Gulcan Turker - Academia.edu (original) (raw)
Papers by Gulcan Turker
European Respiratory Journal, Sep 1, 2012
Number: 4234 Publication Number: P4140 Abstract Group: 7.5. Neonatology and Paediatric Intensive ... more Number: 4234 Publication Number: P4140 Abstract Group: 7.5. Neonatology and Paediatric Intensive Care
Mikrobiyoloji Bulteni, Apr 1, 2008
Cytomegalovirus (CMV) infections are commonly seen in humans and are usually mild or asymptomatic... more Cytomegalovirus (CMV) infections are commonly seen in humans and are usually mild or asymptomatic. However, these infections have significant medical risks in pregnant women, newborns and immunocompromised patients. Seronegative subjects and infants acquire CMV through infected blood products or direct contact with infected people. The use of seronegative blood products for selected patients, as in newborns and/or immunosuppressed patients has vital importance in medical management. Providing seronegative blood in countries where the prevalence of CMV is high (>90%), is difficult since this requires screening of a great number of blood donations. The aim of this study was to detect the CMV seroprevalence among voluntary blood donors in Kocaeli (located at northwestern region of Turkey) and to determine whether the screening procedure was cost-effective. CMV-IgG was investigated by a commercial ELISA method (AXSYM, Abbott, USA) in 1264 blood donors who were voluntarily admitted to donate blood for newborns between January to December 2006. In 1229 (97.2%) of these donors CMV-IgG was found positive while it was negative in 35 (2.8%). It was estimated that CMV-IgG screening was not cost-effective to provide seronegative blood donations because of the high rate of seropositivity in Kocaeli as well as other regions of Turkey, so it would be more favorable to apply alternative methods such as leukocyte reduction.
Marmara Medical Journal, 2004
Objective: Alpha fetoprotein (AFP) is an important tumor marker in childhood. However, AFP levels... more Objective: Alpha fetoprotein (AFP) is an important tumor marker in childhood. However, AFP levels remain high during the first few months of life, making clinical interpretation difficult in this period. The aim of the present study is to determine normal AFP levels in healthy full-term neonates and infants followed-up at Kocaeli University Hospital, Department of Pediatrics.
In this paper, two cases with mucolipidosis type II (I-cell disease) (proven in one presenting ne... more In this paper, two cases with mucolipidosis type II (I-cell disease) (proven in one presenting newborn and presumed in an elder deceased brother) are presented. These infants showed severe skeletal changes with diffuse periosteal new bone formation in long bones and ribs, marked osteopenia, and resorption of scapula, clavicula, and mandible. There was also irregular demineralization of metaphyses of long
Pediatrics international : official journal of the Japan Pediatric Society, Jan 11, 2015
There is a paucity of data on lung physiology in late-preterm who may be exposed to a risk of dec... more There is a paucity of data on lung physiology in late-preterm who may be exposed to a risk of decline in lung functions during childhood. In this study, we aimed to evaluate the lung function in preschool children born late-preterm using impulse oscillometry (IOS) and to compare the results with those obtained in healthy term-born children. Children between 3 and 7 years of age born late-preterm who are currently being followed-up at the outpatient clinic were included as the late-preterm group. Age matched healthy term-born children served as controls. A total of 90 late-preterm and 75 healthy children were included in the study. At 5-20 Hz, resistances (R5-R20), reactances (X5-X20) and resonant frequency were measured by IOS. The mean IOS R5 and R10 values were significantly higher in late-preterm group than those in the control group (p < 0.05). The mean values of R5, R10 and Z5 were statistically higher in late-preterms who had been hospitalized for pulmonary infections as co...
International Medical Journal (1994)
Objective: Environmental pollution has become a global issue affecting the public health. The pur... more Objective: Environmental pollution has become a global issue affecting the public health. The purpose of this study was to measure the particle mass (PM10) and heavy metal concentrations in the air of industrial and non-industrial districts in an industrial city and to determine if heavy metals are present in the colostrum of mothers and meconium of newborns. Material and Method: PM10 presence and concentration per unit volume were determined in air samples using the Equal Pay Act-29 technique. The presence of heavy metals in PM10 and their amounts per unit volume were determined using Inductively Coupled Plasma-Mass Spectroscopy (ICP-MS) and cold vapor Atomic Absorption Spectroscopy. The colostrum and meconium samples were analyzed using ICP-MS and Inductively Coupled Plasma Optical-Emission Spectroscopy. Results: The mean PM10 levels in both districts were higher than World Health Organization limit values. The mean heavy metal concentrations of Al, As, Cd, Cu, Fe, Hg, Pb and Zn i...
