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Erolu E, Sahin O, Bilgin L, Karacan M, Akalin F. The effect of maternal weight on neonatal cardiac functions following diabetic and non-diabetic pregnancies. North Clin Istanb 2024; 11:60-65. [PMID: 38357322 PMCID: PMC10861430 DOI: 10.14744/nci.2023.03342] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 02/02/2023] [Accepted: 07/15/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE We aimed to study myocardial functions of infants appropriate and large for gestational age (IDM-AGA, IDM-LGA) of diabetic mothers (IDM) and AGA and LGA infants of non-diabetic mothers comparatively. METHODS Newborns were assessed between 24 and 72 h. M-Mode, pulsed wave, and tissue Doppler echocardiography were performed. RESULTS A negative correlation was found between shortening fraction and maternal weight at delivery in the LGA group (p=0.009, r=-0.58). E/Early diastolic (E') ratio and deceleration time were increased in IDM-AGA than AGA group (p=0.02, p=0.02). There was a negative correlation between maternal blood glucose and E/A ratio (p=0.015 r=-0.63), a positive correlation between maternal blood glucose and mitral A, late diastolic (A') wave in IDM-AGA (p=0.014 r=0.63, p=0.016 r=0.62). Maternal weight gain during pregnancy was in correlation with measured and tei index in IDM-AGA group (p=0.008 r=0.72). Maternal age, pre-pregnancy weight, and weight at delivery and mitral E were higher in IDM-LGA group than IDM-AGA (p=0.03, p=0.01, p=0.003, p=0.012). CONCLUSION We found that maternal weight has a negative effect on myocardial function in LGA newborns. Diastolic functions were found impaired in IDM-AGA infants and in infants of mothers with high blood glucose. Maternal weight gain during pregnancy has a negative effect on myocardial functions.
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Affiliation(s)
- Elif Erolu
- Division of Pediatric Cardiology, Departmant of Pediatrics, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkiye
| | - Ozlem Sahin
- Division of Neonatology, Departmant of Pediatrics, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkiye
| | - Leyla Bilgin
- Division of Neonatology, Departmant of Pediatrics, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkiye
| | - Mehmet Karacan
- Division of Pediatric Cardiology, Departmant of Pediatrics, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkiye
| | - Figen Akalin
- Division of Pediatric Cardiology, Departmant of Pediatrics, Marmara University Pendik Training and Research Hospital, Istanbul, Turkiye
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Yasa B, Kirit E, Coban A, Bilgin L, Kavram G, Ince Z. Coagulation parameters in very preterm infants. Blood Coagul Fibrinolysis 2023; 34:494-498. [PMID: 37823397 DOI: 10.1097/mbc.0000000000001256] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
The aim of this study was to define normal percentile values of coagulation parameters in preterm infants below 32 weeks of gestational age. This retrospective cohort study was conducted at Istanbul Medical Faculty. Preterm infants who were born prior to 32 weeks of gestation, between 2011 and 2021 were included and evaluated for coagulation parameters. Blood samples obtained through umbilical catheters prior to administration of heparinized flushes/fluids, vitamin K or fresh frozen plasma (FFP). Infants with a major bleeding disorder, intrapartum asphyxia or a history of familial bleeding disorders were excluded. Infants were grouped according to their gestational ages and birth weights: less than 24, 25-26, 27-28, 29-30, 31-32 weeks and <500, 500-749, 750-999, 1000-1249, 1250-1499, more than 1500 g. Third to 97th percentile values of both prothrombin time (PT) and activated partial thromboplastin time (aPTT) were defined. A total of 420 preterm infants were included. The median value and range of gestational age and birth weight of the infants were 29 (22.3-32.9) weeks and 1150 (395-2790) g, respectively. PT values were similar between subgroups according to gestational age but longer in infants with a birth weight less than 1000 g. aPTT values in infants born less than 24 weeks of gestation were found significantly longer. As maturation of the coagulation system increases by gestational age, very preterm infants (<32 gestational week (GW)) are under increased risk of bleeding. Determination of normal percentile distribution of coagulation parameters for preterm infants will shed light on the interpretation of coagulation parameters of these infants and minimize unnecessary FFP administrations.
