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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 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 left and right ventricular pulsed and tissue Doppler myocardial performance index values using Z-score in newborns with hypoxic-ischemic encephalopathy(TURKISH SOC CARDIOLOGY, 2011) Alp, Hayrullah; Karaaslan, Sevim; Baysal, Tamer; Oran, Bulent; Ors, RahmiObjective: The aim of the study is determination of myocardial performance index (MPI/Tei index) using pulsed (PD) and tissue Doppler (TD) techniques to show cardiac response in newborns with hypoxic-ischemic encephalopathy (HIE) and healthy newborns and eventually evaluation of the differences between these two techniques. Methods: The study is a prospective observational study. Twenty term newborns diagnosed as perinatal asphyxia during postnatal 24 hours due to the defined criteria and fifty healthy term neonates as control group were included the study. Hypoxic group was divided into two groups with Sarnat stages, Sarnat Stage 1 and 2-3. MP's (Tei indexes) were calculated with PD and TO echocardiographic techniques in all groups after the 24 hours of birth and one year later. The statistical differences between same techniques were calculated with Kruskal-Wallis test and Z score was used to compare the superiority of two techniques. Results: The MPI values calculated by PD (0.41 +/- 0.04, 0.51 +/- 0.02) and TD (0.59 +/- 0.04, 0.51 +/- 0.02) during the first day of life in Sarnat Stage 2-3 in both ventricles were significantly higher than the control group (p<0.01, p<0.02, p<0.03). While the Z score, calculated for MPI measured by PD and TD methods, were found similar in both ventricles in Sarnat Stage 1 and control groups, it was significantly different in other groups of Sarnat stages. Conclusion: The degree of cardiac response in neonates with HIE is associated with the severity of hypoxia. MPI values are not different from the controls in newborns received mild hypoxia while they are higher in the patients who were received moderate or severe hypoxia. Any advantage could not be found between two techniques according to the measurement values, but higher variability in the value of MPI, measured by TO method, calculated from moderate and severe hypoxia group was detected. (Anadolu Kardiyol Derg 2011; 11: 719-25)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 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 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 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 Pyridoxine may protect the cerebellar granular cells against glutamate-induced toxicity(VERLAG HANS HUBER, 2007) Bueyuekokuroglu, Mehmet Emin; Gepdiremen, Akcahan; Tastekin, Ayhan; Ors, RahmiIn the present study, the possible protective effect of the pyridoxine against glutamate-induced neurotoxicity in cerebellar granular cell culture of rat pups is investigated for its therapeutic potential. Glutamate (10(-7) M) was administered to cerebellar granular cell cultures that were prepared from one-day-old Sprague-Dawley rats. The neuroprotective effect of pyridoxine was examined. Pyridoxine at the doses of 10(-8), 10(-7), 10(-6), and 10(-5) M was introduced into the culture flasks before inclusion of glutamate. Pyridoxine at the doses of 10(-8) M and 10(-7) M significantly reduced glutamate cytotoxicity. A 10(-7) M dose of pyridoxine proved to be more effective than a 10(-8) M dose. The present study demonstrates that pyridoxine may protect glutamate-induced neurotoxicity. Neuroprotective effect of pyridoxine, at least in part, may result from its anti-glutamatergic activity. Pyridoxine merits further investigation as a therapeutic option in hypoxic-ischemic brain injury.Öğe Serum ischemia-modified albumin and oxidized LDL in cord blood and serum of neonates born to pre-eclamptic mothers(WILEY, 2015) Mehmetoglu, Idris; Kurban, Sevil; Toker, Aysun; Annaguer, Ali; Altunhan, Huseyin; Erbay, Ekrem; Ors, RahmiBackgroundWe investigated oxidized low-density lipoprotein (OxLDL) and ischemia-modified albumin (IMA) in cord blood and neonatal blood of 7-day-old neonates born to pre-eclamptic and normotensive healthy mothers. MethodsThe study was performed on 30 neonates born to pre-eclamptic and 20 neonates born to normotensive mothers. IMA and OxLDL were determined on spectrophotometry and ELISA, respectively. ResultsIMA in cord blood was higher in the pre-eclamptic group as compared with the normotensive group, but the difference between the groups was not significant. IMA in neonate venous blood was significantly higher in the pre-eclamptic group than in the normotensive group (P < 0.001). OxLDL in both cord blood and in neonate venous blood was significantly higher in the pre-eclamptic group compared with the normotensive group (P < 0.001). IMA and OxLDL were significantly decreased after delivery in both groups. ConclusionsSignificantly increased cord blood OxLDL and significantly increased OxLDL and IMA 7days after birth in neonates born to pre-eclamptic mothers might be an indicator of increased oxidative stress in pre-eclampsia.