Person: ÖZKAN, HİLAL
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ÖZKAN
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HİLAL
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Publication Effects of early aggressive total parenteral nutrition on biochemical parameters outcome in preterm infants(Galenos Yayincilik, 2019-12-01) Özkan, Hilal; ÖZKAN, HİLAL; Başak, Mehmet Fatih; Köksal, Nilgün; Dorum, Bayram; Çakır, Salih Cağri; ÇAKIR, SALİH ÇAĞRI; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0002-2823-8454; 0000-0001-5761-4757; AAG-8393-2021; HJZ-4508-2023; A-5375-2017; AEZ-2469-2022INTRODUCTION: Initiation of high protein, especially on the first day, was reported to positively affect growth and neuromotor development in premature infants. However the effect of high protein content on metabolic and biochemical parameters is unknown. The aim of this study was to investigate the effects of low and high dose protein administration on biochemical parameters in premature infants.METHODS: Premature infants born <= 34 gestational weeks were included in this retrospective study. The infants were divided into two groups as low protein (LP; first day of 1 g/kg/day, daily 1g increments up to max. 3 g/kg/day) and high protein (HP; first day 3 g/kg/day, max. 3,5-4 g/kg/day) and both groups were compared in terms of antenatal and postanatal characteristics, biochemical results, and growth.RESULTS: A total of 364 infants, 264 in HP and 100 in LP groups, were included in this study. When the groups were compared in terms of biochemical markers; blood urea nitrogen levels showed an increase in HP group in correlation with protein intake, however, no deterioration in renal functions occured. No electrolyte impairment was observed between two groups. Compared with HP group, more number of infants in LP group had weight, height, and head circumference of <3 percentile at the time of hospital dischargeDISCUSSION and CONCLUSION: This study showed that high dose protein administration is safe and effective. Furthermore, when considering the positive effects on postnatal growth, it was observed that the main goal of the feeding was achieved.Publication Evaluation of risk and prognostic factors in neonatal meningitis(Galenos Yayınevi, 2023-04-01) Parlakay, Gülşah; Çakır, Salih Çağrı; Dorum, Bayram Ali; Özkan, Hilal; Çelebi, Solmaz; Hacımustafaoğlu, Mustafa; Köksal, Nilgün; Parlakay, Gülşah; ÇAKIR, SALİH ÇAĞRI; Dorum, Bayram Ali; ÖZKAN, HİLAL; ÇELEBİ, SOLMAZ; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Köksal, Nilgün; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Neonatoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Hastalıkları Bilim Dalı.; 0000-0001-5761-4757; 0000-0002-2823-8454; 0000-0003-4646-660X; HJZ-4508-2023; A-5375-2017; JJW-4932-2023; JJY-3921-2023; JHN-1091-2023; CTG-5805-2022; JGS-7600-2023Introduction: Neonatal meningitis is one of the important causes of mortality and morbidity in newborns. In this study, it was aimed to examine the microbiological factors, biochemical and clinical characteristics of neonatal meningitis cases, to reveal the risk factors, and to investigate the effect on the morbidities associated with meningitis in the first year of life.Materials and Methods: The files of patients diagnosed with meningitis in the level 3 Neonatal Intensive Care Unit between January 2010 and December 2015 were retrospectively analyzed.Results: There were 118 patients diagnosed with meningitis. The median gestational age of the patients was 32 weeks (24-40 weeks), and the median birth weight was 1987 grams (690-5020 grams). Most of the meningitis patients (n=106, 90%) were with late sepsis. The diagnosis day of those with poor prognosis was found to be greater [9.7 (2-28) days to 15.5 (3-138) days, p=0.03]. Cerebrospinal fluid (CSF) leukocytes were significantly higher in term babies with abnormal cranial magnetic resonance imaging (MRI) findings (p=0.037) and loss in hearing tests (p=0.045). CSF sugar levels were significantly lower in preterm babies with neuromotor retardation (p=0.001), history of seizures (p=0.003), abnormal cranial MRI findings (p=0.008) and hearing loss (p=0.005).Conclusion: In the long term, a significant number of cases with neonatal meningitis have neuromotor retarda-tion and hearing problems. Factors that can be used as predictors for poor neurological development; late-onset day, increased CSF leukocyte in all babies, and decreased CSF sugar in preterm babies.Publication Mesenteric tissue oxygenation status on the development of necrotizing