Researcher:
Coşkun, Yeşim

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Doctor

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Yeşim

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Coşkun

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Coşkun, Yeşim

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2021 - 20226

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Researcher Of Publications: search.filters.isAuthorOfPublication.225bcf79-f7d2-4296-a9e6-6a806a4e6ae1

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Now showing 1 - 6 of 6
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    Positive direct antiglobulin test: is it a risk factor for significant hyperbilirubinemia in neonates with ABO incompatibility?
    (Thieme Medical Publishers, Inc., 2022) Erçin, Seçil; Coşkun, Yeşim; Kayas, Kalender; Kavas, Nazan; Gürsoy, Tuğba; Doctor; Doctor; Doctor; Doctor; Faculty Member; N/A; N/A; N/A; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 214691
    Objective: ABO blood group (ABO) incompatibility is a common cause of neonatal indirect hyperbilirubinemia. The direct antiglobulin test (DAT) can identify infants developing hemolytic disease. This study aims to evaluate the significance of DAT positivity among neonates with ABO incompatibility. Study Design: This retrospective study included 820 neonates with blood group A or B who were born to blood group O mothers. The study group consisted of neonates (n = 79) who had positive DAT, and the control group consisted of infants (n = 741) who had negative DAT. Demographic and clinical data of the neonates regarding jaundice were collected and compared statistically. Results:The bilirubin level at 24 hours of life (study group: 8 ± 2.6 mg/dL, control group: 6 ± 2.2 mg/dL, p < 0.001) and the highest bilirubin level (study group: 12.7 ± 3.6 mg/dL, control group: 10.4 ± 4.2 mg/dL, p < 0.001) were higher in infants with positive DAT. A total of 37 (46.8%) infants in the study group and 83 (11.2%) infants in the control group received phototherapy (PT) in the nursery (p < 0.001). In neonates with positive DAT, direct bilirubin level, duration of hospitalization, and PT in the nursery were higher (p = 0.002, <0.001, and <0.001, respectively), whereas hemoglobin level was lower (p < 0.001). Conclusion: In neonates with ABO incompatibility, a positive DAT is a risk factor for developing significant hyperbilirubinemia. Close follow-up of newborn infants with ABO incompatibility is crucial for early detection and treatment of neonatal jaundice to avoid early and late complications. Key Points The clinical spectrum of ABO incompatibility varies widely. The ABO incompatibility with positive DAT are at greater risk for high bilirubin levels. Infants with blood group incompatibilities must be monitored closely. © 2022 Georg Thieme Verlag. All rights reserved.
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    Evaluating the effects of two different lipid emulsions on morbidities in premature infants
    (İnönü Üniversitesi, 2021) Deliloğlu, Burak; Bilgin, Leyla; N/A; Erçin, Seçil; Coşkun, Yeşim; Doctor; Doctor; N/A; Koç University Hospital; N/A; N/A
    Aim: The aim of this study is to evaluate the effect of OO and FO based LEs on morbidities in preterm infants. Materials and Methods: A total of 44 neonates with a gestation ≤32 weeks were included in this retrospective observational study. The study group composed of neonates (n=28) who received SMOFlipid and the control group consisted of infants (n=16) who received ClinOleic. Demographic and clinical data of the neonates in terms of duration of PN, respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), ), duration of mechanical ventilation (MV), patent ductus arteriosus (PDA), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), PN-associated cholestasis (PNAC) and plasma triglyceride (TG) levels (mg/dl) were collected and compared statistically. Results: We did not find significant difference in terms of RDS, BPD, NEC, IVH, ROP and PNAC. The study group had lower TG levels than the control group which were 93.03±24.55 mg/dL and 151.31±114 mg/dL, respectively (p=0.002). Conclusion: Both LEs are well tolerated and safe without any side effects in preterm infants. Although both LEs have no significant effect on morbidities, FO based LE provide better TG levels than OO based LEs.
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    A 3-year-old child with multi-drug resistant epilepsy responding to pharmacological and nonpharmacological treatments
    (Taylor & Francis, 2022) Yıldırım, Canan; N/A; Coşkun, Yeşim; Doctor; N/A; Koç University Hospital; N/A
    Introduction: Despite the development of new antiseizure drugs (ASDs), around one third of epilepsy patients become refractory to treatment or experience adverse events due to ASDs. Therefore, discovery of new ASDs and new therapy options are crucial to improve the quality of life. Herein, we report a 3-year-old child with multi-drug resistant epilepsy caused by perinatal asphyxia whose seizures were reduced by 90% after the introduction of ketogenic diet, vagal nerve stimulation (VNS) AspireSR (SR-seizure response) and oral cannabidiol.Case presentation: A 9-month-old female infant had a history of multidrug resistant epilepsy due to perinatal asphyxia. At admission, she was experiencing up to 20-25 seizures per day lasting for 2-3 minutes. In addition to antiseizure drugs (ASDs), she was put on ketogenic diet (KD), vagal nerve stimulation (VNS) aspire seizure response (AspireSR) was inserted and oral cannabidiol (CBD) was started sequentially. Using pharmacological and nonph armacological therapies, her seizures have been reduced by 90%.Conclusion: The concurrent use of pharmacological and nonpharmacological therapies may be beneficial to improve seizures in infants with multi- Furthermore, our patient is the youngest child inserted VNS AspireSR in Turkey.