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 Therapeutic management of neonatal hemochromatosis: Report of four cases and literature review(SAGE PUBLICATIONS LTD, 2011) Annagur, Ali; Altunhan, Huseyin; Yuksekkaya, Hasan Ali; Ors, RahmiNeonatal hemochromatosis (NH) is a rare disease of iron metabolism that starts at intrauterine period causing liver failure and extrahepatic siderozis. The etiology of NH has not been understood exactly, yet it is accepted that a maternofetal alloimmune disorder that leads to liver failure in fetus causes the illness. The prognosis of NH is generally bad and death is inevitable if left untreated. The efficiency of chelation antioxidant coctail used in medical treatment is between 10% and 20% and these patients frequently need liver transplantation. In our study, we presented four newborn cases diagnosed as NH and treated medically. Of the four patients, one died of pulmonary hemorrhage and another died of multiorgan failure in the first week of hospitalization. The other two patients' clinical status and laboratory parameters recovered with medical treatment. However, since liver transplantation was not carried out, one of these patients died at the age of two and a half months and the other at eighth month due to sepsis. In this study, we would like to emphasize the importance of early liver transplantation in patients recovered with medical treatment.Öğe Total antioxidant and total oxidant states, and serum paraoxonase-1 in neonatal sepsis(WILEY, 2015) Annagur, Ali; Ors, Rahmi; Altunhan, Huseyin; Kurban, Sevil; Ertugrul, Sabahattin; Konak, Murat; Uygun, Saime SunduzBackgroundParaoxonase-1 (PON-1) is an enzyme with a glycoprotein structure that depends on calcium and which is located in serum high-density lipoprotein (HDL). The aim of this study was to evaluate PON-1, and oxidant/antioxidant state, before and after treatment for neonatal sepsis, and to determine the usability of PON-1 in neonatal sepsis treatment. MethodsA total of 35 neonatal sepsis patients and 35 healthy controls were included in the study. Activity of PON-1, total oxidant state (TOS) and total antioxidant state (TAS) were measured and oxidative stress index (OSI) was calculated. ResultsIn the neonatal sepsis patients, pre-treatment TAS, TOS and OSI were significantly higher than the post-treatment levels (P < 0.0001, P < 0.0001 and P < 0.0001, respectively), and PON-1 was significantly lower (P < 0.0001). Similarly, pre-treatment TAS, TOS and OSI in the sepsis group were also significantly higher than in the control group (P < 0.0001, P < 0.0001 and P < 0.0001, respectively) and PON-1 was significantly lower (P < 0.0001). Post-treatment TAS in the sepsis group was significantly higher than in the control group (P = 0.009), whereas post-treatment TOS, OSI and PON-1 in the sepsis group were not significantly different to the control group (P = 0.078, P = 0.597 and P = 0.086, respectively). ConclusionLow serum PON-1 was found in neonatal sepsis. Serum PON-1 is thought to be a useful biomarker to evaluate the effectiveness of treatment and recovery in neonatal sepsis.Öğe Total antioxidant, total oxidant and serum paraoxonase levels according to lipid administration method in parenterally fed premature infants(TAYLOR & FRANCIS LTD, 2017) Konak, Murat; Tarakci, Nuriye; Altunhan, Huseyin; Annagur, Ali; Toker, Aysun; Ors, RahmiObjective: The aim of our study was to determine whether lipid solutions delivered separately or in mixture with total parenteral nutrition (TPN) solutions effect the balance between oxidant and antioxidant levels in premature infants.Methods: A total of 60 preterm newborns who were delivered at their 30-34 gestational weeks and received TPN were included in the study. Premature newborns were randomized into two groups based on the delivery method of the lipid solution, separately (Group 1) or in mixture with TPN solutions (Group 2). Total antioxidant status (TAS), total oxidant status (TOS) and paraoxonase (PON-1) levels were analyzed in both blood samples, and oxidative stress index (OSI) was also calculated.Results: Thirty cases from both groups were included in the study. Statistically significant decrease in the level of TAS and increase in the level of PON-1 were detected at 72h of TPN therapy in both groups (p<0.05). Statistically significant decrease in both TOS and OSI levels were observed in Group 2 (p<0.05). In association with these findings, any statistically significant intergroup difference was not detected in both parameters regarding oxidant balance (p>0.05).Conclusion: Our study showed that according to lipid administration method any difference for oxidant-antioxidant balance was not detected.Öğe Total oxidant, antioxidant, and paraoxonase levels in babies born to pre-eclamptic mothers(WILEY, 2013) Altunhan, Huseyin; Annagur, Ali; Kurban, Sevil; Ertugrul, Sabahattin; Konak, Murat; Ors, RahmiAim The aim of this study was to investigate the oxidant-antioxidant status in babies born to pre-eclamptic mothers (BBPM). Material and Methods The paraoxonase (PON)-1, total antioxidant status (TAS), and total oxidant status (TOS) levels were measured in the cord blood and venous blood (7th day) of BBPM (n=31) and babies born to normotensive mothers (n=25). Results The PON-1 and TOS levels in the cord blood and venous blood on the 7th day were not significantly different between the two groups; however, the cord blood TAS levels were higher in BBPM (P=0.001), and the TAS levels in the venous blood were higher in the control group (P=0.021). Furthermore, the cord blood PON-1 levels of babies born to severely pre-eclamptic mothers (n=18) were higher than those of babies born to moderately pre-eclamptic mothers (n=13) (P=0.042). There were no differences in the cord blood TAS and TOS levels and venous blood PON-1, TAS, and TOS levels between babies born to severely and moderately pre-eclamptic mothers. Conclusion The increased TAS levels found in the cord blood of BBPM indicate that the fetus is protected against oxidative damage caused by increased oxidative stress in the mother. To the best of our knowledge, this is the first study in the published work investigating PON-1 levels in BBPM.