Information on the use of high-frequency oscillatory ventilation in neonatal surgeries is very ra... more Information on the use of high-frequency oscillatory ventilation in neonatal surgeries is very rare. In this report, we discuss two pre-term infants who had to receive high-frequency oscillatory ventilation as a rescue treatment due to severe pre-maturity. These two cases underwent successful bedside patent ductus arteriosus ligation under high-frequency oscillatory ventilation, and this shows us that patent ductus arteriosus ligation can be performed successfully in neonates even under high-frequency oscillatory ventilation.
journal of anatolia nursing and health sciences, 2007
Arastirma cocuk kliniklerindeki refakatcilerin hastanede yasadiklari sorunlari, beklentileri ve p... more Arastirma cocuk kliniklerindeki refakatcilerin hastanede yasadiklari sorunlari, beklentileri ve problem cozme duzeyleri ile iliskisini degerlendirmek, sosyodemografik ozelliklerle karsilastirmak amaciyla, Ataturk Universitesi Yakutiye Arastirma Hastanesi Cocuk Kliniginin butun bolumlerinde Şubat-Mayis 2004 tarihleri arasinda basit rastgele ornekleme yontemi ile secilen toplam 269 refakatci uzerinde tanimlayici olarak yapilmistir. Veriler, bir soru formu ve Problem Cozme Envanteri ile elde edilmis, yuzdelik, varyans (ANOVA), Kruskal-Wallis varyans analizi, MannWhitney U testi, t testi ve ileri istatistiksel analiz yontemi (Bonferroni) ile degerlendirilmistir. Refakatcilerin % 27.1’inin hicbir sorunu olmadigi bulunmustur. Diger yandan %24.9’unun temizlik, %19.3’unun dinlenme, % 5.9’unun ibadetle ilgili sorunlari oldugu belirlenmistir. Calisma kapsamina alinan refakatcilerin guleryuz, hosgoru (% 31.2), dinlenme odasinin temizligi ve duzenlenmesi gibi bazi beklentileri oldugu belirlenmi...
Aim: Survival and complications are very sensitive in preterm infants. Any negative situation in ... more Aim: Survival and complications are very sensitive in preterm infants. Any negative situation in the preterms can lead to unintended consequences. In this study, it was aimed to analyze the data on demographic characteristics, complications, morbidity, mortality, and weight monitoring information of a high number of preterm neonates. Material and Methods: A total of 1091 preterm newborns born before the 37th gestational week in our tertiary care hospital were included in the study. All data were analyzed from hospital records. The weights of the newborns at birth, on the 7th, 15th, and 30th days were recorded.. Results: Of the newborns, 39 (3.6%) died within 30 days after delivery. The cesarean section rate was 91.7%. While 7.9% of the preterms had birth weight below 1000 grams, the preterm rate in normal birth weight (>2500 g) was 15.6%. The mean birth weight was 1909.76 g, the first day mean weight loss was 0.6%, the first 3-day mean weight loss was 3.8% and the first 7-day mean weight loss was 2.5%. The mean birth weight in late preterm infants was significantly lower than in those who were born in the following weeks, while the mean birth weight in late preterm births was significantly higher than in those born before (p<0.001). Discussion: We found that preterm infants and those with lower birth weight had a worse prognosis, and that weight gain after birth was associated with prognosis. We believe that data obtained from our study may be a guide for clinicians and researchers.
The Journal of Maternal-Fetal & Neonatal Medicine, 2019
To determine whether there is any association between platelet indices within the first hours of ... more To determine whether there is any association between platelet indices within the first hours of life and hemodynamically significant patent ductus arteriosus (hsPDA) in preterm newborns. Patient and methods: A total of 100 preterm infants, gestational age <32 weeks and birth weight <1500 grams were analyzed in the study. Complete blood counts obtained within the first six hours of life were evaluated for platelet parameters and compared for PDA status.
Thyroid functions in the fetus and newborn carry importance in terms of the baby's health and dev... more Thyroid functions in the fetus and newborn carry importance in terms of the baby's health and development of the central nervous system. Maternaliodine deficiency, exposure to iodine, thyroid diseases (Hashimoto thyroiditis, Graves') and drugs used by the mother affect thyroid functions in the fetus. Reflections of these effects are observed immediately after delivery. Investigation of the mother in terms of thyroid diseases during pregnancy, recognition and appropriate assessment of the required conditions, screening of all newborns in the first days of life in terms of congenital hypothyroidism, timely and appropriate evaluation of the screening results, early diagnosis and appropriate treatment of cases of congenital hypothyroidism, assessment and management of cases of transient thyroid hormone disorders and close monitoring of the thyroid functions and development of patients in whom treatment has been initiated with a diagnosis of hypothyroidism are crucial in terms of developmental outcomes of the babies who have thyroid function disorders or hypothyroidism. This guideline was written with the objective of guiding pediatricians, neonatologists and pediatric endocrinologists in the issue of assessment, diagnosis and management of thyroid function disorders and thyroid diseases concerning the fetus and baby during gestation and neonatal period.
