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Öğe Adipokine, adropin and endothelin-1 levels in intrauterine growth restricted neonates and their mothers(Walter De Gruyter Gmbh, 2016) Aydin, Halil Ibrahim; Eser, Ayla; Kaygusuz, Ikbal; Yildirim, Sevgi; Celik, Tugrul; Gunduz, Suzan; Kalman, SuleymanIntrauterine growth retardation/restriction (IUGR) is associated with fetal malnutrition. It has consequences for later life including increased incidence of obesity, diabetes mellitus, cardiovascular disease (CVD), and metabolic syndrome. Adipokines (adiponectin and leptin), adropin, and endothelin-1 are associated with obesity and metabolic syndrome regulation. Intrauterine changes in these mediators could affect programming of later adult obesity and metabolic syndrome. Our objectives were to compare the levels of these mediators in both cord and maternal blood between IUGR pregnancies and control, healthy pregnancies, and to study the correlation of adipokines with adropin and endothelin-1 in maternal and cord blood in IUGR pregnancies as well as in healthy control pregnancies. Maternal and cord blood samples were taken from 16 women with IUGR pregnancies and 16 women with healthy pregnancies. Serum levels of leptin, adiponectin, adropin, and endothelin-1 were measured by ELISA. Maternal blood adropin levels were significantly lower in the IUGR group than in the control group; the other mediators did not differ significantly. There was a positive correlation between maternal blood adropin and endothelin levels. (r = 0.731, P = 0.001) in the control but not the IUGR group. Cord blood adropin and adiponectin levels were significantly lower in the IUGR group compared with the control group, while leptin or endothelin-1 did not differ significantly. There was a negative correlation between adropin and leptin (r = -0.704, P = 0.001) in the IUGR but not the control group cord blood. There were also positive correlations between endothelin and adropin for both groups (r = 0.594, P = 0.006; r = 0.560, P = 0.010, respectively); to the best of our knowledge, this is the first report of such a correlation. Differences in fetal expression of adropin and adiponectin in IUGR could influence programming of obesity, metabolic syndrome, diabetes, and CVD in later life.Öğe Attitudes towards influenza vaccination in high socioeconomic status Turkish parents(Tubitak Scientific & Technological Research Council Turkey, 2014) Gunduz, Suzan; Yuksel, Cigdem Nuket; Aktoprak, Hale Bozkurt; Canbal, Metin; Kaya, MehmetBackground/aim: To better understand the knowledge, attitudes, and demographic factors that influence the rate of influenza vaccination among high socioeconomic status parents. Materials and methods: questionnaire exploring the attitudes of parents to the influenza vaccine, and their knowledge about influenza and its vaccination, was given to parents of children from 1 through 16 years of age attending the Turgut Ozal University Hospital after the 2011/12 influenza season. Results: In the present study, 285 mothers and their children participated and 8.8% (n = 25) of children had the influenza vaccination. Between the vaccinated and nonvaccinated groups, there were statistically significantly differences for having received the recommendation of the physician, consulting with the physician, having the influenza vaccine previously, and having a chronic disease. The most common misconceptions of the parents about the vaccine were; there being no need for it, it not being useful, it having no effect, and it being harmful. Parents' knowledge about influenza and the influenza vaccine were not satisfactory. Conclusion: Reliable information from both health care providers during visits and the media about influenza, its severity, and the effectiveness and side effects of its vaccine should be provided.