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Öğe A morphometric evaluation of anterior fontanel and cranial sutures in infants using computed tomography(Ondokuz Mayis Universitesi, 2022) Sasani, Hadi; Tüfekçi, Sinan; Haksayar, AyşenTo retrospectively analyze anterior fontanel (AF) and the morphometric findings of cranial sutures in infants under two years of age who underwent cranial computed tomography (CT). A total of 227 cases, who had cranial CT examination, were studied retrospectively. Forty-five patients were excluded. The study was conducted with 182 patients who had adeqaute imaging with optimum quality. The diameter and area of AF and cranial sutures of the patients were measured using three-dimensional CT reformat and axial CT images. Male patients made up 53.8% of the total patients and the median age was 6 months. Normocephaly in 86.3%, plagiocephaly in 10.4%, scaphocephaly in 2.7% and trigonocephaly in 0.5% of the cases were present. The median AF transverse diameter was 29.75 mm, the median anteriorposterior diameter was 27.25 mm, and the median fontanel area was 400 mm2. AF was closed in 30.4% in 13-18 months old patiets and 85.7% in 19-24 months old patients. Metopic suture was closed 10% in the first 3 months of age / their lives, 74.3% in 7-9 months of age, and 100% in 19-24 months of age. There was a significant negative correlation between head circumference and suture diameters in infants with open and normosephalic AF, in the CT examination (p <0.05. R = - 0.106 -0.271). In this study, it was observed that 14.3% of AF did not close radiologically in 19-24 months in the Turkish population living in the Europe - Balkan region. This suggests that AF closes in some patients after the age of two. © 2022 Ondokuz Mayis Universitesi. All rights reserved.Öğe Immunological aspects of breast milk(Springer International Publishing, 2023) Güngör, Hilal; Tüfekçi, SinanFor term infants whose mothers are healthy and have a satisfactory dietary intake, breast milk is the ideal mode of nutrition. The recommendation is that infants up to the age of 6 months be solely breastfed, after which breastfeeding should continue alongside the introduction of solid food up to at least the age of 2 years. The composition of breast milk varies over the course of a single feed, and according to when in the day feeding occurs, as well as the stage of lactation. Alongside this intra-individual variation in composition, the composition varies from mother to mother and from population to population. Both the environment and the woman's genetics affect composition, as does whether the infant is a boy or girl, if an infection occurs, and any change in the mother's lifestyle, such as changes in diet [1]. © Springer Nature Switzerland AG 2023. All rights reserved.Öğe N-TERMINAL PROHORMONE OF BRAIN NATRIURETIC PEPTIDE IN THE DIAGNOSIS AND MANAGEMENT OF PERSISTENT PULMONARY HYPERTENSION IN NEWBORNS(Istanbul Univ, Fac Medicine, Publ Off, 2022) Tüfekçi, Sinan; Kızılca, Özgür; Aygün, ErhanObjective: This study aimed to investigate the levels and utility of amino/N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in the diagnosis of neonatal persistent pulmonary hypertension (PPHT). Materials and Methods: Infants born at Z34 weeks of gestation were included in this retrospective cross-sectional study. In total, 33 newborns diagnosed with PPHT were included in the patient group and 50 healthy newborns were included in the control group. Patient and control groups were compared in terms of plasma NT-proBNP levels measured in the umbilical cord (UC) and at 72 hours of life. Results: The NT-proBNP levels in UC and at 72 hours were significantly higher in neonates with PPHT compared to controls (p<0.01). For the diagnosis of PPHT, UC NT-proBNP cut-off value was >2760.5 pg/ml, sensitivity was 90.7%, and specificity was 96.6%(p<0.01). For NT-proBNP at 72 hours, the cut-off value was >1414 pg/ml, sensitivity was 95.9%, and specificity was 91.2% (p<0.01). The mean UC NT-proBNP levels were 1094.7 +/- 603 pg/ml and mean NT-proBNP levels at 72 hours were 875.7 +/- 423 pg/ml in the control group. Conclusion: NT-proBNP levels are high during the initial days of life. They are useful in the diagnosis and follow-up of PPHT in newborns with hypoxemic respiratory failure and high fraction of inspired oxygen (FiO(2)) requirement, especially in cases where transthoracic echocardiography (TTE) cannot be performed.Öğe Serum vitamin D levels in newborn with clavicle fracture(Cukurova Univ, Fac Medicine, 2022) Aygün, Erhan; Tüfekçi, Sinan; Semerci, Seda YılmazPurpose: The aim of this study was to determine the possible role of vitamin D on the clavicle fracture in the newborn. Materials and Methods: This retrospective crosssectional study was conducted between 2018-2020. Infants who were admitted to neonatal intensive care unit due to the clavicle fracture were included. Infants who did not have a fracture, but were admitted to the hospital for reasons instead of exclusion criteria were included as the control group. Birth weight, height, head circumference, gender, gestational week, delivery type, other clinical findings such as brachial plexus paralysis in the infant, maternal age, number of pregnancies, risk factors time to diagnosis were recorded. According to the serum 25-OH vitamin D levels, newborns were classified as having normal vitamin D status (>30 ng/mL), vitamin D insufficient (between 20-30 ng/mL), or deficiency (<20 ng/mL). Groups were compared for the vitamin D levels, the demographics and clinical characteristics. Results: A total of 48 infants were included. The groups did not differ in terms of demographics. Age of diagnosis ranged from postnatal 1 to 6 days of life. Serum calcium levels were significantly lower in the case group. Although phosphorus and alkaline phosphatase levels did not differ between groups, vitamin D levels were significantly lower in the case group. Conclusion: This study shows that newborns with clavicle fracture had lower vitamin D levels. Cautious palpation of the clavicle can catch the fracture before the hospital discharge even there is no evident symptom and serum vitamin D level of those infants should be checked in order to detect the possible deficiency timely.
