Emel Okulu - Academia.edu (original) (raw)
Papers by Emel Okulu
Infectious Diseases, 2021
Abstract Background Invasive aspergillosis (IA) is an important cause of morbidity and mortality ... more Abstract Background Invasive aspergillosis (IA) is an important cause of morbidity and mortality in immunosuppressed children. Early detection of the infection can improve prognosis in this patient population. Objectives To investigate the utility of Aspergillus galactomannan antigen assay (GM-EIA) as a diagnostic tool for IA in at-risk paediatric patients. Patients/Methods For the study, 659 GM-EIA results from 59 patients diagnosed with IA and 3368 GM-EIA results from 351 subjects without evidence for IA (controls) were reviewed retrospectively. Three cut-off values (i.e. ≥0.5, ≥1, ≥1.5) were specified to determine GM-EIA positivity. Results The median age was 6.3 years for boys and 14.5 years for girls. There was a significant difference between the girls and boys in terms of age (p < 0.01). For proven/probable/possible IA patients, sensitivity of 67.8% and specificity of 59.8% were detected when the ≥0.5 cut-off value was used for GM-EIA-positivity. The specificity increased to 80% at the cut-off of ≥1 and to 88% at the cut-off of ≥1.5. False positivity rates were 9.14, 3, and 1.45% at the ≥0.5, ≥1 and ≥1.5 cut-offs respectively. In the proven/probable IA group, sensitivity and negative predictive values were 86.9 and 97.2% at the ≥0.5 cut-off, 85.7 and 97.9%, at the ≥1 cut-off and 84.2 and 98.1% at ≥1.5 cut-off respectively. The positive likelihood ratio was 7.57 and the odds ratio was 42.67 at ≥1.5 cut-off. Conclusion The GM-EIA may be used for both screening and diagnostic purposes in paediatric patients using a cut-off value of ≥1.5 for GM-EIA positivity.
Sepsis, yenidoganda onemli bir morbidite ve mortalite nedenidir. Baslangicta bulgular silik olmak... more Sepsis, yenidoganda onemli bir morbidite ve mortalite nedenidir. Baslangicta bulgular silik olmakla birlikte, klinik seyir hizla kotulesebilmekte ve saatler icinde olume neden olabilmektedir, bu nedenle yenidogan sepsisinde hizli ve dogru tani koymak onem tasimaktadir. Gunumuzde sepsisin erken saptanmasinda tek basina yeterli bir gosterge bulunmamaktadir. Sepsiste inflamatuar yollarin daha iyi anlasilmasi ve tanisal teknolojideki hizli gelismeler ile pek cok infeksiyon gostergesi arastirilmaktadir. Bu calismanin amaci, gec neonatal sepsis dusunulen bebeklerde, tani esnasinda, klinik izlem sirasinda ve tedavi bitiminde serum suPAR duzeylerinin calisilmasi, diger laboratuar testleri ile karsilastirildiginda serum suPAR duzeylerinin katkisinin incelenmesidir. Calisma, prospektif kohort bir calismadir. Gec neonatal sepsis tanisi alan bebeklerde tani aninda, 72.saat ve tedavi bitiminde serum suPAR duzeyleri degerlendirildi. Serum suPAR duzeyleri diger laboratuvar parametreleri i...
Journal of Trace Elements in Medicine and Biology, 2021
PONTE International Scientific Researchs Journal, 2018
Genetic counseling (Geneva, Switzerland), 2009
The Fukuyama type congenital muscular dystrophy (FCMD) is a rare autosomal recessive disorder cha... more The Fukuyama type congenital muscular dystrophy (FCMD) is a rare autosomal recessive disorder characterized by cranial, cerebellar and ocular malformations and congenital muscular dystrophy. Hyperekplexia is characterized by transient, generalized rigidity in response to unexpected loud noises or sudden tactile stimulation. Herein, we report an infant who had typical clinical features of FCMD with hyperekplexia. Our purpose is to draw attention to this first report of concomitant FCMD and hyperekplexia.
Early Human Development, 2014
10% to 30%, in Canada from 11% to 19.5%, in Germany from 15% to 17%, in France 15%. In the North ... more 10% to 30%, in Canada from 11% to 19.5%, in Germany from 15% to 17%, in France 15%. In the North Eastern Italy it is reported as 17.9%, in Friuli Venezia Giulia 19.7%, in Palermo 8%. The number of women (76 with term delivery + 9 with preterm delivery) who had positive swabs in our data is only 7.9% (85/1075). It's reasonable to believe that the high number of not tested pregnant mystifies the rates of colonization and the risk for newborns. IAP is the key therapy to prevent GBS early onset sepsis and criteria for administration are reported in CDC guidelines 2010. Our data demonstrate that nevertheless IAP was indicated in 93 mothers of term newborns, only 44% (41/93) received it correctly, while 56% (52/93) didn't received it. Between mothers who delivered prematurely and needed IAP, only 12% (10/84) received it correctly. Conclusions: Our data demonstrate a lack of adherence of clinical management to international guidelines. It's evident the necessity to prevent GBS sepsis in newborn by improving protocol adherence and surveying constantly clinical practice.
