Publications by authors named "Tolga Celik"

16 Publications

  • Page 1 of 1

The outcome of two SMA cases treated with nusinersen at seven hours and at three days of life: the earliest ever.

Neuromuscul Disord 2022 07 8;32(7):575-577. Epub 2022 Jun 8.

Department of Pediatrics, Yeditepe School of Medicine, İstanbul, Turkey. Electronic address:

New molecular therapies are available for the treatment of spinal muscular atrophy (SMA) but early intervention is required. We report two cases that were diagnosed prenatally, where treatment with nusinersen was initiated within 7 h and three days respectively. The children were followed up for 13 months and almost six years respectively. Both children have developed within entirely normal centiles, indicating that initiating treatment immediately after birth, as in these cases, is essential for a good outcome.
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http://dx.doi.org/10.1016/j.nmd.2022.06.002DOI Listing
July 2022

The Effect of Asthma Severity on Perinatal Outcomes: A Tertiary Hospital Experience.

Z Geburtshilfe Neonatol 2021 Aug 14;225(4):333-340. Epub 2020 Oct 14.

Department of Obstetric and Gynecology, Division of Perinatology, Hacettepe Universitesi Tip Fakultesi, Ankara, Turkey.

Objective: To evaluate the effect of asthma severity and disease exacerbation on pregnancy outcomes.

Materials And Methods: Pregnancies were classified into 3 groups as mild (n=195), moderate (n=63), and severe (n=26) according to preconceptional asthma severity. Demographic features, clinical characteristics, and perinatal outcomes were compared between the groups. Delivery characteristics and pregnancy outcomes were also compared between the pregnancies with or without asthma exacerbation (43 and 241 pregnancies, respectively).

Results: Worsening of symptoms during pregnancy was higher in moderate and severe asthma groups (p<0.001). Rates of spontaneous abortion, fetal structural anomaly, preterm delivery, preeclampsia, fetal growth restriction (FGR), oligohydramnios, gestational diabetes, and intrauterine fetal demise were higher in moderate and severe asthma groups (p-values were < 0.001, 0.01, 0.008, 0.02, 0.01, < 0.001, < 0.001, and 0.007, respectively). Admissions to neonatal intensive care units and neonatal complication rates were higher among moderate and severe asthma groups (p=0.035 and < 0.001). Spontaneous abortion, preterm delivery, preeclampsia, FGR, oligohydramnios, and neonatal complication rates were higher (p<0.001) in the group with exacerbated symptoms.

Conclusion: Moderate to severe asthma before pregnancy and the exacerbation of asthma symptoms during pregnancy may lead to increased rates of perinatal complications.
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http://dx.doi.org/10.1055/a-1264-8207DOI Listing
August 2021

Accuracy of lung ultrasonography in the diagnosis of respiratory distress syndrome in newborns.

J Matern Fetal Neonatal Med 2021 Jan 22;34(2):281-286. Epub 2019 Apr 22.

Department of Neonatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Lung ultrasonography has become an important tool in the diagnosis and follow-up of lung diseases in the newborn period in recent years. Lung diseases such as pneumonia, transient tachypnea of the newborn and respiratory distress syndrome (RDS) can be diagnosed with lung ultrasound. Lung USG is a simple, practical and low-cost method in diagnosing neonatal RDS. This study was performed in Hacettepe University Neonatal Intensive Care Unit From December 2015 to February 2017. Forty patients who were diagnosed as RDS and given surfactant [200 mg/kg poractant alfa (CUROSURF®, Chiesi, Italy) intratracheal Suspension] were included in the study. Lung ultrasonography was performed at the bedside by a single expert, once before surfactant treatment and three times after surfactant treatment. Post-treatment ultrasonographic examinations were carried out at 2, 4 and 6 h after surfactant treatment. Before surfactant treatment, lung USG findings of patients were as follows: lung consolidation with air bronchograms (40/40), B-pattern (36/40), pleural line abnormalities (37/40), severe B-pattern (12/40) and disappearance of A-lines in all USG of patients. In the second hour of treatment, we did not see any valuable change or difference in lung USG findings of patients. The only change was the disappearance of air bronchograms and lung consolidation in five patients. Four hours after treatment we saw a reduction in lung consolidation in 14 patients, B-pattern had decreased in 15 patients, the appearance of A-lines and spared areas. But after 6 h, we started to see A-lines clearly, loss of B-pattern, an appearance of pleural line, and lung sliding in nearly all patients except three. Ultrasound is nonionizing and gives no hazard to the patient. Also, making it bedside is feasible and comfortable than other methods. Responsive and unresponsive patients to surfactant treatment can be determined in the early course of the disease and the cases needing re-treatment can be diagnosed easily by performing lung USG. This review focuses on ultrasonographic changes of the lung after surfactant treatment in premature newborns.
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http://dx.doi.org/10.1080/14767058.2019.1605350DOI Listing
January 2021

