Fakülteler / Faculties
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Item Neonatal Thyrotoxicosis with Severe Supraventricular Tachycardia: Case Report and Review of the Literature(2015) Abbasoglu, Aslihan; Ecevit, Ayse; Tugcu, Ali Ulas; Erdogan, Ilkay; Kinik, Sibel Tulgar; Tarcan, Aylin; 0000-0002-2232-8117; 0000-0001-6887-3033; 25153577; AAJ-2305-2021; AAJ-4616-2021; ABB-2220-2021; ABI-2113-2020Neonatal thyrotoxicosis is a rare condition caused by the transplacental passage of thyroid stimulating immunoglobulins from mothers with Graves' disease. We report a case of neonatal thyrotoxicosis with concurrent supraventricular tachycardia (SVT). The female infant, who was born by section due to breech delivery and meconium in the amniotic fluid at 36 weeks of gestation, presented with tachycardia on day 7. Her heart rate was between 260 and 300 beats/min, and an electrocardiogram revealed ongoing SVT. Sotalol was effective after two cardioversions in maintaining sinus rhythm. Thyroid function studies revealed hyperthyroidism in the infant, and her mother was found to have Graves' disease. Since symptoms and signs can vary, especially in preterm infants with neonatal hyperthyroidism, we want to emphasize the importance of prenatal care and follow-ups of Graves' disease associated pregnancies and management of newborns after birth.Item 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-0591-2022Congenital 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.Item Erythropoietin May Attenuate Lung Inflammation in A Rat Model of Meconium Aspiration Syndrome(2016) Turhan, Ali Haydar; Atici, Aytug; Muslu, Necati; Polat, Ayse; Sungur, Mehmet Ali; 27266360Background: Inflammation is believed to play a key role in the pathophysiology of meconium aspiration syndrome (MAS). Purpose of the Study: The objective was to determine whether the recombinant human Erythropoietin (rhEPO) pretreatment could attenuate meconium-induced inflammation. Materials and Methods: In this study, 24 ventilated adult male rats were studied to examine the effects of recombinant human EPO (rhEPO) onmeconium-induced inflammation. Seventeen rats were instilled with human meconium (1.5 mL/kg, 65 mg/mL) intratracheally and ventilated for 3 hours. rhEPO (1000 U/kg) (n = 9) or saline (n = 8) was given to the animals. Seven rats that were ventilated and not instilled with meconium served as a sham-controlled group. Analysis of the blood gases, interleukin (IL)-1 beta, IL-6, IL-8, and tumor necrosis factor (TNF)-alpha in blood and bronchoalveolar lavage (BAL) fluid samples, and lung tissue myeloperoxidase levels were performed. Results: Intrapulmonary instillation of meconium resulted in the increase of TNF-alpha (p = 0.005 and p < 0.001, respectively) and IL-8 concentrations (p < 0.001 and p < 0.001, respectively) in BAL fluid in the EPO + meconium and saline + meconium groups compared with the sham-controlled group. rhEPO pretreatment prevented the increase of BAL fluid IL-1 beta, IL-6, and IL-8 levels (p < 0.001, p = 0.021, and p = 0.005, respectively), and serum IL-6 levels (p = 0.036). Conclusion: rhEPO pretreatment is associated with improved BAL fluid and serum cytokine levels. Pretreatment with rhEPO might reduce the risk of developing of meconium-induced derangements.Item Prevalence of Congenital Cutaneous Anomalies in 1000 Newborns and a Review of the Literature(2016) Solak, Sezgi Sarikaya; Altunay, Ilknur Kivanc; Demirci, Gulsen Tukenmez; Can, Burce; https://orcid.org/0000-0002-9646-0719; 26171599; D-6031-2017Objective There are limited reports studying on congenital cutaneous anomalies in newborns, particularly in Turkey. Some of congenital cutaneous anomalies serve as an important clue for accompanying syndromes or other medical conditions. This study aimed to determine the prevalence of congenital cutaneous anomalies in newborns and to discuss their clinical significance with a brief review of literature. Study Design A total of 1,000 newborns were examined by a dermatologist in a hospital-based, cross-sectional, prospective study between October 2011 and April 2012. Results We observed 11 different congenital cutaneous anomalies in 48 newborns of 1,000 (4.8%). The most commonly seen anomalies were sacral dimple, accessory nipple, acrochordon, hypospadias, open spinal dysraphism, and accessory tragus. None of the newborns with cutaneous anomalies had any association. Conclusions Although congenital cutaneous anomalies are rare in newborns, clinicians should be aware of them as they may be in association with syndromes and other medical conditions. It is also important to give appropriately provided information to avoid parents concerns.Item A Rare Giant Congenital Left Atrial Appendage Aneurysm in A 1-Day-Old Newborn(2018) Sahin, Derya Aydin; Yildirim, Selman Vefa; Ozkan, Murat; 29648705Congenital left atrial appendage aneurysm (LAAA) is a very rare condition and occurs as a result of congenital dysplasia of musculi pectinate. These patients may be asymptomatic and/or may present with dyspnea, and thromboembolic