Publications by authors named "Hülya Özdemir"

35 Publications

The alteration of lymphocyte subsets in idiopathic granulomatous mastitis.

Turk J Med Sci 2021 Apr 17. Epub 2021 Apr 17.

Background And Aim: This study analyzed peripheral blood lymphocyte subsets to determine their role in the etiopathogenesis of IGM.

Materials And Methods: This study includes 51 pathologically proven IGM patients (active disease: 26 and in remission: 25) and 28 healthy volunteers. The analyses of lymphocyte subsets were performed by flow cytometric immunophenotyping.

Results: The percentage of T helper lymphocyte of the all IGM patients were lower than control groups (p = .001). Absolute cytotoxic T lymphocyte count (p=.03), both percentage (p=.035) and absolute count (p=.002) of the natural killer cells, and both percentage (p=.038) and absolute count (p=.008) of the naturel killer T cells were higher than control group. The percentage of the T helper lymphocyte of the patients with active disease was lower than control group (p = .0003). Absolute cytotoxic T lymphocyte (p=.029) and natural killer T cells (p=.012) of the patients with active disease were higher than control group.

Conclusion: Idiopathic granulomatous mastitis is defined as a localized form of granulomatous disorders. However, the observed changes in T cells, NK and NKT cells suggested that there is systemic immune dysregulation in patients with IGM.
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http://dx.doi.org/10.3906/sag-2012-192DOI Listing
April 2021

Acute lung injury after exchange transfusion in two newborns with Glucose-6-phosphate dehydrogenase deficiency.

Transfus Apher Sci 2021 Apr 6:103133. Epub 2021 Apr 6.

Department of Pediatrics, Division of Neonatology, Marmara University Faculty of Medicine, İstanbul, Turkey. Electronic address:

Transfusion-related lung injury (TRALI) is a condition that develops suddenly within the first six hours after a blood transfusion and it is one of the most important causes of blood transfusion-related mortality. There are few data in the literature about TRALI in the neonatal period. We present two newborn patients who developed TRALI after exchange transfusion due to high bilirubin levels. Our first case was a late preterm LGA baby and was on CPAP. The baby was intubated due to sudden deterioration after the exchange transfusion. Our second case was born at term and, an exchange transfusion was performed on the 5th day of life. He developed respiratory distress unexpectedly soon after the exchange transfusion and was intubated. Glucose-6- phosphate dehydrogenase (G6PD) deficiency was detected in both of our cases. We wanted to emphasize that TRALI should be considered in the differential diagnosis of respiratory distress that develops soon after a transfusion in the newborn period and to draw attention to that TRALI may develop more frequently in patients with G6PD deficiency.
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http://dx.doi.org/10.1016/j.transci.2021.103133DOI Listing
April 2021

Relationship between Gene Polymorphisms and Gastrointestinal Tumors Development: Perspective from Eastern Part of Turkey.

J Invest Surg 2020 Dec 15:1-9. Epub 2020 Dec 15.

Medical Faculty, Van Yuzuncu Yıl University, Van, Turkey.

Background: Gastric and esophageal cancers are 2 of the most prevalent cancer types worldwide. Polymorphisms in the genes that code the methylenetetrahydrofolate reductase (MTHFR) enzyme increase the formation of both cancer types. In this study, it was aimed to research the relationship between the existence of and polymorphisms in patients with gastric and esophageal cancer and the lifespans of patients.

Methods And Materials: This prospective study was performed at Van Yuzuncu Yil University. Included in the study were 30 patients with esophageal tumors, 70 patients with gastric tumors, and 61 healthy volunteers. From each of the patients, 5 mL of blood was drawn. DNA was isolated via kits with spin-column technology.

Results: It was concluded that the risk of developing gastric cancer was 4.13 times higher in individuals who had the genotype of the polymorphism when compared to those who had the genotype, while the risk was 2.91 times higher in individuals who had the genotype when compared to those who had the genotype (P = 0.001, P = 0.027). Carriers of the genotype of the polymorphism had 2.89 times higher risk of developing esophageal cancer when compared to those who had the genotype (P = 0.033). It was determined that individuals who had the 1298 genotype were not at higher risk of developing esophageal cancer when compared to those with the genotype (P = 0.863). It was concluded that individuals who had the genotype of the polymorphism were not at higher risk of developing gastric and esophageal cancers when compared to those who had the genotype (P > 0.05). There was no difference in terms of the life spans of the patients with regards to the genotypes (P > 0.05).

Conclusion: The results showed that the polymorphism on the MTHFR gene can be a risk factor for gastric and esophageal cancer in eastern Turkey. These polymorphisms may have no effect on the life spans of the patients.
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http://dx.doi.org/10.1080/08941939.2020.1824249DOI Listing
December 2020

Effect of Paracetamol in the Proliferation of Glioblastoma Cell Line: The Role of Apoptosis, COX-2 and Cyclin B Expressions.

Turk Neurosurg 2021 ;31(1):46-50

Van Yuzuncu Yıl University, School of Medicine, Department of Medical Pharmacology, Van, Turkey.

Aim: To investigate the relationship between paracetamol and expression levels of cyclooxygenase-2, cyclin B, cell viability and apoptosis in glioblastoma cell line.

Material And Methods: The A172 glioblastoma cells were treated with different concentrations of paracetamol and phosphate buffer saline as a vehicle for 24, 48, and 72 hours. Cell viability was detected by MTT. Bax, procaspase 3, COX-2 and Cyclin B expressions were detected using Western blotting.

Results: A paracetamol treatment of 0.5 mg/mL for 24, 48, and 72 hours led to a 14%, 31%, and 37% decrease in cell viability. The expression of COX-2 and cyclin B levels decreased by 36% and 52% respectively, after treatment with 0.5 mg/mL paracetamol. Treatment with 0.5 mg/mL and 1 mg/mL paracetamol significantly induced the expression of cleaved caspase 3, procaspase 3 and Bax proteins compared to the control group (60%, 40%, 21%, %100, 18%, 17%, respectively).

