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Öğe Cord blood and consecutive chitotriosidase activity: Relationship to prematurity and early prognosis(Wiley-Blackwell, 2015) Gunes, Sezgin; Yalaz, Mehmet; Sozmen, Eser; Altun Koroglu, Ozge; Kultursay, NilgunBackgroundThe aim of this study was to investigate the relationship between plasma chitotriosidase activity, an inflammatory protein secreted mainly from macrophages, and neonatal morbidity and mortality in premature infants. MethodsCord blood chitotriosidase activity was studied in healthy control infants (53 term, group 1; 26 late preterm [33-37gestational weeks], group 2) and 35 preterm infants (32weeks; group 3). In group 3, consecutive samples at 3h, 24h, 72h, 7days, 14days, and 36weeks after conception were also analyzed. Group 3 was also evaluated for mortality, respiratory treatment and bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA), intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP) and necrotizing enterocolitis (NEC). ResultsCord blood chitotriosidase activity was positively correlated with gestational age and birthweight. SNAPPE-II score was correlated with chitotriosidase activity at 24h. Consecutive chitotriosidase activity for group 3 was non-significantly higher in infants who died in the early neonatal period. Higher chitotriosidase activity was observed in mechanically ventilated infants than infants treated with non-invasive assisted ventilation. BPD, PDA, IVH and ROP, but not NEC, were related to higher chitotriosidase activity, being significant at some of the time points. ConclusionNeonatal stress such as invasive ventilation may create a risk for the development of BPD, PDA, IVH, and ROP by increasing macrophage activation in preterm infants as reflected in the higher chitotriosidase activity. High chitotriosidase activity may also be associated with disease severity and mortality.Öğe Cord blood and consecutive chitotriosidase activity: Relationship to prematurity and early prognosis(Wiley-Blackwell, 2015) Gunes, Sezgin; Yalaz, Mehmet; Sozmen, Eser; Altun Koroglu, Ozge; Kultursay, NilgunBackgroundThe aim of this study was to investigate the relationship between plasma chitotriosidase activity, an inflammatory protein secreted mainly from macrophages, and neonatal morbidity and mortality in premature infants. MethodsCord blood chitotriosidase activity was studied in healthy control infants (53 term, group 1; 26 late preterm [33-37gestational weeks], group 2) and 35 preterm infants (32weeks; group 3). In group 3, consecutive samples at 3h, 24h, 72h, 7days, 14days, and 36weeks after conception were also analyzed. Group 3 was also evaluated for mortality, respiratory treatment and bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA), intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP) and necrotizing enterocolitis (NEC). ResultsCord blood chitotriosidase activity was positively correlated with gestational age and birthweight. SNAPPE-II score was correlated with chitotriosidase activity at 24h. Consecutive chitotriosidase activity for group 3 was non-significantly higher in infants who died in the early neonatal period. Higher chitotriosidase activity was observed in mechanically ventilated infants than infants treated with non-invasive assisted ventilation. BPD, PDA, IVH and ROP, but not NEC, were related to higher chitotriosidase activity, being significant at some of the time points. ConclusionNeonatal stress such as invasive ventilation may create a risk for the development of BPD, PDA, IVH, and ROP by increasing macrophage activation in preterm infants as reflected in the higher chitotriosidase activity. High chitotriosidase activity may also be associated with disease severity and mortality.Öğe Cord blood and consecutive chitotriosidase activity: Relationship to prematurity and early prognosis(Wiley-Blackwell, 2015) Gunes, Sezgin; Yalaz, Mehmet; Sozmen, Eser; Altun Koroglu, Ozge; Kultursay, NilgunBackgroundThe aim of this study was to investigate the relationship between plasma chitotriosidase activity, an inflammatory protein secreted mainly from macrophages, and neonatal morbidity and mortality in premature infants. MethodsCord blood chitotriosidase activity was studied in healthy control infants (53 term, group 1; 26 late preterm [33-37gestational weeks], group 2) and 35 preterm infants (32weeks; group 3). In group 3, consecutive samples at 3h, 24h, 72h, 7days, 14days, and 36weeks after conception were also analyzed. Group 3 was also evaluated for mortality, respiratory treatment and bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA), intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP) and necrotizing enterocolitis (NEC). ResultsCord blood chitotriosidase activity was positively correlated with gestational