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Iseri Nepesov M, Kilic H, Yildirim S, Gulec S, Kara Y, Kizil MC, Karbuz A, Terek D, Sutcu M, Tufan E, Dinleyici M, Kurugol Z, Kilic O, Dinleyici EC. Comparison of Bordetella pertussis Antibody Levels in Pregnant Women and Umbilical Cord Blood: A Multicenter Study. Pediatr Infect Dis J 2024:00006454-990000000-00783. [PMID: 38451894 DOI: 10.1097/inf.0000000000004298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
BACKGROUND In countries where pertussis vaccination is not administered during pregnancy, the determination of pertussis antibody levels in pregnant women is very important in terms of knowing the current seroepidemiology and potential strategies for immunizations. METHODS We included 396 pregnant women who were admitted to 4 different obstetrics and gynecology clinics. Anti-Bordetella pertussis toxin (PT) IgG and anti-Bordetella pertussis filamentous hemagglutinin IgG levels in maternal and cord blood pairs were determined by the ELISA method. RESULTS Venous blood serum anti-PT level was below 5 IU/mL in 58.8%, 5-40 IU/mL in 34.8%, 40-100 IU/mL in 5.1% and >100 IU/mL in 1.3% of pregnant women. Cord blood serum anti-PT level was below 5 IU/mL in 47.7%, 5-40 IU/mL in 44.5%, 40-100 IU/mL in 6.8% and >100 IU/mL in 1% of pregnant women. In our study, the anti-PT level was found below 40 IU/mL in 93.6% of pregnant women and 92.2% of cord blood. Our study found the anti-filamentous hemagglutinin level below 40 IU/mL in 81% of pregnant women and 66.2% of cord blood. CONCLUSIONS Although it is known that pertussis causes serious morbidity and mortality in young infants all over the world and that the most effective and reliable way to prevent it is vaccination of pregnant women, it is a remarkable contradiction that pertussis vaccination rates and therefore seropositivity rates in pregnant women are very low.
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Affiliation(s)
- Merve Iseri Nepesov
- From the Department of Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University
| | - Halime Kilic
- Department of Obstetrics and Gynecology, Eskisehir City Hospital, Eskisehir, Turkiye
| | | | - Sevgi Gulec
- Department of Obstetrics and Gynecology, Eskisehir City Hospital, Eskisehir, Turkiye
| | - Yalcin Kara
- From the Department of Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University
| | - Mahmut Can Kizil
- From the Department of Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University
| | - Adem Karbuz
- Department of Pediatric Infectious Diseases, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkiye
| | - Demet Terek
- Department of Neonatology, Faculty of Medicine, Ege University, Izmir, Turkiye
| | - Murat Sutcu
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Istinye University, Istanbul, Turkiye
| | - Ergun Tufan
- Department of Obstetrics and Gynecology, Eskisehir City Hospital, Eskisehir, Turkiye
| | - Meltem Dinleyici
- Department of Social Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkiye
| | - Zafer Kurugol
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir, Turkiye
| | - Omer Kilic
- From the Department of Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University
| | - Ener Cagri Dinleyici
- Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkiye
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Tekgul H, Koroğlu OA, Tanrıverdi M, Yalaz M, Terek D, Aktan G, Akisu M, Kültürsay N. The net impact of clinical seizures on outcome characteristics in infants with neonatal encephalopathies at 12 months of age. Seizure 2024; 116:133-139. [PMID: 36588060 DOI: 10.1016/j.seizure.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To assess the impact of clinical neonatal seizures on outcome characteristics of preterm and term newborns with neonatal encephalopathy (NE). METHODS We designed a prospective comparative study with 53 babies (preterm neonates: 26 and term neonates: 27) with NE: group 1 (preterm neonates with seizures, n = 13), group 2 (preterm neonates without seizures, n = 13), group 3 (term neonates with seizures, n = 13) and group 4 (term neonates without seizures, n = 14). The functional outcome characteristics of the survivors were assessed by the Ankara Developmental Screening Inventory (ADSI) and the Guide for Monitoring Child Development (GMCD) at 12 months of age. RESULTS Clinically defined acute symptomatic seizures were diagnosed with prompt conventional EEG / amplitude-integrated EEG in preterm (92.3%) and term neonates (81.4%) with etiology-specific diagnoses of NE. There were no differences between the study groups regarding seizure semiology and EEG characteristics. A primary adverse outcome was defined in 22 (41.5%) of the cohort. However, only 15.3% of infants had an unfavorable functional outcome with ADSI at 12 months. Among the survivors, there was no significant difference between the study groups regarding ADSI scores. The GMDC test revealed normal development in 50% of survivors with seizures in the preterm group and 83% in the term group. CONCLUSION There was no significant difference between the characteristics of functional outcomes at 12 months in preterm and term neonates with NE for clinical seizures.
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Affiliation(s)
- Hasan Tekgul
- Department of Pediatrics, Division of Child Neurology, Ege University Medical Faculty, Turkey.
| | - Ozge A Koroğlu
- Department of Pediatrics, Division of Neonatology, Ege University Medical Faculty, Turkey
| | - Mahir Tanrıverdi
- Department of Pediatrics, Ege University Medical Faculty, Turkey
| | - Mehmet Yalaz
- Department of Pediatrics, Division of Neonatology, Ege University Medical Faculty, Turkey
| | - Demet Terek
- Department of Pediatrics, Division of Neonatology, Ege University Medical Faculty, Turkey
| | - Gül Aktan
- Department of Pediatrics, Division of Child Neurology, Ege University Medical Faculty, Turkey
| | - Mete Akisu
- Department of Pediatrics, Division of Neonatology, Ege University Medical Faculty, Turkey
| | - Nilgün Kültürsay
- Department of Pediatrics, Division of Neonatology, Ege University Medical Faculty, Turkey
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Okulu E, Hirfanoglu IM, Satar M, Erdeve O, Koc E, Ozlu F, Gokce M, Armangil D, Tunc G, Demirel N, Unal S, Ozdemir R, Deveci MF, Akar M, Demirel MK, Çetinkaya M, Buker HSC, Karagöl BS, Yaprak D, Akcan AB, Anik A, Narter F, Arayici S, Yildirim E, Akin IM, Sahin O, Ozdemir OEB, Ovali F, Akin MA, Celik Y, Orman A, Uslu S, Ozkan H, Koksal N, Tastekin A, Gunduz M, Arisoy AE, Gurpinar R, Ors R, Altunhan H, Kececi R, Yildizdas HY, Terek D, Ates M, Kader S, Mutlu M, Çelik K, Yucesoy E, Mert MK, Gulasi S, Kucuktasci K, Arman D, Hekimoglu B, Gultekin ND, Celik HT, Kahvecioglu D, Akyildiz C, Taşkın E, Ciftdemir NA, Uygun SS, Kaya TB, Akdag A, Yilmaz A. An observational, multicenter, registry-based cohort study of Turkish Neonatal Society in neonates with Hypoxic ischemic encephalopathy. PLoS One 2023; 18:e0295759. [PMID: 38096201 PMCID: PMC10721008 DOI: 10.1371/journal.pone.0295759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Hypoxic ischemic encephalopathy (HIE) is a significant cause of mortality and short- and long-term morbidities. Therapeutic hypothermia (TH) has been shown to be the standard care for HIE of infants ≥36 weeks gestational age (GA), as it has been demonstrated to reduce the rates of mortality, and adverse neurodevelopmental outcomes. This study aims to determine the incidence of HIE in our country, to assess the TH management in infants with HIE, and present short-term outcomes of these infants. METHODS The Turkish Hypoxic Ischemic Encephalopathy Online Registry database was established for this multicenter, prospective, observational, nationally-based cohort study to evaluate the data of infants born at ≥34 weeks GA who displayed evidence of neonatal encephalopathy (NE) between March, 2020 and April 2022. RESULTS The incidence of HIE among infants born at ≥36 weeks GA (n = 965) was 2.13 per 1000 live births (517:242440), and accounting for 1.55% (965:62062) of all neonatal intensive care unit admissions. The rates of mild, moderate and severe HİE were 25.5% (n = 246), 58.9% (n = 568), and 15.6% (n = 151), respectively. Infants with severe HIE had higher rates of abnormal magnetic resonance imaging (MRI) findings, and mortality (p<0.001). No significant difference in mortality and abnormal MRI results was found according to the time of TH initiation (<3 h, 3-6 h and >6 h) (p>0.05). TH was administered to 85 (34.5%) infants with mild HIE, and of those born of 34-35 weeks of GA, 67.4% (n = 31) received TH. A total of 58 (6%) deaths were reported with a higher mortality rate in infants born at 34-35 weeks of GA (OR 3.941, 95% Cl 1.446-10.7422, p = 0.007). CONCLUSION The incidence of HIE remained similar over time with a reduction in mortality rate. The timing of TH initiation, whether <3 or 3-6 h, did not result in lower occurrences of brain lesions on MRI or mortality. An increasing number of infants with mild HIE and late preterm infants with HIE are receiving TH; however, the indications for TH require further clarification. Longer follow-up studies are necessary for this vulnerable population.
