Papers by Nadide Melike Sav
Refugee and asylum‐seeker children and health problems in the city of Duzce, Türkiye
Child care health and development/Child, care, health and development, Jun 26, 2024
Preterm doğum yenidoğan ölümlerinin önde gelen nedenidir. Bu ölümlerin arasında en yüksek oran so... more Preterm doğum yenidoğan ölümlerinin önde gelen nedenidir. Bu ölümlerin arasında en yüksek oran solunum sıkıntısı sendromu' na (RDS) aittir. Bu çalışmanın amacı, yenidoğanlarda RDS yönetiminin en uygun ve etkin hale getirilmesine yardımcı olmak için; RDS'nin risk faktörlerini, klinik özelliklerini ve komplikasyonlarını belirlemektir. Gereç ve Yöntemler: Çalışmaya ikinci düzey yenidoğan yoğun bakım servisimizdeki Ocak 2016 ile Haziran 2021 tarihleri arasında düşük doğum ağırlıklı bebekler alındı. Olgular geriye dönük incelenerek, demografik özellikleri, verilmiş olan tedaviler (mekanik ventilasyon, surfaktan), ve erken ve geç komplikasyonları; ölüm oranları ve sebepleri belirlendi. Bulgular: Toplam 130 olgu çalışmaya alındı. Yüzde altmış ikisi erkek, %38'i kızdı.Yüzde 85'i sezaryen doğum, % 15'inde normal vajinal yoldu. Ortalama doğum ağırlığı 2043±372 gr, ortalama gebelik haftası 32±5 hafta bulundu. Antenatal steroid (ACS), %67,6' sında uygulanmıştı.Yüzde otuzüçünde erken membran rüptürü (EMR) saptandı. Erken ve geç komplikasyonlar; %3,8'inde ventilatöre bağlı pnömoni ve %3'ünde pnömotoraks idi.Yüzde 4,6'ında ise sepsis saptandı. Bronkopulmoner displazi (BPD) %2,3, Prematür Retinopatisi (ROP) %1,5, periventriküler lökomalazi %1,7 ile intrakraniyal kanama (IKK evre III-IV) %2 olarak görüldü. Ölüm oranı %10'du. Sonuç: Ölüm oranlarımız; ülkemizden yayınlanan verilerle benzer olarak bulundu. Doğum öncesi izlemin iyileştirilmesi, gebe takiplerinin düzenli yapılması, sık görülen ölüm nedenleri için risklerin tespit edilip bunlara karşı yeterli ve etkin önlemlerin alınması durumunda ölüm oranlarımızın azalacağını düşünmekteyiz.
Duzce Universitesi Tip Fakültesi Dergisi, Apr 30, 2021
The aim of this study was to determine the diagnostic utility of chromosomal microarray analysis ... more The aim of this study was to determine the diagnostic utility of chromosomal microarray analysis (CMA) in daily pediatric neurology practice and to identify the guiding clinical parameters for patients requiring this test. The CMA results for 91 patients with global developmental delay/intellectual disability (GDD/ID) admitted to our pediatric neurology clinic for various reasons between 2018 and 2020 were examined. Demographical and clinical data for 34 patients (37.4%) in whom del/dup was determined at CMA and 57 patients (62.6%) with normal CMA were compared. Results: There was no statistically significant difference between two groups in terms of demographic characteristics such as age, gender, type of delivery, gestational age, etc. Dysmorphisms, hypotonia, myelination abnormalities were significantly more frequent in patients with del/dup than in patients with normal result. The frequency of macrocephaly and obesity was higher in the normal group, and that of generalized seizures was higher among epileptic patients in this group. Nineteen (55.9%) of the 34 cases who have del/dup detected at analysis were regarded as pathogenic, 15 (44.1%) as uncertain clinical significance (likely pathogenic, likely benign and no subclassification). Conclusion: Since CMA is an expensive, laborious, and time-consuming test, considering clinical parameters when requesting CMA will yield high diagnostic efficiency. A high possibility of copy number variants may be predicted in GDD/ID patients with dysmorphisms, hypotonia, and myelination delay. CMA should represent the genetic analysis of choice in pediatric neurology practice in case of no finding suggesting a different etiology in these patients.