age and birthweight. SNAPPE-II score was correlated with chitotriosidase activity at 24h. Consecutive chitotriosidase activity for group 3 was non-significantly higher in infants who died in the early neonatal period. Higher chitotriosidase activity was observed in mechanically ventilated infants than infants treated with non-invasive assisted ventilation. BPD, PDA, IVH and ROP, but not NEC, were related to higher chitotriosidase activity, being significant at some of the time points. ConclusionNeonatal stress such as invasive ventilation may create a risk for the development of BPD, PDA, IVH, and ROP by increasing macrophage activation in preterm infants as reflected in the higher chitotriosidase activity. High chitotriosidase activity may also be associated with disease severity and mortality.Öğe Investigation of Congenital CMV Infection with the Presence of CMV DNA in Saliva Samples of New Born Babies(Ankara Microbiology Soc, 2019) Zeytinoglu, Aysin; Terek, Demet; Arslan, Ayse; Erensoy, Selda; Altun Koroglu, Ozge; Bozdemir, Tugba; Yalaz, Mehmet; Ergor, Serap Nur; Ogut, Mehmet Fatih; Kultursay, NilgunCytomegalovirus (CMV), is the most common cause among congenital infections and is the most seen etiology in long-term sensorineural hearing loss (SNHL) and neurological impairment. Congenital CMV infection (CCMV) was reported in 0.15-2.2% of live-borne neonates in studies from different countries. A significant proportion of infected infants are asymptomatic after birth and might only be detected by routine screening methods during the new born period. The aim of this study was to screen the saliva of live-born neonates with areal-time PCR based method for the detection of CCMV in our hospital. Saliva samples collected in half an hour after birth by dry dacron swabs and were evaluated for CMV DNA (Rt-PCR, Abbott Molecular USA) from 1000 babies born in Ege University Faculty of Medicine Hospital Obstetrics Clinic between October 2015-October 2017. For the confirmation of CCMV, saliva positive newborns were evaluated with the same method for CMV DNA from their urine or blood within 21 days. All newborns were screened for sensorineural hearing tests. Subjects were 497 girls (49.7%) and 503 boys (50.3%), with a mean weight of 3116.8 g and mean of 37.61 birth week. CMV DNA was positive in the saliva of 16 newborns (1.6%). Fourteen newborns were weakly positive for CMV DNA in their saliva and were not confirmed for CCMV infection. Congenital CMV was confirmed in only two (0.2%) with the CMV DNA results in urine and/or blood samples. One of the two newborns with CCMV was symptomatic and had a neurosensorial hearing loss. The other one was asymptomatic. Saliva samples, taken immediately after birth with a noninvasive and easy method for the detection of CMV DNA is very important for diagnosis of CCMV. Positive samples should be confirmed with CMV DNA in urine or blood samples of these newborns. In this study, detection of positivity in saliva samples that were confirmed with other samples of our newborn population for CCMV was 0.2%. The specific diagnosis for CCMV in newborns with a noninvasive and easy collecting sample is important to avoid sequelae and for public health concerns.Öğe Medical students' opinions on career planning course: evaluations of the relationship between course and faculty attributes and student characteristics(Walter De Gruyter Gmbh, 2022) Caliskan, S. Ayhan; Durmaz, Seyfi; Akcicek, Selahattin Fehmi; Bati, Ayse Hilal; Kalyoncu, Ebru; Karabilgin Ozturkcu, Ozlem Surel; Altun Koroglu, OzgeObjectives The Presidency of the Republic of Turkey Human Resources Office has stated that a Career Planning Course (CPC) should be implemented in higher education curricula by 2020. An institutional CPC consisting of 10-online sessions was designed and implemented in at Ege University Faculty of Medicine (EUFM) curriculum. This study reports the design, implementation, and evaluation of this new CPC at EUFM. Methods A descriptive, cross-sectional research design was used in this study. An online questionnaire (n=253) focusing mainly on Kirkpatrick-model Level 1 was administered to gather students' feedback on CPC as well as perceptions regarding the concept of Career Planning. Percentage distributions were used for categorical variables and mean +/- standard deviation calculations were used for numerical variables. Student's t-test was used to compare students' characteristics with career planning and important factors, and Pearson correlation test was used to evaluate competency areas with the mean scores of important factors in career planning. Statistical significance level was accepted as pResults The perception of the term career planning revealed 12 themes of which life was the most common (140/245; 57.1%), followed by professional life (102/245; 41.6%). Participants' total satisfaction rate was found 65.6% (Mean=39.36 +/- 14.88) for the course. Students were most satisfied with the goals and content appropriateness (7.77 +/- 3.08). The stimulating and motivating attribute of the CPC was the least satisfactory item. Conclusions An evaluation report, based on students' feedback, was shared with the faculty members involved in education via an interactive web page. The survey not only benefitted course educators but also helped students to reflect on the course content. CPC can help students to address their strengths and weaknesses and hopefully to take supportive initiatives at the beginning of their career.