Öğe Breastfeeding Throughout Pregnancy in Turkish Women(Mary Ann Liebert, Inc, 2014) Ayrim, Aylin; Gunduz, Suzan; Akcal, Banu; Kafali, HasanIntroduction: Around the world, as well as in Turkey, women breastfeed their infants as long as possible. There is, however, a strong cultural taboo against continuing breastfeeding while having a new pregnancy. The aim of this study was to evaluate the outcome of pregnancies occurring during the lactation period and to determine whether lactation throughout the pregnancy had any adverse effects. This is the first study in Turkey to provide data on the association between the practice of lactation throughout pregnancy and outcome. Subjects and Methods: One hundred sixty-five multiparous women with singleton pregnancies who were >= 18 years of age, breastfeeding the previous child, and did not have systemic disease were included. Forty-five of the 165 pregnant women continued lactating, whereas 120 did not. We compared weight gain during pregnancy, hemoglobin level alterations, pregnancy complications, neonatal weight, and Apgar scores between the two groups. Results: Lactating pregnant women gained less weight than the nonlactating group, and the decreased level of hemoglobin during pregnancy was significant in the lactating group. Between the two groups, there was no statistically significant difference in hyperemesis gravidarum, threatened abortion, preeclampsia, premature labor and birth, neonatal weight, or Apgar scores. Conclusions: Breastfeeding during pregnancy is not harmful, and health professionals should not advise weaning if overlapping occurs and should observe mother, infant, and fetus closely for negative effects, and if a negative effect occurs they should take precautions.Öğe Efficacy and safety of pamidronate in children with vitamin D intoxication(Wiley-Blackwell, 2016) Kara, Cengiz; Cetinkaya, Semra; Gunduz, Suzan; Yilmaz, Gulay Can; Aycan, Zehra; Aydin, MuratBackgroundBisphosphonates are used in the treatment of vitamin D intoxication (VDI) after failure of conventional therapy including prednisolone. Safety concerns restrict the use of bisphosphonates from being used as first-line therapy for VDI in children. The aim of this study was to evaluate the efficacy and safety of pamidronate in comparison with prednisolone in children with VDI. MethodsWe reviewed the hospital records of children consecutively diagnosed with VDI at two medical centers in a 15year period. ResultsThe subjects consisted of 21 children (age, 0.3-4.2years) who were treated with prednisolone and/or bisphosphonates. Pamidronate (n=18) or alendronate (n=3) was used in six patients after unsuccessful prednisolone treatment, and in 15 patients from baseline. Initial serum calcium and 25-hydroxyvitamin D were 16.11.9mg/dL and 493 +/- 219ng/mL, respectively. The median time to reach normocalcemia in the pamidronate, alendronate and prednisolone groups was 3days (range, 2-12days), 4days (range, 3-6days) and 17days (range, 12-26days), respectively (P=0.013). The pamidronate group had a fivefold shorter hospital stay than the prednisolone group. Three patients initially treated with prednisolone developed nephrocalcinosis but this did not occur in any patient treated with bisphosphonates from baseline. Apart from transient fever and moderate hypophosphatemia, no side-effect of bisphosphonate treatment was observed. ConclusionsPamidronate is efficient and safe for the treatment of VDI in children. Pamidronate use significantly shortens the duration of treatment, and thereby may prevent the development of nephrocalcinosis. Instead of prednisolone, pamidronate should be used together with hydration and furosemide as the first-line therapy for VDI.Öğe Four hours is enough for lactation interruption after high-dose methylprednisolone treatment in multiple sclerosis mothers by measuring milk cortisol levels(Taylor & Francis Ltd, 2016) Gunduz, Suzan; Gencler, Onur Serdar; Celik, Huseyin Tugrul[Abstract Not Available]Öğe Rectus sheath hematoma in a macrosomic neonate following difficult delivery. Case report(Soc Argentina Pediatria, 2018) Gunduz, Suzan; Kara, Semra; Aktas, Ayse; Eren, Abdulkadir; Bakan, VedatMacrosomia is a risk factor for birth injuries and is associated with neonatal morbidity and mortality. Cephalohematoma and clavicular fracture are the most frequent birth injuries. Intraabdominal injuries are uncommon birth injuries. Rectus sheath hematoma (RSH) is an accumulation of blood in the sheath of rectus abdominis muscle. It is associated with trauma, operations and anticoagulant therapy, especially in adults and elders. We present a macrosomic male neonate with difficult vaginal delivery, who had in the physical examination periumblical ecchymose of 1x1 cm and a parietal cephalohametoma of 1x1 cm. The abdominal ultrasonogram and the computed tomography scan of the abdomen showed a 7x4x2 cm right rectus sheath hematoma.