Browsing by Author "Unal, S"

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    Sleep quality in patients with chronic spontaneous urticaria and relation with Orexin-A, leptin, and ghrelin
    Gultuna, S; Akdogan, BB; Gonul, M; Aydin, FN; Unal, S; Erkek, GN; Ates, FSO; Yuceege, MB; Ozdemir, SAO
    Background: Sleep can be affected in patients with chronic spontaneous urticaria (CSU). The mechanisms of sleep regulation remain poorly understood. Orexin-A, a neuroexcitatory peptide, plays a role in coordinating sleep-wake states. Ghrelin and leptin are involved in sleep regulation through the orexin system. Objective: The effects of orexin-A, ghrelin, and leptin on sleep quality in patients with CSU have not been investigated. We aimed to determine the effects of CSU on sleep quality and the association between serum orexin-A, ghrelin, and leptin levels, and sleep quality in patients with CSU. Methods: Thirty-three patients with CSU and 34 sex- and age-matched controls were included in the study. Serum orexin-A, leptin, and ghrelin levels, and the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) scores were measured in patients with CSU and in the controls; also used were the chronic urticaria quality-of-life questionnaire score and the urticaria activity score used for 7 consecutive days. Results: Median (minimum-maximum) orexin-A, leptin, and ghrelin levels in patients were 385 pg/mL (90-495 pg/mL), 3.1 ng/mL (0-21.2 ng/mL), and 701.8 pg/mL (101.9-827.7 pg/mL), respectively. Median serum orexin-A and leptin levels were higher in the patients compared with the controls (p <0.001 and p = 0.012, respectively), whereas the median serum ghrelin levels were similar to the controls (p = 0.616). The serum orexin-A level was positively correlated with ghrelin (r = 0.298, p = 0.014), PSQI sleep quality (r = 0.356, p = 0.003), and ESS (r = 0.357, p = 0.003). Conclusion: Serum orexin-A is associated with sleep quality in patients with CSU. Further studies are needed to elucidate the role of ghrelin and leptin on sleep quality in patients with CSU.
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    Caffeine use in preterm neonates: national insights into Turkish NICU practices
    Unal, S; Beken, S; Ince, DA; Turan, O; Toygar, AK; Ecevit, A; Akcan, AB; Akin, MA; Aktas, S; Ciftdemir, NA; Altuncu, E; Altunhan, H; Arcagok, BC; Armangil, D; Ozer, EA; Aydin, B; Bezirganoglu, H; Bilgin, L; Calisici, E; Calkavur, S; Celik, K; Celik, Y; Cetinkaya, B; Cetinkaya, M; Demirel, A; Demirel, G; Dogan, NN; Dogan, P; Durukan, M; Engur, D; Ercan, TE; Gokmen, Z; Varal, IG; Gulasi, S; Gunlemez, A; Gursoy, T; Toptan, HH; Hamitoglu, S; Isleyen, F; Iyigun, I; Kader, S; Kahvecioglu, D; Kayki, G; Kostu, M; Kurnaz, D; Mammadaliyev, T; Akin, IM; Narli, N; Okulu, E; Okur, N; Olukman, O; Ovali, F; Ozcan, B; Ozdemir, A; Ozdemir, O; Ozkan, H; Sandal, G; Sarici, D; Sivrikaya, C; Bilgin, BS; Sundus, S; Onay, OS; Simsek, H; Tandircioglu, UA; Tanriverdi, S; Tekgunduz, KS; Terek, D; Tunc, G; Tunc, T; Tutak, E; Tufekcioglu, E; Erdogan, FT; Ulu, E; Isik, DU; Uras, N; Uslu, SI; Unal, I; Yilmaz, FH; Moniri, A
    Objective: Caffeine is a proven medication used for the prevention and treatment of apnea in premature infants, offering both short- and long-term benefits. International guidelines provide a range of recommendations regarding the preterm population eligible for caffeine prophylaxis, including the timing, dosage, and duration of treatment. Our national guidelines, published prior to the most recent updates of the international guidelines, recommend the use of caffeine citrate starting from the first day after delivery for preterm infants with a gestational age of <28 weeks. For infants up to 32 weeks, if positive pressure ventilation is required, the decision should be made on an individual basis. This study aims to describe the variability in caffeine usage across neonatal intensive care units in our country. Methods: An online survey was sent to neonatologist who are members of the Turkish Neonatology Society to describe the variability in caffeine usage in neonatal intensive care units in our country. Results: We collected responses from 74 units. Prophylactic caffeine usage was observed as; GA <= 27(6/7): 98.6%, GA 28(0/7)-28(6/7): 89.0%, GA 29(0/7)-29(6/7): 75.3%, GA 30(0/7)-31(6/7): 53.4%. 62.2% of units reported administering loading dose within the first two hours. The initial maintenance dose was 5 mg/kg in 64.8% of units, 10 mg/kg in 32.4% of units, and intermediate dose in 5.3% of units. 47.3% of units reported no routine dose adjustment. The postmenstrual age that caffeine treatment was stopped was found to be 34 (min-max; 32-36) weeks for infants without apnea and respiratory support, 36 (min-max; 34-52) weeks for infants without apnea but any respiratory support. The time to discharge after treatment cessation was found as; 1-4 days: 37.8%, 5-7 days: 68.9%. Among the 56 units with multiple responsible physicians, 32.1% reported intra-unit variations. Conclusion: The significant differences in caffeine usage characteristics between and within units highlight the need for clear recommendations provided by standardized guidelines.