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Affiliation(s)
- Emel Okulu
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye
| | - Ibrahim Murat Hirfanoglu
- Gazi University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye
| | - Mehmet Satar
- Cukurova University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Adana, Türkiye
| | - Omer Erdeve
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye
| | - Esin Koc
- Gazi University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye
| | - Ferda Ozlu
- Cukurova University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Adana, Türkiye
- Department of Neonatology, Seyhan State Hospital, Adana, Türkiye
| | - Mahmut Gokce
- Department of Neonatology, Seyhan State Hospital, Adana, Türkiye
| | - Didem Armangil
- Department of Pediatrics, Neonatal Intensive Care Unit, Koru Hospital, Ankara, Türkiye
| | - Gaffari Tunc
- Cumhuriyet University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Sivas, Türkiye
| | - Nihal Demirel
- Yildirim Beyazit University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye
- Department of Neonatology, Etlik Zubeyde Hanim Women’s Health Teaching and Research Hospital, Ankara, Türkiye
| | - Sezin Unal
- Department of Neonatology, Etlik Zubeyde Hanim Women’s Health Teaching and Research Hospital, Ankara, Türkiye
| | - Ramazan Ozdemir
- Inonu University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Malatya, Türkiye
| | - Mehmet Fatih Deveci
- Inonu University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Malatya, Türkiye
| | - Melek Akar
- Department of Neonatology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir Türkiye
| | - Melike Kefeli Demirel
- Department of Neonatology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir Türkiye
| | - Merih Çetinkaya
- Department of Neonatology, University of Health Sciences, Basaksehir Çam and Sakura City Hospital, Istanbul, Türkiye
| | - Halime Sema Can Buker
- Department of Neonatology, University of Health Sciences, Basaksehir Çam and Sakura City Hospital, Istanbul, Türkiye
| | - Belma Saygılı Karagöl
- Gulhane Faculty of Medicine, Department of Pediatrics, Division of Neonatology, University of Health Sciences, Ankara, Türkiye
| | - Deniz Yaprak
- Gulhane Faculty of Medicine, Department of Pediatrics, Division of Neonatology, University of Health Sciences, Ankara, Türkiye
| | - Abdullah Barıs Akcan
- Adnan Menderes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Aydin, Türkiye
| | - Ayse Anik
- Adnan Menderes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Aydin, Türkiye
| | - Fatma Narter
- Department of Neonatology, University of Health Sciences, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Türkiye
| | - Sema Arayici
- Department of Neonatology, Eskisehir State Hospital, Eskisehir, Türkiye
| | - Egemen Yildirim
- Department of Neonatology, Eskisehir State Hospital, Eskisehir, Türkiye
| | - Ilke Mungan Akin
- Department of Neonatology, University of Health Sciences, Umraniye Training and Research Hospital Istanbul, Istanbul, Türkiye
| | - Ozlem Sahin
- Department of Neonatology, University of Health Sciences, Umraniye Training and Research Hospital Istanbul, Istanbul, Türkiye
| | - Ozgul Emel Bulut Ozdemir
- Medeniyet University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Türkiye
| | - Fahri Ovali
- Medeniyet University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Türkiye
| | - Mustafa Ali Akin
- Ondokuz Mayis University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Samsun, Türkiye
| | - Yalcin Celik
- Mersin University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Mersin, Türkiye
| | - Aysen Orman
- Mersin University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Mersin, Türkiye
| | - Sinan Uslu
- Department of Neonatology, University of Health Sciences, Sisli Etfal Hamidiye Training and Research Hospital, Istanbul, Türkiye
| | - Hilal Ozkan
- Uludag University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Bursa, Türkiye
| | - Nilgun Koksal
- Uludag University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Bursa, Türkiye
| | - Ayhan Tastekin
- Medipol University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Türkiye
| | - Mehmet Gunduz
- Medipol University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Türkiye
| | - Ayse Engin Arisoy
- Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kocaeli, Türkiye
| | - Resat Gurpinar
- Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kocaeli, Türkiye
| | - Rahmi Ors
- Department of Pediatrics, Neonatal Intensive Care Unit, Ozel Medova Hospital, Konya, Türkiye
| | - Huseyin Altunhan
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Konya, Türkiye
| | - Ramazan Kececi
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Konya, Türkiye
| | - Hacer Yapicioglu Yildizdas
- Cukurova University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Adana, Türkiye
| | - Demet Terek
- Ege University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Izmir, Türkiye
| | - Mehmet Ates
- Ege University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Izmir, Türkiye
| | - Sebnem Kader
- Karadeniz Technical University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Trabzon, Türkiye
| | - Mehmet Mutlu
- Karadeniz Technical University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Trabzon, Türkiye
| | - Kıymet Çelik
- Akdeniz University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Antalya, Türkiye
| | - Ebru Yucesoy
- Harran University Faculty of Medicine, Department of Pediatrics Division of Neonatology, Sanliurfa, Türkiye
| | | | - Selvi Gulasi
- Department of Neonatology, University of Health Sciences, Adana, Türkiye
| | - Kazım Kucuktasci
- Adana City Training and Research Hospital, Department of Pediatrics, Neonatal Intensive Care Unit, Ozel Saglik Hospital, Denizli, Türkiye
| | - Didem Arman
- Department of Neonatology, Istanbul Training and Research Hospital, Istanbul, Türkiye
| | - Berna Hekimoglu
- Department of Neonatology, University of Health Sciences, Kanuni Training and Research Hospital, Trabzon, Türkiye
| | - Nazlı Dilay Gultekin
- Department of Neonatology, Van Regional Training and Research Hospital, Van, Türkiye
| | - Hasan Tolga Celik
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye
| | - Dilek Kahvecioglu
- Department of Neonatology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Türkiye
| | - Can Akyildiz
- Dokuz Eylul University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Izmir, Türkiye
| | - Erdal Taşkın
- Fırat University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Elazıg, Türkiye
| | - Nukhet Aladag Ciftdemir
- Trakya University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Edirne, Türkiye
| | - Saime Sundus Uygun
- Necmettin Erbakan University Selcuk Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Konya, Türkiye
| | - Tugba Barsan Kaya
- Osmangazi University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Eskisehir, Türkiye
| | - Arzu Akdag
- Department of Neonatology, University of Health Sciences, Yuksek Ihtisas Teaching Hospital, Bursa, Türkiye
| | - Aslan Yilmaz
- Cerrahpasa University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Türkiye
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Güner Özenen G, Şahbudak Bal Z, Özek G, Bilen NM, Ümit Z, Terek D, Hilmioğlu Polat S, Aksoylar S. Micafungin Use in Children: A Tertiary Referral Hospital Experience in the Treatment of Invasive Fungal Infections. J Pediatr Inf 2023. [DOI: 10.5578/ced.20239901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Özenen GG, Şahbudak Bal Z, Özek G, Bilen NM, Ümit Z, Terek D, Hilmioğlu Polat S, Aksoylar S. Micafungin Use in Children: A tertiary Referral Hospital Experience in the Treatment of Invasive Fungal Infections. J Pediatr Inf 2023. [DOI: 10.5578/ced.20239915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Okulu E, Erdeve O, Kilic I, Olukman O, Calkavur S, Buyukkale G, Cetinkaya M, Ulubas D, Demirel N, Hanta D, Ertugrul S, Gultekin ND, Tuncer O, Demir N, Bilgin L, Narli N, Yildiz D, Terek D, Koroglu OA, Seren C, Ozyazici E, Ozdemir R, Turgut H, Narter F, Akin Y, Ozyazici A, Zenciroglu A, Asker HS, Gokmen Z, Salihli M, Bulbul A, Zubarioglu U, Atasay B, Koc E. Intravenous Immunoglobulin Use in Hemolytic Disease Due to ABO Incompatibility to Prevent Exchange Transfusion. Front Pediatr 2022; 10:864609. [PMID: 35573949 PMCID: PMC9095978 DOI: 10.3389/fped.2022.864609] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Intravenous immunoglobulin (IVIG) has been widely used to treat the hemolytic disease of the newborn (HDN). Although it has been shown that IVIG treatment reduces the duration of phototherapy and hospitalization, the use of IVIG in hemolytic disease due to ABO incompatibility has been controversial in recent years. This study aimed to investigate the role of IVIG in the prevention of exchange transfusion in infants with ABO HDN who presented with bilirubin levels at or above the level of exchange transfusion. MATERIALS AND METHODS This study evaluated the data of infants with ABO HDN in the Turkish Neonatal Jaundice Online Registry. The infants with ABO HDN who met the total serum bilirubin level inclusion criteria (within 2-3 mg/dL of exchange transfusion or even above exchange transfusion level) were included in the study according to the guidelines from the American Academy of Pediatrics and the Turkish Neonatal Society. All patients were managed according to the unit protocols recommended by these guidelines and received light-emitting diode (LED) phototherapy. Infants who only received LED phototherapy, and who received one dose of IVIG with LED phototherapy were compared. RESULTS During the study period, 531 term infants were included in the study according to inclusion criteria. There were 408 cases in the phototherapy-only group, and 123 cases in the IVIG group. The demographic findings and the mean bilirubin and reticulocyte levels at admission were similar between the groups (p > 0.05), whereas the mean hemoglobin level was slightly lower in the IVIG group (p = 0.037). The mean age at admission was earlier, the need for exchange transfusion was higher, and the duration of phototherapy was longer in the IVIG group (p < 0.001, p = 0.001, and p < 0.001, respectively). The rate of re-hospitalization and acute bilirubin encephalopathy (ABE) was higher in the IVIG group (p < 0.001 and p = 0.01, respectively). CONCLUSION In this study, we determined that one dose of IVIG did not prevent an exchange transfusion nor decrease the duration of phototherapy in infants, who had bilirubin levels near or at exchange transfusion level, with hemolytic disease due to ABO incompatibility.
