Browsing by Author "Cetinkaya, Merih"

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Effects of different onset times of early caffeine treatment on mesenteric tissue oxygenation and necrotizing enterocolitis: A prospective, randomized study
(Thieme Medical Publ Inc, 2021-04-20) Ozkan, Hilal; Cetinkaya, Merih; Cakir, Salih C.; Saglam, Ozge; Koksal, Nilgun; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; 0000-0001-5761-4757; AFP-9671-2022; AEZ-2469-2022; HJZ-4508-2023
Objective Caffeine treatment is routinely used in premature infants to prevent development of apnea and bronchopulmonary dysplasia. Although a limited number of studies have reported that early caffeine treatment may cause development of necrotizing enterocolitis (NEC) by reducing mesenteric blood flow, this issue is still under discussion. The aim of this study is to investigate the possible effect of different onset times of early caffeine treatment on mesenteric tissue oxygen saturation and NEC development in premature infants.Study Design A total of 87 preterm infants with <= 1,250-g birth weight (BW) was included in this prospective study. The cases were randomized as group 1 (first 24 hours) and group 2 (72nd hour) caffeine treatment groups and monitored by near-infrared spectroscopy (NIRS) for 72 hours from the time of admission until cerebral, renal, and mesenteric tissue oxygen saturations (rSO (2) ) were recorded. The cases were followed-up to the 40th week in terms of NEC and other neonatal morbidities.Results A total of 87 infants were included in the study, including 45 in group 1 and 42 in group 2. The groups were similar in terms of demographic characteristics. The incidence of NEC in group 1 (20%) was higher in comparison to group 2 (9%). The mesenteric rSO (2) values in the first 72 hours of group 1 were lower than those of group 2. Low gestational week, BW, and late onset of enteral feeding were found to be other significant risk factors for NEC.Conclusion In this study, mesenteric tissue oxygenation was lower, and NEC was higher in group 1. Mesenteric rSO (2) measurements may be useful in predicting the development of NEC in patients receiving early caffeine therapy.
Extremely preterm infant admissions within the safeboosc-III consortium during the Covid-19 lockdown
(Frontiers Media, 2021-06-15) Rasmussen, Marie Isabel; Hansen, Mathias Luehr; Pichler, Gerhard; Dempsey, Eugene; Pellicer, Adelina; El-Khuffash, Afif; Shashidhar, A.; Piris-Borregas, Salvador; Alsina, Miguel; Cetinkaya, Merih; Chalak, Lina; Özkan, Hilal; Baserga, Mariana; Sirc, Jan; Fuchs, Hans; Ergenekon, Ebru; Arruza, Luis; Mathur, Amit; Stocker, Martin; Vaccarello, Olalla Otero; Szczapa, Tomasz; Sarafidis, Kosmas; Krolak-Olejnik, Barbara; Memişoğlu, Aslı; Reigstad, Hallvard; Rafinska-Wazny, Elzbieta; Hatzidaki, Eleftheria; Peng, Zhang; Gkentzi, Despoina; Viellevoye, Renaud; De Buyst, Julie; Mastretta, Emmanuele; Wang, Ping; Hahn, Gitte Holst; Bender, Lars; Cornette, Luc; Tkaczyk, Jakub; del Rio, Ruth; Fumagalli, Monica; Papathoma, Evangelia; Wilinska, Maria; Naulaers, Gunnar; Sadowska-Krawczenko, Iwona; Lecart, Chantal; Couce, Maria Luz; Fredly, Siv; Heuchan, Anne Marie; Karen, Tanja; Greisen, Gorm; ÖZKAN, HİLAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Neonatoloji Bölümü.; JJY-3921-2023
Objective: To evaluate if the number of admitted extremely preterm (EP) infants (born before 28 weeks of gestational age) differed in the neonatal intensive care units (NICUs) of the SafeBoosC-III consortium during the global lockdown when compared to the corresponding time period in 2019.Design: This is a retrospective, observational study. Forty-six out of 79 NICUs (58%) from 17 countries participated. Principal investigators were asked to report the following information: (1) Total number of EP infant admissions to their NICU in the 3 months where the lockdown restrictions were most rigorous during the first phase of the COVID-19 pandemic, (2) Similar EP infant admissions in the corresponding 3 months of 2019, (3) the level of local restrictions during the lockdown period, and (4) the local impact of the COVID-19 lockdown on the everyday life of a pregnant woman.Results: The number of EP infant admissions during the first wave of the COVID-19 pandemic was 428 compared to 457 in the corresponding 3 months in 2019 (-6.6%, 95% CI -18.2 to +7.1%, p = 0.33). There were no statistically significant differences within individual geographic regions and no significant association between the level of lockdown restrictions and difference in the number of EP infant admissions. A post-hoc analysis based on data from the 46 NICUs found a decrease of 10.3%in the total number of NICU admissions (n = 7,499 in 2020 vs. n = 8,362 in 2019).Conclusion: This ad hoc study did not confirm previous reports of a major reduction in the number of extremely pretermbirths during the first phase of the COVID-19 pandemic.
