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Gunay M.,Training and Treatment Center | Celik G.,Training and Treatment Center | Gunay B.O.,Umraniye Training and Research Hospital | Aktas A.,Zeynep Kamil Maternity and Childrens Disease Training and Research Hospital | And 2 more authors.
Arquivos Brasileiros de Oftalmologia | Year: 2015

Purpose: To evaluate 2-year outcomes following intravitreal bevacizumab (IVB) as monotherapy for aggressive posterior retinopathy of prematurity (APROP). Methods: Medical records of 40 infants were retrospectively reviewed. Group I included infants who had received IVB injections for APROP. Group II included infants who underwent laser treatment for APROP. Anatomic and refractive outcomes and the presence of anisometropia and strabismus were assessed at follow-up examinations. Results: Group I included 48 eyes of 25 infants (11 males) with a mean gestational age (GA) of 26.40 ± 1.82 weeks and a mean birth weight (BW) of 901.40 ± 304.60 g. Group II included 30 eyes of 15 infants (6 males) with a mean GA of 27.30 ± 1.82 weeks and a mean BW of 941.00 ± 282.48 g. GA, BW, and gender distributions were similar between groups (P=0.187, P=0.685, and P=1.000, respectively). Refractive errors were significantly less myopic in group I (0.42 ± 3.42 D) than in group II (-6.66 ± 4.96 D) at 2 years (P=0.001). Significantly higher rates of anisometropia and strabismus were observed in group II than in group I (P=0.009 and P=0.036, respectively). Conclusions: The study demonstrated that IVB monotherapy can be useful in the treatment of APROP. The decreased incidence of early unfavorable refractive and functional outcomes in the IVB group compared with the laser group showed a potential benefit for patients treated with IVB, and this needs to be better evaluated in future prospective studies. Source


Sezer R.G.,Zeynep Kamil Maternity and Childrens Disease Training and Research Hospital | Aydemir G.,GATA Teaching Hospital | Bozaykut A.,Zeynep Kamil Maternity and Childrens Disease Training and Research Hospital | Hira S.,GATA Teaching Hospital | And 2 more authors.
Annals of Thoracic Medicine | Year: 2013

Aims: Matrix metalloproteinases (MMP) have been associated with neonatal lung morbidity and MMP dysregulation contributes to the pathology of chronic and acute lung disorders. Most of the previous studies were performed in the 1 st weeks of life of the preterm newborns. There are no data on the serum levels of MMP-2, MMP-9 or tissue inhibitors of matrix metalloproteinases (TIMP-1) from preterm infants recovering from lung morbidities. We aimed to compare MMP-2, MMP-9 and TIMP-1 levels in preterm and term infants hospitalized with their first episode of wheezing. Methods: We prospectively evaluated 18 preterm infants with a history of chronic lung disease, respiratory distress syndrome or oxygen therapy and 14 age- and sex-matched term infants who were admitted for a first episode of wheezing. We quantified total serum concentrations of MMP-2, MMP-9 and TIMP-1 to assess whether these serum markers levels were associated with the first episode of wheezing in infants with a history of oxygen therapy during the neonatal period. Results: Upon hospitalization, MMP-2 and TIMP-1 levels were higher in preterm infants than in term infants. In contrast, there was no significant relationship between MMP-9 levels or the MMP-9/TIMP-1 ratio between preterm and term infants. The area under the receiver operating characteristic curve for MMP-2 was 0.70 (95% confidence interval [CI] 0.51-0.89). The area under the curve for TIMP-1 was 0.78 (95% CI 0.61-0.94). MMP-9, MMP-2 and TIMP-1 levels did not correlate with gestational age, gender or severity of wheezing. Conclusion: The negative proportion of MMP-9 to TIMP-1 that we detected in term infants was not present in preterm infants. The balance of MMP-9 to TIMP-1 may have been disrupted by lung damage in the premature infants. Overproduction of MMP-2 and TIMP-1 in the serum may be associated with the pathogenesis of wheezing in preterm infants. Source