Yılmaz-Semerci S, Demirel G, Taştekin A. Wickerhamomyces anomalus blood stream infection in a ter... more Yılmaz-Semerci S, Demirel G, Taştekin A. Wickerhamomyces anomalus blood stream infection in a term newborn with pneumonia. Turk J Pediatr 2017; 59: 349-351. The incidence of invasive candidiasis is high in neonates admitted to neonatal intensive care unit and is associated with significant morbidity and mortality rates. Candida albicans is the most common fungal agent pathogenic to neonates but invasive fungal infections caused by uncommon fungi have increased in recent years. Wickerhamomyces anomalus is a very rare pathogen causing blood stream infection in neonates, which has reportedly caused only few cases in the literature. Here we report a case of blood stream infection caused by a fungal agent Wickerhamomyces anomalus in a term male infant.
Nicolau syndrome (NS) is a rare complication of intramuscular, intraarticular or subcutaneous inj... more Nicolau syndrome (NS) is a rare complication of intramuscular, intraarticular or subcutaneous injection of particular drugs leading to ischemic necrosis of the surrounding skin, soft tissue and muscular tissue. Benzathine penicilin one of the most widely used antibiotic for upper respiratory tract infections and has been rarely reported to cause NS. Here we describe a 4 year old boy with diagnosis of NS after the injection of benzathine penicillin who was successfuly treated with unfractionized heparin (enoxaparine) and pentoxifylline. The practitioners should pay attention for unnecessary use of benzathine penicillin to avoid from probable complications.
Purpose: To investigate the longitudinal change in intraocular pressure (IOP) in premature infant... more Purpose: To investigate the longitudinal change in intraocular pressure (IOP) in premature infants and to establish a normative IOP value. Methods: Forty premature infants with a gestational age (GA) of 26 weeks were enrolled in this longitudinal study. Measurements were taken initially at 28 weeks postconceptional age (PCA) and at 2-week intervals up to 40 weeks PCA. Intraocular pressure was measured with a hand-held tonometer (Tono-Pen XL; Reichert Inc.). Results: From 40 (22 male, 18 female) premature Caucasian infants, seven (for each eye) IOP measurements were obtained. Mean GA was 26 weeks and mean birthweight was 820 ± 112 grams. The mean IOP was 15.1 ± 1.2 mm Hg and 14.9 ± 1.1 mm Hg for the right and left eyes, respectively. The mean IOP in both eyes for all measurements was 15.0 ± 1.1 mm Hg. At 28 weeks PCA, 9 (22.5%) preterm infants had IOP values greater than 20 mm Hg. The mean IOPs at 28 weeks, 30 weeks, 32 weeks, 34 weeks, 36 weeks, 38 weeks, and 40 weeks PCA were 18.7 ...
Hemangiopericytoma is a rare mesenchymal tumor originating from capillary pericytes, known as Zim... more Hemangiopericytoma is a rare mesenchymal tumor originating from capillary pericytes, known as Zimmermann pericytes. The adult form is not uncommon and generally malignant but tumor is found rarely in children. Here we describe an intracranial hemangiopericytoma in a preterm newborn whose had the tumor resected successfully shortly after birth.
The Journal of Maternal-Fetal & Neonatal Medicine, 2017
Purpose: To compare the antioxidant status of three cord clamping procedures (early clamping, del... more Purpose: To compare the antioxidant status of three cord clamping procedures (early clamping, delayed clamping and milking) by analyzing the thiol-disulfide balance. Patients and methods: This randomized controlled study enrolled 189 term infants who were divided into three groups according to the cord clamping procedure: early clamping, delayed clamping and milking. Blood samples were collected from the umbilical arteries immediately after clamping, and the thiol/disulfide homeostasis was analyzed. Results: The native and total thiol levels were significantly (p < .05) lower in the early cord clamping group compared with the other two groups. The disulfide/total thiol ratio was significantly (p ¼ .026) lower in the delayed cord clamping and milking groups compared with the early clamping groups. Early cord clamping causes the production of more disulfide bonds and lower thiol levels, indicating that oxidation reactions are increased in the early cord clamping procedure compared with the delayed cord clamping and milking procedures. Conclusion: The oxidant capacity is greater with early cord clamping than with delayed clamping or cord milking. Delayed cord clamping or milking are beneficial in neonatal care, and we suggest that they be performed routinely in all deliveries.
