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Öğe Clinical outcomes of thyroid hormone replacement therapy in premature infants(Karger, 2008) Goksen, Damla; Tanriverdi, Sema; Koroglu, Ozge Altun; Kultursay, Nilgun; Darcan, SukranÖğe Comparison Between Simultaneously Recorded Amplitude Integrated Electroencephalography and Standard Electroencephalography in Neonates with Acute Brain Injury(Galenos Yayincilik, 2015) Akcay, Ayfer; Yilmaz, Sanem; Tanriverdi, Sema; Koroglu, Ozge Altun; Yalaz, Mehmet; Kultursay, Nilgun; Gokben, Sarenur; Tekgul, Hasan; Serdaroglu, GulAim: There are many risk factors that cause significant neurologic damage in term and preterm infants who need intensive care. For these patients brain injury prevention has become the main goal of modern neonatalogy. Observing brain functions with electroencephalography (EEG) in newborns may be helpful in determining patients who carry increased risk factors for neurologic morbidity. The aim of this study is to compare the results of the synchronous amplitude EEG (aEEG) and conventional EEG (cEEG) in cases with newborn encephalopathy. Materials and Methods: Fifty two newborns cases (27 term, 25 preterm) were included to Ege University, Faculty of Medicine Pediatrics Department Neonatal ICU with possible neurological risk, thus, with neonatal encephalopathy, neurologic disturbance, or severe respiratory distress syndrome (RDS). Amplitude EEG was performed for 24-48 hours. Amplitude EEG was assessed by a neonatalogist using Burdjalov scoring system. The results of simultaneously performed amplitude EEG and conventional EEG were compared. Results: The results of synchronous aEEG and cEEG were compared and there was significant difference between aEEG scores (between 0-13 points) and cEEG grade(grade 0-3) (p<0.05). Amplitude EEG detected seizures in 15 cases. No clinical seizure activity was noted in 8 (53%) of the cases during aEEG. Clinical seizures developed in 11 patients throughout aEEG recordings and 7 of these were detected (sensitivity 63.6%, positive predictive value 46.6%). It was assessed that the aEEG score of the patients who had clinical seizures was 4.26 +/- 3.17, the score of the cases who had no seizures was 6.29 +/- 2.6. The missing seizures in aEEG were myoclonic and brief seizures. Conclusion: Monitorization with aEEG is suggested in newborns with acute brain injury to follow up the electrophysiological seizures and electrophysiological alterations. Amplitude EEG gave similar results to cEEG in detection of background rhytm. It is an easily applicable and alternative method. However, the sensitivity of aEEG in detecting seizure activity is low, particularly the brief seizures can be missed by using aEEG alone. Therefore, in suspicion of clinical seizure activity, it should be confirmed by cEEG.Öğe Early Immunomodulatory Effects of Different Natural Surfactant Preparations in Preterms With Respiratory Distress(Frontiers Media Sa, 2022) Yalaz, Mehmet; Tanriverdi, Sema; Uygur, Ozgun; Koroglu, Ozge Altun; Azarsiz, Elif; Aksu, Guzide; Kultursay, NilgunBackgroundRespiratory distress syndrome (RDS) is the most common respiratory disease in premature infants. Exogenous natural surfactant preparations are used in the treatment of RDS. In recent years, it has become increasingly evident that surfactant plays an immunoregulatory role. ObjectivesThe aim of this study was to evaluate cytokine and chemokine response following three different regimens of natural surfactant treatment in preterm newborns with RDS. MethodsPremature newborns below 32 weeks of gestation who were intubated for RDS and given early surfactant rescue therapy were included in the study. Newborns were randomly divided into three groups and Beractant 100 mg/kg (B-100), Poractant alfa 100 mg/kg (P alpha-100) and Poractant alfa 200 mg/kg (P alpha-200) were administered intratracheally. Blood samples and transtracheal aspirates (TA) were collected just before and 4-6 h after the surfactant treatment. Total eosinophil count, inducible T Cell alpha chemoattractant (ITaC), macrophage inflammatory protein 3 beta (MIP3b), interleukins (IL) 5, 8, 9, 10, 13, immunoglobulin E (IgE), interferon gamma (IFN-gamma), eotaxin and tumor necrosis factor beta-1 (TGF-beta 1) were measured from blood and tracheal aspirate samples. ResultsA total of 45 infants, 15 in each group, were included in the study. Mean gestational age, birth weight, antenatal, demographic and clinical characteristics of the study groups were similar. IFN gamma concentration and eosinophil counts in TA decreased after surfactant replacement in all groups, especially in the infants treated with P alpha-100 and P alpha-200. Eotaxin, TGF beta and IL-8 concentrations in TA increased significantly in the infants treated with P alpha-100 and P alpha-200. IL-9 levels in TA decreased in the B-100 group but increased in the P alpha-100 and P alpha-200 groups. Blood levels of cytokines and chemokines showed significantly decreased levels of ITaC and MIP3b only in the B-100 group, but no significant change was observed in the P alpha-100 and P alpha-200 groups. ConclusionIn our study, the different immunomodulatory effects of natural surfactant preparations on newborn lung is proven. We found that Poractant alpha, one of the natural surfactant preparations, shifted the lung immune system toward TH2.