Gestational Outcomes of Pregnancies with Prenatally Detected Gastroschisis and Omphalocele.

Fetal Pediatr Pathol 2019 Aug 20;38(4):282-289. Epub 2019 Mar 20.

a Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University Hospital , Ankara , Turkey.

To evaluate and compare the outcomes of pregnancies with prenatally detected gastroschisis and omphalocele. We retrospectively evaluated prenatally detected gastroschisis and omphalocele cases. Cases were compared in terms of maternal demographic and clinical characteristics as well as pregnancy and neonatal outcomes. This study consisted of 17 gastroschisis and 30 omphalocele cases. Only one case with gastroschisis was terminated due to additional severe limb deformities. Seventeen out of 30 cases of omphalocele were terminated for various reasons (56.7%). All patients with gastroschisis had surgical repair, while 8 out of 13 omphalocele cases had surgery. One patient with an omphalocele died after surgery due to sepsis. Six cases of gastroschisis also died in the neonatal period due to various reasons (6/16, 37.5%). Additional genetic disorders are more frequent in those with omphalocele cases, and they are more frequently terminated during gestation that the gastroschisis fetuses.
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http://dx.doi.org/10.1080/15513815.2019.1585501DOI Listing
August 2019

The effectiveness of an integrated BIM/UAV model in managing safety on construction sites.

Int J Occup Saf Ergon 2020 Dec 19;26(4):829-844. Epub 2018 Sep 19.

Department of Civil and Architectural Engineering, Illinois Institute of Technology, USA.

A variety of approaches exist to achieve better construction safety performance, but only a few consider a combination of building information modeling (BIM) and unmanned aerial vehicles (UAVs). This article presents a four-dimensional (4D) BIM/UAV-enabled safety management model based on IDEF0 language. In the first step, potential hazards are identified with the help of safety specialists' experiences and BIM software used in the design of the structure. Then, a UAV monitors the location of the potential hazards. The third step involves the integration of the 4D BIM-based model and the information obtained from the UAV. Finally, the combined data are analyzed and interpreted, and site safety staff are notified about measures to be put in place to prevent accidents. This model shows a strong relationship between the design and construction phases by using BIM in the design phase and UAVs in the construction phase. The proposed safety model was evaluated by construction safety specialists in a two-pronged approach. . The number of fatal, non-fatal and property damage-causing accidents may be significantly lower when the proposed system was used. This model allows safety specialists to identify hazards and develop suitable mitigation strategies.
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http://dx.doi.org/10.1080/10803548.2018.1504487DOI Listing
December 2020

Does inhaled salbutamol before surfactant therapy have any beneficial effect?

Turk J Pediatr 2018 ;60(6):669-674

Division of Neonatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Çelik HT, Yurdakök M, Korkmaz A, Yiğit Ş. Does inhaled salbutamol before surfactant therapy have any beneficial effect? Turk J Pediatr 2018; 60: 669-674. Beta (β)2 adrenergic receptors are present in alveolar type II cells. Previously, the beneficial effects of inhaled salbutamol treatment on respiratory outcomes were shown in premature infants with transient tachypnea of the newborn. We hypothesized that inhaled salbutamol would increase the effects of surfactant on oxygenation in premature infants with respiratory distress syndrome (RDS). Inhaled salbutamol (0.15 mg/kg) or normal saline solution (0.30 ml/ kg) was administered as a single dose by micropump nebulizer 10 minutes before the first dose of surfactant (Poractant alfa) treatment in 40 infants with gestational ages ranging from 26 to 36 weeks. The effects of salbutamol therapy were evaluated by determining the duration of respiratory support, number of doses of surfactant, respiratory rate, heart rate, fraction of inspired oxygen, and partial pressure of arterial oxygen before and after salbutamol nebulization. No statistically significant difference was detected between the two groups in duration of respiratory support, number of doses of surfactant, respiratory rate, fraction of inspired oxygen, or partial pressure of arterial oxygen. In this study, no significant effect of inhaled salbutamol treatment on the surfactant therapy in premature infants with RDS was detected.
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http://dx.doi.org/10.24953/turkjped.2018.06.007DOI Listing
January 2018

Autoimmune hepatitis and pregnancy: report of two cases with different maternal outcomes.