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Affiliation(s)
- Emel Okulu
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ilknur Kilic
- Department of Neonatology, Atasehir Florence Nightingale Hospital, Istanbul, Turkey
| | - Ozgur Olukman
- Department of Neonatology, Izmir Behcet Uz Children's Hospital, University of Health Sciences, Izmir, Turkey
| | - Sebnem Calkavur
- Department of Neonatology, Izmir Behcet Uz Children's Hospital, University of Health Sciences, Izmir, Turkey
| | - Gokhan Buyukkale
- Department of Neonatology, Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Merih Cetinkaya
- Department of Neonatology, Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Dilek Ulubas
- Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Nihal Demirel
- Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey.,Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Deniz Hanta
- Department of Neonatology, Adana Delivery and Child Disease Hospital, Adana, Turkey
| | - Sabahattin Ertugrul
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Nazli Dilay Gultekin
- Division of Neonatology, Department of Pediatrics, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Oguz Tuncer
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Yuzuncuyil University, Van, Turkey
| | - Nihat Demir
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Yuzuncuyil University, Van, Turkey
| | - Leyla Bilgin
- Department of Neonatology, Umraniye Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Nejat Narli
- Neonatal Intensive Care Unit, Adana Metro Hospital, Adana, Turkey
| | - Duran Yildiz
- Nenehatun Obstetrics and Gynecology Hospital, Erzurum, Turkey
| | - Demet Terek
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ozge Altun Koroglu
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Canan Seren
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Elif Ozyazici
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Ramazan Ozdemir
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Hatice Turgut
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Fatma Narter
- Department of Neonatology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Yasemin Akin
- Department of Neonatology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ahmet Ozyazici
- Department of Neonatology, Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey
| | - Aysegul Zenciroglu
- Department of Neonatology, Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey
| | | | - Zeynel Gokmen
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Konya Hospital, Başkent University, Konya, Turkey
| | - Musa Salihli
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Konya Hospital, Başkent University, Konya, Turkey
| | - Ali Bulbul
- Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Umut Zubarioglu
- Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Esin Koc
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey
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Kanmaz S, Altun Köroğlu Ö, Terek D, Serin HM, Simsek E, Dokurel Cetin İ, Yilmaz S, Yalaz M, Aktan G, Akisu M, Kultursay N, Gokben S, Tekgul H. Efficacy of levetiracetam as first-line therapy for neonatal clinical seizures and neurodevelopmental outcome at 12 months of age. Acta Neurol Belg 2021; 121:1495-1503. [PMID: 32424740 DOI: 10.1007/s13760-020-01366-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 04/24/2020] [Indexed: 10/24/2022]
Abstract
Appropriate treatment of neonatal seizures with an effective therapy is important in reducing long-term neurologic disabilities. Sixty-seven neonates, who received intravenous (IV) levetiracetam (LEV) as first-line therapy for treating seizures between 2013 and 2017 were evaluated retrospectively to investigate the efficacy of LEV and its neurodevelopmental outcome at 12 months of age. Of the 67 neonates (44 preterm and 23 term babies) evaluated for seizures, 55 (82%) had a defined etiology. EEG confirmation was obtained in 36 (57.1%) of the neonates with clinical seizures. On the 7th day of the treatment (mean seizure control time 7.4 ± 15.1 days), LEV was effective as monotherapy in 43 (64%), whereas add-on therapy was required in 24 (36%) neonates. At the 1-year follow-up, 76% of infants achieved drug-free state, nine (18%) infants remained on LEV monotherapy and three (6%) needed add-on therapy. Neurodevelopmental outcome of the infants was assessed with Ankara Development Screening Inventory and results suggested favorable neurodevelopmental outcome in 69.7% of the infants with at the end of the 1-year follow-up with LEV monotherapy. In conclusion, this retrospective cross-sectional study demonstrated that IV LEV is an effective first-line therapy for treating neonatal clinical seizures and LEV monotherapy effect was sustained during the first year follow-up.
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Seymen-Karabulut G, Günlemez A, Gökalp AS, Hatun Ş, Kaya Narter F, Mutlu M, Kader Ş, Terek D, Hanta D, Okulu E, Karadeniz L, Kanmaz Kutman HG, Zenciroğlu A, Özdemir ÖMA, Sarıcı D, Çelik M, Demir N, Turan Ö, Çelik K, Kılıçbay F, Uslu S, Erol S, Ertuğrul S, Er İ, Çelik HT, Çetinkaya M, Aktürk-Acar F, Aslan Y, Tunç G, Güran Ö, Engin Arısoy A. Vitamin D Deficiency Prevalence in Late Neonatal Hypocalcemia: A Multicenter Study. J Clin Res Pediatr Endocrinol 2021; 13:384-390. [PMID: 34013710 PMCID: PMC8638626 DOI: 10.4274/jcrpe.galenos.2020.2021.0169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Late neonatal hypocalcemia (LNH) is a common metabolic problem associated with hypoparathyroidism, high phosphate intake and vitamin D deficiency, often presenting with seizures. In this cross-sectional study, we aimed to evaluate the role of vitamin D deficiency in LNH in Turkey and to describe the characteristics of affected newborns. METHODS Conducted with a cross-sectional design and with the participation of 61 neonatal centers from December 2015 to December 2016, the study included term neonates with LNH (n=96) and their mothers (n=93). Data were registered on the FAVOR Web Registry System. Serum samples of newborns and mothers were analyzed for calcium, phosphate, magnesium, albumin, alkaline phosphatase, intact parathyroid hormone (iPTH) and 25 hydroxyvitamin D [25(OH)D] levels. RESULTS The median (range) onset time of hypocalcemia was 5.0 (4.0-8.0) days of age, with a male preponderance (60.4%). The median (range) serum 25(OH)D levels of the neonates and their mothers were 6.3 (4.1-9.05) and 5.2 (4.7-8.8) ng/mL, respectively. The prevalence of vitamin D deficiency (<12 ng/mL) was high in both the neonates (86.5%) and mothers (93%). Serum 25(OH)D levels of the infants and mothers showed a strong correlation (p<0.001). While the majority (93.7%) of the neonates had normal/high phosphorus levels, iPTH levels were low or inappropriately normal in 54.2% of the patients. CONCLUSION Vitamin D deficiency prevalence was found to be high in LNH. Efforts to provide vitamin D supplementation during pregnancy should be encouraged. Evaluation of vitamin D status should be included in the workup of LNH.