Öğe Molecular typing and sequencing of adenovirus isolated from a conjunctivitis outbreak in a neonatal intensive care unit by PCR(Tubitak Scientific & Technical Research Council Turkey, 2012) Cicek, Candan; Sanlidag, Tamer; Bilgin, Betul Siyah; Pullukcu, Husnu; Akcali, Sinem; Altun Koroglu, Ozge; Yalaz, Mehmet; Kultursay, NilgunAim: We aimed to evaluate the molecular typing of adenovirus isolated during an epidemic at the Ege University Children's Hospital neonatal intensive care unit (NICU). Materials and methods: During the NICU outbreak management, 40 clinical samples (from 15 newborn infants and 25 health care providers) were sent to a microbiology laboratory in viral transport media. All the samples were processed using a direct fluorescent antibody (DFA) test and a shell vial cell culture followed by adenovirus polymerase chain reaction (PCR) and DNA sequencing. PCR and DNA sequencing for adenovirus hexon gene hypervariable regions 1-6 were done after DNA extraction from clinical specimens. Adenovirus typing was done using BLAST analysis. Results: Ten adenoviruses were isolated from 4 out of 10 infants, 3 out of 5 hospital staff with conjunctivitis, and 3 asymptomatic staff. Ten positive samples were identified as adenovirus type 8 by using BLAST analysis. Conclusion: We isolated adenovirus type 8, one of the most common serotypes causing conjunctivitis, during an adenovirus outbreak in our NICU. The highest positivity was obtained using the PCR method. Although DFA was positive in a limited number of cases, this test was applied rapidly at the beginning of the epidemic and contributed to the prevention of further spread.Öğe Omitting routine gastric residual checks may help to accelerate enteral feeds and postnatal growth in stable preterm infants(Wiley, 2022) Terek, Demet; Celik, Mahmut; Ergin, Firat; Erol, Elif; Altun Koroglu, Ozge; Yalaz, Mehmet; Akisu, MeteBackground The prefeed gastric residual check (GRC) when increasing the amounts of feeds given via orogastric and nasogastric tubes as a precaution for necrotizing enterocolitis (NEC) and intestinal intolerance is a routine procedure. However, it is mostly misleading, and recently, there has been a tendency not to check prefeed residuals. Methods We changed our nutrition protocol at the end of 2018 to start minimal enteral feeds (MEFs) and increase feeds without GRCs. We investigated the effects on the incidence of NEC, complications, time to reach full feeds, and growth parameters Results We compared the results of 60 preterm infants at <= 35 weeks' gestational age (group 1: 2016-2017, cared for with GRC) and 77 preterm infants (group 2: 2019, without routine GRCs). No differences in incidence of NEC and complications were observed. Group 2 started enteral feeds 3 days earlier, reached total feeds 6 days earlier (P < 0.01), and had higher weight (P < 0.01) and head circumference gain (P < 0.01). Extrauterine growth restriction was significantly less for head circumference and also insignificantly less for weight and height. Conclusion We conclude that starting MEFs earlier and omitting routine GRCs in clinically stable preterm infants accelerate enteral feeds and growth parameters.Öğe Presentation and management of classical urea cycle disorders: lessons from our experience(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2016) Kalkan Ucar, Sema; Canda, Ebru; Kose, Melis; Kaginici, Mehtap; Altun Koroglu, Ozge; Calkavur, Sebnem; Habif, Sara; Coker, MahmutObjective: The urea cycle disorders (UCD) are inherited deficiencies of the enzymes or transport molecules involved in the cellular excretion of excess ammonia produced during protein metabolism. The aim of this study was to evaluate the clinical characteristics and long-term outcome of pediatric patients with UCD seen during childhood. Methods: Clinical characteristics in 13 patients with classical UCD (carbamoyl phosphate synthetase I deficiency (n= 4), argininosuccinate lyase deficiency (n= 4), argininosuccinate synthetase deficiency (n= 3), arginase deficiency (n= 1), and ornithine transcarbamylase deficiency (n= 1)) were