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Öğe Colchicine Protects against Hyperoxic Lung Injury in Neonatal Rats(Karger, 2012) Ozdemir, Ramazan; Yurttutan, Sadik; Talim, Beril; Uysal, Bulent; Erdeve, Omer; Oguz, Serife Suna; Dilmen, UgurBackground: Bronchopulmonary dysplasia (BPD) is characterized by inflammation, fibrosis and mucosal necrosis, which leads to emphysematous coalescence of alveoli. Objective: We tested whether prophylaxis with colchicine, an anti-inflammatory, antioxidant and antifibrotic drug, would decrease the severity of lung injury in an animal model of BPD. Methods: Twenty-five rat pups were divided into three groups: control (n = 8), hyperoxia (n = 7), and hyperoxia + colchicine (n = 10). The hyperoxia groups were exposed to >95% oxygen from day 1 to 10 of life. On day 10, the animals were sacrificed and the lungs were processed for histology and biochemical analysis. Lung morphology was assessed by the mean linear intercept (MLI), a measure of alveolar size. The degree of lung inflammation and antioxidant capacity were assessed by quantifying lung homogenate tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), malondialde-hyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels. Results: Colchicine significantly decreased lung damage as determined by the MLI in the c groups (p < 0.01). The median level of lung MDA was significantly higher in the hyperoxia group compared with the control group (p < 0.05) and the colchicine-treated group (p < 0.05). Lung homogenate SOD and GSH-Px activities in the colchicine-treated group were significantly higher than in the hyperoxia group (p < 0.05). Furthermore, colchicine-treated pups had lower lung homogenate TNF-alpha and IL-1 beta levels compared with the hyperoxia group (p < 0.05). Conclusions: Colchicine has favorable effects on alveolarization as well as inflammation and oxidative stress markers in an animal model of BPD. Copyright (C) 2012 S. Karger AG, BaselÖğe Comparison of Three Different Administration Positions for Intratracheal Beractant in Preterm Newborns with Respiratory Distress Syndrome(Elsevier Taiwan, 2016) Karadag, Ahmet; Ozdemir, Ramazan; Degirmencioglu, Halil; Uras, Nurdan; Dilmen, Ugur; Bilgili, Gokmen; Erdeve, OmerBackground: The aim of this study was to compare the efficacy and adverse effects of various intratracheal beractant administration positions in preterm newborns with respiratory distress syndrome. Methods: This study was performed on preterm newborns with respiratory distress syndrome. The inclusion criteria were being between 26 weeks and 32 weeks of gestational age, having a birth weight between 600 g and 1500 g, having received clinical and radiological confirmation for the diagnosis of respiratory distress syndrome (RDS) within 3 hours of life, having been born in one of the centers where the study was carried out, and having fractions of inspired oxygen (FiO(2)) >= 0.40 to maintain oxygen saturation by pulse oximeter at 88-96%. Beractant was administered in four positions to Group I newborns, in two positions to Group II, and in neutral position to Group III. Results: Groups I and II consisted of 42 preterm infants in each whereas Group III included 41 preterm infants. No significant differences were detected among the groups with regards to maternal and neonatal risk factors. Groups were also similar in terms of the following complications: patent ductus arteriosus (PDA), pneumothorax, intraventricular hemorrhage (IVH), chronic lung disease (CLD), retinopathy of prematurity (ROP), necrotising enterocolitis (NEC), death within the first 3 days of life, death within the first 28 days of life, and rehospitalization within 1 month after discharge. Neither any statistically significant differences among the parameters related with surfactant administration, nor any significant statistical differences among the FiO(2) levels and the saturation levels before and after the first surfactant administration among the groups were determined. Conclusion: In terms of efficacy and side effects, no important difference was observed between the recommended four position beractant application, the two position administration, and the neutral position. Copyright (C) 2016, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.