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Öğe Association Between Cardiothoracic Ratio and Mortality in Neonates with Pneumothorax(Galenos Yayincilik, 2019) Yilmaz, Fatma Hilal; Tarakci, Nuriye Emiroglu; Gultekin, Nazli Dilay; Gultekin, Umit; Altunhan, HuseyinAim: The aim of this study was to determine the effect of a reduction in the cardiothoracic ratio (CTR) on mortality in newborns with pneumothorax. Methods: Newborns with pneumothorax, who were admitted to our neonatal intensive care unit, were included in the study. The cardiothoracic ratio was calculated by dividing the transverse cardiac diameter by maximum internal thoracic diameter. Results: Of 7909 infants admitted to our neonatal intensive care unit from September 2006 to September 2017, a total of 82 (1.03%) newborns had pneumothorax. Patients who died had a lower CTR than surviving patients (0.39 +/- 0.056 and 0.44 +/- 0.048, respectively; p<0.001). It was found that the cut-off value was 0.4, area under the curve (AUC) value was 0.79, sensitivity was 68%, specificity was 87.7%, positive predictive value was 70.8%, and negative predictive value was 86.2%. Low birth weight, preterm birth, low maternal age, presence of respiratory distress syndrome, need for resuscitation at birth, and invasive mechanical ventilation were found to be significantly associated with mortality. However, among overall significant parameters, CTR and implementation of resuscitation at birth were the independent prognostic factors determined by regression analysis (p=0.001 and p=0.036, respectively). Conclusion: A CTR below 0.4% can be considered an important parameter indicating an increased risk of mortality in newborns with pneumothorax.Öğe Clinical characteristics and neonatal outcomes of liveborn newborns with hydrops fetalis treated in a tertiary level neonatal intensive care unit(Wiley, 2020) Emiroglu, Nuriye; Yilmaz, Fatma Hilal; Kececi, Ramazan; Yucel, Mehmet; Gultekin, Nazli Dilay; Altunhan, HuseyinBackground This study was performed for examining the neonatal results and aetiological factors of neonates with hydrops fetalis (HF) and determining the factors affecting mortality. Methods The medical records of liveborn neonates with HF who were admitted to a tertiary Neonatal Intensive Care Unit (NICU) in Konya, Turkey, between 2013 and 2019 were reviewed retrospectively. The demographic data, prenatal intervention, clinical findings, and results of the patients were recorded. Results A total of 32.6% of the 46 liveborn HF infants had immune HF (IHF), while 67.4% had nonimmune HF (NIHF); there was prenatal diagnoses in 39 (84.7%) cases. Cordocentesis and blood transfusion (n = 14; 30.4%) were the prenatal diagnosis and treatment interventions with the highest rate. A total of 16 patients (34.7%) received in utero interventional treatment. It was determined that the mean gestational age was not associated with mortality; moreover, birthweight (BW), Apgar score and the need for mechanical ventilation affected mortality. Conclusion The prognosis changes according to different etiologies of HF. However, despite the developments in neonatal care, mortality is still high in HF infants.Öğe Comparison of the Efficacy of Three Natural Surfactants in Preterm Turkish Newborns with Respiratory Distress Syndrome(Galenos Yayincilik, 2021) Yilmaz, Fatma Hilal; Tarakci, Nuriye; Gultekin, Nazli Dilay; Yucel, Mehmet; Kececi, Ramazan; Ozturk, Elif Nur Yildirim; Altunhan, HuseyinAim: To determine the efficacy of three natural surfactant preparations in our community and the short- and long-term results of these on preterm infants. Materials and Methods: This was a retrospective research on 193 premature babies with respiratory distress syndrome (RDS). The patients were divided into three groups, each of which received one of three surfactants: Group 1; beractant (100 mg/kg); group 2; poractant alfa (first dose of 200 mg/kg, recurrent doses of 100 mg/kg); group 3; calfactant (100 mg/kg). The groups were compared according to demographic