enterocolitis(Turkish J Pediatrics, 2021-09-01) Çetinkaya, Merih; Dorum, Bayram Ali; Özkan, Hilal; ÖZKAN, HİLAL; Köksal, Nilgün; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Neontoloji Anabilim Dalı.; 0000-0002-2823-8454; A-5375-2017; AFP-9671-2022Background. Necrotizing enterocolitis (NEC) is an important cause of morbidity and mortality in preterm infants. There is limited data about the role of mesenteric oxygenation status during the first enteral feeding. Therefore, the aim of this study was to determine the mesenteric tissue oxygen saturation values before, during and after the first enteral feeding and to evaluate the effect of these values on the development of NEC in preterm infants. Methods. A total of 105 preterm babies with <= 32 gestational weeks were included in this prospective study. The continuous monitoring of the mesenteric tissue oxygenation status was performed before, during and 3 hours after the first feeding by near-infrared spectroscopy (NIRS). Results. The mean gestational week and birth weight of the study group were 28.8 +/- 2.1 weeks, and 1215 +/- 387 g, respectively. The first enteral feeding was started at 2.4 +/- 1.4 days with breast milk in 85% of infants. A total of 12 infants (11.4%) developed NEC (66% stage II, 34% stage III). The mean mesenteric tissue oxygen saturation levels of the infants that developed NEC were significantly lower both before and one hour after feeding (56.1 +/- 3.4 vs. 34 +/- 8.8, and 47.4 +/- 3.3 vs 37.8 +/- 10.9, respectively) compared with infants that did not develop NEC. Conclusions. Lower mesenteric tissue oxygenation values measured before, and one hour after enteral feeding was associated with NEC development. We suggest that lower mesenteric tissue oxygenation during continuous monitoring of first enteral feeding may be used to predict NEC development during follow-up.Publication Evaluation of micafungin use in children(Ankara Microbiology, 2020-01-01) Hacimustafaoglu, Mustafa; Yeşil, Edanur; YEŞİL, EDANUR; Çelebi, Solmaz; ÇELEBİ, SOLMAZ; Sezgin Evim, Melike; SEZGİN EVİM, MELİKE; Özer, Arife; Turan, Cansu; TURAN, CANSU; Timur, Demet; TİMUR, DEMET; Çakır, Salih Cağrı; ÇAKIR, SALİH ÇAĞRI; Bülbül, Beyhan; BÜLBÜL, BEYHAN; Ener, Beyza; ENER, BEYZA; Güneş, Adalet Meral; MERAL GÜNEŞ, ADALET; Koksal, Nilgun; Özkan, Hilal; ÖZKAN, HİLAL; Sevinir, Betul; SEVİNİR, BETÜL BERRİN; Düzcan Kilimci, Duygu; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Onkoloji Anabilim Dalı.; 0000-0002-8926-9959; 0000-0003-3146-6391; 0000-0001-5761-4757; 0000-0002-5720-1212; 0000-0002-3232-7652; 0000-0003-4646-660X; AAG-8523-2021; AEZ-2469-2022; GSO-3630-2022; AAH-1570-2021; HJZ-4508-2023; AAE-6201-2021; AAG-8393-2021; JCD-9679-2023Micafungin is recommended especially in patients with liver and kidney failure and in the presence of other side effects due to antifungals apart from its known priority indications such as invasive candidiasis. The aim of this study was to evaluate the children who have received micafungin treatment. In the study, 125 children who were hospitalized in the pediatric wards and intensive care units of our hospital and had used micafungin between November 2016 and January 2019 were analyzed retrospectively. Clinical data, micafungin indication, blood values on the first and fourth days of the treatment, side effects of the drug and efficacy were evaluated. Sixty percent (75/125) of the patients were male and the mean age of all the patients were 58 +/- 67 (0-215, 30) months. Approximately half of the cases (48%) had malignancy and 13% of them were premature. Sixty-two percent (n= 37) of the malignencies were hematological (27 acute lymphocytic leukemia, nine acute myeloid leukemia, one myelodysplastic syndrome) and 38% (n= 23) were oncological (six neuroblastoma, four Hodgkin lymphoma, two Non-Hodgkin's lymphoma, five sarcomas, one hepatoblastoma, five others) malignencies. The major cause of hospitalization was sepsis (53%). The patients had several risk factors like immunosuppressive therapy (n= 68, 54%), neutropenia (n= 61, 49%), central venous catheter (n= 102, 82%), nasogastric tube (n= 63, 50%), endotracheal intubation tube (n= 49, 39%), urinary catheter (n= 14, 11%) and total parenteral nutrition (n= 81, 65%). Thirteen percent (n= 16) of the cases were post-operative patients. Candida species were cultivated in 97 clinical specimens (blood, endotracheal aspirate, sputum, urine, etc.) among 23 (18%) of the patients. Thirteen (10%) of the patients had candidemia and 62% of them were non-albicans strains. In all candidemias, strains