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Öğe The Association of Carpenter Syndrome and Situs Inversus Totalis: First Case Report(ORTADOGU AD PRES & PUBL CO, 2011) Altunhan, Huseyin; Annagur, Ali; Ors, RahmiCarpenter syndrome (acrocephalopolysyndactyly type II) is a rare autosomal recessive disorder that classically consists of acrocephaly, facial dysmorphism, mental retardation, congenital heart disease and hypogenitalism. To the best of our knowledge, situs inversus totalis has not been demonstrated previously in Carpenter syndrome. We report here a 6-day-old boy with many abnormalities diagnosed clinically and also having situs inversus totalis. As far as we know, this is the first Carpenter syndrome case associated with situs inversus totalis in the literature.Öğe Birth Weight and Preterm Birth in Babies of Pregnant Women With Major Depression in Relation to Treatment With Antidepressants(LIPPINCOTT WILLIAMS & WILKINS, 2014) Sahingoz, Mine; Yuksel, Goksen; Karsidag, Cagatay; Uguz, Faruk; Sonmez, Erdem Onder; Annagur, Bilge Burcak; Annagur, AliObjective It is unclear whether antidepressant treatment has a preventive effect on negative neonatal outcomes due to major depression in pregnant women. The objective of the present study was to compare women with major depression treated with antidepressants, untreated women with major depression, and healthy women during pregnancy with respect to birth weight and preterm birth. Methods The study sample included a total of 23 women taking antidepressant medication, 36 women who were not taking antidepressant medication for major depression during pregnancy, and 30 healthy women. Major depression was diagnosed via the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Results The study groups were similar with respect to sociodemographic characteristics. Compared with infants of healthy control subjects, infants of untreated major depressed women had significantly lower birth weight and shorter gestational age at delivery. There is no significant difference between infants of major depressed women treated with antidepressants and infants of healthy subjects for these variables. Conclusions Our results suggest that antidepressants may have beneficial effects on the risk of low birth weight and preterm birth in the infants of depressed women.Öğe Coexistence of Congenital Chylous Ascites and Congenital Hypothyroidism: Case Report(ORTADOGU AD PRES & PUBL CO, 2012) Altunhan, Huseyin; Annagur, Ali; Ertugrul, Sabahattin; Yuksekkaya, Hasan Ali; Ors, RahmiChylous ascites is a rare clinical entity occurring as the result of the extravasation of the chyle into the peritoneal cavity. A 20-day newborn admitted to our clinic with high level of thyroid stimulating hormone (TSH) and abdominal distension was diagnosed with chylous ascites and congenital hypothyroidism after paracentesis. Thyroid hormone supplementation, a diet containing middle-chain triglycerides and octreotide were started. To our knowledge, the patient who recovered completely with the treatment is the first case in the literature with chylous ascites accompanied by congenital hypothyroidism. Thus, in newborns with chylous ascites, congenital hypothyroidism should be considered and the diagnosis should be confirmed with paracentesis. This approach may be beneficial for early diagnosis and treatment. Chylous ascites can be treated successfully with a diet containing middle-chain triglycerides and octreotide.