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Affiliation(s)
- Beril Yasa
- Istanbul University, Istanbul Medical Faculty, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey
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3
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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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Gözen D, Erkut Z, Uslubaş R, Bilgin L. Effect of different positions on gastric residuals in preterm infants initiating full enteral feeding. Nutr Clin Pract 2021; 37:945-954. [PMID: 34647337 DOI: 10.1002/ncp.10789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND This study was conducted to determine the effect of feeding in different positions on the gastric residual volume after feeding in preterm infants who initiated full enteral feeding. METHODS This quasi-experimental study was conducted with the hypothesis that testing the right lateral position leads to less gastric residual than left lateral position and the prone position leads to less gastric residual than the supine position. The data were collected in four stages from 35 preterm infants. Initially, the infants were positioned in supine position and were fed. After feeding, the infant rested in the supine position for 3 h. The stomach content was aspirated, and the volume of gastric residual was measured at the 60th, 120th, and 180th min after feeding. These steps are repeated in order of in the right lateral, left lateral, and prone position. Total gastric residual volume and type of enteral feeding were evaluated. RESULTS There was no significant difference among the positions in terms of the volume of gastric residuals in the measurements made at 60th (P = 9.552), 120th (P = .505), and 180th min (P = .430). When the amount of decrease in the gastric residual volumes was a significant difference between all measurement times in right lateral and prone positions (P < .001). CONCLUSION Although no significant difference was determined between the positions, the smallest residual volumes were determined in the right lateral and prone positions. The amount of decrease in residual volume was significant in right lateral and prone positions.
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Affiliation(s)
- Duygu Gözen
- Department of Pediatric Nursing, Istanbul University-Cerrahpaşa, Florence Nightingale Faculty of Nursing, Istanbul, Turkey
| | - Zeynep Erkut
- School of Nursing, Maltepe University, Istanbul, Turkey
| | - Rabia Uslubaş
- Neonatal Intensive Care Unit, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Leyla Bilgin
- Neonatal Intensive Care Unit, Umraniye Training and Research Hospital, Istanbul, Turkey
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Aykanat Girgin B, Gözen D, Uslubaş R, Bilgin L. The Evaluation of Oral Feeding in Preterm Infants: Turkish Validation of the Early Feeding Skills Assessment Tool. Turk Arch Pediatr 2021; 56:440-446. [PMID: 35110111 PMCID: PMC8849411 DOI: 10.5152/turkarchpediatr.2021.21008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Burcu Aykanat Girgin
- Department of Pediatric Nursing, University of Health Sciences Hamidiye Faculty of Nursing, Istanbul, Turkey
| | - Duygu Gözen
- Department of Pediatric Nursing, Istanbul University- Cerrahpasa Florence Nightingale Faculty of Nursing, Istanbul, Turkey
- Corresponding author:Duygu Gözen ✉
| | - Rabia Uslubaş
- Neonatal Intensive Care Unit, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Leyla Bilgin
- Neonatal Intensive Care Unit, Ümraniye Training and Research Hospital, Istanbul, Turkey
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Kanburoglu MK, Tayman C, Oncel MY, Akin IM, Can E, Demir N, Arayici S, Baser DO, Caner I, Memisoglu A, Uygun SS, Akar S, Akin MA, Ataoglu E, Bezirganoglu H, Bilgin L, Bozdag S, Comert S, Gurpinar R, Imamoglu EY, Imdadoglu T, Narter F, Ozdemir R, Toptan HH, Yalinbas EE, Yaman A, Erdeve O, Koc E. A Multicentered Study on Epidemiologic and Clinical Characteristics of 37 Neonates With Community-acquired COVID-19. Pediatr Infect Dis J 2020; 39:e297-e302. [PMID: 32932329 DOI: 10.1097/inf.0000000000002862] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 12/18/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) primarily affects adults and spares children, whereas very little is known about neonates. We tried to define the clinical characteristics, risk factors, laboratory, and imagining results of neonates with community-acquired COVID-19. METHODS This prospective multicentered cohort study included 24 neonatal intensive care units around Turkey, wherein outpatient neonates with COVID-19 were registered in an online national database. Full-term and premature neonates diagnosed with COVID-19 were included in the study, whether hospitalized or followed up as ambulatory patients. Neonates without severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) via reverse transcriptase-polymerase chain reaction testing or whose mothers had been diagnosed with COVID-19 during pregnancy were excluded. RESULTS Thirty-seven symptomatic neonates were included. The most frequent findings were fever, hypoxemia, and cough (49%, 41%, 27%, respectively). Oxygen administration (41%) and noninvasive ventilation (16%) were frequently required; however, mechanical ventilation (3%) was rarely needed. Median hospitalization was 11 days (1-35 days). One patient with Down syndrome and congenital cardiovascular disorders died in the study period. C-reactive protein (CRP) and prothrombin time (PT) levels were found to be higher in patients who needed supplemental oxygen (0.9 [0.1-8.6] vs. 5.8 [0.3-69.2] p = 0.002, 11.9 [10.1-17.2] vs. 15.2 [11.7-18.0] p = 0.01, respectively) or who were severe/critical (1.0 [0.01-8.6] vs. 4.5 [0.1-69.2] p = 0.01, 11.7 [10.1-13.9] vs. 15.0 [11.7-18.0] p = 0.001, respectively). CONCLUSIONS Symptomatic neonates with COVID-19 had high rates of respiratory support requirements. High CRP levels or a greater PT should alert the physician to more severe disease.
