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Öğe Acute kidney injury and peritoneal dialysis in extremely low birth weight newborns(Edizioni Minerva Medica, 2023) Kaya, Huseyin; Gokce, Ismail K.; Turgut, Hatice; Ozdemir, Ramazan; Tabel, YilmazBACKGROUND: In 12.5-56% of extremely low birth weight (ELBW) infants treated in newborn units, acute kidney injury (AKI) develops. Some of these infants may need renal replacement therapy for several reasons including hyperkalemia, hypovolemia and resistant acidosis. METHODS: All ELBW infants who were followed in our hospital between January 2015 and December 2017 and who lived longer than 48 hours were assessed. Patients were followed for AKI and peritoneal dialysis (PD). RESULTS: AKI developed in 25 of 201 ELBW infants. PD was administered to nine patients. PD was initiated at a median of 11 days (2-22 days) for all patients due to hyperkalemia which did not respond to medical treatment. Three of the nine infants who received PD died while dialysis was ongoing. The remaining six patients completed PD successfully. In these patients, the serum potassium value returned to normal in three days, and dialysis was continued for a median of 93 hours (40-172 hours). Dialysis leakage occurred in two patients, and hyperglycemia developed in two patients. On average, diuresis started at the 25(th) hour (8-40(th) hour). CONCLUSIONS: In the renal failure treatment of ELBW infants, PD is the only option which can be used for many units. It was found that in ELBW infants, who had wider peritoneal surface when compared to their body weight, biochemical values recovered rapidly with PD, and diuresis started a short while later in most patients.Öğe Combined (dual) drug therapy for the treatment of patent ductus arteriosus: last approach prior to ligation(Cambridge Univ Press, 2023) Deveci, Mehmet F.; Kaya, Huseyin; Yurttutan, Sadik; Alagoz, Meral; Gokce, Ismail K.; Karakurt, Cemsit; Gullu, Ufuk U.Objective: We aimed to evaluate the efficacy of combined (ibuprofen+paracetamol) medical therapy in cases of persistent haemodynamically significant patent ductus arteriosus that are resistant to standard medical monotherapy (ibuprofen and/or paracetamol) in this retrospective multi-centre study. Methods: The combined therapy included the administration of 15mg/kg/dose of paracetamol every 6 h for 3 days and ibuprofen at an initial dose of 10mg/kg/dose followed by 5 mg/kg/dose every 24 h. After 2 days following the administration of the last dose, the researchers evaluated the efficacy of combined treatment by conducting an echocardiographic examination. Results: Of all 42 patients who received combined therapy, 37 (88.1%) patients exhibited closure of the haemodynamically significant patent ductus arteriosus without requiring surgical ligation. Patients who did not respond to combined therapy had a higher mean birth weight and gestational age compared to those who responded (p < 0.05). Conclusion: The researchers believe the success of ibuprofen and paracetamol in haemodynamically significant patent ductus arteriosus treatment may be due to their synergistic efficacy and inhibition of the prostaglandin synthesis pathway through different enzymes. The results of our retrospective trial suggest that combination therapy with paracetamol and ibuprofen can be attempted when monotherapy is unsuccessful in treating haemodynamically significant patent ductus arteriosus, especially in centres without a surgical department.Öğe Demographic characteristics of cases diagnosed with cleft palate(2020) Kaya, Huseyin; Guliyeva, Lale; Ozdemir, Ramazan; Gokce, Ismail Kursad; Deveci, Mehmet FatihAim: The aim of this study is to retrospectively evaluate the cleft palate cases in our neonatal clinic and to examine the associated clinical features, predisposing factors, accompanying anomalies, additional findings, treatment approaches and follow-up results.Material and Methods: The study included babies that were diagnosed with cleft palate in our Neonatal Intensive Care Unit between January 2014 and December 2018. The etiological risk factors, demographic characteristics, clinical features and concomitant malformations of the patients included in the study were retrospectively recorded from the patient files and the database system of our hospital.Results: A total of 70 cleft palate patients were observed over a five year period. Of these, 30 (42.9%) were female and 40 (57.1%) were male. The mean gestational age was 38 ± 2.9 weeks and the mean birth weight was 2845 ± 700 grams. 