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Öğe A case of diastrophic dysplasia associated with mega cysterna magna(Aves Yayincilik, Ibrahim Kara, 2007) Duran, Ridvan; Vatansever, Uelfet; Aladag, Nuekhet; Acunas, Betuel; Tuysuz, BeyhanSkeletal dysplasias comprise a large group of hereditary disorders characterized by abnormal growth, short stature and malformations and deformations of bone and cartilage. Diastrophic dysplasia is a skeletal-disorder characterized by short stature, foot and spinal deformities, hitchhiker's thumb and ear abnormalities. Internal organs develop normally. The physical examination of the newborn referred to our hospital for multiple abnormalities revealed a poor general condition with cyanosis, disproportionate short stature, large front fontanel, short neck, misshapen upper ear and 'cauliflower' deformity, cleft palate, hitchhiker's thumb, long and slim fingers except the thumb, proximally located toes, flexion contractures in the large joints, bilateral talipes equinovarus and left scrotal hernia. Mega cysterna magna was demonstrated in,the posterior fossa in the cranial tomography. With these clinical and radiological findings, the newborn was diagnosed as diastrophic dysplasia. The infant was discharged on day 19 after genetic counseling to the family and was to be followed up by the newborn outpatient clinic.Öğe Comparison of temporal artery, mid-forehead skin and axillary temperature recordings in preterm infants <1500 g of birthweight*(Wiley, 2009) Duran, Ridvan; Vatansever, Uelfet; Acunas, Betuel; Suet, NecdetAim: Preterm infants are prone to temperature maintenance problems due to immature thermoregulatory mechanism and relatively large body surface area. The objective of the present study was to evaluate the performance of a new non-invasive infrared thermometer applied to the mid-forehead and temporal artery in comparison with axillary temperature recordings by mercury-in-glass thermometer, and to determine the discomfort caused by these procedures in preterm infants on incubator care. Methods: The present comparative prospective study was composed of 34 preterm infants < 1500 g of birthweight nursed in an incubator. Temperature recording from mid-forehead, temporal artery and axilla were recorded six times a day for 7 days since the end of the first week of life. For pain assessment, the premature infant pain profile (PIPP) was used. Results: The mean mid-forehead, temporal artery and axillary temperatures were 36.72 +/- 0.08, 36.81 +/- 0.09 and 36.71 +/- 0.07 degrees C, respectively. No statistically significant difference was noted between the means of mid-forehead and axillary temperatures. The mean temporal artery temperature was statistically higher than the means of the mid-forehead and axillary temperatures. The PIPP scores of the mid-forehead, temporal artery and axillary temperature measurements were 5.07 +/- 0.36 degrees C, 5.18 +/- 0.43 degrees C and 7.59 +/- 0.84 degrees C, respectively. The mean PIPP score of axillary temperature measurements was statistically higher than the means of mid-forehead and temporal artery measurements. Conclusions: The infrared skin thermometer applied to the mid-forehead is a useful and valid device for easy and less painful measurement of skin temperature in preterm infants < 1500 g of birthweight.Öğe Etiology of neonatal gastric perforations(Wiley, 2007) Duran, Ridvan; Inan, Mustafa; Vatansever, Uelfet; Aladag, Nuekhet; Acunas, BetuelBackground: Neonatal gastric perforation (NGP) is a rare event and its etiology is still controversial. Although it has previously been described as spontaneous, recently some risk factors have been reported to be associated with the development of NGP including prematurity and nasal ventilation. The purpose of the present paper was to report and discuss etiology, clinical features, and outcome of the authors' NGP cases over a 10 year period. Methods: Charts of five infants with NGP was reviewed in terms of gender, birthweight, gestational age, time of diagnosis, associated disease, site of perforation, type of surgery performed, and clinical outcome. Results: There were three boys and two girls with a mean birthweight and gestational age of 1650 g and 32 weeks, respectively. Three of them were premature. Mean perforation time was day 10 postnatally. Three infants had associated problems including prematurity, respiratory distress syndrome type 1, necrotizing enterocolitis, mechanical ventilator support, and one of them had tracheaesophageal fistula. Mothers of two out of these three infants had chorioamnionitis. One full-term infant received dexamethasone because of brain edema. Only one patient had no associated problem. Perforation occurred in the lesser curvature in three infants and in the greater curvature in two infants. Mortality rate was 60%. Conclusions: Contrary to previous literature, and similar to recent publications, it was found that essentially low-birthweight infants with tracheaesophageal fistula or chorioamnionitis and full-term babies on steroid therapy may have a risk for NGP, suggesting that an infant with contributing factors should be monitored more carefully for the development of NGP.