Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Refractive Change in Pediatric Patients with Intermittent Exotropia(2023) Oruz, Oguzhan; Pelit, Aysel; Akar, Serpil; Ates, Eylem Gul; Oto, Sibel; 0000-0002-4771-4698; 37730159; U-5246-2018PURPOSE To determine the relationship between intermittent exotropia (IXT) and refractive change and the effects of the methods applied in IXT follow-up on refractive change.METHOD The medical records of 228 patients with IXT (group 1) and 110 patients without strabismus (group 2) who were followed between 2008 and 2022 were analyzed retrospectively. Group 1 was divided into three subgroups: overminus correction (group 1A), patients who underwent surgery (group 1B), and patients who were observed (group 1C).RESULTS Annual myopic progression was-0.21 +/- 0.32 D (range,-1.26 to +1.92) in group 1 and -0.07 +/- 0.30 D (range,-1.13 to +1.00) in group 2 (P < 0.001). Annual myopic progression was-0.26 +/- 0.29 D (range,-1.26 D to +0.12 D) in group 1A,-0.25 +/- 0.35 D (range, -1.15 D to +0.25 D) in group 1B, and-0.19 +/- 0.33 D (range,-1.12 D to +1.92 D) in group 1C. There was no difference in annual myopic progression between the subgroups (P = 0.670). The annual change in myopic refraction between each of the group 1 subgroups and group 2 was statistically significantly different (P < 0.001, P = 0.023, P < 0.001, resp.).CONCLUSIONS Myopia progression was significantly greater in children with IXT than in the normal population. Myopia progression did not vary with exotropia treatment.Item Evaluation of Burn Injuries Related to Liquefied Petroleum Gas(2014) Tarim, Mehmet Akin; 23799481Liquefied petroleum gas (LPG) is a fuel that is widely used for domestic, agricultural, and industrial purposes. LPG is also commonly used in restaurants, industries, and cars; however, the home continues to be the main site for accidents. In Turkey, the increased usage of LPG as a cooking or heating fuel has resulted in many burn injuries from LPG mishaps. Between January 2000 and June 2011, 56 LPG-burned patients were compared with 112 flame-burned patients. There were no significant differences with respect to the mean age, sex, hospitalization time, and mortality in both groups. In the LPG-caused burn cases, 41 burns (73.2%) occurred at home, seven (12.5) were work-related mishaps, and eight (14.3) were associated with car accidents. The majority of the LPG burns (82%, 46 patients) resulted from a gas leak, and 18% of them were related to the failure to close LPG tubes in the patients' kitchens (10 patients). Burns to the face and neck (82 vs 67%, P = .039) and upper (62 vs 23%, P = .000) and lower (70 vs 45%, P = .002) extremities were significantly higher in LPG-caused burn cases than flame-burned cases. General awareness regarding the risk of LPG and first aid for burns appears to be lacking. The LPG delivery system should be standardized throughout countries that widely use LPG.Item Laser Acupuncture Before Heel Lancing for Pain Management in Healthy Term Newborns: A Randomised Controlled Trial(2015) Abbasoglu, Aslihan; Cabioglu, Mehmet Tugrul; Tugcu, Ali Ulas; Yapakci, Ece; Tekindal, Mustafa Agah; Tarcan, Aylin; 0000-0002-4060-7048; 26438556; AIC-4823-2022; ABI-2113-2020; U-9270-2018Background Healthy term newborns commonly undergo painful procedures during routine follow-up visits. Non-pharmacological strategies have currently become more important than pharmacological analgesic agents in neonatal pain management. Acupuncture is a new non-pharmacological method for preventing pain in newborns. Objective We aimed to investigate the effect of laser acupuncture (LA) at the Yintang point before heel lancing as a non-pharmacological intervention for procedural pain management in infants. MethodsForty-two term newborns, who were undergoing heel lancing between postnatal days 3 to 8 as part of routine neonatal screening, were randomly assigned to the LA group or the oral sucrose group. In the LA group, 2 min before the heel lancing, 0.3 J of energy was applied to the Yintang point using a Laser PREMIO-30 unit for 30 s. In the sucrose group, each infant received 0.5 mL of 24% sucrose orally via syringe 2 min before the heel lancing. Each baby's behaviour was scored using the Neonatal Infant Pain Scale (NIPS), assessed blinded to group. Results There were no significant differences between the LA and oral sucrose groups with respect to means for gestational week of age at birth, birth weight, actual weight, or Apgar score. Mean procedure time was significantly shorter in the LA group; however, mean crying time was longer and NIPS score was lower compared to the oral sucrose group. Conclusions Our results indicate that 0.3 J of LA at the Yintang point before heel lancing is less effective than oral sucrose for reducing the discomfort of this procedure.Item Natural History and Conservative Treatment Outcomes for Hydroceles: A Retrospective