77.1% of the patients were found to additionally have cleft lips. 27 patients (38.5%) had cardiac defects, 18 (25.7%) had central nervous system anomalies and 4 (5.7%) had hypothyroidism. 24 (34.3%) of the parents were consanguineous. The median age at the time of the initial operation was 13 months for cleft palate cases and 5 months for cleft lip cases.Conclusion: As a result, treatment and follow-up of patients with cleft palate defect requires a multidisciplinary approach. These patients should undergo a thorough examination and evaluation. Since many syndromes or malformations may accompany the palate defects, these cases should be investigated with respect to genetic disease and other system anomalies.Öğe The effect of defect size on mortality and morbidity in patients with neural tube defect(2022) Turgut, Hatice; Ozdemir, Ramazan; Gokce, Ismail Kursad; Kaya, Huseyin; Onal, Selami CagatayAim: Neural tube defects (NTD) occur due to errors in the closing of neural canal in embryo. All over the world, the incidence of all forms of NTD varies between 1.4 and 2 in every 1000 live births. The aim of the present study was to investigate the short term prognosis, accompanying anomalies and complications in patients with NTD and to evaluate the relation between defect sizes. Material and Methods: Patients who applied to Inonu University Neonatology Department between January 2010 and December 2017 with the diagnosis of NTD and were operated on were included in the study. Babies who died within the first 24 hours were excluded from the study. Patients were divided into two groups according to the size of NTD; < 5 cm (Group 1) and ≥ 5 cm (Group 2). Approval for the study was obtained from local ethics committee. Results: Overall 133 infants were included in the study. Mean birth weight was 3155 ± 531 g and mean duration of pregnancy was on 38.1 ± 1.8 weeks. Of NTD’s 82% was located in lumbosacral region. 90.2% of the patients underwent operation within the first 24 hours. Parameters such as hydrocephalus, need for shunt, need for flap in tissue defects, the rate of postoperative complications, duration of hospitalization, mortality and the use of antibiotics were found to be at a higher rate in cases whose defect size was ≥5 cm than in those whose defect size was < 5 cm (p < 0.005). Postoperative complications developed in 48.1% of the patients. The most common complications were observed to be cerebrospinal fluid (CSF) leakage (24.1%) and bladder dysfunction (7.5%). Conclusion: In patients with NTD, as the size of the defect increases, additional interventions, complications, hospitalization rates and mortality increase as well. Therefore, it is recommended that health care personnel should take care against problems in the management of this group of patients and inform familes beforehand on these issues.Öğe The evaluation of the relationship between scleral and conjunctival thickness with age in a healthy Turkish population(2020) Kaya, Huseyin; Akkaya, Hasan Samed; Yilmaz, UgurAim: To evaluate the relationship between scleral and conjunctival thickness with age in normal subjectsMaterial and Methods: One hundred five normal subjects were evaluated in this study. Scleral thickness (ST) and conjunctival thickness( CT) were measured by Spectralis Anterior Segment Module Optical Coherence Tomography (AS-OCT). ST and CT were measured at a distance of 1,000, 2,000, 3,000, 4,000 and 5,000 microns from temporal scleral spur. The mean sclera (STmean) and conjunctival (CTmean) thickness were obtained by the mean of the sclera and conjunctival thickness at 5 points. The axial length (AL) was evaluated by using AL-Scan Optical Biometer(Nidek co.,ltd.). SPSS 21 was used for statistical analysis. Results: There was no significant difference between males and females according to ST, CT and AL values (p>0.05). There was a significant