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    A confusing coincidence: Neonatal hypoglycemic seizures and hyperekplexia
    (Hindawi Limited, 2014) Demir N.; Dogan M.; Ylmaz S.; Peker E.; Bulan K.; Tuncer O.
    Hyperekplexia is a rare, nonepileptic, genetic, or sporadic neurologic disorder characterized by startle responses to acoustic, optic, or tactile stimuli. Genetic defects in glycine receptors as well as encephalitis, tumors, inflammation, and disgenesis are among the etiologic causes of the disease. The main problem in hyperekplexia is the incomplete development of inhibitory mechanisms or exaggerated stimulation of excitatory mediators. Hyperekplexia is often confused with epileptic seizures. Here we present a case with hypoglycemic convulsions coexisting with hyperekplexia, causing diagnostic difficulty. © 2014 Nihat Demir et al.
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    Incidence and severity of retinopathy of prematurity in Turkey
    (BMJ Publishing Group, 2015) Bas A.Y.; Koc E.; Dilmen U.; Oguz S.S.; Ovali F.; Demirel N.; Zenciroglu A.; Tekin N.; Caner I.; Arslanoglu S.; Celik Y.; Öztürk A.; Cömert S.; Bulbul A.; Kultursay N.; Koklu E.; Duman N.; Koksal N.; Salihoglu O.; Coban A.; Demirel G.; Bolat F.; Gökalp A.; Satar M.; Ipek M.S.; Bas E.K.; Narli N.; Mutlu M.; Cetinkaya M.; Akman I.; Yigit S.; Narter F.; Sivasli E.; Ahrabi A.F.; Atalay Y.; Tanyeri B.; Arsan S.; Perk Y.; Ors R.; Tuncer O.; Ecevit A.; Oygur N.; Ozdemir O.M.; Hakan N.; Aliefendioglu D.; Acunas B.; Cetin H.; Ozek E.; Tunc T.; Turkmen M.; Aydemir C.; Takci S.
    Background: The purpose of this study was to estimate the current incidence of retinopathy of prematurity (ROP) and the need for treatment in preterm infants in Turkey. Methods: The study included preterm infants who had been screened for ROP between 2011 and 2013 in 49 neonatal intensive care units. Infants with birth weight (BW) ?1500 g or ?32 weeks' gestational age and those with BW >1500 g or >32 weeks' GA with an unstable clinical course were included. The incidence of any ROP or severe ROP and treatment modalities were determined. Results: The study population included 15 745 preterm infants: 11 803 (75%) with GA ?32 weeks, and 3942 (25%) with GA >32 weeks. Overall, 30% were found to have any stage of ROP, and 5% had severe ROP. Severe ROP was diagnosed in 8.2% of infants with BW ?1500 g and 0.6% of infants with BW >1500 g. Of all infants diagnosed with ROP, 16.5% needed laser photocoagulation, and 20 patients born at >32 weeks' GA required this treatment modality. Vitroretinal surgery was performed in 28 infants with severe ROP: 23 with GA ?28 weeks and 5 with GA 29-32 weeks. Conclusions: The findings of our study have the important implication that more mature babies are at risk of severe ROP requiring treatment. An effective programme for detecting and treating ROP should be established in Turkey.
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    NMR-Based screening for inborn errors of metabolism: Initial results from a study on Turkish neonates
    (Springer, 2014) Aygen S.; Dürr U.; Hegele P.; Kunig J.; Spraul M.; Schäfer H.; Krings D.; Cannet C.; Fang F.; Schütz B.; Bülbül S.F.H.; Aydin H.I.; Sarıcı S.Ü.; Yalaz M.; Örs R.; Atalan R.; Tuncer O.
