Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, 2020
Aim Preeclampsia may cause both maternal and neonatal complications. Uteroplacental dysfunction i... more Aim Preeclampsia may cause both maternal and neonatal complications. Uteroplacental dysfunction is one of the reasons of fetal and neonatal complications in preeclampsia. Recent findings about the etiology and pathogenesis of the disease shows that inflammation is one of the factors responsible for maternal complications, thus neonatal complications should be associated with the same inflammatory process. We considered evaluating mean platelet volume (MPV) of infants born to mothers with preeclampsia, based on the findings of elevated MPV values in pregnant women with preeclampsia. Materials and methods This study was carried out at the Neonatal Intensive Care Unit of Hacettepe University Ihsan Dogramacı Children’s Hospital and consisted of 148 infants born to mothers with preeclampsia and 147 infants as a control group which were selected by stratified sampling system. Hematological parameters (mean platelet volume, hemoglobin values, white blood cell and platelet counts) and commo...
Objective: Cardiac conduction system is affected and heart blocks can be seen in newborns whose m... more Objective: Cardiac conduction system is affected and heart blocks can be seen in newborns whose mothers have connective tissue disease, especially with systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS). Anti-SS-A (Ro), anti-SS-B (La) antibodies in the mother's circulation are responsible for this situation. In this study, it was aimed to evaluate the clinical features and long-term follow-up results of babies born to mothers with connective tissue disease in our hospital. Materials and methods: Patients who were hospitalized in the neonatal intensive care unit between January 2001 and January 2016 due to the diagnosis of SLE, SS or connective tissue disease in their mothers were retrospectively screened, and their demographic and clinical characteristics and electrocardiographic findings were recorded. Results: A total of 49 babies from 48 mothers were included in the study. Mean age of mothers at birth was 30.8±5.0 years (28-41), mean gestational week of patien...
Hospitalized newborns have an increased risk of malnutrition and, especially preterm infants, oft... more Hospitalized newborns have an increased risk of malnutrition and, especially preterm infants, often experience malnutrition-related extrauterine growth restriction (EUGR). The aim of this study was to predict the discharge weight and the presence of weight gain at discharge with machine learning (ML) algorithms. The demographic and clinical parameters were used to develop the models using fivefold cross-validation in the software-R with a neonatal nutritional screening tool (NNST). A total of 512 NICU patients were prospectively included in the study. Length of hospital stay (LOS), parenteral nutrition treatment (PN), postnatal age (PNA), surgery, and sodium were the most important variables in predicting the presence of weight gain at discharge with a random forest classification (AUROC:0.847). The AUROC of NNST-Plus, which was improved by adding LOS, PN, PNA, surgery, and sodium to NNST, increased by 16.5%. In addition, weight at admission, LOS, gestation-adjusted age at admission...
Aims: Evidence for drug–drug interactions (DDIs) that may cause age-dependent differences in the ... more Aims: Evidence for drug–drug interactions (DDIs) that may cause age-dependent differences in the incidence and severity of adverse drug reactions (ADRs) in newborns is sparse. We aimed to develop machine learning (ML) algorithms that predict DDI presence by integrating each DDI, which is objectively evaluated with the scales in a risk matrix (probability + severity). Methods: This double-center, prospective randomized cohort study included neonates admitted to the neonatal intensive care unit in a tertiary referral hospital during the 17-month study period. Drugs were classified by the Anatomical Therapeutic Chemical (ATC) classification and assessed for potential and clinically relevant DDIs to risk analyses with the Drug Interaction Probability Scale (DIPS, causal probability) and the Lexicomp® DDI (severity) database. Results: A total of 412 neonates (median (interquartile range) gestational age of 37 (4) weeks) were included with 32,925 patient days, 131 different medications, a...
The vein of galen aneurysmal malformations (VGAM) is a rare congenital cerebral arteriovenous def... more The vein of galen aneurysmal malformations (VGAM) is a rare congenital cerebral arteriovenous deformity. Recently, this anomaly may be diagnosed prenatally by imaging methods. MR-angiography is useful for the post-natal confirmation of VGAM anatomy and the demonstration of the vessels feeding the aneurysm. It occurs most frequently in high-burdened heart failure during the neonatal period. Thus, the greater the severity of heart failure, the lower the response to treatment, and the higher the mortality rate occur, if not treated on time. The successful management and treatment of this condition requires multidisciplinary approach and good follow up. In this study, eleven newborns with VGAM, diagnosed in the prenatal and neonatal period, with severe heart failure and pulmonary hypertension are presented.