were echinocandin susceptible, and blood cultures were negative within four days. When all the patients (n= 125) were evaluated, a significant decrease in C-reactive protein, an increase in sodium, and a decrease in alanine aminotransferase were observed on the fourth day of micafungin treatment (p< 0.05). A total of 39 (31%) patients underwent various antifungal treatments for median seven (1-60) days prior to micafungin treatment. Fourteen (36%) of these 39 patients, had elevated liver function tests (LFT), 10 (26%) of them had hypokalemia, and five (13%) of them had elevated renal function tests. Ten (26%) patients had antifungal-induced hypokalemia previously; and potassium levels were normalized after micafungin treatment (p= 0.0001). The patients for which micafungin treatment was chosen due to elevated liver function tests (n= 47, 38%), whether the antifungalinduced or not; alanine aminotransferase and aspartate aminotransferase levels were decreased after micafungin treatment (p= 0.0001 and p= 0.0001, respectively). Nineteen (15%) of the patients have died within the first 30 days of micafungin treatment and one of them had candidemia. No micafungin treatment related significant side effects were observed in any of the patients. Our study showed that micafungin could be a safe and effective option in pediatric cases including newborns with high liver and kidney function tests.Publication What should be the protein target for adjustable human milk fortification in premature infants?(Professional Medical Publications, 2019-01-01) Dorum, Bayram Ali; Özkan, Hilal; ÖZKAN, HİLAL; Çakir, Salih Cağrı; ÇAKIR, SALİH ÇAĞRI; Köksal, Nilgün; Şen, Gizem Ezgi; ŞEN, GİZEM EZGİ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; 0000-0002-2823-8454; 0000-0001-5761-4757; AAG-8393-2021; HJZ-4508-2023; AEZ-2469-2022; A-5375-2017Objective: To assess the short- and long-term effects of the adjustable fortification (ADJ) regimen on growth parameters in premature infants and to evaluate the amount of protein supplements given to reach the targeted blood urea nitrogen (BUN) levels.Methods: In this retrospective study, preterm babies who were born at <= 32 weeks gestational age and fed with human milk, were evaluated in two groups. Infants in Group-I were fed only standard fortification (STD). Infants in Group-II were fed the ADJ regimen. The study was conducted between 2011 and 2016.Results: There were 123 infants in the STD group and 119 in the ADJ group. The mean gestational age of the patients in Group-I was 29.7 +/- 1.8 weeks, and mean birth weight was 1266.1 +/- 347.1 g. The mean gestational age of the patients in Group-II was 29.5 +/- 1.9 weeks, and the mean birth weight was 1217.5 +/- 345.5 g. The daily increase in weight and weekly increase in HC were significantly higher in the ADJ group infants. Weight and HC of infants in the ADJ group were significantly higher at 40 weeks. At one year corrected age, weight, length, and HC measurements of both groups were similar. In Group-II, 63% of patients required additional protein supplementation up to 1.6 g/day to achieve the target BUN levels.Conclusion: A higher protein intake through the ADJ regimen improves the physical growth rate of premature infants in the NICU and after discharge. However, sometimes, the targeted growth and BUN values cannot be achieved despite the administration of protein at the recommended increased doses. Increasing protein supplementation up to 1.6 g/day is safe, feasible, and beneficial for these infants.Publication Two cases diagnosed with tuberosclerosis in neonatal period(Galenos Yayıncılık, 2014-12-01) Varal, İpek Güney; Köksal, Nilgün; Özkan, Hilal; Bostan, Özlem; Bağcı, Onur; Uysal, Fahrettin; Yazıcı, Zeynep; Doğan, Pelin; Varal, İpek Güney; Köksal, Nilgün; BOSTAN, ÖZLEM MEHTAP; ÖZKAN, HİLAL; Bağcı, Onur; UYSAL, FAHRETTİN; YAZICI, ZEYNEP; Doğan, Pelin; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Neonatoloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Pediatrik Kardiyoloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı/Pediatrik Radyoloji Bilim Dalı.; 0000-0001-7707-2174; 0000-0001-9308-9806; CIR-8129-2022; JGS-7600-2023; JJY-3921-2023; AAG-8558-2021; KYP-5736-2024; AAH-4421-2021; AAI-2303-2021; CNZ-3688-2022Congenital heart tumors are very rare and the most common type is the rhabdomyoma. Frequency during autopsy is between 0.027-0.08%. Moreover 51-86% of these tumors are associated with tuberosclerosis. Also hamartomas might accompany, particularly on the central nervous system and