Research Square (Research Square), Aug 4, 2022
Purpose: Elevation of acute phase reactants during attack is an important indicator of acute in a... more Purpose: Elevation of acute phase reactants during attack is an important indicator of acute in ammation in Familial Mediterranean Fever (FMF). However, the disease course also involves in ammation in remission period. Subclinical in ammation is a major etiological factor for organ involvement of the disease. The eye is one of the target organs in the course of FMF. Methods: The study included 51 patients with FMF in remission period for at least 3 months and 51 agematched healthy individuals. Intraocular pressure, axial length, peripapillary retinal nerve ber layer (RNFL) thickness, central macular thickness, and subfoveal choroidal thickness were assessed for patient and control groups using spectral domain optical coherence tomography (SD-OCT). Patients were grouped according to disease severity scores, and laboratory and ocular ndings were compared. Results: Serum amyloid A, C-reactive protein and brinogen were higher and temporal inferior RNFL was thinner in the patient group than in the control group (p<0.05). Central macular, submacular choroidal, nasal and temporal thicknesses were lesser in the patient group than in the control group, but there was no statistically signi cant difference between the groups (p>0.05). On the other hand, a positive correlation was found between proteinuria and axial length in the patient group. Conclusion: Subclinical in ammation is one of the factors responsible for important changes in the eye in FMF. Some changes that occur in the early period can become more prominent with a longer duration of the disease. Follow-up from childhood to adulthood would enable revealing the effects of subclinical in ammation in these patients.
Open Journal of Surgery
Pneumomediastinum is the presence of free air in the mediastinum. Spontaneous pneumomediastinum (... more Pneumomediastinum is the presence of free air in the mediastinum. Spontaneous pneumomediastinum (SPM) occurs when air enters the interstitial space and mediastinum as a result of rupture of the alveoli in cases of increased intrathoracic pressure such as asthma and lung infection. A 3-year-old girl was admitted to the Pediatric Emergency Department with cough. On physical examination, his general condition was moderate and he had groaning due to respiratory distress. Pulmonary sounds were decreased on the left side with auscultation and rhonchus on the right side. Bilateral crepitation was detected between chest and shoulder. After imaging, SPM, retrosternal emphysema, subcutaneous emphysema and minimal pneumothorax were detected in the chest and neck region. The patient was admitted to the Pediatric Intensive Care Unit for further follow-up and treatment. Our patient was followed up in the intensive care unit for two days and inpatient service for two days and discharged without any complication with conservative treatment. We suggest that patients with a diagnosis of SPM should be followed for at least 24 hours in terms of complications and prophylactic antibiotics should be given to prevent the development of mediastinitis.
Purpose: Elevation of acute phase reactants during attack is an important indicator of acute infl... more Purpose: Elevation of acute phase reactants during attack is an important indicator of acute inflammation in Familial Mediterranean Fever (FMF). However, the disease course also involves inflammation in remission period. Subclinical inflammation is a major etiological factor for organ involvement of the disease. The eye is one of the target organs in the course of FMF.Methods: The study included 51 patients with FMF in remission period for at least 3 months and 51 age-matched healthy individuals. Intraocular pressure, axial length, peripapillary retinal nerve fiber layer (RNFL) thickness, central macular thickness, and subfoveal choroidal thickness were assessed for patient and control groups using spectral domain optical coherence tomography (SD-OCT). Patients were grouped according to disease severity scores, and laboratory and ocular findings were compared.Results: Serum amyloid A, C-reactive protein and fibrinogen were higher and temporal inferior RNFL was thinner in the patient...
Pediatrik Nörolojide Klinik Fenotipler ve Kromozomal Mikrodelesyon/Duplikasyonlar Arasındaki İlişki
Düzce Tıp Fakültesi Dergisi
Aim: The aim of this study was to determine the diagnostic utility of chromosomal microarray anal... more Aim: The aim of this study was to determine the diagnostic utility of chromosomal microarray analysis (CMA) in daily pediatric neurology practice and to identify the guiding clinical parameters for patients requiring this test. Material and Methods: The CMA results for 91 patients with global developmental delay/intellectual disability (GDD/ID) admitted to our pediatric neurology clinic for various reasons between 2018 and 2020 were examined. Demographical and clinical data for 34 patients (37.4%) in whom del/dup was determined at CMA and 57 patients (62.6%) with normal CMA were compared. Results: There was no statistically significant difference between two groups in terms of demographic characteristics such as age, gender, type of delivery, gestational age, etc. Dysmorphisms, hypotonia, myelination abnormalities were significantly more frequent in patients with del/dup than in patients with normal result. The frequency of macrocephaly and obesity was higher in the normal group, an...