Conclusion: The results of our study showed that paracetamol has antitumoral effects on glioblastoma cells and this activity was induced by different signaling pathways.
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http://dx.doi.org/10.5137/1019-5149.JTN.27866-19.7DOI Listing
March 2021

The Effect of Patellar Height by Using Insall Salvati Index on Pain, Function, Muscle Strength and Postural Stability in Patients with Primary Knee Osteoarthritis.

Curr Med Imaging 2021 ;17(4):532-538

Department of Radiology, Baskent University Faculty of Medicine, Adana, Turkey.

Purpose: The Insall-Salvati Index (ISI) is the ratio of the patellar tendon length to the length of the patella. This ratio is the most commonly used method for evaluating patellar placement and patellofemoral imbalance. The position of the patella is important for the knee joint function and also for biomechanics. The abnormal position of the patella may lead to patellofemoral malalignment and instability. Herein, we aimed to analyze the relationship between the ISI and pain, physical function, muscle strength, fall risk, and postural stability in patients with primary knee osteoarthritis (OA).

Methods: Sixty-two symptomatic knees of 45 patients (aged between 40 -75 years) who were suffering from the primary knee OA according to the American College of Rheumatology criteria were included retrospectively in the study. Patients with stages II and III osteoarthritis according to the Kellgren-Lawrence (K/L) radiological grading system were included. The ISI was measured on the lateral knee radiograph in a 30° flexed posture. Visual Analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and Lequesne indexes were recorded for evaluating pain and function. Tetrax Interactive Balance System was used to assess fall risk and postural stability. Isokinetic muscle strength measurements of quadriceps and hamstrings were recorded at the constant angular velocities of 60 and 180°/sec.

Results: The mean age of the study population was 58.52 ±8.01 years. The frequency of the patellar situation types was as follows; patella alta; 15 (24.2%), patella baja; n=2(3.2%), and normal patellar height; n=45(72.6%). The mean ISI was 1.19 ±0.17 on the right side and 1.18±0.16 on the left side. There was no significant correlation between the ISI and VAS, WOMAC and Lequesne indexes, postural stability scores, and isokinetic measurements (r<0.3, p>0.05).

Conclusion: In primary knee OA, the ISI may not have an effect on pain, physical function, fall risk, postural stability, and isokinetic muscle strength.

Clinical Trial Registration Number: KA18/170.
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http://dx.doi.org/10.2174/1573405616999200817172649DOI Listing
January 2021

Clinical and laboratory awareness for an under recognized pathogen in newborn meningitis: Mycoplasma Hominis: a case report.

Turk J Pediatr 2020 ;62(2):280-283

Division of Neonatology, Departments of Pediatrics, Marmara University Faculty of Medicine, İstanbul, Turkey.

Background: Mycoplasma hominis is a well-known bacterium colonizing the genito-urinary tract. It may cause pneumonia, bacteremia, abscesses, chronic lung disease, and rarely meningitis during the newborn period.

Case: A preterm infant with a birth weight of 885 grams was born at 27 weeks of gestation and had respiratory distress syndrome needing mechanical ventilation. Spontaneous intestinal perforation and grade four intraventricular hemorrhage was diagnosed on day three.

Conclusion: M. hominis was accepted as the causative agent of meningitis in this case report.
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http://dx.doi.org/10.24953/turkjped.2020.02.015DOI Listing
January 2020

The impact of socioeconomic factors on the healthcare costs of people living with HIV in Turkey.

BMC Public Health 2020 Mar 20;20(1):368. Epub 2020 Mar 20.

Department of Economics, Yaşar University, Üniversite Caddesi No: 37-39, 35040 Bornova, İzmir, Turkey.

Background: This study addresses an important field within HIV research, the impact of socioeconomic factors on the healthcare costs of people living with HIV/AIDS (PLHIV). We aimed to understand how different socioeconomic factors could create diverse healthcare costs for PLHIV in Turkey.

Methods: Data were collected between January 2017 and December 2017. HIV-positive people attending the clinic who had been referred to the national ART programme from January 1992 until December 2017 were surveyed. The questionnaire collected socioeconomic data. The cost data for the same patients was taken from the electronic database Probel Hospital Information Management System (PHIMS) for the same period. The PHIMS data include costs for medication (highly active antiretroviral therapy or HAART), laboratory, pathology, radiology, polyclinic, examination and consultation, hospitalisation, surgery and intervention, blood and blood products, supplies and other costs. Data were analysed using STATA 14.2 to estimate the generalised linear model (GLM).

Results: The findings of our GLM indicate that age, gender, marital and parental status, time since diagnosis, employment, wealth status, illicit drug use and CD4 cell count are the factors significantly related to the healthcare cost of patients. We found that compared with people who have AIDS (CD4 cells < 200 cells/mm), people who have a normal range of CD4 cells (≥ 500 cells/mm) have $1046 less in expenditures on average. Compared to younger people (19-39 years), older people (≥ 55) have $1934 higher expenditures on average. Costs are $644 higher on average for married people and $401 higher on average for people who have children. Healthcare costs are $518 and $651 higher on average for patients who are addicted to drugs and who use psychiatric drug(s), respectively. Compared to people who were recently diagnosed with HIV, people who were diagnosed ≥10 years ago have $743 lower expenditures on average.

Conclusion: Our results suggest that in addition to immunological status, socioeconomic factors play a substantial role in the healthcare costs of PLHIV. The key factors influencing the healthcare costs of PLHIV are also critical for public policy makers, healthcare workers, health ministries and employment community programs.
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http://dx.doi.org/10.1186/s12889-020-08469-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082973PMC
March 2020

The role of regulatory T cells in allergic rhinitis and their correlation with IL-10, IL-17 and neopterin levels in serum and nasal lavage fluid.