Early Human Development, 2012
The aim of the study was to determine the clinical risk factors to predict the progress of TTN in... more The aim of the study was to determine the clinical risk factors to predict the progress of TTN in late-preterm and term infants. Design: The diagnosis of TTN was established based on: (i) onset of tachypnea within 6 h after birth, (ii) persistence of tachypnea for at least 12 h, (iii) chest x-ray findings, (iv) exclusion of all other known respiratory disorders. The late-preterm and term infants who were diagnosed as TTN were evaluated retrospectively in last two years. Patients were divided into two groups according to the intensity of respiratory support. Infants in group 1 received invasive or non-invasive ventilatory support, where group 2 needed only oxygen. Clinical findings, Richardson and Silverman scores were compared between the groups. Results: In last two years 554 late-preterm and term infants admitted to NICU. One-hundred-six (19.1%) infants were diagnosed as TTN (50 late-preterm, 56 term infants). There were 68 (64%) infants in group 1, and 38 (36%) in group 2. Mean gestational age and birth weight were lower in group 2 (p< 0.05). The incidence of C/S (87% vs 92%) and male gender was similar in both groups. Richardson scores, Silverman scores, peak respiratory rates (pRR) and oxygen need (FiO2) in the first 24 hours were statistically higher, duration of total respiratory support and hospitalisation were statistically longer in group 1 (p < 0.001). Nine infants were experienced air leak and 5 infants received surfactant in group 1, where none of the infants in group 2 did. The cutoff for Richardson score was 3 and the patients whose score higher than 3 had a 6.98-fold risk, the cutoff for Silverman score was 5 and whose score higher than 5 had a 7.46-fold risk, and the cutoff for pRR in first 24 hours was 75/min and whose pRR was higher than 75/min in first 24-hours had a 1.10-fold risk of receiving ventilatory support (95% CI: 2.30-21.18, 2.54-21.89, and 1.035-1.17, p < 0.01, respectively). Conclusion: TTN, is usually a benign and self-limited disease and the prognosis is generally excellent. But associated hypoxaemia, respiratory failure and air leak syndromes may increase the risk of morbidity and duration of hospitalisation. Assessment of Richardson score, Silverman score, and pRR in first 24-hours of patients may be useful in predicting clinical course of TTN. So by predicting of the intensity for ventilatory support in the patients, it is important to plan and provide the appropriate level of care for these infants.
Early Human Development, 2012
Journal of Clinical Laboratory Analysis, Jul 10, 2014
Journal of Ankara University Faculty of Medicine
Objectives: Despite improvements in neonatal care and survival of preterm infants, the incidence ... more Objectives: Despite improvements in neonatal care and survival of preterm infants, the incidence of bronchopulmonary dysplasia (BPD) is not decreasing. The aim of this study was to evaluate the impact of initial mode of respiratory support on BPD in extremely low birth weight (ELBW) infants. Materials and Methods: ELBW infants admitted to neonatal intensive care unit were analyzed retrospectively between 2014 and 2017. The effects of initial respiratory support options and morbidities on BPD were evaluated between infants who developed BPD or not. Results: Total 101 infants were evaluated, and 68 were included. For those whose incidence of BPD was 46%, the mean gestational age and birth weight were 27.8±1.8 weeks and 814±118 g, respectively. Patients with BPD (n=31) had a lower mean gestational age and birth weight, higher rates of necrotizing enterocolitis and retinopathy of prematurity (p<0.001, p=0.012, p=0.024, and p=0.018, respectively). Requirement of surfactant and need for invasive respiratory support initially after birth were found to be major risk factors for BPD. The duration of invasive ventilation after birth was longer in patients with BPD (p=0.034). BPD or death occurred in 66 of 101 infants. Infants received non-invasive respiratory support after birth had a lower risk for BPD, and BPD or death. Conclusion: To prevent the development of BPD in ELBW infants, the respiratory support should be non-invasive after birth, and if the infant is intubated, duration of invasive respiratory support should be shortened for less than 3 days.