positive correlation between age and ST values at 2000, 3000, 4000, and 5000 micron apart from temporal scleral spur (r=0.237 p=0.015, r=0.241 p=0.013, r=0.276 p=0.004, r=0.202 p=0.039 respectively). There was a significant negative correlation between age and CT values at 3000, 4000 and, 5000 micron apart from temporal scleral spur(r= -0.222 p=0.023, r= -0.288 p=0.003,r= -0.350 p0.001). There was a significant positive correlation between age and STmean and, a negative between age and CTmean (r=0.289 p=0.003, r= -0.251 p=0.010) .Conclusion: According to this study ST positively and CT negatively correlated with age significantly.Öğe Extensively drug-resistant acinetobacter baumannii meningitis which successfully treated with tigecycline; a case report of preterm newborn(2021) Deveci, Mehmet Fatih; Gokce, Ismail Kursad; Kaya, Huseyin; Ozdemir, RamazanAcinetobacter baumannii (A. baumannii) meningitis is a state difficult to treat with a high mortality rate, since antibiotics have low CSF penetration level and antibiotic resistance is frequently encountered. Multidrug-resistance is common in hospital-acquired A. baumannii infections, and in these cases, colistin treatment is frequently used as the last option. Colistin-resistant A. baumannii infections are reported in recent years. We present a case of preterm newborn who developed extensively drug-resistant (carbapenem and colistin resistance) A. baumannii meningitis after ventriculoperitoneal shunt operation. Although not approved in children, combined intravenous treatment including tigecycline, meropenem and colistin provides clinical and bacteriological recovery in colistin and carbapenem-resistant A. baumannii meningitis.Öğe Extensively drug-resistant acinetobacter baumannii meningitis which successfully treated with tigecycline; a case report of preterm newborn(2021) Deveci, Mehmet Fatih; Gokce, Ismail Kursad; Kaya, Huseyin; Ozdemir, RamazanAcinetobacter baumannii (A. baumannii) meningitis is a state difficult to treat with a high mortality rate, since antibiotics have low CSF penetration level and antibiotic resistance is frequently encountered. Multidrug-resistance is common in hospital-acquired A. baumannii infections, and in these cases, colistin treatment is frequently used as the last option. Colistin-resistant A. baumannii infections are reported in recent years. We present a case of preterm newborn who developed extensively drug-resistant (carbapenem and colistin resistance) A. baumannii meningitis after ventriculoperitoneal shunt operation. Although not approved in children, combined intravenous treatment including tigecycline, meropenem and colistin provides clinical and bacteriological recovery in colistin and carbapenem-resistant A. baumannii meningitisÖğe Investigation of the cause, anatomical localization of perforations and demographic characteristics in patients with perforating eye injuries(2020) Kaya, Huseyin; Yilmaz, UgurAim: To investigate the clinical features of open globe injuries treated in our clinic.Material and Methods: 65 eyes of 65 patients who were operated for open globe injury between 2016-2018 in Pamukkale University ophthalmology clinic were retrospectively analyzed. File records; age, sex, injury with which eye was affected, the cause and type of injury, biomicroscopic examination findings were recorded. The type of injury was classified as corneal, scleral and cornea-scleral according to localization.Results: 65 eyes of 65 patients were included in this retrospective study. 65 of 30 eyes were right eye and 35 eyes were left eye. The mean age of the patients was 41.33 ± 23.52 years. 15 (23.0%) of the patients were under the age of 18 and 50 (67%) were adults. 23 (35.4%) women and 42 (64.6%) men were included in the study. The causes of eye trauma are shown in Table 1. 35 (53.8%) of the injuries were classified as blunt and 30 (46.2%) were classified as penetrating injuries.Conclusion: Open globe injuries, which is one of the most important causes of preventable blindness, is an important public health problem, we think that necessary precautions should be taken and public awareness should be taken in this direction.