Öğe Comparing the efficacy of nebulizer recombinant human DNase and hypertonic saline as monotherapy and combined treatment in the treatment of persistent atelectasis in mechanically ventilated newborns(WILEY, 2012) Altunhan, Huseyin; Annagur, Ali; Pekcan, Sevgi; Ors, Rahmi; Koc, HasanBackground: The purpose of the present study was to compare the cost-effectiveness and efficacy of nebulizer recombinant human DNase (rhDNase) and hypertonic saline (HS) as monotherapy and combined treatment in neonatal atelectasis. Methods: Eighty-seven newborns with persistent atelectasis who did not respond to traditional treatment were studied retrospectively. Group 1 did not receive nebulizer drugs; Group 2 received 7% HS; Group 3 received rhDNase; and Group 4 received both 7% HS and rhDNase. Subjects' chest X-ray scores, partial pressure of CO2, respiratory rate, fraction of inspired oxygen (FiO2) peak inspiratory pressure, atelectasis healing rate, median duration of nebulizer treatment and costs were compared. Results: Percentages of improvement in atelectasis on Day 3 of treatment in Group 1, Group 2, Group 3 and Group 4 were 27, 70, 81 and 95%, respectively, while median duration of treatment was 8.1, 3.3, 2.9 and 2.4 days, respectively. Comparison of chest X-ray scores, partial pressure of CO2, respiratory rate, FiO(2) and peak inspiratory pressure values before and 48 h after treatment did not yield a significant difference for the control group (P > 0.05), while a marked improvement was observed in other groups for all parameters (P < 0.05). The most distinct improvement was in Group 4, followed by Group 3. Conclusions: Although both the combined treatment with HS and rhDNase and their monotherapies are effective in the treatment of persistent atelectasis in newborns receiving mechanical ventilation, their combined use produces higher efficacy. The efficacy of rhDNase is superior to monotherapy with HS. Use of these two treatments concomitantly reduces the cost. To the best of our knowledge, the present study is the first to use HS alone or in combination with rhDNase in newborn patients.Öğe Comparison of urinary neutrophil gelatinase-associated lipocalin, C-reactive protein and procalcitonin in the diagnosis of late onset sepsis in preterm newborns(TAYLOR & FRANCIS LTD, 2013) Ertugrul, Sabahattin; Annagur, Ali; Kurban, Sevil; Altunhan, Huseyin; Ors, Rahmi[Abstract not Available]Öğe The effects of maternal major depression, generalized anxiety disorder, and panic disorder on birth weight and gestational age: A comparative study(PERGAMON-ELSEVIER SCIENCE LTD, 2013) Uguz, Faruk; Sahingoz, Mine; Sonmez, Erdem Onder; Karsidag, Cagatay; Yuksel, Goksen; Annagur, Bilge Burcak; Annagur, AliObjective: The present study comparatively examined the impact of maternal major depression, generalized anxiety disorder and panic disorder on gestational age and birth weight. Methods: A total of 90 women (24 subjects with major depression, 19 subjects with panic disorder, 22 subjects with generalized anxiety disorder, and 25 healthy subjects) in the perinatal period who were admitted to three hospitals were included in the study. Psychiatric diagnoses were determined by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The birth weight and gestational age of the subjects in each groups were compared with one-way analysis of variance (ANOVA). Results: There were significant differences among the study groups for birth weight and gestational age (P < 0.001 for both variables). These parameters were significantly lower in the subjects with major depression (P = 0.021 and P = 0.015, respectively) and panic disorder (P < 0.001 for both variables) compared to healthy controls. Compared with major depression, panic disorder was associated more negatively with birth weight (P = 0.036). Conclusion: Major depression, and especially panic disorder, may negatively affect the gestational length and birth weight. (C) 2013 Elsevier Inc. All rights reserved.Öğe EFFECTS OF PHOTOTHERAPY ON SERUM PARAOXONASE ACTIVITY AND TOTAL ANTIOXIDANT CAPACITY IN NEWBORN JAUNDICE(NOBEL ILAC, 2014) Kurban, Sevil; Annagur, Ali; Altunhan, Huseyin; Mehmetoglu, Idris; Ors, Rahmi; Erdem, Said Sami; Yerlikaya, Fatma HumeyraObjective: Phototherapy is an efficient and commonly used form of therapy for the treatment of neonatal hyperbilirubinemia. Paraoxonase 1 (PON1) is an anti oxidative enzyme, which eliminates lipid peroxides. The aim of our study was to investigate the effect of phototherapy on serum PON1 activity and total antioxidant capacity (TAC) in hyperbilirubinemic full-term newborns. Material and Method: The study was performed on 40 full-tenn newborns between 3 to 15 days of age exposed to phototherapy. SerumPON1 activity and TAC levels of the babies were determined before and after phototherapy by spectrophotometric assays. Results: We have found that PON1 activity was not significantly affected by phototherapy whereas TAC levels were decreased significantly after phototherapy (p<0.001). Conclusion: Our findings demonstrated that phototherapy has no direct effect on PON1 activity. Also, decreased TAC levels might have resulted from increased oxidative stress which may lead to consumption of antioxidant molecules.