Browsing by Author "Hanta, Deniz"

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An Aggressive Parenteral Nutrition Protocol Improves Growth in Preterm Infants
(2015) Torer, Birgin; Hanta, Deniz; Ozdemir, Zeliha; Cetinkaya, Bilin; Gulcan, Hande; 0000-0003-0055-8277; 0000-0003-0866-7339; 26701941; F-5143-2017; JMQ-5983-2023; AAF-1346-2021
Antibiotic Use in Pediatric and Neonatal Intensive Care Units; Multicenter Point Prevalence Study
(2014) Tolunay, Orkun; Celik, Umit; Yucel, Gulperi; Celik, Tamer; Mert, Mustafa Kurthan; Resitoglu, Salim; Ozdemir, Ulas; Narli, Nejat; Hanta, Deniz; Yapicioglu, Hacer; Gulcan, Hande; Ozcan, Kenan; Yildizdas, Dincer; Tolunay, Ilknur; Gokay, Naime; Kiraz, Kemal
Objective: Identifying antibiotic use in pediatric and neonatal intensive care units with a point prevalence study in Adana, Turkey's sixth largest city. Material and Methods: In this point prevalence study, demographic information and antibiotic treatment data were taken on the same day from patients in pediatric and neonatal intensive care units of 6 hospitals located in Adana's city center. Results: Four pediatric intensive care units (two university, one research and training hospital, and one public hospital) and six neonatal intensive care units (two university, one research and training hospital, one public hospital, and two private hospital) were included in the study; 220 patients were at the intensive care units at the time of the study-44 (20%) of the patients were in the pediatric intensive care units, and 176 (80%) of them were at the neonatal intensive care units. Also, 146 (66.4%) of the patients were using antibiotics. The frequency of antibiotic use was 72.7% in the pediatric intensive care units and 64.8% in neonatal intensive care units. There was a pediatric infectious disease physician at the university and research and training hospital. Antibiotic usage was lower (p= 0.002) in clinics where pediatric infectious disease physician consultations could be done. Dual antibiotic combination was applied most frequently. Mostly, ampicillin was preferred at neonatal intensive care units. Clarithromycin was used as a second choice because of seasonal lower respiratory tract infections. Vancomycin was the most preferred antibiotic in pediatric intensive care units, and meropenem and linezolid were the second and third choices. At both intensive care units, use of empiric antibiotic treatment was more frequent. Empiric treatment was applied in 22 (68.7%) patients in the pediatric intensive care units and 95 (83.3%) in neonatal intensive care units. Antibiotics were given to 14.3% of the patients in line with the resulting cultures. Conclusion: Intensive care units are services where antibiotics are used most frequently both in Turkey and in the world. In our opinion, protocols need to be established in clinics, national and international guides should be followed; and pediatric infectious disease physician consultations should be increased in order to reduce the frequency of antibiotic use, inappropriate indications, and inappropriate doses.
Determination of tissue hypoxia by physicochemical approach in premature anemia
(2017) Torer, Birgin; Ozdemir, Zeliha; Hanta, Deniz; Cetinkaya, Min; Gulcan, Hande; Tarcan, Aylin; 28395879
Background: Anemia is a common problem in premature infants and its most rapid and effective therapy is erythrocyte transfusion. However, owing to inherent risks of transfusion in this population, transfusions should be administered only when adequate oxygen delivery to tissues is impaired. The aim of this study was to determine tissue acid levels using Stewart method in an attempt to evaluate the tissue oxygenation level and thereby the accuracy of transfusion timing. Methods: This study included 47 infants delivered at gestational age below 34 weeks who required erythrocyte transfusion for premature anemia. Strong ion gap (SIG), unmeasurable anions (UMA), tissue acid levels (TA), and Cl/Na ratios were calculated before and after transfusion. Results: The mean birth weight and gestational age of the study population were 121 +/- 365 g and 29.2 +/- 2.7 weeks, respectively. Tissue acid levels were increased (TA > 4) and tissue hypoxia developed in 10 (16.6%) of 60 erythrocyte transfusions administered according to the restrictive transfusion approach. The patients were divided into two. groups according to tissue acid levels as low (<4) and high (>4) tissue acid groups. The group with tissue hypoxia (TA > 4) had significantly higher UMA levels but a significantly lower Cl/Na ratio; and UMA levels decreased and Cl/ Na ratio increased after transfusion in this group. Tissue hypoxia secondary to anemia was shown to be improved by erythrocyte transfusion. Conclusion: The results of the present study suggest that the determination of the level of tissue hypoxia by the Stewart approach may be an alternative to restrictive transfusion guidelines for timing of transfusion in premature anemia. It also showed that a low Cl/Na ratio can be used as a simple marker of tissue hypoxia. Copyright (C) 2017, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license
Idiopathic Central Diabetes Insipidus Presenting in A Very Low Birth Weight Infant Successfully Managed with Lyophilized Sublingual Desmopressin
(2015) Hanta, Deniz; Torer, Birgin; Temiz, Fatih; Kilicdag, Hasan; Gokce, Mahmut; Erdogan, Ozlem; 26613228; JMQ-5983-2023
Neonatal central diabetes insipidus (DI) is an extremely rare disorder that can cause severe morbidity and mortality. We have reported a very low birth weight infant with idiopathic central DI presenting in the first month of life who was successfully treated with sublingual desmopressin therapy. In this report, we emphasize that central DI should be kept in mind in an infant with unexplained hypernatremia and polyuria. Timely diagnosis and treatment with lyophilized desmopressin may prevent severe morbidity and mortality.
