic blood pressure values. Insulin level, homeostasis model assessment (HOMA) score, and total cholesterol, triglycerides, lowdensity lipoprotein (LDL), and leptin levels were significantly higher, while adiponectin, high-density lipoprotein (HDL) levels and quantitative insulin sensitivity check index (QUICKI) scores were significantly lower in obese children than i...

Research paper thumbnail of Isolated Retrovesical Cyst Hydatid in a Child: An Unusual Presentation of Echinococcosis

Journal of Tropical Pediatrics, 2004

Research paper thumbnail of Preterm infantta katater ilişkili sepsisin neden olduğu kardiyak tamponad

Ege Tıp Dergisi, 2019

Cardiac tamponade due to catheter related sepsis in premature neonate is a rare and life-threaten... more Cardiac tamponade due to catheter related sepsis in premature neonate is a rare and life-threatening complication; but prompt diagnosis and intervention can reverse this situation. We report a nine-day-old preterm infant who presented with pericardial effusion and cardiac tamponade secondary to catheter related sepsis. This report highlights two important aspects: occurrence of pericardial effusion in a neonate with peripherally inserted central venous catheter (PICC), with no evidence of composition of hyperosmolar parenteral solution, and awareness of sepsis as a cause for this critical condition.

Research paper thumbnail of Meningomyelosel Olgularında Prognozu Etkileyen Faktörler ve Eşlik Eden Anomaliler: 40 Olguluk Deneyim

Aim: The aim of this study was to determine clinical features and short-term prognosis of hospita... more Aim: The aim of this study was to determine clinical features and short-term prognosis of hospitalized neonates with meningomyelocele, and to asses the association between the serum levels of vitamin D and meningomyelocele. Material and Methods: In this single center retrospective study, all infants with meningomyelocele were considered eligible. This study was conducted in Tepecik Training and Research Hospital between January 2014 and December 2015. Data of the patients were noted from the medical records. Results: A total of 40 infants with meningomyelocele were eligible for the study. The mean gestational age of infants was 38.6 ± 2.2 weeks and mean birth weight was 3099 ± 553 g. None of the mothers had taken folic acid support preconceptionally. The meningomyelocele was localized in lumbar (80%), thoracolumbar (12.5%) and cervical (7.5%) areas. The average time of surgical operation for meningomyelocele was 5.1 ± 4.65 days and the rate of operation in the first 72 hours of lif...

Research paper thumbnail of Servi̇kal Meni̇ngomyeloselli̇ Yeni̇doğanlarin Kli̇ni̇k Ve Cerrahi̇ Yöneti̇mi̇

AMAC: Servikal yerlesimli meningomyeloseller; torakal, lomber ve sakral lokalizasyonlu olanlardan... more AMAC: Servikal yerlesimli meningomyeloseller; torakal, lomber ve sakral lokalizasyonlu olanlardan farklidir. Calismamizda; servikal meningomyeloselin klinigini, eslik eden anomalileri, radyolojisini, cerrahi oncesi ve sonrasindaki hasta izlemini, cerrahi yaklasimi ve prognozunu degerlendirmeyi amacladik. GEREC VE YONTEM: 1 Ocak 2012 - 31 Aralik 2016 tarihleri arasinda meningomyelosel nedeniyle 3. basamak yenidogan yogun bakima yatirilan 88 yenidoganin 2’si servikal yerlesimliydi. Servikal meningomyeloselli hastalarin klinigi, radyolojisi, cerrahi teknigi, cerrahi oncesi ve sonrasi yonetimi ile prognozu prospektif olarak incelendi. Hastalarin psikomotor gelisimleri postnatal 18. ayda Denver Gelisimsel Tarama Testi ile degerlendirildi. BULGULAR: Ortalama gestasyonel yasi 39.5 hafta olan bir erkek bir kiz yenidoganin ortalama dogum agirliklari 3635 gr ve keselerinin ortalama capi 5x5 cm idi. Motor defisiti olmayan her iki hastanin manyetik rezonans goruntulemelerinde kese icinde noral ...

Research paper thumbnail of Effect of humic acid on oxidative stress and neuroprotection in hypoxic-ischemic brain injury: part 1

The Journal of Maternal-Fetal & Neonatal Medicine, 2020

Background: Aimed to investigate in an animal model the efficacy of humic acid by showing its ant... more Background: Aimed to investigate in an animal model the efficacy of humic acid by showing its antioxidant and anti-apoptotic effect comparing with the histopathological and neurological outcomes for the hypoxic-ischemic brain injury. Methods: 28 Wistar-Albino rats who were on the 7th postnatal day and weighting between 9 and 19 g randomly divided into four groups with developed HIE model under the gas anesthesia. 20 mg/kg and 10 mg/kg intraperitoneal HA were given to Group I and II respectively. Saline was given to Group III and the sham group was Group IV. The brain tissues were stained with cresyl-violet histochemistry for grading neuronal cell injury and caspase immunohistochemistry. Results: The neuronal cell injury was statistically lower in all neuroanatomical lands in HA treatment groups. The degree of ischemia was significantly smaller in HA groups. Caspase-3 immunoreactivity was decreased in the HA groups compared with the saline group. When the groups were compared, there were no serious neuronal injury in Group I. Conclusions: This is the first study which investigates the role of HA in HIE model. HA reduces apoptosis and neuronal injury in cerebral tissue of the rats. This findings suggest that HA may be viable protective agent against HIE.

