Research Outputs
Permanent URI for this communityhttps://hdl.handle.net/20.500.14288/2
Browse
19 results
Search Results
Publication Open Access A rare presentation of adrenal adenoma in infancy: isolated Cushing's syndrome(Turkish National Pediatric Society, 2020) Yeğen, Gülçin; Şal, Oğuzhan; Oğuzkurt, Nigar Pelin; Undergraduate Student; School of MedicineAdrenocortical tumors are rare in children. Most of these tumors present with endocrinological manifestations, majority of which with virilizing features alone or in combination with over production of other adrenal hormones. However, it is uncommon of an adrenocortical tumor to present solely with Cushing's syndrome. In this paper we discuss the clinical presentation and management of a 5-month-old infant who had presented with Cushing's syndrome due to a functioning adrenocortical adenoma without androgen and mineralocorticoid excess, and made a brief review on the clinical and histopathological characteristics of adrenocortical tumors.Publication Open Access Being a pediatrician and living in the world of children(Aves, 2022) Hatun, Şükrü; Faculty Member; School of Medicine; 153504Publication Open Access Birth weight reference percentiles by gestational age for Turkish twin neonates(Aves, 2021) İmamoğlu, Ebru Yalın; Hayran, Mutlu; Kayıran, Sinan Mahir; Zeybek, Gözde; Özumut, Sibel Sevuk; Karatekin, GÜner; Ovalı, Fahri; Gürsoy, Tuğba; Faculty Member; School of Medicine; 214691Aims: in clinical practice, birth weight reference percentiles for singletons are used to evaluate twin births. The utilization of singleton reference percentiles for twins is not appropriate as they experience different growth trajectories. However, Turkey still lacks such references. Our aim was to create gestational age-specific birth weight references for female and male Turkish twins. Materials and methods: this is a hospital-based, multi-centered, retrospective study. In total, 2544 live-born twins between 2010 and 2019 were included in the study. Gestational age, birth weight, mode of delivery, gender, birth order, chorionicity, maternal age, pregnancy resulting from assisted reproduction techniques, APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) score at 5 minutes, admission to the neonatal intensive care unit (NICU), length of stay in NICU, and death during the NICU stay were recorded. Results: smoothed reference curves for birth weight by gestational age and separate tables for female and male twin neonates for the 3rd, 10th, 50th, 90th, and 97th percentiles from 26 to 39 weeks of gestational age were constructed. Overall neonatal and infant mortality rates during NICU stay in our twin cohort were 12/1000 and 16/1000, respectively. Conclusion: twin-specific birth weight nomograms could be helpful as a reference for clinicians to identify high-risk neonates and fetuses who need specialized care. However, further studies with larger series are urgently needed for validation and use of these nomograms in clinical practice.
Publication Metadata only Birth weight reference percentiles by gestational age for Turkish twin neonates(Aves, 2021) Imamoglu, Ebru Yalin; Hayran, Mutlu; Kayiran, Sinan Mahir; Zeybek, Gozde; Ozumut, Sibel Sevuk; Karatekin, Guner; Ovali, Fahri; N/A; Gürsoy, Tuğba; Faculty Member; School of Medicine; 214691N/APublication Open Access Comparison of intraoperative and postoperative analgesic properties of ilioinguinal/iliohypogastric and sacral epidural block in pediatric unilateral inguinal hernia operations(Kare Yayıncılık, 2022) Mahli, A.; Coşarcan, Sami Kaan; Doctor; Koç University HospitalObjectives: Central blocks such as caudal, spinal, and sacral epidural are frequently used in pediatric inguinal surgeries. Furthermore, peripheral blocks have been used and successful results have been obtained in pediatric inguinal surgeries. In this study, we aimed to compare the intraoperative and postoperative analgesic efficacy of the ilioinguinal/iliohypogastric (IL/IH) block under general anesthesia with the sacral epidural block. Methods: This study was carried out in Gazi University Faculty of Medicine, Department of Anesthesiology and Reanimation, after obtaining permission from the Ethics Committee of Gazi University Faculty of Medicine and the Central Ethics Committee of the General Directorate of Pharmaceuticals and Pharmacy of the Turkish Ministry of Health, numbered B.10.0.