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    Does being an infant of gestational diabetic mother affect cerebellar size?
    (Logos Medical Publishing, 2016) İmamoğlu, Ebru Yalın; Gürsoy, Tuğba; Sancak, Selim; Karatekin, Güner; Ovalı, Fahri
    In this study, our aim was to investigate cerebellar vermis height and transverse cerebellar diameter with cranial ultrasonography in infants of gestational diabetic mothers. Forty infants of diabetic mothers (21 appropriate-for-gestational age and 19 large-for-gestational age infants) and 40 gestational-age matched healthy controls were evaluated with cranial ultrasonography within 24 hours of birth. Cerebellar vermis height and transverse cerebellar diameter were measured midsagitally from anterior fontanelle and then coronally from mastoid fontanelle. In terms of cerebellar vermis height and transverse cerebellar diameter, no statistically significant difference was found between infants of diabetic and healthy mothers. Gestational diabetes mellitus could not affect cerebellar size in neonates. In studies with larger series, evaluation of cerebellar size and morphology in infants of diabetic mothers during long-term monitorization of their neurodevelopment could be also useful. © 2018, Logos Medical Publishing. All rights reserved.
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    Effect of intraventricular hemorrhage on cerebellar growth in preterm neonates
    (Springer, 2017) Sancak, Selim; Gürsoy, Tuğba; Karatekin, Güner; Ovalı, Fahri
    The aim of this study is to evaluate cerebellar growth of preterm infants with intraventricular hemorrhage. Vermis height (VH) and transverse cerebellar diameter (TCD) were measured by cranial ultrasound in 18 preterm infants (26-30 weeks) with intraventricular hemorrhage (IVH) at first 3 days of life and at term equivalent age (TEA). IVH was diagnosed by ultrasonography and scaled in accordance with the definitions by Papile et al. Measurements were compared with 18 preterm (26-30 weeks) infants without IVH. Both VH and TCD of preterm infants with IVH were significantly lower than those of preterm ones without IVH at TEA (p < 0.001). No significant difference was found for head circumference (p = 0.158) and weight (p = 0.092). In subgroup analysis, preterm infants with grades 3-4 IVH had significantly lower TCD (p = 0.008) and head circumference (p = 0.033) than the ones with grades 1-2 IVH. However, VH (p = 0.102) and weight (p = 0.480) did not show any difference between these subgroups. IVH may have a significant impact on cerebellar growth on preterm infants at TEA, specially those with a severe IVH. TCD is affected more than VH.
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    Effect of single intravitreal bevacizumab on ophthalmic and middle cerebral arterial blood flow in retinopathy of prematurity
    (Karger, 2016) Günay, Murat; Tüten, Abdulhamit; Sancak, Selim; Çelik, Gökhan; Bardak, Handan
    Purpose: To evaluate the effect of a single intravitreal bevacizumab (IVB) injection on blood flow parameters in the ophthalmic artery (OA) and middle cerebral artery (MCA) in infants with retinopathy of prematurity (ROP). Materials and Methods: This prospective and interventional study included 15 infants with ROP who were treated with IVB. Peak systolic velocity (PSV), end-diastolic velocity, mean velocity (MV) and resistivity index were measured using pulse wave Doppler ultrasonography (Philips En Visor C, Amsterdam, The Netherlands) in the OA and MCA, before IVB injection and 1 day, 1 week and 1 month after IVB injection. Results: Measurements of PSV-OA, MV-OA and PSV-MCA showed significant changes after IVB treatment (p = 0.01, p = 0.02, p = 0.02, respectively). The PSV-OA measurements at 1 week and 1 month were significantly lower than the baseline PSV-OA measurement (p = 0.03 and p = 0.01, respectively). The MV-OA measurement was significantly lower at 1 month following IVB as compared to the baseline MV-OA measurement (p = 0.03). The PSV-MCA showed a significant decline 1 day after IVB injection (p = 0.03). Conclusions: The study demonstrated that IVB causes significant alterations in blood flow parameters in the OA and MCA predicted by Doppler ultrasonography in infants with ROP. (C) 2016 S. Karger AG, Basel
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    The effects of intravenous paracetamol use on blood parameters in the treatment of patent ductus arteriosus
    (2023) Dinçel, Gökçe Kaya; Dilek, Mustafa; Bekdaş, Mervan; Sancak, Selim; Kabakuş, Nimet
    Background: Patent ductus arteriosus (PDA), a cause of significant hemodynamic imbalance in newborn babies, can be treated using pharmacological or surgical methods. The purpose of this study was to compare intravenous (IV) paracetamol in newborns with hemodynamically significant PDA, with indomethacin and ibuprofen in terms of changes caused in blood parameters. Methods: Intravenous paracetamol was used for 3-6 days at 4x15 mg/kg/dose in cases diagnosed with PDA and admitted for follow-up between November 2014 and December 2015, and unable to receive oral medication or with contraindications for indomethacinibuprofen use. These cases were investigated retrospectively in terms of changes in pre and post-treatment AST (aspartate aminotransferase), ALT (alanine aminotransferase), urea, creatinine, platelet, and neutrophil values. Results: Intravenous paracetamol was administered to 10 cases of PDA, diagnosed between November 2014 and December 2015. Prior to paracetamol therapy, an increase in urea values was present in one case, increased AST in two, and decreased platelet values in two. Post-treatment values returned to normal ranges in all cases, and hemodynamic improvement was observed after the closure of the ductus arteriosus. Conclusion: Our analysis of its effect on PDA closure and its potential side-effect profile in patient blood parameters compared to other known therapeutic agents indicates that intravenous paracetamol, which is easily available and accessible in Turkey, may be an important option for the treatment of PDA.
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    New findings in fetal valproate syndrome: Hiatal hernia, gastric volvulus and ectopic kidney
    (Taylor & Francis Inc, 2016) Arman, Didem; Sancak, Selim; Topçuoğlu, Sevilay; Karatekin, Güner
    It is known that use of several antiepileptic drugs (AED) during pregnancy has been associated with an increased risk of major congenital anomalies. Approximately one in 250 pregnancies is known to be exposed to AED and a significant proportion of these are exposed to valproate, either as monotherapy or as part of a polytherapy drug regimen (Lindhout and Omtzigt 1992). Valproic acid (VPA) also has relatively less sedative and behavioural effects. Because of the previous reports suggesting a decreased risk of adverse pregnancy outcome, VPA was used extensively. It is a popular drug used for the treatment of seizures because of its broad range of anticonvulsant effect. It is generally accepted that the lowest dose at which the patient is seizure free should be used during pregnancy. The dose of VPA is titrated according to the clinical response (ClaytonSmith and Donnai 1995) Several studies have also shown that VPA doses over 1000 mg/day are associated with a doubling of the risk for the fetus (Morrow et al. 2006) Fetal valproate syndrome (FVS) is seen in infants after in utero exposure to sodium valproate, with typical facial appearance, various malformations and neurodevelopmental delay. It can be characterised by neural tube defects, congenital heart disease, genitourinary, skeletal and respiratory system anomalies, brain, eye and abdominal wall defects (Ozkan et al. 2011)