Research paper thumbnail of Solitary median maxillary central incisor, holoprosencephaly and congenital nasal pyriform aperture stenosis in a premature infant: case report

Archivos argentinos de pediatria, 2018

Solitary median maxillary central incisor syndrome is a rare disorder involving midline abnormali... more Solitary median maxillary central incisor syndrome is a rare disorder involving midline abnormalities such as holoprosencephaly, nasal cavity anomalies, cleft palate-lip, hypotelorism, microcephaly, and panhypopituitarism. Congenital nasal pyriform aperture stenosis is a lethal cause of neonatal respiratory distress due to narrowing of the pyriform aperture anteriorly and it can be confused with choanal atresia. In this report, we present a newborn infant with solitary median maxillary central incisor syndrome accompanied by other abnormalities including holoprosencephaly, nasal pyriform aperture stenosis, microcephaly and panhypopituitarism. Chromosomal analysis showed heterozygous SIX3 gene deletion at 2p21 region resulting in a more severe form of holoprosencephaly.

Research paper thumbnail of Prevalência e fatores de risco associados à colonização por enterococos resistente à vancomicina

Revista de Ciências Médicas e Biológicas, 2009

Os enterococos foram reconhecidos como patógenos clinicamente importantes na população de alto ri... more Os enterococos foram reconhecidos como patógenos clinicamente importantes na população de alto risco de pacientes hospitalizados. Os objetivos deste estudo foram detectar a prevalência da colonização por enterocos intestinais resistentes à vancomicina (VRE) no Hospital Tepecik, Izmir, Turquia, entre pacientes dos serviços de alto risco e os fatores de risco relacionados com a resistência em pacientes internados onde a VRE foi raramente isolada anteriormente. Após o primeiro isolamento de VRE em dois pacientes na unidade de terapia intensiva (UTI) e UTI neonatal, no mesmo dia, foi realizado um levantamento de prevalência utilizando swab retal. Para efeito de comparação, 30 amostras de pacientes-controle do serviço de controle de medicina interna também foram analisadas. Noventa e três pacientes foram investigados. Dezoito pacientes (19,3%) foram considerados portadores de VRE, apesar de nenhum dos pacientes do grupo controle tinham VRE. Treze cepas foram identificadas como Enterococc...

Research paper thumbnail of Comparison of CrIb-II and Snap-Pe-II Scoring Systems in Predicting the Mortality and Morbidity of Very Low Birth Weight Infants

Turkish Journal of Pediatric Disease, 2017

Objective: A number of illness severity scores have been established to predict mortality and mor... more Objective: A number of illness severity scores have been established to predict mortality and morbidity in neonatal intensive care units (NICUs). The objective of this study was to compare SNAPPE-II (Scores for Neonatal Acute Physiology-Perinatal Extension-II) and CRIB-II (Clinical Risk Index for Babies-II), the latest versions of European and American scoring systems, in predicting hospital mortality and overall morbidity of surviving infants. Material and Methods: Very low birthweight infants (VLBW) admitted to the neonatal intensive care unit were identified. CRIB-II and SNAP-PE-II scores were electronically calculated for each patient via the website www.sfar.org. The receiver operating characteristics (ROC) curve was used to check the accuracy of the mortality and morbidity prediction. results: A total of 189 VLBW neonates (mean CRIB-II:9.9±3.8; mean SNAP-PE-II: 45.8±25.4) were evaluated. The mean birth weight, gestational age, CRIB-II, SNAP-PE-II scores were associated with mortality. Both CRIB-II and SNAP-PE-II were determined to be discriminatory for mortality, but not predictive enough for morbidity when evaluated with ROC curve analysis. conclusion: Both CRIB-II and SNAP-PE-II were found to be eligible in predicting hospital mortality of VLBW patients whereas their value was poor in predicting morbidity. CRIB-II, due to fewer parameters to evaluate, may be the preferred scoring system to predict mortality in NICUs with high patient capacity.