Prilocaine is a strong local anesthetic, widely used in children and adults in cream or injectabl... more Prilocaine is a strong local anesthetic, widely used in children and adults in cream or injectable form. In the literature, there have been many case reports presenting patients developing acquired methemoglobinemia during its usage in therapeutic doses. In this paper, we report an infant who developed methemoglobinemia after prilocaine injection for local anesthesia and treated successfully with oral methylene blue.
Background: There are limited data about the results of repeated oral ibuprofen (OIBU) treatment.... more Background: There are limited data about the results of repeated oral ibuprofen (OIBU) treatment. This study aimed to describe patent ductus arteriosus (PDA) closure rates and adverse events after repeated courses of OIBU in premature infants with PDA. Methods: Preterm infants with hemodynamically significant (hs)PDA were enrolled in the study. If the first course of OIBU treatment failed, a second and, if required, third course was administered. Results: A total of 100 patients received OIBU. In six patients, treatment could not be completed due to death (n Z 3) and side effects (n Z 3). In three patients, adverse effects related to OIBU (thrombocytopenia and impairment of renal function) developed during the first course. During the second and third courses, no new adverse event occurred. After all courses, the PDA closure rate was determined as 88%. The rate was 71% after the first course, 40% after the second course, and 35% after the third course. Although the second course resulted in a significant increase in the closure rate (p < 0.05), the rate did not increase significantly with the third course (p > 0.05). The mean postnatal age at the start of the first dose of OIBU was not significantly different among the responders and non-responders to the first course (p > 0.05). Clinical characteristics did not affect the closure rate significantly. The number of courses did not have a significant effect on death, when gestational age and birth weight were used as covariates [p Z 0.867, Exp(B) Z 0.901, 95% confidence interval Z 0.264e3.1]. Conclusion: A second course of OIBU seems effective and safe for use in preterm infants with hsPDA. Although a third course of OIBU results in PDA closure in some additional patients, the
Introduction: The aim of this study was evaluation of broncoscopic findings in children with cong... more Introduction: The aim of this study was evaluation of broncoscopic findings in children with congenital heart disease(CHD). Method: Bronchoscopy was performed in 37 patients with CHD who were followed between October 2012–December 2014 in our hospital. The data obtained from these patients were evaluated retrospectively. Results: Twenty-one of the patients were males and 16 were females, median ages 12.5 mo (1-36m). Twenty-seven patients (72.9 %) were operated for congenital heart disease. Twelve of the patients had pulmonary hypertension. Bronchoscopy was performed because of extubation failure, atelectasis, recurrent or persistant pneumonia, stridor and persistant cough; 17,7,7,4 and 2, respectively. Laryngomalacia, tracheomalacia, bronchomalacia, tracheal stenosis, airway branch anomalies, granulation tissue formation and pulsatile airway pressure was determined in flexible bronchoscopy, 13,12,8,4,17,7 and 10, respectively. Twenty-seven of the patients were followed with mechanical ventilation(MV). MV duration before and after bronchoscopy was median 30 and 12 days, respectively. Tracheostomy was performed in 15 cases. After bronchoscopy five of these patients were removed from tracheostomy. Eleven out of the patients had positive culture in bronkoalveolar lavage. Patients were discharged with room air, tracheostomy with room air, only with supplemental oxygen, tracheostomy with supplemental oxygen; 19(51.3%), 6(16.2%), 1(2.7%),1(2.7%), respectively. One patient was following intubated with ventilatory support. Nine patients died. Conclusions: Airway anomalies were more frequently encountered in patients with congenital heart disease.
McKusick-Kaufman syndrome is a rare syndrome inherited in an autosomal recessive pattern with a p... more McKusick-Kaufman syndrome is a rare syndrome inherited in an autosomal recessive pattern with a phenotypic triad comprising hydrometrocolpos, postaxial polydactyly and congenital cardiac disease. The syndrome is caused by mutations in the MKKS gene mapped onto chromosome 20p12. Diagnosis of this syndrome is based on clinical and imaging findings. In our paper, we have presented the first McKusick-Kaufman syndrome patient accompanied by congenital laryngomalacia, intestinal malrotation and hypothalamic hamartoma as well as postaxial polydactyly, hydrometrocolpos in the neonatal period.
