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Öğe A 10-year-old boy with limping complaint(Galenos Yayincilik, 2015) Ciftdemir, Mert; Ciftdemir, Nukhet Aladag; Aydin, Deniz; Ozbek, Ulfet Vatansever; Saridogan, Kenan[Abstract Not Available]Öğe A case report: 13q21-qter deletion with digital anomalies, duodenal atresia and anal atresia(Springer, 2015) Ozen, Yasemin; Gurkan, Hakan; Ozbek, Ulfet Vatansever; Atli, Emine Ikbal; Eker, Damla; Acunas, Betul[Abstract Not Available]Öğe Comparison of sleep problems between term and preterm born preschool children(Elsevier, 2020) Durankus, Ferit; Ciftdemir, Nukhet Aladag; Ozbek, Ulfet Vatansever; Duran, Ridvan; Acunas, BetulObjectives: Sleep disorders are common problems among all age groups. If sleep problems detected in childhood are not resolved successfully, they become sleep disorders and a chronic state. In this study, we aimed to compare sleep problems between preterm-born and term-born preschool-age children. Methods: In the cross-sectional study, children were grouped according to whether they were born preterm or at term. The preterm group included 137 children aged four to six years. The control group comprised 145 age-matched term-born preschool children. The prenatal, natal, demographical, and clinical characteristics of preterm- and term-born preschool-age children were compared. The Children's Sleep Habits Questionnaire (CSHQ) was used to identify sleep problems. The total score and subscores of the CSHQ were compared between the groups. Results: The percentage of gastroesophageal reflux (GER) symptoms and obstructive sleep apnea (OSA) symptoms were significantly higher in the preterm group. According to the cutoff point of the CSHQ, 97 children in the preterm group (70.8%) and 88 children in the control group (60.7%) had a sleep disorder. The total score of the CSHQ was significantly higher in the preterm group compared with the control group; however, the scores of the subscales were similar between the groups. In the regression analysis, a significant association was found between being born preterm and having sleep disorder (beta = 0.308, OR = 1.36, p = 0.04). Conclusions: Our study reported a high percentage of sleep problems in preterm-born preschool children. We suggest that prematurity is associated with sleep problems even if the etiology of sleep problems is heterogeneous. Symptoms regarding GER and OAS should be investigated, and precautions, such as prohibiting maternal cigarette smoking, should be taken in preterm infants. (C) 2020 Elsevier B.V. All rights reserved.Öğe Effect of neonatal resuscitation courses on long-term neurodevelopmental outcomes of newborn infants with perinatal asphyxia(Wiley-Blackwell, 2012) Duran, Ridvan; Gorker, Isik; Kucukugurluoglu, Yasemin; Ciftdemir, Nukhet Aladag; Ozbek, Ulfet Vatansever; Acunas, BetulBackground: In previous studies, it has been demonstrated that Neonatal Resuscitation Program (NRP) courses improve the early outcomes of infants with perinatal asphyxia, but there has been no evidence to demonstrate the effect of NRP on long-term outcomes of perinatal asphyxia. The goal of the present study was to determine the effect of NRP courses on the long-term neurodevelopmental outcome of perinatal asphyxia. Methods: This prospective study included infants referred to the Neonatal Unit during the years 2003-2005. Those patients who were referred before NRP courses (pretraining period) were designated as group 1, those who were referred after the first NRP course (transition period) as group 2, and those who were referred after the second NRP course (post-training period) as group 3. Neurodevelopmental outcomes were assessed and compared at 4-6 years of age. Results: The study involved 40 patients: 23 in group 1, nine in group 2 and eight in group 3. The number of patients who had been diagnosed with cerebral palsy was 13 in group 1, two in group 2, and one in group 3, which was a significant decrease. The number of patients with seizures and electroencephalography abnormality was 12 and 14 in group 1, three and two in group 2, and one and one in group 3, respectively, which was also a significant decrease. Conclusions: NRP courses have positive effects on short-term as well as long-term neurodevelopmental outcomes of infants with perinatal asphyxia. Further studies are required to determine the effects of NRP courses on minor deficits, such as cognitive and behavioral disturbances.