İEG.011.00.01. Sixty patients in the American Society of Anesthesiologists I-II group between the ages of 1 and 8 years who will undergo elective unilateral inguinal hernia operation under general anesthesia were randomly divided into two groups. Group S (n=30) sacral epidural block and group I (n=30) IL/IH nerve block were planned. Results: Hemodynamic values were found to be statistically significantly lower than control values in both groups. The minimum alveolar concentration values for sevoflurane were statistically significantly lower values in both groups at all surgery periods. In terms of additional analgesic requirement, the group I was found to be statistically significantly lower than the group s at the 8th-12th h. When the first analgesic intake hours were examined, no significant difference was found between the two groups. Conclusion: In our study, group I and group S analgesic efficacy was found to be similar. / Amaç: pediatrik inguinal girişimlerde kaudal, spinal ve sakral epidural gibi santral bloklar sıklıkla kullanılmaktadır. Bu girişimlerde periferik bloklar da kullanılmakta ve başarılı sonuçlar alınmaktadır. Bu çalışmada, genel anestezi altında ilioinguinal/ iliohipogastrik bloğunun intraoperatif ve postoperatif analjezik etkinliğini sakral epidural blok ile karşılaştırmayı amaçladık. Gereç ve yöntem: bu çalışma, Gazi Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı’nda, Gazi Üniversitesi Tıp Fakültesi Etik Kurulu’ndan ve Sağlık Bakanlığı İlaç ve Eczacılık Genel Müdürlüğü Merkez Etik Kurulu’ndan B.10.0.İEG.011.00.01 numaralı izin alındıktan sonra gerçekleştirilmiştir. ASA I - II grubunda olup genel anestezi altında elektif tek taraflı inguinal herni ameliyatı olacak, yaşları 1-8 arasında olan 60 hasta randomize olarak iki gruba ayrıldı: Grup S (n=30) sakral epidural blok grubu ve Grup I (n=30) ilioinguinal / iliohipogastrik sinir bloğu grubu. Bulgular: hemodinamik değerler her iki grupta da kontrol değerlerinden istatistiksel olarak anlamlı derecede düşük bulundu. Sevofluran için MAC değerleri, tüm cerrahi periyotlarda her iki grupta da istatistiksel olarak anlamlı derecede düşüktü. Ek analjezik gereksiniminin Grup I’da, 8. ve 12. saatlerde Grup S’ye göre istatistiksel olarak anlamlı derecede düşük olduğu gözlendi. İlk analjezik alım saatleri açısından iki grup arasında anlamlı fark bulunmadı. Sonuç: çalışmamızda Grup I ve Grup S’de analjezik etkinlikleri benzer bulundu.Publication Metadata only Congenital prepubic sinus(Bmj Publishing Group, 2016) N/A; N/A; N/A; Eroğlu, Egemen; Özen, Mehmet Ali; Gündoğdu, Gökhan; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 214688; 293404; N/AN/APublication Open Access Differential lung ventilation via tracheostomy using two endotracheal tubes in an infant: a case report(BioMed Central, 2017) Ataman, Yasemin; N/A; Demirkol, Demet; Gündoğdu, Gökhan; Faculty Member; School of MedicineBackground: This case report presents differential lung ventilation in an infant. The aim is to define an alternative technique for performing differential lung ventilation in children. To the best of our knowledge, this is the first report of this kind. Case presentation: A 4.2-kg, 2.5-month-old Asian boy was referred to our facility with refractory hypoxemia and hypercarbia due to asymmetric lung disease with atelectasis of the left lung and hyperinflation of the right lung. He was unresponsive to conventional ventilator strategies; different ventilator settings were