Impact of antenatal corticosteroid exposure on thymus size in premature infants
(2022) Kilicdag, Hasan; Torer, Birgin; Demir, Senay; Hanta, Deniz; Akbas, Tugana; Mert, Mustafa Kurthan; Soker, Gokhan; 0000-0002-5505-8707; 34763993
Background: This study examined the effect of corticosteroids on the thymic index (TI) and the thymus/weight index (TWI) in infants exposed to antenatal corticosteroids (ACS). Methods: This prospective study was conducted between August 2014 and October 2018. A thymus ultrasound was performed to assess thymus size on the second day of life. Thymus size was assessed as TI and TWI. Results: In total, 167 neonates (<= 34 weeks gestation) constituted the study population, including 94 ACSexposed infants and 73 untreated infants. The treatment group exhibited significantly lower birth weight and significantly shorter birth length than the ACS (-) group. Therefore, TI was smaller in the treatment group than in the untreated group (6.96 +/- 4.05 cm(3) vs. 5.64 +/- 3.39 cm(3)). The TWI was 3.69 +/- 1.8 cm(3)/kg in the ACS (-) group versus 3.32 +/- 1.56 cm(3)/kg in the ACS (+) group. The median anteroposterior diameter of the right lobe was 1.33 cm (range, 0.45-2.40) in the ACS (-) group compared to 1.15 cm (range, 0.47-2.40) in the ACS (+) group. The median anteroposterior diameter of the left lobe was 1.40 cm (range, 0.43-2.20) in the ACS (-) group and 1.19 cm (range, 0.32-2.36) in the ACS (+) group. The median largest sagittal area was 2.64 cm(2) (range, 0.5-5.46) in the ACS (-) group versus 2.20 cm(2) (range, 0.55-5.90) in the ACS (+) group. Conclusion: We found that TWI was not significantly changed by ACS exposure in premature infants. (C) 2021 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.
Is Umbilical Cord Milking Always an Advantage?
(2016) Kilicdag, Hasan; Gulcan, Hande; Hanta, Deniz; Torer, Birgin; Gokmen, Zeynel; Ozdemir, Sonay Incesoy; Antmen, Bulent Ali; 25731653
Objective: The role of cord milking as an alternative to delayed cord clamping is an area that requires more research. Purpose of this clinical trial was to investigate the impact of umbilical cord milking on the absolute neutrophil counts (ANCs) and the neutropenia frequency of preterm infants.Methods: Fifty-eight pregnant women were randomly assigned to one of the umbilical cord milking and control groups. A total of 54 preterm infants (gestational age 32 weeks) were enrolled into the study. The umbilical cords of 25 infants were clamped immediately after birth, and in 29 infants, umbilical cord milking was performed first.Results: The ANCs were statistically significantly lower in the cord milking group compared with the control group on days 1, 3 and 7. The frequency of neutropenia was higher in the cord milking group compared with the control group.Conclusion: In our study, ANCs were lower in the cord milking group and the frequency of neutropenia was higher. Umbilical cord milking plays a role on the ANCs of preterm infants.
Primary Repair of Esophageal Atresia with Distal Tracheoesophageal Fistula in a Low-Birth-Weight Neonate
(2015) Hanta, Deniz; Metin, Seval; Cekinmez, Eren Kale; Torer, Birgin; Kilicdag, Hasan; Cevirgenoglu, Bahar
Esophageal atresia is complex congenital anomaly of respiratory tract occuring often associated with anomalies of other systems and chromosomal abnormalities. This congenital anomaly is a surgical emergency. The management mode of Esophageal atresia/Tracheoesophageal Fistula in the premature, low birth weight neonate remains controversial. Traditionally, treatment has been based on a staged approach. The primary repair of Esophageal atresia and fistula closure is achievable in Low Birth Weight infants and offer a good treatment in the absence of additional severe malformations. Treatment of these neonates should not be limited to tertiary pediatric surgical centers, contrarily it is also achievable in secondary heath care centers. Near cooperation with neonatal intensivist and the pediatric surgeon is essential for good survival.