Research paper thumbnail of Change in Pathogens Causing Late-onset Sepsis in Neonatal Intensive Care Unit in Izmir, Turkey

Iranian journal of pediatrics, 2010

Neonatal sepsis is a common cause of morbidity and mortality among newborns in the developing wor... more Neonatal sepsis is a common cause of morbidity and mortality among newborns in the developing world. We have investigated the causative agents and their antimicrobial susceptibility of late-onset sepsis (>72 h post-delivery), and determined the possible association between various risk factors and the mortality due to neonatal sepsis in 2008. To view the changes in years, we compared them with the data which we gained in 2004. Medical records of all neonates with late-onset sepsis were reviewed for demographic characteristics (birth weight, gestational age, gender, type of delivery, and mortality rate), positive cultures and risk factors of mortality. One hundred and forty-seven and 227 neonates had been diagnosed as late-onset sepsis in 2004 and 2008, respectively. Coagulase-negative staphylococcus was the most frequent microorganisms. Gram-negative bacilli, particularly Pseudomonas aeruginosa showed a significant increase in years. The mortality rate was 11.5% and 19% in 2004 a...

Research paper thumbnail of The Effect of Neonatal Jaundice on Long Term Neuromotor Development

The Journal of Tepecik Education and Research Hospital, 2003

Neonatal indirekt hiperbiluribinemi, uzun dönemde nöromotor gelişim üzerine olumsuz etkileri olan... more Neonatal indirekt hiperbiluribinemi, uzun dönemde nöromotor gelişim üzerine olumsuz etkileri olan bir klinik tablodur. Bu çalışmada, ağır indirekt hiperbilirubineminin, nöromotor gelişimin uzun dönemdeki etkilerinin değerlendirilmesi amaçlanmıştır. Yöntem: Bilirubin düzeyleri kan değişimi sınır/arı ve üzerinde bulunan, hemo/iz, asfiksi, enfeksiyon gibi sarılığa yol açacak ek risk faktörü taşımayan 55 ağır hiperbilirubinemili term bebek (Çalışma Grubu) ile aynı yaşlardaki (medyan 22 ay), fizyolojik ikter dışında hiçbir sağlık sorunu olmayan 32 çocuk (Kontrol Grubu) çalişma kapsamına C!_/ınmıştır. Olgular 18-27. aylarında ve takiben 3 ay sonra nörolojik bakı ve Denver Gelişimsel Tarama Testi (DGTT) ile değerlendirilmiştir. Bulgular: DGTT, Çalışma Grubundaki olguların 7'sinde (%12. 7) ANORMAL bulunmuş,bu durum Kontrol Grubu ile istatistiksel fark yaratmİştır {p= 0.04). NORMAL ve ANORMAL DGTT'/i olgular arasında gebelik yaşı, doğum ağırlığı, cinsiyet, başvuru yaşı, yatış süresi ve kan değişimi uygulanan olgu sayısı yönlerinden fark bullunmazken, başvuru indirek bilirubin düzeyleri, sırası i/e 22.1 ± 3. 7 mgldl ve 29.2 ± 6.8 mgldl olup, istatistiksel olarak anlamlı bulunmuştur. Serum indirek bilirubin düzeyi "?.22 mgldl ile <22 mgldl olan olgular arasında Anorma/DGTT yönünden istatistiksel fark tesbit edilmiştir {p=0.03). Sonuç: Yenidoğan dönemindeki ağır hiperbilirubineminin, etkin tedavi yöntemlerine karşın, uzun dönemde, nöromotor gelişimi olumsuz etkilediği ve indirek bilirubinin "?.22 mg/d! değerlerinin, sağlıklı Jerm bebek/erde, nörotoksisite yönünden risk faktörü kabul edilebileceği kanısına varılmıştır.

Research paper thumbnail of Chiari Tip 2 Malformasyonunda Cerrahi Karar Yönetimi: Tek Merkez Deneyimi

Aim: Chiari malformation type II (CM-II) is frequent with meningomyelocele (MMC). We aim to prese... more Aim: Chiari malformation type II (CM-II) is frequent with meningomyelocele (MMC). We aim to present the accurate timing and indications and to reveal the necessity of the CM-II surgery. Materials & Methods: This was a prospective and observational study which involved 25 patients (9 infants operated, 16 infants non-operated). Spinal and cranial MRI examinations were performed on all infants. MMC, CM-II and hydrocephalus of infants were evaluated clinically and radiologically. The operation decision was made for infants who had symptoms of apnea, nourishment, respiratory distress, persistent vomiting and progressive weakness in the upper extremity, and these symptoms were associated with CM-II malformation. The follow-up decision was made independently of the MRIs that did not show these symptoms. Clinical, surgical management and long-term outcomes were compared for both groups. Results: 25 infants were included, 14 of them were male. 9 MMC baby was performed during neonatal period ...