defined. The term "neonatal-onset" UCD was used if symptoms occurred within 28 days of life, and "late-onset" if symptoms started after that period. Results: The majority of patients (n= 9) presented with acute metabolic crisis during newborn period. Core clinical phenotype in neonatal-onset UCD included sepsis-like neonatal crisis revealed in patients within 28 days after birth, whereas mental retardation was predominant peculiarity in late-onset UCD emerging more than 28 days after birth. Vomiting and hypotonia were frequently reported in neonatal-onset UCD, and epilepsy with/without movement disorder was found in late-onset UCD patients. For patients with neonatal-onset UCD hyperammonemia was more severe at first diagnosis of the disease, and remained near upper limits of normal during the follow-up period. However, hyperammonemia and metabolic crisis have been reported lomber spinal stenoz frequently in symptomatic patients. A cardinal principal of UCD in acute and long-term management of UCD. Despite these evolving treatment opportunities, still higher mortality rates were found in neonatal-onset UCD (44% (4/9)). Conclusion: Neonatal-onset UCD were generally presents itself as acute onset hyperammonemia during the newborn period. However, neurological manifestations were reportedly more diagnostic in the late-onset UCD. It has been concluded that the basic principles of diagnosis and treatment need to be reorganized to improve recognition and outcome in these diseases.Öğe Reference values of anthropometric measurements in healthy late preterm and term infants(Tubitak Scientific & Technical Research Council Turkey, 2018) Siyah Bilgin, Betul; Uygur, Ozgun; Terek, Demet; Altun Koroglu, Ozge; Yalaz, Mehmet; Akisu, Mete; Cogulu, Ozgur; Kultursay, NilgunBackground/aim: Geographical distribution, ethnicity, and other socioeconomic factors may affect anthropometric measurements, and for that reason each society should determine their own measurements accounting for those factors. In this study, we aimed to determine the anthropometric measurements of healthy late preterm and term infants to compare the results with other national and international studies. Materials and methods: This sectional study was carried out among 1197 infants born with a gestational age of 35 weeks. Chest circumference, ear length, foot length, palmar length, middle finger length, philtrum distance, inner and outer canthal distances, and palpebral fissure length were measured in the first 24 h of life. Results: All measurements of late preterm infants were smaller than those of term infants (P < 0.05). Compared with male infants, the chest circumference, ear length, foot length, pahnar length, philtrum distance, and inner canthal distances of the female infants were lower (P < 0.05). No significant differences were found between male and female infants' middle finger length, outer canthal distance, and palpebral fissure length measurements. Percentile values for all measurements of 35-42-week male and female infants were described. Condusion: These measurements of male and female infants born between 35 and 42 weeks may be useful for early detection of syndromes by detecting anatomical abnormalities in our population.Öğe The serial changes of perfusion index in preterm infants with patent ductus arteriosus: is perfusion index clinically significant?(Edizioni Minerva Medica, 2016) Terek, Demet; Altun Koroglu, Ozge; Ulger, Zulal; Yalaz, Mehmet; Kultursay, NilgunBACKGROUND: Perfusion Index (PI) which reflects the peripheral blood flow may help early detection and treatment decision of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. The present study is designed to analyze the usefulness of PI level in early detection of hsPDA in preterm infants. METHODS: Preterm infants born before 36 gestational weeks were assessed for PI and simultaneous echocardiography. Based on echocardiography, each infant is categorized into no-PDA (group 1), non-hsPDA (group 2) and hsPDA (group 3). Heart rate (HR), mean arterial pressure (MAP), body temperature and oxygen saturation (SpO(2)) and concomitant PI were measured on days 1, 2, 3 and 4. RESULTS: In all preterm infants (N.=42) PI significantly increased from 0.7 on day 1 to 1.4 on day 4. The HR did not change by the days; however, the MAP increased on days 3 and 4 compared to day 1. In hsPDA group, the median PI was 0.7 (IQR, 0.4) on day 1 compared to 0.9 (IQR, 0.2) on day 2. PI is significantly lower in hsPDA group compared to no-PDA group on day 1 and 2; however, this difference disappeared at 48 hour on the intravenous ibuprofen treatment (on day 3 and 4). CONCLUSIONS: PI may predict the perfusion disorder and help to decide for treatment of hsPDA and was also helpful to monitor the response to treatment in hsPDA patients.
