İstanbul Sağlık ve Teknoloji Üniversitesi Kurumsal Akademik Arşivi
DSpace@İSTÜN, Üniversite mensupları tarafından doğrudan ve dolaylı olarak yayınlanan; kitap, makale, tez, bildiri, rapor, araştırma verisi gibi tüm akademik kaynakları uluslararası standartlarda dijital ortamda depolar, Üniversitenin akademik performansını izlemeye aracılık eder, kaynakları uzun süreli saklar ve telif haklarına uygun olarak Açık Erişime sunar.
Güncel Gönderiler
Evaluation of management strategies for viral upper respiratory tract infections among pediatricians in Türkiye
(Taylor & Francis, 2025) Yıldız, İsmail; Gönüllü, Erdem; Uçkun, Utkucan; Kandemir, İbrahim; Soysal, Ahmet; Karaböcüoğlu, Metin
Background: To evaluate how pediatricians manage viral upper respiratory tract infections (URTIs) in children and their tendencies about the viral URTIs approaches. Materials and Methods: This study was conducted among pediatricians who participated in a descriptive cross-sectional survey. The survey included pediatricians who were willing to participate and who completed the survey forms between June 2023 and February 2024. The survey gathered data on the demographic characteristics of the pediatricians, as well as their diagnostic and treatment approaches for viral URTIs. Demographic data included the physicians’ gender, age, academic title, province of duty, institution of practice, and duration of experience in pediatrics. Results: This study involved 203 pediatricians. The diagnosis of viral URTI based on clinical findings had a negative correlation with pediatricians’ work experience (OR: 0.96 per year) and was more common among those working in private settings (OR: 0.38). Use of medications for symptomatic cough treatment was 2.72 times higher among pediatricians in private practice. Herbal supplement use was more common among pediatricians in private practice (p = 0.021) and those with ≥10 years of experience (p = 0.010). Systemic decongestant use was more frequent among pediatricians without an academic title (p = 0.030). Pelargonium sidoides root extract was used more often by pediatricians in private practice (p = 0.003), and they also preferred honey-containing supplements more frequently (p < 0.05). There was a negative correlation between experience in pediatric practice and multivitamins and minerals prescriptions for prevention of viral URTIs (OR: 0.97 for each year). Conclusion: Pediatricians in private settings and with more experience tend not to make a diagnosis of viral URTIs solely based on physical examination. Pediatricians working in private settings focus more on treatments that relieve cough symptoms. A viral URTI diagnostic and treatment algorithm with proven validity will help physicians in clinical diagnosis and treatment.
Effect of slow versus rapid advancement of enteral feeding on intestinal oxygenation in preterm infants
(MDPI Publishing, 2025) Özdemir, Hülya; Kersin, Sinem Gülcan; Can Buker, Halime Sema; Çetinkaya, Merih; Kandemir, İbrahim; Memişoğlu, Aslı; Bilgen, Hülya Selva
Background/Objectives: The optimal rate of enteral feeding advancement in preterm infants remains uncertain despite decades of clinical research. This uncertainty arises from concerns that rapid feeding progression may increase the risk of feeding intolerance and necrotizing enterocolitis (NEC), two major causes of morbidity and mortality in this population. The feeding rate may also influence intestinal oxygenation due to mesen teric hemodynamic changes during feeding. This study aimed to evaluate whether the rate of enteral feeding advancement (slow vs. rapid) affects intestinal oxygenation and its association with feeding intolerance (FI) or necrotizing enterocolitis in very low birth weight preterm infants. Methods: This prospective, randomized, two-center study in cluded infants born at 28–32 weeks of gestation. Group 1 received slow advancement (20 mL/kg/day) and Group 2 rapid advancement (30 mL/kg/day) of enteral feeds. Splanchnic (srSO2) and cerebral (crSO2) oxygenation were monitored daily using the FDA approved INVOS NIRS device during feeding periods (08:00–16:00). Monitoring was per formed during minimal enteral nutrition (Phase 1), advancement phases (Phase 2), and for two days after achieving full enteral feeding (Phase 3). The splanchnic-to-cerebral oxygena tion ratio (SCOR) was also calculated. Percentage changes in srSO2 and SCOR during and after feeding were calculated from baseline (prefeeding) values and analyzed. Results: Sixty infants were enrolled. Mean gestational age and birth weight were 29.76 ± 1.33 weeks and 1375.05 ± 271.19 g, respectively. Group 2 achieved full enteral feeding significantly earlier (p = 0.001), with no other demographic differences between groups. No cases of NEC were observed. Feeding intolerance occurred in 14 infants (23.3%): 8 in Group 1 and 6 in Group 2 (p = 0.192). Both groups exhibited increased srSO2 and SCOR during feeding; however, the between-group differences were not statistically significant (Phase 2 srSO2 and SCOR: p = 0.07, 0.08; Phase 3 srSO2 and SCOR: p = 0.069, 0.071). However, the percentage change from baseline in srSO2 and SCOR during and after feeding was significantly greater in Group 2 during the advancement and full enteral feeding phases (Phase 2 srSO2 and SCOR: p = 0.03, 0.022; Phase 3 srSO2 and SCOR: p = 0.015, 0.048). Infants with feeding intolerance demonstrated significantly lower srSO2 and SCOR values compared to tolerant infants, and this reduction persisted even after reaching full enteral feeding. ROC analysis sug gested gestational age < 30 weeks, birth weight < 1180 g, srSO2 < 52, and SCOR < 0.6 were associated with feeding intolerance. Conclusions: Intermittent bolus feeding increased intestinal oxygenation, with a more pronounced effect in the rapid advancement group. No difference in gastrointestinal adverse outcomes was observed between groups. Lower in testinal oxygenation was associated with feeding intolerance, and the suggested predictive criteria may help guide individualized feeding strategies.