Frontiers in Pediatrics
Background:The umbilical cord blood contains a high concentration of stem cells. There is not any... more Background:The umbilical cord blood contains a high concentration of stem cells. There is not any published study evaluating the amount of stem cells that have the potential to be transferred to the infant through placental transfusion methods as delayed cord clamping (DCC) and umbilical cord milking (UCM). The aim of this study is to measure the concentrations of endothelial progenitor cell (EPC) and CD34+ hematopoietic stem cell (HSC) in the placental residual blood volume (PRBV), and evaluate the delivery room adaptation and cerebral oxygenation of these infants.MethodsInfants with ≥36 gestational weeks were randomized to receive DCC (120 s), UCM, or immediate cord clamping (ICC). EPC and CD34+ HSC were measured by flow cytometry from the cord blood. PRBV was collected in the setup. The cord blood gas analysis and complete blood count were performed. The heart rate (HR), oxygen saturation (SpO2), and cerebral regional oxygen saturation (crSO2) were recorded.ResultsA total of 103 ...
Zeitschrift für Geburtshilfe und Neonatologie
We aimed to compare the definitions of National Institute of Child Health and Human Development (... more We aimed to compare the definitions of National Institute of Child Health and Human Development (NICHD) for bronchopulmonary dysplasia (BPD) for determining the incidences, and predicting late death and respiratory outcome. This retrospective cohort study included infants born at<32 weeks’ gestation who survived up to 36 weeks’ postmenstrual age (PMA). Infants were classified as having BPD or no BPD per thedefinitions of NICHD 2001 and 2018. The incidences of BPD were 49 and 32% according to the 2001 and 2018 NICHD definitions. Gestational age, birth weight and intubation after birth were associated with BPD by both definitions. The NICHD 2018 definition displayed similar sensitivity (100%) and negative predictive value (100%), and higher specificity (70 vs. 52%) for predicting death after 36 weeks’ PMA; a higher specificity (72 vs. 53%), comparable negative predictive value (77 vs.76%), but lower sensitivity for predicting adverse respiratory outcome within 12 months corrected a...
Journal of Clinical Research in Pediatric Endocrinology, 2021
What is already known on this topic? Late neonatal hypocalcemia occurs after the first 72 hours a... more What is already known on this topic? Late neonatal hypocalcemia occurs after the first 72 hours and the most common causes include excessive phosphate intake, hypomagnesemia, hypoparathyroidism, and vitamin D deficiency. What this study adds? Maternal vitamin D deficiency was found to be the most common cause of late neonatal hypocalcemia in our study. Due to the immaturity of regulating factors of parathormone and calcium, serum iPTH levels may not reach expected levels and serum phosphorus levels may remain high in vitamin D deficient neonates, posing a diagnostic dilemma by mimicking primary hypoparathyroidism.
Objective: To investigate the morbidity pattern of late preterm infants (born between 34(0/7) and... more Objective: To investigate the morbidity pattern of late preterm infants (born between 34(0/7) and 36(6/7)) born in Obstetric and Gynecology Department or in an another hospital and admitted to Neonatal Intensive Care Unit (NICU). Methods: Hospital records of maternal age, parity, use of reproductive techniques, gestation week, birth type, birth weight, neonatal problems and reasons for hospitalization, length of stay at hospital, rehospitalization rates of late preterm infants admitted to NICU between the period of January 1 and December 31, 2007 were reviewed retrospectively. Results: At Obstetric and Gynecology Department, 1852 infants were born in the 12-month period; 1556 (84%) were full-term and 296 (16%) were preterm. One hundred seventy four infants were late preterm and late preterm delivery rate was 9.4%. NICU admission rate was 10% and 36.2% for full-term and late preterm infants, respectively. Seventeen of 80 late preterm infants admitted from another hospital. Mean mater...
Objective: We aimed to define the clinical and epidemiological features of neonates hospitalized ... more Objective: We aimed to define the clinical and epidemiological features of neonates hospitalized in the neonatal care unit with virus-related to lower respiratory tract infections in this study. Material and Methods: The neonates who were hospitalized with lower respiratory tract infection between January 2014 and December 2015 were evaluated for clinical features and the viruses were identified on multiplex reverse transcription polymerase chain reaction using nasal swab samples. Neonates with congenital heart disease, malformation of the respiratory tract, immune deficiency and nosocomial virus infection were excluded. Results: Eighty-one (4.6%) of 1768 neonates were admitted to NICU with lower respiratory tract infection during the study period. In 56 of 81 patients, a virus was identified from the nasal swab sample. Respiratory syncytial virus (RSV) was the most common etiology (80.4%, n=45), four patients had RSV co-infection (7.1%), and seven patients had a virus other than RS...