To investigate the effects of L-carnitine (LC) on rats with oxygen-induced retinopathy. Materials... more To investigate the effects of L-carnitine (LC) on rats with oxygen-induced retinopathy. Materials and methods: The study was conducted on 40 Sprague Dawley rat pups. The rat pups were randomly divided into 4 groups: group 1 (n = 10), the healthy control group with intraperitoneal 0.1 mL/day physiological saline injection; group 2 (n = 10), exposed to hyperoxygen, did not receive LC but received 0.1 mL/day physiological saline intraperitoneally; group 3 (n = 10), exposed to hyperoxygen and received 100 mg/kg/day LC intraperitoneally; group 4 (n = 10), exposed to hyperoxygen and received 200 mg/kg/ day LC intraperitoneally. After postnatal day 20, the rat pups were killed and an histological examination was performed on the eyes, in addition to the detection of plasma malondialdehyde (MDA) levels. Results: The retinal and choroidal histopathological changes due to hyperoxygen were less in group 3 and minimal in group 4 compared with group 2. Compared with the healthy control group, the increase in the MDA levels in group 2 was significant (P < 0.05). Compared with group 2 there was a significant (P < 0.05) decrease in the MDA levels in groups 3 and 4. Conclusion: LC has beneficial effects on oxygen-induced retinopathy in rats in terms of histopathological changes and MDA levels.
The aim of this study was to investigate the effect of the application of the odor of breast milk... more The aim of this study was to investigate the effect of the application of the odor of breast milk in preterm infants during gavage feeding on the period of transition to total oral feeding. Design: This prospective experimental study was performed on a total of 80 preterm infants: 40 infants in the study group and 40 in the control group. Methods: This experimental study was performed in eastern Turkey at the Neonatal Intensive Care and Premature Unit of a university hospital between September 2007 and December 2008. The demographic data were collected via a questionnaire, and an intervention and follow-up table was prepared by the researcher based on relevant literature. The study was approved by the local institution, and written informed consent was obtained from all parents. Findings: The findings of the study indicated that the preterm infants who were stimulated by the odor of breast milk during gavage feeding transitioned to oral feeding 3 days earlier than control subjects. Moreover, the mean hospitalization time of these infants was 4 days shorter. Conclusions: The results show that stimulation with breast milk odor is an effective method for decreasing transition of preterm infants from gavage to oral feeding. Clinical Relevance: Nurses can train mothers to pump their breast milk, stimulate their infants with the odor of their breast milk, and feed it to their infants in the premature unit. This may lead to a quicker transition to oral feeding.
NICU nurses should be able to protect high-risk newborns from the sensorial stimuli which create ... more NICU nurses should be able to protect high-risk newborns from the sensorial stimuli which create toxic stress within the physical environment (3-5). In order to protect high
To the Editor — Sreenan et al1 should be complimented for publishing a study that has important p... more To the Editor — Sreenan et al1 should be complimented for publishing a study that has important practical implications. There is no doubt that if one could establish that high-flow nasal cannula (HFNC) oxygen is as effective and safe and better tolerated than nasal continuous positive airway pressure (nCPAP), it would make the administration of continuous positive airway pressure (CPAP) simpler and cheaper. However, I wish to discuss certain aspects of the study which, I feel, have not been adequately addressed by the authors. The authors enrolled the subjects only after they had already been on nCPAP for at least 24 hours. The need for this pre-enrollment nCPAP and the upper limit of its duration are not mentioned. This is despite the fact that the natural course of the disease could change over this duration and the pre-enrollment nCPAP does not serve any purpose in the study. If the authors had enrolled patients immediately after the decision …
Chickenpox is due to infection with the varicella zoster virus (VZV), a human alphaherpervirus fo... more Chickenpox is due to infection with the varicella zoster virus (VZV), a human alphaherpervirus found worldwide. Classically, the cinical disease is a febrile illness with a pruritic vesicular rash. Maternal chickenpox between 5 days before delivery to 2 days after delivery (perinatal varicella) can cause severe and even fatal illness in the newborn. A 7-day old girl baby presented on day 4 of postnatal with the complaints of widespread vesicular rash and non-suckling. Mother of the baby also had a similar eruption four day prior to delivery, which was clinically characteristic of varicella. Considering history and clinical presentation, a diagnosis of perinatal chickenpox was considered and the baby was treated with acyclovir which she responded and recovered. Herein, the clinical feasures and treatment of chickenpox infection in the perinatal period have been emphasized with this case report.
Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants disc... more Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey. Material and methods dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers. Conclusion The present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs.