Eur Arch Otorhinolaryngol 2020 Apr 28;277(4):1109-1114. Epub 2020 Jan 28.

Otolaryngology Department, Selcuk University School of Medicine, Konya, Turkey.

Purpose: Allergic rhinitis (AR), is an IgE-mediated inflammation of the nose. Regulatory T cells (Tregs) and inflammatory cytokines have been shown to play a critical role in allergic airway inflammation. The aim of the study was to compare the levels of blood T lymphocyte subsets and IL-10, IL-17 and neopterin concentrations in serum and nasal lavage of patients with AR compared to healthy subjects.

Methods: The study included 38 subjects with moderate-severe AR and 36 sex- and age-matched controls. Peripheral blood CD3+, CD3+CD4+ and CD4+CD25+Foxp3 percentages were evaluated using flow cytometry. Levels of IL-10, IL-17 and neopterin were measured both in serum and nasal lavage fluid with ELISA and HPLC, respectively.

Results: No difference was found in the percentages of T lymphocyte subsets between the two groups (p > 0.05). Serum IL-10 levels were similar (p > 0.05), whereas nasal IL-10 was lower in AR subjects compared to control group (2.22 ± 0.91 and 3.12 ± 1.45 pg/ml, respectively) (p < 0.05). Mean serum and nasal IL-17 were higher in AR (107.7 ± 79.61 and 527.36 ± 738.7 pg/ml) than the control group (76.29 ± 28.94 and 328.9 ± 430.8 pg/ml) (p < 0.05 and p > 0.05). There were no significant differences in serum and nasal neopterin levels (p > 0.05).

Conclusions: Although there were no differences in the distribution of lymphocyte subsets between the AR and control groups, the finding of higher levels of serum and nasal IL-17 and lower levels of nasal IL-10 support the cytokine imbalance in the pathogenesis of AR.
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http://dx.doi.org/10.1007/s00405-020-05811-4DOI Listing
April 2020

The determinants of employability of people living with HIV/AIDS in Turkey.

Am J Ind Med 2020 01 5;63(1):92-98. Epub 2019 Nov 5.

Department of Economics, Ege University, İzmir, Turkey.

Background: This study addresses an important field within HIV research, the factors affecting the determinants of the employability of people living with HIV/AIDS (PLHIV) in Turkey. The employability of PLHIV is now even more vital because the use of antiretroviral therapy improves the quality of life of patients. In spite of this, the related literature suggests that there are serious impediments to the employment of PLHIV who face considerable levels of discrimination based on their HIV status.

Methods: This is a cohort study of 170 PLHIV of working age, treated at the Izmir Bozyaka Education and Training Hospital. We use a univariate logistic model to determine the effects of all determinants of interest with probit/logit modeling and penalized maximum likelihood estimation to avoid bias and to test the robustness of results.

Results: Age, time since diagnosis, work status at diagnosis, wealth status, illicit drug use, and CD4 cell count were significantly related to the employability of PLHIV. Younger individuals had a higher probability of workforce participation. HIV-infected patients aged 19 to 39 and 40 to 54 years were 32% and 20% more likely, respectively, to be employed. Economically better-off PLHIV were more likely to participate in the labor force and HIV patients who were working at the time of diagnosis were more likely to be re-employed. Time since diagnosis was negatively associated with the employment status. Compared to recently diagnosed patients, PLHIV for more than a decade were less likely to be employed. Those with high CD4 cell counts were more likely to be employed. Illicit drug use was negatively associated with employment and drug-addicted HIV patients were less likely to be employed. Higher education did not significantly predict the employability of PLHIV.

Conclusions: Our results suggest that besides immunological status, socioeconomic factors play a substantial role in the employability of PLHIV. We suggest that even if a patient is skilled, educated, and qualified for the job, other factors such as stigma and employment discrimination in the workplace may hinder employment even among highly educated PLHIV.
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http://dx.doi.org/10.1002/ajim.23056DOI Listing
January 2020

Does Repeated Painful Stimuli Change Cerebral Near-Infrared Spectroscopy Response in Healthy, Term, Large for Gestational Age Newborns?

Clin J Pain 2020 02;36(2):110-116

Department of Pediatrics, Division of Neonatology Marmara University Faculty of Medicine, Istanbul.

Objective: The objective of this study was to evaluate the effect of repeated painful stimuli on short-term pain response in healthy, term, large for gestational age newborns by measuring the regional cerebral oxygen saturation (rScO2), and behavioral and physiological responses.

Methods: We compared term large for gestational age infants who received repeated painful stimuli (study group) with term, appropriate for gestational age infants (control group). A pulse oximeter and a near-infrared spectroscopy probe were connected to babies during the study period, and the responses of the babies were recorded by video, from which the crying time and the Neonatal Infant Pain Scale were obtained. The heart rate, peripheral oxygen saturation (SpO2), and rScO2 data were sampled every 1 second and exported to a personal computer via digital output during the study period. The maximum heart rate, the minimum SpO2, and peak, baseline, and mean rScO2 measurements following skin puncture were recorded. Data were compared within 1 group and between the 2 groups.

Results: After the heel prick, crying time (P<0.001) and Neonatal Infant Pain Scale scores (P=0.024) increased, and SpO2 levels decreased significantly (P=0.012) in the study group versus the control group. Although mean rScO2 increased significantly within 1 group (P<0.001), it was not significant between the 2 groups. The percent change in rScO2 was greater in the study group (5.2 [2.5 to 9.3]) compared with the control group (2.8 [1.1 to 8.2], P=0.037).

Conclusion: We showed that rScO2 values changed significantly within the first few days of life in babies who received more painful stimuli compared with the control group, similar to behavioral and physiological responses.
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http://dx.doi.org/10.1097/AJP.0000000000000774DOI Listing
February 2020

Current status of HIV/AIDS-syphilis co-infections: a retrospective multicentre study.