required. To perform differential lung ventilation, two separate single-lumen endotracheal tubes were inserted into the main bronchus of each lung by tracheotomy; the tracheal tubes were attached to discrete ventilators. The left lung was ventilated with a lung salvage strategy using high-frequency oscillatory ventilation, and the right lung was ventilated with a lung-protective strategy using pressure-regulated volume control mode. Differential lung ventilation was performed successfully with this technique without complications. Conclusions: Differential lung ventilation may be a lifesaving procedure in select patients who have asymmetric lung disease. Inserting two single-lumen endotracheal tubes via tracheotomy for differential lung ventilation can be an effective and safe alternative method.Publication Open Access Does being born small-for-gestational-age affect cerebellar size in neonates?(Taylor _ Francis, 2016) Imamoglu, Ebru Yalin; Sancak, Selim; Ovali, Fahri; Gürsoy, Tuğba; Faculty Member; School of Medicine; Koç University Hospital; 214691Objective: To investigate how cerebellar vermis height (CVH) and transverse cerebellar diameter (TCD) measurements are affected in SGA neonates.Methods: A total of 176 [88 SGA and 88 appropriate for gestational age (AGA)] neonates between 26 and 42 weeks of gestation were included. Midsagittal plane through the anterior fontanel and coronal plane through the left mastoid fontanel were used to measure CVH and TCD, respectively. CVH and TCD values were considered normal when they were 10th percentile, according to nomograms of AGA neonates.Results: Thirty-six asymmetric SGA neonates, 52 symmetric SGA neonates and their 88 gestational age-matched AGA controls were studied. The percentages of neonates with normal CVH and TCD in the symmetric SGA sub-group were significantly lower than those in the AGA and asymmetric SGA sub-groups. The percentages with normal CVH and TCD in the asymmetric SGA sub-group were also found to be low when compared with the AGA sub-group.Conclusion: Growth and development of cerebellum may be less spared in SGA neonates. Further studies with larger series are needed in order to evaluate how being born SGA (symmetric and asymmetric) affects cerebellar size and also to see how these findings influence the neurocognitive outcomes of these infants at long-term follow-up.Publication Open Access Education of healthcare personnel working with pediatric patients during COVID-19 pandemic within the framework of infection control(Bilimsel Tıp Yayınevi, 2020) Oygar, Pembe Derin; Büyükçam, Ayşe; Bal, Zümrüt Şahbudak; Dalgıç, Nazan; Bozdemir, Şefika Elmas; Karbuz, Adem; Çetin, Benhur Şirvan; Kara, Yalçın; Çetin, Ceren; Hatipoğlu, Nevin; Uygun, Hatice; Aygün, Fatma Deniz; Törün, Selda Hançerli; Okur, Dicle Şener; Çiftdoğan, Dilek Yılmaz; Kara, Tuğçe Tural; Yahşi, Aysun; Özer, Arife; Demir, Sevliya Öcal; Akkoç, Gülşen; Turan, Cansu; Salı, Enes; Şen, Semra; Erdeniz, Emine Hafize; Kara, Soner Sertan; Emiroğlu, Melike; Erat, Tuğba; Gürlevik, Sibel Laçinel; Sütçü, Murat; Aydin, Zeynep Gökçe Gayretli; Atıkan, Başak Yıldız; Yeşil, Edanur; Güner, Gizem; Çelebi, Emel; Efe, Kadir; İşançlı, Didem Kızmaz; Durmuş, Habibe Selver; Tekeli, Seher; Karaarslan, Ayşe; Bülbül, Lida; Almiş, Habip; Kaba, Özge; Keleş, Yıldız Ekemen; Yazıcıoğlu, Bahadır; Oğuz, Şerife Bahtiyar; Ovalı, Hüsnü Fahri; Doğan, Hazal Helin; Çelebi, Solmaz; Çakır, Deniz; Karasulu, Burcugül; Alkan, Gülsüm; Gül, Doruk; Küçükalioğlu, Burcu Parıltan; Avcu, Gülhadiye; Kukul, Musa Gürel; Bilen, Melis; Yaşar, Belma; Üstün, Tuğba; Kılıç, Ömer; Akın, Yasemin; Cebeci, Sinem Oral; Turgut, Mehmet; Yanartaş, Mehpare Sarı; Şahin, Aslıhan; Arslanoğlu, Sertaç; Elevli, Murat; Öz, Şadiye Kübra Tüter; Hatipoğlu, Halil; Erkum, İlyas Tolga; Demirbuğa, Asuman; Özçelik, Taha; Sarı, Emine Ergül; Akkuş, Gökhan; Hatipoğlu, Sadık Sami; Dinleyici, Ener Cağrı; Hacımustafaoğlu, Mustafa; Özkınay, Ferda; Kurugöl, Zafer; Cengiz, Ali