Gunay M.,Zeynep Kamil Maternity and Childrens Disease Training and Research Hospital | Sekeroglu M.A.,Ulucanlar Eye Disease Training and Research Hospital | Celik G.,Zeynep Kamil Maternity and Childrens Disease Training and Research Hospital | Gunay B.O.,Umraniye Training and Research Hospital | And 2 more authors.
Graefe's Archive for Clinical and Experimental Ophthalmology | Year: 2015

Purpose: To describe the clinical and demographical characteristics and treatment outcomes of the premature infants who were presented with the signs of anterior segment ischemia (ASI) following transpupillary diode laser photocoagulation for aggressive posterior retinopathy of prematurity (APROP). Methods: The records of the premature infants who developed ASI following bilateral laser photocoagulation between November 2010 and December 2013 in a single institution for the treatment of APROP were retrospectively reviewed. The clinical and demographical characteristics, laser parameters, anterior segment complications, and structural outcomes were evaluated. Results: Nine eyes of five infants (three males, two females) were recruited for the study. Mean gestational age (GA), birth weight (BW), and postmenstrual age (PMA) at the time of laser ablation were 28.2 ± 2.5 weeks, 1,287.0 ± 483.4 g and 34.8 ± 2.2 weeks, respectively. All eyes were treated with a near-confluent pattern of laser ablation. Several anterior segment complications were observed including corneal edema (nine eyes), posterior synechia (nine eyes), pupillary membranes (five eyes), shallow anterior chamber (three eyes), hyphema (three eyes), and focal lens opacities (two eyes), of all resolved completely. Permanent dense cataracts observed in two eyes of two infants who were scheduled for lensectomy and anterior vitrectomy. None of the eyes progressed to phthisis bulbi. Conclusions: Anterior segment ischemia after laser treatment of APROP is a rarely encountered clinical entity. Mild and transient cases may resolve without any long-term sequelae but severe ones may progress to permanent cataract requiring further surgery. © 2014, Springer-Verlag Berlin Heidelberg. Source


Dogru M.,Zeynep Kamil Maternity and Childrens Disease Training and Research Hospital | Kirmizibekmez H.,Zeynep Kamil Maternity and Childrens Disease Training and Research Hospital | Mutlu R.G.Y.,Zeynep Kamil Maternity and Childrens Disease Training and Research Hospital | Aktas A.,Zeynep Kamil Maternity and Childrens Disease Training and Research Hospital | Ozturkmen S.,Zeynep Kamil Maternity and Childrens Disease Training and Research Hospital
International Archives of Allergy and Immunology | Year: 2014

Objective: Both asthma and vitamin D deficiency are common among children. The results from studies examining the relationship between them are contradictory. The aim of this study is to determine the relationship between the clinical parameters of asthma and vitamin D status in children.Methods: One hundred and twenty children diagnosed with asthma and followed-up in our hospital were included in the study. The control group included 74 children with no evidence of allergic disease. The eosinophil counts, IgE levels and serum 25 OH cholecalciferol [25(OH)D] levels were measured.Results: The patient group consisted of 73 (60.8%) males and 47 (39.2%) females with a mean age of 4.4 ± 1.2 years. There was no significant difference between the patient and control groups with respect to gender and age. The mean 25(OH)D level was 21.49 ± 7.74 ng/ml in the study group and 23.94 ± 8.97 ng/ml in the control group, and this difference was not significant (p = 0.094). The patients with asthma were grouped according to their vitamin D status as deficient' (group 1), insufficient' (group 2) and normal' (group 3). The sociodemographic features, duration of illness, number of hospitalizations, number of sensitivities to allergens, eosinophil count and serum IgE levels were not found to be different between the groups. However, the total number of exacerbations, asthma severity and systemic glucocorticoid need in the previous year were significantly higher in the deficiency group (p < 0.05).Conclusion: Vitamin D levels were not significantly different in patients with asthma. Vitamin D deficiency was common in the study group as well as in the control group. The clinical severity of disease, the number of exacerbations and the systemic glucocorticoid need were related to vitamin D level. © 2014 S. Karger AG, Basel. Source

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