An observational, multicenter, registry-based cohort study of Turkish Neonatal Society in neonates with Hypoxic ischemic encephalopathy

BACKGROUND: Hypoxic ischemic encephalopathy (HIE) is a significant cause of mortality and short- and long-term morbidities. Therapeutic hypothermia (TH) has been shown to be the standard care for HIE of infants ≥36 weeks gestational age (GA), as it has been demonstrated to reduce the rates of mortality, and adverse neurodevelopmental outcomes. This study aims to determine the incidence of HIE in our country, to assess the TH management in infants with HIE, and present short-term outcomes of these infants. METHODS: The Turkish Hypoxic Ischemic Encephalopathy Online Registry database was established for this multicenter, prospective, observational, nationally-based cohort study to evaluate the data of infants born at ≥34 weeks GA who displayed evidence of neonatal encephalopathy (NE) between March, 2020 and April 2022. RESULTS: The incidence of HIE among infants born at ≥36 weeks GA (n = 965) was 2.13 per 1000 live births (517:242440), and accounting for 1.55% (965:62062) of all neonatal intensive care unit admissions. The rates of mild, moderate and severe HİE were 25.5% (n = 246), 58.9% (n = 568), and 15.6% (n = 151), respectively. Infants with severe HIE had higher rates of abnormal magnetic resonance imaging (MRI) findings, and mortality (p0.05). TH was administered to 85 (34.5%) infants with mild HIE, and of those born of 34-35 weeks of GA, 67.4% (n = 31) received TH. A total of 58 (6%) deaths were reported with a higher mortality rate in infants born at 34-35 weeks of GA (OR 3.941, 95% Cl 1.446-10.7422, p = 0.007). CONCLUSION: The incidence of HIE remained similar over time with a reduction in mortality rate. The timing of TH initiation, whether [removed

A Population Model of Time-Dependent Changes in Serum Creatinine in (Near)term Neonates with Hypoxic-Ischemic Encephalopathy During and After Therapeutic Hypothermia

The objective was to apply a population model to describe the time course and variability of serum creatinine (sCr) in (near)term neonates with moderate to severe encephalopathy during and after therapeutic hypothermia (TH). The data consisted of sCr observations up to 10 days of postnatal age in neonates who underwent TH during the first 3 days after birth. Available covariates were birth weight (BWT), gestational age (GA), survival, and acute kidney injury (AKI). A previously published population model of sCr kinetics in neonates served as the base model. This model predicted not only sCr but also the glomerular filtration rate normalized by its value at birth (GFR/GFR0). The model was used to compare the TH neonates with a reference full term non-asphyxiated population of neonates. The estimates of the model parameters had good precision and showed high between subject variability. AKI influenced most of the estimated parameters denoting a strong impact on sCr kinetics and GFR. BWT and GA were not significant covariates. TH transiently increased sCr in TH neonates over the first days compared to the reference group. Asphyxia impacted not only GFR, but also the sCr synthesis rate. We also observed that AKI neonates exhibit a delayed onset of postnatal GFR increase and have a higher sCr synthesis rate compared to no-AKI patients. Our findings show that the use of sCr as marker of renal function in asphyxiated neonates treated with TH to guide dose selection for renally cleared drugs is challenging, while we captured the postnatal sCr patterns in this specific population. Graphical Abstract: [Figure not available: see fulltext.].</p

Serum Creatinine Patterns in Neonates Treated with Therapeutic Hypothermia for Neonatal Encephalopathy

Introduction: There is large variability in kidney function and injury in neonates with neonatal encephalopathy (NE) treated with therapeutic hypothermia (TH). Acute kidney injury (AKI) definitions that apply categorical approaches may lose valuable information about kidney function in individual patients. Centile serum creatinine (SCr) over postnatal age (PNA) may provide more valuable information in TH neonates. Methods: Data from seven TH neonates and one non-TH-treated, non-NE control cohorts were pooled in a retrospective study. SCr centiles over PNA, and AKI incidence (definition: SCr ↑≥0.3 mg/dL within 48 h, or ↑ ≥1.5 fold vs. the lowest prior SCr within 7 days) and mortality were calculated. Repeated measurement linear models were applied to SCr trends, modeling SCr on PNA, birth weight or gestational age (GA), using heterogeneous autoregressive residual covariance structure and maximum likelihood methods. Findings were compared to patterns in the control cohort. Results: Among 1,136 TH neonates, representing 4,724 SCr observations, SCr (10th-25th-50th-75th-90th-95th) PNA centiles (day 1-10) were generated. In TH neonates, the AKI incidence was 132/1,136 (11.6%), mortality 193/1,136 (17%). AKI neonates had a higher mortality (37.2-14.3%, p < 0.001). Median SCr patterns over PNA were significantly higher in nonsurvivors (p < 0.01) or AKI neonates (p < 0.001). In TH-treated neonates, PNA and GA or birth weight explained SCr variability. Patterns over PNA were significantly higher in TH neonates to controls (801 neonates, 2,779 SCr). Conclusions: SCr patterns in TH-treated NE neonates are specific. Knowing PNA-related patterns enable clinicians to better assess kidney function and tailor pharmacotherapy, fluids, or kidney supportive therapies