Information on the use of high-frequency oscillatory ventilation in neonatal surgeries is very ra... more Information on the use of high-frequency oscillatory ventilation in neonatal surgeries is very rare. In this report, we discuss two pre-term infants who had to receive high-frequency oscillatory ventilation as a rescue treatment due to severe pre-maturity. These two cases underwent successful bedside patent ductus arteriosus ligation under high-frequency oscillatory ventilation, and this shows us that patent ductus arteriosus ligation can be performed successfully in neonates even under high-frequency oscillatory ventilation.
journal of anatolia nursing and health sciences, 2007
Arastirma cocuk kliniklerindeki refakatcilerin hastanede yasadiklari sorunlari, beklentileri ve p... more Arastirma cocuk kliniklerindeki refakatcilerin hastanede yasadiklari sorunlari, beklentileri ve problem cozme duzeyleri ile iliskisini degerlendirmek, sosyodemografik ozelliklerle karsilastirmak amaciyla, Ataturk Universitesi Yakutiye Arastirma Hastanesi Cocuk Kliniginin butun bolumlerinde Şubat-Mayis 2004 tarihleri arasinda basit rastgele ornekleme yontemi ile secilen toplam 269 refakatci uzerinde tanimlayici olarak yapilmistir. Veriler, bir soru formu ve Problem Cozme Envanteri ile elde edilmis, yuzdelik, varyans (ANOVA), Kruskal-Wallis varyans analizi, MannWhitney U testi, t testi ve ileri istatistiksel analiz yontemi (Bonferroni) ile degerlendirilmistir. Refakatcilerin % 27.1’inin hicbir sorunu olmadigi bulunmustur. Diger yandan %24.9’unun temizlik, %19.3’unun dinlenme, % 5.9’unun ibadetle ilgili sorunlari oldugu belirlenmistir. Calisma kapsamina alinan refakatcilerin guleryuz, hosgoru (% 31.2), dinlenme odasinin temizligi ve duzenlenmesi gibi bazi beklentileri oldugu belirlenmi...
Aim: Survival and complications are very sensitive in preterm infants. Any negative situation in ... more Aim: Survival and complications are very sensitive in preterm infants. Any negative situation in the preterms can lead to unintended consequences. In this study, it was aimed to analyze the data on demographic characteristics, complications, morbidity, mortality, and weight monitoring information of a high number of preterm neonates. Material and Methods: A total of 1091 preterm newborns born before the 37th gestational week in our tertiary care hospital were included in the study. All data were analyzed from hospital records. The weights of the newborns at birth, on the 7th, 15th, and 30th days were recorded.. Results: Of the newborns, 39 (3.6%) died within 30 days after delivery. The cesarean section rate was 91.7%. While 7.9% of the preterms had birth weight below 1000 grams, the preterm rate in normal birth weight (>2500 g) was 15.6%. The mean birth weight was 1909.76 g, the first day mean weight loss was 0.6%, the first 3-day mean weight loss was 3.8% and the first 7-day mean weight loss was 2.5%. The mean birth weight in late preterm infants was significantly lower than in those who were born in the following weeks, while the mean birth weight in late preterm births was significantly higher than in those born before (p<0.001). Discussion: We found that preterm infants and those with lower birth weight had a worse prognosis, and that weight gain after birth was associated with prognosis. We believe that data obtained from our study may be a guide for clinicians and researchers.
The Journal of Maternal-Fetal & Neonatal Medicine, 2019
To determine whether there is any association between platelet indices within the first hours of ... more To determine whether there is any association between platelet indices within the first hours of life and hemodynamically significant patent ductus arteriosus (hsPDA) in preterm newborns. Patient and methods: A total of 100 preterm infants, gestational age <32 weeks and birth weight <1500 grams were analyzed in the study. Complete blood counts obtained within the first six hours of life were evaluated for platelet parameters and compared for PDA status.
Thyroid functions in the fetus and newborn carry importance in terms of the baby's health and dev... more Thyroid functions in the fetus and newborn carry importance in terms of the baby's health and development of the central nervous system. Maternaliodine deficiency, exposure to iodine, thyroid diseases (Hashimoto thyroiditis, Graves') and drugs used by the mother affect thyroid functions in the fetus. Reflections of these effects are observed immediately after delivery. Investigation of the mother in terms of thyroid diseases during pregnancy, recognition and appropriate assessment of the required conditions, screening of all newborns in the first days of life in terms of congenital hypothyroidism, timely and appropriate evaluation of the screening results, early diagnosis and appropriate treatment of cases of congenital hypothyroidism, assessment and management of cases of transient thyroid hormone disorders and close monitoring of the thyroid functions and development of patients in whom treatment has been initiated with a diagnosis of hypothyroidism are crucial in terms of developmental outcomes of the babies who have thyroid function disorders or hypothyroidism. This guideline was written with the objective of guiding pediatricians, neonatologists and pediatric endocrinologists in the issue of assessment, diagnosis and management of thyroid function disorders and thyroid diseases concerning the fetus and baby during gestation and neonatal period.