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    The efficacy of lacosamide in children with drug-resistant focal epilepsy
    (Haydarpaşa Numune Training and Research Hospital, 2021) Yıldırım, Canan; N/A; Coşkun, Yeşim; Doctor; N/A; Koç University Hospital; N/A
    Introduction: This study aimed to assess the efficacy, tolerability and adverse effects of Lacosamide (LCM) in children with refractory focal epilepsy. Methods: Children aged younger than 16 years with drug-resistant focal epilepsy were enrolled. The medical records and seizure diaries that were evaluated every three months were reviewed. Response to LCM was defined as ≥50% reduction in seizure frequency. Results: Twenty-five children with drug-resistant focal epilepsy received LCM as add-on therapy. The mean duration of epilepsy was 5.2 years and the mean age at LCM initiation was 8 years. The rate of response to LCM treatment in the 3th, 6th and 9th months were 44%, 64%, 76%, respectively. At the end of 12 months, the response rate was 84% and 16% of the patients were seizure free. Four patients had adverse effects; three patients were discontinued LCM and one improved after decreasing the dose of the drug. Discussion and Conclusion: LCM is an effective add-on antiepileptic drug for children with refractory focal epilepsy. It diminishes the frequency of seizures over time. It is well tolerated and a promising option in these patients.
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    PublicationOpen Access
    Use of silver-impregnated umbilical venous catheters for prevention of catheter associated bloodstream infection in neonates
    (İnönü Üniversitesi Tıp Fakültesi, 2022) Gürsoy, Tuğba; Coşkun, Yeşim; Kayas, Kalender; Erçin, Seçil; Faculty Member; School of Medicine; Koç University Hospital; 214691; N/A; N/A; N/A
    Aim: neonates hospitalized in neonatal intensive care units (NICU)s often require a venous access. Umbilical venous catheter (UVC) is the commonly used one. UVCs are known to cause life-threatening complications such as catheter-associated bloodstream infections (CABSI). To the best of our knowledge, our unit is the first and only NICU in Turkey that used silver-impregnated UVCs. This study aims to evaluate the impact of silver-impregnated UVC insertion on the incidence of CABSI. Materials and methods: a total of 108 patients were included in this retrospective study. After the application of exclusion criteria, the control group was composed of neonates (n=58) who had polyurethane (PU) UVCs inserted and the study group consisted of infants (n=41) who had silver-impregnated UVCs inserted. Demographic and clinical data of the mothers and neonates including duration of UVC insertion and sepsis incidence were collected and compared statistically. Results: there was no statistically significant difference between the groups except for intubation period and mortality. One neonate in each group had CABSI (p=1). Four neonates, two in each group, were diagnosed with clinical sepsis. Total CABSI incidence in our whole population was 2% and 3.3 per 1000 catheter days. Conclusion: strict precautions should be taken to prevent infection in every unit. In NICUs with low incidence of sepsis, silverimpregnated UVCs may have no further effect in the reduction of CABSI.
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    PublicationOpen Access
    General movements assessment and Alberta Infant Motor Scale in neurodevelopmental outcome of preterm infants
    (Elsevier, 2022) Yıldırım, C.; Asalıoğlu, A.; Acar, G., Akman, İ.; Coşkun, Yeşim; Koç University Hospital
    Aim: we aimed to compare the General Movement Assessment (GMA) and the Alberta Infant Motor Scale (AIMS) in preterm infants for the prediction of cerebral palsy (CP) and neurodeve-lopmental delay (NDD). Additionally, we aimed to evaluate the diagnostic compatibility of the General Movement Optimality Score (GMOS), the Motor Optimality Score (MOS), and AIMS for detecting CP and NDD.Method: seventy-five preterm infants with gestational age (GA) 24-37 weeks were enrolled. Group 1 was composed of infants with 24-28 GA (n = 22); groups 2 and 3 consisted of infants with 29-32 GA weeks (n = 23) and 33-37 GA (n = 30) weeks, respectively. The infants were assessed during the writhing period, the fidgety period, and at 6-12 months of corrected age with GMOS, MOS, and AIMS, respectively.Results: in the writhing period, a cramped-synchronized pattern was observed in 17 (22%) in-fants, whereas a poor repertoire pattern was observed in 34 (45%) infants. In the fidgety period of the 63 infants, 29 (46%) presented with fidgety movements absent. The MOS and AIMS scores of the infants in group 1 were significantly lower than the other groups, which were statisti-cally significant (p = 0.004, p<0.00 1). High and positive compatibility (Kappa coefficient: 0.709; p = 0.001) was found between AIMS and GMOS scores and between AIMS and MOS scores (Kappa coefficient: 0.804; p < 0.001). In all groups, a statistically significant association was found between total GMOS scores (p = 0.003) and the presence of fidgety movements (p = 0.003). GMOS, MOS, and AIMS were found to be associated with CP and NDD (p < 0.001).Conclusion: GMA is an important tool for the prediction of CP and NDD. The combined use of GMOS, MOS, and AIMS may guide the clinical practice for the valid and reliable diagnosis of CP and NDD.Copyright 2022, Taiwan Pediatric Association.