Fakülteler / Faculties

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    Noninvasive Evaluation of Swallowing Sound is an Effective Way of Diagnosing Feeding Maturation in Newborn Infants
    (2014) Ince, Deniz Anuk; Ecevit, Ayse; Acar, Banu Oskay; Saracoglu, Ahmet; Kurt, Abdullah; Tekindal, Mustafa Agah; Tarcan, Aylin; https://orcid.org/0000-0002-4369-2110; https://orcid.org/0000-0002-2232-8117; https://orcid.org/0000-0002-4430-444X; https://orcid.org/0000-0002-4060-7048; 24814215; I-6746-2016; AAJ-4616-2021; HIU-0129-2022; U-9270-2018
    Aim: Despite extensive research, there is still controversy regarding the time at which sucking and swallowing functions mature in preterm infants. This study aimed to evaluate maturation using the noninvasive method of swallowing sound. Methods: We compared 52 preterm infants of between 27 and 36 weeks' gestational age with a control group of 42 healthy full-term infants. Feeding performance was based on swallowing data collected during two-minute audio recordings. The following variables were generated for each evaluation: total number of swallows, total number of rhythmic swallows, total number of resting intervals, average time between resting intervals, average time between swallows, average time between rhythmic swallows, maximum number of rhythmic swallows and volume of milk ingested. The dependency of the variables on postmenstrual age was also investigated. Results: The volume of milk ingested by the preterm infants and the maximum number of rhythmic swallows were positively correlated with postmenstrual age (PMA). The preterm infants reached the 10th percentile of the control infants at 34-35 weeks' PMA and were not significantly different from the control infants at 38-40 weeks' PMA. Conclusion: Swallowing sound can be used to assess feeding maturation in preterm infants during neonatal intensive care unit follow-up.
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    "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.
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    Acupressure at BL60 and K3 Points Before Heel Lancing in Preterm Infants
    (2015) Abbasoglu, Aslihan; Cabioglu, Mehmet Tugrul; Tugcu, Ali Ulas; Ince, Deniz Anuk; Tekindal, Mustafa Agah; Ecevit, Ayse; Tarcan, Aylin; 0000-0002-2232-8117; 0000-0002-4060-7048; 0000-0002-4369-2110; 26242287; ABI-2113-2020; AAJ-4616-2021; U-9270-2018; I-6746-2016
    Context: Acupressure is an ancient Chinese healing art. In this pain-relieving method, the fingers are used to press key acupuncture points on the skin surface that stimulates the body's regulatory processes. Objective: The aim of this study was to investigate the effect of acupressure at Kun Lun (UB60) and Taixi (K3) points for pain management in preterrn infants prior to heel lancing for blood collection. Design: This was a prospective, randomized controlled study. Setting: The study setting was the neonatal intensive care unit at Baskent University Hospital in Turkey. Patients: A total of 32 preterm infants between 28 and 36 weeks' gestational age were randomly assigned to one of two groups: an acupressure group (n = 16) or a control group (n = 16). Intervention: In the acupressure group, immediately before the heel prick, acupressure was applied for three minutes at UB60 and K3 points. Main Outcome Measures: A behavioral pain score was determined using the Premature Infant Pain Profile (PIPP) scale. Results: There were no significant differences between the groups with respect to gestational age, birth weight, sex, mode of delivery, age at time of procedure, weight at time of procedure, or PIPP score. Mean duration of procedure and mean duration of crying were both shorter in the acupressure group (both P = .001). Conclusions: Applying acupressure at the BL60 and K3 points before heel lancing was associated with shorter procedural time and shorter duration of crying in preterm infants.