Yılmaz-Semerci S, Demirel G, Taştekin A. Wickerhamomyces anomalus blood stream infection in a ter... more Yılmaz-Semerci S, Demirel G, Taştekin A. Wickerhamomyces anomalus blood stream infection in a term newborn with pneumonia. Turk J Pediatr 2017; 59: 349-351. The incidence of invasive candidiasis is high in neonates admitted to neonatal intensive care unit and is associated with significant morbidity and mortality rates. Candida albicans is the most common fungal agent pathogenic to neonates but invasive fungal infections caused by uncommon fungi have increased in recent years. Wickerhamomyces anomalus is a very rare pathogen causing blood stream infection in neonates, which has reportedly caused only few cases in the literature. Here we report a case of blood stream infection caused by a fungal agent Wickerhamomyces anomalus in a term male infant.
Nicolau syndrome (NS) is a rare complication of intramuscular, intraarticular or subcutaneous inj... more Nicolau syndrome (NS) is a rare complication of intramuscular, intraarticular or subcutaneous injection of particular drugs leading to ischemic necrosis of the surrounding skin, soft tissue and muscular tissue. Benzathine penicilin one of the most widely used antibiotic for upper respiratory tract infections and has been rarely reported to cause NS. Here we describe a 4 year old boy with diagnosis of NS after the injection of benzathine penicillin who was successfuly treated with unfractionized heparin (enoxaparine) and pentoxifylline. The practitioners should pay attention for unnecessary use of benzathine penicillin to avoid from probable complications.
Purpose: To investigate the longitudinal change in intraocular pressure (IOP) in premature infant... more Purpose: To investigate the longitudinal change in intraocular pressure (IOP) in premature infants and to establish a normative IOP value. Methods: Forty premature infants with a gestational age (GA) of 26 weeks were enrolled in this longitudinal study. Measurements were taken initially at 28 weeks postconceptional age (PCA) and at 2-week intervals up to 40 weeks PCA. Intraocular pressure was measured with a hand-held tonometer (Tono-Pen XL; Reichert Inc.). Results: From 40 (22 male, 18 female) premature Caucasian infants, seven (for each eye) IOP measurements were obtained. Mean GA was 26 weeks and mean birthweight was 820 ± 112 grams. The mean IOP was 15.1 ± 1.2 mm Hg and 14.9 ± 1.1 mm Hg for the right and left eyes, respectively. The mean IOP in both eyes for all measurements was 15.0 ± 1.1 mm Hg. At 28 weeks PCA, 9 (22.5%) preterm infants had IOP values greater than 20 mm Hg. The mean IOPs at 28 weeks, 30 weeks, 32 weeks, 34 weeks, 36 weeks, 38 weeks, and 40 weeks PCA were 18.7 ...
Hemangiopericytoma is a rare mesenchymal tumor originating from capillary pericytes, known as Zim... more Hemangiopericytoma is a rare mesenchymal tumor originating from capillary pericytes, known as Zimmermann pericytes. The adult form is not uncommon and generally malignant but tumor is found rarely in children. Here we describe an intracranial hemangiopericytoma in a preterm newborn whose had the tumor resected successfully shortly after birth.
The Journal of Maternal-Fetal & Neonatal Medicine, 2017
Purpose: To compare the antioxidant status of three cord clamping procedures (early clamping, del... more Purpose: To compare the antioxidant status of three cord clamping procedures (early clamping, delayed clamping and milking) by analyzing the thiol-disulfide balance. Patients and methods: This randomized controlled study enrolled 189 term infants who were divided into three groups according to the cord clamping procedure: early clamping, delayed clamping and milking. Blood samples were collected from the umbilical arteries immediately after clamping, and the thiol/disulfide homeostasis was analyzed. Results: The native and total thiol levels were significantly (p < .05) lower in the early cord clamping group compared with the other two groups. The disulfide/total thiol ratio was significantly (p ¼ .026) lower in the delayed cord clamping and milking groups compared with the early clamping groups. Early cord clamping causes the production of more disulfide bonds and lower thiol levels, indicating that oxidation reactions are increased in the early cord clamping procedure compared with the delayed cord clamping and milking procedures. Conclusion: The oxidant capacity is greater with early cord clamping than with delayed clamping or cord milking. Delayed cord clamping or milking are beneficial in neonatal care, and we suggest that they be performed routinely in all deliveries.
