Browsing by Author "Aycan, N."

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Case Series: 11 Cases of Hemolytic Disease of the Fetus and Newborn Due To Kell Blood Group Incompatibility
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Yürektürk, E.; Aycan, N.; Başaranoğlu, M.; Arslan, B.; Tuncer, O.
Hemolytic disease of the fetus and newborn (HDFN) results from the destruction of the newborn's red blood cells or the fetus by the mother's immune globulin G antibodies. Although HDFN is often caused by RhD and ABO incompatibility, it can also be seen due to minor blood groups such as Kell, Kidd, Duffy, P, MNS, or Rh subgroup (C, c, E, e) alloantibodies. Our study aims to share our experiences regarding a rare cause of HDFN. The files of patients who were followed up with the diagnosis of jaundice in a third-level Neonatology Unit of a university hospital between January 2014 and September 2023 were retrospectively examined. Eleven patients with Kell incompatibility were included in the study. There was no ABO/RhD incompatibility in any case. RhD subgroup incompatibility and Kell incompatibility were present in four cases. Phototherapy was applied to all patients. The patient, whose total bilirubin level was high despite phototherapy, was treated with an exchange transfusion. No complications were observed due to treatment or high total bilirubin. No significant difference was observed between the parameters evaluated according to the gender variable. It should be kept in mind that severe hemolysis and related deaths may occur due to Kell incompatibility. In order to reduce and prevent severe hemolysis due to Kell and other minor blood groups in newborns, transfusing blood products suitable for minor blood groups to women of childbearing age (especially pregnant women) may be a correct approach as a country policy. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Evaluation of Immunoglobulin Levels in Children Aged 1-5 Years With Recurrent Lower Respiratory Tract Infections
(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Aycan, N.; Sazak, S.; Samanci, N.
Immunodeficiency plays a crucial role in the etiology of recurrent pneumonia. Humoral immunodeficiencies account for approximately 60% of all primary immunodeficiencies, and in such patients, antibody deficiencies are the leading cause of immunodeficiency. That study aimed to investigate the effect of immunoglobulin levels on the frequency of pneumonia episodes and the relationship between immunoglobulin levels and risk factors for pneumonia in children aged 1-5 years with recurrent pneumonia caused by humoral immunity. The prospective study included a total of 92 randomly selected children aged 1-5 years, comprising a group of 70 patients hospitalized due to pneumonia and a group of 22 healthy controls who had no chronic diseases and infections. Body height and weight were significantly lower in the patient group compared to the control group (p=0.012 and p=0.022, respectively). The mean breastfeeding duration was significantly lower (p=0.001), and the prevalence of exposure to environmental tobacco smoking (ETS) was significantly higher (p=0.018) compared to the control group. In the patient group, 65% of the participants had a deficiency of an immunoglobulin isotope and/or IgG subclasses in isolation or combination. IgG4 deficiency was the most common deficiency (38.5%), followed by IgG1 (21.4%), IgG2 (18.5%), IgA (15.7%), and IgG3 deficiency (12.8%), respectively. Our results indicated that inadequate breastfeeding and environmental tobacco smoking prepare the ground for pneumonia, a significant cause of morbidity and mortality in children, and contributes to the recurrence of this disease. Humoral immunodeficiencies, a significant underlying cause of recurrent pneumonia that leads to growth retardation, may have different clinical manifestations. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Evaluation of Patients Followed in He Third Level Pediatric Intensive Care Unit: Single Center Experience
(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Ateş, A.; Aycan, N.; Shermatov, K.
Pediatric intensive care practices have undergone great changes in the last 30 years. Our knowledge about the pathophysiology of life-threatening processes and the follow-up and treatment of pediatric patients with life-threatening diseases continues to expand in this process. In this study, the outcomes, treatment modalities, treatment responses and clinical characteristics of patients hospitalized in the pediatric intensive care unit (PICU) were evaluated. 497 patients who were hospitalized and followed up in Harran University Faculty of Medicine, PICU between January 2016 and December 2016 were evaluated. There were 276 (55.5%) male and 221 (44.5%) female patients in our study. The median age and median PICU stay of the patients were 23 months (1-212 months) and 7 days (1-134 days), respectively. The reasons for admission to the intensive care unit were respiratory system diseases in 171 patients (34.4%), poisonings in 88 patients (17.7%), neurological diseases in 71 patients (14.3%), gastrointestinal system diseases in 59 (11.9%) patients, 42 (4%) patients were admitted to the intensive care unit. The need for mechanical ventilation developed in 35.6% of the patients. 49.3% (n=245) of the patients had comorbid disease. Of the patients, 74.7% (n=371) were discharged from the PICU, 6.4% (n=32) were referred to another center, and 18.9% (n=94) died. Some factors affecting clinical outcomes and mortality were identified. As a result of the regression analyses of these factors, mechanical ventilation requirement (OR=192.8), multi-organ failure (OR=21.2), disseminated intravascular coagulation (OR=9.6), thrombocytopenia (OR=2.4) and positive inotropic drug requirement (OR= 2.3) were associated with mortality. The clinical results of the patients in the PICU were similar to the results of other PICUs in our country. Our findings showed that there are some factors affecting clinical outcomes. Mechanical ventilation requirement, multiple organ failure, disseminated intravascular coagulation, thrombocytopenia, and need for positive inotropic drugs were found to be effective on mortality. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Povidone-Iodine Antisepsis in Lumbar Disc Surgery
(Yuzuncu Yil Universitesi Tip Fakultesi, 2022) Taş, A.; Aycan, N.; Aycan, A.; Zengin, İ.; Akyol, M.E.