Clin Exp Hepatol 2017 Dec 14;3(4):212-214. Epub 2017 Nov 14.

Department of Obstetrics and Gynecology, Division of Perinatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Women of childbearing age with autoimmune hepatitis (AIH) are now able to get pregnant. The progress of the disease during pregnancy is not well clarified yet. The first pregnant woman had cirrhosis secondary to AIH, and she delivered by cesarean section. The patient had severe thrombocytopenia at the time of hospitalization. Unfortunately, she died due to massive thromboembolism at the 24 hour after delivery. The other patient had three recurrent abortions with a diagnosis of AIH. Low-dose low molecular weight heparin and low-dose acetylsalicylic acid along with low-dose prednisolone were administered during the course of the following pregnancies. The following pregnancies ended up with a living child. There is a high morbidity and mortality risk for both fetus and mother. Hepatic performance of the patients, thrombotic events, inflammatory disorders and autoimmune system activation must be the main concerns together with necessary precautions.
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http://dx.doi.org/10.5114/ceh.2017.71445DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731429PMC
December 2017

Efficacy of new leukocyte parameters versus serum C-reactive protein, procalcitonin, and interleukin-6 in the diagnosis of neonatal sepsis.

Pediatr Int 2016 Feb;58(2):119-25

Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Background: The aim of this study was to investigate and compare the efficacy of the new leukocyte parameters mean neutrophil and monocyte volume (MNV, MMV), conductivity (MNC, MMC), scattering (MNS, MMS) and volume distribution width (NDW, MDW) with serum C-reactive protein (CRP), procalcitonin (PC) and interleukin (IL)-6 in the diagnosis of neonatal sepsis.

Methods: A total of 227 newborns (132 boys, 95 girls) were analyzed. There were 116 infants in the sepsis group (proven sepsis, n = 40; clinical sepsis, n = 76) and 111 in the control group. Venous blood samples were collected from infants at the time of diagnosis and complete blood count, peripheral blood smear, blood cultures, CRP, PC, IL-6 and MNV, MMV, MNC, MMC, MNS, MMS, NDW, and MDW were analyzed.

Results: MNV, NDW, MMV and, MDW were higher in infants with sepsis than in controls (P < 0.05 for all). MNS was lower in the patients with sepsis (P = 0.002). There was no significant difference between the sepsis and control groups in terms of MNC, MMC and MMS.

Conclusion: Although the predictive value of leukocyte parameters including neutrophil and monocyte volume, conductivity, scattering and volume distribution width in the diagnosis of neonatal sepsis was lower than that of CRP, PC and IL-6, some of these new parameters may be useful in the differential diagnosis of newborn sepsis, along with the other screening tools. In particular, MNV seems to be the most useful parameter with the highest specificity; also, the importance of PC in the diagnosis of early onset sepsis was confirmed.
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http://dx.doi.org/10.1111/ped.12754DOI Listing
February 2016

Serum prohepcidin levels in premature newborns with oxygen radical diseases.

J Matern Fetal Neonatal Med 2015 4;28(18):2228-33. Epub 2014 Dec 4.

b Division of Neonatology, Department of Pediatrics , Prof. Dr, Hacettepe University Faculty of Medicine , Ankara , Turkey.

This study aimed to investigate the prohepcidin levels in premature newborns with oxygen radical diseases such as bronchopulmonary dysplasia, retinopathy of prematurity and necrotizing enterocolitis and to compare these levels with those of healthy premature newborns. Eighty premature infants (25-34 weeks gestational age) were enrolled. The patient group was composed of 38 premature babies with oxygen radical diseases, and the control group consisted of 42 healthy premature newborns. Complete blood count, serum iron and ferritin concentrations, iron-binding capacity (IBC), transferrin and prohepcidin levels were measured. The mean ferritin and prohepcidin levels were higher in the patient group than in the control group (p = 0.038 and p = 0.022, respectively). No significant correlations were found between serum prohepcidin levels and iron parameters. We believe that this finding will contribute to a greater understanding of the etiopathogenesis of oxygen radical diseases. There is a need for future studies to explore the link between underlying inflammatory mechanisms and hepcidin in oxygen radical diseases.
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http://dx.doi.org/10.3109/14767058.2014.983064DOI Listing
July 2016

Hypotonia and poor feeding in an infant exposed to lamotrigine and valproic acid in utero.