Research paper thumbnail of Macrophage Activation Syndrome in Children with Systemic Juvenile Idiopathic Arthritis Successfully Treated with Megadose Methyl Prednisolone Therapy

Journal of Pediatric Research, Jun 19, 2015

Re cei ved/Ge liş ta ri hi: 18.02.2015 Ac cep ted/Ka bul ta ri hi: 10.04.2015 ABS TRACT ÖZET Macr... more Re cei ved/Ge liş ta ri hi: 18.02.2015 Ac cep ted/Ka bul ta ri hi: 10.04.2015 ABS TRACT ÖZET Macrophage activation syndrome (MAS) is the most common serious and fatal complication of systemic juvenile idiopathic arthritis (SJIA). MAS is most commonly seen in SJIA and there are no true estimates of its incidence. Although it has been considered a rare complication, it is probably more common than it is thought. In the last sixteen years, 240 patients were diagnosed with JIA in our institute. Out of the 240 patients, 16 were diagnosed with SJIA; and four of these 16 SJIA patients had MAS. There is no consensus on the treatment of MAS. Four cases of MAS diagnosed in our institution were administered intravenous mega-dose methylprednisolone (MDMP) as induction therapy successfully without any serious adverse effects. To the best of authors' knowledge, MDMP as a treatment modality in MAS therapy is reported for the first time. Herein, we report the clinical and laboratory data of our cases who received MDMP and evaluate our clinical experience reviewing the literature.

Research paper thumbnail of Comparison of oral and intravenous fluid therapy in newborns with hypernatremic dehydration

The Journal of Maternal-Fetal & Neonatal Medicine, 2013

To evaluate the efficacy and complications of oral and intravenous fluid therapy in newborns with... more To evaluate the efficacy and complications of oral and intravenous fluid therapy in newborns with hypernatremic dehydration. A total of 75 term and near-term (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;35 weeks) neonates with hypernatremic dehydration (Na ≥ 150 mmol/L) were included in this retrospective study. The patients were divided into two groups according to therapy approach for rehydration (breast milk-oral formula and intravenous fluid). The decline in sodium concentration (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.5 mmol/L/h was regarded as safe drop) and complications were analyzed. The mean gestational age, birth weight and age at admission were 38.9 ± 1.4(36-42) weeks, 3341 ± 504 (2500-4500) gram and 4.3 ± 2.6 (1-17) day, respectively. Fever (61.8%) and jaundice (39.4%) were the most common presenting signs. Forty-four (58.6%) of the infants were treated with breast milk and/or oral formula (group 1) and 31 (41.4%) of the infants were treated with IV fluid (group 2). In group 1 and group 2, respectively, mean % weight loss, 5 and 7.5; median serum sodium at admission, 153 and 152 mmol/L; median change in sodium at 12 hours, 7 and 11 mmol/L; and median change in sodium at 24 hours, 10 and 15 mmol/L. The decline in sodium concentration was more safely in group 1 than group 2 at both 12 and 24 hours of rehydration. One patient had convulsion associated with cerebral edema in group 2. Otherwise no complication was observed in both groups. Enteral route for fluid replacement may be safe and effective and may be an alternative to intravenous fluid therapy in newborns with hypernatremic dehydration when clinical situation is stable.

Research paper thumbnail of Traditional methods used in the care of babies of mothers in Muğla province

Ortadoğu tıp dergisi, Sep 1, 2019

Gelenekler, kuşaktan kuşağa ve toplumdan topluma geçen kültür mirasları, alışkanlıklar, bilgiler,... more Gelenekler, kuşaktan kuşağa ve toplumdan topluma geçen kültür mirasları, alışkanlıklar, bilgiler, töreler ve davranışlardır. Bebek bakımıyla ilgili bazı geleneklerde kundaklama gibi güncel tıbbi bilgiyle çelişen uygulamalar bulunmaktadır. Bu tür geleneksel uygulamaların eğitim sonrası büyük ölçüde azaldığı gözlenmektedir. Buna karşılık, ülkemizde bebek tuzlama gibi bazı yan etkileri ciddi sorunlara neden olan geleneksel uygulamaların pek çok yörede hala yaygın olarak uygulandığı bilinmektedir. Çocuk hekimlerinin görev yaptıkları bölgelerdeki halkın geleneklerini tanıması ve eğitici rol üstlenmesi çocuk sağlığının geliştirilmesi açısından önem arz etmektedir. Çalışmamızda Muğla ilimizde bebek bakımındaki geleneksel uygulamaların araştırılması amaçlanmıştır. Hastanemiz Çocuk Sağlığı ve Hastalıkları polikliniğine başvuran 305 anneye bebek bakımındaki geleneksel uygulamalara yönelik olarak anket uygulanmıştır. En sık gözlenen geleneksel uygulama %59,9 ile bebek tuzlama olmuştur. Annelerin eğitim süresiyle geleneksel uygulamalar arasında anlamlı ilişki olduğu görülmüştür. Sonuç olarak annelerin eğitilmesinin bebek bakımında zararlı olma potansiyeli olan geleneksel uygulamaları azaltabileceği kanısına varılmıştır.

