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Item Consensus report for workshop on ⇜early diagnosis and intervention in cerebral Palsy” Turkey’s approach to babies at risk and suggestions 1. National congress on babies at risk (1-4 March 2018, the Ankara Hotel)(2018) Karadavut, K.İ.; Biri, A.; Şenbil, N.; Gülümser, Ö.; Aydın, R.; Sezgin, M.; El, Ö.; Karaca, Ş.B.; Kuzan, N.D.; Atay, G.; Üstünyurt, Z.; Gülümser, Ö.; Saltık, S.; Yüksel, D.; Armangil, D.; Alan, S.; Biri, A.; Akarsu, S.; Koçbulut, E.; Karaaslan, B.T.; Kahraman, A.; Altunalan, T.; Taşkın, S.; Kalkır, Ö.The workshop on “Early Diagnosis and Intervention in Cerebral Palsy” aimed to reflect the current situation of and the challenges encountered in the early diagnosis and intervention in cerebral palsy in babies at risk, in order to raise awareness in the corresponding community by putting forth suggestions for providing solutions to these problems, and also, to provide a model suggestion suitable for the whole country. In the direction of these purposes, problems encountered in the prenatal, natal, and postnatal periods, and the corresponding suggestions were discussed, and vital topics concerning numerous disciplines, especially for the postnatal period, were emphasized in the workshop. With the aim of providing a solution to the current problems in the country regarding the matter, by employing an interdisciplinary approach, the establishment of Monitoring Centers for the Babies at Risk was proposed, and a model for these centers was created. Implications derived from this workshop will establish a foundation for the creation of a special strategic plan for the early diagnosis and intervention in cerebral palsy for the babies at risk. Copyright © 2018 by Türkiye Klinikleri.Item Determination of tissue hypoxia by physicochemical approach in premature anemia(2017) Torer, Birgin; Ozdemir, Zeliha; Hanta, Deniz; Cetinkaya, Min; Gulcan, Hande; Tarcan, Aylin; 28395879Background: 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