Bülent; Somer, Ayper; Tezer, Hasan; Kara, Ateş; Aktürk, Hacer; Yenidoğan, İrem; Faculty Member; Researcher; Koç University HospitalObjective: in the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and methods: a survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n=4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: it is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic. / Giriş: yeni ortaya çıkan patojenlerin neden olduğu salgınların erken dönemleri sağlık çalışanları için büyük bir risk taşımaktadır. SARS-CoV-2’nin neden olduğu pandemide de durum farklı olmamış, alınan yetersiz önlemler ve kişisel korunma eksikliği nedenleriyle pandemi başlangıcında birçok sağlık çalışanı hayatını kaybetmiştir. Sağlık çalışanlarının koruması ve güvenli ortamda çalışmalarının devamlılığının sağlanması sağlık hizmetlerinin aksamamasının yanında salgının sınırlandırması içinde gereklidir. Kişisel koruyucu ekipmaların kullanımı ile ilgili eğitimlerin verilmesi, gerekli durumlarda güncellenmesi koruyucu ekipmanların sağlanması kadar önemlidir. Gereç ve yöntemler: otuz iki farklı merkezde çocuklara sağlık hizmeti veren 4927 sağlık personeli üzerinde anket uygulanmış, kişisel koruyucu ekipman kullanımı konusunda alınan eğitim değerlendirilmiş, yaş, cinsiyet, meslek ve bölgesel farklılıkların eğitim alma üzerine etki edip etmediği değerlendirilmiştir. Bulgular: otuz iki farklı merkezden 4927 sağlık çalışanın katıldığı çalışmada, 4457 (%91) sağlık çalışanın kişisel koruyucu ekipmaların kullanımı ile ilgili eğitim aldığı saptanmış, yalnızca %36’sının hem teorik hem de uygulamalı eğitim aldığı bulunmuştur. Meslek grupları arasında eğitim alma yönünden fark görülmezken, bölgelere göre eğitim alıp almamada anlamlı fark olduğu saptanmıştır. Sonuç: tüm bölgelerde sağlık personelinin kişisel korunma konusunda eğitilmesi ve verilen eğitimin denetimi ve sürekliliği kaliteli sağlık hizmetlerinin devamlılığı için gereklidir.Publication Open Access Evaluation of arterial functions and carotid intima media thickness in children during mid-term follow-up after Kawasaki disease(Aves, 2021) Akalın, Figen; Erolu, Elif; Bayram, Tevfik; Haklar, Goncagül; Çetiner, Nilüfer; Faculty Member; School of MedicineObjective: Kawasaki disease (KD) is a multisystemic vasculitis of medium-and small-sized arteries. The involvement of the coronary arteries may lead to long-term cardiovascular sequelae. We studied the elasticity of the aorta and the common carotid artery (CCA), flow-mediated dilatation of the brachial artery, and carotid intima media thickness, as well bio-markers such as high-sensitivity C-reactive protein (hs-CRP) and elastin, as useful indicators of cardiovascular risk in patients, following KD. Methods: the study group consisted of 26 patients with a history of KD, and 26 healthy children. Echocardiography, and carotid and brachial ultrasound studies were performed. Plasma hs-CRP and elastin levels were studied in both groups. Results: the stiffness indices (SI) obtained from the aortic arch, abdominal aorta, and the CCA were increased in the patients, compared to the controls. Distensibility was decreased at the sinus of Valsalva, the sinotubular junction, the aortic arch, and the ascending aorta, compared to the control group. Flow-mediated dilatation (FMD) was lower in the patients than in the con-trols. The age of the patients had a negative correlation to distensibility of the aortic arch and abdominal aorta, and a positive correlation to the stiffness of the aortic arch. Follow-up dura-tion correlated positively to stiffness of the aortic arch. Carotid intima-media thickness (CIMT), serum hs-CRP, and elastin levels did not differ between the groups. Conclusion: increased aortic and carotid stiffness and decreased aortic distensibility suggest impaired arterial functions following KD. Long-term follow-up and monitorization early in cardiovascular disease is needed.