Publications by authors named "Nilgun Koksal"

The aim of this study is to investigate the diagnostic value of cerebrospinal fluid (CSF) and serum levels of the soluble form of triggering receptor-1 expressed on myeloid cells (sTREM-1) in neonatal meningitis. Serum sTREM-1 levels were measured in all neonatal sepsis patients at the start of antibiotic therapy and the 48th hour of treatment. At the beginning of antibiotic therapy, CSF samples were collected for sTREM-1 measurements.

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Critical congenital heart disease (CCHD) is one of the leading causes of neonatal and infant mortality. We aimed to elucidate the epidemiology, spectrum, and outcome of neonatal CCHD in Türkiye. This was a multicenter epidemiological study of neonates with CCHD conducted from October 2021 to November 2022 at national tertiary health centers.

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Article Synopsis
  • - The study investigates the incidence of hypoxic ischemic encephalopathy (HIE) in infants ≥36 weeks gestational age in Turkey, finding an incidence rate of 2.13 per 1000 live births, with varying severity levels among those affected.
  • - Among infants with HIE, therapeutic hypothermia (TH) was notably administered to 34.5% of those with mild HIE, while factors like gestational age affected mortality rates, especially in those born at 34-35 weeks.
  • - Despite an unchanged incidence of HIE, the study revealed a decreased mortality rate and no significant impact of TH timing on MRI findings or mortality.
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Background: Povidone-iodine (10%; PI) and 2% chlorhexidine in 70% isopropyl alcohol (CHG-IA) solutions are among the most widely used disinfectants in the neonatal intensive care units. This study compares the use of these disinfectants and helps decide which is superior to the other for neonatal use.

Methods: All term and preterm infants born and hospitalized in Bursa Uludag University Hospital between July 2018-March 2020 were included.

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Background: The use of cerebral oximetry monitoring in the care of extremely preterm infants is increasing. However, evidence that its use improves clinical outcomes is lacking.

Methods: In this randomized, phase 3 trial conducted at 70 sites in 17 countries, we assigned extremely preterm infants (gestational age, <28 weeks), within 6 hours after birth, to receive treatment guided by cerebral oximetry monitoring for the first 72 hours after birth or to receive usual care.

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Background: 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.

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Objective: Portable X-rays remain one of the most frequently used diagnostic procedures in neonatal intensive care units (NICU). Premature infants are more sensitive to radiation-induced harmful effects. Dangers from diagnostic radiation can occur with stochastic effects.

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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.

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Background: The positive effects of steroids on lung development are well known, and 1,25-dihydroxy vitamin D has been shown to exert positive effects on fetal lung development.

Objective: We aimed to investigate the relationship between 25-hydroxyvitamin D [25(OH)D] levels and respiratory distress syndrome (RDS) in premature infants.

Methods: Infants aged ≤32 gestational weeks who were admitted to the neonatal intensive care unit (NICU) during 1 year were enrolled in this prospective study.

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Aim: Umbilical venous catheters are frequently used in the neonatal period. The incidence of umbilical venous catheter-related thrombosis is between 1.3% and 43% in ultrasound scans.

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Article Synopsis
  • * It found that 46% of the infants had moderate-to-large PDA, with 24% managed conservatively and 76% receiving medical treatment, revealing no significant differences in severe complications or surgical needs between the two groups.
  • * Notably, medical treatment raised the risk of mortality but lowered the chances of bronchopulmonary dysplasia (BPD) or death, with ibuprofen and paracetamol being the most common treatments; however, early treatment (before day
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Objective: Respiratory syncytial virus (RSV) is one of the most prevalent causes of lower respiratory tract infection (LRTI). The primary objective of this study is to provide the risk modelling of confirmed RSV infection in children who were born preterm at 29 to 35 weeks of gestational age and presented with LRTI.

Study Design: This prospective, multicenter study was performed between October 2015 and March 2017.

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Background: Decreased renal blood flow plays a vital role in the etiology of acute kidney injury (AKI). In this study, we aim to investigate the role of renal regional oxygen saturation (rSO ) reductions in predicting AKI in the first 24 h of life.

