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Oğuz S, Arslan UE, Kiper PÖŞ, Alikaşifoğlu M, Boduroğlu K, Utine GE. Diagnostic yield of microarrays in individuals with non-syndromic developmental delay and intellectual disability. J Intellect Disabil Res 2021; 65:1033-1048. [PMID: 34661940 DOI: 10.1111/jir.12892] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 07/04/2021] [Accepted: 09/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Intellectual disability (ID), or developmental delay (DD) when the individual is yet under 5 years of age, is evident before 18 years of age and is characterised by significant limitations in both intellectual functioning and adaptive behaviour. ID/DD may be clinically classified as syndromic or non-syndromic. Genomic copy number variations (CNVs) constitute a well-established aetiological subgroup of ID/DD. Overall diagnostic yield of microarrays is estimated at 10-25% for ID/DD, especially higher when particular clinical features that render the condition syndromic accompany. METHODS In this study, we aimed to investigate the diagnostic yield of microarrays in the subgroup of individuals with non-syndromic ID/DD (NSID/NSDD). A total of 302 NSID/NSDD individuals who have undergone microarray analysis between October 2013 and April 2020 were included. Accompanying clinical data, including head circumference, delayed developmental areas, seizures and behavioural problems were collected and analysed separately in NSID and NSDD subgroups. RESULTS The diagnostic yield of microarray analyses in NSID/NSDD was determined as 10.9% in NSID (10.7%) and in NSDD (11.1%). Presence of behavioural and epileptic problems did not contribute to the diagnostic yield. However, in the presence of macrocephaly, the contribution to diagnostic yield was statistically significant particularly in NSDD group. The most common pathogenic CNVs involved chromosomes 16, 15 and X. Lastly, we propose a Xq21.32q22.1 deletion as likely pathogenic in a child with isolated language delay and accompanying seizures. CONCLUSIONS Particularly in neurodevelopmental diseases, microarrays are useful for establishing the diagnosis and detecting novel susceptibility regions. Future studies would accurately classify the herein presented variants of uncertain significance CNVs as pathogenic or benign.
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Affiliation(s)
- S Oğuz
- Department of Medical Genetics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - U E Arslan
- Department of Health Research, Public Health Institute, Ankara, Turkey
| | - P Ö Ş Kiper
- Department of Pediatrics, Department of Pediatric Genetics, Faculty of Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - M Alikaşifoğlu
- Department of Medical Genetics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- Department of Pediatrics, Department of Pediatric Genetics, Faculty of Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - K Boduroğlu
- Department of Medical Genetics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- Department of Pediatrics, Department of Pediatric Genetics, Faculty of Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - G E Utine
- Department of Pediatrics, Department of Pediatric Genetics, Faculty of Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Uygur Ö, Öncel MY, Şimşek GK, Okur N, Çelik K, Bozkurt Ö, Yücesoy E, Terek D, Arslan MK, Pekçevik Y, Akar M, Köroğlu ÖA, Oğuz S, Kültürsay N. Is Nasal Septum-Tragus Length Measurement Appropriate for Endotracheal Tube Intubation Depth in Neonates? A Randomized Controlled Study. Am J Perinatol 2021; 38:728-733. [PMID: 31858502 DOI: 10.1055/s-0039-3400982] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Endotracheal intubation is a frequent procedure performed in neonates with respiratory distress. Clinicians use different methods to estimate the intubation insertion depth, but, unfortunately, the improper insertion results are very high. In this study, we aimed to compare the two different methods (Tochen's formula = weight in kilograms + 6 cm; and nasal septum-tragus length [NTL] + 1 cm) used to determine the endotracheal tube (ETT) insertion depth. STUDY DESIGN Infants who had intubation indications were enrolled in this study. The intubation tube was fixed using the Tochen formula (Tochen group) or the NTL + 1 cm formula (NTL group). After intubation, the chest radiograph was evaluated (above T1, proper place, and below T2). RESULTS A total of 167 infants (22-42 weeks of gestational age) were included in the study. The proper tube placement rate in both groups was similar (32.4 vs. 30.4% for infants < 34 weeks of gestational age and 56.8 vs. 45.0% in infants > 34 weeks of gestational age). The ETT was frequently placed below T2 at a higher rate in infants with a gestational age of <34 weeks, especially in the NTL group (46% in the Tochen group and 60.7% in the NTL group). CONCLUSION The NTL + 1 cm formula led to a higher rate of ETT placement below T2, especially in infants with a birth weight of <1,500 g. Therefore, more studies are needed to determine the optimal ETT insertion depth.
