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Öğe A down syndrome patient diagnosed with transient myeloproliferative disease after presenting with cutaneous findings(2021) Ceran, Burak; Derme, Turan; Erkan, Mehmet Orhan; Sahin, Seda; Gurlek Gokcebay, Dilek; Cakir, Ufuk; Tayman, CuneytTransient myeloproliferative disease (TMD) is among the main hematologic problems seen in neonates with Down syndrome (DS). It is usually self-limiting and results in spontaneous remission within 3 to 6 months. Characteristic signs of TMD are leukocytosis, thrombocytopenia, anemia, hepatosplenomegaly, cutaneous nodules, and increased numbers of circulating blasts. In this article, we present a DS neonate without leukocytosis who was diagnosed as having TMD after a diffuse vesiculopapular eruption on the face, which is a different clinical presentation than other cases in the literature. Our aim is to emphasize the importance of early diagnosis and close multidisciplinary monitoring of these patients.Öğe Epidemiologic and clinical characteristics of neonates with late-onset COVID-19: 1-year data of Turkish Neonatal Society(Springer, 2022) Akin, Ilke Mungan; Kanburoglu, Mehmet Kenan; Tayman, Cuneyt; Oncel, Mehmet Yekta; Imdadoglu, Timucin; Dilek, Mustafa; Yaman, AkanThe literature on neonates with SARS-CoV-2 is mainly concerned with perinatal cases, and scanty data are available about environmentally infected neonates. To fill knowledge gaps on the course and prognosis of neonatal cases, we analyzed 1-year data from the Turkish Neonatal Society in this prospective cohort study of neonates with postnatal transmission. Data from 44 neonatal intensive care units (NICUs), of neonates with positive RT-PCR results at days 5-28 of life, were extracted from the online registry system and analyzed. Of 176 cases, most were term infants with normal birth weight. Fever was the most common symptom (64.2%), followed by feeding intolerance (25.6%), and cough (21.6%). The median length of hospitalization was 9 days, with approximately one quarter of infants receiving some type of ventilatory support. Myocarditis (5.7%) was the most common complication during follow-up. Among the clinical findings, cough (odds ratio [OR]: 9.52, 95% confidence interval [CI]: 4.17-21.71), tachypnea (OR: 26.5, 95% CI: 9.59-73.19), and chest retractions (OR: 27.5, 95% CI: 5.96-126.96) were associated with more severe clinical disease. Also, there were significant differences in the C-reactive protein level, prothrombin time (PT), partial thromboplastin time, international normalized ratio, and days in the NICU (p = 0.002, p = 0.012, p = 0.034, p = 0.008, and p < 0.001, respectively) between patients with mild-moderate and severe-critical presentations. A PT above 14 s was a significant predictor of severe/critical cases, with a sensitivity of 64% and specificity of 73%. Conclusions: Our data showed that late-onset COVID-19 infection in neonates who need hospitalization can be severe, showing associations with high rates of ventilatory support and myocarditis. Cough, tachypnea, and retractions on admission suggest a severe disease course.Öğe Evaluation of therapeutic and prophylactic platelet transfusion practices in a neonatal intensive care unit(2019) Korkut, Sabriye; Bozkaya, Davut; Tayman, CuneytAim: To investigate the causes of thrombocytopenia requiring platelet transfusion (PT), clinical factors influencing the decision to give PT, and the frequency of major hemorrhage post-PT in a neonatal intensive care unit (NICU). Material and Methods: This retrospective cross-sectional study included neonates who underwent PT at least once in the NICU during a 4-month period. Demographic characteristics, postnatal age at time of PT, number of PTs, thrombocytopenia etiology, and occurrence of major hemorrhage were analyzed. PT threshold was <20x103 /µL in group 1; 20x103 /µL – 49x103 /µL in group 2; and >503 /µL in group 3. Results: Thirty-seven (4.9%) of the 751 patients admitted to the NICU during the study period received PT. These 37 patients received a total of 133 PTs. The most common etiology of thrombocytopenia requiring PT was sepsis (83.5%), followed by NEC (9.8%). Of the 133 PTs, 7 were administered for early-onset thrombocytopenia and 126 for late-onset thrombocytopenia. All patients in group 1 (n=56) had severe thrombocytopenia only with no additional morbidity; patients in group 2 (n=72) had thrombocytopenia accompanied by severe morbidity and/or major hemorrhage, coagulopathy, or extremely low birth weight (ELBW); patients in group 3 (n=4) received PT due to thrombocytopenia and preoperative preparation, coagulopathy, or major hemorrhage. Seven of the 133 PTs (5.3%) were therapeutic and the other 126 (94.7%) were prophylactic. Existing major hemorrhage persisted after 6 of the 7 therapeutic PTs. Major hemorrhage occurred after only 1 prophylactic PT. Conclusion: It was identified bacterial sepsis and NEC as the two most common clinical indications for PT. In general, prophylactic PT was not followed by major hemorrhage, whereas recurrent major hemorrhage occurred after therapeutic PT. Therefore, randomized controlled studies are needed to determine a safe PT threshold value based on a scoring system for predicting the risk of major hemorrhage.Öğe A Multicentered Study on Epidemiologic and Clinical Characteristics of 37 Neonates With Community-acquired COVID-19(Lippincott Williams & Wilkins, 2020) Kanburoglu, Mehmet Kenan; Tayman, Cuneyt; Oncel, Mehmet Yekta; Akin, Ilke Mungan; Can, Emrah; Demir, Nihat; Arayici, SemaBackground: Coronavirus disease 2019 (COVID-19) primarily affects adults and spares children, whereas very little is known about neonates. We tried to define the clinical characteristics, risk factors, laboratory, and imagining results of neonates with community-acquired COVID-19. Methods: This prospective multicentered cohort study included 24 neonatal intensive care units around Turkey, wherein outpatient neonates with COVID-19 were registered in an online national database. Full-term and premature neonates diagnosed with COVID-19 were included in the study, whether hospitalized or followed up as ambulatory patients. Neonates without severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) via reverse transcriptase-polymerase chain reaction testing or whose mothers had been diagnosed with COVID-19 during pregnancy were excluded. Results: Thirty-seven symptomatic neonates were included. The most frequent findings were fever, hypoxemia, and cough (49%, 41%, 27%, respectively). Oxygen administration (41%) and noninvasive ventilation (16%) were frequently required; however, mechanical ventilation (3%) was rarely needed. Median hospitalization was 11 days (1-35 days). One patient with Down syndrome and congenital cardiovascular disorders died in the study period. C-reactive protein (CRP) and prothrombin time (PT) levels were found to be higher in patients who needed supplemental oxygen (0.9 [0.1-8.6] vs. 5.8 [0.3-69.2]p= 0.002, 11.9 [10.1-17.2] vs. 15.2 [11.7-18.0]p= 0.01, respectively) or who were severe/critical (1.0 [0.01-8.6] vs. 4.5 [0.1-69.2]p= 0.01, 11.7 [10.1-13.9] vs. 15.0 [11.7-18.0]p= 0.001, respectively). Conclusions: Symptomatic neonates with COVID-19 had high rates of respiratory support requirements. High CRP levels or a greater PT should alert the physician to more severe disease.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.