Cent Eur J Public Health 2019 Sep;27(3):223-228

Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.

Objective: Treponema pallidum and HIV are transmitted frequently through sexual contact, these agents with epidemiological similarities co-infect the same host. The current number of HIV-infected cases in Turkey is increasing. For this reason, we aimed to reveal the characteristics of syphilis in HIV/AIDS cases.

Methods: A retrospective longitudinal cohort study was performed, patients were followed up at 24 clinics in 16 cities from all seven regions of Turkey between January 2010 to April 2018. We examined the socio-demographic characteristics, laboratory parameters and neurosyphilis association in HIV/AIDS-syphilis co-infected cases.

Results: Among 3,641 patients with HIV-1 infection, 291 (8%) patients were diagnosed with syphilis co-infection. Most patients were older than 25 years (92%), 96% were males, 74% were working, 23% unemployed, and 3% were students. The three highest prevalence of syphilis were in Black Sea (10.3%), Mediterranean (8.4%) and Marmara Regions (7.4%). As for sexual orientation, 46% were heterosexuals, 42% men who have sex with men (MSM), and no data available for 12%. Patients with the number of CD4+ ≤ 350 mm reached 46%, 17% of the patients received antiretroviral therapy and neurosyphilis association reached 9%.

Conclusion: Although HIV/AIDS-syphilis co-infection status appeared high in heterosexuals, MSM had a moderate level increase in cases. Our results suggested syphilis co-infection in HIV/AIDS cases should be integral part of monitoring in a national sexual transmitted diseases surveillance system. However, our data may provide base for HIV/syphilis prevention and treatment efforts in the future.
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http://dx.doi.org/10.21101/cejph.a5467DOI Listing
September 2019

Health Care Cost of Socioeconomic Inequalities: A Pioneering Population-Wide Study.

Am J Public Health 2019 06;109(6):835-836

Durmuş Özdemir is with the Department of Economics, Yaşar University, İzmir, Turkey. Hülya Özkan Özdemir is with the Department of Clinical Microbiology and Infectious Diseases, Bozyaka Education and Research Hospital, University of Health Sciences, İzmir.

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http://dx.doi.org/10.2105/AJPH.2019.305099DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6508002PMC
June 2019

Reference ranges for serum immunoglobulin (IgG, IgA, and IgM) and IgG subclass levels in healthy children

Turk J Med Sci 2019 Apr 18;49(2):497-505. Epub 2019 Apr 18.

Background/aim: The serum immunoglobulin levels are used routinely in clinical practice because they provide key information on the humoral immune status. This study aimed to determine the age-related reference values of serum immunoglobulin levels in healthy children.

Materials And Methods: A total of 330 healthy children, aged between 0 and 18 years, were included in this study. The serum immunoglobulin levels were measured using a nephelometric method in a total of 11 groups, each group consisting of 30 individuals, and IgG subclasses in 6 groups of children aged more than 2 years.

Results: The serum IgG levels were high during the newborn period, decreased until the sixth month, and again increased to a maximum level at the age of 18 years. The level of IgA was found to be extremely low in the newborn period and then increased with age. While the lowest value was in the newborn period for serum IgM level, the highest value was in the 16- to 18-year-old period. The IgG subclasses varied depending on the age groups.

Conclusion: The updated reference intervals of immunoglobulin levels in children may be used for the accurate diagnosis of immune deficiencies.
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http://dx.doi.org/10.3906/sag-1807-282DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018341PMC
April 2019

Effect of dietary boron on learning and behavior in rats administered with boric acid.

Cell Mol Biol (Noisy-le-grand) 2019 Jan 31;65(1):65-72. Epub 2019 Jan 31.

Department of Pharmacology, School of Medicine, Van Yuzuncu Yil University, Van, Turkey.

This study was designed to investigate the effect of dietary boron on spatial learning, anxiety, some vitamins and oxidative parameters in rats. Thirty-two Wistar albino male rats were used in the study. The rats were equally divided into four groups with 8 rats each: I control group: standard pellet diet only, II. group: 250 ppm boric acid, III. group: 500 ppm boric acid and IV. group: 1000 ppm boric acid added into standard pellet diet. Over a five-week period, elevated plus-maze test was used for anxiety assessment and Morris water maze test was used for evaluating spatial learning. Additionally, blood samples were obtained at the end of the experiment and were used to determine the serum levels of some vitamins and oxidative parameters. Dietary boron significantly increased weight gain (p<0.001) and food consumption in the 250 ppm and 500 ppm groups (p<0.05). Although boron supplementation had no significant effect on learning and anxiety-related behavior, it had beneficiary effects on memory retention in the 1000 ppm group (p<0.05). Biochemical analyses showed a significant decrease in the MDA levels (p<0.05) and an increase in vitamin D3 levels (p<0.01) in the 500 ppm group, a significant increase in GSH-Px activity in the 250 ppm and 500 ppm groups (p<0.05), and a decrease in vitamin E levels in all the experimental groups (p<0.05). In conclusion, our study demonstrated that dietary boron can be beneficial for health when administered at appropriate doses.
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January 2019

Delayed cord clamping in term large-for-gestational age infants: A prospective randomised study.

J Paediatr Child Health 2019 May 4;55(5):555-560. Epub 2018 Oct 4.

Division of Neonatology, Department of Pediatrics, Marmara University Faculty of Medicine, Istanbul, Turkey.

Aim: To compare the post-natal effects of delayed cord clamping (DCC) and early cord clamping (ECC) in term large-for-gestational age (LGA) infants.

Methods: This prospective randomised study included 51 term LGA infants. The umbilical cords of these infants were clamped at 15 s in group 1 (ECC group (n = 26)) and at 60 s in group 2 (DCC group (n = 25)). Data for Apgar scores, cord blood, pH and lactate values, second haematocrit, 24th bilirubin levels, duration of hospital stay and admission to the neonatal intensive care unit (NICU) were recorded.