Öğe Molsidomine decreases hyperoxia-induced lung injury in neonatal rats(Springernature, 2023) Aslan, Mehmet; Gokce, Ismail Kursat; Turgut, Hatice; Tekin, Suat; Taslidere, Asli Cetin; Deveci, Mehmet Fatih; Kaya, HuseyinBackgroundThe study's objective is to evaluate if Molsidomine (MOL), an anti-oxidant, anti-inflammatory, and anti-apoptotic drug, is effective in treating hyperoxic lung injury (HLI).MethodsThe study consisted of four groups of neonatal rats characterized as the Control, Control+MOL, HLI, HLI + MOL groups. Near the end of the study, the lung tissue of the rats were evaluated with respect to apoptosis, histopathological damage, anti-oxidant and oxidant capacity as well as degree of inflammation.ResultsCompared to the HLI group, malondialdehyde and total oxidant status levels in lung tissue were notably reduced in the HLI + MOL group. Furthermore, mean superoxide dismutase, glutathione peroxidase, and glutathione activities/levels in lung tissue were significantly higher in the HLI + MOL group as compared to the HLI group. Tumor necrosis factor-alpha and interleukin-1 beta elevations associated with hyperoxia were significantly reduced following MOL treatment. Median histopathological damage and mean alveolar macrophage numbers were found to be higher in the HLI and HLI + MOL groups when compared to the Control and Control+MOL groups. Both values were increased in the HLI group when compared to the HLI + MOL group.ConclusionsOur research is the first to demonstrate that bronchopulmonary dysplasia may be prevented through the protective characteristics of MOL, an anti-inflammatory, anti-oxidant, and anti-apoptotic drug.ImpactMolsidomine prophylaxis significantly decreased the level of oxidative stress markers.Molsidomine administration restored the activities of antioxidant enzymes.Molsidomine prophylaxis significantly reduced the levels of inflammatory cytokines.Molsidomine may provide a new and promising therapy for BPD in the future.Molsidomine prophylaxis decreased lung damage and macrophage infiltration in the tissue.Öğe A newborn with gastric hemangioma treated using propranolol(Korean soc pedıatrıc gastroenterology & nutrıtıon, 301 dongsung-dong 25-ı, jongno-gu, seoul, 301 dongsung, south korea, 2018) Kaya, Huseyin; Gokce, Ismail Kursad; Gungor, Sukru; Turgut, Hatice; Ozdemir, RamazanGastric hemangiomas are rare benign vascular tumors that can cause severe gastrointestinal system bleeding. We presented the case of a neonate with fresh bleeding and melena from the orogastric tube and detected gastric hemangioma in esophagogastroduodenoscopic examination. Propranolol is widely used in treatment of cutaneous hemangiomas and non-gastric gastrointestinal system hemangiomas. However, the surgical approach is preferred for treating gastric hemangiomas, and there are few reports of gastric hemangiomas associated with non-surgical treatment. Gastric hemorrhage decreased with antacid and somatostatin treatment. Propranolol treatment was initiated before the surgery decision. After three weeks of treatment, we observed regression in the hemangioma with endoscopic evaluation. During the course of treatment, the patient's gastrointestinal system bleeding did not recur, and there were no side effects associated with propranolol.Öğe A Newborn with Gastric Hemangioma Treated Using Propranolol(Korean Soc Pediatric Gastroenterology & Nutrition, 2018) Kaya, Huseyin; Gokce, Ismail Kursad; Gungor, Sukru; Turgut, Hatice; Ozdemir, RamazanGastric hemangiomas are rare benign vascular tumors that can cause severe gastrointestinal system bleeding. We presented the case of a neonate with fresh bleeding and melena from the orogastric tube and detected gastric hemangioma in esophagogastroduodenoscopic examination. Propranolol is widely used in treatment of cutaneous hemangiomas and non-gastric gastrointestinal system hemangiomas. However, the surgical approach is preferred for treating gastric hemangiomas, and there are few reports of gastric hemangiomas associated with non-surgical treatment. Gastric hemorrhage decreased with antacid and somatostatin treatment. Propranolol treatment was initiated before the surgery decision. After three weeks of treatment, we observed regression in the hemangioma with endoscopic evaluation. During the course of treatment, the patient's gastrointestinal system bleeding did not recur, and there were no side effects associated with propranolol.