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Öğe Colistin use in critically ill neonates: A case–control study(Elsevier (Singapore) Pte Ltd, 2017) İpek, Mehmet Şah; Aktar, Fesih; Okur, Nilufer; Çelik, Muhittin; Özbek, ErdalBackground The aim of this study was to assess the safety and efficacy of colistin use in critically ill neonates. Methods This was a case–control study that included newborn infants with proven or suspected nosocomial infections between January 2012 and October 2015, at two centers in Diyarbakir, Turkey. The clinical and laboratory characteristics and outcomes of patients who received colistin therapy were reviewed and compared to patients who were treated with antimicrobial agents other than colistin during the same period. Results Forty-seven cases who received intravenous colistin (colistin group) and 59 control patients (control group) were included. There were no significant differences between the groups regarding outcomes and nephrotoxicity, including acute renal failure. Colistin therapy was associated with significantly reduced serum magnesium (1.38 ± 0.39 mg/dL vs. 1.96 ± 0.39 mg/dL, p < 0.001) and hypokalemia (46.8% vs. 25.4%, p = 0.026). The patients who received colistin also had longer hospital stays (43 (32–70) days vs. 39 (28–55) days, p = 0.047), a higher rate of previous carbapenem exposure (40.4% vs. 11.9%, p = 0.001), and a higher age at the onset of infection (13 (10–21) days vs. 11 (9–15) days, p = 0.03). Conclusion This study showed that colistin was both effective and safe for treating neonatal infections caused by multidrug-resistant gram-negative bacteria. However, intravenous colistin use was significantly associated with hypomagnesemia and hypokalemia.Öğe Evaluation of Syringe Feeding Compared to Bottle Feeding for the Transition from Gavage Feeding to Oral Feeding in Preterm Infants(Galenos Yayincilik, 2019) Sayl, Birgul; Buyuktiryaki, Mehmet; Okur, Nilufer; Simsek, Gulsum Kadioglu; Canpolat, Fuat Emre; Uras, Nurdan; Osguz, Serife SunaAim: Syringe feeding is a good alternative to a nursing supplementer when breastfeeding is not possible. Materials and Methods: This study was conducted at a level 2 neonatal intensive care unit in the Zekai Tahir Burak Maternity Teaching Hospital in a comparative and descriptive clinical study pattern. The study was carried out with 47 preterm infants in a syringe-fed group (SG) and 56 preterm infants in a bottle-fed group (BG). Primary outcomes were time of transition from gavage feeding to full oral feeding time of transition from tube to breastfeeding, and hospitalization time. Secondary outcomes were body weight at discharge (g), daily body weight gain (g/days) and gastro-intestinal intolerance symptoms during the transition period. Results: Mean gestational ages were 29.82 +/- 2.03 vs 28.18 +/- 1.56 weeks (p=0.24) and mean birth weights were 1,150.31 +/- 232.29 vs 1,016.87 +/- 186.64 g (p=0.72) in the SG and BG groups, respectively. One hundred and three infants receiving gavage feeding with gestational ages ranging from 26 to 32 weeks were evaluated for full oral feeding start time. Syringe-fed preterm infants had a mean of 40.45 +/- 19.50 days and bottle-fed infants had a mean of 53.81 +/- 16.97 days (p>0.05). The time to transition to breastfeeding (42.54 +/- 21.21 days) and time to discharge (54.48 +/- 26.92 days) in the SG was significantly shorter compared to the BG (50.45 +/- 15.95, 67.21 +/- 22.07, respectively) (p<0.05). Conclusion: We found that preterm infants for whom feeding with a syringe was used as a reinforcement in addition to orogastric feeding switched to full breastfeeding in a shorter time compared to infants who were fed by bottle. From these results, we recommend syringe feeding as a transitional method prior to breastfeeding for preterm infants during hospitalization.Öğe Naloxone use in a newborn with apnea due to tetrahydrozoline intoxication(Wiley-Blackwell, 2010) Katar, Selahattin; Taskesen, Mustafa; Okur, Nilufer[Abstract Not Available]Öğe Prevalence and clinical significance of elevated antinuclear antibody test in children and adult patients with idiopathic thrombocytopenic purpura(Springer, 2007) Altintas, Abdullah; Ozel, Abdulkadir; Okur, Nilufer; Okur, Nurettin; Cil, Timucin; Pasa, Semir; Ayyildiz, OrhanBackground To determine the clinical significance of the antinuclear antibody (ANA) test in children and adult patients with idiopathic thrombocytopenic purpura (ITP). Method We conducted a retrospective analysis of 365 children and 108 adult patients with ITP. Patients found to have positive ANA were regularly followed-up by an experienced hematologist until December 2006 for development of symptoms indicative of autoimmune disorder. Mean follow-up 3.6 years (range: 2.1-7 years) for all patients. At the time of diagnosis of ITP, patients with connective tissue diseases (CTD) were excluded. Out of 365 childhood ITP; 301 (82.4%) patients were acute, 64 (17.6%) patients were chronic ITP. ANA titer :1:80 were positive in 33 (9.04%) of 365 patients with childhood ITP; 21 patients (6.9%) were in acute, and 12 patients (18.7%) were in chronic group. Out of 108 adult patients with ITP; 31 (28.7%) patients were acute and 77 (71.3%) patients were chronic ITP cases. ANA titer >= 1:80 were positive in 36 (33.3%) of 108 patients with adult ITP; 12 patients (38.8%) were in acute, and 24 patients (31.2%) were in chronic group. At the end of follow-up period Sjogren's syndrome (SS) was diagnosed in only one adult chronic ITP cases. None of the other ANA positive patients developed SLE or other CTD. Conclusions Our data demonstrated that ANA positivity is often found in adult and children patients with ITP, and indicate that the detection of ANA positivity is not enough to identify those patients with ITP who are at risk of developing SLE or other CTD. There is a statistically significant difference in terms of ANA positivity between childhood acute and chronic ITP patients. We think that ANA positivity may be an indicator in terms of chronicity for childhood ITP. However, large-scale studies should be considered to determine the significance of ANA positivity and their utility in differentiating acute from chronic ITP.
