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    Alkaline phosphatase levels of preterm infants under 30 weeks of gestational age and its role in the diagnosis of osteopenia of prematurity
    (2019) Kadioglu Simsek, Gulsum; Buyuktiryaki, Mehmet; Kanmaz Kutman, Hayriye Gozde; Canpolat, Fuat Emre
    Aim: Alkaline phosphatase is perhaps the most important biochemical marker used in the diagnosis and follow-up of metabolic bone disease or osteopenia of prematurity (OP). The aim of this study was to investigate the percentiles of alkaline phosphatase (ALP) levels in premature infants compared to gestational age and to determine cut-off values for the diagnosis of osteopenia.Material Methods: All ALP results sent to our biochemistry laboratory between 2013-2018 were evaluated retrospectively. Of the total 2476 results, 1830 (74%) were found to belong to a separate infant born before 30 weeks of gestation. The results and demographic data of the patients whose clinical information could be reached were statistically analyzed.Results: The mean birth weight of the infants included in the study was 995 g±254 (450-1500 g) and the mean gestational week was calculated as 27±1.7 (24-29,6 weeks). The average alkaline phosphatase level was 510±225 U/L [median: 458 IU/L (159-1554)]. In serum ALP levels; 160.8 IU/L value 5. Percentile, 203 IU/L 10. percentile, 290 U/L 25. percentile 421 IU/L 50. percentile, 583 U/L 75. Percentile, 819 U/L formed 90th percentile and 969 U/L formed 95th percentile. Separate percentiles were also calculated for each gestational week interval.Conclusion: Although the infants included in the study were hospitalized premature infants, this is the reference range study with the largest number of patients in our country. Although the data is retrospective, these percentiles may be helpful in the evaluation and the diagnosis of osteopenia in premature infants.Keywords: Preterm infant; alkaline phosphatase; osteopenia; phosphorus.
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    Effect of partially hydrolyzed synbiotic formula milk on weight gain of late preterm and term infants-a multicenter study
    (Frontiers Media Sa, 2023) Sahin, Suzan; Buyuktiryaki, Mehmet; Okur, Nilufer; Akcan, Abdullah Baris; Deveci, Mehmet Fatih; Yurttutan, Sadik; Gunes, Sezgin
    Introduction: Data on the effectiveness of hydrolyzed infant formula containing both pre- and probiotics (synbiotic formula) on the growth of infants is still scarce. This retrospective study was designed to evaluate the effect of a partially hydrolyzed synbiotic formula on growth parameters and the possible occurrence of major gastrointestinal adverse events or morbidities in infants born via cesarean section (C-section) delivery.Methods: C-section-delivered term and late preterm infants who received either partially hydrolyzed synbiotic formula, standard formula, or maternal milk and followed at seven different hospitals from five different regions of Turkey, during a 1-year period with a minimum follow-up duration of 3 months were evaluated retrospectively. All the included infants were evaluated for their growth patterns and any kind of morbidity such as diarrhea, constipation, vomiting, infection, or history of hospitalization.Results: A total of 198 infants (73 in the human milk group, 61 in the standard formula group, and 64 in the partially hydrolyzed synbiotic formula group) reached the final analysis. The groups were similar regarding their demographic and perinatal characteristics. No difference was observed between the three groups regarding gastrointestinal major side effects. Growth velocities of the infants in the human milk and partially hydrolyzed synbiotic formula groups during the first month of life were similar whereas the weight gain of infants in the standard formula group was significantly less than these two groups (p < 0.001). Growth velocities were similar among the three groups between 1st and 3rd months of age.Discussion: A partially hydrolyzed synbiotic formula provided better weight gain in late-preterm and term infants who were delivered via C-section delivery compared to the standard formula during the first month of life. This weight gain was similar to the infants receiving exclusively human milk. This difference was not observed in length and head circumference gain. No difference was observed in any of the parameters during the 1st-3rd months of age. Specially formulated partially hydrolyzed synbiotic formulas may reverse at least some of the negative impacts of C-section delivery on the infant and help to provide better growth, especially during the early periods of life.
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    Postnatal hydrocortisone therapy for the treatment of bronchopulmonary dysplasia in very low birth weight infants
    (2019) Buyuktiryaki, Mehmet; Alyamac Dizdar, Evrim; Okur, Nilufer; Sari, Fatmanur; Bezirganoglu, Handan; Canpolat, Fuat Emre; Uras, Nurdan; Oguz, Serife Suna
    Aim: Corticosteroids are widely used to prevent and treat bronchopulmonary dysplasia (BPD) due to their strong anti-inflammatory effects. We aim to evaluate the outcomes of late onset systemic hydrocortisone (HC) therapy in very low birth weight infants with BPD.Material and Methods: The medical records of 706 preterm infants with gestational age ≤ 30 weeks over a 4-year period were retrospectively reviewed. Infants who required invasive/noninvasive respiratory support or ≥ 30% oxygen due to BPD and were treated with HC after the third postnatal week were included. The infants were divided into 3 groups according to respiratory support at the beginning of the HC treatment: mechanical ventilation (MV), noninvasive ventilation (NIV), and free oxygen.Results: Seventy-six (11.9%) infants in our cohort received HC therapy. In the MV group, 83.3% of the infants were successfully extubated after a median of 4 days (interquartile range [IQR], 2-8 days). In the NIV group, 83.9% of the infants required no longer respiratory support after a median of 6 days (IQR, 3-16 days). In the free oxygen group, none of the infants needed supplemental oxygen after a median of 8 days (IQR, 6-12 days). Conclusion: Late HC therapy facilitates extubating without adverse short-term effects, reduces the need of invasive and noninvasive ventilation, and facilitates discharge without supplemental oxygen.