Güncel Pediatri, 2021
Giriş: Yenidoğan sarılığında kan değişimi, yaşamsal önemde ancak riskleri olan girişimsel bir işl... more Giriş: Yenidoğan sarılığında kan değişimi, yaşamsal önemde ancak riskleri olan girişimsel bir işlemdir. Kan değişimi gerektirecek hiperbilirubinemi gelişiminin önlenmesi öncelikli yaklaşımdır. Çalışmamızda şiddetli hiperbilirubinemide, kan değişimi risk faktörleri ve ileri dönem nörogelişimsel durumun araştırılması amaçlanmıştır. Gereç ve Yöntem: Total serum bilirubin değeri Amerikan Pediatri Akademisi rehberine göre kan değişimi sınırında veya sınırın üstünde, 35 ve üstü gestasyonel hafta doğumlu 104 yenidoğan çalışmaya dahil edildi. Olguların 12-36 ayındayken ulaşılabilen 65'ine Gelişimi İzleme ve Destekleme Rehberi uygulandı. Kan değişimi uygulanan ve uygulanmayanlar sosyodemografik özellikler, risk faktörleri, etiyoloji, tedavi süreçleri ve ileri dönem nörogelişimsel durum açılarından karşılaştırıldı. Bulgular: Kan değişimi olguların %18,3'ünde uygulandı. Başvuru total serum bilirubin ve bilirubin/albümin oranı yüksekliği kan değişimi riskini arttıran temel değişkenlerdi. Kan değişimi riskini artıran eşik değerler, total serum bilirubinde 26,43 mg/dl ve bilirubin albümin oranında 7,43 mg/g saptandı. Sarılık etiyolojisinde ilk üç sırada; hemolitik hastalık, dehidratasyon ve erken anne sütü sarılığı ile prematürelik saptandı. Etiyolojilerle tedavi şekilleri arasında anlamlı ilişki bulunmadı. Postnatal 96 saatten sonra hastaneye başvuranların istatistiksel anlamlı yüsek bilirubinle (≥25 mg/dl) yattığı görüldü. On iki-otuz altı ayında değerlendirilen 65 olgunun %13,8'inde farklı alanlarda gelişimsel gecikme saptandı. Başvuru zamanı, tedavi şekilleri, total serum bilirubin ve bilirubin albümin oranıyla nörogelişimsel durum arasında anlamlı farklılık saptanmadı. Sonuç: Kan değişimi için başlıca risk faktörleri yüksek total serum bilirubin ve bilirubin albümin oranı bulundu. Hastaneye geç başvuranların daha sıklıkla ciddi hiperbilirubinemiyle yatması, taburculuk öncesi riskli grubun saptanması temel yaklaşımının önemini vurgulamaktadır. Ciddi hiperbilirubinemili olgular gelişimsel gecikmeler için riskli sayılmalı, düzenli izlem ve erken tanıyla müdahale fırsatları kaçırılmamalıdır. Anah tar ke li me ler Hiperbilirubinemi, kan değişimi, nörogelişim, yenidoğan
Pediatric Nephrology, 2021
Background Continuous kidney replacement therapies (CKRT) have been reported to be an effective a... more Background Continuous kidney replacement therapies (CKRT) have been reported to be an effective approach to removing toxic metabolites in inborn errors of metabolism (IEM). The present study evaluates efficiency and complications of CKRT in children with IEM. Methods Patients diagnosed with IEM who underwent CKRT in pediatric and neonatal intensive care units were analyzed. CKRT were initiated in patients with persistently high blood ammonia levels (≥ 500 μmol/L), blood ammonia levels > 250 μmol/L in the presence of moderate encephalopathy, high blood leucine levels (≥ 1500 μmol/L), and blood leucine levels < 1500 μmol/L in the presence of deteriorating neurological status or persistent metabolic acidosis. Results Of 22 patients enrolled, nine (40.9%) Maple syrup urine disease (MSUD), eight (36.4%) urea cycle disorders (UCD), and five (22.7%) organic acidemias (OA). Median age was 72.3 [9.9-1040.8] days. In total, 28 dialysis sessions were analyzed [16 (57.1%) continuous venovenous hemodialysis, and 12 (42.9%) continuous venovenous hemodiafiltration]. A significant decrease was noted in leucine levels (from 1608.4 ± 885.3 to 314.6 ± 109.9 µmol/L) of patients with MSUD, while ammonia levels were significantly decreased in patients with UCD and OA (from 1279.9 ± 612.1 to 85.1 ± 21.6 µmol/L). The most frequent complications of CKRT were thrombocytopenia (60.7%), hypotension (53.6%), and hypocalcemia (42.9%). Median age of patients with hypotension treated with vasoactive medications was significantly lower than median age of those with normal blood pressure. Conclusion CKRT is a reliable approach for effective and rapid removal of toxic metabolites in children with IEM, and CKRT modalities can be safely used and are well-tolerated in infants.