Turkiye Klinikleri Journal of Medical Sciences
Pediatrics international : official journal of the Japan Pediatric Society, 2012
Although the effects of cardiac troponin I (cTnI) have been documented in infants, the associatio... more Although the effects of cardiac troponin I (cTnI) have been documented in infants, the associations among the value of maternal and cord blood total homocysteine (Hcy) levels, cord blood cTnI and the score for neonatal acute physiology and perinatal extension II (SNAPPE-II) values in infants have not been documented. The aim of this study was to determine the value of maternal total Hcy (mtHcy) and cord blood total Hcy (ctHcy) levels, cTnI and SNAPPE-IIas predictive factors of morbidity in newborns. Maternal and cord blood samples were routinely collected for analysis from all prospective participating volunteers. In this case–control study, both hospitalized (n = 71) and non-hospitalized (n = 148) newborns were identified and followed until discharge. Regression analysis revealed that pre-eclampsia, gestational age, mtHcy and SNAPPE-II values were significantly and independently associated with morbidity. Cord blood pH, ctHcy levels, SNAPPE-II values, and pre-eclampsia were associa...
Mikrobiyoloji bülteni, 2008
Cytomegalovirus (CMV) infections are commonly seen in humans and are usually mild or asymptomatic... more Cytomegalovirus (CMV) infections are commonly seen in humans and are usually mild or asymptomatic. However, these infections have significant medical risks in pregnant women, newborns and immunocompromised patients. Seronegative subjects and infants acquire CMV through infected blood products or direct contact with infected people. The use of seronegative blood products for selected patients, as in newborns and/or immunosuppressed patients has vital importance in medical management. Providing seronegative blood in countries where the prevalence of CMV is high (>90%), is difficult since this requires screening of a great number of blood donations. The aim of this study was to detect the CMV seroprevalence among voluntary blood donors in Kocaeli (located at northwestern region of Turkey) and to determine whether the screening procedure was cost-effective. CMV-IgG was investigated by a commercial ELISA method (AXSYM, Abbott, USA) in 1264 blood donors who were voluntarily admitted to...
The Turkish journal of pediatrics
In this paper, two cases with mucolipidosis type II (I-cell disease) (proven in one presenting ne... more In this paper, two cases with mucolipidosis type II (I-cell disease) (proven in one presenting newborn and presumed in an elder deceased brother) are presented. These infants showed severe skeletal changes with diffuse periosteal new bone formation in long bones and ribs, marked osteopenia, and resorption of scapula, clavicula, and mandible. There was also irregular demineralization of metaphyses of long tubular bones, as seen in rickets. The activities of serum alkaline phosphatase and parathyroid hormone were markedly elevated. Phosphorus was decreased. Serum 1,25-dihydroxyvitamin D was slightly elevated, but 25-hydroxyvitamin D and calcium were normal. Dysostosis multiplex resembling rickets and very high alkaline phosphatase activity were due to defective osteoblastic activity, but the mechanism of elevated parathyroid hormone was not clear. We conclude that early skeletal manifestation of mucolipidosis type II is not clearly identified and that differentiation from congenital r...
Türk Pediatri Arşivi, 2011
... İstatistiksel analiz Verilerin istatistiksel analizi, SPSS-13 programında yapıldı. ... Dalı, ... more ... İstatistiksel analiz Verilerin istatistiksel analizi, SPSS-13 programında yapıldı. ... Dalı, Umuttepe Kampusu, 41380, Kocaeli, Türkiye Tel.: +90 262 303 72 17 Faks: +90 262 303 80 03 E-posta: gulcanturker@superonline.com-gulcanturker@kocaeli.edu.tr ... Uzmanlık tezi, İstanbul 2006. ...
Cardiovascular Journal Of Africa, 2014
Objective: This study aimed to evaluate the aetiology, spectrum, course and outcomes of neonates ... more Objective: This study aimed to evaluate the aetiology, spectrum, course and outcomes of neonates with arrhythmias observed in a tertiary neonatal intensive care unit from 2007 to 2012. Methods: Neonates with rhythm problems were included. The results of electrocardiography (ECG), Holter ECG, echocardiography and biochemical analysis were evaluated. The long-term results of follow up were reviewed. Results: Forty-five patients were male (68%) and 21 (32%) were female. Fifty-five patients (83.3%) were term, 11 (16.6%) were preterm, and 34% were diagnosed in the prenatal period. Twenty cases (30.3%) had congenital heart disease. Twenty-three patients (34.8%) were diagnosed during the foetal period. The most common arrhythmias were supraventricular ectopic beats and supraventricular tachycardia (SVT) at 39.3 and 22.7%, respectively. SVT recurred in five patients after the neonatal period. Conclusion: Supraventricular ectopic beats and SVT were the most common arrhythmias during the neonatal period. Although the prognosis of arrhythmias in the neonatal period is relatively good, regular monitoring is required.
