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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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    Beneficial effects of Etanercept on experimental necrotizing enterocolitis
    (Springer, 2014) Yurttutan, Sadik; Ozdemir, Ramazan; Canpolat, Fuat Emre; Oncel, Mehmet Yekta; Unverdi, Hatice Germen; Uysal, Bulent; Erdeve, Omer
    Tissue damage in necrotizing enterocolitis (NEC) of infants occurs as a result of an uncontrolled inflammatory response. The aim of this study was to investigate any potential anti-inflammatory effects that Etanercept may have on the inflammatory response in an experimental NEC model in newborn rats. Newborn pups were randomized into three groups immediately after birth (Control, NEC + Placebo and NEC + Etanercept). Pups in the NEC + Placebo and NEC + Etanercept groups were subjected to an NEC-inducing protocol (hypercarbia, hypothermia and hyperoxia) twice a day for 3 days. Pups in the NEC + Etanercept group were given an intraperitoneal injection of Etanercept. Rats were harvested for biochemical and histopathological examinations. The histopathological injury score of rats in the NEC + Placebo group was significantly higher compared to the NEC + Etanercept and Control groups (p < 0.05 for both comparisons). Tissue levels of tumor necrosis factor-alpha, interleukin-1 beta, and malondialdehyde were higher in the placebo group compared to the Etanercept group. Our results suggest that Etanercept attenuates intestinal tissue damage in NEC by reducing inflammation and blocking the production of free-oxygen radicals, while also reducing tissue levels of tumor necrosis factor-alpha and interleukin-1 beta.
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    Mean Platelet Volume in Neonatal Sepsis
    (Wiley, 2012) Oncel, Mehmet Yekta; Ozdemir, Ramazan; Yurttutan, Sadik; Canpolat, Fuat Emre; Erdeve, Omer; Oguz, Serife Suna; Uras, Nurdan
    Background The aim of this study was to investigate any changes in mean platelet volume (MPV) in patients with neonatal sepsis (NS). Methods Subjects were stratified into two groups: proven sepsis (Group 1a) and clinical sepsis (Group 1b). The control group (Group 2) consisted of healthy newborns matched for gestational age and birth weight. Results A total of 100 patients with NS (35 with proven sepsis and 65 with clinical sepsis) and 50 healthy controls were enrolled. A comparison of markers of sepsis obtained at baseline revealed white blood cell count (WBC), C-reactive protein (CRP), interleukin-6 (IL-6), and MPV levels to be significantly higher in newborns with sepsis compared to healthy controls (P = 0.01, <0.001, <0.001, and 0.001, respectively). Mean baseline serum levels of CRP and MPV were significantly higher in Group 1a compared to Group 1b (P = 0.003, P = 0.007, respectively), whereas the difference between group with regards to baseline serum levels of IL-6 and platelet count was statistically insignificant (P = 0.14, P = 0.28, respectively). Conclusion This is the first study to demonstrate a statistically significant difference with regard to baseline MPV values between patients with sepsis (proven or clinical) and healthy controls. J. Clin. Lab. Anal. 26:493-496, 2012. (C) 2012 Wiley Periodicals, Inc.
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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.
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    Successful Implementation of a Bundle Strategy to Prevent Ventilator-Associated Pneumonia in a Neonatal Intensive Care Unit
    (Oxford Univ Press, 2018) Gokce, Ismail Kursad; Kutman, Hayriye Gozde Kanmaz; Uras, Nurdan; Canpolat, Fuat Emre; Dursun, Yasemin; Oguz, Serife Suna
    Background: We aimed to investigate the effectiveness of evidence-based bundle that we developed to reduce ventilator-associated pneumonia (VAP) rates and to assess the degree of compliance rates to this strategy in a tertiary neonatal intensive care unit. Methods: This before-after prospective cohort trial divided into two periods was conducted. All neonates requiring ventilation were enrolled in the study. VAP incidence, compliance rates to bundle components and the contribution of each bundle component to VAP rates were compared between the periods. Results: Throughout the study period, 13 VAP episodes were observed. Full adherence to all six components of the bundle doubled in the active-bundle period (12.8 vs. 24.3%, p<0.01). The mean VAP rate decreased from 7.33/1000 to 2.71/1000 ventilator days following intervention (p = 0.083). Conclusion: This study showed that reliable implementation of a neonate-specific VAP prevention bundle can produce sustained reductions in VAP rates.
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    Successful ımplementation of a bundle strategy to prevent ventilator-associated pneumonia in aneonatal ıntensive care unit
    (Oxford unıv press, great clarendon st, oxford ox2 6dp, england, 2018) Gokce, Ismail Kursad; Kutman, Hayriye Gozde Kanmaz; Uras, Nurdan; Canpolat, Fuat Emre; Dursun, Yasemin; Oguz, Serife Suna
    Background: We aimed to investigate the effectiveness of evidence-based bundle that we developed to reduce ventilator-associated pneumonia (VAP) rates and to assess the degree of compliance rates to this strategy in a tertiary neonatal intensive care unit. Methods: This before-after prospective cohort trial divided into two periods was conducted. All neonates requiring ventilation were enrolled in the study. VAP incidence, compliance rates to bundle components and the contribution of each bundle component to VAP rates were compared between the periods. Results: Throughout the study period, 13 VAP episodes were observed. Full adherence to all six components of the bundle doubled in the active-bundle period (12.8 vs. 24.3%, p<0.01). The mean VAP rate decreased from 7.33/1000 to 2.71/1000 ventilator days following intervention (p = 0.083).