The impact of infant positioning on pain and early neonatal morbidities
(Elsevier, 2025) Kersin, Sinem Gülcan; Kandemir, İbrahim; Cıbır, Seval; Özdemir, Hülya; Memişoğlu, Aslı; Bilgen, Hülya Selva
Purpose: To investigate whether appropriate positioning, assessed using the Infant Positioning Assessment Tool (IPAT), is associated with lower pain scores and reduced incidence of early neonatal morbidities in the first week of life in premature infants. Methods: This retrospective observational study was conducted at a single center. The pre-implementation (non IPAT) group was assessed using the NPASS (Neonatal Pain, Agitation, and Sedation Scale) alone, whereas the post-implementation (IPAT) group was evaluated using both the NPASS and the IPAT. Results: The IPAT group consisted of 77 infants, and the non-IPAT group consisted of 40 infants. The mean gestational age and weight of the cases were 29.9 ± 1.2 weeks and 1350 ± 234 g, respectively. Pain scores increased in infants with intraventricular hemorrhage (IVH) (days 3 and 7) and necrotizing enterocolitis (NEC) (days 4 and 5), but decreased with IPAT use on days 5–7. IPAT scores showed a moderate negative correlation with IVH on days 1 and 6, and a strong negative correlation with NEC on day 7. Conclusion: Higher positioning quality is associated with lower pain scores and potentially fewer early morbid ities in preterm infants during the first week of life. Optimal positioning using the IPAT will help establish nursing standards and increase awareness among primary caregivers.
Diffuse alveolar hemorrhage induced by epileptic seizure
(Wiley, 2025) Talibov, Tural; İnci, Meltem; Ismayilov, Rashad; Bebek, Nerses
Diffuse alveolar hemorrhage (DAH) is a rare but life-threatening complication of generalized tonic–clonic seizures. We describe a 28-year-old woman with no prior seizure history who experienced three consecutive generalized tonic–clonic seizures, followed by acute hemoptysis and dyspnea. Imaging confirmed diffuse alveolar hemorrhage, which responded rapidly to corticosteroid therapy. Seizure-induced DAH is an uncommon and underrecognized condition. This case underscores the importance of considering DAH in patients presenting with respiratory symptoms following seizures, even in the absence of underlying systemic disease.
Testing the performance of cross-correlation techniques to search for molecular features in JWST NIRSpec G395H observations of transiting exoplanets
(Oxford University Press, 2025) Esparza-Borges, Emma; Lopez-Morales, Mercedes; Palle, Enric; Makhnev, Vladimir; Gordon, Iouli; Hargreaves, Robert; Kirk, James; Caceres, Claudio; Solmaz, Arif; Redfield, Seth
Cross-correlations techniques offer an alternative method to search for molecular species in James Webb Space Telescope (JWST) observations of exoplanet atmospheres. In a previous article, we applied cross-correlation functions for the first time to JWST NIRSpec/G395H observations of exoplanet atmospheres, resulting in a detection of CO in the transmission spectrum of WASP-39b and a tentative detection of CO isotopologues. Here, we present an improved version of our cross-correlation technique and an investigation into how efficient the technique is when searching for other molecules in JWST NIRSpec/G395H data. Our search results in the detection of more molecules via cross-correlations in the atmosphere of WASP-39b, including H2O and CO2, and confirms the CO detection. This result proves that cross-correlations are a robust and computationally cheap alternative method to search for molecular species in transmission spectra observed with JWST. We also searched for other molecules (CH4, NH3, SO2, N2O, H2S, PH3, O3, and C2H2) that were not detected, for which we provide the definition of their cross-correlation baselines for future searches of those molecules in other targets. We find that that the cross-correlation search of each molecule is more efficient over limited wavelength regions of the spectrum, where the signal for that molecule dominates over other molecules, than over broad wavelength ranges. In general, we also find that Gaussian normalization is the most efficient normalization mode for the generation of the molecular templates.