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Affiliation(s)
- Özgün Uygur
- Division of Neonatology, Department of Pediatrics, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Mehmet Yekta Öncel
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Izmir Katip Çelebi University, Izmir, Turkey
| | - Gülsüm Kadıoğlu Şimşek
- Clinic of Neonatology, Zekai Tahir Burak Women's Health and Research Hospital, Ankara, Turkey
| | - Nilüfer Okur
- Clinic of Neonatology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Kıymet Çelik
- Clinic of Neonatology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Özlem Bozkurt
- Clinic of Neonatology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - Ebru Yücesoy
- Clinic of Neonatology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - Demet Terek
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Meltem Koyuncu Arslan
- Division of Neonatology, Department of Pediatrics, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Yeliz Pekçevik
- Department of Radiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Melek Akar
- Division of Neonatology, Department of Pediatrics, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Özge Altun Köroğlu
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Suna Oğuz
- Clinic of Neonatology, Zekai Tahir Burak Women's Health and Research Hospital, Ankara, Turkey
| | - Nilgün Kültürsay
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
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Bedir Demirdağ T, Koç E, Tezer H, Oğuz S, Satar M, Sağlam Ö, Uygun SS, Önal E, Hirfanoğlu İM, Tekgündüz K, Oygür N, Bülbül A, Zübarioğlu AU, Üstün N, Ünal S, Aygün C, Saygılı Karagöl B, Zenciroğlu A, Öncel MY, Çakıl Sağlık A, Okulu E, Terek D, Narlı N, Aliefendioğlu D, Gürsoy T, Ünal S, Kaynak Türkmen M, Kaya Narter F, Aladağ Çiftdemir N, Beken S, Çakır SÇ, Yiğit Ş, Çoban A, Ecevit A, Çelik Y, Kulalı F. The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study. Pediatr Neonatol 2021; 62:208-217. [PMID: 33546932 DOI: 10.1016/j.pedneo.2021.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/01/2020] [Accepted: 01/11/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Healthcare-acquired infections (HAIs) in the neonatal period cause substantial morbidity, mortality, and healthcare costs. Our purpose was to determine the prevalence of HAIs, antimicrobial susceptibility of causative agents, and the adaptivity of the Centres for Disease Control and Prevention (CDC) criteria in neonatal HAI diagnosis. METHODS A HAI point prevalence survey was conducted in the neonatal intensive care units (NICUs) of 31 hospitals from different geographic regions in Turkey. RESULTS The Point HAI prevalence was 7.6%. Ventilator-associated pneumonia (VAP) and central line-associated bloodstream infections (CLABSI) and late onset sepsis were predominant. The point prevalence of VAP was 2.1%, and the point prevalence of CLABSI was 1.2% in our study. The most common causative agents in HAIs were Gram-negative rods (43.0%), and the most common agent was Klebsiella spp (24.6%); 81.2% of these species were extended spectrum beta-lactamase (ESBL) (+). Blood culture positivity was seen in 33.3% of samples taken from the umbilical venous catheter, whereas 0.9% of samples of peripherally inserted central catheters (PICCs) were positive. In our study, 60% of patients who had culture positivity in endotracheal aspirate or who had purulent endotracheal secretions did not have any daily FiO2 change (p = 0.67) and also 80% did not have any increase in positive end-expiratory pressure (PEEP) (p = 0.7). On the other hand, 18.1% of patients who had clinical deterioration compatible with VAP did not have endotracheal culture positivity (p = 0.005). CONCLUSIONS Neonatal HAIs are frequent adverse events in district and regional hospitals. This at-risk population should be prioritized for HAI surveillance and prevention programs through improved infection prevention practices, and hand hygiene compliance should be conducted. CDC diagnostic criteria are not sufficient for NICUs. Future studies are warranted for the diagnosis of HAIs in NICUs.
