Browsing by Author "Torer, Birgin"

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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
Carbon monoxide poisoning in a newborn
(2020) Torer, Birgin
Cardiac rhabdomyoma associated with tuberosclerosis complex in a newborn
(2016) Torer, Birgin; Cetinkaya, Bilin; Arslan, Alevi; Alkan, Ozlem; Erol, Ilknur; Gulcan, Hande; 0000-0002-3530-0463; 0000-0003-0866-7339; 0000-0003-4444-0027; 0000-0001-7526-3460; AAK-4825-2021; AAF-1346-2021; V-1112-2019; AAM-4169-2021
Cardiac rhabdomyomas are the most comman cardiac tumors in children. They are hamartomatous benign tumors composed of myocytes. They often presents as multiple lesions involving the ventricular cavities. Rhabdomyomas are usually detected in utero by fetal echocardiography. Although patients with cardiac rhabdomyomas are generally asymptomatic these tumors may cause heart failure, severe arrhyhmias and sudden death. Cardiac rhabdomyomas are often associated with tuberosclerosis and they may be the earliest manifestation of tuberosclerosis. Here, we report a newborn infant with antenatally detected cardiac rhabdomyomas associated with tuberosclerosis and we want to emphasize that other diagnostic features of tuberosclerosis should be evaluated in patients with cardiac rhabdomyomas.
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
The Effect of the Cause of Delivery on Neonatal Outcomes in Early Preterm Deliveries
(2019) Baran, Safak Yilmaz; Torer, Birgin; Kalayci, Hakan; Durdag, Gulsen Dogan; 0000-0001-5874-7324; 0000-0002-5505-8707
The aim of this study was to evaluate the effect of causes of delivery on short-term neonatal morbidities and mortality in EPD (< 34 gestational weeks). We retrospectively analysed the deliveries occurring between 23 + 0 and 33 + 6th gestational weeks at our tertiary center during 2014-2018. A total of 290 deliveries were evaluated, and 369 newborns [singletons (56.4%), twins (36.6%) and triplets (7.1%)] were included in the study. The causes of deliveries were defined as spontaneously preterm birth (n = 107, 29%), preterm premature rupture of membranes (PPROM) (n = 131, 35.5%) or iatrogenic preterm birth (n = 131, 35.5%). The rate of neonatal respiratory distress syndrome (RDS), patent ductus arteriosus, bronchopulmonary dysplasia (BPD), intraventricular haemorrhagia (IVH), necrotising enterocolitis, retinopathy of prematurity, neonatal resuscitation, sepsis and death were similar between groups. However; neonatal RDS, BPD, IVH and sepsis were found to be higher in cases with chorioamnionitis, which could be considered as subcategory of PPROM. Preterm deliveries have an adverse effect on perinatal outcomes. Also, such causes of labor might be related to varied neonatal morbidities. However, splitting to early preterm deliveries into subgroups, according to cause of delivery, did not provide further information to predict such complications except chorioamnionitis.
Epidermoid Cyst of Orbit in a Newborn
(2015) Canan, Handan; Altan-Yaycioglu, Rana; Bal, Nebil; Torer, Birgin; Cetinkaya-Cakmak, Bilin; Gulcan, Hande; 26075126
A 3-day-old male newborn presented with a severe proptosis of the left eye leading to exposure keratopathy. He underwent debulking of the cyst and biopsy of the tumour and received the pathological diagnosis of epidermoid cyst of orbit. Clinicopathological features of this rare disease are discussed.
Favorable outcomes in the treatment of aggressive posterior retinopathy of prematurity
(2019) Sahinoglu-Keskek, Nedime; Akkoyun, Imren; Torer, Birgin; 0000-0001-8544-103X; 31718282; T-4258-2017
Objectives: To report the results of intravitreal ranibizumab injection as primary therapy in aggressive posterior retinopathy of prematurity, the process of the disease, and the additive treatments performed. Methods: This retrospective case review included 15 eyes of 8 premature babies with aggressive posterior retinopathy of prematurity who were initially treated with intravitreal ranibizumab injection. The documented data were gestational age, birth weight, gender, postmenstrual age at intravitreal ranibizumab injection, zone of retinopathy of prematurity, reactivation time of disease, iris neovascularization, retinal hemorrhage, anatomical outcome, and additional treatment. Results: Median gestational age at birth was 26 (range, 23-27)weeks, birth weight was 730 (range, 550-970)g, and postconceptional age at aggressive posterior retinopathy of prematurity diagnosis and intravitreal ranibizumab injection was 35 (range, 33-35)weeks. Intravitreal ranibizumab injection was performed as primary treatment. Two eyes necessitated a second intravitreal ranibizumab injection. The reactivation of retinopathy of prematurity was 5 (range, 3-7)weeks after intravitreal ranibizumab injection. Recurrence of the disease in Zone II was treated with laser photocoagulation. A favorable outcome was obtained in all eyes (100%). Conclusion: Aggressive posterior retinopathy of prematurity is a serious, rapidly progressing form of retinopathy of prematurity that requires quick and proper management. This study indicates that primary treatment with ranibizumab and laser photocoagulation on recurrence provide favorable anatomical outcomes.
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.
Idiopathic congenital unilateral vocal cord paralysis: a rare cause of recurrent pneumonia attacks in a newborn
(2019) Gulcan, Hande; Cetinkaya, Bilin; Torer, Birgin; Ozer, Fulya
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.
"Shunt Index'' Can Be Used to Predict Clinically Significant Patent Ductus Arteriosus in Premature Neonates in Early Post-Natal Life
(2014) Yapakci, Ece; Ecevit, Ayse; Torer, Birgin; Ince, Deniz Anuk; Gokdemir, Mahmut; Gulcan, Hande; Tarcan, Aylin; https://orcid.org/0000-0002-2232-8117; https://orcid.org/0000-0002-4369-2110; https://orcid.org/0000-0002-5676-2747; 23816200; AIC-4823-2022; AAJ-4616-2021; I-6746-2016; N-4174-2014
Background: This study aimed to examine the differences between arterial and inferior caval vein oxygen saturation, fractional oxygen extraction, and the shunt index, which were calculated in the diagnosis of patent ductus arteriosus. Methods: Twenty-seven preterm infants were included in this study and were divided into two groups according to patent ductus arteriosus. Among them, 11 (41%) infants had haemodynamically significant patent ductus arteriosus and 16 (59%) did not have significant patent ductus arteriosus. Synchronous arterial and venous blood gases were measured during the first post-natal hours after the insertion of umbilical catheters. The differences between arterial and inferior caval vein oxygen saturation, inferior body fractional oxygen extraction, and the shunt index were calculated. Echocardiography was performed before the 72nd hour of life in a selected group of patients who had haemodynamically significant patent ductus arteriosus. Ibuprofen treatment was administered to patients with patent ductus arteriosus. Echocardiography was performed on the 72nd hour of life in preterm infants without any clinical suspicion of patent ductus arteriosus. Results: The early measured differences between arterial and inferior caval vein oxygen saturation and inferior body fractional oxygen extraction were found to be lower and the shunt index was found to be higher in the haemodynamically significant patent ductus arteriosus group than in the group without haemodynamically significant patent ductus arteriosus. Conclusion: We found that the shunt index, calculated in the first hours of life as >= 63%, predicted haemodynamically significant patent ductus arteriosus with a sensitivity of 78% and specificity of 82% in preterm newborns.