Hemoperfusion in a child with amitriptyline intoxication
(Springer, 2005-01) Dönmez, Osman; Cetinkaya, Merih; Canbek, Rahmiye; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Nefrolojisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Hemodiyaliz Ünitesi, Erişkin Nefroloji Anabilim Dalı.; AAA-8778-2021
Tricyclic antidepressant overdose is one of the most common causes of serious drug poisoning in children and adults. We report a 17-month-old girl with severe amitriptyline intoxication. She was admitted to hospital because of lethargy and seizures. It was estimated that she took approximately 75 mg/kg of amitriptyline 2 h before admission. On examination she was comatose, had ventricular tachycardia and multifocal clonic seizures. Intravenous fluid, per oral activated charcoal, diazepam, lidocaine, and sodium bicarbonate infusion were given. However, there was no response to this therapy, and the patient remained in a deep coma with cardiac arrhythmias and seizures. Hemoperfusion ( HP) was performed for 2 h. During this procedure, cardioversion was used six times due to ventricular fibrillation. She had a very good clinical response to HP and no complication was observed. We suggest that HP may be an effective treatment in children with severe amitriptyline intoxication.
Protective effects of valproic acid, a histone deacetylase inhibitor, against hyperoxic lung injury in a neonatal rat model
(Public Library Science, 2015-05-04) Cetinkaya, Merih; Cekmez, Ferhat; Tayman, Cuneyt; Canpolat, Fuat Emre; Kramer, Boris W.; Sarici, Serdar Umit; Cansev, Mehmet; Kafa, Ilker Mustafa; Yaylagul, Esra Orenlili; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Farmakoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Anatomi Anabilim Dalı.; Uludağ Üniversitesi/Fen Edebiyat Fakültesi/Biyoloji Bölümü.; 0000-0003-2918-5064; 0000-0001-8309-0934; 0000-0002-5206-1185; M-9071-2019; AAG-7125-2021; ABH-4915-2020; 8872816100; 8450193200; 55618956600
Objective: Histone acetylation and deacetylation may play a role in the pathogenesis of inflammatory lung diseases. We evaluated the preventive effect of valproic acid (VPA), a histone deacetylase (HDAC) inhibitor, on neonatal hyperoxic lung injury. Methods: Forty newborn rat pups were randomized in normoxia, normoxia+VPA, hyperoxia and hyperoxia+VPA groups. Pups in the normoxia and normoxia+VPA groups were kept in room air and received daily saline and VPA (30 mg/kg) injections, respectively, while those in hyperoxia and hyperoxia+VPA groups were exposed to 95% O2 and received daily saline and VPA (30 mg/kg) injections for 10 days, respectively. Growth, histopathological, biochemical and molecular biological indicators of lung injury, apoptosis, inflammation, fibrosis and histone acetylation were evaluated. Results: VPA treatment during hyperoxia significantly improved weight gain, histopathologic grade, radial alveolar count and lamellar body membrane protein expression, while it decreased number of TUNEL(+) cells and active Caspase-3 expression. Expressions of TGFβ3 and phospho-SMAD2 proteins and levels of tissue proinflammatory cytokines as well as lipid peroxidation biomarkers were reduced, while anti-oxidative enzyme activities were enhanced by VPA treatment. VPA administration also reduced HDAC activity while increasing acetylated H3 and H4 protein expressions. Conclusions: The present study shows for the first time that VPA treatment ameliorates lung damage in a neonatal rat model of hyperoxic lung injury. The preventive effect of VPA involves HDAC inhibition.
