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Öğe A Case of Early Infantile Epileptic Encephalopathy Due to KCNQ2 Gene Mutation Presenting With Episodes of Hiccups(Cureus Inc, 2022) Alan, Serdar; Vural, Sevde Nur; Aliefendioglu, Didem; Senbil, NesrinNeonatal epilepsy syndromes are responsible for only 15% of the cases of neonatal seizure. An underlying genetic disorder can be detected in approximately 42% of this subgroup. KCNQ2 gene-associated epilepsies are very rare and more common presentations are self-limited familial neonatal epilepsy (SLFNE) and early infantile epileptic encephalopathies (EIEE). The most common initial seizure semiologies are tonic seizures with or without autonomic symptoms in EIEE resulting from KCNQ2 gene mutation. It is characterized by early neonatal onset seizures with suppression burst pattern on electroencephalogram and typically results in severe developmental delay. Therapeutic options for infants with KCNQ2-related EIEE are limited and there is no consensus about it in the literature. Herein, the neonate with EIEE with unexpected episodes of hiccups due to novel mutation of the KCNQ2 gene, which was reported second time, was presented and antiepileptic treatment strategies were discussed in the light of current literature.Öğe Differences in Possible Risk Factors, Treatment Strategies, and Outcomes of Neonatal Pneumothorax in Preterm and Term Infants(Aves, 2024) Tandircioglu, Umit Ayse; Koral, Umran; Guzoglu, Nilufer; Alan, Serdar; Aliefendioglu, DidemObjective: The study aimed to compare the risk factors, treatment strategies, and early outcomes of symptomatic neonatal pneumothorax (NP) between preterm and term newborns. Materials and Methods: This retrospective cross-sectional study was conducted in a neonatal intensive care unit between 2015 and 2022, consisting of hospitalized neonates with symptomatic NP. The cases were divided into three groups according to their gestational ages: <34(0/7 )(group 1), 34(0/7)-36(6/7) (group 2), and >= 37(0/7) weeks (group 3). Risk factors, treatment strategies, and mortality rates of the study groups were compared using Kruskal-Wallis analysis. Results: Fifty-nine infants with a diagnosis of symptomatic NP were included in the study. The number of participants was as follows: 25 (42.3%) in group 1, 18 (30.5%) in group 2, and 16 (27.1%) in group 3. The need of delivery room (DR) resuscitation was significantly higher in group 1 (40%, P = .003). The surfactant administration rate was significantly higher in group 1 when compared to group 2 and group 3 (68% vs. 22% and 19%, respectively), P < .001. Similarly, the invasive mechanical ventilation percentage was significantly higher in group 1 than group 2 and group 3, P = .014. However, compared to group 3 (63%), the percentage of chest drain insertion (CDI) need was significantly higher in group 1 (96%) and group 2 (89%) (P = .014). Conclusion: Exposure to DR resuscitation and the need for surfactant are the most common risk factors for NP in preterm infants. Although oxygen and/or needle aspiration treatments are less invasive in symptomatic NP, the improvement rate without CDI is very low in preterm infants born before 34 weeks of gestational age.Öğe How reliable is the statistical evaluation using the 'mean' in an abnormally distributed dataset?(Springer Science and Business Media Deutschland GmbH, 2024) Tandircioglu, Umit Ayse; Ates, Can; Alan, Serdar[No abstract available]Öğe Life-threatening massive upper gastrointestinal bleeding in a term and healthy baby(Taylor and Francis Ltd., 2023) Alan, Serdar; Vural, Sevde Nur; Gulerman, Hacer Fulya; Albayrak, Meryem; Aliefendioglu, DidemUpper gastrointestinal (UGI) bleeding due to gastric ulcer and gastritis can be seen in severely ill or premature infants but is rarely reported in healthy term newborns. UGI endoscopy is crucial for the etiological evaluation and appropriate treatment of UGI hemorrhages. This report discusses the differential diagnosis and treatment approach in a previously healthy infant who was admitted to the neonatal intensive care unit due to life-threatening severe UGI bleeding causing hemodynamic instability. © Copyright © 2022 Baylor University Medical Center.