Methods: One hundred premature babies with a gestational age of ≤32 weeks were included.

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We investigated the association between low 25-hydroxyvitamin D (25-OHD) levels and late-onset sepsis (LOS) in preterm infants (<37 weeks). Infants with culture-proven LOS were the study group, infants without LOS were the controls. 25-OHD levels were compared between these groups.

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Objective: To investigate the effects of maternal preeclampsia on inflammatory cytokines and neonatal outcomes in premature infants.

Methods: The study included preterm infants born at gestational age ≤32 weeks in a tertiary university hospital between January 2016 and January 2017. The study group consisted of infants born from mothers with preeclampsia (Group-1), and the control group consisted of infants born from normotensive mothers (Group-2).

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Micafungin 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.

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İstanbullu K, Köksal N, Çetinkaya M, Özkan H, Yakut T, Karkucak M, Doğan H. The potential utility of real-time PCR of the 16S-rRNA gene in the diagnosis of neonatal sepsis. Turk J Pediatr 2019; 61: 493-499.

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Özkan H, Köksal N, Doğan P, Güney-Varal İ, Bağcı O, Özgür T. The effectiveness of serum amyloid A for prediction of neonatal cholestasis associated with parenteral nutrition in premature infants. Turk J Pediatr 2019; 61: 26-33.

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This study aimed to determine the association between serum mannose-binding lectin (MBL) levels, gene polymorphisms and late-onset sepsis (LOS) in preterm infants. Infants with <37 gestational weeks were categorized into two groups according to the presence of LOS during their hospitalization. An MBL level <700 ng/ml was defined as deficiency, <400 ng/ml as severe deficiency.

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Ductus arteriosus is a physiologic phenomenon in utero and it closes spontaneously in term babies. The closure is problematic in preterm infants due to the intrinsic properties of the preterm ductus arteriosus tissue. Although patent ductus arteriosus has been reported to be associated with many adverse outcomes in this population, treatment has not led to a decrease in outcomes such as bronchopulmonary dysplasia.

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Background: To achieve gas exchange goals and mitigate lung injury, infants who fail with conventional ventilation (CV) are generally switched to high-frequency oscillatory ventilation (HFOV). Although preferred in many neonatal intensive care units (NICUs), research on this type of rescue HFOV has not been reported recently.

Methods: An online registry database for a multicenter, prospective study was set to evaluate factors affecting the response of newborn infants to rescue HFOV treatment.

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Objective: Mannose-binding lectin, which belongs to the collectin family, is an acute-phase reactant that activates the complement system. This study aimed to investigate the effect of MBL2 gene polymorphism on short-term outcomes in preterm infants.

Method: Infants of <37 gestational weeks who were admitted to the neonatal intensive care unit during a two-year period were enrolled in this prospective study.

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Objective: 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).

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Background: Parenteral nutrition (PN) has been widely used in preterm infants. The lipid solutions used for PN, however, are associated with oxidative stress and morbidity. The aim of this study was to compare the effectiveness of a new-generation lipid emulsion (SMOFLipid) and olive-oil based lipid emulsion for prevention of PN-associated oxidative damage.

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Synopsis of recent research by authors named "Nilgun Koksal"

  • - Nilgun Koksal's recent research predominantly focuses on neonatal care, investigating critical areas such as neonatal meningitis, congenital heart defects, and hypoxic ischemic encephalopathy, aiming to improve diagnostic and treatment approaches in these conditions.
  • - A significant finding from Koksal's studies is the exploration of biomarkers like sTREM-1 for diagnosing neonatal meningitis, alongside epidemiological insights into critical congenital heart disease outcomes in Türkiye, underscoring the importance of early detection and management strategies.
  • - Koksal also examines the clinical implications of practices in neonatal intensive care, such as the effects of different disinfectants, the use of cerebral oximetry monitoring, and the management of mesenteric oxygenation, contributing to a better understanding of neonates' health challenges and improving outcomes in this vulnerable population.