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Affiliation(s)
- Gülcan Seymen-Karabulut
- University of Health Sciences Turkey, Ümraniye Training and Research Hospital, Clinic of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Ayla Günlemez
- Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kocaeli, Turkey
| | - Ayşe Sevim Gökalp
- Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kocaeli, Turkey
| | - Şükrü Hatun
- Koç University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Fatma Kaya Narter
- Dr. Lütfi Kırdar Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, İstanbul, Turkey
| | - Mehmet Mutlu
- Karadeniz Technical University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Trabzon, Turkey
| | - Şebnem Kader
- Trabzon Kanuni Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, Trabzon, Turkey
| | - Demet Terek
- Ege University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, İzmir, Turkey
| | - Deniz Hanta
- Adana Women and Children Hospital, Clinic of Pediatrics, Division of Neonatology, Adana, Turkey
| | - Emel Okulu
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Leyla Karadeniz
- University of Health Sciences Turkey, Ümraniye Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, İstanbul, Turkey
| | - H Gözde Kanmaz Kutman
- Zekai Tahir Burak Maternity Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Ayşegül Zenciroğlu
- University of Health Sciences Turkey, Ankara Dr. Sami Ulus Maternity Women and Children Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Özmert M. A. Özdemir
- Pamukkale University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Denizli, Turkey
| | - Dilek Sarıcı
- Keçiören Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Muhittin Çelik
- Diyarbakır Children Hospital, Clinic of Pediatrics, Division of Neonatology, Diyarbakır, Turkey
| | - Nihat Demir
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Van, Turkey
| | - Özden Turan
- Başkent University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Kıymet Çelik
- Dr. Behçet Uz Children Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, İzmir, Turkey
| | - Fatih Kılıçbay
- Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kocaeli, Turkey
| | - Sinan Uslu
- Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, İstanbul, Turkey
| | - Sara Erol
- Etlik Zübeyde Hanım Maternity Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Sabahattin Ertuğrul
- Dicle University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Diyarbakır, Turkey
| | - İlkay Er
- Derince Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, Kocaeli, Turkey
| | - Hasan Tolga Çelik
- acettepe University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Merih Çetinkaya
- Kanuni Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, İstanbul, Turkey
| | - Filiz Aktürk-Acar
- Karadeniz Technical University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Trabzon, Turkey
| | - Yakup Aslan
- Trabzon Kanuni Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, Trabzon, Turkey
| | - Gaffari Tunç
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Ömer Güran
- University of Health Sciences Turkey, Ümraniye Training and Research Hospital, Clinic of Pediatrics, Division of Neonatology, İstanbul, Turkey
| | - Ayşe Engin Arısoy
- Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kocaeli, Turkey
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9
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Terek D, Celik M, Ergin F, Erol E, Koroglu OA, Yalaz M, Akisu M, Kultursay N. Omitting Routine Gastric Residual Checks May Help To Accelerate Enteral Feeds And Postnatal Growth In Stable Preterm Infants. JPEN J Parenter Enteral Nutr 2021; 46:1198-1202. [PMID: 34599757 DOI: 10.1002/jpen.2270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/25/2021] [Accepted: 09/28/2021] [Indexed: 11/10/2022]
Abstract
BACGROUND The gastric residual check is routine procedure in neonatal intensive care units while increasing the amounts of feeds given via oro/nasogastric tubes as a precaution for necrotising entereocolitis and intestinal intolerance. However this time consuming procedure is mostly misleading and there is recently a tendency not to check prefeed residuals. METHODS We have changed our clinical protocol at the end of 2018 to increase the feeds without checking the residuals and investigated its effects on the incidence of intestinal intolerance, time to reach full feeds and growth parameters. RESULTS Comparing the results of 60 preterm infants < 35 weeks cared in previous years (2016-2017), 77 preterms cared in 2019 without routine residual checks have reached total feeds 6 days earlier (9,32 (±8,52), 15,32 (±12,98), p< 0.01) discharged 1 day earlier (41,72 (±28,73), 43,90 (±35,13), p = 091) and had higher weight (2832,17 (±520,40), 2534,15 (±451,84), p<0.01) and head circumference gain (33,82 (±1,51, 32,58 (±1,84), p<0.01). Extrauterine growth restriction rate (<10 percentile) for head circumference was significantly lower and for weight and height also insignificantly decreased. CONCLUSION We conclude that omitting routine gastric residual check in a clinically stable preterm infant may help to accelerate enteral feeds and growth parameters. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Demet Terek
- Department of Pediatrics, Division of Neonatology, Ege University Hospital, Bornova, Izmir, Turkey
| | - Mahmut Celik
- Department of Pediatrics, Division of Neonatology, Ege University Hospital, Bornova, Izmir, Turkey
| | - Firat Ergin
- Department of Pediatrics, Division of Neonatology, Ege University Hospital, Bornova, Izmir, Turkey
| | - Elif Erol
- Department of Pediatrics, Division of Neonatology, Ege University Hospital, Bornova, Izmir, Turkey
| | - Ozge Altun Koroglu
- Department of Pediatrics, Division of Neonatology, Ege University Hospital, Bornova, Izmir, Turkey
| | - Mehmet Yalaz
- Department of Pediatrics, Division of Neonatology, Ege University Hospital, Bornova, Izmir, Turkey
| | - Mete Akisu
- Department of Pediatrics, Division of Neonatology, Ege University Hospital, Bornova, Izmir, Turkey
| | - Nilgun Kultursay
- Department of Pediatrics, Division of Neonatology, Ege University Hospital, Bornova, Izmir, Turkey
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10
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Uygur Ö, Öncel MY, Şimşek GK, Okur N, Çelik K, Bozkurt Ö, Yücesoy E, Terek D, Arslan MK, Pekçevik Y, Akar M, Köroğlu ÖA, Oğuz S, Kültürsay N. Is Nasal Septum-Tragus Length Measurement Appropriate for Endotracheal Tube Intubation Depth in Neonates? A Randomized Controlled Study. Am J Perinatol 2021; 38:728-733. [PMID: 31858502 DOI: 10.1055/s-0039-3400982] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Endotracheal intubation is a frequent procedure performed in neonates with respiratory distress. Clinicians use different methods to estimate the intubation insertion depth, but, unfortunately, the improper insertion results are very high. In this study, we aimed to compare the two different methods (Tochen's formula = weight in kilograms + 6 cm; and nasal septum-tragus length [NTL] + 1 cm) used to determine the endotracheal tube (ETT) insertion depth. STUDY DESIGN Infants who had intubation indications were enrolled in this study. The intubation tube was fixed using the Tochen formula (Tochen group) or the NTL + 1 cm formula (NTL group). After intubation, the chest radiograph was evaluated (above T1, proper place, and below T2). RESULTS A total of 167 infants (22-42 weeks of gestational age) were included in the study. The proper tube placement rate in both groups was similar (32.4 vs. 30.4% for infants < 34 weeks of gestational age and 56.8 vs. 45.0% in infants > 34 weeks of gestational age). The ETT was frequently placed below T2 at a higher rate in infants with a gestational age of <34 weeks, especially in the NTL group (46% in the Tochen group and 60.7% in the NTL group). CONCLUSION The NTL + 1 cm formula led to a higher rate of ETT placement below T2, especially in infants with a birth weight of <1,500 g. Therefore, more studies are needed to determine the optimal ETT insertion depth.
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Affiliation(s)
- Özgün Uygur
- Division of Neonatology, Department of Pediatrics, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Mehmet Yekta Öncel
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Izmir Katip Çelebi University, Izmir, Turkey
| | - Gülsüm Kadıoğlu Şimşek
- Clinic of Neonatology, Zekai Tahir Burak Women's Health and Research Hospital, Ankara, Turkey
| | - Nilüfer Okur
- Clinic of Neonatology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Kıymet Çelik
- Clinic of Neonatology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Özlem Bozkurt
- Clinic of Neonatology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - Ebru Yücesoy
- Clinic of Neonatology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - Demet Terek
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Meltem Koyuncu Arslan
- Division of Neonatology, Department of Pediatrics, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Yeliz Pekçevik
- Department of Radiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Melek Akar
- Division of Neonatology, Department of Pediatrics, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Özge Altun Köroğlu
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Suna Oğuz
- Clinic of Neonatology, Zekai Tahir Burak Women's Health and Research Hospital, Ankara, Turkey
| | - Nilgün Kültürsay
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
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11
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Bedir Demirdağ T, Koç E, Tezer H, Oğuz S, Satar M, Sağlam Ö, Uygun SS, Önal E, Hirfanoğlu İM, Tekgündüz K, Oygür N, Bülbül A, Zübarioğlu AU, Üstün N, Ünal S, Aygün C, Saygılı Karagöl B, Zenciroğlu A, Öncel MY, Çakıl Sağlık A, Okulu E, Terek D, Narlı N, Aliefendioğlu D, Gürsoy T, Ünal S, Kaynak Türkmen M, Kaya Narter F, Aladağ Çiftdemir N, Beken S, Çakır SÇ, Yiğit Ş, Çoban A, Ecevit A, Çelik Y, Kulalı F. The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study. Pediatr Neonatol 2021; 62:208-217. [PMID: 33546932 DOI: 10.1016/j.pedneo.2021.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/01/2020] [Accepted: 01/11/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Healthcare-acquired infections (HAIs) in the neonatal period cause substantial morbidity, mortality, and healthcare costs. Our purpose was to determine the prevalence of HAIs, antimicrobial susceptibility of causative agents, and the adaptivity of the Centres for Disease Control and Prevention (CDC) criteria in neonatal HAI diagnosis. METHODS A HAI point prevalence survey was conducted in the neonatal intensive care units (NICUs) of 31 hospitals from different geographic regions in Turkey. RESULTS The Point HAI prevalence was 7.6%. Ventilator-associated pneumonia (VAP) and central line-associated bloodstream infections (CLABSI) and late onset sepsis were predominant. The point prevalence of VAP was 2.1%, and the point prevalence of CLABSI was 1.2% in our study. The most common causative agents in HAIs were Gram-negative rods (43.0%), and the most common agent was Klebsiella spp (24.6%); 81.2% of these species were extended spectrum beta-lactamase (ESBL) (+). Blood culture positivity was seen in 33.3% of samples taken from the umbilical venous catheter, whereas 0.9% of samples of peripherally inserted central catheters (PICCs) were positive. In our study, 60% of patients who had culture positivity in endotracheal aspirate or who had purulent endotracheal secretions did not have any daily FiO2 change (p = 0.67) and also 80% did not have any increase in positive end-expiratory pressure (PEEP) (p = 0.7). On the other hand, 18.1% of patients who had clinical deterioration compatible with VAP did not have endotracheal culture positivity (p = 0.005). CONCLUSIONS Neonatal HAIs are frequent adverse events in district and regional hospitals. This at-risk population should be prioritized for HAI surveillance and prevention programs through improved infection prevention practices, and hand hygiene compliance should be conducted. CDC diagnostic criteria are not sufficient for NICUs. Future studies are warranted for the diagnosis of HAIs in NICUs.