Postoperative surgical sit e infection still constitutes a major concern in spinal surgery and related with poor outcome. We aimed to investigate the effect of povidone-iodine (PVP-I) on skin colonization in lumbar disc herniation (LDH) surgery. Adult patients scheduled for LDH surgery were included in the study. Three skin swab cultures were taken when lying on the operating table (culture 1), after PVP-I application (culture 2), and at the end of the operation (culture 3). The effect of PVP-I and other independent predictors on ski n culture was analyzed. A total of 62 [28 (45%) female, mean age 47±13 years] patients were included. Only male sex and taking shower before the surgery have been found to be independent factors for affecting culture 1 growth while adjusted to age, body ma ss index, smoking, preoperative hospital stay, and surgery site shaving [OR (95% CI): 7.8 (1.4-41.9), p=0.016; OR (95% CI): 0.34 (0.003-0.35), p=0.005]. After PVP-I, the growth frequency of culture 2 decreased significantly compared to culture 1 [8 (13%) vs. 43 (70%), p<0.001]. However, culture 3 positivity rate was similar to culture 2 (p=0.219). In preoperative sterilization of lumbar disc surgery, PVP-I significantly reduces skin colonization both immediately after application and at the end of the operation. © 2022, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Role of Netrin-1 in Staging Hypoxic Ischemic Encephalopathy
(Associacao Medica Brasileira, 2025) Aycan, N.; Demir, D.Ç.; Yürektürk, E.; Başaranoglu, M.; Karaman, S.; Tuncer, O.
OBJECTIVE: The diagnosis and prognosis of neonatal hypoxic-ischemic encephalopathy are established through clinical evidence and laboratory, imaging, and electrophysiological assessments of the nervous system. Netrin-1 was the first axon guidance molecule identified as a critical component of embryonic development in vertebrates and has a solid chemotropic function for angiogenesis, morphogenesis, cell migration, and axonal guidance. It was hypothesized that Netrin-1 will differ at different hypoxic-ischemic encephalopathy stages. METHODS: This study included 75 hospitalized hypoxic-ischemic encephalopathy newborns and 48 healthy newborns born at the same hospital and followed up only by their mothers. Demographic, laboratory, and Netrin-1 data were evaluated for all hypoxic-ischemic encephalopathy stages. RESULTS: Serum Netrin-1 concentrations were significantly greater in patients with moderate and severe hypoxic-ischemic encephalopathy who underwent therapeutic hypothermia than in controls and patients with severe hypoxic-ischemic encephalopathy. However, serum Netrin-1 concentrations were not significantly greater in patients with mild hypoxic-ischemic encephalopathy than in controls. In 75 hypoxic-ischemic encephalopathy patients, correlations of Netrin-1 with lactate, uric acid, and lactate dehydrogenase were statistically significant (p=0.0001, 0.008, and 0.043, respectively). CONCLUSION: Netrin-1 significantly increased in moderate and severe patients. Therefore, this marker could be a biomarker for staging hypoxic-ischemic encephalopathy and therapeutic hypothermia and predicting the prognosis of neonatal hypoxic-ischemic encephalopathy patients. © 2025 Associacao Medica Brasileira. All rights reserved.
Treatment and Outcomes of Patients With Metastatic Spinal Cord Compression: a Double-Center Study
(NLM (Medline), 2023) Aycan, A.; Eren, B.; Tas, A.; Celik, S.; Karagoz Guzey, F.; Kuyumcu, F.; Aycan, N.
OBJECTIVE: Spinal metastases may only affect the bone tissue and result in spinal instability or may additionally result in epidural compression, leading to neurological deficits. Surgery has emerged as a popular method in treating metastatic epidural spinal cord compression (MESCC) due to the advances in surgical techniques and instrumentation. In this study, we evaluated patients with MESCC regarding neurological status, pain status, and survival rates, and presented our experience managing MESCC. PATIENTS AND METHODS: Clinical and radiographic records of 53 patients diagnosed with MESCC between January 2011 and March 2017 were retrospectively evaluated. The study included patients with a pathological diagnosis of primary cancer, those who complained of spinal metastasis, and those who had indications of MESCC on Magnetic Resonance Imaging (MRI). Bone structure and spinal stability were evaluated using assessed Computed Tomography (CT), and metastatic spread was considered using assessed Positron Emission Tomography (PET) in suitable cases. For each patient, the presence of a tumor compressing the spinal cord, age, gender, preoperative, and postoperative American Spinal Injury Association scores (ASIA), Tokuhashi prognostic score (TPS), affected spinal segment, pathological diagnosis, preoperative, and postoperative Visual Analog Scale (VAS), the status of spinal stability, follow-up period, and complications were evaluated. RESULTS: Forty-five patients (82.2% of them were women) underwent surgery with a mean age of 58.29 ± 15.14 years. The most frequent type of primary tumor was multiple myeloma (33.9%), followed by lung (24.6%), gastric (7.5%), and prostate (5.7%). The most common site of metastasis was the thoracic region (43.4%), followed by lumbar (24.5%), multiple (24.5%), and cervical (5.7%). The analysis indicated that a significant difference was found between the survival rates of the TPS categories. CONCLUSIONS: Common symptoms of MESCC include spinal pain and neurological deficit below the level of the injury. Prompt surgical treatment followed by oncological treatment leads to significant neurological recovery, more prolonged survival, pain relief, and improved quality of life in patients with a short survival time. Oncological treatments, including radiotherapy (RT), should be recommended after surgical treatment.