characteristics, 1- and 5-minute Apgar scores, weight percentiles by gestational week, presence of pulmonary hemorrhage, surfactant dose repetition, air leak, bronchopulmonary dysplasia (BPD), stage of intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), hemodynamically significantpatent ductus arteriosus (hs-PDA) and its medical or surgical treatment, retinopathy of premature (ROP) and its treatment, sepsis, ventilation time (both non-invasive and invasive), free oxygen need time, time to start full enteral feeding, discharge time, and mortality. Results: A total of 193 preterm infants with a mean gestational age of 28.9 +/- 3.1 weeks and mean birth weight of 1,190.4 +/- 504.3 grams were included in this study. The neonates were allocated into three different groups randomly, namely group-1 (n=77), group-2 (n=59), and group-3 (n=57). There were no differences in the clinical and demographic features of the groups. The incidence of pulmonary hemorrhage, surfactant dose repetition, air leak, ventilation time for both non-invasive and invasive, free oxygen need time, hs-PDA and surgical treatment of PDA, BPD, NEC (>= stage II), IVH (>stage III), ROP, time to start full enteral feeding, and discharge time were similar between the study groups. The sepsis and mortality rates were lower in group 3 compared to groups 1 and 2 (p=0.015, p=0.001). Conclusion: In this study, beractant, proctant alfa and calfactant had clinically similar efficacy in patients with RDS.Öğe From the Symptoms of an Undiagnosed Mother to the Infant with Congenital Myotonic Dystrophy(Derman Medical Publ, 2017) Gultekin, Nazli Dilay; Yilmaz, Fatma Hilal; Altunhan, Huseyin; Ors, RahmiCongenital myotonic dystrophia (CMD) is a disorder with a wide clinical spectrum, characterized by hypotonia, respiratory failure, and nutritional challenges in the neonatal period. Although familial history is important in the diagnostic process, diagnosing the infant in the neonatal period may, conversely, lead the mother, or rarely the father, to be diagnosed. Here, a male infant presenting with hypotonicity and respiratory failure in the neonatal period was diagnosed with CMD through genetic testing by looking at the complaints of fatigue, muscle pain, and hypersomnia in the mother. As in our case, it should be kept in mind that CMD can be diagnosed at an early stage only by focusing on the familial history in hypotonic infants.Öğe Giant maxillofacial teratoma in a newborn(Bayrakol Medical Publisher, 2019) Yilmaz, Fatma Hilal; Gultekin, Nazli Dilay; Emiroglu, Nuriye Tarakci; Altunhan, Huseyin[Abstract Not Availabe]Öğe Glanzmann Thrombasthenia in a Newborn with Heterozygous Factor V Leiden and Heterozygous MTHFR C677T Gene Mutations(Springer India, 2019) Gultekin, Nazli Dilay; Yilmaz, Fatma Hilal; Tokgoz, Huseyin; Tarakci, Nuriye; Caliskan, UmranIntroductionGlanzmann thrombasthenia is a rare congenital platelet dysfunction.Case characteristicsA 2-day-old male neonate delivered at 35 weeks' gestation was referred with extensive bruising and jaundice. His elder sibling had Glanzmann thrombasthenia, and his mother had thrombophilic risk factors. Flow cytometric analysis revealed absent CD41/ CD61. A molecular thrombophilia panel revealed the presence of heterozygous factor V Leiden G1691A and methylenetetrahydrofolate reductase C677T gene mutations.OutcomeGeneral precautions to avoid injuries and spontaneous bleeding were advised.MessageLife-threatening bleeding may not be the first finding in cases of thrombasthenia accompanied by thrombophilic risk factors.