Turkiye Klinikleri Journal of Medical Sciences, 2010
ABSTRACT Objective: Troponin is an inhibitory protein complex located on the actin flament in all... more ABSTRACT Objective: Troponin is an inhibitory protein complex located on the actin flament in all striated muscles. Cardiac Troponin I is found only in the heart and has been used as a sensitive and specific marker of myocardial injury. Our aim was to investigate the different percentile limits and determinants of cord blood cardiac Troponin I (Tn I) concentrations. Material and Methods: A total of 378 consecutive healthy neonates were included in the study. Umbilical cord arterial and venous blood samples were obtained at the time of delivery. Concentrations and determinants of cardiac Tn I were analyzed using multivariate analysis, and percentile values were calculated. Results: Multivariate analyses showed that gestational age in weeks (B= -0.17, p= 0.02, t= -2.3) and fetal gender (B= -0.11, p=0.03, t= -2.08) were independent determinants of cord blood cardiac Tn I concentrations. The cases were divided into term 07 weeks of gestation) and pretem (<37 weeks of gestation) subgroups for the ease of clinical evaluation. The demographic variables of mothers of term and preterm infants were similar (p> 0.05) except for gestational age (p< 0.01). Mothers of preterm cases had significantly more frequent tocolytic therapy, early rupture of membranes, hypertension and cesarean delivery (p< 0.01). Term infants had more frequent labor induction and labor augmentation (p< 0.01). The 99th percentile limits of cardiac Tn I were 3.8 ng/ml in male (n= 47) and 0.8 ng/ml in female (n= 32) for pre-terms. In term neonates, these values were 2.7 ng/ml in males (n= 166) and 3.1 ng/ml in females (n= 133). Conclusion: This study reports the different cardiac Tn I percentile limits in a neonatal population. Our results suggested that the upper reference limits for cardiac Tn I may vary according to gestational age and gender.
Pediatrics International, 2011
The aim of the present study was to determine, using the score for neonatal acute physiology and ... more The aim of the present study was to determine, using the score for neonatal acute physiology and perinatal extension II (SNAPPE-II), whether there is an association with acute renal failure (ARF) and whether it is possible to identify newborns at risk for ARF prior to a rise in creatinine in newborns. Methods: Information on postnatal risk factors and SNAPPE-II on the first day of life (non-ARF group, n = 475; ARF group, n = 78) were collected. Renal failure was defined as serum creatinine level >1 mg/dL and >1.3 mg/dL (for 333 weeks and <33 weeks, respectively) after 48 h of life. Results: In newborns with ARF (n = 78), the median (range) of SNAPPE-II and mortality rate were significantly higher than those of the control group. Patent ductus arteriosus (PDA), disseminated intravascular coagulation (DIC), SNAPPE-II, and resuscitation were identified as independent predictors of ARF in infants on forward stepwise logistic regression. Sepsis, respiratory distress syndrome, ARF, DIC, and SNAPPE-II were identified as independent predictors of mortality in infants on the same analysis. Conclusions: SNAPPE-II on the first day of life was significantly higher among babies with ARF, suggesting a positive association between higher scores and the development of ARF and mortality, but based on receiver operating characteristic curve results, SNAPPE-II at admission did not enhance the assessment of risk for ARF prior to a rise in creatinine.
Journal of Maternal-Fetal and Neonatal Medicine, 2004
Objectives: The aims of this study were to (a) establish a reference range for cardiac troponin I... more Objectives: The aims of this study were to (a) establish a reference range for cardiac troponin I (cTnI) in the cord blood of healthy infants, and (b) investigate the effect of Apgar score, cord blood gas, gestational age, and creatine kinase (CK) and creatine kinase MB (CK-MB) fraction levels on cord blood cTnI levels. Methods: 112 perinatal hypoxic and 84 control newborns without perinatal hypoxia were enrolled in this study. Cord blood samples were collected from the babies for arterial blood gas analysis, cTnI, CK and CK-MB measurements. Gestational age, birth weight, sex, Apgar score and history of fetal distress were recorded. Hypoxic ischemic encephalopathy (HIE) group, hypoxic but without HIE group and control groups were identified according to clinical observations during the first 72 h in the newborn unit. Results: HIE and perinatal hypoxic without HIE groups had a significantly higher cord blood cTnI level according to the control group (1.8 ng/mL (0-13), 0 ng/ml (0-1.1) and 0 ng/ml (0-0.3) respectively). Cord blood cTnI level did not have a correlation with birth weight and gestational age (r = 70.02, p 4 0.05 and r = 0.08, p 4 0.05 respectively). Cord blood cTnI level also had a negative correlation with pH, bicarbonate, base deficit, and Apgar score (r = 70.40, p 5 0.001; r = 70.39 p 5 0.001; r = 70.45 p 5 0.001; r = 70.41, p 5 0.001) respectively). Cord blood cTnI level showed a positive correlation with CK and CK-MB levels (r = 0.45, p 5 0.001 and r = 0.37, p 5 0.001 respectively). Receiver operator curve analysis revealed that the most sensitive factor for prediction of perinatal hypoxia is cord cTnI value [area under curve = 0.929]. The optimal cut-off value of cord cTnI was 0.35 ng/ml for hypoxia. Conclusion: cTnI levels in the cord blood are not affected by gestational age and birth weight. cTnI together with CK and CK-MB has been found to be elevated in hypoxic infants compared to normal infants. Therefore cTnI may be an indicator for perinatal hypoxia in neonates.
