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    A newborn infant with intrathoracic mass: Answers
    (Springer Verlag, 2016) Alan, Serdar; Erdeve, Ömer; Yıldız, Duran; Kahvecioğlu, Dilek; Atasay, Begüm; Arsan, Saadet
    The patient’s lesion in the lung did not respond to antibiotic treatment, which eliminated pneumonia or atelectasis. Diaphragmatic hernia, teratoma, mediastinal neuroblastoma, intra- or extralobar pulmonary sequestration, broncho-foregut malformations, such as cystic adenomatoid malformation or bronchogenic cysts, and intrathoracic kidney can cause this X-ray appearance, and these pathologies should be considered in the differential diagnosis
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    A newborn infant with intrathoracic mass: Questions
    (Springer Verlag, 2016) Alan, Serdar; Erdeve, Ömer; Yıldız, Duran; Kahvecioğlu, Dilek; Atasay, Begüm; Arsan, Saadet
    A 3,430-g male term newborn was delivered spontaneously to a 25-year-old mother after an uneventful pregnancy and discharged 1 day after birth. The newborn presented with cough and respiratory insufficiency on postnatal day 12, concurrently with upper respiratory tract infection of his older brother. The patient’s physical examination on admission was normal except for wheezing and desaturation. His chest radiograph revealed para-cardiac consolidation (Fig. 1a), and he was admitted to the neonatal intensive care unit (NICU) where he received inhaler salbutamol, oxygen and antibiotic therapy for 10 days.
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    Impact of prophylactic continuous positive airway pressure on transient tachypnea of the newborn and neonatal intensive care admission in newborns delivered by elective cesarean section
    (Thieme Medical Publishers, Inc., 2015) Çelebi, Miray Yılmaz; Alan, Serdar; Kahvecioğlu, Dilek; Çakır, Ufuk; Yıldız, Duran; Erdeve, Ömer; Arsan, Saadet; Atasay, Begüm
    Objective This study aims to evaluate the effect of the prophylactic continuous positive airway pressure (CPAP) administration in the delivery room to newborns who were delivered by elective cesarean section (CS). Study Design Inborn infants with gestational age between 340/7 to 386/7 and born by elective CS were prospectively randomized to receive either prophylactic CPAP for 20 minutes via face mask or standardized care without CPAP in the delivery room. Primary outcomes were the incidence of transient tachypnea of the newborn (TTN) and neonatal intensive care unit (NICU) admission due to respiratory distress. Results A total of 259 infants with a mean gestational age of 37.7 ± 0.8 weeks and birth weight of 3,244 ± 477 g were included. A total of 134 infants received prophylactic CPAP and 125 received control standard care. The rate of NICU admission was significantly lower in prophylactic CPAP group (p = 0.045). Although the rate of TTN was lower in the prophylactic CPAP group, the difference was not statistically significant (p = 0.059). The rate of NICU admission due to respiratory distress was significantly higher in late-preterm cohort than early-term cohort (p < 0.0001). Conclusion Prophylactic CPAP administration decreases the rate of NICU admission without any side effect in late-preterm and early-term infants delivered by elective CS. Copyright © 2016 by Thieme Medical Publishers, Inc.
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    Outcome of the Respiratory Syncytial Virus related acute lower respiratory tract infection among hospitalized newborns: A prospective multicenter study
    (Taylor and Francis Ltd, 2016) Alan, Serdar; Erdeve, Ömer; Çakır, Ufuk; Akduman, Hasan; Zenciroğlu, Ayşegül; Akçakuş, Mustafa; Tunç, Turan; Gökmen, Zeynel
    Aim: To determine the incidence and outcomes of respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (ALRI) including morbidity, nosocomial infection and mortality among newborn infants who were admitted to the neonatal intensive care units (NICUs).Methods: A multicenter, prospective study was conducted in newborns who were hospitalized with community acquired or nosocomial RSV infection in 44 NICUs throughout Turkey. Newborns with ALRI were screened for RSV infection by Respi-Strip®-test. Main outcome measures were the incidence of RSV-associated admissions in the NICUs and morbidity, mortality and epidemics results related to these admissions.Findings: The incidence of RSV infection was 1.24% (n: 250) and RSV infection constituted 19.6% of all ALRI hospitalizations, 226 newborns (90.4%) had community-acquired whereas 24 (9.6%) patients had nosocomial RSV infection in the NICUs. Of the 250 newborns, 171 (68.4%) were full-term infants, 183 (73.2%) had a BW >2500 g. RSV-related mortality rate was 1.2%. Four NICUs reported seven outbreaks on different months, which could be eliminated by palivizumab prophylaxis in one NICU.Conclusion: RSV-associated ALRI both in preterm and term infants accounts an important percent of hospitalizations in the season, and may threat other high-risk patients in the NICU. © 2015 Taylor & Francis.