Infectious Diseases, 2021
Abstract Background Invasive aspergillosis (IA) is an important cause of morbidity and mortality ... more Abstract Background Invasive aspergillosis (IA) is an important cause of morbidity and mortality in immunosuppressed children. Early detection of the infection can improve prognosis in this patient population. Objectives To investigate the utility of Aspergillus galactomannan antigen assay (GM-EIA) as a diagnostic tool for IA in at-risk paediatric patients. Patients/Methods For the study, 659 GM-EIA results from 59 patients diagnosed with IA and 3368 GM-EIA results from 351 subjects without evidence for IA (controls) were reviewed retrospectively. Three cut-off values (i.e. ≥0.5, ≥1, ≥1.5) were specified to determine GM-EIA positivity. Results The median age was 6.3 years for boys and 14.5 years for girls. There was a significant difference between the girls and boys in terms of age (p < 0.01). For proven/probable/possible IA patients, sensitivity of 67.8% and specificity of 59.8% were detected when the ≥0.5 cut-off value was used for GM-EIA-positivity. The specificity increased to 80% at the cut-off of ≥1 and to 88% at the cut-off of ≥1.5. False positivity rates were 9.14, 3, and 1.45% at the ≥0.5, ≥1 and ≥1.5 cut-offs respectively. In the proven/probable IA group, sensitivity and negative predictive values were 86.9 and 97.2% at the ≥0.5 cut-off, 85.7 and 97.9%, at the ≥1 cut-off and 84.2 and 98.1% at ≥1.5 cut-off respectively. The positive likelihood ratio was 7.57 and the odds ratio was 42.67 at ≥1.5 cut-off. Conclusion The GM-EIA may be used for both screening and diagnostic purposes in paediatric patients using a cut-off value of ≥1.5 for GM-EIA positivity.
Sepsis, yenidoganda onemli bir morbidite ve mortalite nedenidir. Baslangicta bulgular silik olmak... more Sepsis, yenidoganda onemli bir morbidite ve mortalite nedenidir. Baslangicta bulgular silik olmakla birlikte, klinik seyir hizla kotulesebilmekte ve saatler icinde olume neden olabilmektedir, bu nedenle yenidogan sepsisinde hizli ve dogru tani koymak onem tasimaktadir. Gunumuzde sepsisin erken saptanmasinda tek basina yeterli bir gosterge bulunmamaktadir. Sepsiste inflamatuar yollarin daha iyi anlasilmasi ve tanisal teknolojideki hizli gelismeler ile pek cok infeksiyon gostergesi arastirilmaktadir. Bu calismanin amaci, gec neonatal sepsis dusunulen bebeklerde, tani esnasinda, klinik izlem sirasinda ve tedavi bitiminde serum suPAR duzeylerinin calisilmasi, diger laboratuar testleri ile karsilastirildiginda serum suPAR duzeylerinin katkisinin incelenmesidir. Calisma, prospektif kohort bir calismadir. Gec neonatal sepsis tanisi alan bebeklerde tani aninda, 72.saat ve tedavi bitiminde serum suPAR duzeyleri degerlendirildi. Serum suPAR duzeyleri diger laboratuvar parametreleri i...
Journal of Trace Elements in Medicine and Biology, 2021
PONTE International Scientific Researchs Journal, 2018
Genetic counseling (Geneva, Switzerland), 2009
The Fukuyama type congenital muscular dystrophy (FCMD) is a rare autosomal recessive disorder cha... more The Fukuyama type congenital muscular dystrophy (FCMD) is a rare autosomal recessive disorder characterized by cranial, cerebellar and ocular malformations and congenital muscular dystrophy. Hyperekplexia is characterized by transient, generalized rigidity in response to unexpected loud noises or sudden tactile stimulation. Herein, we report an infant who had typical clinical features of FCMD with hyperekplexia. Our purpose is to draw attention to this first report of concomitant FCMD and hyperekplexia.
Early Human Development, 2014
10% to 30%, in Canada from 11% to 19.5%, in Germany from 15% to 17%, in France 15%. In the North ... more 10% to 30%, in Canada from 11% to 19.5%, in Germany from 15% to 17%, in France 15%. In the North Eastern Italy it is reported as 17.9%, in Friuli Venezia Giulia 19.7%, in Palermo 8%. The number of women (76 with term delivery + 9 with preterm delivery) who had positive swabs in our data is only 7.9% (85/1075). It's reasonable to believe that the high number of not tested pregnant mystifies the rates of colonization and the risk for newborns. IAP is the key therapy to prevent GBS early onset sepsis and criteria for administration are reported in CDC guidelines 2010. Our data demonstrate that nevertheless IAP was indicated in 93 mothers of term newborns, only 44% (41/93) received it correctly, while 56% (52/93) didn't received it. Between mothers who delivered prematurely and needed IAP, only 12% (10/84) received it correctly. Conclusions: Our data demonstrate a lack of adherence of clinical management to international guidelines. It's evident the necessity to prevent GBS sepsis in newborn by improving protocol adherence and surveying constantly clinical practice.