Pediatric Research, 2010
ABSTRACT Aim: To assess the effect of early parenteral amino acids, on growth and neurodevelopmen... more ABSTRACT Aim: To assess the effect of early parenteral amino acids, on growth and neurodevelopment of very low birth weight infants at 36 weeks' postmenstrual age and 18 months' corrected age.
Pediatric Research, 2010
ABSTRACT Background: Many studies suggest an association between heavy metals in the blood or pla... more ABSTRACT Background: Many studies suggest an association between heavy metals in the blood or placenta and premature birth. However, there have been no studies that show an association between premature birth and exposure to trace elements at toxic levels in the meconium. The meconium is a matrix that can be obtained easily and noninvasively and is representative of a wide period of exposure in the fetus during gestation. Aim. The purpose of this study was to measure the levels of toxic metals (lead, cadmium) and trace elements (zinc, iron, copper) in meconium samples and to understand their association with prematurity.Method: Metal and trace element levels in the meconium of 810 infants were measured with a flame atomic absorption spectrophotometer.Results: Toxic metals and trace element levels in the meconium were significantly higher in preterm compared to term infants (for all p< 0.0001). In the regression analysis, it was shown that meconium metal levels were among the risk factors for prematurity.Conclusion: These results suggest that exposure to toxic metals and trace elements at toxic levels are among the risk factors for prematurity.
Nephrology Dialysis Transplantation, 2004
Factor H deficiency is reported infrequently, however, it has been associated with a variety of r... more Factor H deficiency is reported infrequently, however, it has been associated with a variety of renal diseases . Here we report the second case of factor H complement deficiency presenting with fibrillary glomerulonephritis.
Biology of the Neonate, 2004
In most perinatal-hypoxia survivors, myocardial dysfunction can be reversed with appropriate inot... more In most perinatal-hypoxia survivors, myocardial dysfunction can be reversed with appropriate inotropic support and oxygenation. The main problem related to outcome is cerebral damage. We tested the hypothesis that cardiac troponin I (cTnI), a known marker of myocardial injury, is also an early predictor of severity of cerebral damage and mortality in intrauterine hypoxia. Venous and arterial cord blood samples were collected at delivery from 54 consecutive newborns with hypoxic-ischemic encephalopathy and from 50 consecutive healthy controls. Arterial blood gas analysis was performed and levels of cTnI, creatine kinase and creatine kinase-MB in venous cord blood were measured. The same serum parameters were also measured on the 3rd and 7th day of life. Infants with hypoxia had a significantly higher cord blood cTnI levels than controls (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Cord blood and 3rd and 7th day serum cTnI values showed a significant increase with severity of HIE (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). In non-survivors cord blood cTnI levels were significantly higher than the survivors (5.9 ng/ml, range 2.1-12.8, and 1.6 ng/ml, range 0.4-5.8, respectively; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Receiver-operator curve analysis revealed cord cTnI as the most sensitive factor for predicting early death (area under curve = 0.956; SE: 0.028; 95% CI: 0.9-1.01). Cord blood cTnI of 4.6 ng/ml was identified as the optimal cut-off level for predicting serious risk of early mortality. The results suggest that significant elevation of cord cTnI is an excellent early predictor of severity of hypoxic-ischemic encephalopathy and mortality in term infants.
Journal of Perinatal Medicine, 2000
To determine the value of cord blood cardiac troponin I levels (cTnI) as an early prognostic fact... more To determine the value of cord blood cardiac troponin I levels (cTnI) as an early prognostic factor in critically ill newborns, and to compare cord cTnI levels with the prognostic value of the score for neonatal acute physiology (SNAP). Methods: Cord arterial samples were collected routinely for blood gas analysis, and cord venous samples for cTnI and cardiac-specific creatine kinase assay. The study group (ns109) comprised critically ill newborns who required mechanical ventilation. The control group (ns96) comprised newborns who were either completely healthy (ns48) or were followed in a level I neonatal care unit due to moderate-severity problems. Results: The critically ill newborns had significantly higher cTnI levels than control babies (median wmin-maxx 1.4 w0-13x vs. 0 w0-1.8x ng/mL, respectively; P-0.001). In critically ill newborns, non-survivors had significantly higher cTnI levels than survivors (median wmin-maxx 6.6 w1.3-13.0x vs. 1.3 w0-8.0x ng/mL, respectively; P-0.001). Receiver-operator curve analysis revealed that, compared with SNAP, cTnI was a more sensitive predictor of mortality in critically ill newborns (area under curves0.96; 95% CIs0.90-1.02). Conclusion: Significantly elevated cord cTnI may be a valuable predictor of mortality in critically ill newborns.