Öğe The effect of inhaled nitric oxide therapy on thromboelastogram in newborns with persistent pulmonary hypertension(Springer, 2014) Tanriverdi, Sema; Koroglu, Ozge Altun; Uygur, Ozgun; Balkan, Can; Yalaz, Mehmet; Kultursay, NilgunStudies about the effects of inhaled nitric oxide (iNO) on bleeding time and platelet aggregation in newborns are limited in number and have inconclusive results. Thromboelastogram (TEG) shows the combined effects of coagulation factors and platelet functions. In this preliminary study, we aimed to evaluate the effects of iNO on coagulation using TEG in newborns with persistent pulmonary hypertension (PPH). TEG assays were performed in 10 term infants receiving iNO treatment for PPH and 32 healthy term infants. Samples of the iNO group were collected before and during iNO. Clot reaction time (R), clot kinetics (K), maximum amplitude (MA), and alpha angle were obtained from the TEG tracing. TEG-R values were statistically higher during iNO treatment (7.75 +/- 3.34) when compared to the values before iNO (4.83 +/- 1.38) and the healthy controls (3.75 +/- 0.98). The alpha angle was lower in iNO treated infants at both periods (before iNO, 55.33 +/- 8.58; during iNO, 42.90 +/- 18.34) compared to the control group (64.95 +/- 6.88). MA values before iNO treatment were the lowest (44.43 +/- 14.09) and improved with the iNO treatment (48.40 +/- 9.49) despite still being lower compared to the controls (53.67 +/- 5.56). Conclusion: Both PPH and iNO may negatively effect in vitro coagulation tests. Therefore, newborns with PPH requiring iNO treatment should be closely monitored for coagulation problems.Öğe Efficacy and Maternal Comfort of Sequential versus Simultaneous Breast Expression by Mothers of Critically III Newborns(Galenos Yayincilik, 2017) Koroglu, Ozge Altun; Can, Nazmiye; Atikan, Basak Yildiz; Tanriverdi, Sema; Yalaz, Mehmet; Akisu, Mete; Kultursay, NilgunAim: Expressed breast milk is beneficial for infants in neonatal intensive care unit (NICU) when direct breastfeeding is not possible. Breast expression with manual or electric breast pumps is promoted for the initiation and maintenance of lactation in this critical period. In this study, we aimed to compare the efficacy and maternal comfort of sequential versus simultaneous breast expression in newly delivered mothers whose infants were admitted to NICU. Materials and Methods: Thirty five mothers were followed prospectively for milk expression either sequentially (n=21, group 1) or simultaneously (n=14, group 2) with breast pumps for 10 days. The total amount of milk expressed per day and per each period was recorded together with the duration of breast expression. The mothers' impressions about the easiness and comfort of the procedure, and their satisfaction with the amount of milk were evaluated with a questionnaire at the end of the study. Results: The amounts of expressed milk per day and per each expression period were similar in both groups. However, time spent for each expression period was significantly lower in the simultaneous breast expression group. Mothers in this group gave higher scores with regard to ease of use when compared to mothers in the sequential expression group (4.36 +/- 0.50 vs. 4.00 +/- 0.44, p=0.046). The mothers graded both methods with similar scores in all other parameters. Conclusion: Simultaneous breast expression is time saving while both simultaneous and sequential breast expression are similarly efficient for milk production, and both methods are helpful and tolerable in promoting breastfeeding for NICU mothers.Öğe Evaluation of macronutrient content of fresh and frozen human milk over 6 months(Taylor & Francis Ltd, 2021) Tanriverdi, Sema; Koroglu, Ozge; Uygur, Ozgun; Yalaz, Mehmet; Kultursay, NilgunAim: In this study; we aimed to see the time-dependent changes in the macronutrient content of early frozen breast milk and also to compare it with fresh breast milk in the first 6 months. Materials and method: We evaluated the milk samples of 43 mothers who delivered at term. Milk samples after the first 15 days following delivery were expressed and collected dividing into seven aliquots to be stored frozen at -20 degrees C. Every month freshly collected new milk samples were analyzed together with one aliquot of the stored samples, up to 6 months. The energy, protein, lipid, and carbohydrate contents of samples were analyzed by Miris Human Milk Analyzer. Results: In the first 3 months, fresh milk had higher caloric and lipid content when compared to frozen samples. The protein content of fresh milk decreased after 2 months and became lower than frozen samples. The energy and lipid content of frozen milk decreased over time but protein and carbohydrate contents stayed stable. Carbohydrate content of fresh and frozen samples did not show major changes. Conclusion: It may be more suitable to consume the frozen milk that was collected in the early weeks of delivery within first 2 months.