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    Congenital Hyperinsulinism in A Newborn with A Novel Homozygous Mutation (P.Q392H) in The ABCC8 Gene
    (2014) Ince, Deniz Anuk; Sahin, Nursel Muratoglu; Ecevit, Ayse; Kurt, Abdullah; Kinik, Sibel Tulgar; Flanagan, Sarah E.; Hussain, Khalid; Tarcan, Aylin; https://orcid.org/0000-0002-4369-2110; https://orcid.org/0000-0002-8215-0146; https://orcid.org/0000-0002-2232-8117; https://orcid.org/0000-0002-4430-444X; https://orcid.org/0000-0002-8670-6340; 24945427; I-6746-2016; AAA-1266-2019; AAJ-4616-2021; HIU-0129-2022; AFK-0591-2022
    Congenital hyperinsulinism is the most frequent cause of persistent hypoglycemia in infancy. We present the case of a preterm, large-for-gestation-age infant with congenital hyperinsulinism who was found to have a novel p.Q392H homozygous mutation in the ABCC8 gene. The patient had severe brain damage, despite early diagnosis and appropriate management. The new mutations may provide an understanding of the prognosis and treatment of the disease. In addition, the data will help the family make informed decisions about future pregnancies.
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    Goniometer Measurements of Oral Labial Angle and Evaluation of Oral Motor Reflexes in Preterm Infants: Comparison to Findings in Term Infants
    (2015) Ince, Deniz Anuk; Tugcu, Ali Ulas; Ecevit, Ayse; Ciyiltepe, Muzeyyen; Kurt, Abdullah; Abbasoglu, Aslihan; Tekindal, Mustafa Agah; Tarcan, Aylin; 0000-0002-4430-444X; 0000-0002-2232-8117; 0000-0002-4369-2110; 0000-0003-4161-8117; 0000-0002-4060-7048; 25792430; HIU-0129-2022; AAJ-4616-2021; I-6746-2016; Q-1547-2019; U-9270-2018; ABI-2113-2020
    To date, no study has evaluated changes in oral labial angle as preterm infants mature. The main purpose of this study was to document goniometer measurements of the labial angle of the mouth in preterm infants, to assess changes with development, to compare to findings in healthy term infants, and also evaluate oral motor reflexes in these groups. Seventy-eight preterm infants and 45 healthy term infants were recruited for the prospective study. Labial angle was assessed via goniometer, and oral motor reflexes and the volume of milk ingested were evaluated. There was significant difference between term and preterm infants' labial angles (P < .01). The distribution of preterm infants' angles were similar to term infants' by 36 to 40 weeks' postmenstrual age. Goniometer measurements of the oral labial angle may reveal oral motor performance in preterm infants and may be relevant for feeding skills assessment in this group of infants.
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    Effect of breast milk and sucrose on pain and perfusion index during examination for retinopathy of prematurity
    (2021) Turan, Ozden; Akkoyun, Imren; Ince, Deniz Anuk; Doganay, Beyza; Tugcu, A. Ulas; Ecevit, Ayse; 0000-0002-7707-1881; 0000-0002-2860-7424; 0000-0002-4369-2110; 31203685; 0000-0002-7707-1881; AAK-7713-2021; I-6746-2016
    Objective: The objective of this study is to investigate the effect of breast milk and sucrose on pain scores and perfusion index (PI) and to evaluate the alteration in pain and PI during retinopathy of prematurity (ROP) examination. Methods: This prospective randomized controlled study was conducted with preterm infants who were born in our hospital, hospitalized in the neonatal intensive care unit and whose gestational week was <32 weeks and birth weight was <1500 g. The preterm infants who would undergo ROP examination were allocated to three groups according to simple randomization method as follows: group 1: only local anesthetic eye drops, proparacaine HCl ophthalmic solution 0.5%, group 2: proparacaine HCl ophthalmic solution 0.5% plus breast milk, and group 3: proparacaine HCl ophthalmic solution 0.5% plus sucrose 24%. Postductal PI, transcutaneous oxygen saturation and heart rate (HR) values were measured before the eye examination (0), at the 30th, 60th, and 90th seconds (s) of the eye examination and 30 s after lasting of the examination in all infants. Pain was evaluated using Neonatal Infant Pain Scale (NIPS) during the examination. Results: Fifty-one preterm neonates were prospectively enrolled into the study. The HR was higher during and after the examination in all infants according to before the examination (p < .001). Transcutaneous oxygen saturation values significantly decreased during the examination in breast milk and sucrose groups (p = .001 and <.001, respectively). While PI was found to be lower at the 60th s compared to the 30th s of the examination in the proparacaine HCl group, no difference was found between the values before and after the examination. Perfusion index was found to significantly decrease during and after the examination compared to the values before the examination in the breast milk group. Perfusion index values were determined to significantly decrease at the 30th and 60th s of the examination in the sucrose group. The NIPS scores during the examination were determined to be higher compared to the NIPS scores before the examination in all groups (p< .001). In the intergroup comparisons, the NIPS scores were found to be higher in the sucrose group compared to the proparacaine HCl group at the 60th s of the examination and higher than that in the breast milk group at the 90th s of the examination (p = .02 and p = .01, respectively). Conclusions: The present study indicates that alterations may be seen in PI during the ROP examination; in other words, peripheral tissue perfusion could be affected. We consider that eye examination is a very painful procedure, and administering breast milk, sucrose or local anesthetic is not sufficient for reducing pain.