Turk J Pediatr 2013 Sep-Oct;55(5):546-8

Division of Neonatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Lamotrigine has been considered a safe new-generation antiepileptic drug during the perinatal period for both mothers and infants. Despite the concerns regarding its possible teratogenic effect, very limited data have been reported on the adverse effects of perinatal lamotrigine exposure. Herein, we report a case of an infant with hypotonicity and poor feeding who was exposed to lamotrigine in utero. The drug interaction probability scale indicated a probable relationship between sepsis-like symptoms and exposure to lamotrigine and valproic acid in utero in this infant.
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January 2015

Myoclonic seizure due to cyclopentolate eye drop in a preterm infant.

Turk J Pediatr 2012 Jul-Aug;54(4):419-20

Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Cyclopentolate is widely used in ophthalmology for its intense mydriatic and cycloplegic activity. Systemic side effects have been described in both adults and children. Myoclonic seizure is a rare side effect of eye drops that are used in eye examinations. We report herein a case of convulsion in a three month- old girl following cyclopentolate hydrochloride and phenylephrine hydrochloride eye drops, which were used in advance of ophthalmoscopy for examination of retinopathy of prematurity (ROP). Physicians should be aware of the uncommon systemic side effects of cyclopentolate, and drops should be used in appropriate dosages.
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August 2013

Glucose-6-phosphate dehydrogenase deficiency in neonatal hyperbilirubinaemia: Hacettepe experıence.

J Paediatr Child Health 2013 May 11;49(5):399-402. Epub 2013 Apr 11.

Section of Neonatology, Department of Pediatrics, Hacettepe University, Ankara, Turkey.

Aim: The aim of this study was to investigate the prevalence of glucose-6-phospate dehydrogenase (G6PD) deficiency in newborn infants with neonatal hyperbilirubinaemia and to compare the clinical features of G6PD-deficient and G6PD-normal newborn infants.

Methods: A total of 4906 term and preterm neonates with indirect hyperbilirubinaemia were retrospectively evaluated according to demographic, neonatal features, bilirubin levels, erythrocyte G6PD levels, other risk factors and treatments.

Results: Among 4906 newborn infants with indirect hyperbilirubinaemia, 55 (1.12%) neonates were G6PD-deficient. In our study, no statistically significant difference was detected between G6PD-deficient and G6PD-normal infants in relation to the time of onset of jaundice, bilirubin levels and duration of phototherapy. However, the incidence of exchange transfusion in G6PD-deficient infants was 16.4% while it was only 3.3% in G6PD normal infants (P < 0.05).

Conclusion: Testing for G6PD must be ordered to all newborns who are receiving phototherapy and especially to those who are coming from the high incident geographical regions and less responsive to phototherapy.
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http://dx.doi.org/10.1111/jpc.12193DOI Listing
May 2013

A newborn with overlapping features of AEC and EEC syndromes.

Am J Med Genet A 2011 Dec 7;155A(12):3100-3. Epub 2011 Nov 7.

Neonatology Unit, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Ectrodactyly, ectodermal dysplasia, clefting (EEC) syndrome is the prototype of several p63 conditions, which include ankyloblepharon, ectodermal dysplasia, clefting (AEC) syndrome, limb-mammary syndrome (LMS), Rapp-Hodgkin syndrome (RHS), ADULT syndrome, and others. All these disorders include combinations of ectodermal dysplasia, orofacial clefting and limb malformations in variable severity. A newborn patient is presented with diffuse erythematous and desquamating skin lesions and anal atresia. She also had sparse and lightly colored thin hair, deeply set eyes, hypoplastic alae nasi, and a short philtrum. Cleft lip/palate and ankyloblepharon were not present. Complete cutaneous syndactyly was present on both hands in between the third and fourth fingers. Mild ectrodactyly was evident on all four extremities in between first and second digits. There was post-axial polydactyly on both feet. Anal atresia was present and defecation occurred through a rectovaginal fistula. The patient represented an interesting overlapping clinical condition between AEC and EEC syndromes. Diffuse skin lesions with excoriation and desquamation suggest AEC syndrome, despite the absence of ankyloblepharon, however; ectrodactyly and polydactyly strongly suggest the EEC syndrome. C308Y mutation in exon 8 of TP63 gene was detected, which was previously described to lead only to EEC syndrome and not to any of the other allelic conditions. These data emphasize the large degree of clinical variability that may be seen for specific TP63 mutations.
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http://dx.doi.org/10.1002/ajmg.a.34328DOI Listing
December 2011