Öğe Sleep deprivation in the last trimester of pregnancy and inadequate vitamin D: Is there a relationship?(Lippincott Williams & Wilkins, 2016) Gunduz, Suzan; Kosger, Hatice; Aldemir, Secil; Akcal, Banu; Tevrizci, Hatice; Hizli, Deniz; Celik, Huseyin TugrulBackground: Disturbed sleep is a significant health issue for pregnant women. Inadequate vitamin D intake is common among pregnant women and can affect many bodily systems. The purpose of this cross-sectional study was to test the hypothesis that serum vitamin D levels are low in pregnant women who have poor sleep quality in their last trimester. Methods: We enrolled 92 pregnant women who were admitted to the Maternity Clinic of Turgut Ozal University (Ankara, Turkey) in their last trimester. Venous blood sampling was performed to determine serum 25-hydroxyvitamin D levels. Sleep quality was measured by the Pittsburgh Sleep Questionnaire. The Student t test and Chi-square test were used to evaluate the relationships between variables. Logistic regression analysis was used to identify independent predictors of the vitamin D level. Results: The median score of the Pittsburgh Sleep Questionnaire was 6.2 +/- 3.3 (range, 1-17). We determined that 43.5% (40) of participants had poor sleep quality. The mean number of sleep hours at night was 8.6 +/- 1 hours (range, 6.30-11 hours), and the mean sleep latency was 20.3 +/- 12.7 minutes (range, 5-60 minutes). Vitamin D levels were measured for 87 participants; the median serum level of 25 (OH) vitamin D was 22.9 +/- 16.2 ng/mL (range, 4.9-99 ng/mL). Among all patients, we did not determine any significance between the vitamin D-deficient group and the non vitamin D-deficient group with regard to the Pittsburgh Sleep Questionnaire Inventory (PSQI) total score and subcomponents scores of the questionnaire (p > 0.05). Among 37 patients with poor sleep quality and for whom the vitamin D level was measured, 56.8% (21) women had vitamin D deficiency, and 81% (30) women had vitamin D insufficiency. However, we did not find any significance between participants with poor sleep and participants with good sleep quality with regard to age, occupational status, relationship with her partner, prepregnancy body mass index (BMI), weight gain during pregnancy, being primiparus, length of labor, and mode of delivery. Our findings further showed that being in a low income family was associated with poor sleep quality. Conclusion: Inadequate vitamin D and poor sleep quality are prevalent in pregnant women, but low levels of vitamin D are not associated with poor sleep quality. Further studies with larger sample sizes and studies that include preterm deliveries and special sleep disorders should be performed to understand this issue better. Copyright (C) 2015 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.Öğe Why Fever Phobia Is Still Common?(Kowsar Publ, 2016) Gunduz, Suzan; Usak, Esma; Koksal, Tulin; Canbal, MetinBackground: Fever is a reliable sign of illness, but it also evokes fear and anxiety. It is not the fever itself but the fear of possible complications and accompanying symptoms that is important for pediatricians and parents. Objectives: We aimed to investigate maternal understanding of fever, its potential consequences, and impacts on the treatment of children. Patients and Methods: A questionnaire was use to explore the attitudes, knowledge, and practices of mothers of 861 children brought to four medical centers in different regions of Turkey in 2012, with fever being the chief complaint. All the children were aged 3 months - 15 years. Results: Among the 861 mothers, 92.2% favored antipyretics for fever, either alone or in addition to external cooling measures. Most favored paracetamol or ibuprofen. In this study, the appropriate use of antipyretics was 75.2%, which was higher than that reported in the literature. In common with previous reports, seizures and brain damage were perceived as the most frightening and harmful effects of fever. All the mothers expressed concerns about fever, but they were most common among the highly educated or those with one child. Conclusions: Fever phobia remains common, not only among low socioeconomic status mothers but also among those of high socioeconomic status. Healthcare providers should take fever phobia into account and provide correct information to caregivers about fever at all visits.