European Respiratory Journal, Sep 1, 2012
Number: 4234 Publication Number: P4140 Abstract Group: 7.5. Neonatology and Paediatric Intensive ... more Number: 4234 Publication Number: P4140 Abstract Group: 7.5. Neonatology and Paediatric Intensive Care
Mikrobiyoloji Bulteni, Apr 1, 2008
Cytomegalovirus (CMV) infections are commonly seen in humans and are usually mild or asymptomatic... more Cytomegalovirus (CMV) infections are commonly seen in humans and are usually mild or asymptomatic. However, these infections have significant medical risks in pregnant women, newborns and immunocompromised patients. Seronegative subjects and infants acquire CMV through infected blood products or direct contact with infected people. The use of seronegative blood products for selected patients, as in newborns and/or immunosuppressed patients has vital importance in medical management. Providing seronegative blood in countries where the prevalence of CMV is high (>90%), is difficult since this requires screening of a great number of blood donations. The aim of this study was to detect the CMV seroprevalence among voluntary blood donors in Kocaeli (located at northwestern region of Turkey) and to determine whether the screening procedure was cost-effective. CMV-IgG was investigated by a commercial ELISA method (AXSYM, Abbott, USA) in 1264 blood donors who were voluntarily admitted to donate blood for newborns between January to December 2006. In 1229 (97.2%) of these donors CMV-IgG was found positive while it was negative in 35 (2.8%). It was estimated that CMV-IgG screening was not cost-effective to provide seronegative blood donations because of the high rate of seropositivity in Kocaeli as well as other regions of Turkey, so it would be more favorable to apply alternative methods such as leukocyte reduction.
Marmara Medical Journal, 2004
Objective: Alpha fetoprotein (AFP) is an important tumor marker in childhood. However, AFP levels... more Objective: Alpha fetoprotein (AFP) is an important tumor marker in childhood. However, AFP levels remain high during the first few months of life, making clinical interpretation difficult in this period. The aim of the present study is to determine normal AFP levels in healthy full-term neonates and infants followed-up at Kocaeli University Hospital, Department of Pediatrics.
In this paper, two cases with mucolipidosis type II (I-cell disease) (proven in one presenting ne... more In this paper, two cases with mucolipidosis type II (I-cell disease) (proven in one presenting newborn and presumed in an elder deceased brother) are presented. These infants showed severe skeletal changes with diffuse periosteal new bone formation in long bones and ribs, marked osteopenia, and resorption of scapula, clavicula, and mandible. There was also irregular demineralization of metaphyses of long
Pediatrics international : official journal of the Japan Pediatric Society, Jan 11, 2015
There is a paucity of data on lung physiology in late-preterm who may be exposed to a risk of dec... more There is a paucity of data on lung physiology in late-preterm who may be exposed to a risk of decline in lung functions during childhood. In this study, we aimed to evaluate the lung function in preschool children born late-preterm using impulse oscillometry (IOS) and to compare the results with those obtained in healthy term-born children. Children between 3 and 7 years of age born late-preterm who are currently being followed-up at the outpatient clinic were included as the late-preterm group. Age matched healthy term-born children served as controls. A total of 90 late-preterm and 75 healthy children were included in the study. At 5-20 Hz, resistances (R5-R20), reactances (X5-X20) and resonant frequency were measured by IOS. The mean IOS R5 and R10 values were significantly higher in late-preterm group than those in the control group (p < 0.05). The mean values of R5, R10 and Z5 were statistically higher in late-preterms who had been hospitalized for pulmonary infections as co...
International Medical Journal (1994)
Objective: Environmental pollution has become a global issue affecting the public health. The pur... more Objective: Environmental pollution has become a global issue affecting the public health. The purpose of this study was to measure the particle mass (PM10) and heavy metal concentrations in the air of industrial and non-industrial districts in an industrial city and to determine if heavy metals are present in the colostrum of mothers and meconium of newborns. Material and Method: PM10 presence and concentration per unit volume were determined in air samples using the Equal Pay Act-29 technique. The presence of heavy metals in PM10 and their amounts per unit volume were determined using Inductively Coupled Plasma-Mass Spectroscopy (ICP-MS) and cold vapor Atomic Absorption Spectroscopy. The colostrum and meconium samples were analyzed using ICP-MS and Inductively Coupled Plasma Optical-Emission Spectroscopy. Results: The mean PM10 levels in both districts were higher than World Health Organization limit values. The mean heavy metal concentrations of Al, As, Cd, Cu, Fe, Hg, Pb and Zn i...