Proximal tubular defects (renal Fanconi syndrome) may occur secondary to some inborn errors of me... more Proximal tubular defects (renal Fanconi syndrome) may occur secondary to some inborn errors of metabolism. Shohl’s solution is used in renal Fanconi syndrome for the treatment of metabolic acidosis. Herein, we report a newborn with galactosemia, a solitary kidney and renal Fanconi syndrome who developed hypocalcemic convulsions under Shohl’s solution treatment. Experience and knowledge regarding treatment with Shohl’s solution in neonates is limited. We thus recommend that clinicians should be cautious regarding the possibility of hypocalcemia while administering Shohl’s solution in newborns. Key words: Hypocalcemia, Shohl’s solution, newborn
Background Granulocyte-colony stimulating factor (G-CSF) is frequently used to treat neonatal neu... more Background Granulocyte-colony stimulating factor (G-CSF) is frequently used to treat neonatal neutropenia. There is a paucity of data in the literature on when immature to total neutrophil ratio (I/T ratio) can be accurately used as a sepsis marker after G-CSF therapy, as well as when I/T ratio returns to normal values expected in newborns who did not receive G-CSF. Objective To investigate changes in white blood cells counts and ratios in neonates with neutropenia before and after G-CSF therapy. Methods This retrospective study included newborns admitted to the NICU of Hacettepe University Ihsan Dogramaci Hospital, Ankara, Turkey, between 2005 and 2017 who received G-CSF therapy for neutropenia. Subjects underwent complete blood counts on the day before receiving G-CSF therapy (day 0) as well as days 1, 2, and 3 after treatment; I/T ratios were recorded from peripheral smears. Results Twenty-eight neonates were included in the study. Subjects’ median gestational age (interquartile ...
BACKGROUND: Our objective in this study was to assess the association between eNOS gene, that ach... more BACKGROUND: Our objective in this study was to assess the association between eNOS gene, that achieves synthesis of nitric oxide especially in the endothelial cells known to have an important role in angiogenesis and vasculogenesis, G894T, intron 4 VNTR (27-bp repeat) and T786C functional polymorphisms and retinopathy of prematurity (ROP), which is an important cause of morbidity in premature or low birth weight babies. METHODS: A total of 139 babies who were followed up in our neonatal intensive care unit because of premature birth in our hospital or admitted to our unit. 69 of them had retinopathy of prematurity and comprised the patients group. The remaining 70 babies who did not have ROP comprised the control group. An additional of 1 ml of blood samples were drawn from babies who were in the study groups during routine laboratory analysis. eNOS gene polymorphisms were determined by using polymerase chain reaction method. RESULTS: eNOS G894T, intron 4 VNTR and T786C gene polymor...
Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, 2020
Aim Preeclampsia may cause both maternal and neonatal complications. Uteroplacental dysfunction i... more Aim Preeclampsia may cause both maternal and neonatal complications. Uteroplacental dysfunction is one of the reasons of fetal and neonatal complications in preeclampsia. Recent findings about the etiology and pathogenesis of the disease shows that inflammation is one of the factors responsible for maternal complications, thus neonatal complications should be associated with the same inflammatory process. We considered evaluating mean platelet volume (MPV) of infants born to mothers with preeclampsia, based on the findings of elevated MPV values in pregnant women with preeclampsia. Materials and methods This study was carried out at the Neonatal Intensive Care Unit of Hacettepe University Ihsan Dogramacı Children’s Hospital and consisted of 148 infants born to mothers with preeclampsia and 147 infants as a control group which were selected by stratified sampling system. Hematological parameters (mean platelet volume, hemoglobin values, white blood cell and platelet counts) and commo...
Objective: Cardiac conduction system is affected and heart blocks can be seen in newborns whose m... more Objective: Cardiac conduction system is affected and heart blocks can be seen in newborns whose mothers have connective tissue disease, especially with systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS). Anti-SS-A (Ro), anti-SS-B (La) antibodies in the mother's circulation are responsible for this situation. In this study, it was aimed to evaluate the clinical features and long-term follow-up results of babies born to mothers with connective tissue disease in our hospital. Materials and methods: Patients who were hospitalized in the neonatal intensive care unit between January 2001 and January 2016 due to the diagnosis of SLE, SS or connective tissue disease in their mothers were retrospectively screened, and their demographic and clinical characteristics and electrocardiographic findings were recorded. Results: A total of 49 babies from 48 mothers were included in the study. Mean age of mothers at birth was 30.8±5.0 years (28-41), mean gestational week of patien...
Hospitalized newborns have an increased risk of malnutrition and, especially preterm infants, oft... more Hospitalized newborns have an increased risk of malnutrition and, especially preterm infants, often experience malnutrition-related extrauterine growth restriction (EUGR). The aim of this study was to predict the discharge weight and the presence of weight gain at discharge with machine learning (ML) algorithms. The demographic and clinical parameters were used to develop the models using fivefold cross-validation in the software-R with a neonatal nutritional screening tool (NNST). A total of 512 NICU patients were prospectively included in the study. Length of hospital stay (LOS), parenteral nutrition treatment (PN), postnatal age (PNA), surgery, and sodium were the most important variables in predicting the presence of weight gain at discharge with a random forest classification (AUROC:0.847). The AUROC of NNST-Plus, which was improved by adding LOS, PN, PNA, surgery, and sodium to NNST, increased by 16.5%. In addition, weight at admission, LOS, gestation-adjusted age at admission...