Research paper thumbnail of Konjenital Lenfanjiektazinin Neden Olduğu Dirençli Şilöz Asidin Propanolol İle Tedavisi: Olgu Sunumu

Chylous ascites is a rare clinical condition occurring as the result of the extravasation of the ... more Chylous ascites is a rare clinical condition occurring as the result of the extravasation of the chyle into the peritoneal cavity and caused by numerous factors. The most common cause of underlying pathologies are lymphatic vessel disorders. Owing to the lack of the therapeutic and diagnostic standards, individual therapy seems to be extremely important. Octreotide administration, total parenteral nutrition and a diet rich in medium-chain triglycerides constitute first step of the treatment, but surgical intervention may be performed in case of failure of the medical treatment. In literature, there is only one neonate with refractory generalized lymphangiectasia who is treated with propranolol. A newborn baby was admitted to our clinic after delivery due to nonimmune hydropsfetalis and he was diagnosed as lymphangiectasia with lymphoscintigraphy. Herein, we describe the use of propranolol in the therapy of lymphangiectasia in an infant with refractory chylous ascites.

Research paper thumbnail of A newborn with Dubowitz syndrome: a case report

Journal of Dr. Behcet Uz Children s Hospital, 2014

Dubowitz syndrome was first reported in 1965 by Victor Dubowitz. Dubowitz syndrome is a rare auto... more Dubowitz syndrome was first reported in 1965 by Victor Dubowitz. Dubowitz syndrome is a rare autosomal recessive disorder characterized by microcephaly, short stature, abnormal faces, eczematous skin eruption, and mild to severe mental retardation. In this review, we describe a female newborn with microcephaly, micrognathia, high narrow, syndactyly, clinodactyly, ventricular septal defect, poor feeding and sacral dimple. Here, we heard the requirement to report this case because of rarity.

Research paper thumbnail of Assessment of hemodynamic changes in preterm infants with respiratory distress syndrome

Anatolian journal of cardiology, 2017

Research paper thumbnail of Scrotal Hematoma as a Sign of Subcapsular Liver Hematoma in a Preterm Infant

Pediatrics & Neonatology, 2017

Research paper thumbnail of Sleeping Disorders in lnfancy

The Journal of Tepecik Education and Research Hospital, 2003

Süt çocukluğu döneminde uyku bozuklukları çok sayıda ailenin ortak yakınmasıdır. Ailelerin sosyal... more Süt çocukluğu döneminde uyku bozuklukları çok sayıda ailenin ortak yakınmasıdır. Ailelerin sosyal yaşantısını olumsuz yönde etkileyen bu durum, büyük ölçüde ailenin sosyokültürel yapısı ile ilişkilidir. Bu çalışmada, süt çocukluğu döneminde uyku bozukluğuna neden olan faktörlerin araştırılması amaçlanmıştır. Yöntem: Hastanemiz Çocuk Sağlığı ve Hastalıkları Kliniklerine en az 6 aydır süregelen, uyku bozukluğu ile başvuran, organik patolojisi bulunmayan, doğum ağırlığı 2500 g üzerinde, zamanında doğmuş 6-24 ay arası 40 olgu ve aynı özelliklere sahip 70 kontrol olgu çalışma grubu olarak alınmıştır. Uyku bozukluğu üzerine etkili olan faktörler ile ilgili veriler olguların annelerine uygulanan anket formlarından elde edilmiştir. Bulgular: Uyku bozukluğu ile getirilen bebek/erde, uyku süresinin kontrol grubu ile yakınlık gösterdiği, gece uyanma sıklığının ise anlamlı olarak artmış olduğu görüldü (p=O.OOO). Buna karşın her iki grup arasında olgu yaşı, doğum ağırlığı, anne ve baba yaşı, anne sütü ile beslenme süresi, ek gıda/ara başlangıç yaşı, ailedeki kişi ve kardeş sayısı ve anne eğitimi süresi yönünden anlamlı fark bulunmadı. Ancak kontrol grubunda babaların daha yüksek tahsil/i olduğu gözlendi (p=0.008). Uyutulurken obje kullanımı, aydınlık ortamda uyuma yüzdesi ve saliayarak uyutma kontrol grubunda çalışma grubuna göre anlamlı derecede yüksek idi (sırasıyla p=O.OOO, p=0.04, p=0.004). Kundakla uyutma çalışma grubunda daha sık kullanılan bir yöntem olarak bulundu (p=O.Oll). Buna karşın uyutu/madan önceki beslenme özellikleri ve çocuğun uyuduğu yerin her iki grup için farklılık göstermediği dikkati çekti. Sonuç: Süt çocukluğu dönemindeki uyku bozukluklarının geceleri sık uyanma ile karakterize olduğu ve bebeğin uyutu/ma biçimi yanısıra ebeveyn/erin tutumu ve uyuma ortamı ile ilişkili olabileceği kanısına varılmıştır.