Early Human Development, 2012
The aim of the study was to determine the clinical risk factors to predict the progress of TTN in... more The aim of the study was to determine the clinical risk factors to predict the progress of TTN in late-preterm and term infants. Design: The diagnosis of TTN was established based on: (i) onset of tachypnea within 6 h after birth, (ii) persistence of tachypnea for at least 12 h, (iii) chest x-ray findings, (iv) exclusion of all other known respiratory disorders. The late-preterm and term infants who were diagnosed as TTN were evaluated retrospectively in last two years. Patients were divided into two groups according to the intensity of respiratory support. Infants in group 1 received invasive or non-invasive ventilatory support, where group 2 needed only oxygen. Clinical findings, Richardson and Silverman scores were compared between the groups. Results: In last two years 554 late-preterm and term infants admitted to NICU. One-hundred-six (19.1%) infants were diagnosed as TTN (50 late-preterm, 56 term infants). There were 68 (64%) infants in group 1, and 38 (36%) in group 2. Mean gestational age and birth weight were lower in group 2 (p< 0.05). The incidence of C/S (87% vs 92%) and male gender was similar in both groups. Richardson scores, Silverman scores, peak respiratory rates (pRR) and oxygen need (FiO2) in the first 24 hours were statistically higher, duration of total respiratory support and hospitalisation were statistically longer in group 1 (p < 0.001). Nine infants were experienced air leak and 5 infants received surfactant in group 1, where none of the infants in group 2 did. The cutoff for Richardson score was 3 and the patients whose score higher than 3 had a 6.98-fold risk, the cutoff for Silverman score was 5 and whose score higher than 5 had a 7.46-fold risk, and the cutoff for pRR in first 24 hours was 75/min and whose pRR was higher than 75/min in first 24-hours had a 1.10-fold risk of receiving ventilatory support (95% CI: 2.30-21.18, 2.54-21.89, and 1.035-1.17, p < 0.01, respectively). Conclusion: TTN, is usually a benign and self-limited disease and the prognosis is generally excellent. But associated hypoxaemia, respiratory failure and air leak syndromes may increase the risk of morbidity and duration of hospitalisation. Assessment of Richardson score, Silverman score, and pRR in first 24-hours of patients may be useful in predicting clinical course of TTN. So by predicting of the intensity for ventilatory support in the patients, it is important to plan and provide the appropriate level of care for these infants.
Early Human Development, 2012
Journal of Clinical Laboratory Analysis, Jul 10, 2014
Journal of Ankara University Faculty of Medicine
Objectives: Despite improvements in neonatal care and survival of preterm infants, the incidence ... more Objectives: Despite improvements in neonatal care and survival of preterm infants, the incidence of bronchopulmonary dysplasia (BPD) is not decreasing. The aim of this study was to evaluate the impact of initial mode of respiratory support on BPD in extremely low birth weight (ELBW) infants. Materials and Methods: ELBW infants admitted to neonatal intensive care unit were analyzed retrospectively between 2014 and 2017. The effects of initial respiratory support options and morbidities on BPD were evaluated between infants who developed BPD or not. Results: Total 101 infants were evaluated, and 68 were included. For those whose incidence of BPD was 46%, the mean gestational age and birth weight were 27.8±1.8 weeks and 814±118 g, respectively. Patients with BPD (n=31) had a lower mean gestational age and birth weight, higher rates of necrotizing enterocolitis and retinopathy of prematurity (p<0.001, p=0.012, p=0.024, and p=0.018, respectively). Requirement of surfactant and need for invasive respiratory support initially after birth were found to be major risk factors for BPD. The duration of invasive ventilation after birth was longer in patients with BPD (p=0.034). BPD or death occurred in 66 of 101 infants. Infants received non-invasive respiratory support after birth had a lower risk for BPD, and BPD or death. Conclusion: To prevent the development of BPD in ELBW infants, the respiratory support should be non-invasive after birth, and if the infant is intubated, duration of invasive respiratory support should be shortened for less than 3 days.