Öğe Early regular versus late selective poractant treatment in preterm infants born between 25 and 30 gestational weeks: a prospective randomized multicenter study(Taylor & Francis Ltd, 2014) Dilmen, Ugur; Ozdemir, Ramazan; Aksoy, Hatice Tatar; Uras, Nurdan; Demirel, Nihal; Kirimi, Ercan; Erdeve, OmerObjective: Surfactant treatment in the early hours of life significantly decreases the rates of death and air leak, and increases survival without bronchopulmonary dysplasia (BPD) in preterm infants. We aimed to compare the impact of early surfactant (ES) administration to late selective (LS) treatment on neonatal outcomes in preterm infants. Methods: All preterm infants between 25 and 30 wks gestational age and who were not entubated in the delivery room and did not have any major congenital malformation or perinatal asphyxia were randomized to ES treatment (200 mg/kg Curosurf (R) administration in 1 hour after birth) or LS treatment (200 mg/kg Curosurf (R) administration in the first 6 h of life if needed). The patients were treated by nasal continuous positive airway pressure (nCPAP) treatment regardless of the surfactant requirement. Outcomes were the necessity of mechanical ventilation, nCPAP duration, the oxygen requirement duration, the rates of BPD, retinopathy of prematurity (ROP) and mortality, and the assesment of the following situations; (pneumothorax, patent ductus arteriosus (PDA), necrotizing enterocolitis (NEC), and intraventricular hemorrhage (IVH) >= grade III). Results: Among 159 infants enrolled in the study, 79 were randomized to ES and 80 to LS treatment groups. Thirty-five patients (44%) in the LS treatment group needed surfactant administration. Necessity of second dose surfactant administration was 8.9% in the ES treatment group. Although necessity of mechanical ventilation, nCPAP duration, oxygen need duration, rates of PDA, NEC, BPD, ROP stage >3 and mortality did not show a significant difference between groups, the ES treatment group had lower rates of pneumothorax and IVH >= grade III when compared to the LS treatment group. Conclusions: ES treatment decreases IVH (>= grade III) and pneumothorax rates but does not have any effect on BPD when compared to LS.Öğe Is Folic Acid Supplementation Really Necessary in Preterm Infants ?32 Weeks of Gestation?(Lippincott Williams & Wilkins, 2014) Oncel, Mehmet Yekta; Calisici, Erhan; Ozdemir, Ramazan; Yurttutan, Sadik; Erdeve, Omer; Karahan, Sevilay; Dilmen, UgurObjectives: The aim of this study was to define whether there was folate deficiency in hospitalized preterm infants, and, second, to define the effect of feeding modalities on serum folate levels. Methods: Infants born <= 32 weeks of gestation were included in the study. Blood samples for the determination of serum folate levels were obtained on days 14 and 28 postnatally, as well as 36 weeks postconceptionally (or just before discharge if patients are discharged <36 weeks)-samples A, B, and C, respectively. Infants were divided into 3 groups based on mode of feeding; human breast milk (HBM), fortified HBM (fHBM), or preterm formula (PF). Results: A total of 162 preterm infants were enrolled: 17 (10.5%) of whom received HBM alone, 94 (58%) received fHBM, and 51 (31.5%) were fed with PF. None of the preterm infants developed folate deficiency during the study period. Preterm infants in the fHBM and PF groups had significant higher serum folate levels in samples C when compared with those receiving HBM alone (P < 0.001 for both). Multivariate analysis to evaluate the effects of maternal supplementation, smoking habit, gestational age, birth weight, and cumulative folic acid intake in samples A, B, and C suggested that maternal smoking and maternal folic acid supplementation had significant effects on serum folate levels in sample A and B. Conclusions: Preterm infants receiving parenteral nutrition with high folic acid content have no risk of folate deficiency during the 2 months of age; however, preterm infants fed orally from birth with HBM or PF with a low folic acid content could be at risk for folate deficiency, especially when mothers are smokers and/or do not receive folic acid supplementation during pregnancy.Öğe The relationship between trough drug concentrations and ductal closure in preterm infants treated with three-dose-oral ibuprofen(Taylor & Francis Ltd, 2013) Yurttutan, Sadik; Erdeve, Omer; Oncel, Mehmet Yekta; Ozdemir, Ramazan; Dilmen, UgurThe aim of the present study was to characterize the pharmacokinetic profile of oral ibuprofen on consecutive 3 d by trough serum levels, and if possible to define a cut-off level for ductal closure in preterm infants. The study enrolled 20 preterm infants with gestational age <= 30 weeks, birth weight <1250 g and hemodynamically significant patent ductus arteriosus (hsPDA). Patients received oral ibuprofen at an initial dose of 10 mg/kg, followed by 5 mg/kg at 24 and 48 h. Patients were compared for serum ibuprofen levels in