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    Identification of the molecular etiology in rare congenital hemolytic anemias using next-generation sequencing with exome-based copy number variant analysis
    Isik, E; Aydinok, Y; Albayrak, C; Durmus, B; Karakas, Z; Orhan, MF; Sarper, N; Aydin, S; Unal, S; Oymak, Y; Karadas, N; Turedi, A; Albayrak, D; Tayfun, F; Tugcu, D; Karaman, S; Tobu, M; Unal, E; Ozcan, A; Unal, S; Aksu, T; Unuvar, A; Bilici, M; Azik, F; Ay, Y; Gelen, SA; Zengin, E; Albudak, E; Eker, I; Karakaya, T; Cogulu, O; Ozkinay, F; Atik, T
    ObjectivesIn congenital hemolytic anemias (CHA), it is not always possible to determine the specific diagnosis by evaluating clinical findings and conventional laboratory tests. The aim of this study is to evaluate the utility of next-generation sequencing (NGS) and clinical-exome-based copy number variant (CNV) analysis in patients with CHA.MethodsOne hundred and forty-three CHA cases from 115 unrelated families referred for molecular analysis were enrolled in the study. Molecular analysis was performed using two different clinical exome panels in 130 patients, and whole-exome sequencing in nine patients. Exome-based CNV calling was incorporated into the traditional single-nucleotide variant and small insertion/deletion analysis pipeline for NGS data in 92 cases. In four patients from the same family, the PK Gypsy variant was investigated using long-range polymerase chain reaction.ResultsMolecular diagnosis was established in 86% of the study group. The most frequently mutated genes were SPTB (31.7%) and PKLR (28.5%). CNV analysis of 92 cases revealed that three patients had different sizes of large deletions in the SPTB and six patients had a deletion in the PKLR.ConclusionsIn this study, NGS provided a high molecular diagnostic rate in cases with rare CHA. Analysis of the CNVs contributed to the diagnostic success.
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    Mortality indicators in community-acquired pneumonia requiring intensive care in Turkey
    Erdem, H; Turkan, H; Cilli, A; Karakas, A; Karakurt, Z; Bilge, U; Yazicioglu-Mocin, O; Elaldi, N; Adiguzel, N; Gungor, G; Tasci, C; Yilmaz, G; Oncul, O; Dogan-Celik, A; Erdemli, O; Oztoprak, N; Tomak, Y; Inan, A; Karaboga, B; Tok, D; Temur, S; Oksuz, H; Senturk, O; Buyukkocak, U; Yilmaz-Karadag, F; Ozcengiz, D; Turker, T; Afyon, M; Samur, AA; Ulcay, A; Savasci, U; Diktas, H; Ozgen-Alpaydin, A; Kilic, E; Bilgic, H; Leblebicioglu, H; Unal, S; Sonmez, G; Gorenek, L
    Background: Severe community-acquired pneumonia (SCAP) is a fatal disease. This study was conducted to describe an outcome analysis of the intensive care units (ICUs) of Turkey. Methods: This study evaluated SCAP cases hospitalized in the ICUs of 19 different hospitals between October 2008 and January 2011. The cases of 413 patients admitted to the ICUs were retrospectively analyzed. Results: Overall 413 patients were included in the study and 129 (31.2%) died. It was found that bilateral pulmonary involvement (odds ratio (OR) 2.5, 95% confidence interval (CI) 1.1-5.7) and CAP PIRO score (OR 2, 95% CI 1.3-2.9) were independent risk factors for a higher in-ICU mortality, while arterial hypertension (OR 0.3, 95% CI 0.1-0.9) and the application of non-invasive ventilation (OR 0.2, 95% CI 0.1-0.5) decreased mortality. No culture of any kind was obtained for 90 (22%) patients during the entire course of the hospitalization. Blood, bronchoalveolar lavage, and non-bronchoscopic lavage cultures yielded enteric Gram-negatives (n = 12), followed by Staphylococcus aureus (n = 10), pneumococci (n = 6), and Pseudomonas aeruginosa (n = 6). For 22% of the patients, none of the culture methods were applied. Conclusions: SCAP requiring ICU admission is associated with considerable mortality for ICU patients. Increased awareness appears essential for the microbiological diagnosis of this disease. (C) 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.