Results: The demographic characteristics of the infants in the study group were not significantly different. No statistically significant difference was observed in the post-natal haematocrit and bilirubin levels between the groups. Six infants (group 1, n = 3; group 2, n = 3) were diagnosed with polycythaemia (P = 0.79); however, these infants remained asymptomatic, and no treatment was required. One infant in each group developed hyperbilirubinemia, which required phototherapy (P = 1.00). The infant with hyperbilirubinemia in the DCC group presented with asymptomatic polycythaemia. Three neonates in the DCC group required admission to the NICU for transient tachypnoea.

Conclusions: No significant increase in the rate of post-natal complications of DCC in term LGA infants was observed in the study. However, before recommending DCC on a routine basis, studies with a larger sample size and long-term follow-up are required to elucidate the risks and benefits of DCC in this group of infants.
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http://dx.doi.org/10.1111/jpc.14242DOI Listing
May 2019

The impact of economic and social factors on the prevalence of hepatitis B in Turkey.

BMC Public Health 2018 05 22;18(1):649. Epub 2018 May 22.

Department of Economics, Yaşar University, Üniversite Caddesi No: 37-39, 35040 Bornova, İzmir, Turkey.

Background: Viral Hepatitis is one of the major global health problems, affecting millions of people every year. Limited information is available on the impact of social and economic factors on the prevalence of Hepatitis B virus (HBV) in Turkey. This study, contrary to other studies in the literature, was undertaken with the aim of examining the Majority of the excluded data come from the volunteers.

Methods: There are medical and the social-economic factors affecting the prevalence of HBV. This research, while taking medical factors as control variables, clarify the social and economic factors affecting the prevalence of HBV by utilising clinical data with the use of the Binary Probit Model (BPM). The BPM estimation is a powerful tool to determine not only the factors but explain also the exact impacts of each factor.

Results: The estimations of the BPM shows that economic and social variables such as age, gender, migration, education, awareness, social welfare, occupation are very important factors for determining HBV prevalence. Compared to the youngest population, the 46 to 66+ age group has a higher prevalence of HBV. The male respondents were 5% more likely to develop HBV compared to females. When region-specific differences are taken into account, migrating from the poorest parts of the country such as the eastern and south-eastern regions of Turkey are approximately 16% more likely to be infected. The welfare indicators such as a higher number of rooms in the respondent's house or flat decreases the probability of having HBV and, relatively higher income groups are less likely to develop HBV compared to labourers. The Self-employed/Business owner/Public sector worker category are approximately 10% less likely to develop HBV. When people are aware of the methods of prevention of HBV, they are 6% less likely to be infected. Previous HBV infection history increases the probability of having HBV again B by 17%.

Conclusions: These findings strongly suggest that the impact of social and economic factors on the prevalence of HBV is vital. Any improvements in these factors are likely to reduce prevalence of HBV.
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http://dx.doi.org/10.1186/s12889-018-5575-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964685PMC
May 2018

Severe lactic acidosis in an extremely low birth weight infant due to thiamine deficiency.

J Pediatr Endocrinol Metab 2018 Jun;31(6):693-695

Department of Pediatrics, Division of Neonatology, Marmara University Faculty of Medicine, Istanbul, Turkey.

Background: In this case report, we present a preterm newborn with persistent lactic acidosis who received total parenteral nutrition (TPN) that lacked thiamine.

Case Presentation: A 28-week-old, 750 g female infant was born with an Apgar score of 8 at the 5th minute. Umbilical cord blood gas levels, including lactate level, were normal, and she was admitted to our neonatal intensive care unit (NICU). Achieving full enteral feeding was not possible due to gastric residues and abdominal distention, making the patient dependent on TPN during the first 2 weeks of life. An insidious increase in lactic acid levels and uncompensated metabolic acidosis were apparent from the 23rd day of life. Severe metabolic acidosis was persistent despite massive doses of bicarbonate. The acidosis resolved dramatically within 6 h when the patient was administered with thiamine.

Conclusions: Although TPN is life saving in the NICU, meticulous attention must be paid to provide all essential macro- and micro-nutrients.
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http://dx.doi.org/10.1515/jpem-2017-0554DOI Listing
June 2018

B cell aplasia and hypogammaglobulinemia associated with levetiracetam.

Ann Saudi Med 2018 Jan-Feb;38(1):65-68. Epub 2018 Jan 9.

Hulya Ozdemir, Department of Pediatric Immunology and Allergy,, Medical Faculty, Selcuk University,, Alaeddin Keykubat Campus,, 42130 Selcuklu/Konya, Turkey, T: +90 332 2244496, ORCID: http://orcid.org/0000-0002-0287-5260.

Levetiracetam (LEV) is a second-generation antiepileptic drug approved for the treatment of several types of epilepsy. We report a 45-year-old female who developed hypogammaglobulinemia and B cell aplasia during LEV treatment. The Naranjo probability score for an adverse drug reaction was 6. After LEV discontinuation, the number of B cells gradually increased and reached normal levels within two months. This case suggests that monitoring of immunoglobulin levels and lymphocyte subsets analysis is important in patients treated with LEV, especially in cases of prolonged infections.

Similar Cases Published: 1.
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http://dx.doi.org/10.5144/0256-4947.2018.09.01.1430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074184PMC
September 2018

Persistent hyperglycemia in a neonate: Is it a complication of therapeutic hypothermia?

Turk J Pediatr 2017 ;59(2):193-196

Divisions of Neonatology, Department of Pediatrics, Marmara University Faculty of Medicine, Istanbul, Turkey.