Aims: Evidence for drug–drug interactions (DDIs) that may cause age-dependent differences in the ... more Aims: Evidence for drug–drug interactions (DDIs) that may cause age-dependent differences in the incidence and severity of adverse drug reactions (ADRs) in newborns is sparse. We aimed to develop machine learning (ML) algorithms that predict DDI presence by integrating each DDI, which is objectively evaluated with the scales in a risk matrix (probability + severity). Methods: This double-center, prospective randomized cohort study included neonates admitted to the neonatal intensive care unit in a tertiary referral hospital during the 17-month study period. Drugs were classified by the Anatomical Therapeutic Chemical (ATC) classification and assessed for potential and clinically relevant DDIs to risk analyses with the Drug Interaction Probability Scale (DIPS, causal probability) and the Lexicomp® DDI (severity) database. Results: A total of 412 neonates (median (interquartile range) gestational age of 37 (4) weeks) were included with 32,925 patient days, 131 different medications, a...
The vein of galen aneurysmal malformations (VGAM) is a rare congenital cerebral arteriovenous def... more The vein of galen aneurysmal malformations (VGAM) is a rare congenital cerebral arteriovenous deformity. Recently, this anomaly may be diagnosed prenatally by imaging methods. MR-angiography is useful for the post-natal confirmation of VGAM anatomy and the demonstration of the vessels feeding the aneurysm. It occurs most frequently in high-burdened heart failure during the neonatal period. Thus, the greater the severity of heart failure, the lower the response to treatment, and the higher the mortality rate occur, if not treated on time. The successful management and treatment of this condition requires multidisciplinary approach and good follow up. In this study, eleven newborns with VGAM, diagnosed in the prenatal and neonatal period, with severe heart failure and pulmonary hypertension are presented.
Proximal tubular defects (renal Fanconi syndrome) may occur secondary to some inborn errors of me... more Proximal tubular defects (renal Fanconi syndrome) may occur secondary to some inborn errors of metabolism. Shohl’s solution is used in renal Fanconi syndrome for the treatment of metabolic acidosis. Herein, we report a newborn with galactosemia, a solitary kidney and renal Fanconi syndrome who developed hypocalcemic convulsions under Shohl’s solution treatment. Experience and knowledge regarding treatment with Shohl’s solution in neonates is limited. We thus recommend that clinicians should be cautious regarding the possibility of hypocalcemia while administering Shohl’s solution in newborns. Key words: Hypocalcemia, Shohl’s solution, newborn
Background Granulocyte-colony stimulating factor (G-CSF) is frequently used to treat neonatal neu... more Background Granulocyte-colony stimulating factor (G-CSF) is frequently used to treat neonatal neutropenia. There is a paucity of data in the literature on when immature to total neutrophil ratio (I/T ratio) can be accurately used as a sepsis marker after G-CSF therapy, as well as when I/T ratio returns to normal values expected in newborns who did not receive G-CSF. Objective To investigate changes in white blood cells counts and ratios in neonates with neutropenia before and after G-CSF therapy. Methods This retrospective study included newborns admitted to the NICU of Hacettepe University Ihsan Dogramaci Hospital, Ankara, Turkey, between 2005 and 2017 who received G-CSF therapy for neutropenia. Subjects underwent complete blood counts on the day before receiving G-CSF therapy (day 0) as well as days 1, 2, and 3 after treatment; I/T ratios were recorded from peripheral smears. Results Twenty-eight neonates were included in the study. Subjects’ median gestational age (interquartile ...
BACKGROUND: Our objective in this study was to assess the association between eNOS gene, that ach... more BACKGROUND: Our objective in this study was to assess the association between eNOS gene, that achieves synthesis of nitric oxide especially in the endothelial cells known to have an important role in angiogenesis and vasculogenesis, G894T, intron 4 VNTR (27-bp repeat) and T786C functional polymorphisms and retinopathy of prematurity (ROP), which is an important cause of morbidity in premature or low birth weight babies. METHODS: A total of 139 babies who were followed up in our neonatal intensive care unit because of premature birth in our hospital or admitted to our unit. 69 of them had retinopathy of prematurity and comprised the patients group. The remaining 70 babies who did not have ROP comprised the control group. An additional of 1 ml of blood samples were drawn from babies who were in the study groups during routine laboratory analysis. eNOS gene polymorphisms were determined by using polymerase chain reaction method. RESULTS: eNOS G894T, intron 4 VNTR and T786C gene polymor...
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