addition to their demographic and clinical data in case of their response to the treatment. hsPDA closed in 16 (80%) of the patients. Although mean ibuprofen levels on consecutive 3 d showed a plateau in general, ibuprofen serum levels on the first treatment day were statistically low in patients with unclosed hsPDA (p = 0.003). The optimal cut-off value for serum ibuprofen level on the first treatment day was measured as 5.5 mg/l with 100% sensitivity and 93% specificity. Serum ibuprofen level on the first treatment day seems to be an important factor for a successful ductal closure. Target concentration approach by the evaluation of trough level may be applicable to real-time dosing strategy.Öğe Renal and mesenteric tissue oxygenation in preterm infants treated with oral ibuprofen(Taylor & Francis Ltd, 2014) Guzoglu, Nilufer; Sari, Fatma Nur; Ozdemir, Ramazan; Oguz, Serife Suna; Uras, Nurdan; Altug, Nahide; Dilmen, UgurBackground: Hemodynamically significant patent ductus arteriosus (PDA) is a common problem in preterm infants which often causes significant morbidities. Although PDA induces alterations in various tissue perfusion, there is scarce information about the effect of oral ibuprofen on hemodynamics of regional tissues. Objective: To investigate, using near-infrared spectroscopy, the effect of oral ibuprofen on renal and mesenteric tissue oxygenation and oxygen extraction in preterm infants with a diagnosis of hemodynamically significant PDA. Patients and methods: Fifteen infants (gestational age <32 weeks) with the diagnosis of hemodynamically significant PDA treated with oral ibuprofen were monitored for near-infrared spectroscopy - determined renal and mesenteric oxygenation. The infants with PDA were matched for gestational age, postnatal age with infants without PDA, who served as control subjects. Results: In infants with PDA, mean arterial blood pressure was significantly lower compared with the control infants [39.3 (range: 36-54) versus 51 (range: 43-66) mmHg, respectively; p < 0.001)]. There were no significant differences in regional oxygen saturation and fractional oxygen extraction of renal and mesenteric tissues in PDA and control infants (p > 0.05). And ibuprofen treatment did not negatively influence renal and mesenteric oxygenation and extraction in infants with PDA (p > 0.05). Conclusion: Renal and mesenteric tissue oxygenation and oxygen extraction were preserved in preterm infants with a diagnosis of hemodynamically significant PDA treated with oral ibuprofen.Öğe Subclinical hypoxia of infants with intrauterine growth retardation determined by increased serum S100B protein levels(Tubitak Scientific & Technological Research Council Turkey, 2011) Kirmemis, Ozlem; Tatli, Mustafa Mansur; Tayman, Cuneyt; Koca, Cemile; Karadag, Ahmet; Uras, Nurdan; Dilmen, UgurAim: To test the hypothesis that serum S100B levels could be useful in detecting neurological damage in infants with intrauterine growth retardation (IUGR). Materials and methods: The study group consisted of infants with IUGR and the control group consisted of age-matched healthy infants. S100B protein levels were measured after birth and compared between groups. Results: For this study, 43 infants with IUGR and 25 infants as a control group were recruited. Gender, gestational age, type of delivery, and maternal age of the groups were statistically insignificant, with the exception of the mean birth weights (2120 +/- 450 g in the IUGR group and 3096 +/- 570 g in the control group (P < 0.001), respectively). S100B protein levels of the IUGR infants (1.13 +/- 0.54) were significantly higher than those of the control group (0.45 +/- 0.13) (P < 0.001). IUGR infants treated with antenatal steroids showed lower S100B levels than IUGR infants that did not receive antenatal steroid treatments (P < 0.05). The study group infants were divided into 2 groups, for growth retardation (GR) that was asymmetric (n = 15) and symmetric (n = 28). The asymmetric and symmetric GR infants' S100B levels were 1.14 +/- 0.47 pg/mL and 1.21 +/- 0.34 pg/mL, respectively, and no significant differences were found between the 2 groups in terms of S100B levels (P = 0.32). Conclusion: The results of this study favor the opinion that there is an existing intrauterine hypoxia causing hypoxic brain tissue damage in IUGR infants, even when followed up with modern obstetrical screening protocols. Measurements of S100B may be useful in the prediction of outcome in these infants.Öğe Thrombocytopenia in very low birth weight infants(Springer, 2014) Sari, Fatma Nur; Ozdemir, Ramazan; Dilmen, Ugur[Abstract Not Available]
