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    Effects of neonatal sepsis on thrombocyte tests
    (Taylor & Francis Ltd, 2016) Kara, Semra; Emeksiz, Zeynep; Alioglu, Bulent; Bilge, Yildiz Dallar
    Objective: Hemostatic disorders are common complications in sepsis, and coagulation abnormalities occur in almost all the septic patients. Thrombocytes have a key role in the pathogenesis of coagulation abnormalities in sepsis. This study aimed to investigate thrombocyte function disorders as a likely cause of hemorrhagic diathesis in patients with neonatal sepsis.Material and methods: The study included 70 septic newborns (sepsis group) and 59 healthy newborns (control group). Blood samples were collected from the patients within the first 24h of hospitalization. Thrombocyte aggregation and secretion tests were performed by optical aggregometry and lumi-aggregometry, respectively. Collagen (2g/mL), epinephrine (5M), standard (5M) and high (10M) doses of adenosine diphosphate (ADP), standard (1 unit) and high (4 units) doses of thrombin, ristocetin (1.25mg/mL) and arachidonic acid (0.5mM) were used as the agonists.Results: The mean age of the septic newborns was significantly higher than that of the controls (6.7814.47 days versus 1.25 +/- 1.17, p<0.001). There was no difference between the groups regarding gender- and birth-related characteristics. No difference was observed between the groups regarding platelet count (293.37 +/- 144.48x10(9)/L in the sepsis group and 254.22 +/- 65.26x10(9)/L in the control group, p=0.195). Platelet secretion induced by collagen, epinephrine, standard and high (10M) doses of ADP, or arachidonic acid and platelet aggregation induced by collagen, high-dose ADP, arachidonic acid, ristocetin or thrombin (1 unit) were significantly higher in the sepsis group than in the control group.Conclusion: Based on the results, we concluded that large-scale studies with recurrent tests performed in different periods of sepsis are needed.
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    Evaluation of bone metabolism in newborn twins using quantitative ultrasound and biochemical parameters
    (Taylor & Francis Ltd, 2016) Kara, Semra; Guzoglu, Nilufer; Gocer, Emine; Arikan, Fatma Inci; Dilmen, Ugur; Bilge, Yildiz Dallar
    Metabolic bone disease (MBD) is one of the important complications of prematurity. Early and adequate nutritional interventions may reduce the incidence and potential complications of MBD. The present study aimed to evaluate bone metabolism in twins via biochemical parameters and quantitative ultrasound (QUS) and to compare the results between twin pairs. Moreover, twin infants were evaluated in terms of potential risk factors likely to have impact on MBD. Forty-three pairs of twins were included in the study. Serum calcium, phosphorus, magnesium, and alkaline phosphatase concentrations were assessed and bone mineral density was measured using QUS (speed of sound, SOS) at postnatal 30d. Co-twin with the higher birth weight was assigned to Group 1 (n=36) and the other twin was assigned to Group 2 (n=36). Birth weight and head circumference were significantly higher in the infants of Group 1 compared with Group 2. No significant difference was found among the groups in terms of gender, history of resuscitation, length of stay in intensive care unit (ICU) or in the incubator, duration of total parenteral nutrition (TPN), type of nutrition, vitamin D use, biochemical parameters, and the SOS value. The factors likely to affect SOS, including type of pregnancy, maternal drug use, gender of infant, birth weight, head circumference at birth, gestational week, length of stay at the ICU, duration of TPN, type of nutrition, resuscitation, vitamin D use, and levels of calcium, phosphorus, magnesium, and alkaline phosphatase were entered into the model. The phosphorus level and the maternal drug use were found to be the factors that significantly reduced SOS, whereas pregnancy after assisted reproductive techniques was found to be a significant enhancing factor.
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    Feeding an infant with high arched palate by high flow rate bottle nipple
    (H E C Press, Healthy Eating Club Pty Ltd, 2015) Eren, Abdulkadir; Bilgin, Huseyin; Kara, Semra
    For infants with high arched palate, feeding is one of the most immediate challenges faced by parents and caretakers. General suggestions for feeding in infants with cleft palate may be adapted to infants with high arched palate. These include oral feeding facilitation techniques and special feeding tools. Here we present a newborn with a high arched palate and serious feeding problems who was fed easily by a large size and a large hole nipple, ordinarily used for infants older than 6 months, instead of specialized feeding equipment.