Prilocaine is a strong local anesthetic, widely used in children and adults in cream or injectabl... more Prilocaine is a strong local anesthetic, widely used in children and adults in cream or injectable form. In the literature, there have been many case reports presenting patients developing acquired methemoglobinemia during its usage in therapeutic doses. In this paper, we report an infant who developed methemoglobinemia after prilocaine injection for local anesthesia and treated successfully with oral methylene blue.
Background: There are limited data about the results of repeated oral ibuprofen (OIBU) treatment.... more Background: There are limited data about the results of repeated oral ibuprofen (OIBU) treatment. This study aimed to describe patent ductus arteriosus (PDA) closure rates and adverse events after repeated courses of OIBU in premature infants with PDA. Methods: Preterm infants with hemodynamically significant (hs)PDA were enrolled in the study. If the first course of OIBU treatment failed, a second and, if required, third course was administered. Results: A total of 100 patients received OIBU. In six patients, treatment could not be completed due to death (n Z 3) and side effects (n Z 3). In three patients, adverse effects related to OIBU (thrombocytopenia and impairment of renal function) developed during the first course. During the second and third courses, no new adverse event occurred. After all courses, the PDA closure rate was determined as 88%. The rate was 71% after the first course, 40% after the second course, and 35% after the third course. Although the second course resulted in a significant increase in the closure rate (p < 0.05), the rate did not increase significantly with the third course (p > 0.05). The mean postnatal age at the start of the first dose of OIBU was not significantly different among the responders and non-responders to the first course (p > 0.05). Clinical characteristics did not affect the closure rate significantly. The number of courses did not have a significant effect on death, when gestational age and birth weight were used as covariates [p Z 0.867, Exp(B) Z 0.901, 95% confidence interval Z 0.264e3.1]. Conclusion: A second course of OIBU seems effective and safe for use in preterm infants with hsPDA. Although a third course of OIBU results in PDA closure in some additional patients, the
Introduction: The aim of this study was evaluation of broncoscopic findings in children with cong... more Introduction: The aim of this study was evaluation of broncoscopic findings in children with congenital heart disease(CHD). Method: Bronchoscopy was performed in 37 patients with CHD who were followed between October 2012–December 2014 in our hospital. The data obtained from these patients were evaluated retrospectively. Results: Twenty-one of the patients were males and 16 were females, median ages 12.5 mo (1-36m). Twenty-seven patients (72.9 %) were operated for congenital heart disease. Twelve of the patients had pulmonary hypertension. Bronchoscopy was performed because of extubation failure, atelectasis, recurrent or persistant pneumonia, stridor and persistant cough; 17,7,7,4 and 2, respectively. Laryngomalacia, tracheomalacia, bronchomalacia, tracheal stenosis, airway branch anomalies, granulation tissue formation and pulsatile airway pressure was determined in flexible bronchoscopy, 13,12,8,4,17,7 and 10, respectively. Twenty-seven of the patients were followed with mechanical ventilation(MV). MV duration before and after bronchoscopy was median 30 and 12 days, respectively. Tracheostomy was performed in 15 cases. After bronchoscopy five of these patients were removed from tracheostomy. Eleven out of the patients had positive culture in bronkoalveolar lavage. Patients were discharged with room air, tracheostomy with room air, only with supplemental oxygen, tracheostomy with supplemental oxygen; 19(51.3%), 6(16.2%), 1(2.7%),1(2.7%), respectively. One patient was following intubated with ventilatory support. Nine patients died. Conclusions: Airway anomalies were more frequently encountered in patients with congenital heart disease.
McKusick-Kaufman syndrome is a rare syndrome inherited in an autosomal recessive pattern with a p... more McKusick-Kaufman syndrome is a rare syndrome inherited in an autosomal recessive pattern with a phenotypic triad comprising hydrometrocolpos, postaxial polydactyly and congenital cardiac disease. The syndrome is caused by mutations in the MKKS gene mapped onto chromosome 20p12. Diagnosis of this syndrome is based on clinical and imaging findings. In our paper, we have presented the first McKusick-Kaufman syndrome patient accompanied by congenital laryngomalacia, intestinal malrotation and hypothalamic hamartoma as well as postaxial polydactyly, hydrometrocolpos in the neonatal period.