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Affiliation(s)
- Tuğba Bedir Demirdağ
- Gazi University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey.
| | - Esin Koç
- Gazi University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey
| | - Hasan Tezer
- Gazi University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Suna Oğuz
- University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Neonatology, Ankara, Turkey
| | - Mehmet Satar
- Çukurova University, Faculty of Medicine, Department of Neonatology, Adana, Turkey
| | - Özge Sağlam
- University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Department of Neonatology, Istanbul, Turkey
| | - Saime Sündüz Uygun
- Konya Selcuk University, Faculty of Medicine, Department of Neonatology, Konya, Turkey
| | - Esra Önal
- Gazi University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey
| | | | - Kadir Tekgündüz
- Atatürk University, Faculty of Medicine, Department of Neonatology, Erzurum, Turkey
| | - Nihal Oygür
- Akdeniz University, Faculty of Medicine, Department of Neonatology, Antalya, Turkey
| | - Ali Bülbül
- University of Health Sciences, Sisli Etfal Training and Research Hospital, Department of Neonatology, Istanbul, Turkey
| | - Adil Umut Zübarioğlu
- Yeni Yüzyıl University Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
| | - Nuran Üstün
- Medeniyet University. Goztepe Training and Research Hospital, Department of Neonatology, Istanbul, Turkey
| | - Sezin Ünal
- University of Health Sciences, Etlik Zübeyde Hanim Women's Health Training and Research Hospital, Department of Neonatology, Ankara, Turkey
| | - Canan Aygün
- Ondokuz Mayıs University, Faculty of Medicine, Department of Neonatology, Turkey
| | - Belma Saygılı Karagöl
- University of Health Sciences, Gülhane Training and Research Hospital, Department of Neonatology, Ankara, Turkey
| | - Ayşegül Zenciroğlu
- University of Health Sciences, Dr. Sami Ulus Maternity and Children Education and Research Hospital, Department of Neonatology, Ankara, Turkey
| | - M Yekta Öncel
- University of Health Sciences Izmir Tepecik Training and Research Hospital, Department of Neonatology, Izmir, Turkey
| | - Adviye Çakıl Sağlık
- Osmangazi University, Faculty of Medicine, Department of Neonatology, Eskisehir, Turkey
| | - Emel Okulu
- Ankara University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey
| | - Demet Terek
- Ege University, Faculty of Medicine, Department of Neonatology, Izmir, Turkey
| | - Nejat Narlı
- Metro Private Hospital, Neonatology Unit, Adana, Turkey
| | - Didem Aliefendioğlu
- Kırıkkale University, Faculty of Medicine, Department of Neonatology, Kırıkkale, Turkey
| | - Tuğba Gürsoy
- Koc University, Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
| | - Sevim Ünal
- University of Health Sciences, Ankara Hematology Oncology Children's Training and Research Hospital, Department of Neonatology, Ankara, Turkey
| | | | - Fatma Kaya Narter
- University of Health Sciences, Kartal Dr Lutfi Kirdar Training and Research Hospital, Department of Neonatology, Istanbul, Turkey
| | | | - Serdar Beken
- Acıbadem University, Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
| | - Salih Çağrı Çakır
- Uludağ University, Faculty of Medicine, Department of Neonatology, Bursa, Turkey
| | - Şule Yiğit
- Hacettepe University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey
| | - Asuman Çoban
- Istanbul University, Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
| | - Ayse Ecevit
- Baskent University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey
| | - Yalçın Çelik
- Mersin University, Faculty of Medicine, Department of Neonatology, Mersin, Turkey
| | - Ferit Kulalı
- University of Health Sciences, Dr. Behcet Uz Children's Health and Diseases and Surgery Training and Research Hospital, Department of Neonatology, Izmir, Turkey
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Abstract
Scientific and technological advances in perinatology and neonatology have led to an increased rate of survival and decreased incidences of various neonatal morbidities. However, the incidence of bronchopulmonary dysplasia has remained almost the same for years in very-low-birth-weight preterm infants. Although bronchopulmonary dysplasia is the leading cause of chronic respiratory morbidity in small preterms, no substantial improvement has been achieved in prevention and treatment strategies to date. Currently, postnatal very-low-dose corticosteroids, caffeine, and vitamin A seem to be the drugs of choice, and stem cell therapy appears to be the most promising treatment modality for the future. In this guideline, which was prepared by the Turkish Neonatal Society, recent evidence-based recommendations for the prevention and treatment of bronchopulmonary dysplasia are summarized.