Journal of Medical and Scientific Research
Purpose: The present study aimed to evaluate and estimate the additional and auxiliary diagnostic... more Purpose: The present study aimed to evaluate and estimate the additional and auxiliary diagnostic value of routine laboratory parameters in patients with acute diarrhea caused by rotavirus and adenovirus. Methods/ patients: A total of 6784 patients diagnosed with acute gastroenteritis were evaluated. Rotavirus and adenovirus infection was diagnosed via a Qualitative immunochromatographic combo rapid cassette antigen test. Complete blood count and biochemical blood tests were performed in all the patients and were compared between the groups according to the positivity or negativity of the virus. Results: Rotavirus diarrhea was diagnosed in 16.8% and adenovirus diarrhea in 3.2% of patients. Hemoglobin, hematocrit, and mean cell volume (MCV) levels were lower, and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were significantly higher in rotavirus positive cases. Neutrophil to lymphocyte ratio was significantly higher, and lymphocyte to monocyte ratio was ...
Decreased Uric Acid and Phosphorus Levels in Active Juvenile Systemic Lupus Erythematosus
Haydarpasa Numune Training and Research Hospital Medical Journal
Serious form of hereditary multiple exostoses in a female child
erciyes medical journal, 2011
Turkish journal of medical sciences, Jan 14, 2018
Background/aim: Chronic kidney disease (CKD), which is one of the most important health problems ... more Background/aim: Chronic kidney disease (CKD), which is one of the most important health problems worldwide, could be considered as an immune inflammatory disease. A prognostic biomarker may be helpful in determining the progression of CKD in children. We aimed to investigate the serum vasohibin-1 and soluble suppression of tumorigenicity-2 (sST2) levels as potential biomarkers in children with predialysis CKD. Materials and methods: Forty-seven children with stage 2-4 CKD and 20 healthy controls were included in this cross-sectional study. Glomerular filtration rate (GFR) and urinary excretion of protein were measured in 24-h urine samples. Serum vasohibin-1 levels and sST2 were measured. The results were expressed as pg/mL and ng/mL, respectively. Results: Serum vasohibin-1 levels were similar between the patients and the control group (P > 0.05), but serum vasohibin-1 levels were higher in patients with proteinuria than in nonproteinuric patients (2574.5 ± 701.60 vs. 1822.4 ± 3...
Hemodialysis-related headache
Hemodialysis International, 2014
Headache is one of the most frequently encountered neurological symptoms during hemodialysis. Acc... more Headache is one of the most frequently encountered neurological symptoms during hemodialysis. According to International Classification of Headache criteria dialysis-related headache was defined as the headache occurring during hemodialysis with no specific characteristic. It resolves spontaneously within 72 hours after the hemodialysis session ends. There are few studies in the literature investigating the clinical features of dialysis headache. The pathophysiology of hemodialysis-related headache is not known, but various triggering factors have been identified, including changes in blood pressure, serum sodium and magnesium levels during hemodialysis sessions, caffeine deprivation and stress. The aim of this article is to evaluate and analyze features of headache in patients undergoing hemodialysis.
Evaluation of cardiovascular risk in children with solitary functioning kidney
Clinical and Experimental Nephrology, 2022
The present study investigates cardiovascular risk and kidney damage in patients with solitary ki... more The present study investigates cardiovascular risk and kidney damage in patients with solitary kidneys. Included in the study were 40 children with a unilateral functioning kidney and 60 healthy controls, all of whom were evaluated for carotid intima-media thickness, ischemia-modified albumin and oxidative stress parameters, and 24-h ambulatory blood pressure monitoring. Serum creatinine and urine microalbumin levels were higher and creatinine clearance was lower in the patient group than in the control group, and serum ischemia-modified albumin, carotid intima-media thickness, aldosterone, plasma renin activity and blood pressure were all higher in the patient group than in the control group. In addition, the patient group was showed a non-dipper pattern. Children with a normal functioning solitary kidney are likely at higher risk of developing cardiovascular disease and such patients should be followed closely before marked kidney impairment occurs.