Research paper thumbnail of The mechanical properties and stiffness of aorta in obese children

The Turkish journal of pediatrics

Obesity in children has also been associated with the development of early cardiovascular abnorma... more Obesity in children has also been associated with the development of early cardiovascular abnormalities. The aim of this study was to investigate the relationship between aortic stiffness and some risk factors in obese children. Sixty obese children and 60 age- and sex-matched healthy controls were assessed. The mechanical property parameters were measured or computed: lumen diastolic and systolic diameters, aortic strain and elastic modules. Compared to controls, obese children had altered stiffness values of the aorta, whereas strain was not different. Compared to controls, obese children had higher systolic and diastolic blood pressure values. Insulin level, homeostasis model assessment (HOMA) score, and total cholesterol, triglycerides, lowdensity lipoprotein (LDL), and leptin levels were significantly higher, while adiponectin, high-density lipoprotein (HDL) levels and quantitative insulin sensitivity check index (QUICKI) scores were significantly lower in obese children than i...

Research paper thumbnail of Isolated Retrovesical Cyst Hydatid in a Child: An Unusual Presentation of Echinococcosis

Journal of Tropical Pediatrics, 2004

Research paper thumbnail of Preterm infantta katater ilişkili sepsisin neden olduğu kardiyak tamponad

Ege Tıp Dergisi, 2019

Cardiac tamponade due to catheter related sepsis in premature neonate is a rare and life-threaten... more Cardiac tamponade due to catheter related sepsis in premature neonate is a rare and life-threatening complication; but prompt diagnosis and intervention can reverse this situation. We report a nine-day-old preterm infant who presented with pericardial effusion and cardiac tamponade secondary to catheter related sepsis. This report highlights two important aspects: occurrence of pericardial effusion in a neonate with peripherally inserted central venous catheter (PICC), with no evidence of composition of hyperosmolar parenteral solution, and awareness of sepsis as a cause for this critical condition.

Research paper thumbnail of Meningomyelosel Olgularında Prognozu Etkileyen Faktörler ve Eşlik Eden Anomaliler: 40 Olguluk Deneyim

Aim: The aim of this study was to determine clinical features and short-term prognosis of hospita... more Aim: The aim of this study was to determine clinical features and short-term prognosis of hospitalized neonates with meningomyelocele, and to asses the association between the serum levels of vitamin D and meningomyelocele. Material and Methods: In this single center retrospective study, all infants with meningomyelocele were considered eligible. This study was conducted in Tepecik Training and Research Hospital between January 2014 and December 2015. Data of the patients were noted from the medical records. Results: A total of 40 infants with meningomyelocele were eligible for the study. The mean gestational age of infants was 38.6 ± 2.2 weeks and mean birth weight was 3099 ± 553 g. None of the mothers had taken folic acid support preconceptionally. The meningomyelocele was localized in lumbar (80%), thoracolumbar (12.5%) and cervical (7.5%) areas. The average time of surgical operation for meningomyelocele was 5.1 ± 4.65 days and the rate of operation in the first 72 hours of lif...

Research paper thumbnail of Servi̇kal Meni̇ngomyeloselli̇ Yeni̇doğanlarin Kli̇ni̇k Ve Cerrahi̇ Yöneti̇mi̇

AMAC: Servikal yerlesimli meningomyeloseller; torakal, lomber ve sakral lokalizasyonlu olanlardan... more AMAC: Servikal yerlesimli meningomyeloseller; torakal, lomber ve sakral lokalizasyonlu olanlardan farklidir. Calismamizda; servikal meningomyeloselin klinigini, eslik eden anomalileri, radyolojisini, cerrahi oncesi ve sonrasindaki hasta izlemini, cerrahi yaklasimi ve prognozunu degerlendirmeyi amacladik. GEREC VE YONTEM: 1 Ocak 2012 - 31 Aralik 2016 tarihleri arasinda meningomyelosel nedeniyle 3. basamak yenidogan yogun bakima yatirilan 88 yenidoganin 2’si servikal yerlesimliydi. Servikal meningomyeloselli hastalarin klinigi, radyolojisi, cerrahi teknigi, cerrahi oncesi ve sonrasi yonetimi ile prognozu prospektif olarak incelendi. Hastalarin psikomotor gelisimleri postnatal 18. ayda Denver Gelisimsel Tarama Testi ile degerlendirildi. BULGULAR: Ortalama gestasyonel yasi 39.5 hafta olan bir erkek bir kiz yenidoganin ortalama dogum agirliklari 3635 gr ve keselerinin ortalama capi 5x5 cm idi. Motor defisiti olmayan her iki hastanin manyetik rezonans goruntulemelerinde kese icinde noral ...