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Affiliation(s)
- Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Ayşe Korkmaz
- Division of Neonatology, Department of Pediatrics, Acıbadem University, Faculty of Medicine, İstanbul, Turkey
| | - Suna Oğuz
- Zekai Tahir Burak Women's Health Practice and Research Center, Health Sciences University, Ankara, Turkey
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Aydin I, Yeldan E, Ibiş AC, Albayrak D, Oğuz S, Senlikci A. Comparison between electronic method and conventional method recording and follow-up of general surgery ward-round notes taken. MINERVA CHIR 2014; 69:331-336. [PMID: 25493394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Patient anamneses and ward-rounds notes taken are two key elements which have been and will be used to ensure accurate and reliable sustainability at surgery services. In this study, we aimed to find a new method which is capable of better addressing the needs in this process, simplifying it and also saving time. We also targeted to compare this new method used by us with the method, also known as conventional method, having been used for years. METHODS Thirty patients were included in the study. The prehospitalization anamneses of the patients were taken using the two methods and the durations were recorded separately for the two methods. Thereafter, the patients were visited by two methods in the morning on each day of their stay. The durations were recorded daily and separately for the two methods. The durations were statistically evaluated separately for the anamneses and ward-round notes taken. RESULTS Evaluations showed that the method using hand terminal (1.2250 minutes) is more advantageous in terms of duration in recording ward-round scores than the conventional method (1.3853 minutes). It was founded that in regard to the duration, the average duration of manual anamnesis taking (16.3350 minutes) is higher than that of taking anamnesis by means of hand terminal (15.4733 minutes). Furthermore, it was also seen that the use of this new technique eliminated the problems previously experienced in data transfer, access to historical data etc. CONCLUSION In conclusion, this method that is tested by use of hand terminal is more advantageous than the conventional method in terms of time saving and accurate data transfer. It is our opinion that it will provide advantages in many more aspects if it is worked on.
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Affiliation(s)
- I Aydin
- General Surgery Clinic at the Faculty of Medicine of Trakya University Edirne, Turkey -
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6
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Oncel MY, Alyamaç-Dizdar E, Erdeve O, Oğuz S, Dilmen U. Cost-effectiveness of respiratory syncytial virus prophylaxis in premature infants less than 32 weeks gestational age in Turkey: author's reply. Turk J Pediatr 2013; 55:568. [PMID: 24401320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Mehmet Yekta Oncel
- Division of Neonatology, Zekai Tahir Burak Maternity Training Hospital, Ankara, Turkey.
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7
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Oğuz S, Değer I. Ventilator-associated pneumonia in patients using HME filters and heated humidifiers. Ir J Med Sci 2013; 182:651-5. [PMID: 23568432 DOI: 10.1007/s11845-013-0947-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 04/01/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Ventilator-associated pneumonia (VAP) is a clinical form of hospital-associated pneumonia, which may develop within 48 h in patients on mechanical ventilation who had no pre-existing pneumonia at the time of intubation. OBJECTIVE The objective of this study was to compare the incidence of VAP among patients who started receiving treatment with heat and moisture exchanger (HME) filters and heated humidifiers (HHs) for mechanical ventilation. METHODS Patients who were on the first day of intubation, did not have pre-intubation pneumonia, presented to the healthcare centre with no infections at the time of presentation, were not on antibiotic treatment for pulmonary infections and did not have evidence of infiltration with chest radiography were included in the study. Data were evaluated using Fischer's exact, Mann-Whitney's U and t tests. RESULTS The patients in the HME filter and HHs groups had a mean age of 47.9 ± 2.2 and 44.5 ± 2.1 years, respectively. Infiltration on chest radiography was identified on day 6.33 for the patients in the HME filter group and on day 5.8 in the HHs group. Patients using HME filters and HHs did not differ significantly with regard to the day of mechanical ventilation and number of days hospitalized (p > 0.5). Comparison of the two groups with regard to presence of fever during the first 24 h, however, demonstrated higher than expected values for the patients using HHs, with a significant difference (p = 0.001). CONCLUSION There were no significant differences between the groups on HME filters and heated humidifiers in terms of infection development; although pulmonary radiography showed delayed average days to infiltration development for subjects using HME filters.
