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Öğe Analysis of Pediatric Patients Presenting to a Reference Child Hospital with Complaint of Poisoning(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2020) Ceylan, Gokhan; Keskin, Meliksah; Sandal, Ozlem; Tunc, Gaffari; Tuygun, Nilden; Yilmaz, GoncaObjective: Although it has different mortality and morbidity rates all over the world, childhood poisoning has an important place among childhood health problems. Considering increase in health expenditures, duration of hospital stay and loss of labor caused by poisonings, the problem has not only medical but also social aspects. Method: In addition to demographic data of 1043 pediatric patients admitted to our hospital with complaints of poisoning, pre-admission intervention, place of poisoning, admission time, agent and time of poisoning, time elapsed after poisoning, admission findings, hospitalization period, diagnostic tests applied and treatment modalities were evaluated retrospectively with their prognosis. Results: Of the 1043 cases, 54.5% were female. Female ratio increased to 82% in 139 cases of suicide. When the causes of poisoning were examined, they occurred due to use of pharmaceutical agents drugs (47.2%), industrial (41.5%), and agricultural products (5.4%), CO (2.7%), foods (2.6%), unknown factors (0.5%), and animal bites (0.2%). Gastric-lavage, activated-charcoal, intravenous-fluid regimen (33%) were the most common treatment modalities. Two of the three mortal cases were due to colchicine, and the third one was caused by CO poisoning. Conclusion: Although the development in the diagnosis and treatment of poisonings is pleasing, the most accurate approach to this issue will be to increase the protective measures. In addition to these standard measures, each country should set priorities in line with its own epidemiological study. Regarding the higher mortality rate (22%) we may suggest that clinicians should be more careful and aggressive in the diagnosis and treatment of colchicine intoxications, which can be associated with mortality even at low doses.Öğe Association between thiol-disulfide hemostasis and transient tachypnea of the newborn in late-preterm and term infants(Bmc, 2023) Demirtas, Mehmet Semih; Erdal, Huseyin; Kilicbay, Fatih; Tunc, GaffariBackgroundTransient tachypnea of the newborn (TTN), which is the most common respiratory disease in the neonatal period, increases respiratory workload in newborns. We purposed to evaluate the oxidative stress (OS) status and thiol disulfide hemostasis in late preterm and term newborns with TTN in this study.MethodsThe study was carried out in a single-centre neonatal intensive care unit to investigate the effect of continuous airway positive pressure (CPAP) on the oxidative system in newborns with TTN. Thiol (native and total) and disulfide levels, total antioxidant and oxidant status (TAS/TOS) and Oxidative stress index (OSI) levels were measured.ResultsTotal thiol levels measured before treatment was 429.5 (369.5-487) mu mol/L in the late preterm group and 425 (370-475) mu mol/L in the term group (p = 0.741). We found significant changes in TOS, OSI and TAS levels after CPAP treatment in the late preterm group (p < 0.001, p < 0.001, p = 0.012 respectively). It was also found that the disulfide level, which was 26.2 (19.2-31.7) before the treatment, decreased to 19.5 (15.5-28.75) after the treatment (p = 0.001) in late preterms.ConclusionCPAP treatment reduced the OS status burden associated with TTN in neonates. The late preterm newborns with TTN are more affected by OS and increased OS levels decrease with CPAP treatment.Öğe Candidal Infections in the Neonatal Intensive Care Unit: A Retrospective Observational Study(Kare Publ, 2023) Tunc, Gaffari; Toksoz, Arife; Kilicbay, FatihObjectives: The aims of this study were to evaluate the demographic characteristics, risk factors, mortality rates, and laboratory findings of infants with fungal sepsis in the Neonatal Intensive Care Unit (NICU).Methods: This retrospective multicenter study included patients in NICU with Candida spp isolated in blood cultures between November 01, 2019, and September 01, 2022. The patients were evaluated in two groups as Group 1 infants with Candida albicans and Group 2 infants with Candida non-albicans positive blood cultures.Results: Candida infection was detected in blood cultures in 57 of 3450 patients admitted to the NICU. A total of 57 