Öğe A FRONTONASAL DYSPLASIA CASE WITH ABSENCE OF FALX CEREBRI(NOBEL ILAC, 2013) Altunhan, Huseyin; Annagur, Ali; Ozbek, Orhan; Ors, RahmiFrontonasal dysplasia which is also called median cleft face syndrome, is a disease that presents with signs like hypertelorism, broad nasal base, formation defect of nasal edge, anterior cranium, bifidum ocultum, microphtalmia in the face and head but with possible anomalies in any organ or system. Central nervous system anomalies like corpus callosum agenesis, lipomas of corpus callosum and encephalosel may also be seen in these cases. We presented a frontonasal dysplasia case without falx cerebri. According to our investigation, this is the first case of frontonasal dysplasia without falx cerebri.Öğe Fully automated simultaneous umbilical arteriovenous exchange transfusion in term and late preterm infants with neonatal hyperbilirubinemia(TAYLOR & FRANCIS LTD, 2016) Altunhan, Huseyin; Annagur, Ali; Tarakci, Nuriye; Konak, Murat; Ertugrul, Sabahattin; Ors, RahmiObjectives: The purpose of this study was to compare the efficacy and safety of two different catheterization techniques of exchange transfusion (ET) used in the therapy of newborn jaundice: fully automated two-way ET technique and the classical one-way ET.Patients and methods: The study included babies at gestational age of >34 weeks. In total, 107 ETs were performed on 86 babies. Totally, the umbilical vein (UV) group included 54 babies having undergone 69 ETs and the UV/UA group included 32 babies having undergone 38 ETs.Results: The declines in bilirubin levels right after ET (p=0.018) and 8h after ET (p=0.014) were higher in the fully automated UV/UA technique than in the classical UV technique. Furthermore, the duration of intensive phototherapy following ET was shorter in the UV/UA method than in the UV method (p=0.003). There was no difference between the two methods in terms of ET-associated complications (p=0.927).Conclusions: In neonatal hyperbilirubinemia, ET with fully automated UV/UA technique is more efficient than the classical ET technique, causing no additional side-effects. It is also more physiological than the classical technique, since it minimizes the fluctuations in the blood volume and intravascular pressure during ET.Öğe Hypertrophic cardiomyopathy with Jeune syndrome: The first reported case(TURKISH SOC CARDIOLOGY, 2016) Guvenc, Osman; Uygun, Saime Sundus; Cimen, Derya; Aslan, Eyup; Annagur, AliJeune syndrome (Asphyxiating thoracic dysplasia) is a rare dystrophy of the skeleton, inherited as an autosomal recessive condition. Patients develop a narrowed thorax, rhizomelic dwarfism, and hepatic, renal, and pancreatic abnormalities. High rates of pulmonary hypoplasia and pulmonary hypertension have been reported. Some patients die in early stages of life due to respiratory failure. The case of a patient referred with a history of severe asphyxiating birth, who had been diagnosed with Jeune syndrome and later hypertrophic cardiomyopathy (HCM) upon echocardiographic examination is described in the present report. This rare disease is discussed with respect to the current literature, as the present is the first reported case to be accompanied by HCM.