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    Complete Fetal Atrioventricular Block Associated with Maternal Autoinflammatory Diseases: Case Report and Literature Review
    (2020) Tugcu, Ali Ulas; Ince, Deniz Anuk; Esin, Sertac; Turan, Ozden; Erdogan, Ilkay; Ecevit, Ayse; 0000-0002-2232-8117; 0000-0002-7707-1881; 0000-0001-9577-4946; 0000-0002-4369-2110; 31903011; AAJ-4616-2021; AAJ-2333-2021; AAJ-2305-2021; AAI-8810-2021; I-6746-2016
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    A newborn case diagnosed as isolated TBX1 deletion with 22q11 deletion syndrome
    (2020) Turan, Ozden; Celik, Zerrin Yilmaz; Ince, Deniz Anuk; Terzi, Yunus Kasim; Ecevit, Ayse; 0000-0002-2232-8117; 0000-0002-7707-1881; 0000-0002-4369-2110; AAJ-4616-2021; AAJ-2333-2021; I-6746-2016
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    Evaluation of Moro reflex with an objective method in late preterm and term infants
    (2019) Ince, Deniz Anuk; Ecevit, Ayse; Yildiz, Metin; Tugcu, Ali Ulas; Ceran, Burak; Tekindal, Mustafa Agah; Turan, Ozden; Tarcan, Aylin; 0000-0002-4369-2110; 0000-0002-2554-6953; 30660088; I-6746-2016
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    Hemolytic anemia caused by non-D minor blood incompatibilities in a newborn
    (2019) Tugcu, Ali Ulas; Ince, Deniz Anuk; Turan, Ozden; Belen, Burcu; Olcay, Lale; Ecevit, Ayse; 31692740
    Hyperbilirubinemia is one of the most widely seen cause of neonatal morbidity. Besides ABO and Rh isoimmunization, minor blood incompatibilities have been also been identified as the other causes of severe newborn jaundice. We report a newborn with indirect hyperbilirubinemia caused by minor blood group incompatibilities (P1, M, N, s and Duffy) whose hemolysis was successfully managed with intravenous immunoglobulin therapy. A thirty-two gestational weeks of preterm male baby became severely icteric on postnatal day 11, with a total bilirubin level of 14.66 mg/dl. Antibody screening tests revealed incompatibility on different minor groups (P1, M, N, s and Duffy (Fya ve Fyb)). On postnatal day thirteen, the level of bilirubin increased to 20.66 mg/dl although baby was under intensive phototherapy. After the administration of intravenous immunoglobulin and red blood cell transfusion, hemoglobin and total bilirubin levels became stabilised. Minor blood incompatibilities should be kept in mind during differential diagnosis of hemolytic anemia of the newborn. They share the same treatment algorithm with the other types hemolytic anemia. New studies revealed that intravenous immunoglobulin treatment in hemolytic anemia have some attractive and glamorous results. It should be seriously taken into consideration for treatment of minor blood incompatibilities.