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Affiliation(s)
- S Oğuz
- Division of Internal Medicine Nursing, Nursing Department, Faculty of Health Sciences, Marmara University, Tıbbiye Caddesi, No:49, Haydarpasa Campus, Haydarpasa, Istanbul, Turkey,
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Abstract
We aimed to evaluate serum levels of serum amyloid-A (SAA) both in the diagnosis and monitoring the treatment response of necrotizing enterocolitis (NEC). Forty-five preterm neonates were enrolled in the study, including 15 infants with NEC, 15 with sepsis, and 15 healthy preterm infants. Pre- and posttreatment serum SAA levels were measured. Among patients with NEC, 11 had stage 1 and 4 had stage 2 disease according to the modified Bell's staging criteria. Baseline SAA levels of the infants with NEC were significantly higher than controls (P=0.013) and were significantly lower than those with sepsis (P=0.004). When infants with stage 1 and stage 2 NEC were analyzed separately, baseline SAA levels of the infants with stage 2 NEC were significantly higher than controls (P=0.027) than those with stage 1 NEC (P=0.018), but similar to those with sepsis. There was a trend that baseline SAA levels were also correlated with the Bell stage (r=0.501, P=0.057). Posttreatment SAA levels significantly decreased in infants with sepsis (P=0.002). Pre- and posttreatment SAA levels were similar in patients with stage 1 and 2 NEC. In conclusion, SAA rises in early stages of NEC and may aid in diagnosis as a serum marker.
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Affiliation(s)
- Zeynep Eras
- Zekai Tahir Burak Maternity Teaching Hospital, Neonatal Intensive Care Unit, Ankara, Turkey
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Dilli D, Oğuz S, Dilmen U. A case of congenital warfarin syndrome due to maternal drug administration during the pregnancy. Genet Couns 2011; 22:221-226. [PMID: 21848016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Warfarin, which is used for anticoagulant therapy, rarely produces congenital warfarin syndrome characterized with hypoplastic nose, stippled epiphyses, and skeletal abnormalities when ingested during pregnancy. Here, we present a male infant, whose mother was treated with warfarin because of a prosthetic heart valve replacement after rheumatic heart disease, with signs of warfarin embryopathy. The mother's first pregnancy at 12 weeks gestation resulted in abortus due to warfarin toxicity. Subsequently, she delivered two healthy girls after her treatment had changed to low molecular heparin during pregnancy periods. We want to emphasize that risk-benefit ratio should be well weighed by both obstetricians and cardiologists when considering warfarin therapy for a woman at childbearing age.
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Affiliation(s)
- D Dilli
- Department of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
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Celen O, Oğuz S, Doğan M. [Abdominal gunshot wounds: retrospective analysis of 164 patients]. Ulus Travma Derg 2001; 7:258-61. [PMID: 11705082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
The medical reports of 164 patients who were operated for abdominal gunshot wounds at Sirnak Military hospital were reviewed retrospectively. One hundred and twenty-nine patients had isolated abdominal injury whereas, 28 had associated thoracic injuries. Seven of these laparotomies revealed no intraperitoneal injury and were considered as non-therapeutic laparotomy. The time for transportation to the emergency department were less than 2 hours in 69% of the patients. The most commonly injured organs were the small bowel in 67, the colon in 63 and the liver in 49 patients. Postoperative complications occurred in 34 patients (20.7%) and mortality rate was 6% (10 patients). In spite of the developing technology and operative techniques, gunshot wounds are still very important with high morbidity and mortality rates.
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Affiliation(s)
- O Celen
- Genel Cerrahi Uzmani, Ankara.