Öğe PANDEMİ SONRASI YENİDOĞANLARDA VİRAL SOLUNUM YOLU ENFEKSİYONLARI(2023) Tandırcıoğlu, Ümit Ayşe; Alan, Serdarİnsanlarda ‘severe acute respiratory syndrome coronavirus 2’ (SARS-CoV-2) olarak adlandırılan yeni coronavirüs suşuna bağlı enfeksiyonlar ilk olarak 2019 yılında görülmeye başlamış ve Mart 2020 yılında dünya sağlık örgütü tarafından COVİD-19 pandemisi kabul edilmiştir. Bununla birlikte bireysel, toplumsal ve ülkesel bazda farmakolojik olmayan müdahaleler hayatımıza girmiş ve pandemi yavaşlatılmaya çalışılmıştır. Bu farmakolojik olmayan müdahaleler ile sadece SARS-CoV-2 değil, diğer solunum sistemini tutan viral ajanlarda etkilenmiştir. Özellikle küçük çocuklar ve yenidoğanlarda ciddi alt solunum yolu enfeksiyonu yapan başta respiratuvar sinsityal virüs, rinovirüs ve respiratuvar enterovirüsler olmak üzere diğer tüm virüslerin toplumda görülmesinde ve enfeksiyon şiddetinde değişiklikler ortaya çıkmıştır. Bu derlemede özellikle respiratuvar sinsityal virüs, influenza virüs, rinovirüs ve respiratuvar enterovirüsler, adenovirüs, insan metapnömovirüs ve parainfluenza üzerinde durularak pandemi öncesi, pandemi sırası ve pandemi sonrasında görülme sıklıkları ve yenidoğan üzerindeki farklılaşan etkilerine değinilmiştir. COVID-19 pandemisi sırasında elde edilen bu bulgular gelecekte başka bir virüsün yol açabileceği olası bir pandemi yönetiminde ışık tutucu olacaktır.Öğe RESPİRATUVAR DİSTRES SENDROMLU PREMATÜRE BEBEKLERDE SURFAKTAN UYGULANMASINDA GÜNCEL METOTLAR(2022) Alan, SerdarPrematürelerde görülen respiratuvar distres sendromunda surfaktanın klinik kullanıma girmesi ile birlikte prematüre bebeklerdeki yaşam oranı dramatik olarak artmıştır. Surfaktanın akciğerlere iletiminde kullanılan yöntemler zaman içerisinde daha az invaziv ve hatta invaziv olmayan yöntemlere doğru evrilmeye başlamıştır. Surfaktanın ince kateter ile uygulanması, bir larengeal veya suproglottik havayolu cihazı kullanılarak, farengeal uygulama ile ve aerosolize şekilde verilmesi gibi yeni yöntem çalışmaları giderek artmaktadır. Böylece, immatür akciğerin klasik olarak kabul edilen entübasyon, pozitif basınçlı ventilasyon ve mekanik ventilasyonun zararlı etkilerinden korunması hedeflenmiştir. İnce kateter ile surfaktan uygulanması metodu ile yapılan çok sayıda çalışma ve meta-analizin sonuçları entübasyon, surfaktan uygulanması ve pozitif basınçlı ventilasyon metotları ile karşılaştırıldığında mekanik ventilasyon ihtiyacı ve süresi, bronkopulmoner displazi insidansı ve neonatal mortalite oranlarında azalmaya neden olduğu gösterilmiştir. Ancak çalışmalarda premedikasyon yönetimi ve solunum desteği türü, uygulanan surfaktan türü gibi birçok konuda heterojenite mevcuttur. Supraglottik hava yolu cihazı, farengeal uygulama ve aerosolizasyon uygulamaları özellikle laringoskopinin dezavantajlarını ortadan kaldırması ve daha da az invaziv olmaları, daha az tecrübe ve yetenek gerektirmeleri nedenleri ile ince kateter ile surfaktan uygulanması yönteminden avantajlı olsalar da henüz rutin klinik kullanıma girmeleri için daha fazla veriye ihtiyaç vardır.Öğe The diagnostic value of n-terminal probrain natriuretic peptides to differentiate neonatal pneumoniae and transient tachypnea of the newborn(Tubitak Scientific & Technological Research Council Turkey, 2023) Arslan, Zeynep; Alan, Serdar; Aliefendioglu, DidemBackground/aim: The primary objective of the study was to determine the diagnostic value of serum N-terminal probrain natriuretic peptide (NT-proBNP) levels to differentiate neonatal pneumonia (NP) and transient tachypnea of the newborn (TTN). The secondary objective was to investigate the prognostic role of NT-proBNP levels in neonates