Öğe Intrauterine volvulus that had been misunderstood as an antenatal mesenteric cyst(Elsevier Taiwan, 2019) Gultekin, Nazli Dilay; Salihoglu, Ozgul; Alptekin, Ahmet; Yilmaz, Fatma Hilal; Altunhan, Huseyin[Abstract Not Availabe]Öğe Lneonatal meningitis due to streptoccocus dysgalactiae subspecies equisimilis: a case report and literature review(Derman Medical Publ, 2018) Tarakci, Nuriye; Yilmaz, Fatma Hilal; Gultekin, Nazli Dilay; Altunhan, Huseyin; Ors, RahmiStreptococcus dysgalactiae subsp. equisimilis (SDSE) was firstly reported as a toxon among human streptococcal pathogens in the year 1996. Diseases caused by SDSE may vary from milder skin involvements including wound infection, erysipelas, and cellulitis to life-threatening clinical pictures as streptococcal toxic shock syndrome and necrotizing fasciitis. We describe a case of SDSE sepsis and meningitis in a 2-day-old newborn. He was referred to our intensive care unit (ICU) with fever, respiratory distress, seizures, peripheral cyanosis, and somnolence. SDSE grew out of the CSF and blood cultures obtained on admission to the ICU. SDSE cases reported in the literature are frequently older patients with an underlying disease. Also, SDSE may cause serious neonatal infections.Öğe Management of Patent Ductus Arteriosus in Preterm Patients Who Were Given Surfactant(Bayrakol Medical Publisher, 2020) Yilmaz, Fatma Hilal; Emiroglu, Nuriye; Oflaz, Mehmet Burhan; Gultekin, Nazli Dilay; Yucel, Mehmet; Kececi, Ramazan; Altunhan, HuseyinAim: Respiratory distress syndrome (RDS) and perinatal asphyxia are known to be risk factors in hemodynamically significant Patent Ductus Arteriosus (hsPDA). In this study, we aimed to reveal scientific data in respiratory distressed preterm infants in the light of the current literature and to discuss the management of PDA in babies born at 33d weeks of gestation and up to 33d weeks which we have treated and followed in our unit. Materials and Methods: The medical records of premature infants treated at Necmettin Erbakan University Neonatal Intensive Care Unit (NICU) between January 2016 and January 2019 were retrospectively evaluated. Results: Between January 2016 and January 2019, 476 patients born prior to 33d gestational weeks were admitted to our unit.. PDA was detected in 149 of these patients because of RDS due to the surfactants. In 112 (75.1%) of these patients, the PDA closed spontaneously within the first week of life. Thirty-seven (24.8%) patients developed hs-PDA. The incidence of premature retinopathy (ROP), bronchopulmonary dysplasia (BPD), and late neonatal sepsis morbidity was significantly elevated during the hospitalization (p=0.05, p=0.01, p=0.06). Invasive mechanical ventilation, non-invasive mechanical ventilation, and free oxygen requirement times were found to be longer (p= 0.0001, p= 0.004, p= 0.014). Complete enteral nutrition and discharge times were longer in the treated group (p= 0.03, p= 0.002). We identified the presence of Small for Gestational Age (SGA) (r = 0.30 p = 0.04) and low birth weight (r = 0.99 p = 0.02) in logistic regression analysis of the factors affecting the PDA as meaningful results. Discussion: The presence of hs-PDA in infants with RDS is directly proportional to the birth week and weight, the presence of SGA reduces the frequency of hs-PDAs, the presence of hs-PDA is associated with ROP, BPD, and late sepsis. The presence of hs-PDA has been found to be correlated with prolonged respiratory support and delayed discharge.Öğe Palivizumab prophylaxis in respiratory syncytial virus epidemia; Neonatal intensive care unit experience(Derman Medical Publ, 2017) Yilmaz, Fatma Hilal; Gultekin, Nazli Dilay; Altunhan, Huseyin[Abstract Not Availabe]Öğe Psoas Abscess Accompanied by Neonatal Appendicitis: A Case Report(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2019) Yucel, Mehmet; Yilmaz, Fatma Hilal; Tarakci, Nuriye; Gultekin, Nazli Dilay; Altunhan, Huseyin; Esen, Haci HasanNeonatal appendicitis is a very rare event leading to acute abdomen manifestation in neonatal period, and is associated with high mortality rates. In these patients, symptoms and findings are not apparent, most of the time, urgent surgery is carried out without preoperative diagnosis; and diagnoses are made with intraoperative findings or pathological results. In the present case, a case with neonatal appendicitis that had psoas abscess with swelling and circulatory disorder in the right leg on the 15th day of life is presented.