Öğe The effects of noise reduction by earmuffs on the physiologic and behavioral responses in very low birth weight preterm infants(Elsevier Ireland Ltd, 2012) Duran, Ridvan; Ciftdemir, Nukhet Aladag; Ozbek, Ulfet Vatansever; Berberoglu, Ufuk; Durankus, Ferit; Sut, Necdet; Acunas, BetulObjective: Preterm infants are exposed to loud noises during their stay in the neonatal intensive care unit which can lead to physiologic and behavioral alterations and even hearing loss. The use of earmuffs can reduce sound level and these changes. The objective of the present study is to evaluate the effectiveness of the earmuffs in preterm infants solely cared for in closed incubators. Methods: A comparative prospective study comprising 20 clinically stable preterm infants weighing less than 1500 g cared in closed incubator was conducted. Preterm infants acted as their own controls whereby they were observed without earmuffs (Group 1) for 2 days and with earmuffs (Group 2) on consecutive 2 days. The preterm infants' physiologic responses and Anderson Behavioral State Scoring System (ABSS) scores were assessed over 30 s every 2 h for 8 h during daytime for 4 days. Results: Out of 20 preterm infants, 6 were male and 14 female with a mean birth weight of 1220 +/- 209 g, gestational age of 29.9 +/- 2.1 weeks. The total number of measurements was 320. The mean ABSS scores of Group 1 and 2 were 3.07 +/- 1.1 and 1.34 +/- 0.3, respectively. Statistically significant difference was noted between the means of ABSS scores (p < 0.001). Preterm infants with earmuffs (87.5%) were more frequently observed in a quiet sleep state of ABSS compared with those without earmuffs (29.4%). Conclusions: Noise level reduction was associated with significant improvement in behavioral states of ABSS. We suggest that noise reduction in preterm infants with earmuffs is helpful by improving sleep efficiency and increasing time of quiet sleep. (C) 2012 Elsevier Ireland Ltd. All rights reserved.Öğe Evaluation of Infant Mortality in Edirne Between Years 2012-2013(Galenos Yayincilik, 2015) Ciftdemir, Nukhet Aladag; Ozden, Deniz; Sayin, Muge; Oksay, Altan; Tarim, Celalettin; Ozbek, Ulfet Vatansever; Ceylan, GulsahAim: Infant mortality rate is one of the most important medical indicators of the quality of health services provided in a country or region. The goal of the study is to detect causes of the infant mortality in Edirne province in 2012 and 2013 and to investigate the factors that affect this rate. Materials and Methods: This descriptive study was carried out retrospectively and the authors examined Infant Mortality Provincial Preliminary Examination reports for babies. Causes of mortality and preventability were examined, analyzed on SPSS 20.0 program, percentage and Chi-square test were used in statistical analysis and p<0.05 level was accepted as significant. Results: Infant mortality rate was found to be 8.3 per thousand in 2012 and 7.5 per thousand in 2013. The first three causes of mortality and their percentages were prematurity-immaturity 39.4% (n=26), congenital anomalies-syndromes 13.6% (n=9) and congenital heart diseases 12.1% (n=8). 86.4% of child deaths (n=57) occurred due to unpreventable causes and 9.1% (n=6) occurred due to preventable causes while no decision could be made in 2 cases and no data were reported in 1 stillbirth case. 59.6% (n=34) of the babies whose mortality causes were unpreventable died at early neonatal period while 100% (n=6) of the babies whose mortality causes were preventable died at post-neonatal period and no significant difference was detected (p<0.05). The rate of unpreventable causes increased as gestational age and birth weight decreased while the rate of preventable causes increased as gestational age and birth weight increased and a significant difference was detected (p<0.05). Conclusion: Neonatal deaths comprise a vast majority of infant mortality cases in our country and worldwide. Decreasing prematurity, improving perinatal care, developing staff and technical requirements of newborn intensive care units, increasing the number of centers to give medical and surgical care for congenital heart diseases, terminating congenital anomalies during pregnancy will help dropping infant mortality rate.