infants in-cluded in the study. Candida infection was determined 1.6% of infants in the study population, and 57% of them were extremely pre-term infants. There was no significant difference between the two groups in terms of laboratory data. Normal vaginal birth was determined at a higher rate in Group 1. In Group 2, length of hospital stay, duration of total parenteral nutrition (TPN), and mechanical ventilation (MV) were determined to be longer. The mortality due to Candida fungemia was determined as 35%, and of these patients, 65% had an additional medical condition.Conclusion: In accordance with the literature, this study showed that prolonged MV and longer TPN increased the incidence of fungal sepsis. Therefore, to decrease the fungal sepsis rate of NICU, shortening the hospital stay and effective screening programs are recommended.Öğe Evaluation of conus medullaris level in newborn infants(Cukurova Univ, Fac Medicine, 2023) Yildiz, Bulent; Tunc, Gaffari; Soylemez, BurcakPurpose: Previous studies have reported that the conus medullaris (CM) is located between T12 and L2 in most adults, but no significant ascent has been observed during childhood. There is evidence that the normal position of the CM in an adult is acquired at birth in the majority of cases. Studies have shown that there are differences in CM levels in neonates. This situation causes problems for interventional procedures in the neonatal period. The aim of this study is to determine CM levels in preterm/term neonates using ultrasound (US).Materials and Methods: Newborn infants (gestational age: 24-43 weeks) admitted to the neonatal intensive care unit between March 2020 and June 2021 were evaluated for CM levels by the postnatal US. Infants with central nervous system abnormalities, dysmorphic features, somatic or various genetic diseases, or their parent's refusal to participate were excluded from the study.Results: Of the 189 neonates infants included in our study, 85 (44.6%) were female, 104 (55.4%) were male, 139 (73.54%) were preterm (24-36 weeks), and 50 (26.46%) were term (37-42 weeks) neonates. As a result of the US performed on the first day of 189 neonates, CM levels, 31 (16.4%) were L1, 31 (16.4%) were L1-2, and 71 (37.6%) were L2. There is a strong correlation between birth weight and birth week (r 0.84). There is a negative relationship between birth weight and CM level (r-0,20), gestational age, and CM level (r-0,23).Conclusion: Conus medullaris level was negatively correlated with gestational age and increased with advancing gestational age. In addition, the CM level shows a slower rise at 28-40 weeks of postmenstrual age and reaches the normal level (L1-L2) in the neonatal period, as in adults. Knowing the level of the CM in the newborn period will ensure that spinal procedures such as lumbar puncture to be applied to the spinal region can be performed safely.Öğe Evaluation of Oxidative Stress Levels and Dynamic Thiol-disulfide Balance in Patients with Retinopathy of Prematurity(Taylor & Francis Inc, 2023) Erdal, Huseyin; Demirtas, Mehmet Semih; Kilicbay, Fatih; Tunc, GaffariPurposeThe aim of this study is to evaluate both dynamic thiol-disulfide homeostasis and oxidative stress (OS) levels in patients with retinopathy of prematurity (ROP).MethodsA total of 129 infants of <34 weeks gestational age were enrolled in the present study. The thiol-disulfide homeostasis was determined by using the new, cost-effective and fully automated colorimetric method. Total antioxidant status (TAS), Total oxidant status (TOS) and Oxidative stress index (OSI) levels were evaluated.ResultsWe found serum TAS levels were lower while serum TOS and OSI levels were significantly higher in patients with ROP compare to the without ROP group (p < .05). However, native, total and disulfide values were not statistically significant between the groups (p > .05). In addition, we also evaluated the native, total and disulfide levels in patients with ROP according to grades and no statistically significant results were found (p > .05). Low birth weight (p = .001), gestational age (p = .001) and 5-min Apgar score were significantly lower in the ROP group.ConclusionThis study revealed that dynamic thiol-disulfide homeostasis was changed in patients with ROP. Increased TOS and decreased TAS levels may be associated with functional reduction of the antioxidant system due to increased OS. This indicate that ROP patients are highly sensitive to OS. The dynamic thiol-disulfide homeostasis may conduce to the pathophysiological mechanism and disease follow-up in patients with ROP. The results of this study show that ROP patients are highly sensitive to oxidative stress.