Öğe An Observational, Prospective, Multicenter, Registry-Based Cohort Study Comparing Conservative and Medical Management for Patent Ductus Arteriosus(Frontiers Media Sa, 2020) Okulu, Emel; Erdeve, Omer; Arslan, Zehra; Demirel, Nihal; Kaya, Huseyin; Gokce, Ismail Kursad; Ertugrul, SabahattinNo consensus has been reached on which patent ductus arteriosus (PDAs) in preterm infants require treatment and if so, how, and when they should be treated. A prospective, multicenter, cohort study was conducted to compare the effects of conservative approaches and medical treatment options on ductal closure at discharge, surgical ligation, prematurity-related morbidities, and mortality. Infants between 24(0/7)and 28(6/7)weeks of gestation from 24 neonatal intensive care units were enrolled. Data on PDA management and patients' clinical characteristics were recorded prospectively. Patients with moderate-to-large PDA were compared. Among the 1,193 enrolled infants (26.7 +/- 1.4 weeks and 926 +/- 243 g), 649 (54%) had no or small PDA, whereas 544 (46%) had moderate-to-large PDA. One hundred thirty (24%) infants with moderate-to-large PDA were managed conservatively, in contrast to 414 (76%) who received medical treatment. Eighty (62%) of 130 infants who were managed conservatively did not receive any rescue treatment and the PDA closure rate was 53% at discharge. There were no differences in the rates of late-onset sepsis, necrotizing enterocolitis (NEC), retinopathy of prematurity, intraventricular hemorrhage (>= Grade 3), surgical ligation, and presence of PDA at discharge between conservatively-managed and medically-treated infants (p> 0.05). Multivariate analysis including perinatal factors showed that medical treatment was associated with increased risk for mortality (OR 1.68, 95% Cl 1.01-2.80,p= 0.046), but decreased risk for BPD or death (BPD/death) (OR 0.59, 95%Cl 0.37-0.92,p= 0.022). The preferred treatment options were ibuprofen (intravenous 36%, oral 31%), and paracetamol (intravenous 26%, oral 7%). Infants who were treated with oral paracetamol had higher rates of NEC and mortality in comparison to other treatment options. Infants treated before postnatal day 7 had higher rates of mortality and BPD/death than infants who were conservatively managed or treated beyond day 7 (p= 0.009 and 0.007, respectively). In preterm infants born at <29 weeks of gestation with moderate-to-large PDA, medical treatment did not show any reduction in the rates of open PDA at discharge, surgical or prematurity-related secondary outcomes. In addition to the high incidence of spontaneous closure of PDA in the first week of life, early treatment (<7 days) was associated with higher rates of mortality and BPD/death.Öğe A randomized trial comparing the short binasal prong to the RAM cannula for noninvasive ventilation support of preterm infants with respiratory distress syndrome(Taylor & Francis Ltd, 2021) Gokce, Ismail Kursad; Kaya, Huseyin; Ozdemir, RamazanPurpose: In this study, we compared the efficacy of the RAM cannula and the short binasal prong (SBP) as noninvasive ventilation (NIV) interfaces in preterm infants with respiratory distress syndrome (RDS). Materials and Methods: Premature infants with RDS who required NIV were randomized in the RAM cannula and SBP groups within the first half hour. The groups were compared in terms of their need for invasive ventilation, their surfactant use, and their morbidities. Results: We assessed 126 patients (62 SBPs and 64 RAM cannulas). Clinical and demographic features of the groups were similar. Within the first 72 hours, the RAM cannula group showed a higher need for invasive ventilation (32.8 and 9.6%, p = .002, respectively), surfactant (42.1 and 19.3%, p = .007, respectively), and rate of pulmonary hemorrhage was also higher. There were no differences between the groups in terms of other morbidities. Conclusions: In preterm infants with RDS, RAM cannula use as an interface for NIV results in increased invasive ventilation and surfactant use.