Turkiye Klinikleri Journal of Medical Sciences
Pediatrics international : official journal of the Japan Pediatric Society, 2012
Although the effects of cardiac troponin I (cTnI) have been documented in infants, the associatio... more Although the effects of cardiac troponin I (cTnI) have been documented in infants, the associations among the value of maternal and cord blood total homocysteine (Hcy) levels, cord blood cTnI and the score for neonatal acute physiology and perinatal extension II (SNAPPE-II) values in infants have not been documented. The aim of this study was to determine the value of maternal total Hcy (mtHcy) and cord blood total Hcy (ctHcy) levels, cTnI and SNAPPE-IIas predictive factors of morbidity in newborns. Maternal and cord blood samples were routinely collected for analysis from all prospective participating volunteers. In this case–control study, both hospitalized (n = 71) and non-hospitalized (n = 148) newborns were identified and followed until discharge. Regression analysis revealed that pre-eclampsia, gestational age, mtHcy and SNAPPE-II values were significantly and independently associated with morbidity. Cord blood pH, ctHcy levels, SNAPPE-II values, and pre-eclampsia were associa...
Mikrobiyoloji bülteni, 2008
Cytomegalovirus (CMV) infections are commonly seen in humans and are usually mild or asymptomatic... more Cytomegalovirus (CMV) infections are commonly seen in humans and are usually mild or asymptomatic. However, these infections have significant medical risks in pregnant women, newborns and immunocompromised patients. Seronegative subjects and infants acquire CMV through infected blood products or direct contact with infected people. The use of seronegative blood products for selected patients, as in newborns and/or immunosuppressed patients has vital importance in medical management. Providing seronegative blood in countries where the prevalence of CMV is high (>90%), is difficult since this requires screening of a great number of blood donations. The aim of this study was to detect the CMV seroprevalence among voluntary blood donors in Kocaeli (located at northwestern region of Turkey) and to determine whether the screening procedure was cost-effective. CMV-IgG was investigated by a commercial ELISA method (AXSYM, Abbott, USA) in 1264 blood donors who were voluntarily admitted to...
The Turkish journal of pediatrics
In this paper, two cases with mucolipidosis type II (I-cell disease) (proven in one presenting ne... more In this paper, two cases with mucolipidosis type II (I-cell disease) (proven in one presenting newborn and presumed in an elder deceased brother) are presented. These infants showed severe skeletal changes with diffuse periosteal new bone formation in long bones and ribs, marked osteopenia, and resorption of scapula, clavicula, and mandible. There was also irregular demineralization of metaphyses of long tubular bones, as seen in rickets. The activities of serum alkaline phosphatase and parathyroid hormone were markedly elevated. Phosphorus was decreased. Serum 1,25-dihydroxyvitamin D was slightly elevated, but 25-hydroxyvitamin D and calcium were normal. Dysostosis multiplex resembling rickets and very high alkaline phosphatase activity were due to defective osteoblastic activity, but the mechanism of elevated parathyroid hormone was not clear. We conclude that early skeletal manifestation of mucolipidosis type II is not clearly identified and that differentiation from congenital r...
Türk Pediatri Arşivi, 2011
... İstatistiksel analiz Verilerin istatistiksel analizi, SPSS-13 programında yapıldı. ... Dalı, ... more ... İstatistiksel analiz Verilerin istatistiksel analizi, SPSS-13 programında yapıldı. ... Dalı, Umuttepe Kampusu, 41380, Kocaeli, Türkiye Tel.: +90 262 303 72 17 Faks: +90 262 303 80 03 E-posta: gulcanturker@superonline.com-gulcanturker@kocaeli.edu.tr ... Uzmanlık tezi, İstanbul 2006. ...
Cardiovascular Journal Of Africa, 2014
Objective: This study aimed to evaluate the aetiology, spectrum, course and outcomes of neonates ... more Objective: This study aimed to evaluate the aetiology, spectrum, course and outcomes of neonates with arrhythmias observed in a tertiary neonatal intensive care unit from 2007 to 2012. Methods: Neonates with rhythm problems were included. The results of electrocardiography (ECG), Holter ECG, echocardiography and biochemical analysis were evaluated. The long-term results of follow up were reviewed. Results: Forty-five patients were male (68%) and 21 (32%) were female. Fifty-five patients (83.3%) were term, 11 (16.6%) were preterm, and 34% were diagnosed in the prenatal period. Twenty cases (30.3%) had congenital heart disease. Twenty-three patients (34.8%) were diagnosed during the foetal period. The most common arrhythmias were supraventricular ectopic beats and supraventricular tachycardia (SVT) at 39.3 and 22.7%, respectively. SVT recurred in five patients after the neonatal period. Conclusion: Supraventricular ectopic beats and SVT were the most common arrhythmias during the neonatal period. Although the prognosis of arrhythmias in the neonatal period is relatively good, regular monitoring is required.