Two-year outcomes after minimally invasive surfactant therapy in preterm infants follow-up of the OPTIMIST-a randomized clinical trial
(Amer Medical Assoc, 2023-09-11) Dargaville, Peter A.; Kamlin, C. Omar F.; Orsini, Francesca; Wang, Xiaofang; De Paoli, Antonio G.; Kanmaz Kutman, H. Gozde; Cetinkaya, Merih; Kornhauser-Cerar, Lilijana; Derrick, Matthew; Ozkan, Hilal; Hulzebos, Christian V.; Schmoelzer, Georg M.; Aiyappan, Ajit; Lemyre, Brigitte; Kuo, Sheree; Rajadurai, Victor S.; O'Shea, Joyce; Biniwale, Manoj; Ramanathan, Rangasamy; Kushnir, Alla; Bader, David; Thomas, Mark R.; Chakraborty, Mallinath; Buksh, Mariam J.; Bhatia, Risha; Sullivan, Carol L.; Shinwell, Eric S.; Dyson, Amanda; Barker, David P.; Kugelman, Amir; Donovan, Tim J.; Goss, Kevin C. W.; Tauscher, Markus K.; Murthy, Vadivelam; Ali, Sanoj K. M.; Clark, Howard W.; Soll, Roger F.; Johnson, Samantha; Cheong, Jeanie L. Y.; Carlin, John B.; Davis, Peter G.; OPTIMIST-A Trial Investigators; ÖZKAN, HİLAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Neonatoloji Bilim Dalı.; JHM-8406-2023
IMPORTANCE The long-term effects of surfactant administration via a thin catheter (minimally invasive surfactant therapy [MIST]) in preterm infants with respiratory distress syndrome remain to be definitively clarified.OBJECTIVE To examine the effect of MIST on death or neurodevelopmental disability (NDD) at 2 years' corrected age.DESIGN, SETTING, AND PARTICIPANTS Follow-up study of a randomized clinical trial with blinding of clinicians and outcome assessors conducted in 33 tertiary-level neonatal intensive care units in 11 countries. The trial included 486 infants with a gestational age of 25 to 28 weeks supported with continuous positive airway pressure (CPAP). Collection of follow-up data at 2 years' corrected age was completed on December 9, 2022.INTERVENTIONS Infants assigned to MIST (n = 242) received exogenous surfactant (200 mg/kg poractant alfa) via a thin catheter; those assigned to the control group (n = 244) received sham treatment.MAIN OUTCOMES AND MEASURES The key secondary outcome of death or moderate to severe NDD was assessed at 2 years' corrected age. Other secondary outcomes included components of this composite outcome, as well as hospitalizations for respiratory illness and parent-reported wheezing or breathing difficulty in the first 2 years.RESULTS Among the 486 infants randomized, 453 had follow-up data available (median gestation, 27.3 weeks; 228 females [50.3%]); data on the key secondary outcome were available in 434 infants. Death or NDD occurred in 78 infants (36.3%) in the MIST group and 79 (36.1%) in the control group (risk difference, 0%[95% CI, -7.6% to 7.7%]; relative risk [RR], 1.0 [95% CI, 0.81-1.24]); components of this outcome did not differ significantly between groups. Secondary respiratory outcomes favored the MIST group. Hospitalization with respiratory illness occurred in 49 infants (25.1%) in the MIST group vs 78 (38.2%) in the control group (RR, 0.66 [95% CI, 0.54-0.81]) and parent-reported wheezing or breathing difficulty in 73 (40.6%) vs 104 (53.6%), respectively (RR, 0.76 [95% CI, 0.63-0.90]).CONCLUSIONS AND RELEVANCE In this follow-up study of a randomized clinical trial of preterm infants with respiratory distress syndrome supported with CPAP, MIST compared with sham treatment did not reduce the incidence of death or NDD by 2 years of age. However, infants who received MIST had lower rates of adverse respiratory outcomes during their first 2 years of life.