Subtelomeric rearrangements in mental retardation: Hacettepe University experience in 130 patients.

Turk J Pediatr 2009 May-Jun;51(3):199-206

Clinical Genetics Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Recent reports have revealed the presence of subtelomeric rearrangements in 0.5-1.1% of patients with mild mental retardation and in 6.8-7.4% of patients with moderate-severe mental retardation. In the present study, 130 patients with unexplained mental retardation were tested using fluorescence in situ hybridization (FISH) analysis for the first time in a large group of Turkish patients, in order to determine the frequency of subtelomeric rearrangements. Three patients had such rearrangements. We present the clinical findings in these patients with (1) coexistent 9p subtelomeric monosomy and 4q subtelomeric trisomy, (2) 22q13.3 subtelomeric monosomy, and (3) coexistent 4p subtelomeric monosomy and 8p subtelomeric trisomy. Mild retardation without dysmorphic features in one of these patients suggests offering subtelomeric analysis to a wide spectrum of mental retardation.
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October 2009

Influenza vaccine adverse event and effect on acceptability in pediatric residents.

Jpn J Infect Dis 2007 Nov;60(6):387-8

Department of Pediatrics, Hacettepe University School of Medicine, Ankara, Turkey.

Despite the demonstrated benefits of influenza vaccinations, the coverage is lower than expected among health-care personnel (HCP). In this study we surveyed the attitudes of pediatric residents regarding influenza immunization and adverse reactions. Forty-five female and 35 male pediatric residents with ages ranging from 24 to 28 years were vaccinated with an influenza vaccine on 2 days in the 3rd week of September 2005 by the same nurse. Among our resident, 27 (33.7%) thought the vaccine unnecessary; their vaccine coverage was only 12% in the previous year. Thirteen residents (16%) had soreness at the vaccination site; 7 (8%) had other local reactions that did not interfere with everyday activities, and 16 (20%) had any systemic side effects. The overall rate of side effects from the vaccination was 36.5% (n=29). Twenty of the 29 vaccinees who experienced side effects stated they did not want to receive the vaccine the following year because of the side effects, while 13% in the group without side effects stated the same thing, mainly because of the cost of vaccination. We would like to recommend an influenza vaccination campaign for HCP by employers, but first we must plan to take steps to improve the acceptability of the influenza vaccine among HCP.
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November 2007

Prolonged cellulitis due to plant thorn.

Turk J Pediatr 2005 Oct-Dec;47(4):393-6

Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

We report the case of a five-year-old healthy boy who was admitted with abscess and soft tissue infection between the left wrist and the distal end of the forearm. Postero-anterior X-ray examination of the forearm showed a transverse line on the radius; however, further comparative radiographic examinations of the forearm were not compatible with fracture. Enterobacter cloacae was identified in the pus culture and initial intravenous empiric treatment with sulbactam-ampicillin was continued. Although the microorganism was susceptible to the empiric antimicrobial agent, at the eighth day of the treatment, inflammatory drainage was still present so further evaluations were performed. Ultrasonography of the forearm and wrist revealed only collection; magnetic resonance imaging showed a foreign body on the anterior distal section of the left forearm. The patient underwent operation and a 22 mm wooden foreign body was removed. Detailed history after removing a tree branch particle revealed that the boy had recently fallen from a tree causing an abrasion over the left wrist. The postoperative course was uneventful and clinical response was excellent in two days. In view of this case report, we would like to emphasize the importance of medical history and imaging studies in cases of cellulitis that do not respond to appropriate antimicrobial therapy. Another point to be kept in mind is that Enterobacter cloacae, which is very rarely reported as a causative agent for cellulitis, could be the etiological agent in cases after plant thorn injuries.
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January 2006
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