Öğe The Relation Between Serum Levels of Insulin-like Growth Factor-1 and Bronchopulmonary Dysplasia(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2019) Ciftdemir, Nukhet Aladag; Acunas, Betul; Ozbek, Ulfet Vatansever; Duran, RidvanObjective: The etiology of bronchopulmonary dysplasia (BPD) which is the most important unwanted consequence of premature delivery at long term has not been determined clearly yet.. Insulin-like growth factor-1 (IGF-1) is involved in both prenatal and postnatal lung growth. Our aim is to characterize postnatal changes in serum IGF-1 in relation to development of BPD in preterms. Method: Sixty-seven preterm newborns were evaluated prospectively in order to investigate independent risk factors associated with BPD and to determine the relation between serum IGF-1 levels and BPD. Infants included in the study were divided into two groups as those that developed (Group 1; n=12) and did not develop BPD (Group 2; n=55). Serum IGF-1 levels were measured from venous blood samples of each infant on days 1, 7, 14 and 28 after birth. Results: When the variables showing significant differences in the comparisons between the two groups were evaluated in different logistic regression models, according to the most significant model; presence of chorioamnionitis did not contribute significantly to the development of BPD. It was found that 1 week increase in gestational week reduced the risk of BPD formation by half, while the presence of RDS or sepsis increased the risk of development of BPD by 14.4, and 9.6 times, respectively. ROC analysis with serial measurements of IGF-1 showed that IGF-1 was not a determinant of BPD development. Conclusion: We could not find any relation between development of BPD and serum IGF-1 levels in our study and concluded that the smaller number of newborn who developed BPD could have limited the evaluation of this association.Öğe The relationship between leukemoid reaction and perinatal morbidity, mortality, and chorioamnionitis in low birth weight infants(Elsevier Sci Ltd, 2010) Duran, Ridvan; Ozbek, Ulfet Vatansever; Ciftdemir, Nukhet Aladag; Acunas, Betul; Sut, NecdetObjectives: Neonatal leukemoid reaction (NLR) is relatively rare and considered as a white blood cell (WBC) count >= 50 x 10(9)/l. The aim of this study was to investigate the association of NLR with neonatal morbidity and mortality and maternal chorioamnionitis in low birth weight infants. Methods: In this case-controlled retrospective study, the medical records of 1200 newborn infants with a birth weight <2500 g admitted to the neonatal unit over a period of 5 years were reviewed. The infants who developed features of NLR (n = 17, 1.4%) formed the study group, while the remainder without NLR, matched for gestational age and birth weight (n = 123), formed the control group. A chart review was performed and salient demographic, clinical, and laboratory data abstracted. A statistical analysis was subsequently performed on this data. Results: The mean WBC and absolute neutrophil counts of infants with NLR were significantly higher than those in the control group. The peak time of NLR was at 7.9 +/- 3.6 (interquartile range (IQR) 1-30) days and on average it improved within 4.1 +/- 1.95 (IQR 2-9) days. It was noted that those infants with NLR were mostly born by vaginal delivery and their mothers had a higher rate of early rupture of the membranes and chorioamnionitis. NLR was associated with a 4-fold increase in sepsis, 20-fold increase in intraventricular hemorrhage, 54-fold increase in bronchopulmonary dysplasia, and 6-fold increase in mortality. In the study group, those infants whose mothers had chorioamnionitis had a higher rate of early rupture of the membranes and they developed sepsis and intraventricular hemorrhage more often than those whose mothers did not have clinical chorioamnionitis. Conclusions: In low birth weight newborn infants, NLR is significantly associated with sepsis, intraventricular hemorrhage, bronchopulmonary dysplasia, and a high mortality rate. Also, those infants with NLR are more likely to be born to mothers with chorioamnionitis and they face sepsis and intraventricular hemorrhage more often. (C) 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
