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Ozturk MA, Kurtoglu S, Bastug O, Korkmaz L, Daar G, Memur S, Halis H, Günes T, Hussain K, Ellard S. Neonatal diabetes in an infant of diabetic mother: same novel INS missense mutation in the mother and her offspring. J Pediatr Endocrinol Metab 2014; 27:745-8. [PMID: 24566359 DOI: 10.1515/jpem-2013-0285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 01/29/2014] [Indexed: 11/15/2022]
Abstract
Neonatal diabetes is defined as an uncontrolled hyperglycemic state occurring within the first 6 months of life. It is a rare disease with an incidence of 1 to 90,000-250,000. It is usually a disease of genetic origin in which insulin gene mutations play the main role in the disease process. A baby, born to a mother who had previously been diagnosed with type 1 diabetes mellitus at 14 months of age, had a high blood sugar level within the first few hours after birth and was subsequently diagnosed as having neonatal diabetes mellitus. Baby and mother were identified as having a novel heterozygous insulin missense mutation, p.C109R. Difficulties occurred in both follow-up and feeding of the baby. Without the addition of the mother's milk, an appropriate calorie milk formula and isophane insulin were used for the baby during follow-up. Multiple mechanisms are responsible in the pathogenesis of neonatal diabetes mellitus. Insulin gene mutations are one of the factors in the development of neonatal diabetes mellitus. If a resistant hyperglycemic state persists for a long time among babies, especially in those with intrauterine growth retardation whose mothers are diabetic, the baby concerned should be followed-up carefully for the development of neonatal diabetes mellitus.
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Eren OO, Ozturk MA, Sonmez O, Oyan B. Are male gender and non-adenocarcinoma histology valid prognostic factors for breast cancer? Ann Oncol 2014; 25:911. [PMID: 24667723 DOI: 10.1093/annonc/mdu043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ozturk MA, Bastug O, Halis H, Korkmaz L, Memur S, Sarici D, Kara A. A rare association: Sirenomelia with adrenalomegaly in an infant of diabetic mother. J Neonatal Perinatal Med 2014; 7:253-6. [PMID: 25322991 DOI: 10.3233/npm-1476813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sirenomelia or the Mermaid syndrome is a rare congenital anomaly with an incidence of one in 60,000 to 70,000 pregnancies. Sirenomelia is characterized by complete fusion of the lower limbs, commonly associated with renal agenesis, absent external genitalia and other gastrointestinal defects. A 37-week, 3040-g infant was born to a 35-year-old multigravida mother with type 2 diabetes mellitus and hyperlipidemia. To our knowledge, this is the first case of sirenomelia with adrenalomegaly.
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Koklu E, Gurgoze M, Akgun H, Ozturk MA, Poyrazoglu MH. Renal tubular dysgenesis with atypical histology andin-uteroexposure to naproxen sodium. ACTA ACUST UNITED AC 2013; 26:241-5. [PMID: 16925962 DOI: 10.1179/146532806x120345] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Renal tubular dysgenesis (RTD), a rare, lethal, autosomal recessive disorder, is characterised by short and poorly differentiated proximal convoluted tubules associated with oligohydramnios, Potter sequence and neonatal death from respiratory failure. We report an unusual case of neonatal anuria owing to RTD with normally formed lungs, in-utero exposure to naproxen sodium and atypical histology in that the glomeruli were not as crowded as usually seen in RTD. When there is anuria in an infant following birth in the context of a normal renal ultrasound and an absence of objective evidence of perinatal hypoxia, RTD should be considered.