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Affiliation(s)
- Tuğba Bedir Demirdağ
- Gazi University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey.
| | - Esin Koç
- Gazi University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey
| | - Hasan Tezer
- Gazi University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Suna Oğuz
- University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Neonatology, Ankara, Turkey
| | - Mehmet Satar
- Çukurova University, Faculty of Medicine, Department of Neonatology, Adana, Turkey
| | - Özge Sağlam
- University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Department of Neonatology, Istanbul, Turkey
| | - Saime Sündüz Uygun
- Konya Selcuk University, Faculty of Medicine, Department of Neonatology, Konya, Turkey
| | - Esra Önal
- Gazi University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey
| | | | - Kadir Tekgündüz
- Atatürk University, Faculty of Medicine, Department of Neonatology, Erzurum, Turkey
| | - Nihal Oygür
- Akdeniz University, Faculty of Medicine, Department of Neonatology, Antalya, Turkey
| | - Ali Bülbül
- University of Health Sciences, Sisli Etfal Training and Research Hospital, Department of Neonatology, Istanbul, Turkey
| | - Adil Umut Zübarioğlu
- Yeni Yüzyıl University Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
| | - Nuran Üstün
- Medeniyet University. Goztepe Training and Research Hospital, Department of Neonatology, Istanbul, Turkey
| | - Sezin Ünal
- University of Health Sciences, Etlik Zübeyde Hanim Women's Health Training and Research Hospital, Department of Neonatology, Ankara, Turkey
| | - Canan Aygün
- Ondokuz Mayıs University, Faculty of Medicine, Department of Neonatology, Turkey
| | - Belma Saygılı Karagöl
- University of Health Sciences, Gülhane Training and Research Hospital, Department of Neonatology, Ankara, Turkey
| | - Ayşegül Zenciroğlu
- University of Health Sciences, Dr. Sami Ulus Maternity and Children Education and Research Hospital, Department of Neonatology, Ankara, Turkey
| | - M Yekta Öncel
- University of Health Sciences Izmir Tepecik Training and Research Hospital, Department of Neonatology, Izmir, Turkey
| | - Adviye Çakıl Sağlık
- Osmangazi University, Faculty of Medicine, Department of Neonatology, Eskisehir, Turkey
| | - Emel Okulu
- Ankara University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey
| | - Demet Terek
- Ege University, Faculty of Medicine, Department of Neonatology, Izmir, Turkey
| | - Nejat Narlı
- Metro Private Hospital, Neonatology Unit, Adana, Turkey
| | - Didem Aliefendioğlu
- Kırıkkale University, Faculty of Medicine, Department of Neonatology, Kırıkkale, Turkey
| | - Tuğba Gürsoy
- Koc University, Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
| | - Sevim Ünal
- University of Health Sciences, Ankara Hematology Oncology Children's Training and Research Hospital, Department of Neonatology, Ankara, Turkey
| | | | - Fatma Kaya Narter
- University of Health Sciences, Kartal Dr Lutfi Kirdar Training and Research Hospital, Department of Neonatology, Istanbul, Turkey
| | | | - Serdar Beken
- Acıbadem University, Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
| | - Salih Çağrı Çakır
- Uludağ University, Faculty of Medicine, Department of Neonatology, Bursa, Turkey
| | - Şule Yiğit
- Hacettepe University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey
| | - Asuman Çoban
- Istanbul University, Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
| | - Ayse Ecevit
- Baskent University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey
| | - Yalçın Çelik
- Mersin University, Faculty of Medicine, Department of Neonatology, Mersin, Turkey
| | - Ferit Kulalı
- University of Health Sciences, Dr. Behcet Uz Children's Health and Diseases and Surgery Training and Research Hospital, Department of Neonatology, Izmir, Turkey
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Buldur E, Yalcin Baltaci N, Terek D, Yalaz M, Altun Koroglu O, Akisu M, Kultursay N. Comparison of the Finger Feeding Method Versus Syringe Feeding Method in Supporting Sucking Skills of Preterm Babies. Breastfeed Med 2020; 15:703-708. [PMID: 32915053 DOI: 10.1089/bfm.2020.0043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aim: The aim of this study is to compare the efficiency of a new method called "finger feeding" with a well-known technique called syringe feeding for improving sucking skills and accelerating transition to breastfeeding in preterm infants. Materials and Methods: Totally 70 babies were included in this prospective randomized controlled study. Finger feeding method was applied in Group 1 (n = 35) and syringe feeding method was applied in Group 2 (n = 35). The COMFORTneo scale (CnS), oxygen saturation, pulse, respiratory rate, body temperature, amount of breast milk taken, and vomiting data were recorded before and after both applications. Hospitalization period and time elapsed for complete transition from both methods to breastfeeding were also recorded. Results: There was no statistical difference for birth weights, mean gestational age, and vital signs recorded before and after feeding between two groups. Predicted comfort and distress scores of Group 1 determined by the CnS were significantly lower than those of Group 2. This means that babies in the finger feeding group had better comfort than the those in Group 2 (p = 0.000). Time passed for transition to breastfeeding was significantly shorter than that in Group 2 (19.4 ± 15.0 days versus 29.7 ± 10.2 days, p = 0.000). Group 1 had lower amount of food leakage while feeding and their average weight gain at the end of 10th day was significantly higher (322.1 ± 82.3 g versus 252 ± 108.4 g, p = 0.004). They also were discharged earlier than Group 2 (25.8 ± 17.4 days versus 35.9 ± 13.0 days, p = 0.001). Conclusion: Finger feeding method is an effective way for increasing sucking abilities, accelerating transition to breastfeeding, and shortens duration of hospitalization in preterm infants.
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Affiliation(s)
- Emel Buldur
- Division of Neonatology, Department of Pediatrics, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Nalan Yalcin Baltaci
- Division of Neonatology, Department of Pediatrics, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Demet Terek
- Division of Neonatology, Department of Pediatrics, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Mehmet Yalaz
- Division of Neonatology, Department of Pediatrics, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Ozge Altun Koroglu
- Division of Neonatology, Department of Pediatrics, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Mete Akisu
- Division of Neonatology, Department of Pediatrics, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Nilgun Kultursay
- Division of Neonatology, Department of Pediatrics, Ege University, Faculty of Medicine, Izmir, Turkey
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13
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Celik K, Terek D, Olukman O, Gulfidan G, Calkavur S, Devrim I, Arslanoglu S. Colonization and infection with a rare microorganism in a neonatal intensive care unit: three preterm infants with Elizabethkingia meningoseptica. ARCH ARGENT PEDIATR 2020; 117:e631-e634. [PMID: 31758899 DOI: 10.5546/aap.2019.eng.e631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 06/06/2019] [Indexed: 11/12/2022]
Abstract
Elizabethkingia meningoseptica is a widespread gram-negative bacillus in the environment, but a rarely reported human pathogen presenting mostly as nosocomial infections. Advances in neonatal intensive care facilities and usage of sophisticated medical devices strengthen the invasive infectious potential of the microorganism. Clinical manifestations usually include primary bacteremia, meningitis, nosocomial pneumoniae, intravascular catheter-related bacteremia and gastrointestinal and biliary tract infections. Lack of improved diagnostic systems in resource constrained settings, might be a cause of underreporting of such infections. Discrimination between colonization and infection is quite difficult, and it has an unusual antibiotic susceptibility pattern. Therefore clinicians should pay special attention to accurate diagnosis in order to prevent mistreatment. Here we report three newborn cases with the diagnosis of E. meningoseptica infection and colopnization, with the aim of drawing attention to the diagnosis and management of this rare but lethal bacteria that is already present in the intensive care unit environment.
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Affiliation(s)
- Kiymet Celik
- Division of Neonatology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey.
| | - Demet Terek
- Division of Neonatology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Ozgur Olukman
- Division of Neonatology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Gamze Gulfidan
- Microbiology Laboratory, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Sebnem Calkavur
- Division of Neonatology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Ilker Devrim
- Division of Pediatric Infectious Diseases, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Sertac Arslanoglu
- Division of Neonatology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
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14
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Celik K, Olukman O, Demirol H, Terek D, Gulfidan G, Devrim I, Gulcu P, Arslanoglu S, Calkavur S. Prevalence of respiratory pathogens during two consecutive respiratory syncytial virus seasons at a tertiary medical care center. ARCH ARGENT PEDIATR 2019; 117:e356-e362. [PMID: 31339272 DOI: 10.5546/aap.2019.eng.e356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 03/07/2019] [Indexed: 11/12/2022]
Abstract
AIM To determine the etiological profiles of lower respiratory tract infection (LRI) in neonates during respiratory syncytial virus(RSV) season, and to define the clinical features of RSV-related infection and others. METHODS The retrospective study included newborn infants who were hospitalized for LRI during the two consecutive RSV seasons, and then tested for possible etiological agent by multiplex real-time polymerase chain reaction. All relevant data were reviewed, and the clinical characteristics of RSV-related infection were compared to those of others. RESULTS Of 224 patients, 160 (71 %) were positive for at least one potentially causative agent. Of them, 65 % had RSV, and 15 % had more than on ecausative agent (co-infection). The RSV group had more the findings of respiratory distress (p< 0.01), abnormal chest radiography (p< 0.01), need for intensive care (p< 0.01), and duration of oxygen requirement (p< 0.01) but less fever on admission and duration of antibiotic use (for both, p< 0.01), and no longer hospital stay. Need of intensive care nursery was more common in patients with co-infection than others (25 % vs. 6.5 %, p< 0.01). CONCLUSIONS This study highlighted that RSV was the most frequent agent in neonates hospitalized for LRI during the season, with a more severe clinical course than other detected pathogens. The disease severity of RSV infection may have seemed to be increased by the presence of coinfection and abnormal chest radiography.