Research paper thumbnail of Effect of humic acid on oxidative stress and neuroprotection in hypoxic-ischemic brain injury: part 1

The Journal of Maternal-Fetal & Neonatal Medicine, 2020

Background: Aimed to investigate in an animal model the efficacy of humic acid by showing its ant... more Background: Aimed to investigate in an animal model the efficacy of humic acid by showing its antioxidant and anti-apoptotic effect comparing with the histopathological and neurological outcomes for the hypoxic-ischemic brain injury. Methods: 28 Wistar-Albino rats who were on the 7th postnatal day and weighting between 9 and 19 g randomly divided into four groups with developed HIE model under the gas anesthesia. 20 mg/kg and 10 mg/kg intraperitoneal HA were given to Group I and II respectively. Saline was given to Group III and the sham group was Group IV. The brain tissues were stained with cresyl-violet histochemistry for grading neuronal cell injury and caspase immunohistochemistry. Results: The neuronal cell injury was statistically lower in all neuroanatomical lands in HA treatment groups. The degree of ischemia was significantly smaller in HA groups. Caspase-3 immunoreactivity was decreased in the HA groups compared with the saline group. When the groups were compared, there were no serious neuronal injury in Group I. Conclusions: This is the first study which investigates the role of HA in HIE model. HA reduces apoptosis and neuronal injury in cerebral tissue of the rats. This findings suggest that HA may be viable protective agent against HIE.

Research paper thumbnail of Solitary median maxillary central incisor, holoprosencephaly and congenital nasal pyriform aperture stenosis in a premature infant: case report

Archivos argentinos de pediatria, 2018

Solitary median maxillary central incisor syndrome is a rare disorder involving midline abnormali... more Solitary median maxillary central incisor syndrome is a rare disorder involving midline abnormalities such as holoprosencephaly, nasal cavity anomalies, cleft palate-lip, hypotelorism, microcephaly, and panhypopituitarism. Congenital nasal pyriform aperture stenosis is a lethal cause of neonatal respiratory distress due to narrowing of the pyriform aperture anteriorly and it can be confused with choanal atresia. In this report, we present a newborn infant with solitary median maxillary central incisor syndrome accompanied by other abnormalities including holoprosencephaly, nasal pyriform aperture stenosis, microcephaly and panhypopituitarism. Chromosomal analysis showed heterozygous SIX3 gene deletion at 2p21 region resulting in a more severe form of holoprosencephaly.

Research paper thumbnail of Prevalência e fatores de risco associados à colonização por enterococos resistente à vancomicina

Revista de Ciências Médicas e Biológicas, 2009

Os enterococos foram reconhecidos como patógenos clinicamente importantes na população de alto ri... more Os enterococos foram reconhecidos como patógenos clinicamente importantes na população de alto risco de pacientes hospitalizados. Os objetivos deste estudo foram detectar a prevalência da colonização por enterocos intestinais resistentes à vancomicina (VRE) no Hospital Tepecik, Izmir, Turquia, entre pacientes dos serviços de alto risco e os fatores de risco relacionados com a resistência em pacientes internados onde a VRE foi raramente isolada anteriormente. Após o primeiro isolamento de VRE em dois pacientes na unidade de terapia intensiva (UTI) e UTI neonatal, no mesmo dia, foi realizado um levantamento de prevalência utilizando swab retal. Para efeito de comparação, 30 amostras de pacientes-controle do serviço de controle de medicina interna também foram analisadas. Noventa e três pacientes foram investigados. Dezoito pacientes (19,3%) foram considerados portadores de VRE, apesar de nenhum dos pacientes do grupo controle tinham VRE. Treze cepas foram identificadas como Enterococc...

Research paper thumbnail of Comparison of CrIb-II and Snap-Pe-II Scoring Systems in Predicting the Mortality and Morbidity of Very Low Birth Weight Infants

Turkish Journal of Pediatric Disease, 2017

Objective: A number of illness severity scores have been established to predict mortality and mor... more Objective: A number of illness severity scores have been established to predict mortality and morbidity in neonatal intensive care units (NICUs). The objective of this study was to compare SNAPPE-II (Scores for Neonatal Acute Physiology-Perinatal Extension-II) and CRIB-II (Clinical Risk Index for Babies-II), the latest versions of European and American scoring systems, in predicting hospital mortality and overall morbidity of surviving infants. Material and Methods: Very low birthweight infants (VLBW) admitted to the neonatal intensive care unit were identified. CRIB-II and SNAP-PE-II scores were electronically calculated for each patient via the website www.sfar.org. The receiver operating characteristics (ROC) curve was used to check the accuracy of the mortality and morbidity prediction. results: A total of 189 VLBW neonates (mean CRIB-II:9.9±3.8; mean SNAP-PE-II: 45.8±25.4) were evaluated. The mean birth weight, gestational age, CRIB-II, SNAP-PE-II scores were associated with mortality. Both CRIB-II and SNAP-PE-II were determined to be discriminatory for mortality, but not predictive enough for morbidity when evaluated with ROC curve analysis. conclusion: Both CRIB-II and SNAP-PE-II were found to be eligible in predicting hospital mortality of VLBW patients whereas their value was poor in predicting morbidity. CRIB-II, due to fewer parameters to evaluate, may be the preferred scoring system to predict mortality in NICUs with high patient capacity.