To investigate the effects of L-carnitine (LC) on rats with oxygen-induced retinopathy. Materials... more To investigate the effects of L-carnitine (LC) on rats with oxygen-induced retinopathy. Materials and methods: The study was conducted on 40 Sprague Dawley rat pups. The rat pups were randomly divided into 4 groups: group 1 (n = 10), the healthy control group with intraperitoneal 0.1 mL/day physiological saline injection; group 2 (n = 10), exposed to hyperoxygen, did not receive LC but received 0.1 mL/day physiological saline intraperitoneally; group 3 (n = 10), exposed to hyperoxygen and received 100 mg/kg/day LC intraperitoneally; group 4 (n = 10), exposed to hyperoxygen and received 200 mg/kg/ day LC intraperitoneally. After postnatal day 20, the rat pups were killed and an histological examination was performed on the eyes, in addition to the detection of plasma malondialdehyde (MDA) levels. Results: The retinal and choroidal histopathological changes due to hyperoxygen were less in group 3 and minimal in group 4 compared with group 2. Compared with the healthy control group, the increase in the MDA levels in group 2 was significant (P < 0.05). Compared with group 2 there was a significant (P < 0.05) decrease in the MDA levels in groups 3 and 4. Conclusion: LC has beneficial effects on oxygen-induced retinopathy in rats in terms of histopathological changes and MDA levels.
The aim of this study was to investigate the effect of the application of the odor of breast milk... more The aim of this study was to investigate the effect of the application of the odor of breast milk in preterm infants during gavage feeding on the period of transition to total oral feeding. Design: This prospective experimental study was performed on a total of 80 preterm infants: 40 infants in the study group and 40 in the control group. Methods: This experimental study was performed in eastern Turkey at the Neonatal Intensive Care and Premature Unit of a university hospital between September 2007 and December 2008. The demographic data were collected via a questionnaire, and an intervention and follow-up table was prepared by the researcher based on relevant literature. The study was approved by the local institution, and written informed consent was obtained from all parents. Findings: The findings of the study indicated that the preterm infants who were stimulated by the odor of breast milk during gavage feeding transitioned to oral feeding 3 days earlier than control subjects. Moreover, the mean hospitalization time of these infants was 4 days shorter. Conclusions: The results show that stimulation with breast milk odor is an effective method for decreasing transition of preterm infants from gavage to oral feeding. Clinical Relevance: Nurses can train mothers to pump their breast milk, stimulate their infants with the odor of their breast milk, and feed it to their infants in the premature unit. This may lead to a quicker transition to oral feeding.
NICU nurses should be able to protect high-risk newborns from the sensorial stimuli which create ... more NICU nurses should be able to protect high-risk newborns from the sensorial stimuli which create toxic stress within the physical environment (3-5). In order to protect high
To the Editor — Sreenan et al1 should be complimented for publishing a study that has important p... more To the Editor — Sreenan et al1 should be complimented for publishing a study that has important practical implications. There is no doubt that if one could establish that high-flow nasal cannula (HFNC) oxygen is as effective and safe and better tolerated than nasal continuous positive airway pressure (nCPAP), it would make the administration of continuous positive airway pressure (CPAP) simpler and cheaper. However, I wish to discuss certain aspects of the study which, I feel, have not been adequately addressed by the authors. The authors enrolled the subjects only after they had already been on nCPAP for at least 24 hours. The need for this pre-enrollment nCPAP and the upper limit of its duration are not mentioned. This is despite the fact that the natural course of the disease could change over this duration and the pre-enrollment nCPAP does not serve any purpose in the study. If the authors had enrolled patients immediately after the decision …
Chickenpox is due to infection with the varicella zoster virus (VZV), a human alphaherpervirus fo... more Chickenpox is due to infection with the varicella zoster virus (VZV), a human alphaherpervirus found worldwide. Classically, the cinical disease is a febrile illness with a pruritic vesicular rash. Maternal chickenpox between 5 days before delivery to 2 days after delivery (perinatal varicella) can cause severe and even fatal illness in the newborn. A 7-day old girl baby presented on day 4 of postnatal with the complaints of widespread vesicular rash and non-suckling. Mother of the baby also had a similar eruption four day prior to delivery, which was clinically characteristic of varicella. Considering history and clinical presentation, a diagnosis of perinatal chickenpox was considered and the baby was treated with acyclovir which she responded and recovered. Herein, the clinical feasures and treatment of chickenpox infection in the perinatal period have been emphasized with this case report.
Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants disc... more Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey. Material and methods dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers. Conclusion The present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs.
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Papers by Ayhan Tastekin