Özdemir H, Memişoğlu A, Alp-Unkar Z, Arcagök B, Bilgen H, Turan S, Özek E. Persistent hyperglycemia in a neonate: Is it a complication of therapeutic hypothermia? Turk J Pediatr 2017; 59: 193-196. The aim of this report is to present a newborn with persistent hyperglycemia requiring insulin therapy as a possible complication of therapeutic hypothermia. A term appropriate for gestational age (AGA) female infant, was born by emergency cesarean section due to abruption of placenta and was resuscitated and intubated in the delivery room. Whole body cooling was initiated according to standard cooling criteria. The patient`s blood glucose increased up to 250 mg/dl on a glucose perfusion rate of 6 mg/kg/min after the second day of cooling. Insulin therapy was started due to persistent hyperglycemia and continued for 17 days. As it has been reported in adults after therapeutic cooling, persistent hyperglycemia attributed to hypothermia can also complicate therapeutic hypothermia in neonates.
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http://dx.doi.org/10.24953/turkjped.2017.02.013DOI Listing
November 2018

Impact of different antiseptics on umbilical cord colonization and cord separation time.

J Infect Dev Ctries 2017 Feb 28;11(2):152-157. Epub 2017 Feb 28.

Marmara University Faculty of Medicine, Istanbul, Turkey.

Introduction: There is still some uncertainty on cord care practices all around the world, especially in developing countries. The aim of our study was to investigate the effects of six different umbilical cord care practices on the rate of colonization and cord separation time.

Methodology: A total of 516 newborns were randomly allocated to the following six umbilical cord care groups: group 1 received dry care; groups 2-4 received a single application of 70% alcohol, 4% chlorhexidine, or povidon-iodine in the delivery room, respectively, which were discontinued thereafter; groups 5 and 6 received a single application of 70% alcohol or 4% chlorhexidine, respectively, starting in the delivery room and continuing every six hours until discharge. Umbilical cords were examined on the second and third days and between the fifth and seventh day for signs of omphalitis. Swab cultures were taken on the second or third day from all cases.

Results: Cord separation time (median [interquartile range]) was the shortest for group 1 (7 [6-7] days) and the longest for group 3 (10 [7-12] days) and group 6 (10 [8-12] days) (p < 0.001). The cord colonization in the swab cultures was significantly lower in groups 3 and 6 (p < 0.001). Omphalitis was detected in eight (1.5%) patients among the study population, and there was no significant difference between the groups.

Conclusions: Our study showed that chlorhexidine application was the most effective agent in decreasing colonization, though it increased cord separation time significantly in both groups.
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http://dx.doi.org/10.3855/jidc.7224DOI Listing
February 2017

Age-related alterations of the CD19 complex and memory B cells in children with Down syndrome.

Clin Exp Med 2018 Feb 14;18(1):125-131. Epub 2017 Feb 14.

Department of Pediatric Immunology and Allergy, Selcuk University Medical Faculty, Alaeddin Keykubat Kampusu, 42131, Konya, Turkey.

Children with Down syndrome (DS) have a high incidence of recurrent respiratory tract infections, leukaemia and autoimmune disorders, suggesting immune dysfunction. The present study evaluated the role of the CD19 complex and memory B cells in the pathogenesis of immunodeficiency in children with DS. The expression levels (median fluorescein intensity-MFI) of CD19, CD21 and CD81 molecules on the surface of B cells and memory B cell subsets were studied in 37 patients and 39 healthy controls. Twenty-nine of the DS group had congenital cardiac disease. The B cell count was significantly low in children with DS compared with healthy age-matched controls for all three age groups (under 2 years; 2-6 years and older than 6 years). The MFI of CD19 was reduced in all the age groups, whereas that of CD21 was increased in those older than 2 years with DS. The expression level of CD81 was significantly increased in those older than 6 years. Age-related changes were also detected in memory B cell subsets. The frequency of CD27IgDIgM natural effector B cells was reduced in children with DS who had needed hospitalisation admission due to infections. The observed intrinsic defects in B cells may be responsible for the increased susceptibility of children with DS to severe respiratory tract infections.
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http://dx.doi.org/10.1007/s10238-017-0457-2DOI Listing
February 2018

Effects of quercetin and surgicel for preventing adhesions after gynecological surgery: A rat uterine horn model.

J Obstet Gynaecol Res 2017 Jan 12;43(1):179-184. Epub 2016 Dec 12.

Zekai Tahir Burak Training and Research Hospital, Ankara, Turkey.

Aim: Postoperative pelvic adhesions are significant health care problems causing chronic pelvic pain, infertility and intestinal obstruction after abdominal or pelvic surgery. We investigated the effects of quercetin and Surgicel for the prevention of adhesions after gynecological surgery.

Methods: A double blind, randomized, controlled experimental study was designed. Forty female Wistar Hannover rats were divided into five groups: control, sham operated, quercetin, Surgicel, and quercetin + Surgicel. The control group received medication used for the surgical procedure only. The sham group received a laparotomy only. The quercetin group received 15 mg/kg quercetin in addition to undergoing the standard surgical procedure, and the injuries in the surgical group were covered with a single, 1 cm layer of Surgicel (oxidized regenerated cellulose). The quercetin + Surgicel group received both 15 mg/kg quercetin and a single, 1 cm layer of Surgicel. Adhesions were scored 14 days after the first surgical procedure.

Results: The extent, severity, degree, total adhesion, inflammation and fibrosis scores of the control group were significantly higher than those of the quercetin, Surgicel, and quercetin + Surgicel groups. There was no significant difference between the Surgicel and quercetin groups in degree, but all other parameters were significantly higher in the Surgicel than in the quercetin group. The quercetin + Surgicel group had lower adhesion scores than the quercetin group.

Conclusions: Quercetin, Surgicel and quercetin + Surgicel treatment may be useful for preventing pelvic adhesions.
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http://dx.doi.org/10.1111/jog.13185DOI Listing
January 2017

Serum Vitamin D Levels in Children with Vernal Keratoconjunctivitis.

Ocul Immunol Inflamm 2018 24;26(3):435-439. Epub 2016 Oct 24.

e Department of Ophthalmology , Hacettepe University Faculty of Medicine , Ankara , Turkey.