Öğe Hypernatremic dehydration in exclusively breast-fed infants(Aves Yayincilik, Ibrahim Kara, 2007) Vatansever, Uelfet; Duran, Ridvan; Acunas, BetuelObjective: The characteristic features of exclusively breast-fed infants with hypernatremic dehydration in our neonatal intensive care unit were evaluated. Patients and Methods: Within the last two years, fourteen exclusively breast-fed newborn infants (10 females, 4 males; mean gestational age 38 +/- 1.7; range 34 to 40 weeks) whose serum sodium level was equal to or greater than 150 mEq/L with signs of dehydration were evaluated from clinical charts retrospectively. Results: 71% of all cases were girls. Mean birth weight was 3020 +/- 715 gr. 93% of the cases were AGA and 78.6% were first child of the family. Mean age of mothers was 28 +/- 5.4 years. 57% of the cases were born by cesarean and 57% were referred to our hospital from different hospitals. The most common presenting complaint was fever and refusing sucking; and mean application time was 5.5 +/- 4.6 days. On the admission, mean weight loss was 14.5 +/- 9.1%, serum sodium level 158.5 +/- 14 mEq/L, serum urea level 73 +/- 109 mg/d, serum creatinine level 1.2 +/- 2.1 mg/dl, and serum osmolarity 338 +/- 35 mOsmol/L. Conclusion: It was remarkable that the cases were mostly first babies and born by cesarean section. A possible solution for hypernatremic dehydration would be to provide breast feeding consultancy to mothers.Öğe The impact of Neonatal Resuscitation Program courses on mortality and morbidity of newborn infants with perinatal asphyxia(Elsevier Science Bv, 2008) Duran, Ridvan; Aladag, Nuekhet; Vatansever, Uelfet; Sut, Necdet; Acunas, BetuelObjective. Neonatal care provided within the first few minutes of life plays a major role in the reduction of neonatal morbidity and mortality. Neonatal Resuscitation Program (NRP) courses had been held since 1996. The aim of this study was to evaluate the impact of the NRP on morbidity and mortality of newborn infants with perinatal asphyxia. Methods. This retrospective study comprised newborn infants who were born in hospitals at Trakya region of Turkey during the last 3 years and were diagnosed as perinatal asphyxia and were referred to our Neonatal Unit. Those patients who were referred before NRP course (pretraining period) were designated as Group 1, those who were referred after the first NRP course (transition period) as Group 2, and those who were referred after the second NRP course (post-training period) as Group 3. Chart review was performed with regard to gestational age, birth weight, Apgar scores, resuscitation type, stage of hypoxic ischemic encephalopathy (HIE), existence of meconium aspiration syndrome (MAS), progress of the disease, duration of hospitalization. Results. The study comprised 66 patients; 35 in Group 1, 18 in Group 2 and 13 in Group 3. The number of cases who had not been resuscitated was 10 in the pretraining period, 3 in the transition period and I in the post-training period which decreased significantly. The first minute Apgar scores in three groups were as follows; 2.08 +/- 1.2, 2.2 +/- 1.1 and 3.7 +/- 1.4, and this increase was statistically significant. The fifth minute Apgar scores also increased from 5.43 +/- 1.5 in the pretraining period to 6.5 +/- 1.9 in the post-training period, but this increase was not statistically significant. The number of patients with Stage I and 2 HIE decreased more in Group 3 (n = I I in Stage I HIE, n = 17 in Stage 2 HIE) compared to those in Group I (n = 7 in Stage I HIE, n = 5 in Stage 2 HIE) but the difference was not statistically significant. The duration of hospitalization decreased in post-training period (15.1 +/- 10.3 days in pretraining period, 12.0 +/- 8.9 days in transition period, 6.1 +/- 1.2 days in post-training period). Conclusions. After NRP courses, the number of patients with perinatal asphyxia and with no resuscitation and also the duration of hospitalization decreased significantly, whereas the first minute Apgar scores increased significantly. (c) 2007 Elsevier B.V. All rights reserved.Öğe Spontaneous spinal epidural hematoma after seizure(Sage Publications Inc, 2007) Guzel, Ahmet; Simsek, Osman; Karasalihoglu, Serap; Kuecuekugurluoglu, Yasemin; Acunas, Betuel; Tosun, Alptekin; Cakir, Bilge[Abstract Not Available]Öğe Transient leukoerythroblastosis in a very low birth weight infant with parvovirus B19 infection(Elsevier Sci Ltd, 2009) Duran, Ridvan; Vatansever, Uelfet; Acunas, Betuel; Orhaner, Betuel; Demir, MuzafferBackground: Leukoerythroblastosis is characterized by the presence of leukocytosis and erythroid and myeloid blast cells in the peripheral blood. The most common etiological factors of leukoerythroblastosis occurring during early childhood are viral infections, juvenile myelomonocytic leukemia, and osteopetrosis. To our knowledge, an association with parvovirus B19 infection has only been reported in a preterm infant. Human parvovirus B19 has been associated with red cell aplasia, leukopenia, and thrombocytopenia. Case report: The case of a very low birth weight preterm infant with transient leukoerythroblastosis associated with parvovirus B19 infection is described. Conclusions: Leukoerythroblastosis has to be kept in mind if a very high leukocyte count is detected in the neonatal period, and parvovirus B19 infection should be taken into consideration as the etiological factor for this entity. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