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    Gaviscon and domperidon responsive apnea episodes associated with gastro-esophageal reflux disease in twins
    (H E C Press, Healthy Eating Club Pty Ltd, 2015) Bilgin, Huseyin; Eren, Abdulkadir; Kara, Semra
    Background: The possible pathophysiology of the relationship between gastro-esophageal reflux disease and apnea of prematurity has been widely investigated. Various physiological protective reflex responses provide a plausible biological link between gastro-esophageal reflux and apnea of prematurity. It is uncertain whether or not there is a causal relationship between the two diseases. Patient's Findings: Twins were admitted to the neonatal intensive care unit due to feeding problems. Physical examination was normal except for reticulated, blue-violet skin changes. Short apneic attacks occurred on the first day in twin 1 and on the second day in twin 2, and these were initially treated by stimulation and increased ambient O-2 concentration. Then, we conducted methylxanthine and continuous positive airway pressure treatment. Laboratory and radiological analysis were normal. As gastro-esophageal reflux disease was thought to be the causes of the treatment-refractory apnea, therapy with gaviscon and domperidon was begun for both cases. Apneic attacks did not recur after gaviscon and domperidon therapy. Conclusion: Pharmacological therapy for gastro-esophageal reflux disease has not definitively been shown to be effective in improving symptoms and hence, should be reserved especially for infants with treatment refractory apnea episodes suspected as being gastro-esophageal reflux in premature infants.
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    Hemolytic anemia and heart failure caused by anti-C and anti-E immunization
    (College of Physicians and Surgeons Pakistan 7th Central Street Karachi 755000, 2016) Bilgin, Hüseyin; Eren, Abdülkadir; Kara, Semra
    Many different blood group systems, such as Rh, ABO, Kell, Kidd, Duffy, MNS, have been reported as causes of hemolytic disease of the newborn. Hemolysis due to minor blood group incompatibility in the fetus or newborn has been determined in isolated case reports. Here, we report a case of a patient who had received red cell transfusion due to severe Rh c and E incompatibility, leading to hemolytic anemia with heart failure. The mother and the baby were grouped B and B, respectively, both being positive for RhD antigen. The baby's blood group type was C+, c+, E+, e+, K-, while her mother's blood group type was C+, c-, E-, e+, K-. Our patient was diagnosed as Rh c and E incompatibility, leading to the hemolytic anemia. Minor blood group incompatibility should be considered in infants with prolonged jaundice and severe anemia, leading to heart failure. © 2017 Elsevier B.V., All rights reserved.
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    Hemolytic Anemia and Heart Failure Caused by Anti-C and Anti-E Immunization
    (Coll Physicians & Surgeons Pakistan, 2016) Bilgin, Huseyin; Eren, Abdulkadir; Kara, Semra
    Many different blood group systems, such as Rh, ABO, Kell, Kidd, Duffy, MNS, have been reported as causes of hemolytic disease of the newborn. Hemolysis due to minor blood group incompatibility in the fetus or newborn has been determined in isolated case reports. Here, we report a case of a patient who had received red cell transfusion due to severe Rh c and E incompatibility, leading to hemolytic anemia with heart failure. The mother and the baby were grouped B and B, respectively, both being positive for RhD antigen. The baby's blood group type was C+, c+, E+, e+, K-, while her mother's blood group type was C+, c-, E-, e+, K-. Our patient was diagnosed as Rh c and E incompatibility, leading to the hemolytic anemia. Minor blood group incompatibility should be considered in infants with prolonged jaundice and severe anemia, leading to heart failure.
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    Rectus sheath hematoma in a macrosomic neonate following difficult delivery. Case report
    (Soc Argentina Pediatria, 2018) Gunduz, Suzan; Kara, Semra; Aktas, Ayse; Eren, Abdulkadir; Bakan, Vedat
    Macrosomia is a risk factor for birth injuries and is associated with neonatal morbidity and mortality. Cephalohematoma and clavicular fracture are the most frequent birth injuries. Intraabdominal injuries are uncommon birth injuries. Rectus sheath hematoma (RSH) is an accumulation of blood in the sheath of rectus abdominis muscle. It is associated with trauma, operations and anticoagulant therapy, especially in adults and elders. We present a macrosomic male neonate with difficult vaginal delivery, who had in the physical examination periumblical ecchymose of 1x1 cm and a parietal cephalohametoma of 1x1 cm. The abdominal ultrasonogram and the computed tomography scan of the abdomen showed a 7x4x2 cm right rectus sheath hematoma.