Research paper thumbnail of Change in Pathogens Causing Late-onset Sepsis in Neonatal Intensive Care Unit in Izmir, Turkey

Iranian journal of pediatrics, 2010

Neonatal sepsis is a common cause of morbidity and mortality among newborns in the developing wor... more Neonatal sepsis is a common cause of morbidity and mortality among newborns in the developing world. We have investigated the causative agents and their antimicrobial susceptibility of late-onset sepsis (>72 h post-delivery), and determined the possible association between various risk factors and the mortality due to neonatal sepsis in 2008. To view the changes in years, we compared them with the data which we gained in 2004. Medical records of all neonates with late-onset sepsis were reviewed for demographic characteristics (birth weight, gestational age, gender, type of delivery, and mortality rate), positive cultures and risk factors of mortality. One hundred and forty-seven and 227 neonates had been diagnosed as late-onset sepsis in 2004 and 2008, respectively. Coagulase-negative staphylococcus was the most frequent microorganisms. Gram-negative bacilli, particularly Pseudomonas aeruginosa showed a significant increase in years. The mortality rate was 11.5% and 19% in 2004 a...

Research paper thumbnail of The Effect of Neonatal Jaundice on Long Term Neuromotor Development

The Journal of Tepecik Education and Research Hospital, 2003

Neonatal indirekt hiperbiluribinemi, uzun dönemde nöromotor gelişim üzerine olumsuz etkileri olan... more Neonatal indirekt hiperbiluribinemi, uzun dönemde nöromotor gelişim üzerine olumsuz etkileri olan bir klinik tablodur. Bu çalışmada, ağır indirekt hiperbilirubineminin, nöromotor gelişimin uzun dönemdeki etkilerinin değerlendirilmesi amaçlanmıştır. Yöntem: Bilirubin düzeyleri kan değişimi sınır/arı ve üzerinde bulunan, hemo/iz, asfiksi, enfeksiyon gibi sarılığa yol açacak ek risk faktörü taşımayan 55 ağır hiperbilirubinemili term bebek (Çalışma Grubu) ile aynı yaşlardaki (medyan 22 ay), fizyolojik ikter dışında hiçbir sağlık sorunu olmayan 32 çocuk (Kontrol Grubu) çalişma kapsamına C!_/ınmıştır. Olgular 18-27. aylarında ve takiben 3 ay sonra nörolojik bakı ve Denver Gelişimsel Tarama Testi (DGTT) ile değerlendirilmiştir. Bulgular: DGTT, Çalışma Grubundaki olguların 7'sinde (%12. 7) ANORMAL bulunmuş,bu durum Kontrol Grubu ile istatistiksel fark yaratmİştır {p= 0.04). NORMAL ve ANORMAL DGTT'/i olgular arasında gebelik yaşı, doğum ağırlığı, cinsiyet, başvuru yaşı, yatış süresi ve kan değişimi uygulanan olgu sayısı yönlerinden fark bullunmazken, başvuru indirek bilirubin düzeyleri, sırası i/e 22.1 ± 3. 7 mgldl ve 29.2 ± 6.8 mgldl olup, istatistiksel olarak anlamlı bulunmuştur. Serum indirek bilirubin düzeyi "?.22 mgldl ile <22 mgldl olan olgular arasında Anorma/DGTT yönünden istatistiksel fark tesbit edilmiştir {p=0.03). Sonuç: Yenidoğan dönemindeki ağır hiperbilirubineminin, etkin tedavi yöntemlerine karşın, uzun dönemde, nöromotor gelişimi olumsuz etkilediği ve indirek bilirubinin "?.22 mg/d! değerlerinin, sağlıklı Jerm bebek/erde, nörotoksisite yönünden risk faktörü kabul edilebileceği kanısına varılmıştır.

Research paper thumbnail of Chiari Tip 2 Malformasyonunda Cerrahi Karar Yönetimi: Tek Merkez Deneyimi

Aim: Chiari malformation type II (CM-II) is frequent with meningomyelocele (MMC). We aim to prese... more Aim: Chiari malformation type II (CM-II) is frequent with meningomyelocele (MMC). We aim to present the accurate timing and indications and to reveal the necessity of the CM-II surgery. Materials & Methods: This was a prospective and observational study which involved 25 patients (9 infants operated, 16 infants non-operated). Spinal and cranial MRI examinations were performed on all infants. MMC, CM-II and hydrocephalus of infants were evaluated clinically and radiologically. The operation decision was made for infants who had symptoms of apnea, nourishment, respiratory distress, persistent vomiting and progressive weakness in the upper extremity, and these symptoms were associated with CM-II malformation. The follow-up decision was made independently of the MRIs that did not show these symptoms. Clinical, surgical management and long-term outcomes were compared for both groups. Results: 25 infants were included, 14 of them were male. 9 MMC baby was performed during neonatal period ...