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Affiliation(s)
- Mehmet Kenan Kanburoglu
- From the Recep Tayyip Erdoğan University School of Medicine, Department of Pediatrics, Division of Neonatology, Rize
| | - Cuneyt Tayman
- Ministry of Health Ankara City Hospital, Division of Neonatology, Ankara
| | - Mehmet Yekta Oncel
- İzmir Katip Celebi University School of Medicine, Department of Pediatrics, Division of Neonatology, Izmir.,University of Health Sciences, Tepecik Training and Research Hospital, Division of Neonatology, Izmir
| | - Ilke Mungan Akin
- University of Health Sciences, Umraniye Training and Research Hospital, Division of Neonatology, Istanbul
| | - Emrah Can
- University of Health Sciences, Bagcilar Training and Research Hospital, Division of Neonatology, Istanbul
| | - Nihat Demir
- Ozel Esencan Hospital, Division of Neonatology, Esenyurt, Istanbul
| | - Sema Arayici
- Ministry of Health Eskisehir City Hospital, Division of Neonatology, Eskisehir
| | - Demet Orhan Baser
- Batman Obstetric ve Pediatric Hospital, Division of Neonatology, Batman
| | - Ibrahim Caner
- Sakarya University School of Medicine, Department of Pediatrics, Division of Neonatology, Sakarya
| | - Asli Memisoglu
- Marmara University School of Medicine, Department of Pediatrics, Division of Neonatology, İstanbul
| | - Saime Sundus Uygun
- Ministry of Health Kahramanmaras Necip Fazil City Hospital, Division of Neonatology, Kahramanmaras
| | - Selahattin Akar
- Adiyaman University School of Medicine, Department of Pediatrics, Division of Neonatology, Adiyaman
| | - Mustafa Ali Akin
- On dokuz Mayis University School of Medicine, Department of Pediatrics, Division of Neonatology, Samsun
| | - Emel Ataoglu
- Ministry of Health Haseki Training and Research Hospital, Division of Neonatology, Istanbul
| | - Handan Bezirganoglu
- University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakir
| | - Leyla Bilgin
- Istanbul University School of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul
| | - Senol Bozdag
- Istanbul Okan University, Department of Pediatrics, Division of Neonatology, Istanbul
| | - Serdar Comert
- University of Health Sciences, Istanbul Training and Research Hospital, Istanbul
| | - Resat Gurpinar
- Kocaeli University School of Medicine, Department of Pediatrics, Division of Neonatology, Kocaeli
| | - Ebru Yalin Imamoglu
- Medeniyet University School of Medicine, Goztepe Training and Research Hospital, Istanbul
| | - Timucin Imdadoglu
- University of Health Sciences, Sancaktepe Training and Research Hospital, Division of Neonatology, Istanbul
| | - Fatma Narter
- Ministry of Health Kartal Dr. Lütfi Kirdar City Hospital, Division of Neonatology, Istanbul
| | - Ramazan Ozdemir
- Inonu University School of Medicine, Department of Pediatrics, Division of Neonatology, Malatya
| | - Handan Hakyemez Toptan
- University of Health Sciences, İstanbul Zeynep Kamil Training and Research Hospital, Division of Neonatology, Istanbul
| | - Emine Esin Yalinbas
- University of Health Sciences, Evliya Celebi Training and Research Hospital, Division of Neonatology, Kutahya
| | - Akan Yaman
- Nişantaşi University School of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul
| | - Omer Erdeve
- Ankara University School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara
| | - Esin Koc
- Gazi University School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
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Ünal S, Kaya A, Bilgin L, Misirlioğlu E, Kocabaş CN. Wheezing, asthma, and atopy in premature infants at 2 years of age. Turk J Med Sci 2017; 47:607-613. [PMID: 28425254 DOI: 10.3906/sag-1511-37] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 10/08/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM We aimed to evaluate wheezing, bronchial asthma (BA), and atopy in premature infants at 2 years of age via a cross-sectional study. MATERIALS AND METHODS Premature infants at <37 weeks of gestational age (GA) were assessed for atopy by skin-prick test and serum immunoglobulin E level at 2 years of age. The family's and infant's histories of allergy, BA, atopy, and wheezing were obtained by questionnaire and from hospital records. RESULTS There were 98 infants, with mean birth weight (BW) 1517.4 ± 486.5 g and GA 30.8 ± 2.9 weeks. The frequencies of wheezing, asthma, and bronchopulmonary dysplasia (BPD) were 32.7%, 16.3%, and 14.3%, respectively. Skin-prick tests were positive for 11 subjects, with allergy to cereals for 7 infants, egg for 3, and peanut for 1. Wheezing was related to GA, BW, respiratory distress syndrome, mechanical ventilation, sepsis, asphyxia, smoking, antenatal steroid, BA, palivizumab prophylaxis, number of people in the household, and duration of hospitalization (P < 0.05). Wheezing was negatively correlated to GA. Family history of BA, smoking, and number of people in the household were linked to BA (P < 0.05). CONCLUSION Wheezing was related to degree of premature birth, but BA was linked to BA in the family and smoking. Increased gestation should improve the infant's respiratory health up to 2 years of age.