    Approximately 1 in 400 neonates in Turkey is affected by inherited metabolic diseases. This high prevalence is at least in part due to consanguineous marriages. Standard screening in Turkey now covers only three metabolic diseases (phenylketonuria, congenital hypothyroidism, and biotinidase deficiency). Once symptoms have developed, tandem-MS can be used, although this currently covers only up to 40 metabolites. NMR potentially offers a rapid and versatile alternative. We conducted a multi-center clinical study in 14 clinical centers in Turkey. Urine samples from 989 neonates were collected and investigated by using NMR spectroscopy in two different laboratories. The primary objective of the present study was to explore the range of variation of concentration and chemical shifts of specific metabolites without clinically relevant findings that can be detected in the urine of Turkish neonates. The secondary objective was the integration of the results from a healthy reference population of neonates into an NMR database, for routine and completely automatic screening of congenital metabolic diseases. Both targeted and untargeted analyses were performed on the data. Targeted analysis was aimed at 65 metabolites. Limits of detection and quantitation were determined by generating urine spectra, in which known concentrations of the analytes were added electronically as well as by real spiking. Untargeted analysis involved analysis of the whole spectrum for abnormal features, using statistical procedures, including principal component analysis. Outliers were eliminated by model building. Untargeted analysis was used to detect known and unknown compounds and jaundice, proteinuria, and acidemia. The results will be used to establish a database to detect pathological concentration ranges and for routine screening. © SSIEM and Springer-Verlag Berlin Heidelberg 2014.
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    Outcome of the Respiratory Syncytial Virus related acute lower respiratory tract infection among hospitalized newborns: A prospective multicenter study
    (Taylor and Francis Ltd, 2016) Alan S.; Erdeve O.; Cakir U.; Akduman H.; Zenciroglu A.; Akcakus M.; Tunc T.; Gokmen Z.; Ates C.; Atasay B.; Arsan S.; Anik A.; Turkmen M.K.; Erdogan Y.; Oygur N.; Kahvecioglu D.; Yildiz D.; Caner I.; Tekgunduz K.S.; Kurt A.; Yigit Y.; Bilgili G.; Bolat F.; Cevit O.; Ozlu F.; Satar M.; Ertugrul S.; Cakir B.; Unal S.; Iscan B.; Duman N.; Ergor S.N.; Yalaz M.; Celik I.; Celik U.; Hirfanoglu I.M.; Koc E.; Sivasli E.; Melekoglu N.A.; Kiray Bas E.; Bozkaya D.; Korkmaz A.; Ozdemir R.; Karadag A.; Ozer E.; Ilhan O.; Mutlu M.; Aslan Y.; Erener- Ercan T.; Cetinkaya M.; Sahin O.; Akin M.A.; Okumus N.; Demirel G.; Kilic A.; Turkoglu-Unal E.; Bulbul A.; Takci S.; Anuk-Ince D.; Ciftdemir N.A.; Acunas B.; Ozkan H.; Koksal N.; Okulu E.; Demir N.; Tuncer O.; Dizdar E.A.; Oguz S.; Dilmen U.
    Aim: To determine the incidence and outcomes of respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (ALRI) including morbidity, nosocomial infection and mortality among newborn infants who were admitted to the neonatal intensive care units (NICUs).Methods: A multicenter, prospective study was conducted in newborns who were hospitalized with community acquired or nosocomial RSV infection in 44 NICUs throughout Turkey. Newborns with ALRI were screened for RSV infection by Respi-Strip®-test. Main outcome measures were the incidence of RSV-associated admissions in the NICUs and morbidity, mortality and epidemics results related to these admissions.Findings: The incidence of RSV infection was 1.24% (n: 250) and RSV infection constituted 19.6% of all ALRI hospitalizations, 226 newborns (90.4%) had community-acquired whereas 24 (9.6%) patients had nosocomial RSV infection in the NICUs. Of the 250 newborns, 171 (68.4%) were full-term infants, 183 (73.2%) had a BW >2500 g. RSV-related mortality rate was 1.2%. Four NICUs reported seven outbreaks on different months, which could be eliminated by palivizumab prophylaxis in one NICU.Conclusion: RSV-associated ALRI both in preterm and term infants accounts an important percent of hospitalizations in the season, and may threat other high-risk patients in the NICU. © 2015 Taylor & Francis.