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Doğan M, Oğuz S, Celen O. [Injuries of the extremities caused by high energy gunshots and land-mines]. Ulus Travma Derg 2000; 6:231-3. [PMID: 11813476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Hospital records of patients who had extremity injuries caused by high energy gunshots and and land-mines and treated in Sirnak Military Hospital between January 1997 and July 1999 were reviewed retrospectively. Among 236 cases 147 (62.3%) had lower extremity wounds and 89 (37.7%) had upper extremity wounds. The most frequently injured part was hands for the upper extremity and feet for the lower extremity. The most dramatic wounds were caused by stepping on anti personnel mines trapped with anti tank mines. The localization and the extension of the wounds varies with type and power of the gun, the position of the victim at the time of explosion and the distance between the victim and the gun.
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Affiliation(s)
- M Doğan
- Ortopedi ve Travmatoloji Uzmani
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Abstract
Non-Hodgkin's lymphoma during pregnancy is rare. We report a case of non-Hodgkin's lymphoma detected in a pregnant women. She was initially diagnosed as having an ovarian tumor by ultrasonography, but definitive diagnosis was made at the time of cesarean section. After delivery she took combined chemotherapy for 7 cycles and is in complete remission over 1 year.
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Affiliation(s)
- K Vicdan
- Dr. Zekai Tahir Burak Women's Hospital, High Risk Pregnancy Unit, Ankara, Turkey
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14
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Abstract
A histopathologic study in eighty six patients with ectopic pregnancy and in eighty six control patients was undertaken to evaluate the association between ectopic pregnancy and tubal pathology in our population. Fifty six (65%) and nine (10.4%) cases with chronic salpingitis (CS) were diagnosed in the study group and in the control group, respectively. This difference was statistically significant (p < 0.001). Twelve of 56 cases with chronic salpingitis were salpingitis isthmica nodosa (SIN) and no patient with SIN was observed in the control group. SIN was always concomittant with chronic salpingitis in our study. Based on these findings, we concluded that chronic salpingitis and SIN have an important role in the etiology of ectopic pregnancy in our population and SIN is significantly associated with chronic salpingitis.
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Affiliation(s)
- L Kutluay
- Dr. Zekai Tahai Burak Women's Hospital, Ankara, Turkey
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Kuşçu E, Vicdan K, Turhan NO, Oğuz S, Zorlu G, Gökmen O. The hormonal profile in ectopic pregnancies. Mater Med Pol 1993; 25:149-52. [PMID: 7520962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The hormonal profile in a patient with an ectopic pregnancy (EP) differs in many respects from that of a patient with a normal intrauterine pregnancy (IUP). Although there are several reports using different hormones for early diagnosis of ectopic pregnancy most of the results are contradictory. In this study, therefore, we prospectively investigated the maternal serum level of beta-human chorionic gonadotropin (beta-hCG), progesterone (P), estradiol (E2), human placental lactogen (HPL), alfafetoprotein (AFP) and cancer antigen 125 (CA 125) during the first trimester of normal and abnormal pregnancies. Serum samples were obtained from 20 women with normal IUPs, 15 women whose pregnancies complicated with spontaneous abortion and 31 women with surgically and pathologically confirmed EPs. The mean serum levels of beta-hCG, E2 and p in patients with EPs (9490.55 +/- 3071.2 mlU/ml, 100.1 +/- 22.09 pg/ml, 4.18 +/- 1.19 ng/ml, respectively) were significantly lower than those measured in normal IUPs (73796.8 +/- 15554.7 mlU/ml, 500.15 +/- 98.84 pg/ml, 19.2 +/- 2.8 ng/ml, respectively p < 0.001) and significantly lower than in patients with spontaneous abortion (22524 +/- 6213 mlU/ml, p < 0.05, 339.8 +/- 112.16 pg/ml, p < 0.01, 10.59 +/- 3.03 ng/ml, p < 0.05 respectively). No significant difference was recorded with respect to serum levels of HPL, AFP and CA 125 among the groups. We also investigated the diagnostic value of simple E2 and P in patients with EPs. We could not identify a discriminatory cutoff value because there was a considerable overlap in serum P and E2 levels between the patients with IUPs and EPs.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- E Kuşçu
- Dr Zekai Tahir Burak Women's Hospital Ankara, Turkey
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