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Affiliation(s)
- Sevim Ünal
- Department of Neonatology, Ankara Children's Hematology Oncology Research and Training Hospital, Ankara, Turkey
| | - Ayşenur Kaya
- Department of Pediatric Allergy and Immunology, Şişli Hamidiye Etfal Research and Training Hospital, Ankara, Turkey
| | - Leyla Bilgin
- Department of Neonatology, Ümraniye Research and Training Hospital, İstanbul, Turkey
| | - Emine Misirlioğlu
- Department of Pediatric Allergy and Immunology, Ankara Children's Hematology Oncology Research and Training Hospital, Ankara, Turkey
| | - Can Naci Kocabaş
- Department of Pediatric Allergy and Immunology, Muğla Sıtkı Koçman University, Muğla, Turkey
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Bilgin L, Unal S, Gunduz M, Uncu N, Tiryaki T. Utility of peritoneal dialysis in neonates affected by inborn errors of metabolism. J Paediatr Child Health 2014; 50:531-5. [PMID: 24612162 DOI: 10.1111/jpc.12510] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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] [Accepted: 11/30/2013] [Indexed: 12/31/2022]
Abstract
AIM Some inborn errors of metabolism induce metabolic encephalopathy through accumulation of neurotoxic metabolites. Rapid elimination of these metabolites by peritoneal or extracorporeal dialysis is crucial to prevent neuronal damage or death. In this retrospective study, we evaluated the outcomes of nine neonates with metabolic crisis treated with peritoneal dialysis. METHOD Six neonates with hyperammonemic coma (four with organic acidemias, two with urea cycle disorders) and three with leucine accumulation due to maple syrup urine disease (MSUD) were managed with peritoneal dialysis in conjunction with dietary and pharmacological therapy. RESULTS Three patients with organic acidemia survived. One of the patients was normal; others had moderate and severe neurological impairments. One neonate with organic acidemia and both neonates with urea cycle disorders died. Two of the three patients with MSUD survived without neurological impairment; the other had severe neurological damage and died at 9 months of age due to sepsis. CONCLUSION Theoretically, extracorporeal dialysis should be the first dialysis treatment of choice; however, this report demonstrates that peritoneal dialysis has a chance to prevent neurological damage in some patients. Therefore, in developing countries without extracorporeal dialysis opportunities, it can be still a life-saving procedure, if it is applied with skilled staff and standard procedures.
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Affiliation(s)
- Leyla Bilgin
- Division of Neonatology, Republic of Turkey Ministry of Health Ankara Children's Hematology and Oncology Research Hospital, Ankara, Turkey
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Can G, Bilgin L, Tatli B, Saydam R, Coban A, Ince Z. Morbidity in early adulthood among low-risk very low birth weight children in Turkey: a preliminary study. Turk J Pediatr 2012; 54:458-464. [PMID: 23427507] [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: 06/01/2023]
Abstract
The objective of this study was to assess low-risk very low birth weight (VLBW) children, before the era of modern neonatal intensive care in Turkey, during adolescence. Forty-one VLBW adolescents were compared with 40 adolescents who had normal birth weight. The physical and neuromotor development, educational achievement and psychosocial status were assessed at a mean age of 17 +/- 1.6 years. VLBW adolescents were shorter than normal birth weight adolescents (p = 0.01). A major neurological abnormality (cerebral palsy) was seen in 12% and a minor neurological abnormality (tremor, coordination, behavioral and speech disorders) in 17%. VLBW adolescents had higher rates of visual problems (56% vs. 5%). School failure was present in 27%. There were no differences in behavioral problems or quality of life between the two groups, but VLBW adolescents did have a lower self-esteem score. Neurodevelopment and growth sequelae were a significant problem in VLBW adolescents. As early intervention might help to prevent or ameliorate potential problems, long-term follow-up is essential.