Review of One Center's Experience(2018) Acer Demir, Tugba; Ekenci, Berk Yasin; Ozer, Dogancan; Turanoglu, Mehmet Ali; Haberal, Kadem Cem; Bilgin, Elif Bengisu; Hicsonmez, Akgun; 0000-0001-5391-9094; 0000-0002-5939-4548; 29032240; E-4455-2019; GPG-1911-2022OBJECTIVE To elucidate epidemiological data and hydrocele progression, we reviewed pediatric patients diagnosed with hydroceles in our institution retrospectively. MATERIALS AND METHODS We reviewed data from 355 pediatric patients with hydroceles. Questionnaires regarding age at diagnosis, time of delivery, presence of hydroceles in the father and brothers, age at recovery, age at surgery, cause of hydrocele (if present), type of hydrocele, associated pathologies, treatments, and posthydrocelectomy complications were completed by reviewing patients' medical records and interviewing their families. RESULTS Patients with congenital hydroceles were more frequently born prematurely (32.5%) than were patients with noncongenital hydroceles (15.9%; P=.001). Fathers of 10 patients (3.7%) and brothers of 21 patients (7.7%) also had hydroceles. Hydroceles were associated with inguinal hernias on the same side (12.2%), cryptorchidism (7.5%), varicoceles (6.0%), and testis torsion (0.5%). Among patients aged >1 year (n=185), 27 did not undergo operations and healed spontaneously at an average of 5.30 +/- 3.36 months. For children aged >1 year who did not undergo surgery, the rate of spontaneous recovery within 6 months was 77.8% and that within 1 year was 96.3%. CONCLUSION Until strong evidence of hydrocele-induced testicular damage in children arises, we recommend following up congenital hydroceles until at least 1 year and preferably 2 years of age. We recommend following up noncongenital hydroceles for at least 6 months and preferably 1 year if there is no associated pathology indicating the need for earlier surgery such as an inguinal hernia, cryptorchidism, tense hydrocele, testis torsion, or testis mass. (c) 2017 Elsevier Inc.Item Comparative study of treosulfan plus Fludarabine (FT14) with busulfan plus Fludarabine (FB4) for acute myeloid leukemia in first or second complete remission: An analysis from the European Society for Blood and Marrow Transplantation (EBMT) Acute Leukemia Working Party (ALWP)(2022) Gavriilaki, Eleni; Labopin, Myriam; Sakellari, Ioanna; Salmenniemi, Urpu; Yakoub-Agha, Ibrahim; Potter, Victoria; Berceanu, Ana; Rambaldi, Alessandro; Hilgendorf, Inken; Kroeger, Nicolaus; Mielke, Stephan; Zuckerman, Tsila; Sanz, Jaime; Busca, Alessandro; Ozdogu, Hakan; Anagnostopoulos, Achilles; Savani, Bipin; Giebel, Sebastian; Bazarbachi, Ali; Spyridonidis, Alexandros; Nagler, Arnon; Mohty, Mohamad; 36138068Different doses of treosulfan plus fludarabine have shown advantage over reduced intensity regimens. However, data comparing higher doses of treosulfan to myeloablative busulfan are limited. Thus, we compared outcomes between FT14 (fludarabine 150/160 mg/m(2) and treosulfan 42 g/m(2), or FT14) over FB4 (fludarabine 150/160 mg/m(2) and busulfan 12.8 mg/kg). We retrospectively studied patients from European Society for Blood and Marrow Transplantation registry: a) adults diagnosed with acute myeloid leukemia (AML), b) recipients of first allogeneic hematopoietic stem cell transplantation (HSCT) from unrelated or sibling donor (2010-2020), c) HSCT at first or second complete remission, d) conditioning with FT14 or FB4. FT14 recipients (n = 678) were older, with higher rates of secondary AML, unrelated donors, peripheral blood grafts, and adverse cytogenetics, but lower percentage of female donor to male recipient compared to FB4 (n = 2025). Analysis was stratified on age. In patients aged < 55 years, FT14 was associated with higher relapse incidence (RI) and lower Leukemia-Free Survival (LFS). In patients aged >= 55 years, acute GVHD CI was higher in FB4, without significant differences in other outcomes. Although FT14 has been used for higher-risk HSCT patients, our large real-world multicenter study suggests that FB4 is associated with better outcomes compared to FT14 in younger patients.Item Familial Mediterranean fever associated frosted branch angiitis, retinal vasculitis and vascular occlusion(2021) Mansour, Hana A.; Ozdal, Pinar C.; Kadayifcilar, Sibel; Tugal-Tutkun, Ilknur; Eser-Ozturk, Hilal; Yalcindag, F. Nilufer; Petrushkin, Harry; Chan, Errol W.; Belfaiza, Soukaina; Karadag, Remzi; Gungor, Sirel Gur; Parodi, Maurizio Battaglia; Mansour, Ahmad M.; 0000-0001-6178-8362; 34725467; AAD-5967-2021Objectives To analyse the entity of retinal vasculitis, including frosted branch angiitis (FBA), or retina vascular occlusion in patients with familial Mediterranean fever (FMF). Methods Retrospective collaborative case series using invitation by email to uveitis specialists around the Mediterranean basin. This series was combined with a literature review. Exclusion criteria included infectious