Öğe Mortality in patients with hypoxic ischemic encephalopathy treated with therapeutic hypothermia(Cukurova Univ, Fac Medicine, 2025) Tunc, Gaffari; Korgali, Elif Unver; Mutlu, Muhammet Ali; Unsal, Gulsah; Gulturk, Esra AkaydinPurpose: Hypoxic-ischemic encephalopathy is a heterogeneous clinical syndrome that occurs in the perinatal period and is characterized by altered consciousness or seizures, respiratory depression, and hypotension. The aim of this study was to evaluate mortality in hypoxic-ischemic encephalopathy patients receiving therapeutic hypothermia. Materials and Methods: The study included 97 hypoxicUnit. The cases were evaluated for mortality and were divided into two groups: group 1 (n: 9, non-survivors) and complications of hypoxic-ischemic encephalopathy, APGAR scores, blood support, and laboratory parameters were evaluated for mortality. the risk of death. Conclusion: Mortality rates were significantly higher cases that developed Meconium aspiration syndrome associated hypoxic-ischemic encephalopathy than hypoxic-ischemic encephalopathy cases without meconium aspiration syndrome. A low APGAR score, increased number of intubation days, acute kidney injury, thrombocytopenia, and need for fresh frozen plasma were associated with a high risk of mortality in infants receiving therapeutic hypothermia for hypoxic-ischemic encephalopathy, and the presence of meconium aspiration syndrome significantly increased this risk.Öğe Outcomes of rescue exchange transfusion in severe neonatal hyperbilirubinemia(Cukurova Univ, Fac Medicine, 2022) Kilicbay, Fatih; Toksoz, Arife; Tunc, GaffariPurpose: Urgent treatment in newborns with severe hyperbilirubinemia is the removal of bilirubin from the body by exchange transfusion (ET) as the main treatment modality. The aim of this study was to evaluate the outcomes of newborns with severe hyperbilirubinemia who underwent ET in two neonatal intensive care units (NICUs). Materials and Methods: The clinical data were collected of 28 newborns who had undergone rescue exchange transfusions after hospitalization with a diagnosis of severe hyperbilirubinemia in NICUs of a university hospital and a state hospital. Results: Evaluation was made of 28 newbons with a median serum bilirubin level on admission of 31.2 (20.3-36.8) mg/dL. The leading cause for exchange transfusion was hemolytic jaundice (67.8%), followed by inadequate feeding (14%). The most common cause of hyperbilirubinemia was Rh incompatibility. The reported rate of adverse events associated with exchange transfusion was 71%. The most common complications due to ET were thrombocytopenia and anemia. Four infants died after the ET therapy. Acute bilirubin encephalopathy (ABE) was detected in 39% of the newborns. Serum bilirubin and bilirubin/albumin ratios were found to be high in newborns with ABE. Conclusion: Newborns with severe hyperbilirubinemia, especially when related to hemolytic jaundice, may need rescue ET. As newborns with severe hyperbilirubinemia with a high bilirubin/albumin ratio are at risk of ABE, ET should be considered in these casesÖğe Oxidative Stress Levels and Dynamic Thiol-Disulfide Balance in Preterm Newborns with Bronchopulmonary Dysplasia(Oxford Univ Press, 2023) Demirtas, Mehmet Semih; Kilicbay, Fatih; Erdal, Huseyin; Tunc, GaffariObjective The aim of this study was to assess the oxidative stress (OS) levels and dynamic thiol-disulfide balance in preterm newborns with bronchopulmonary dysplasia (BPD). Methods This prospective study included newborns separated into 2 groups, those with BPD (case) or without BPD (control). The 2 groups were compared by clinical and laboratory findings. The OS parameters total oxidant status (TOS), total antioxidant status (TAS), OS index (OSI), native thiol (NT), and total thiol were measured within the first day after birth. Oxygen requirements were measured using the fraction of inspired oxygen (FIO2) recorded in the first hour after birth/admission and the average FIO2 within 28 days of the birth. Results Infants diagnosed with BPD had a significantly lower gestational age and birth weight and a lower 5-min Apgar score (P < .05). Infants with BPD also had a higher rate of respiratory distress syndrome, rate of use of surfactant therapy, duration of ventilation therapy, and duration of hospital stay compared with control (P = .001, P = .001, P = .001, and P = .001, respectively). Plasma TAS and NT levels of newborns with BPD were significantly lower than newborns without BPD (P < .05). In the BPD group, plasma TOS and OSI levels were significantly higher than in the control group. Conclusion We found that OS was increased in newborns with BPD. The clinical significance of this study will provide the clinician with a different perspective on BPD by determining the dynamic thiol disulfide balance.