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Affiliation(s)
- Gülay Can
- Division of Neonatology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine
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Unal S, Ekici F, Cetin İİ, Bilgin L. Heparin infusion to prevent umbilical venous catheter related thrombosis in neonates. Thromb Res 2012; 130:725-8. [PMID: 22901699 DOI: 10.1016/j.thromres.2012.07.018] [Citation(s) in RCA: 15] [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] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 06/21/2012] [Accepted: 07/17/2012] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate umbilical venous catheter (UVC) related thrombosis by Doppler echocardiographic evaluation of neonates infused with heparin or placebo. METHODS We conducted a prospective study to determine UVC-related thrombosis in term and nearterm neonates. Heparin or placebo (0.5 IU/mL) was infused at a rate of 1 mL/hr to the study and control group. Doppler echocardiography was performed at 1, 3, and 5 days after UVC insertion. RESULTS Forty-six neonates (63% males) with a mean gestational age of 38.2 ± 1.8 weeks, and a mean birth-weight of 2993 ± 563 grams were included. No UVC-related thrombosis was observed in the study group, which included 19 neonates. Among the 27 neonates in the control group, one neonate developed UVC-related thrombosis. There were no statistical differences between the groups for gestational age, birth weight, postnatal age, UVC duration, mortality, mechanical ventilation, and inotrope requirement, and hemagram or coagulation profile. The complications were as follows, mild pulmonary hemorrhage, 6.5% (3); leak-out, 4.3% (2); peritoneal leakage, 2.2% (1); occlusion, 2.2% (1); gastrointestinal findings, 6.5% (3); sepsis, 10.9% (5); and catheter-related thrombosis, 2.2% (1). CONCLUSION This study demonstrated that heparin infusion of 0.5 IU/mL through the UVC had no effect on catheter-related thrombosis in term and near-term neonates. Randomized controlled trials are necessary to conclusively evaluate the effect of heparin on UVC-related thrombosis.
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Affiliation(s)
- Sevim Unal
- Division of Neonatology, Ankara Child Health, Hematology, Oncology, Research Hospital, Ankara, Turkey.
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Unal S, Demir HA, Bilgin L, Akcan B, Kacar A. A newborn with respiratory distress and hydrocephalus caused by a giant mature teratoma. Childs Nerv Syst 2012; 28:633-6. [PMID: 22038151 DOI: 10.1007/s00381-011-1612-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 10/10/2011] [Indexed: 11/25/2022]
Affiliation(s)
- Sevim Unal
- Unit of Neonatology, Ankara Children's Hematology Oncology Education and Research Hospital, Ankara, Turkey
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Unal S, Bilgin L, Gunduz M, Uncu N, Azili MN, Tiryaki T. The implementation of neonatal peritoneal dialysis in a clinical setting. J Matern Fetal Neonatal Med 2012; 25:2111-4. [PMID: 22420616 DOI: 10.3109/14767058.2012.665105] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate etiology, outcome and complications related to neonatal peritoneal dialysis (PD). METHODS Neonates treated with PD in our neonatal intensive care unit during 2007-2010 were analyzed retrospectively. RESULTS Among 4036 hospitalized neonates; 20 neonates (0.5%) who underwent 21 cycles of PD [7 preterm, 13 term; 13 female, 7 male] were included. The mean birth weight was 2930.2 ± 720.6 g (1120-4570), mean gestational age was 37.5 ± 3.5 weeks (27-41). The etiologic disorders included inborn errors of metabolism (propionic acidemia, methylmalonic acidemia, citrullinemia, glutaric aciduria type 2, maple syrup urine disease, 10), or acute renal failure secondary to perinatal asphyxia (4), sepsis (2), prematurity (2), hypoplastic left heart syndrome (1), kernicterus (1). The complications included peritonitis (2), early leakage (4), hemorrhage (1), catheter removal (3) and occlusion (2). The mortality rate was 50%. The gestational ages and birth weights of surviving neonates were higher (p < 0.05). Among surviving neonates, chronic renal failure (1), severe (4) and moderate neuromotor impairment (2) developed within 4-43 months. CONCLUSION PD, although invasive, is an effective therapy in neonates. The complexity and invasiveness of the procedure is probably responsible for high rate of complications and mortality. If appropriate catheter selection and technique in the placement should be done, PD might improve outcome.
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Affiliation(s)
- Sevim Unal
- Department of Neonatology, Ankara Children's Health Hematology Oncology Research Hospital, Ankara, Turkey.
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