A Population Model of Time-Dependent Changes in Serum Creatinine in (Near)term Neonates with Hypoxic-Ischemic Encephalopathy During and After Therapeutic Hypothermia

The objective was to apply a population model to describe the time course and variability of serum creatinine (sCr) in (near)term neonates with moderate to severe encephalopathy during and after therapeutic hypothermia (TH). The data consisted of sCr observations up to 10 days of postnatal age in neonates who underwent TH during the first 3 days after birth. Available covariates were birth weight (BWT), gestational age (GA), survival, and acute kidney injury (AKI). A previously published population model of sCr kinetics in neonates served as the base model. This model predicted not only sCr but also the glomerular filtration rate normalized by its value at birth (GFR/GFR0). The model was used to compare the TH neonates with a reference full term non-asphyxiated population of neonates. The estimates of the model parameters had good precision and showed high between subject variability. AKI influenced most of the estimated parameters denoting a strong impact on sCr kinetics and GFR. BWT and GA were not significant covariates. TH transiently increased sCr in TH neonates over the first days compared to the reference group. Asphyxia impacted not only GFR, but also the sCr synthesis rate. We also observed that AKI neonates exhibit a delayed onset of postnatal GFR increase and have a higher sCr synthesis rate compared to no-AKI patients. Our findings show that the use of sCr as marker of renal function in asphyxiated neonates treated with TH to guide dose selection for renally cleared drugs is challenging, while we captured the postnatal sCr patterns in this specific population. Graphical Abstract: [Figure not available: see fulltext.]

Niğde Sungur Bey Camisi'nde görülen muhtemel yabancı etkiler üzerine bir çalışma

Sungur Bey Mosque and the Tomb adjacent to it were built in Nigde in the first half of the 14th century. In many respects, the Mosque is a traditional Anatolian building in terms of its architecture and decoration. Nevertheless, some of the architectural forms observed on the Mosque point to possible foreign interactions. The aim of this thesis is to take a critical look at the sources of the foreign architectural forms observed on the Sungur Bey Mosque and to question how such interactions could be possible in the 14th century Anatolia. In this context, the foreign architectural elements of the Mosque are compared vis-a-vis contemporary examples from Europe, Eastern Crusader States, Cyprus, Armenia and Anatolia. In addition, Crusades, trade relations and traveling artists are considered among possible interactions which could be influential in the transmission of these architectural forms. Thus, Sungur Bey Mosque is evaluated in a different viewpoint, which considers historical events and a number of possible interactions.M.A. - Master of Art

Ichthyosis vulgaris coexisted with acrokeratosis verruciformis : A case report

İktiyozis vulgaris, otozomal dominant geşiş gösteren bir keratinizasyon hastalığıdır ve yaygın pullanma ile karakterizedir. Akrokeratozis verrusiformis de otozomal dominant, nadir görülen bir keratinizasyon hastalığı olup, el ve ayak dorsal yüzde siğilimsi, kahverengi-deri renginde papüller ile karakterizedir. Burada, iktiyozis vulgaris ve akrokeratozis verrüsiformisin bir arada olduğu, 24 yaşında bir bayan hastayı sunmaktayızIchthyosis vulgaris is an autosomal dominant inherited, keratinization disorder and characterized by diffuse scaling. Acrokeratosis verruciformis is also an autosomal dominant, rare keratinization disorder and characterized by warty, brownish to skin colored papules on the dorsa of the hands and feet. We present a case of ichthyosis vulgaris coexisted with acrokeratosis verruciformis in a 24-year-old woman

BESİNSEL DESTEK KULLANIMI: VOLEYBOL ÖRNEĞİ

Bu çalışmada amaç, voleybolda en çok kullanıldığı bildirilen besinsel destekler (C ve D vitamini, demir, magnezyum, kafein,sporcu ve enerji içecekleri, dallı zincirli aminoasitler, HMB, glutamin, whey, kreatin, bikarbonat, karnitin) hakkında bilgivermektedir. Derlemenin içeriği, daha önce çok sayıda araştırmanın toplanıp yorumlandığı besinsel desteklerle ilgili derlemeve ilgili yayınların referans listeleri ile voleybolcular üzerinde yapılmış araştırma makaleleri özetlenerek oluşturulmuştur.İçeriğin hazırlanmasında derlemelerden yararlanılmasının nedeni, çok sayıda ve farklı sonuçlara ulaşan araştırmamakalelerinin seçiminde ortaya çıkabilecek bireysel yanlılığı ortadan kaldırmaktır. Voleybolcular üzerindeki çalışma sayısınınazlığı nedeniyle voleybolda besinsel destek (takviye/suplement) kullanımına özgü bilgi yetersiz olsa da, suplementler ile ilgiliverilen bilgilerin okuyana fikir verecek yeterlilikte olduğu düşünülmektedir. Sonuç olarak, suplementlerin yararlarını araştırançalışmalar yapılmaya devam etmektedir ve kullanım yanıtları yöntemsel ve bireysel farklılık gösterebilmektedir. Diğertakviyelerin vücutta eksikliği olmadığı sürece sporcuda sağlık veya performansı iyileştirmesi olası değildir. Hatta antrenmanadaptasyonunu köreltmesi nedeniyle performansa, yaralanma riskini artırması nedeniyle de sağlığa zararlı etkileri olabilir