Frontiers in Pediatrics
Background:The umbilical cord blood contains a high concentration of stem cells. There is not any... more Background:The umbilical cord blood contains a high concentration of stem cells. There is not any published study evaluating the amount of stem cells that have the potential to be transferred to the infant through placental transfusion methods as delayed cord clamping (DCC) and umbilical cord milking (UCM). The aim of this study is to measure the concentrations of endothelial progenitor cell (EPC) and CD34+ hematopoietic stem cell (HSC) in the placental residual blood volume (PRBV), and evaluate the delivery room adaptation and cerebral oxygenation of these infants.MethodsInfants with ≥36 gestational weeks were randomized to receive DCC (120 s), UCM, or immediate cord clamping (ICC). EPC and CD34+ HSC were measured by flow cytometry from the cord blood. PRBV was collected in the setup. The cord blood gas analysis and complete blood count were performed. The heart rate (HR), oxygen saturation (SpO2), and cerebral regional oxygen saturation (crSO2) were recorded.ResultsA total of 103 ...
Zeitschrift für Geburtshilfe und Neonatologie
We aimed to compare the definitions of National Institute of Child Health and Human Development (... more We aimed to compare the definitions of National Institute of Child Health and Human Development (NICHD) for bronchopulmonary dysplasia (BPD) for determining the incidences, and predicting late death and respiratory outcome. This retrospective cohort study included infants born at<32 weeks’ gestation who survived up to 36 weeks’ postmenstrual age (PMA). Infants were classified as having BPD or no BPD per thedefinitions of NICHD 2001 and 2018. The incidences of BPD were 49 and 32% according to the 2001 and 2018 NICHD definitions. Gestational age, birth weight and intubation after birth were associated with BPD by both definitions. The NICHD 2018 definition displayed similar sensitivity (100%) and negative predictive value (100%), and higher specificity (70 vs. 52%) for predicting death after 36 weeks’ PMA; a higher specificity (72 vs. 53%), comparable negative predictive value (77 vs.76%), but lower sensitivity for predicting adverse respiratory outcome within 12 months corrected a...
Journal of Clinical Research in Pediatric Endocrinology, 2021
What is already known on this topic? Late neonatal hypocalcemia occurs after the first 72 hours a... more What is already known on this topic? Late neonatal hypocalcemia occurs after the first 72 hours and the most common causes include excessive phosphate intake, hypomagnesemia, hypoparathyroidism, and vitamin D deficiency. What this study adds? Maternal vitamin D deficiency was found to be the most common cause of late neonatal hypocalcemia in our study. Due to the immaturity of regulating factors of parathormone and calcium, serum iPTH levels may not reach expected levels and serum phosphorus levels may remain high in vitamin D deficient neonates, posing a diagnostic dilemma by mimicking primary hypoparathyroidism.
Objective: To investigate the morbidity pattern of late preterm infants (born between 34(0/7) and... more Objective: To investigate the morbidity pattern of late preterm infants (born between 34(0/7) and 36(6/7)) born in Obstetric and Gynecology Department or in an another hospital and admitted to Neonatal Intensive Care Unit (NICU). Methods: Hospital records of maternal age, parity, use of reproductive techniques, gestation week, birth type, birth weight, neonatal problems and reasons for hospitalization, length of stay at hospital, rehospitalization rates of late preterm infants admitted to NICU between the period of January 1 and December 31, 2007 were reviewed retrospectively. Results: At Obstetric and Gynecology Department, 1852 infants were born in the 12-month period; 1556 (84%) were full-term and 296 (16%) were preterm. One hundred seventy four infants were late preterm and late preterm delivery rate was 9.4%. NICU admission rate was 10% and 36.2% for full-term and late preterm infants, respectively. Seventeen of 80 late preterm infants admitted from another hospital. Mean mater...
Objective: We aimed to define the clinical and epidemiological features of neonates hospitalized ... more Objective: We aimed to define the clinical and epidemiological features of neonates hospitalized in the neonatal care unit with virus-related to lower respiratory tract infections in this study. Material and Methods: The neonates who were hospitalized with lower respiratory tract infection between January 2014 and December 2015 were evaluated for clinical features and the viruses were identified on multiplex reverse transcription polymerase chain reaction using nasal swab samples. Neonates with congenital heart disease, malformation of the respiratory tract, immune deficiency and nosocomial virus infection were excluded. Results: Eighty-one (4.6%) of 1768 neonates were admitted to NICU with lower respiratory tract infection during the study period. In 56 of 81 patients, a virus was identified from the nasal swab sample. Respiratory syncytial virus (RSV) was the most common etiology (80.4%, n=45), four patients had RSV co-infection (7.1%), and seven patients had a virus other than RS...