Purpose: To evaluate serum 25-hydroxyvitamin D [25(OH)D3] levels of vernal keratoconjunctivitis (VKC) children.

Methods: A total of 62 non-atopic healthy children (64.5% male, mean age 10.79 ± 3.3 years) and 29 VKC children (75.9%, mean age 12.17 ± 2.7 years) were included in the study. Serum 25(OH)D3 levels measured by HPLC were compared between the two groups and a p value of <0.05 was considered as statistically significant.

Results: The mean serum 25(OH)D3 level of VKC group was significantly lower than in the control group (11.02 ± 5.16 ng/mL and 15.99 ± 7.36 ng/mL, respectively) (p = 0.002). Severe vitamin D deficiency (<10 ng/mL) was detected in 48.3% of VKC children and 22.6% of the controls (p = 0.017). Time spent outdoors during daylight was higher in the control group (229.5 ± 101.2 min) compared with the VKC group (160.7 ± 65.9 min) (p = 0.008), and showed a significant correlation with serum 25(OH)D3 levels (Spearman rho = 0.812) (p<0.001).

Conclusions: Children with VKC should be evaluated for vitamin D deficiency, which might occur secondary to sun avoidance.
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http://dx.doi.org/10.1080/09273948.2016.1235714DOI Listing
July 2018

Analysis of CASP8 D302H Gene Variants in Patients with Primary Brain Tumors.

In Vivo 2015 Sep-Oct;29(5):601-4

Department of Molecular Medicine, Institute of Experimental Medicine, Istanbul, Turkey

Background: Alteration in cell-cycle control and apoptosis pathways play important roles in tumorigenesis. Caspase-8 (CASP8) is a member of the cysteine protease family, that is implicated in apoptosis regulation. The present study was designed to investigate the possible role of CASP8 D302H gene polymorphism in the tumor development.

Materials And Methods: A total of 91 patients with brain tumors (including 39 meningioma and 52 glioma cases) and 114 healthy controls were included in the study. We investigated CASP8 D302H polymorphism by using polymorphism chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis.

Results: The CASP8 D302H polymorphism genotypic frequencies were not statistically significantly different between meningioma cases and controls, with frequencies of GG, GC and CC genotypes of 71.2%, 19,2% and 9.6%; and 57.9%, 36.8% and 5.3%, respectively. The GG/CC genotypic frequencies were significantly increased in patients with glioma patients compared to controls (p=0.023) (χ(2)=5.149, odds ratio [OR]=1.27, 95% confidence interval [CI]=1.054-1.551). According to tumor characteristics, there were no statistically significant differences within the groups with astrocytic, oligoastrocytic tumors and oligodentriogliomas.

Conclusion: D302H polymorphism of CASP8 gene may be associated with increased risk of glioma but larger study groups in different ethnic populations are needed to better elucidate the role of CASP8 gene polymorphism in the pathogenesis of primary brain tumors.
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June 2016

Rahnella aquatilis Sepsis in a Premature Newborn.

Case Rep Pediatr 2015 18;2015:860671. Epub 2015 May 18.

Marmara University School of Medicine, Department of Pediatric Infectious Diseases, İstanbul, Turkey.

Rahnella aquatilis is an infrequently isolated Gram-negative rod within the Enterobacteriaceae family. The organism's natural habitat is water. The organism is rarely isolated from clinical specimens and it seldom causes infection in immunocompetent individuals. Here we present a one-month-old boy who was born prematurely at 27th week of gestation by cesarean section with a birth weight of 730 g. He developed sepsis caused by Rahnella aquatilis during the treatment for ventilator associated pneumonia due to Stenotrophomonas maltophilia with ciprofloxacin. He was successfully treated with a combination of amikacin plus meropenem. Although R. aquatilis is one of the saprophyticus organisms, it may cause life-threatening infection in newborn.
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http://dx.doi.org/10.1155/2015/860671DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4451765PMC
June 2015

Ductal closure with intravenous paracetamol: a new approach to patent ductus arteriosus treatment.

J Matern Fetal Neonatal Med 2016 Mar 2;29(6):987-90. Epub 2015 Apr 2.

a Division of Neonatology and.

Objectives: Indomethacin and ibuprofen are commonly used in the treatment of hemodynamically significant patent ductus arteriosus (hsPDA). These drugs are associated with serious adverse events, including gastrointestinal perforation, renal failure and bleeding. The role of paracetamol has been proposed for the treatment of PDA.

Methods: We report a series of 11 neonates (birth weight: 415-1580 g; gestational age: 23-30.3 weeks) who were treated with paracetamol for a hsPDA. Neonates with hsPDA were treated with paracetamol in the presence of contraindications to ibuprofen or indomethacin. The condition of significant PDA was defined by the presence of at least one of the following criteria: internal ductal diameter # 1.4 mm/kg body weight, left atrium (LA)-to-aortic (Ao) root ratio > 1.4, unrestrictive pulsatile transductal flow, reverse or absent diastolic flow in the descending aorta along with clinical findings. Intravenous (IV) paracetamol was given at doses 15 mg/kg every 6 h for three days.

Results: Successful ductal closure was achieved in 10 out of 11 babies (90.9%). No adverse or side effects were observed during the treatment.

Conclusions: On the basis of these results, paracetamol could be considered as a promising and safe therapy for the treatment of PDA in preterm infants.
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http://dx.doi.org/10.3109/14767058.2015.1029912DOI Listing
March 2016

The Adiponectin variants contribute to the genetic background of type 2 diabetes in Turkish population.