Öğe Evaluation of macronutrient content of fresh and frozen human milk over 6 months(Taylor & Francis Ltd, 2019) Tanriverdi, Sema; Koroglu, Ozge; Uygur, Ozgun; Yalaz, Mehmet; Kultursay, NilgunAim: In this study; we aimed to see the time-dependent changes in the macronutrient content of early frozen breast milk and also to compare it with fresh breast milk in the first 6 months. Materials and method: We evaluated the milk samples of 43 mothers who delivered at term. Milk samples after the first 15 days following delivery were expressed and collected dividing into seven aliquots to be stored frozen at -20 degrees C. Every month freshly collected new milk samples were analyzed together with one aliquot of the stored samples, up to 6 months. The energy, protein, lipid, and carbohydrate contents of samples were analyzed by Miris Human Milk Analyzer. Results: In the first 3 months, fresh milk had higher caloric and lipid content when compared to frozen samples. The protein content of fresh milk decreased after 2 months and became lower than frozen samples. The energy and lipid content of frozen milk decreased over time but protein and carbohydrate contents stayed stable. Carbohydrate content of fresh and frozen samples did not show major changes. Conclusion: It may be more suitable to consume the frozen milk that was collected in the early weeks of delivery within first 2 months.Öğe Neonatal status epilepticus controlled with levetiracetam at Sturge Weber syndrome(Elsevier Science Bv, 2013) Tanriverdi, Sema; Terek, Demet; Koroglu, Ozge Altun; Yalaz, Mehmet; Tekgul, Hasan; Kultursay, NilgunSturge Weber syndrome is a rare, sporadic, congenital neurocutaneous syndrome characterized by facial cutaneous vascular malformation, leptomeningeal angioma and eye abnormalities. Seizures develop during the first year of life, may become refractory to multiple anticonvulsants and status epilepticus may develop. A rare subtype of Sturge Weber syndrome with bilateral facial vascular malformation, unilateral cerebral involvement and neonatal status epilepticus is reported here. Neonatal status epilepticus was successfully controlled with intravenous levetiracetam infusion. (C) 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.Öğe Noninvasive Diagnosis and Continuous Monitoring of Local Anesthetic-Induced Methemoglobinemia in a Neonate(Springer India, 2014) Uygur, Ozgun; Esen, Sefika; Tanriverdi, Sema; Koroglu, Ozge A.; Yalaz, Mehmet; Kultursay, NilgunÖğe Serial Intravesical Pressure Measurements Can Predict the Presence and the Severity of Necrotizing Enterocolitis(Georg Thieme Verlag Kg, 2013) Tanriverdi, Sema; Koroglu, Ozge; Uygur, Ozgun; Celik, Ahmet; Dulger, Fatma; Yalaz, Mehmet; Akisu, Mete; Kultursay, NilgunBackground and Aims Necrotizing enterocolitis (NEC) which is accompanied with gastrointestinal ulceration and necrosis is one of the most important problems of preterm infants in neonatal intensive care unit (NICU). Increased intra-abdominal pressure (IAP) is detected among most of the pediatric patients hospitalized in intensive care unit and undergoing surgery or trauma. This pathology, namely, abdominal compartment syndrome, causes ischemia and hypoperfusion of abdominal organs. Recently, the effect of increased IAP on NEC is under focus and this increase is thought to be related with the onset of NEC by leading to intestinal ischemia and necrosis. In this study, we aimed to investigate if serial intravesical pressure (IVP) measurements as an indirect indicator of IAP may help to early diagnosis in NEC and to decision for surgery besides to predict the mortality of NEC. Material and Method A total number of 61 preterm infants with a birth weight of <= 1,500 g hospitalized in NICU were included to the study. IVP values were measured by the same nurse twice daily during their hospitalization through urinary catheter. The IVP values of the preterm infants with and without NEC were compared. Results Totally 61 premature infants included in the study were grouped as follows: group 0, the control group without NEC (n = 38); group 1, medically treated NEC patients (n = 14); and group 2, NEC patients undergoing surgery (n = 9). The median IVP measurements of group 0 were lower than the other groups (p = 0.001). No statistically significant difference in IVP measurements was detected between group 1 and group 2 (p = 0.155). A 10% of increase in IVP measurement was significant in predicting the development of NEC with consecutive serial measurements. The mean IVP measurements were higher in infants with NEC who died during their follow-up at NICU compared with NEC patients who survived (p = 0.043). Conclusion Serial IVP measurements may help for early diagnosis and surgery decision of NEC and high IVP levels also may predict mortality in cases with NEC.