Brazilian Journal of Nephrology, 2020
Introduction: Glomerular hyperfiltration may lead to proteinuria and chronic kidney disease in un... more Introduction: Glomerular hyperfiltration may lead to proteinuria and chronic kidney disease in unilateral multicystic dysplastic kidney (MCDK). We aimed to investigate the urine neutrophil-gelatinase-associated lipocalin (NGAL), netrin-1, hepcidin, and C-C motif chemokine ligand-2 (MCP-1/CCL-2) levels in patients with MCDK. Methods: Thirty-two patients and 25 controls were included. The urine hepcidin, netrin-1, NGAL, and MCP-1/CCL-2 levels were determined by ELISA. Results: The patients had higher serum creatinine (Cr) levels, urine albumin, and netrin-1/Cr ratio with lower GFR. There were positive correlations between urine protein/Cr, MCP-1/CCL-2/Cr, and netrin-1 with NGAL (r = 0.397, p = 0.031; r = 0.437, p = 0.041, r = 0.323, p = 0.042, respectively). Urine netrin-1/Cr was positively correlated with MCP-1/CCL-2/Cr (r = 0.356, p = 0.045). There were positive associations between the presence of proteinuria and netrin-1/Cr, MCP-1/CCL-2/Cr, and NGAL/Cr [Odds ratio (OR): 1.423, p =...
OSMANGAZİ JOURNAL OF MEDICINE, 2022
Lower urinary tract symptoms (LUTS) is very common in childhood. We aimed to investigate the freq... more Lower urinary tract symptoms (LUTS) is very common in childhood. We aimed to investigate the frequency of LUTS in obese, overweight and normal children using voiding dysfunction symptom score validated for Turkish children by Akbal and et al. The children older than five-years-old who were followed in Pediatric Nutrition and Metabolism Outpatient Clinic were included. Children with a body mass index above the 95th percentile were classified as obese. The symptom score was administered face to face to each child and their mothers together. A score ≥9 was defined as lower urinary tract dysfunction (LUTD). A 164 children (62 obese, 52 overweight, 50 normal) were included. Symptom score was significantly higher in obese children than in overweight and normal weight children. (p=0.004, p=000, respectively). Overweight children had higher symptom score than in normal weight children (p=0.037). The frequency of daily urinary incontinence was higher in obese than overweight and normal weight children (p=0.041, p=0.000, respectively). The both obese and overweight children had higher frequencies of urgency and increased urinary frequency than in children with normal weight (p=0.002, p=0.021 for urgency, p=0.000, p=0.037 for increased urinary frequency, respectively). The frequencies of voiding postponement and constipation were higher in the obese children than those of overweight and normal weight (p=0.000, p=0.000 for voiding postponement, p=0.031, p=0.028 for constipation respectively). Obesity is a significant risk factor for LUTD. The questioning LUTS using questionnaire validated by Akbal et al in obese children can help in the early diagnosis of LUTD.
Online Türk Sağlık Bilimleri Dergisi
Objective: Obesity is an important health problem with the potential to cause secondary diseases ... more Objective: Obesity is an important health problem with the potential to cause secondary diseases in children. In these patients, increased intra-abdominal and intra-vesical pressure leads to changes in voiding physiology. In addition, insulin and glucose metabolism disorders can also affect lower urinary system functions. However, the relationship between obesity and sleep disorders is also known. Materials and Methods: The questionnaire, which was prepared to determine voiding and sleep disorders, was applied to 100 obese pediatric patients aged between 9 and 18 and 100 normal weight healthy individuals in the similar age group. Results: Daytime urinary incontinence was present in 17% of the patient group and 2% of the control group. Nocturnal enuresis was present in 25% of the patient group and 2% of the control group. The frequency of overactive bladder was also higher in the patient group compared to the healthy controls (15% and 5%, respectively; p
Düzce Tıp Fakültesi Dergisi
Aim: The epidemiological characteristics and modes of transmission of coronavirus disease 2019 (C... more Aim: The epidemiological characteristics and modes of transmission of coronavirus disease 2019 (COVID-19) in children are not yet fully understood. In this study, it was aimed to evaluate clinical, laboratory, and radiological findings and treatment approaches in patients with negative and positive PCR tests among those with suspected COVID-19 retrospectively. Material and Methods: This study was conducted with 317 patients under 18 years of age, who received outpatient or inpatient treatment with a pre-diagnosis of COVID-19. All patients were assessed for clinical course, disease severity, comorbidity, demographic characteristics, laboratory and radiodiagnostic tests, treatment characteristics, and outcomes. Results: The PCR test was positive in 133 (42%) and negative in 184 (58%) of the patients with suspected COVID-19. There was a history of contact in 78 (58.6%) and 51 (27.7%) of the PCR-positive and negative patients, respectively (p<0.001). While the PCR-negative group had ...