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Gunes T, Koklu E, Ozturk MA, Akcakus M, Kurtoglu S, Cetin N, Koklu S. Antimeasles antibodies in preterm infants during early infancy in Turkey. ACTA ACUST UNITED AC 2013; 27:31-7. [PMID: 17469730 DOI: 10.1179/146532807x170484] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
AIM To measure maternally derived measles antibodies in sera of premature infants at birth and seropositivity rates in early infancy in a rural area of central Turkey. METHODS 65 premature and 24 full-term infants born in Erciyes University Hospital and their mothers were recruited to a longitudinal, prospective study. The infants were divided into three groups by gestational age: group A, <33 weeks; group B, 33-37 weeks; group C, >37 weeks. For specific analyses, the groups were subdivided into groups Al, B1 and C1 (infants of naturally immunised mothers) and A2, B2 and C2 (infants of vaccinated mothers). Blood samples were obtained from mothers and infants after delivery. The infants were re-evaluated at 2, 4 and 6 months of age. RESULTS Of 25 mothers, 20.3% were seronegative for measles antibodies. Twenty of the mothers had not been vaccinated. The percentages of seronegative infants at birth were 24.2% (n=8), 12.5% (n=4) and 0% (n=0) in groups A, B and C, respectively. No infants were seronegative at birth in Al, B1 or C1. Mean levels of antimeasles antibodies in all naturally immunised mothers were significantly higher than in vaccinated mothers. Antibody levels in all infants decreased rapidly with increasing age. Gestational age at birth [beta=0.179, t=3.359, 95% confidence interval (CI) 0.0001-0.0001, p<0.05], birthweight (beta=0.637, t=9.691, 95% CI 0.057-0.086, p<0.05) and maternal naturally immunised status (beta=0.168, t=2.825, 95% CI 0.002-0.014, p<0.05) were significantly associated with antibody levels after birth. In all groups of naturally immunised mothers, the percentages of seronegative infants were significantly lower than in vaccinated mothers at birth and at 2, 4 and 6 months of age. CONCLUSION The current recommendation to immunise all infants at 9 months of age might require revision for premature infants, especially those whose mothers have vaccination-induced immunity.
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Sarici D, Akin MA, Kurtoglu S, Gunes T, Ozturk MA, Akcakus M. Thyroid functions of neonates with Down syndrome. Ital J Pediatr 2012; 38:44. [PMID: 22985522 PMCID: PMC3480826 DOI: 10.1186/1824-7288-38-44] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 09/14/2012] [Indexed: 12/04/2022] Open
Abstract
Background We aimed to evaluate thyroid functions and volumes and detect abnormalities in 80 neonates with Down syndrome. Methods Data about free triiodothyronine, free thyroxine, thyroid stimulating hormone, thyroglobulin and urinary iodine levels, and ultrasonographic thyroid volume were collected. Results Abnormal thyroid function tests were detected in 53.8% of the patients (n = 50) and these were hyperthyrotropinemia, hypothyroidism, iodine deficiency and iodine overload in 32, 2, 12 and 4 patients, respectively. Thyroid volumes were assessed in 36 patients and a total of 17 abnormalities were detected (7 hypoplasia, 3 agenesis and 7 goiter). In patients with hyperthyrotropinemia mean thyroid volume was significantly greater and mean TSH was significantly higher when compared to the patients without hyperthyrotropinemia. Conclusion Neonatal screening by thyroid function tests in Down syndrome should be performed to prevent further intellectual deterioration and improve overall development. In the neonatal period, the risk of hyperthyrotropinemia should be kept in mind.
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Ozbek M, Erdogan M, Dogan M, Akbal E, Ozturk MA, Ureten K. Serum heart-type fatty acid binding protein levels in acromegaly patients. J Endocrinol Invest 2011; 34:576-9. [PMID: 20834198 DOI: 10.3275/7259] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Heart-type fatty acid-binding protein (H-FABP) is a major cytoplasmic low molecular weight protein and released into the circulation when the myocardium is injured. Previous studies have demonstrated that H-FABP is closely associated with acute coronary syndrome, hypertrophic and dilated cardiomyopathy, heart failure, stroke, obstructive sleep apnea syndrome, and pulmonary embolism. The aim of this study was to investigate serum H-FABP value in patients with acromegaly. METHODS AND RESULTS We measured serum H-FABP levels in 30 consecutive patients with acromegaly, and 55 age-matched control subjects by using a sandwich enzymelinked immunosorbent assay. Serum H-FABP levels were significantly higher in patients with acromegaly than in control subjects (17.40 ± 10.70, and 8.30 ± 7.20, respectively) (p<0.001). A significant positive correlation was found by Spearman's correlation test between serum H-FABP levels and left ventricular end-systolic diameter (r=0.483, p=0.004). CONCLUSION Patients with acromegaly have increased levels of H-FABP. Serum H-FABP levels might be a marker of myocardial performance in patients with acromegaly.