events. The most common complications are life-threatening thromboembolic events and supraventricular tachyarrhythmias. Transthoracic echocardiography plays a very important role in the diagnosis of LAAA. Herein, we present a rare case of giant congenital LAAA.Item Vitamin D Deficiency Prevalence in Late Neonatal Hypocalcemia: A Multicenter Study(2021) Celik, Kiymet; 34013710Objective: 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.Item Evaluation of Blood Transfusion Applications in Newborn Intensive Care Unit; Single Center Experience(2019) Turhan, AliINTRODUCTION: The frequency of transfusion is high in infants admitted to neonatal intensive care unit (NICU). There is a higher risk of transfusion complications compared to other age groups, and there are many special considerations for transfusion in neonates. The aim of this study was to investigate the records of infants who had blood product transfusions in NICU, to investigate which patient groups were transfused, the characteristics of the blood products used and the current transfusion practices. MATERIALS and METHODS: Between November 2013 and May 2018, the records of 968 newborn infants admitted to the Istanbul Hospital NICU of Baskent University School of Medicine were retrospectively analyzed. RESULTS: Of the babies, 43.8% were female, median birth weight was 2598 (1478-3228) grams, median birth week was 36.5 (30-39) weeks and median hospitalization days were 32 (15-67.5) days. The most commonly used blood group was A Rh (+), the least used blood group AB Rh (-). 39.9% of the transfusions were fresh frozen plasma, 36.2% erythrocyte and 23.5% platelet suspension. In addition to prematurity and related diseases, diseases requiring surgery of central nervous system, congenital heart or gastrointestinal system diseases were the most common transfused group. According to term babies, the rate of use of thrombocyte suspension was higher in preterm infants, however the rate of use of other products was similar. CONCLUSIONS: Knowledge of the selection, preparation of blood products to be used in transfusion and the specific methods for reducing the risks of transfusion will reduce the potential risks and increase the safety of transfusion.Item A case of neonatal arterial thrombosis mimicking interrupted aortic arch(2015) Gursu, Hazim Alper; Varan, Birgul; Oktay, Ayla; Ozkan, Murat; 26265897Neonatal arterial thrombosis is a very rare entity with clinical findings resembling coarctation of aorta or interrupted aortic arch. A two day-old male newborn was admitted to another hospital with difficulty in sucking and sleepiness. On echocardiographic examination, a diagnosis of interrupted aortic arch was made and he was treated with prostoglandin E2. On physical examination, on admission to our center, the feet were bilaterally cold. The pulses were not palpable and there were ecchymotic regions in the lower extremities. Echocardiography ruled out interrupted aortic arch. Computerized tomographic angiography revealed a large thrombosis and total occlusion of the abdominal aorta. Since there was no response to treatment with tissue plasminogen activator, we performed thrombectomy. Homozygous Factor V Leiden and Methylenetetrahydrofolate reductase mutations were found in this patient. Neonatal aortic thrombosis which is observed very rarely but which is fatal should be considered in the differential diagnosis of coarctation of aorta and interrupted aortic arch.Item Evaluation of peripheral perfusion in term newborns before and after Yintang (EX-HN 3) massage(2015) Tugcu, Ali Ulas; Cabioglu, Tugrul; Abbasoglu, Aslihan; Ecevit, Ayse; Ince, Deniz Anuk; Tarcan, Aylin; 26742308OBJECTIVE: To identify how acupressure on the acupoint Yintang (EX-HN 3) impacts oxygen saturation, pulse rate, and peripheral perfusion in term-born infants without underlying disease. METHODS: Infants born between weeks 37 and 42 of gestation were included in this study. The polyclinic's neonatology room was noise-controlled and made half-dark to prevent the perfusion index from being confounded. A pulse oximeter was linked to the baby's left lower extremity. Acupressure was applied on Yintang (EX-HN 3) for 30 s clockwise, held for 30 s, and then acupressure was applied for another 30 s counterclockwise. The baby's SaO(2), pulse rate, and perfusion index were recorded for each minute before and after acupressure. RESULTS: When pre- and post-acupressure pulse rate values were compared, a significant decrease in pulse rate values after acupressure application was observed. When pre- and post-acupressure oxygen saturation values were compared, a significant increase in post-acupressure oxygen saturation was observed. In addition, peripheral perfusion increased significantly after acupressure. CONCLUSION: Acupressure application has been used in traditional medicine for many years. However, it is not yet widely used in modern medicine. This study shows the impact of acupressure on neonatal skin perfusion, oxygen saturation, and pulse rate. (C) 2015 JTCM. All rights reserved.