International Anatolia Academic Online Journal Health Sciences, Dec 31, 2020
ÖZET Hollanda'da 2001 yılında tanımlanan insan metapnömovirüs (hMPV) tek iplikli, zarflı ve negat... more ÖZET Hollanda'da 2001 yılında tanımlanan insan metapnömovirüs (hMPV) tek iplikli, zarflı ve negatif kutuplu RNA virüsüdür. Etkenin enfeksiyonunda en sık görülen semptomlar; burun akıntısı, ateş, öksürük, hipoksi, dispne, siyanoz ve hırıltıdır. Akut solunum yolu enfeksiyonu olan hastalarda prevalansı %6-16 arasında saptanmıştır. Yapılan çalışmalarda 10 yaş altı çocuklarda solunum yolu enfeksiyonlarında izole edilebilen virüsün etkili olduğu yaş aralığı 6 ay ile 2 yaş arasıdır. Bu raporda boğmaca bulgularıyla başvuran solunum sıkıntısı ve oksijen ihtiyacı nedeniyle takip edilen ve etken olarak hMPV enfeksiyonu saptanan 3 aylık erkek hasta, etkenin boğmaca benzeri öksürük yapabileceği vurgulanarak nadir görülmesinden dolayı tespit edilmesine dikkat çekmek amacıyla sunulmuştur. Hidrasyon, oksijen tedavisi, salbutamol inhalasyonu ve ampirik antibiyotik tedavisi verilen hastamız tedavisinin 5.gününde şifa ile taburcu edilmiştir.
Bolu Abant Izzet Baysal Universitesi, Tip Fakultesi, Abant Tip Dergisi, 2020
GİRİŞ ve AMAÇ: Çocukluk çağı viral hepatitlerin en sık nedeni Hepatit A virüsüdür (HAV). Tanısı a... more GİRİŞ ve AMAÇ: Çocukluk çağı viral hepatitlerin en sık nedeni Hepatit A virüsüdür (HAV). Tanısı anti HAV Ig M testi ile konmaktadır. Hastalığı geçiren veya Hepatit A aşısı yapılan kişilerde ise anti HAV Ig G düzeyi yükselmektedir. Bu çalışma ile hastaların HAV serolojisini araştırmayı ve Hepatit A aşısı tamamlanan çocukların HAV seroprevelansını ortaya koymayı amaçladık. YÖNTEM ve GEREÇLER: Çalışmaya Ocak 2016-Aralık 2018 tarihleri arasında HAV seroloji testleri değerlendirilen, 0-18 yaş çocuklar dahil edildi. Anti HAV Ig G ve anti HAV Ig M düzeylerinin yaşlara ve aşı uygulamalarına göre değişimleri retrospektif olarak incelendi. BULGULAR: Çalışmaya 409 (%53,7) erkek ve 353 (%46,3) kız çocuğu 762 çocuk alındı. Genel yaş ortalaması 7,56±5,27 idi. Çocukların 422'sinde (%55,4) Anti HAV Ig G pozitif saptanırken, 340'ında (%44,6) negatif saptandı. Sadece 4 hastada Anti HAV Ig M pozitif saptandı. Aşılanan çocukların (%38,3) %88,4'ünde Anti HAV Ig G pozitifliği görüldü. TARTIŞMA ve SONUÇ: Verilerimize göre aşısı olmayan çocukların günümüzde dahi Hepatit A hastalığına yakalanma ihtimalleri bulunmaktadır. Bu riski azaltmak için stratejiler geliştirmeli, aşı hakkında ailelerin farkındalıkları sağlanmalı, aşısı olmayan veya Hepatit A enfeksiyonu geçirmeyen kişilerde sağlanacak yüksek aşılanma oranları ile toplum içinde yeterli düzeyde Anti HAV Ig G pozitifliği yüzdesine ulaşılması gerekmektedir.
Konuralp Tıp Dergisi, 2021
Objective: Foreign body aspiration is a preventable cause of mortality and morbidity especially i... more Objective: Foreign body aspiration is a preventable cause of mortality and morbidity especially in younger than three years old children. The aim of this study is to determine the risk factors, causes and prognosis in patients with foreign body aspiration. Methods: In this study, laboratory and examination findings of 35 patients who underwent bronchoscopy, because of suspected foreign body aspiration, were retrospectively analyzed. Results: Of the 35 patients included in the study, 19 were boys and 16 were girls. The mean age was 3,2. The most causes of application were cough, and wheezing. Foreign body was detected in the right main bronchus in 62,8%, in the left main bronchus in 25,7%, in the trachea in 5,7% and in both bronchi in 5,7% of the patients. Conclusions: Early diagnosis and intervention significantly reduce the mortality and morbidity in foreign body aspirations. Prevention of foreign body aspirations is possible with the education of babysitters and family members.
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Papers by Nadide Melike Sav