Öğe The incidence of congenital anomalies associated with cleft palate/cleft lip and palate in neonates in the Konya region, Turkey(CHURCHILL LIVINGSTONE, 2012) Altunhan, Huseyin; Annagur, Ali; Konak, Murat; Ertugrul, Sabahattin; Ors, Rahmi; Koc, HasanAdditional congenital anomalies have often been found in patients with orofacial clefts. We wanted to find out the incidence and type of congenital malformations that may accompany cleft palate (CP) and cleft lip and palate (CLP) in babies born in the Konya region. A total of 121 newborn babies with CP or CLP were prospectively included in the study, and all were assessed in detail for congenital anomalies. Of 121 babies, 86(71%) had CLP and 35 (29%) had CP. There was at least one congenital malformation in 80 (66%) of the cases. Additional congenital malformations were seen in 26 (74%) of the 35 with isolated CP, and 54 (63%) in the 86 patients with CLP (p < 0.05). The most common congenital malformation was congenital heart disease, followed by head and neck anomalies. The most common congenital heart disease was atrial septal defect. A serious chromosomal anomaly was found in 18/121 patients with CP or CLP (15%). Of the 80 babies in whom congenital malformations were found, 31 (39%) had dysmorphic features. While 21 (68%) of dysmorphic cases had isolated CP, 10 (32%) had CLP (p < 0.05). The rates of premature delivery, intrauterine growth retardation, and consanguinity between parents were higher in patients with CP or CLP. The neonatal mortality was 20% (n = 24). Our results indicate that at least one congenital anomaly is also present in about two-thirds of newborn babies with CP and CLP, and these anomalies significantly increase their morbidity and mortality. All newborn babies with CP and CLP should be screened for additional congenital anomalies, particularly of the cardiovascular system. (c) 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.Öğe Is Maternal Depressive Symptomatology Effective on Success of Exclusive Breastfeeding During Postpartum 6 Weeks?(MARY ANN LIEBERT, INC, 2013) Annagur, Ali; Annagur, Bilge Burcak; Sahin, Akkiz; Ors, Rahmi; Kara, FatihAim: The aim of this prospective study was to examine the relationship between success of exclusive breastfeeding and postpartum depressive symptomatology. Our hypothesis was that mothers with depressive symptoms initially fail exclusive breastfeeding. Subjects and Methods: One hundred ninety-seven mothers were enrolled in the study. The participants were interviewed twice. The first visit was within the first 48 hours after birth. The Edinburgh Postnatal Depression Scale (EPDS) was completed by the participants. The second interview was performed at 6 weeks. Participants answered questions regarding methods of breastfeeding for 6 weeks, any methodological problems, and nipple pain. The EPDS was again completed by the participants at 6 weeks. All newborns were term infants. Results: All the participants were divided into two groups: exclusive breastfeeding and mixed-feeding (partial breastfeeding and/or bottle feeding). Both groups were compared in terms of features, such as mode of delivery, parity, prevalence of depressive symptomatology (at 48 hours and 6 weeks), and delayed onset of lactation within the first 48 hours. Statistical significance was found for only three variables: delayed onset of lactation within the first 48 hours, gestational age, and the problems related to breastfeeding methods. Conclusions: Clinicians should pay special attention to any lactation difficulty during the first week postpartum. Early lactation difficulties are associated with greater risk of early termination of breastfeeding and lower breastfeeding success.Öğe Meckel Gruber syndrome: A case report with review of literature(MODESTUM LTD, 2017) Uygun, Saime Sundus; Sivri, Mesut; Topsakal, Ahmet; Dikener, Ahmet Hakan; Soylu, Hanifi; Annagur, AliMeckel-Gruber syndrome, which is firstly described by Friedrich Meckel and Georg B. Gruber, is an autosomal recessive disorder that is characterized triad of occipital encephalocele, bilateral renal dysplasia and polydactyly. Because of the genetic heterogeneity, multiple organs can be affected. The worldwide incidence varies from 1 in 13,250 to 1 in 140,000 live births. We have reported a male baby born at 37-week gestation, who has occipital encephalocele, polydactyly and cystic dysplasia of both kidneys. As a result of these clinical findings, Meckel-Gruber Syndrome is suspected for his baby. This study is presented to draw attention to the Meckel Gruber Syndrome which has high risk of recurrence and early diagnosis by ultrasonographic screening can be confident.