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    Paracetamol for the treatment of patent ductus arteriosus in preterm neonates: A systematic review and meta-analysis
    (BMJ Publishing Group, 2016) Terrin, Gianluca; Conte, Francesca; Öncel, Mehmet Yekta; Scipione, Antonella; McNamara, Patrick J.; Simons, Sinno; Sinha, Rahul; Erdeve, Ömer; Tekgündüz, Kadir S.; Doğan, Mustafa; Kessel, Irena; Hammerman, Cathy; Nadir, E.; Yurttutan, Sadık; Jasani, Bonny; Alan, Serdar; Manguso, Francesco; De Curtis, Mario
    Objectives We performed a systematic review and meta-analysis of all the available evidence to assess the efficacy and safety of paracetamol for the treatment of patent ductus arteriosus (PDA) in neonates, and to explore the effects of clinical variables on the risk of closure. Data source MEDLINE, Scopus and ISI Web of Knowledge databases, using the following medical subject headings and terms: paracetamol, acetaminophen and patent ductus arteriosus. Electronic and manual screening of conference abstracts from international meetings of relevant organisations. Manual search of the reference lists of all eligible articles. Study selection Studies comparing paracetamol versus ibuprofen, indomethacin, placebo or no intervention for the treatment of PDA. Data extraction Data regarding efficacy and safety were collected and analysed. Results Sixteen studies were included: 2 randomised controlled trials (RCTs) and 14 uncontrolled studies. Quality of selected studies is poor. A meta-analysis of RCTs does not demonstrate any difference in the risk of ductal closure (Mantel-Haenszel model, RR 1.07, 95% CI 0.87 to 1.33 and RR 1.03, 95% CI 0.92 to 1.16, after 3 and 6 days of treatment, respectively). Proportion meta-analysis of uncontrolled studies demonstrates a pooled ductal closure rate of 49% (95% CI 29% to 69%) and 76% (95% CI 61% to 88%) after 3 and 6 days of treatment with paracetamol, respectively. Safety profiles of paracetamol and ibuprofen are similar. Conclusions Efficacy and safety of paracetamol appear to be comparable with those of ibuprofen. These results should be interpreted with caution, taking into account the non-optimal quality of the studies analysed and the limited number of neonates treated with paracetamol so far.
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    Prematüre anemisi
    (Murat Yurdakök, 2014) Alan, Serdar; Arsan, Saadet
    ÖZET: Prematüre anemisi, yenidoğanın fizyolojik anemisinden farklı olarak patolojik bir durumu tanımlamaktadır. Birçok fizyolojik ve fizyolojik olmayan faktörler prematüre anemisine katkıda bulunmaktadır. Özellikle, çok düşük doğum ağırlıklı bebekler yenidoğan yoğun bakım ünitelerindeki tedavisinin bir parçası olarak sıklıkla allojenik eritrosit süspansiyonu (ES) transfüzyonu almaktadırlar. Prematüre anemisinde allojenik ES transfüzyonunun yararları doku oksijenlenmesinin bozulduğu durumlar dışında tartışmalıdır. ES transfiizyonlarmın riskleri ve yararlarının daha iyi algılanması nedeniyle son on yılda daha kısıtlı transfüzyon şemaları kullanılmaktadır. Bu nedenlerle prematüre anemisini engelleyici yaklaşımlar gündeme gelmiştir. Bu yaklaşımların temeli bu prematüre bebeklerin yüksek hemoglobin düzeyi ile doğmalarını sağlamaktır. Böylece transfüzyon gereksinimlerinin azaltılması veya engellemesi planlanmaktadır. Bu derlemede prematüre anemisinin patofizyolojisi, tedavisi ve önleme yöntemleri bu alanda yapılan yeni araştırmaların sunduğu bilgiler ışığında özetlenecektir.