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Affiliation(s)
- Kiymet Celik
- Departamento de Neonatologia, Hospital Pediátrico Dr. Behcet Uz, Esmirna, Turquía.
| | - Ozgur Olukman
- Departamento de Neonatologia, Hospital Pediátrico Dr. Behcet Uz, Esmirna, Turquía
| | - Hatice Demirol
- Departamento de Neonatologia, Hospital Pediátrico Dr. Behcet Uz, Esmirna, Turquía
| | - Demet Terek
- Departamento de Neonatologia, Hospital Pediátrico Dr. Behcet Uz, Esmirna, Turquía
| | - Gamze Gulfidan
- Departamento de Microbiologia y Enfermedades Infecciosas, Hospital Pediátrico Dr. Behcet Uz, Esmirna, Turquia
| | - Ilker Devrim
- Departamento de Enfermedades Infecciosas Pediátricas, Hospital Pediátrico Dr. Behcet Uz, Esmirna, Turquia
| | - Pelin Gulcu
- Departamento de Radiologia, Hospital Pediátrico Dr. Behcet Uz, Esmirna, Turquia
| | - Sertac Arslanoglu
- Departamento de Neonatologia, Hospital Pediátrico Dr. Behcet Uz, Esmirna, Turquía
| | - Sebnem Calkavur
- Departamento de Neonatologia, Hospital Pediátrico Dr. Behcet Uz, Esmirna, Turquía
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15
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Zeytinoğlu A, Terek D, Arslan A, Erensoy S, Altun Köroğlu Ö, Bozdemir T, Yalaz M, Ergör SN, Öğüt MF, Kültürsay N. [Investigation of congenital CMV infection with the presence of CMV DNA in saliva samples of new born babies]. MIKROBIYOL BUL 2019; 53:53-60. [PMID: 30683039 DOI: 10.5578/mb.67724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cytomegalovirus (CMV), is the most common cause among congenital infections and is the most seen etiology in long-term sensorineural hearing loss (SNHL) and neurological impairment. Congenital CMV infection (CCMV) was reported in 0.15-2.2% of live-borne neonates in studies from different countries. A significant proportion of infected infants are asymptomatic after birth and might only be detected by routine screening methods during the new born period. The aim of this study was to screen the saliva of live-born neonates with areal-time PCR based method for the detection of CCMV in our hospital. Saliva samples collected in half an hour after birth by dry dacron swabs and were evaluated for CMV DNA (Rt-PCR, Abbott Molecular USA) from 1000 babies born in Ege University Faculty of Medicine Hospital Obstetrics Clinic between October 2015-October 2017. For the confirmation of CCMV, saliva positive newborns were evaluated with the same method for CMV DNA from their urine or blood within 21 days. All newborns were screened for sensorineural hearing tests. Subjects were 497 girls (49.7%) and 503 boys (50.3%), with a mean weight of 3116.8 g and mean of 37.61 birth week. CMV DNA was positive in the saliva of 16 newborns (1.6%). Fourteen newborns were weakly positive for CMV DNA in their saliva and were not confirmed for CCMV infection. Congenital CMV was confirmed in only two (0.2%) with the CMV DNA results in urine and/or blood samples. One of the two newborns with CCMV was symptomatic and had a neurosensorial hearing loss. The other one was asymptomatic. Saliva samples, taken immediately after birth with a noninvasive and easy method for the detection of CMV DNA is very important for diagnosis of CCMV. Positive samples should be confirmed with CMV DNA in urine or blood samples of these newborns. In this study, detection of positivity in saliva samples that were confirmed with other samples of our newborn population for CCMV was 0.2%. The specific diagnosis for CCMV in newborns with a noninvasive and easy collecting sample is important to avoid sequelae and for public health concerns.
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Affiliation(s)
- Ayşın Zeytinoğlu
- Ege University Faculty of Medicine, Department of Medical Microbiology, İzmir, Turkey
| | - Demet Terek
- Ege University Faculty of Medicine, Division of Neonatology, İzmir, Turkey
| | - Ayşe Arslan
- Ege University Faculty of Medicine, Department of Medical Microbiology, İzmir, Turkey
| | - Selda Erensoy
- Ege University Faculty of Medicine, Department of Medical Microbiology, İzmir, Turkey
| | - Özge Altun Köroğlu
- Ege University Faculty of Medicine, Division of Neonatology, İzmir, Turkey
| | - Tuğba Bozdemir
- Ege University Faculty of Medicine, Department of Medical Microbiology, İzmir, Turkey
| | - Mehmet Yalaz
- Ege University Faculty of Medicine, Division of Neonatology, İzmir, Turkey
| | - Serap Nur Ergör
- Ege University Faculty of Medicine, Division of Neonatology, İzmir, Turkey
| | - Mehmet Fatih Öğüt
- Ege University Faculty of Medicine, Department of Ear, Nose and Throat Diseases, İzmir, Turkey
| | - Nilgün Kültürsay
- Ege University Faculty of Medicine, Division of Neonatology, İzmir, Turkey
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16
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Siyah Bilgin B, Uygur Ö, Terek D, Altun Köroğlu Ö, Yalaz M, Akısü M, Çoğulu Ö, Kültürsay N. Reference values of anthropometric measurements
in healthy late preterm and term infants. Turk J Med Sci 2018; 48:862-872. [PMID: 30119594 DOI: 10.3906/sag-1712-44] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim Geographical distribution, ethnicity, and other socioeconomic factors may affect anthropometric measurements,
and for that reason each society should determine their own measurements accounting for those factors. In this study, we aimed to
determine the anthropometric measurements of healthy late preterm and term infants to compare the results with other national and
international studies. Materials and methods This sectional study was carried out among 1197 infants born with a gestational age of ≥35 weeks. Chest
circumference, ear length, foot length, palmar length, middle finger length, philtrum distance, inner and outer canthal distances, and
palpebral fissure length were measured in the first 24 h of life. Results All measurements of late preterm infants were smaller than those of term infants (P
˂
0.05). Compared with male infants, the chest
circumference, ear length, foot length, palmar length, philtrum distance, and inner canthal distances of the female infants were lower (P
˂
0.05). No significant differences were found between male and female infants’ middle finger length, outer canthal distance, and palpebral
fissure length measurements. Percentile values for all measurements of 35–42-week male and female infants were described. Conclusion These measurements of male and female infants born between 35 and 42 weeks may be useful for early detection of
syndromes by detecting anatomical abnormalities in our population.
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17
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Kültürsay N, Aşkar N, Terek D, Yeniel AÖ, Altun Köroğlu Ö, Yalaz M, Özkınay F, Akısü M. The Change of Perinatal Mortality Over Three Decades in a Reference Centre in the Aegean Region: Neonatal Mortality has decreased but Foetal Mortality Remains Unchanged. Balkan Med J 2017; 34:553-558. [PMID: 28832325 PMCID: PMC5785661 DOI: 10.4274/balkanmedj.2016.0870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Perinatal, foetal and neonatal mortality statistics are important to show the development of a health care system in a country. However, in our country there are very few national and regional data about the changing pattern of perinatal neonatal mortality along with the development of new technologies in this area. Aims: Evaluation of the changes in mortality rates and the causes of perinatal and neonatal deaths within years in a perinatal reference centre which serves a high-risk population. Study Design: Cross-sectional retrospective study. Methods: The perinatal, neonatal and foetal mortality rates in the years 1979-1980 (1st time point) and 1988-1989 (2nd time point) were compared with the year 2008 (3rd time point). The causes of mortality were assessed by Wigglesworth classification and death reports. The neonatal mortality in the neonatal intensive care unit was also calculated. Results: Foetal mortality rates were 44/1000, 31.4/1000 and 41.75/1000 births, perinatal mortality rates were 35.6/1000, 18.8/1000 and 9/1000 births, and neonatal mortality rates were 35.6/1000, 18.8/1000 and 9/1000 live births for the three study time points, respectively. The mortality rate in neonatal intensive care unit decreased consistently from 33%, to 22.6% and 10%, respectively, together with decreasing neonatal mortality rates. The causes of perinatal deaths were foetal death 85%, immaturity 4%, and lethal congenital malformations 8% according to Wigglesworth classification in 2008, showing the high impact of foetal deaths on this high perinatal mortality rate. Infectious causes of neonatal deaths decreased but congenital anomalies increased in the last decades. Conclusion: Although neonatal mortality rate decreased significantly; foetal mortality rate has stayed unchanged since the late eighties. In order to decrease foetal and perinatal mortality rates more efficiently, reducing consanguineous marriages and providing better antenatal care for high risk pregnancies are needed.