with severe respiratory distress (RD). Materials and methods: A prospective, observational, single-blinded study involving 58 late preterm and term newborns who were diagnosed with TTN or NP was conducted between June 2020 and June 2021 at a level-3 neonatal intensive care unit in Kirikkale University Faculty of Medicine. TTN and NP groups were compared for serum NT-proBNP levels measured at the 1st and 24th hours of life. Optimal cut-off NT-proBNP value was determined by Youden index to predict the diagnosis of NP. Lung ultrasound was used to support the diagnosis of TTN and NP. In addition, lung ultrasound score (LUS) was used to determine severe RD. Results: The median of NT-proBNP level was significantly higher at the 24th hour of life in the NP group than in the TTN group, respectively 7263.5 pg/mL (1643-35,000) and 3308 pg/mL (69-19,746), p = 0.004. At a cut-off value of 5515.5 pg/mL, NT-proBNP had a sensitivity of 75% and specificity of 73.8% to predict NP [AUC= 0.749 (95% CI: 0.602-0.895; p = 0.004)]. The study population was divided into two groups as high score group (n: 23, LUS >= 7) and low score group (n: 35, LUS < 7) according to the LUS at the 6th hour of life. NT-proBNP values at 24th hour of life were 6320 pg/mL (69-35,000) in high score group and 3500 pg/mL (570-15,948) in low score group, p = 0.044. Duration of oxygen support (p = 0.006), noninvasive ventilation (p = 0.008) and NICU stay (p = 0.004) were higher in high-score group. Conclusion: NT-proBNP values at 24th hour of life can be used as a relatively early predictor in the differentiation between NP and TTN in late preterm and term neonates. In addition, elevated NT-proBNP values are related to the higher LUS which reflects the severity of RD regardless of diagnosis.Öğe The diagnostic value of pulmonary near-infrared spectroscopy in the early distinction of neonatal pneumonia from transient tachypnea of the newborn(Wiley, 2023) Ozdemir, Ferzane Ebrar; Alan, Serdar; Aliefendioglu, DidemAim: Pulmonary near-infrared spectroscopy (NIRS) is a new and promising tool for diagnosis of neonatal respiratory diseases (RD). The study aimed to determine the role of pulmonary regional oxygen saturation (pRSO(2)) values obtained by NIRS in the early distinction of neonatal pneumonia (NP) from transient tachypnea of the newborn (TTN). Methods: This prospective, observational, double-blind study was conducted in neonatal intensive care unit (NICU) between 2020 and 2021. Late preterm and term newborns hospitalized in the NICU due to the diagnosis of TTN and NP were included. Cerebral RSO2 and pRSO(2) values were measured during the 1st, 24th, 48th, and 72nd hours of hospitalization, using NIRS. Results: Of the eligible 40 infants, 65% (n: 26) were diagnosed as TTN and 35% (n: 16) as NP. The pRSO(2) values were significantly higher in theTTN group than the NP group for both apexes (75.3 +/- 8.7 vs. 69 +/- 5.4, p:.018, respectively) and lateral lung (77.8 +/- 6 vs. 72.7 +/- 6.2, p:.016, respectively) in the 1st hour of hospitalization. There were significant differences in pRSO(2)apex and pRSO(2)lateral values between the 1st and 24th hours of hospitalization and the 24th and 48th hours in the NP group (p(2):.001 for both). The optimal pRSO(2)apex cut-off value was >72% to predict the diagnosis of NP with a sensitivity of 78.6% and a specificity of 69.2%. Conclusion: Pulmonary NIRS may be considered as a feasible and promising diagnostic tool in late preterm and term infants with RD. It may also be helpful for the early differentiation of NP from TTN and the courses of these diseases.Öğe The importance of transient hypothyroxinemia of prematurity and its controversial management(Turkish J Pediatrics, 2024) Tandırcıoğlu, Ümit Ayşe; Alan, Serdar[Abstract No tAvailable]Öğe Widespread eruption after blood transfusion during phototherapy in a newborn(Wiley, 2024) Tandircioglu, Umit Ayse; Alan, Serdar[Abstract No tAvailable]