Turkiye Klinikleri Journal of Medical Sciences, 2010
ABSTRACT Objective: Troponin is an inhibitory protein complex located on the actin flament in all... more ABSTRACT Objective: Troponin is an inhibitory protein complex located on the actin flament in all striated muscles. Cardiac Troponin I is found only in the heart and has been used as a sensitive and specific marker of myocardial injury. Our aim was to investigate the different percentile limits and determinants of cord blood cardiac Troponin I (Tn I) concentrations. Material and Methods: A total of 378 consecutive healthy neonates were included in the study. Umbilical cord arterial and venous blood samples were obtained at the time of delivery. Concentrations and determinants of cardiac Tn I were analyzed using multivariate analysis, and percentile values were calculated. Results: Multivariate analyses showed that gestational age in weeks (B= -0.17, p= 0.02, t= -2.3) and fetal gender (B= -0.11, p=0.03, t= -2.08) were independent determinants of cord blood cardiac Tn I concentrations. The cases were divided into term 07 weeks of gestation) and pretem (<37 weeks of gestation) subgroups for the ease of clinical evaluation. The demographic variables of mothers of term and preterm infants were similar (p> 0.05) except for gestational age (p< 0.01). Mothers of preterm cases had significantly more frequent tocolytic therapy, early rupture of membranes, hypertension and cesarean delivery (p< 0.01). Term infants had more frequent labor induction and labor augmentation (p< 0.01). The 99th percentile limits of cardiac Tn I were 3.8 ng/ml in male (n= 47) and 0.8 ng/ml in female (n= 32) for pre-terms. In term neonates, these values were 2.7 ng/ml in males (n= 166) and 3.1 ng/ml in females (n= 133). Conclusion: This study reports the different cardiac Tn I percentile limits in a neonatal population. Our results suggested that the upper reference limits for cardiac Tn I may vary according to gestational age and gender.
Pediatrics International, 2011
The aim of the present study was to determine, using the score for neonatal acute physiology and ... more The aim of the present study was to determine, using the score for neonatal acute physiology and perinatal extension II (SNAPPE-II), whether there is an association with acute renal failure (ARF) and whether it is possible to identify newborns at risk for ARF prior to a rise in creatinine in newborns. Methods: Information on postnatal risk factors and SNAPPE-II on the first day of life (non-ARF group, n = 475; ARF group, n = 78) were collected. Renal failure was defined as serum creatinine level >1 mg/dL and >1.3 mg/dL (for 333 weeks and <33 weeks, respectively) after 48 h of life. Results: In newborns with ARF (n = 78), the median (range) of SNAPPE-II and mortality rate were significantly higher than those of the control group. Patent ductus arteriosus (PDA), disseminated intravascular coagulation (DIC), SNAPPE-II, and resuscitation were identified as independent predictors of ARF in infants on forward stepwise logistic regression. Sepsis, respiratory distress syndrome, ARF, DIC, and SNAPPE-II were identified as independent predictors of mortality in infants on the same analysis. Conclusions: SNAPPE-II on the first day of life was significantly higher among babies with ARF, suggesting a positive association between higher scores and the development of ARF and mortality, but based on receiver operating characteristic curve results, SNAPPE-II at admission did not enhance the assessment of risk for ARF prior to a rise in creatinine.
Journal of Maternal-Fetal and Neonatal Medicine, 2004
Objectives: The aims of this study were to (a) establish a reference range for cardiac troponin I... more Objectives: The aims of this study were to (a) establish a reference range for cardiac troponin I (cTnI) in the cord blood of healthy infants, and (b) investigate the effect of Apgar score, cord blood gas, gestational age, and creatine kinase (CK) and creatine kinase MB (CK-MB) fraction levels on cord blood cTnI levels. Methods: 112 perinatal hypoxic and 84 control newborns without perinatal hypoxia were enrolled in this study. Cord blood samples were collected from the babies for arterial blood gas analysis, cTnI, CK and CK-MB measurements. Gestational age, birth weight, sex, Apgar score and history of fetal distress were recorded. Hypoxic ischemic encephalopathy (HIE) group, hypoxic but without HIE group and control groups were identified according to clinical observations during the first 72 h in the newborn unit. Results: HIE and perinatal hypoxic without HIE groups had a significantly higher cord blood cTnI level according to the control group (1.8 ng/mL (0-13), 0 ng/ml (0-1.1) and 0 ng/ml (0-0.3) respectively). Cord blood cTnI level did not have a correlation with birth weight and gestational age (r = 70.02, p 4 0.05 and r = 0.08, p 4 0.05 respectively). Cord blood cTnI level also had a negative correlation with pH, bicarbonate, base deficit, and Apgar score (r = 70.40, p 5 0.001; r = 70.39 p 5 0.001; r = 70.45 p 5 0.001; r = 70.41, p 5 0.001) respectively). Cord blood cTnI level showed a positive correlation with CK and CK-MB levels (r = 0.45, p 5 0.001 and r = 0.37, p 5 0.001 respectively). Receiver operator curve analysis revealed that the most sensitive factor for prediction of perinatal hypoxia is cord cTnI value [area under curve = 0.929]. The optimal cut-off value of cord cTnI was 0.35 ng/ml for hypoxia. Conclusion: cTnI levels in the cord blood are not affected by gestational age and birth weight. cTnI together with CK and CK-MB has been found to be elevated in hypoxic infants compared to normal infants. Therefore cTnI may be an indicator for perinatal hypoxia in neonates.