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Affiliation(s)
- Nilgün Kültürsay
- Department of Pediatrics Division of Neonatology, Ege University School of Medicine, İzmir, Turkey
| | - Niyazi Aşkar
- Department of Obstetrics and Gynecology, Ege University School of Medicine, İzmir, Turkey
| | - Demet Terek
- Department of Pediatrics Division of Neonatology, Ege University School of Medicine, İzmir, Turkey
| | - Ahmet Özgür Yeniel
- Department of Obstetrics and Gynecology, Ege University School of Medicine, İzmir, Turkey
| | - Özge Altun Köroğlu
- Department of Pediatrics Division of Neonatology, Ege University School of Medicine, İzmir, Turkey
| | - Mehmet Yalaz
- Department of Pediatrics Division of Neonatology, Ege University School of Medicine, İzmir, Turkey
| | - Ferda Özkınay
- Department of Pediatrics Division of Genetics, Ege University School of Medicine, İzmir, Turkey
| | - Mete Akısü
- Department of Pediatrics Division of Neonatology, Ege University School of Medicine, İzmir, Turkey
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Çelik K, Terek D, Olukman Ö, Kağnıcı M, Keskin Gözmen Ş, Serdaroğlu E, Çalkavur Ş, Arslanoğlu S. Urea Cycle Disorders in Neonates: Six Case Reports. jpr 2017. [DOI: 10.4274/jpr.52724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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19
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Terek D, Altun Koroglu O, Ulger Z, Yalaz M, Kultursay N. The serial changes of perfusion index in preterm infants with patent ductus arteriosus: is perfusion index clinically significant? Minerva Pediatr 2016; 68:250-255. [PMID: 27277201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Perfusion Index (PI) which reflects the peripheral blood flow may help early detection and treatment decision of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. The present study is designed to analyze the usefulness of PI level in early detection of hsPDA in preterm infants. METHODS Preterm infants born before 36 gestational weeks were assessed for PI and simultaneous echocardiography. Based on echocardiography, each infant is categorized into no-PDA (group 1), non-hsPDA (group 2) and hsPDA (group 3). Heart rate (HR), mean arterial pressure (MAP), body temperature and oxygen saturation (SpO2) and concomitant PI were measured on days 1, 2, 3 and 4. RESULTS In all preterm infants (N.=42) PI significantly increased from 0.7 on day 1 to 1.4 on day 4. The HR did not change by the days; however, the MAP increased on days 3 and 4 compared to day 1. In hsPDA group, the median PI was 0.7 (IQR, 0.4) on day 1 compared to 0.9 (IQR, 0.2) on day 2. PI is significantly lower in hsPDA group compared to no-PDA group on day 1 and 2; however, this difference disappeared at 48 hour on the intravenous ibuprofen treatment (on day 3 and 4). CONCLUSIONS PI may predict the perfusion disorder and help to decide for treatment of hsPDA and was also helpful to monitor the response to treatment in hsPDA patients.
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Affiliation(s)
- Demet Terek
- Division of Neonatology, Department of Pediatrics, Ege University Faculty of Medicine, Bornova, Izmir, Turkey -
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20
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Kultursay N, Koroglu O, Uygur O, Terek D, Tanrıverdi ST, Akisu M, Yalaz M. Improved neonatal prognosis following restriction in the number of transferred embryos in assisted reproduction – single center yearly comparison from Turkey. CLIN EXP OBSTET GYN 2015. [DOI: 10.12891/ceog1847.2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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21
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Terek D, Gonulal D, Koroglu OA, Yalaz M, Akisu M, Kultursay N. Effects of Two Different Exogenous Surfactant Preparations on Serial Peripheral Perfusion Index and Tissue Carbon Monoxide Measurements in Preterm Infants with Severe Respiratory Distress Syndrome. Pediatr Neonatol 2015; 56:248-55. [PMID: 25603725 DOI: 10.1016/j.pedneo.2014.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 10/03/2014] [Accepted: 11/17/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Administration of an exogenous surfactant may affect both ventilatory and hemodynamic parameters in preterm infants with respiratory distress syndrome (RDS). Peripheral perfusion may be expected to be influenced, and serial perfusion index (PI) values may show this effect. Noninvasive transcutaneous carbon monoxide (TCO) monitoring may show RDS severity, oxidative and inflammatory stress, and response to surfactant treatment. METHODS This randomized controlled nonblinded study was performed in 30 preterm infants with RDS, treated with poractant alfa (n = 15) or beractant (n = 15); 18 preterm infants without RDS served as a control group. Oxygenation and hemodynamic parameters were recorded and compared through the first 6 hours of treatment. PI and TCO values were measured prior to (Tp), immediately after (T0), and at 5 minutes (T5), 30 minutes (T30), 60 minutes (T60), and 360 minutes (T360) after the bolus surfactant administration. The mean arterial pressure, oxygenation index, pH, and lactate levels were recorded simultaneously. RESULTS Both study groups had lower Tp PI and higher Tp TCO levels than controls. Both surfactant preparations improved the PI, TCO, mean arterial pressure, oxygenation index, pH, and lactate levels at the end point of T360. However, the median Tp PI value of 1.3 first decreased to 0.86 at T0 (P < 0.001), and then it increased to 0.99 at T5 (p < 0.001) and to 1.25 at T30 (p = 0.037). The median Tp TCO value of 3 decreased to 2, 1.5, 0, and 0 at T0, T5, T30, and T60, respectively (p < 0.001). PI more quickly recovered to Tp values (30 minutes vs. 60 minutes) and reached the control group values (30 minutes vs. 360 minutes) with beractant compared to that with poractant alfa. TCO recovered to Tp values in both groups at the same time (5 minutes vs. 5 minutes), but reached the control group values more quickly (5 minutes vs. 30 minutes) with poractant alfa than with beractant. CONCLUSION Patients with RDS had poor perfusion, and PI improved with both surfactant preparations only following a short decline in the 1(st) minute. The expected improvement of PI occurred earlier in the beractant subgroup. TCO declined in both groups, showing lung improvement and decreased oxidative/inflammatory stress, and it was normalized earlier with poractant alfa.
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Affiliation(s)
- Demet Terek
- Division of Neonatology, Department of Pediatrics, Ege University Medical Faculty, Izmir, Turkey
| | - Deniz Gonulal
- Division of Neonatology, Department of Pediatrics, Ege University Medical Faculty, Izmir, Turkey
| | - Ozge Altun Koroglu
- Division of Neonatology, Department of Pediatrics, Ege University Medical Faculty, Izmir, Turkey
| | - Mehmet Yalaz
- Division of Neonatology, Department of Pediatrics, Ege University Medical Faculty, Izmir, Turkey.
| | - Mete Akisu
- Division of Neonatology, Department of Pediatrics, Ege University Medical Faculty, Izmir, Turkey
| | - Nilgun Kultursay
- Division of Neonatology, Department of Pediatrics, Ege University Medical Faculty, Izmir, Turkey
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Kultursay N, Koroglu OA, Uygur O, Terek D, Tanriverdi S, Akisu M, Yalaz M. Improved neonatal prognosis following restriction in the number of transferred embryos in assisted reproduction - single center yearly comparison from Turkey. CLIN EXP OBSTET GYN 2015; 42:442-447. [PMID: 26411208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE To evaluate the impact of new legislation for assisted reproductive technology (ART) restricting the number of transferred embryos on neonatal prognosis of infants born after infertility treatments. MATERIALS AND METHODS Neonatal records of all live born infants in Ege University Maternity Ward were reviewed for 2006 and 2012. Neonatal outcome measures such as birth weight (BW), gestational age (GA), preterm birth (PTB), very low birth weight (VLBW), and neonatal intensive care unit (NICU) admission were evaluated. RESULTS Compared to 2006 percentage of newborns conceived by medically assisted reproduction (MAR) decreased from 14.6% to 5% in all live births, from 23.8% to 8.2% in NICU patients in 2012. The number of fetuses in the last pregnancy, frequency of intrauterine reductions, spontaneous pregnancy losses, antenatal bleeding, and premature delivery decreased. Percentage of multiples among MAR newborns (31.7% vs. 55.7%), twins from 51.4% to 30.9%, triplets from 4.3% to 0.8% all decreased significantly. Mean BW and gestational age increased resulting in decreased frequency of PTB and VLBW. Consequently Level 3 NICU admission rate significantly decreased from 44.3% to 22%. CONCLUSION The new ART legislation in Turkey resulted in decreased rate of multiple births, prematurity and related complications, and NICU admissions in MAR newborns. However the twin rates are still high. Since uncontrolled ovulation stimulation and intrauterine insemination techniques are also associated with multiple births and unfavorable neonatal outcomes, these procedures deserve close monitorization.
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Terek D, Yalaz M, Ulger Z, Koroglu OA, Kultursay N. Medical closure of patent ductus arteriosus does not reduce mortality and development of bronchopulmonary dysplasia in preterm infants. J Res Med Sci 2014; 19:1074-9. [PMID: 25657754 PMCID: PMC4310082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 03/09/2014] [Accepted: 11/21/2014] [Indexed: 11/01/2022]
Abstract
BACKGROUND Although, patent ductus arteriosus (PDA) is associated with significant morbidity due to hemodynamic instability in preterm infants, the effect of ductus closure on mortality and morbidity is a controversial issue. The aim is to evaluate the efficacy of oral and intravenous (IV) ibuprofen treatment on ductal closure and effects on mortality and bronchoplumonary dysplasia. MATERIALS AND METHODS The medical records of 292 premature infants treated at Ege University Neonatal Intensive Care Unit were retrospectively evaluated. Patients were classified into 3 groups as; No PDA, hemodynamically insignificant PDA (hiPDA) and hemodynamically significant PDA (hsPDA) according to the presence and hemodynamical significance of PDA by echocardiography. hsPDA group was treated with IV or oral ibuprofen. RESULTS Patent ductus arteriosus was diagnosed by routine echocardiography in 145 patients, of whom 78 (53.7%) had hsPDA. All 65 infants with hiPDA had spontaneous PDA closure. Echocardiographic measurements were similar to those patients treated with oral or IV ibuprofen, as in the response rate to treatment without serious adverse effects. The presence of respiratory distress syndrome, surfactant therapy, late sepsis, bronchopulmonary dysplasia (BPD) and mortality rates were significantly higher in patients with hsPDA. However, with stepwise logistic regression; 5(th) min Apgar score (odds ratio [OR], 1.321, 95% confidence interval [CI], 1.063-1.641, P = 0.012) and gestational age (OR, 1.422, 95% CI, 1.212-1.662, P < 0.001) were the only significant variables associated with mortality. Gestational age (OR, 0.680, 95% CI, 0.531-0.871, P = 0.002) was the only significant variable associated with BPD shown with logistic regression. CONCLUSION Ibuprofen treatment is effective for hsPDA closure with minimal side effects. HiPDA can close spontaneously; therefore treatment decision should be individualized. However, medical treatment of PDA does not reduce mortality and BPD.