Öğe Noninvasive Treatment of Acquired Subglottic Stenosis(LIPPINCOTT WILLIAMS & WILKINS, 2016) Ozturk, Kayhan; Erdur, Omer; Sofiyev, Fuad; Onal, Ibrahim Ozkan; Annagur, AliA 23-day-old infant referred to the neonatal intensive care unit with difficulty breathing and inspiratory stridor increasing with exercise. Medical history included a cardiothoracic surgery for transposition of the great arteries, patent ductus arteriosus, atrial septal defect, and a history of intensive care unit from surgery. Flexible fiberoptic transnasal laryngoscopy revealed subglottic stenosis that was probably caused by prolonged intubation with a higher airway pressure. Computed tomographic scan of the neck showed a tiny stenosis without cartilage deformity and limited in subglottic region. Tracheotomy and external open surgery was found risky for sternal wound infection or mediastinitis as the neonate had newly thoracotomy. The patient had a balloon dilation under general anesthesia without intubation. Presenting symptoms of the neonate were fully improved with balloon dilation.Öğe Persistent Nasal Bleeding Due to Nasal CPAP Application in 2 Premature Newborns Successfully Treated With Topical 'Ankaferd Blood Stopper''(SAGE PUBLICATIONS INC, 2011) Altunhan, Huseyin; Annagur, Ali; Tokgoz, Huseyin; Caliskan, Umran; Ors, Rahmi[Abstract not Available]Öğe Postpartum Depression in Mothers of Infants with Very Low Birth Weight(AVES, 2013) Herguner, Sabri; Annagur, Ali; Clcek, Erdinc; Altunhan, Huseyin; Ors, RahmiBackground: Giving birth to an infant with very low birth weight (VLBW) is a major life event for a mother. Several studies have shown that mothers of these infants are at greater risk of psychological distress. The aim of this study was to investigate the level of depressive symptoms and to determine the associated factors among mothers who have infants with VLBW. Methods: The sample consisted of 105 subjects: 35 mothers of VLBW infants (<1500 g), 35 mothers of low birth weight (LBW) infants (1500-2500 g), and 35 mothers of healthy term infants (>2500 g). The Edinburgh Postpartum Depression Scale (EPDS) was used to detect maternal depressive symptoms. Maternal social support was assessed by the Multidimensional Scale of Perceived Social Support (MSPSS). Results: The mean EPDS score and the number of mothers with high depressive scores (EPDS>12) were significantly higher in mothers of infants with VLBW than in mothers of LBW and term infants. EPDS score was negatively correlated with birth weight, gestational age, and perceived social support and positively correlated with duration of hospital stay in mothers of infants with VLBW. Low birth weight and long hospital stay were found as predictors of postpartum depression in mothers of infants with VLBW. Conclusion: The birth and subsequent hospitalization of an infant with very low birth weight evoke psychological distress in mothers. Pediatricians should be more careful about depressive symptoms of mothers of infants with VLBW and should refer for counseling when it is necessary. (Archives of Neuropsychiatry 2012; 50: 30-33)Öğe Serum ischemia-modified albumin levels at diagnosis and during treatment of late-onset neonatal sepsis(TAYLOR & FRANCIS LTD, 2014) Yerlikaya, F. Humeyra; Kurban, Sevil; Mehmetoglu, Idris; Annagur, Ali; Altunhan, Huseyin; Erbay, Ekrem; Ors, RahmiSepsis is one of the most common infectious conditions in the neonatal period, and continues as a major source of morbidity and mortality. The aim of this study is to determine serum ischemia-modified albumin (IMA) levels in late-onset neonatal sepsis at the time of diagnosis and after therapy, and to show the meaningful on the follow-up. Also, it is aimed to compare