Gene 2014 Jan;534(1):10-6

Adiponectin, an adipose tissue specific protein encoded by the Adiponectin gene, modulates insulin sensitivity and plays an important role in regulating energy homeostasis. Many studies have shown that single nucleotide polymorphisms (SNPs) in the Adiponectin gene are associated with low plasma Adiponectin levels, insulin resistance and an increased risk of type 2 diabetes mellitus. The aim of the present study was to evaluate the contribution of the Adiponectin gene polymorphisms in genetic background of type 2 diabetes in a Turkish population. In total, 169 unrelated and non-obese diabetic patients and 119 age- and BMI-matched nondiabetic individuals with no family history of diabetes were enrolled in this study. We detected a significant association between type 2 diabetes and two SNPs: SNP −11391G N A, which is located in the promoter region of the Adiponectin gene, and SNP +276G N T, which is found in intron 2 of the gene (P b 0.05). The silence SNP G15G (+45TN G) in exon 1 and SNP+349ANG in intron 2 also showed a weak association with type 2 diabetes (P=0.06 and P=0.07, respectively),while SNPs−3971ANG in intron 1 and Y111H, R112C and H241P in exon 3 showed no association (P N 0.05). In conclusion, these findings suggest that Adiponectin gene polymorphisms might be effective on susceptibility for type 2 diabetes development which emerged from the interactions between multiple genes, variants and environmental factors.
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January 2014

Iron deficiency anemia in late-preterm infants.

Turk J Pediatr 2013 Sep-Oct;55(5):500-5

Division of Neonatology, Department of Pediatrics, Marmara University Faculty of Medicine, İstanbul, Turkey.

Iron deficiency anemia is a common problem in newborn infants. The American Academy of Pediatrics recommends iron prophylaxis at 4 months of age for term infants. There is no specific recommendation for iron prophylaxis in late-preterm infants. We aimed to establish the optimum time for iron prophylaxis in late-preterm infants. Thirty-eight late-preterm (Group 1) and 38 term (Group 2) infants born on the same day were enrolled in the study. Hemoglobin, ferritin and reticulocyte values at birth, 2nd month and 4th month were assessed. The cord ferritin, hemoglobin and reticulocyte levels did not differ significantly between groups. However, at the 2nd month, median ferritin and hemoglobin values were lower in late-preterm infants than term infants (145 mg/dl vs. 195 mg/dl, p=0.001 and 10.1 g/dl vs. 11.6 g/dl, p<0.001, respectively). Median ferritin levels were lower at the 4th month in latepreterm infants than term infants, but this difference was not significant after exclusion of three late- preterm infants who required iron therapy (49 mg/dl vs. 62 mg/dl, p=0.2). There was a tendency of higher frequency of anemia in late-preterm infants at 4 months (42.8% vs. 21.1%), but this was statistically insignificant (p=0.07). At the 2nd month of age, the median ferritin and hemoglobin levels of late-preterm infants were lower than those of term infants. Further studies with larger sample sizes are required to determine the need for earlier supplementation of iron in late-preterm infants.
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January 2015

Maternal thyroid dysfunction and neonatal thyroid problems.

Int J Endocrinol 2013 30;2013:987843. Epub 2013 Apr 30.

Department of Pediatrics, Division of Neonatology, Marmara University School of Medicine, Istanbul, Turkey.

Aim. To investigate obstetric features of pregnant women with thyroid disorders and thyroid function tests of their newborn infants. Methods. Women with hypothyroidism and having anti-thyroglobulin (ATG) and anti-thyroid peroxidase (anti-TPO) antibodies were assigned as group I, women with hypothyroidism who did not have autoantibodies were assigned as group II, and women without thyroid problems were assigned as group III. Results. Pregnant women with autoimmune hypothyroidism (group I) had more preterm delivery and their babies needed more frequent neonatal intensive care unit (NICU) admission. In group I, one infant was diagnosed with compensated hypothyroidism and one infant had transient hyperthyrotropinemia. Five infants (23.8%) in group II had thyroid-stimulating hormone (TSH) levels >20 mIU/mL. Only two of them had TSH level >7 mIU/L at the 3rd postnatal week, and all had normal free T4 (FT4). Median maternal TSH level of these five infants with TSH >20 mIU/mL was 6.6 mIU/mL. In group III, six infants (6.5%) had TSH levels above >20 mIU/mL at the 1st postnatal week. Conclusion. Infants of mothers with thyroid problems are more likely to have elevated TSH and higher recall rate on neonatal thyroid screening. Women with thyroid disorders and their newborn infants should be followed closely for both obstetrical problems and for thyroid dysfunction.
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http://dx.doi.org/10.1155/2013/987843DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657451PMC
June 2013

The effect of glutathione treatment on the biochemical and immunohistochemical profile in streptozotocin-induced diabetic rats.

J Membr Biol 2013 Jun 17;246(6):427-33. Epub 2013 May 17.

Biochemistry Department, Faculty of Veterinary Medicine, Yuzuncu Yil University, Van, Turkey.

This study investigated the possible role of glutathione (GSH) in diabetic complications and its biochemical safety in experimental diabetic rats. Serum biochemical parameters and the histology of the pancreas were investigated. Seven rats were separated as controls. To create the diabetes in rats, 45 mg/kg single-dose streptozotocin (STZ) was administered i.p. The treatment was continued for 1 month. STZ was administered to the diabetes + GSH group, then reduced GSH, dissolved in isotonic salt solution (200 mg/kg), was applied i.p. two times a week. The GSH group received i.p. GSH. Serum biochemical parameters were determined by autoanalyzer. Immunohistochemical procedures were used to determine the percentage of the insulin-immunoreactive β-cell area in the islets of Langerhans. The biochemical parameters changed to different degrees or did not change. Pancreatic cells of the control and GSH groups were healthy, but in the diabetic and GSH-treated diabetic groups we found damage in different numbers. The results from these analyses show that GSH supplementation can exert beneficial effects on pancreatic cells in STZ-induced diabetic rats and can safely be used for therapy in and protection from diabetes and complications of diabetes.
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http://dx.doi.org/10.1007/s00232-013-9541-zDOI Listing
June 2013