skin, kidney, liver, lung and heart. In this paper, two cases diagnosed with tuberculosis who showed rhabdomyomas in fetal echocardiography in the antenatal period and were seen to have tubers in cranial magnetic resonance (MR) postnatally, are presented.Publication Spondylocostal dysostosis associated with diaphragmatic hernia and neural tube defects(Lippincott Williams & Wilkins, 2008-04-01) Çetinkaya, Merih; Özkan, Hilal; Köksal, Nilgün; Yazıcı, Zeynep; Yalçınkaya, Ulviye; Çetinkaya, Merih; ÖZKAN, HİLAL; Köksal, Nilgün; YAZICI, ZEYNEP; YALÇINKAYA, ÜLVİYE; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı/Neonatoloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; AFP-9671-2022; JLK-4920-2023; AAI-2303-2021; AAH-8924-2021; FFA-6764-2022Publication Investigation of the relationship between maternal & neonatal vitamin b12 deficiency and neonatal hyperbilirubinemia: A prospective controlled study(Galenos Yayınevi, 2023-04-01) Turan, Meltem; Özkan, Hilal; Evim, Melike Sezgin; Köksal, Nilgün; TURAN, MELTEM; ÖZKAN, HİLAL; SEZGİN EVİM, MELİKE; Köksal, Nilgün; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Neonatoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Hematoloji Anabilim Dalı.; 0000-0002-1690-1511; 0000-0001-5454-5119; 0000-0002-4792-269X; 0000-0002-6067-3886; IQJ-3996-2023; JJY-3921-2023; IRI-7023-2023; JGS-7600-2023Introduction: The aim in this study was to investigate the role of vitamin B12 deficiency in neonatal hyperbilirubinemia.Materials and Methods: Term newborns who were breastfed and with hyperbilirubinemia were included in this prospective study. Those with hyperbilirubinemia were assigned to a patient group, and those without hyperbilirubinemia were assigned to a control group. The vitamin B12 levels of all newborns and their mothers were checked.Results: A total of 154 newborns were included in the study. Vitamin B12 deficiency was significantly higher in the patient group in comparison to the control group. Similarly, vitamin B12 levels of mothers were significantly lower in the patient group. The mean bilirubin level and phototherapy need were found to be significantly higher in patients with vitamin B12 deficiency.Conclusion: This study showed that vitamin B12 deficiency in the mother is related to vitamin B12 deficiency in the newborn, which significantly leads to neonatal hyperbilirubinemia.Publication 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-3921-2023Objective: 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.Publication Can tissue oxygen saturation levels in the first 24 hours predict the development of patent ductus arteriosus in premature babies with respiratory distress syndrome?(Galenos Yayınevi, 2023-12-01) Dorum, Bayram Ali; Özkan, Hilal; Çetinkaya, Merih; Çakır, Salih Çağrı; Köksal, Nilgün; ÖZKAN, HİLAL; ÇAKIR, SALİH ÇAĞRI; Köksal, Nilgün; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Neonatoloji Anabilim Dalı.; 0000-0001-5761-4757; JJY-3921-2023; HJZ-4508-2023; JGS-7600-2023Introduction: Patent ductus arteriosus (PDA) causes a substantial increase in morbidities in premature babies by causing changes in organ perfusion. Various echocardiographic parameters are used to diagnose PDA and determine whether it is hemodynamically significant (HsPDA). This study aimed to investigate the role of tissue oxygen saturation in the first 24 hours in predicting HsPDA in high-risk premature babies who received respiratory support because of respiratory distress syndrome. Materials and Methods: In this prospective, observational study, cerebral, renal, and mesenteric regional tissue oxygen saturation levels were monitored by near infrared spectroscopy (NIRS) for the first 24 hours of the lives of preterm babies at <= 28 weeks of gestation. The NIRS data of babies with and without HsPDA as diagnosed by echocardiographic examination were compared. Results: Eighty-one premature babies who had HsPDA were included in the study. In the control group 51 premature babies who had not HsPDA were evaluated. The median standard deviation (SD) gestational age of the babies included in the study was 26.9 +/- 1 weeks, and the mean +/- SD birth weight was 880 +/- 218 g. Renal and mesenteric NIRS measurements during follow-up were lower in babies with versus without HsPDA, but the difference was not statistically significant. Conclusion: Low renal and mesenteric stO2 values detected on the first day of life in high-risk infants may be associated with HsPDA. More studies are needed to reveal the effects of HsDPA on organs in these vulnerable babies with NIRS monitoring.