Güncel Pediatri, 2021
Giriş: Yenidoğan sarılığında kan değişimi, yaşamsal önemde ancak riskleri olan girişimsel bir işl... more Giriş: Yenidoğan sarılığında kan değişimi, yaşamsal önemde ancak riskleri olan girişimsel bir işlemdir. Kan değişimi gerektirecek hiperbilirubinemi gelişiminin önlenmesi öncelikli yaklaşımdır. Çalışmamızda şiddetli hiperbilirubinemide, kan değişimi risk faktörleri ve ileri dönem nörogelişimsel durumun araştırılması amaçlanmıştır. Gereç ve Yöntem: Total serum bilirubin değeri Amerikan Pediatri Akademisi rehberine göre kan değişimi sınırında veya sınırın üstünde, 35 ve üstü gestasyonel hafta doğumlu 104 yenidoğan çalışmaya dahil edildi. Olguların 12-36 ayındayken ulaşılabilen 65'ine Gelişimi İzleme ve Destekleme Rehberi uygulandı. Kan değişimi uygulanan ve uygulanmayanlar sosyodemografik özellikler, risk faktörleri, etiyoloji, tedavi süreçleri ve ileri dönem nörogelişimsel durum açılarından karşılaştırıldı. Bulgular: Kan değişimi olguların %18,3'ünde uygulandı. Başvuru total serum bilirubin ve bilirubin/albümin oranı yüksekliği kan değişimi riskini arttıran temel değişkenlerdi. Kan değişimi riskini artıran eşik değerler, total serum bilirubinde 26,43 mg/dl ve bilirubin albümin oranında 7,43 mg/g saptandı. Sarılık etiyolojisinde ilk üç sırada; hemolitik hastalık, dehidratasyon ve erken anne sütü sarılığı ile prematürelik saptandı. Etiyolojilerle tedavi şekilleri arasında anlamlı ilişki bulunmadı. Postnatal 96 saatten sonra hastaneye başvuranların istatistiksel anlamlı yüsek bilirubinle (≥25 mg/dl) yattığı görüldü. On iki-otuz altı ayında değerlendirilen 65 olgunun %13,8'inde farklı alanlarda gelişimsel gecikme saptandı. Başvuru zamanı, tedavi şekilleri, total serum bilirubin ve bilirubin albümin oranıyla nörogelişimsel durum arasında anlamlı farklılık saptanmadı. Sonuç: Kan değişimi için başlıca risk faktörleri yüksek total serum bilirubin ve bilirubin albümin oranı bulundu. Hastaneye geç başvuranların daha sıklıkla ciddi hiperbilirubinemiyle yatması, taburculuk öncesi riskli grubun saptanması temel yaklaşımının önemini vurgulamaktadır. Ciddi hiperbilirubinemili olgular gelişimsel gecikmeler için riskli sayılmalı, düzenli izlem ve erken tanıyla müdahale fırsatları kaçırılmamalıdır. Anah tar ke li me ler Hiperbilirubinemi, kan değişimi, nörogelişim, yenidoğan
Pediatric Nephrology, 2021
Background Continuous kidney replacement therapies (CKRT) have been reported to be an effective a... more Background Continuous kidney replacement therapies (CKRT) have been reported to be an effective approach to removing toxic metabolites in inborn errors of metabolism (IEM). The present study evaluates efficiency and complications of CKRT in children with IEM. Methods Patients diagnosed with IEM who underwent CKRT in pediatric and neonatal intensive care units were analyzed. CKRT were initiated in patients with persistently high blood ammonia levels (≥ 500 μmol/L), blood ammonia levels > 250 μmol/L in the presence of moderate encephalopathy, high blood leucine levels (≥ 1500 μmol/L), and blood leucine levels < 1500 μmol/L in the presence of deteriorating neurological status or persistent metabolic acidosis. Results Of 22 patients enrolled, nine (40.9%) Maple syrup urine disease (MSUD), eight (36.4%) urea cycle disorders (UCD), and five (22.7%) organic acidemias (OA). Median age was 72.3 [9.9-1040.8] days. In total, 28 dialysis sessions were analyzed [16 (57.1%) continuous venovenous hemodialysis, and 12 (42.9%) continuous venovenous hemodiafiltration]. A significant decrease was noted in leucine levels (from 1608.4 ± 885.3 to 314.6 ± 109.9 µmol/L) of patients with MSUD, while ammonia levels were significantly decreased in patients with UCD and OA (from 1279.9 ± 612.1 to 85.1 ± 21.6 µmol/L). The most frequent complications of CKRT were thrombocytopenia (60.7%), hypotension (53.6%), and hypocalcemia (42.9%). Median age of patients with hypotension treated with vasoactive medications was significantly lower than median age of those with normal blood pressure. Conclusion CKRT is a reliable approach for effective and rapid removal of toxic metabolites in children with IEM, and CKRT modalities can be safely used and are well-tolerated in infants.