Pediatric Research, 2010
ABSTRACT Aim: To assess the effect of early parenteral amino acids, on growth and neurodevelopmen... more ABSTRACT Aim: To assess the effect of early parenteral amino acids, on growth and neurodevelopment of very low birth weight infants at 36 weeks' postmenstrual age and 18 months' corrected age.
Pediatric Research, 2010
ABSTRACT Background: Many studies suggest an association between heavy metals in the blood or pla... more ABSTRACT Background: Many studies suggest an association between heavy metals in the blood or placenta and premature birth. However, there have been no studies that show an association between premature birth and exposure to trace elements at toxic levels in the meconium. The meconium is a matrix that can be obtained easily and noninvasively and is representative of a wide period of exposure in the fetus during gestation. Aim. The purpose of this study was to measure the levels of toxic metals (lead, cadmium) and trace elements (zinc, iron, copper) in meconium samples and to understand their association with prematurity.Method: Metal and trace element levels in the meconium of 810 infants were measured with a flame atomic absorption spectrophotometer.Results: Toxic metals and trace element levels in the meconium were significantly higher in preterm compared to term infants (for all p< 0.0001). In the regression analysis, it was shown that meconium metal levels were among the risk factors for prematurity.Conclusion: These results suggest that exposure to toxic metals and trace elements at toxic levels are among the risk factors for prematurity.
Nephrology Dialysis Transplantation, 2004
Factor H deficiency is reported infrequently, however, it has been associated with a variety of r... more Factor H deficiency is reported infrequently, however, it has been associated with a variety of renal diseases . Here we report the second case of factor H complement deficiency presenting with fibrillary glomerulonephritis.
Biology of the Neonate, 2004
In most perinatal-hypoxia survivors, myocardial dysfunction can be reversed with appropriate inot... more In most perinatal-hypoxia survivors, myocardial dysfunction can be reversed with appropriate inotropic support and oxygenation. The main problem related to outcome is cerebral damage. We tested the hypothesis that cardiac troponin I (cTnI), a known marker of myocardial injury, is also an early predictor of severity of cerebral damage and mortality in intrauterine hypoxia. Venous and arterial cord blood samples were collected at delivery from 54 consecutive newborns with hypoxic-ischemic encephalopathy and from 50 consecutive healthy controls. Arterial blood gas analysis was performed and levels of cTnI, creatine kinase and creatine kinase-MB in venous cord blood were measured. The same serum parameters were also measured on the 3rd and 7th day of life. Infants with hypoxia had a significantly higher cord blood cTnI levels than controls (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Cord blood and 3rd and 7th day serum cTnI values showed a significant increase with severity of HIE (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). In non-survivors cord blood cTnI levels were significantly higher than the survivors (5.9 ng/ml, range 2.1-12.8, and 1.6 ng/ml, range 0.4-5.8, respectively; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Receiver-operator curve analysis revealed cord cTnI as the most sensitive factor for predicting early death (area under curve = 0.956; SE: 0.028; 95% CI: 0.9-1.01). Cord blood cTnI of 4.6 ng/ml was identified as the optimal cut-off level for predicting serious risk of early mortality. The results suggest that significant elevation of cord cTnI is an excellent early predictor of severity of hypoxic-ischemic encephalopathy and mortality in term infants.
Journal of Perinatal Medicine, 2000
To determine the value of cord blood cardiac troponin I levels (cTnI) as an early prognostic fact... more To determine the value of cord blood cardiac troponin I levels (cTnI) as an early prognostic factor in critically ill newborns, and to compare cord cTnI levels with the prognostic value of the score for neonatal acute physiology (SNAP). Methods: Cord arterial samples were collected routinely for blood gas analysis, and cord venous samples for cTnI and cardiac-specific creatine kinase assay. The study group (ns109) comprised critically ill newborns who required mechanical ventilation. The control group (ns96) comprised newborns who were either completely healthy (ns48) or were followed in a level I neonatal care unit due to moderate-severity problems. Results: The critically ill newborns had significantly higher cTnI levels than control babies (median wmin-maxx 1.4 w0-13x vs. 0 w0-1.8x ng/mL, respectively; P-0.001). In critically ill newborns, non-survivors had significantly higher cTnI levels than survivors (median wmin-maxx 6.6 w1.3-13.0x vs. 1.3 w0-8.0x ng/mL, respectively; P-0.001). Receiver-operator curve analysis revealed that, compared with SNAP, cTnI was a more sensitive predictor of mortality in critically ill newborns (area under curves0.96; 95% CIs0.90-1.02). Conclusion: Significantly elevated cord cTnI may be a valuable predictor of mortality in critically ill newborns.