diseases, Behcet's disease or other autoimmune diseases. Results A total of 16 patients (21 eyes) had FMF and retinal vasculitis (FBA 11 patients, mild retinal vasculitis 5 patients). The mean age at onset of vasculitis was 29.5 +/- 13.4 (range 9-62) with a female to male ratio of 9 to 7. In 19 eyes treated with various forms of corticosteroid and/or immunosuppression, the mean initial spectacle-corrected visual acuity improved from 6/194 to 6/10.5 at the last mean follow-up of 29.0 +/- 34.9 months (p < 0.001). The most common FEVR mutations were M680I and M694V. In addition, retinal vascular occlusions included one case of central retinal artery occlusion and one case of branch retinal artery occlusion. Conclusion FBA and milder forms of retinal vasculitis are associated with FMF. Therapy involves an increase in colchicine dosage in early cases, a long period of oral corticosteroid, intravitreal dexamethasone implant or periocular corticosteroid in select cases, and combination therapy with systemic immunosuppression in severe cases. FMF needs to be included in the differential diagnosis of retinal vasculitis.Item The skills of defibrillation practice and certified life-support training in the healthcare providers in Turkey(2021) Gultekingil, Ayse; 0000-0001-7955-5735; 34669998; AAR-9945-2020Aim of the study Successful cardiopulmonary resuscitation and early defibrillation are critical in survival after in- or out-of-hospital cardiopulmonary arrest. The scope of this multi-centre study is to (a) assess skills of paediatric healthcare providers (HCPs) concerning two domains: (1) recognising rhythm abnormalities and (2) the use of defibrillator devices, and (b) to evaluate the impact of certified basic-life-support (BLS) and advanced-life-support (ALS) training to offer solutions for quality of improvement in several paediatric emergency cares and intensive care settings of Turkey. Methods This cross-sectional and multi-centre survey study included several paediatric emergency care and intensive care settings from different regions of Turkey. Results A total of 716 HCPs participated in the study (physicians: 69.4%, healthcare staff: 30.6%). The median age was 29 (27-33) years. Certified BLS-ALS training was received in 61% (n = 303/497) of the physicians and 45.2% (n = 99/219) of the non-physician healthcare staff (P < .001). The length of professional experience had favourable outcome towards an increased self-confidence in the physicians (P < .01, P < .001). Both physicians and non-physician healthcare staff improved their theoretical knowledge in the practice of synchronised cardioversion defibrillation (P < .001, P < .001). Non-certified healthcare providers were less likely to manage the initial doses of synchronised cardioversion and defibrillation: the correct responses remained at 32.5% and 9.2% for synchronised cardioversion and 44.8% and 16.7% for defibrillation in the physicians and healthcare staff, respectively. The indications for defibrillation were correctly answered in the physicians who had acquired a certificate of BLS-ALS training (P = .047, P = .003). Conclusions The professional experience is significant in the correct use of a defibrillator and related procedures. Given the importance of early defibrillation in survival, the importance and proper use of defibrillators should be emphasised in Certified BLS-ALS programmes. Certified BLS-ALS programmes increase the level of knowledge and self-confidence towards synchronised cardioversion-defibrillation procedures.Item Safe and Effective Use of Venlafaxine, Mirtazapine, and Aripiprazole in an Adolescent with Treatment-Resistant Obsessive Compulsive Disorder(2020) Aksu, Gulen Guler; Dogdu, Pinar Akdere; Dag, Pelin; Kutuk, Meryem Ozlem; Toros, Fevziye; 0000-0002-2918-7871; AAI-9626-2021Managing treatment-resistant obsessive-compulsive disorder (TR-OCD) is often a challenge for clinicians, especially when adolescents and children are the patients. Approximately one-quarter to one-third of children with OCD do not respond to first-line treatments. Studies on the combination of venlafaxine and mirtazapine in children and adolescents are promising, but there is insufficient information about the use of this combination in TR-OCD. As far as we know, this is the first report of an adolescent patient with TR-OCD who responded favorably to a combination of a serotonin-norepinephrine reuptake inhibitor (venlafaxine), an alpha-2 adrenergic receptor antagonist (mirtazapine), and an atypical antipsychotic (aripiprazole). This case provides an example of the effective and safe use of the venlafaxine, mirtazapine, and aripiprazole given in combination in an adolescent with TR-OCD.Item Remifentanil based anesthetic management for orchiopexy operation in pediatric patient with congenital hypotonia(2019) Caliskan, Esra; Sener, Mesut; Kirpi, Meltem; Aribogan, Anis; 0000-0001-6497-0610; 30633316; S-8336-2019