serum IMA levels with serum C-reactive protein (CRP), procalcitonin (PCT) levels and white blood cell count. The study was performed on 33 premature babies with sepsis and 21 healthy premature controls at 7-28 days of age. In the sepsis group, biochemical parameters and blood culture samples were obtained from the blood at the onset and on the fifth day of treatment for each patient. Serum IMA, CRP, PCT and white blood cell count were significantly higher in the sepsis group before treatment when compared with the control group. In addition, the levels of IMA were positively correlated with white blood cell count, CRP and PCT in the sepsis group before treatment. In conclusion, serum IMA levels may be useful in late-onset neonatal sepsis at the time of diagnosis and after therapy. As far as we know this is the first report about the assesment of illness diagnosis and after therapy using serum IMA levels, and further studies are needed to confirm our results in larger groups of patients.Öğe Serum Levels of Neopterin In Gestational Diabetes Mellitus: The Relationship With Apgar Scores(SPRINGER HEIDELBERG, 2015) İpekci, Süleyman Hilmi; Kebapcılar, Ayşe Gül; Yılmaz, Setenay Arzu; İlhan, Tolgay Tuyan; Pekin, Aybike Tazegül; Abuşoğlu, Sedat; Ünlü, Ali; Çelik, Çetin; Annagur, AliPurpose This study was designed to evaluate neopterin levels and low Apgar scores in pregnancies with gestational diabetes mellitus (GDM) vs. normal control pregnancies. Methods We carried out a cross-sectional study by enrolling 81 pregnant women with GDM and 38 pregnant women without GDM. Results Maternal and cord blood neopterin levels were higher in women with GDM. There was a significant positive association between fasting blood glucose levels and maternal serum neopterin levels. The results of 50-g oral glucose challenge tests revealed a correlation between maternal and cord neopterin levels. Pregnancies complicated by GDM exhibited lower fetal Apgar scores than those of control subjects. The levels of cord blood neopterin were inversely correlated with an fetal Apgar score of 1 min in patients with GDM. Conclusions Patients with GDM had higher maternal and cord blood neopterin levels, and the cord blood neopterin levels are inversely associated with lower Apgar scores in women with GDM. The neopterin levels might be potential predictors of low fetal Apgar scores in women with GDM.Öğe Sitting Buddha position: Sacral agenesis case(MEDICAL INVESTIGATIONS SOC, 2016) Guvenc, Osman; Guler, Ibrahim; Annagur, AliSacral agenesis syndrome (Caudal regression syndrome) is a neural tube defect that is characterized by absence of the vertebral segment that constitutes the sacrum. It is very rarely seen and generally develops sporadically. Its etiology is influenced by maternal diabetes, genetic factors, teratogenic agents and vascular hypo-perfusion. It is important to make a diagnosis in the prenatal period. This paper presents a newborn diagnosed with sacral agenesis as a case and discusses this disease in the light of the latest literature information.Öğe Synovial sarcoma in a premature newborn(WILEY-BLACKWELL, 2014) Kose, Dogan; Annagur, Ali; Erol, Cengiz; Ugras, Serdar; Koksal, YavuzSynovial sarcoma is rarely detected in infants, with an annual incidence of 0.5 per million. Synovial sarcoma occurs more frequently in adolescents and young adults, with the majority of patients presenting between 15 and 40 years of age. It is extremely rare, however, in pediatric patients under 2 years of age. In the present study we examined a 3-day-old male infant born at 32 weeks who had a mass on his left arm. Synovial sarcoma was identified on histopathological and immunohistochemical analysis of biopsy material acquired from the mass. On whole body magnetic resonance imaging, diffuse metastases were detected in the bilateral lungs in the retroperitoneal zone, in bilateral suprarenal glands, the right liver lobe, the right kidney, and the brain. To our knowledge this is the youngest patient to be diagnosed with synovial sarcoma in the literature.