Öğe Risk of autism spectrum disorder in children with a history of hospitalization for neonatal jaundice(Tubitak Scientific & Technological Research Council Turkey, 2021) Tunc, Gaffari; Uzun Cicek, Ayla; Kilicbay, FatihBackground/aim: Limited research has focused explicitly on the association between neonatal jaundice and autism spectrum disorder (ASD), and inconclusive evidence exists in the literature within this framework. This study aimed specifically to investigate whether neonatal jaundice is a potential risk factor for ASD and whether there is a connection between the types of neonatal jaundice and the severity of ASD. Materials and method: This study involved 119 children with ASD [90 males (75.6%), 29 females (24.4%), mean age: 45.39 +/- 11.29 months] and 133 healthy controls [100 males (75.2%), 33 females (24.8%), mean age: 46.92 +/- 11.42 months]. Psychiatric disorders were diagnosed through the Diagnostic and Statistical Manual of Mental Disorders criteria. Childhood Autism Rating Scale (CARS) was used to assess the screening and diagnosis of autism. A specially prepared personal information sheet was employed to investigate sociodemographic characteristics and birth and clinical histories. Results: The rate of the history of jaundice and pathological jaundice requiring hospitalization and phototherapy were significantly higher in the ASD group compared to the controls. CARS total score and the mean scores of nearly all items were statistically higher in children with a history of pathological jaundice than those with a history of physiological jaundice. Conclusion: Neonatal jaundice, depends on its severity, seems to be one of the possible biological factors associated with subsequent development of and the severity of ASD. Establishing a causal relationship between neonatal jaundice and ASD by more comprehensive studies may contribute to alleviating of the severity of ASD for individuals at risk.Öğe Splenic rupture presenting with marked scrotal ecchymosis in a 2-day-old newborn(Taylor & Francis Ltd, 2022) Tunc, Gaffari; Guney, Cengiz; Aygunes, UtkuSplenic rupture is a rare and severe condition in neonates. The signs and symptoms are vague and non-specific and are often not recognised before the onset of hypovolaemic shock or death. A 2-day-old infant presented with scrotal ecchymosis, and ultrasonography detected haemorrhage in the scrotal, right inguinal and adrenal regions. Computed tomography demonstrated a peri-splenic haematoma. Haemoglobin (Hb) was 2.79 g/dL and, despite repeated transfusions, the Hb level could not be sustained. Exploratory laparotomy detected a large haematoma in the splenic region, and, because of the uncontrolled haemorrhage, splenectomy was required.Öğe The levels of postpartum depression, anxiety, and hopelessness of the mothers of infants receiving therapeutic hypothermia in NICU(Routledge Journals, Taylor & Francis Ltd, 2023) Korgali, Elif Unver; Tunc, GaffariThe aim of this study was to evaluate anxiety, postpartum depression (PPD), and hopelessness in the mothers of newborns receiving therapeutic hypothermia for hypoxic ischemic encephalopathy (HIE) in NICU. A total of 104 mothers and infants were analyzed as a study group with HIE (n = 52) and a control groups of non-HIE (n = 52). All the mothers completed The State-Trait Anxiety, Beck Hopelessness and Edinburgh Postpartum Depression Scales (EPDS). The EPDS scores, the rate of PPD, state-trait anxiety and hopelessness levels were similar in the two groups. In the HIE group, chest compression and persistent pulmonary hypertension in infants were associated with maternal anxiety, hopelessness, and PPD. The absence of a statistical difference between the two groups in the current study does not mean that these differences do not exist. These results demonstrate the need for further detailed studies on this subject.