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Affiliation(s)
- Demet Terek
- Deparment of Pediatrics, Ege University Hospital, Bornova, İzmir, Turkey
| | - Mehmet Yalaz
- Deparment of Pediatrics, Ege University Hospital, Bornova, İzmir, Turkey,Address for correspondence: Prof. Mehmet Yalaz, Deparment of Pediatrics, Ege University Hospital, Bornova, 35100, İzmir, Turkey. E-mail:
| | - Zulal Ulger
- Deparment of Pediatrics, Ege University Hospital, Bornova, İzmir, Turkey
| | - Ozge Altun Koroglu
- Deparment of Pediatrics, Ege University Hospital, Bornova, İzmir, Turkey
| | - Nilgun Kultursay
- Deparment of Pediatrics, Ege University Hospital, Bornova, İzmir, Turkey
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Korkmaz HA, Demir K, Kılıç FK, Terek D, Arslanoğlu S, Dizdarer C, Ozkan B. Management of central diabetes insipidus with oral desmopressin lyophilisate in infants. J Pediatr Endocrinol Metab 2014; 27:923-7. [PMID: 24854529 DOI: 10.1515/jpem-2013-0368] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 04/17/2014] [Indexed: 11/15/2022]
Abstract
AIM To assess the efficiency of oral desmopressin lyophilisate (ODL) in neonatal central diabetes insipidus (CDI). METHODS The characteristics of four newborns with CDI treated with ODL were evaluated. RESULTS Four newborns with polyuria and hypernatremia were included [male, 2 (50%); mean postnatal age, 19±17 days]. At the time of hypernatremia, the mean serum and urine osmolality values were 310±16 and 179±48 mOsm/kg, respectively. Antidiuretic hormone levels were undetectable (<0.5 pmol/L) in all cases. Magnetic resonance imaging revealed anatomical malformations in all cases. ODL (60 μg/tablet) dissolved in water (3-5 mL) was initiated with a dose of 5 μg/kg/day in two equal doses, together with limitation of water intake to avoid hyponatremia. Serum sodium levels returned to normal in a mean duration of 58±9.9 h with a mean decline rate of 0.37±0.1 mEq/L/h after desmopressin administration. Rehospitalization was required for one of the infants because of hypernatremia due to non-compliance. No episode of hyponatremia was encountered. Weight gain and growth of the infants were normal during the mean follow-up duration of 8.5±1 months. CONCLUSIONS ODL appears to be practical and safe in the treatment of CDI during the first year of life.
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Abstract
Maternal hypercalcemia suppresses parathyroid activity in the fetus resulting in impaired parathyroid responsiveness to hypocalcemia after birth. Resultant hypocalcemia may be severe and prolonged and rarely may lead to convulsions. Here, we present a newborn infant admitted to the pediatric emergency department at age two weeks with recurrent tonic convulsions due to asymptomatic maternal hyperparathyroidism and vitamin D deficiency. Physicians should be aware that undiagnosed maternal hyperparathyroidism can cause severe hypocalcemia in the newborn.
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Affiliation(s)
- Hüseyin Anıl Korkmaz
- Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, Department of Pediatric Endocrinology, İzmir, Turkey. E-mail:
| | - Behzat Özkan
- Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Demet Terek
- Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, Neonatal Intensive Care Unit, İzmir, Turkey
| | - Ceyhun Dizdarer
- Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Sertaç Arslanoğlu
- Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, Neonatal Intensive Care Unit, İzmir, Turkey
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Terek D, Koroglu O, Yalaz M, Gokben S, Calli C, Coker M, Kultursay N. Diagnostic tools of early brain disturbances in an asymptomatic neonate with maple syrup urine disease. Neuropediatrics 2013; 44:208-12. [PMID: 23341096 DOI: 10.1055/s-0032-1332741] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Maple syrup urine disease (MSUD) is a rare inherited metabolic disorder resulting from the defective activity of branched-chain 2-ketoacid dehydrogenase complex. Routine screening of newborn with tandem mass spectroscopy on the third day of life may detect elevated branched-chain amino acids in blood before the appearance of encephalopathic symptoms in MSUD cases. If undiagnosed by such a routine screening test, patients often present with encephalopathy and seizures. Clinical neurologic examination is supplemented by electroencephalography and imaging. Here, we report abnormal amplitude-integrated electroencephalography, electroencephalography, magnetic resonance imaging, and magnetic resonance imaging spectroscopy findings in a neurologically asymptomatic male newborn who was diagnosed with MSUD at the third week of life. These neurologic disturbances disappeared at the fourth month of life with appropriate special diet. Therefore, even in already asymptomatic cases, early neurologic deterioration of brain metabolism and structure can be detected with these early laboratory findings, indicating the importance of early diagnosis and management. Patients may also benefit from these investigations during the follow-up period.
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Affiliation(s)
- Demet Terek
- Department of Pediatrics, Division of Neonatology, Ege University Faculty of Medicine, Izmir, Turkey
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Tanriverdi S, Terek D, Koroglu OA, Yalaz M, Tekgul H, Kultursay N. Neonatal status epilepticus controlled with levetiracetam at Sturge Weber syndrome. Brain Dev 2013; 35:367-71. [PMID: 22804835 DOI: 10.1016/j.braindev.2012.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 05/03/2012] [Accepted: 06/22/2012] [Indexed: 11/28/2022]
Abstract
Sturge-Weber syndrome is a rare, sporadic, congenital neurocutaneous syndrome characterized by facial cutaneous vascular malformation, leptomeningeal angioma and eye abnormalities. Seizures develop during the first year of life, may become refractory to multiple anticonvulsants and status epilepticus may develop. A rare subtype of Sturge-Weber syndrome with bilateral facial vascular malformation, unilateral cerebral involvement and neonatal status epilepticus is reported here. Neonatal status epilepticus was successfully controlled with intravenous levetiracetam infusion.
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Affiliation(s)
- Sema Tanriverdi
- Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ege University, Izmir, Turkey.
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Terek D, Kayikcioglu M, Kultursay H, Ergenoglu M, Yalaz M, Musayev O, Mogulkoc N, Gunusen I, Akisu M, Kultursay N. Pulmonary arterial hypertension and pregnancy. J Res Med Sci 2013; 18:73-6. [PMID: 23900530 PMCID: PMC3719233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Revised: 06/14/2012] [Accepted: 06/24/2012] [Indexed: 11/28/2022]
Abstract
This is the case report of a pregnant woman who refused pregnancy termination when diagnosed with pulmonary arterial hypertension (PAH) functional class 2-3 at the 24th week of gestation and of her newborn. A pregnant woman with PAH functional class 2-3 was treated with inhaled prostacyclin analog (iloprost), oral sildenafil, oxygen, and low molecular weight heparin. She delivered at 32nd week by Cesarean section. The infant required oxygen up to 36th week postconceptional age and had a short steroid treatment. The mother needed close cardiovascular monitorization, intensive oxygen and pulmonary vasodilator therapy for 2 months and was discharged with oxygen and oral iloprost treatment. A multidisciplinary approach together with pulmonary vasodilator therapy may be succesful in such a high-risk pregnant woman.
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Affiliation(s)
- Demet Terek
- Department of Pediatrics, Division of Neonatology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Meral Kayikcioglu
- Department of Cardiology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Hakan Kultursay
- Department of Cardiology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Mete Ergenoglu
- Department of Obstetrics and Gynecology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Mehmet Yalaz
- Department of Pediatrics, Division of Neonatology, Ege University Faculty of Medicine, Izmir, Turkey,Address for correspondence: Mehmet Yalaz, Associate Professor, Department of Pediatrics, Division of Neonatology, Ege University Faculty of Medicine, Bornova, Izmir - 35100, Turkey. E-mail:
| | - Oktay Musayev
- Department of Cardiology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Nesrin Mogulkoc
- Department of Chest Medicine, Ege University Faculty of Medicine, Izmir, Turkey
| | - Ilkben Gunusen
- Department of Anesthesiology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Mete Akisu
- Department of Pediatrics, Division of Neonatology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Nilgun Kultursay
- Department of Pediatrics, Division of Neonatology, Ege University Faculty of Medicine, Izmir, Turkey
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Terek D, Koroglu OA, Gunes S, Yalaz M, Akisu M, Uçar SK, Gokben S, Coker M, Kultursay N. Diagnostic tools of metabolic and structural brain disturbances in neonatal non-ketotic hyperglycinemia. Pediatr Int 2012; 54:717-20. [PMID: 23005907 DOI: 10.1111/j.1442-200x.2012.03591.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Non-ketotic hyperglycinemia (NKH) is a rare autosomal recessive disorder of glycine metabolism. We report a newborn case of NKH and discuss the effects of this rare disease on brain metabolism and structure together with amplitude-integrated electroencephalography, cranial magnetic resonance and magnetic resonance spectroscopy findings which are very rarely reported together so far.
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Affiliation(s)
- Demet Terek
- Division of Neonatology, Department of Pediatrics, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
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