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Buyukkayhan D, Ozturk MA, Kurtoglu S, Koklu E, Yikilmaz A. Effect of antenatal betamethasone use on adrenal gland size and endogenous cortisol and 17-hydroxyprogesterone in preterm neonates. J Pediatr Endocrinol Metab 2009; 22:1027-31. [PMID: 20101888 DOI: 10.1515/jpem.2009.22.11.1027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To assess the effect of antenatal betamethasone use on adrenal gland size and adrenal hormones in preterm neonates who had gestational ages of 27-36 weeks. INFANTS AND METHODS Sixty-six neonates divided into two groups: betamethasone group, whose mothers received betamethasone 12 mg two times 24 h apart, and no betamethasone group, whose mothers did not receive any steroid agent during the antenatal period. Serum 17-hydroxyprogesterone (17-OHP) levels and cortisol levels were measured during the first six hours of life. In addition, adrenal gland length and width were determined on the first day of life. Hormone tests and ultrasonographic evaluation were repeated on the fifth day of life. RESULTS We found statistically significant reductions in 17-OHP and cortisol levels at birth in corticosteroid-exposed neonates (p < 0.05). There was no significant difference between the study groups with regard to adrenal gland length and width (p > 0.05). CONCLUSIONS This study demonstrates that betamethasone use in preterm neonates reduces endogenous 17-OHP and cortisol levels; however, it has no effect on adrenal gland size.
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Ozturk MA, Dane F, Kaygusuz I, Asmaz O, Uzay A, Bayik M, Turhal NS. Synchronous renal cell carcinoma and multiple myeloma: report of two cases and review of the literature. JOURNAL OF B.U.ON. : OFFICIAL JOURNAL OF THE BALKAN UNION OF ONCOLOGY 2009; 14:511-514. [PMID: 19810147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Coexistence of renal cell carcinoma (RCC) and multiple myeloma (MM) is an extremely rare condition. Appearance of synchronous RCC and MM was not reported independently so far. In this brief communication, we report 2 cases of synchronous RCC and MM, discuss common risk factors or pathogenetic mechanisms seen in either RCC or MM, point out the importance of IL-6 in this coexistence and provide some descriptive properties of all reported synchronous RCC and MM cases.
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Dane F, Ozturk MA, Tecimer T, Atasoy BM, Cabuk D, Yumuk PF, Basaran G, Teomete M, Turhal NS. A case of Kikuchi-Fujimoto disease misdiagnosed as Hodgkin's lymphoma: the importance of second opinion. JOURNAL OF B.U.ON. : OFFICIAL JOURNAL OF THE BALKAN UNION OF ONCOLOGY 2009; 14:309-311. [PMID: 19650184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Kikuchi-Fujimoto disease (KFD), a rare clinicopathological entity, is a benign and self-limiting disease. It was first described in 1972 by Kikuchi and Fujimoto in Japan independently. KFD is prevalent in Asia, although it may be seen in wide geographical areas, including Turkey. It mainly affects young women. Cervical lymphadenopathy is the most prominent sign and should be differentiated from lymphoproliferative, autoimmune, and infectious diseases. We report on a 30-year-old female patient who was referred to our medical oncology unit for chemotherapy and/or radiotherapy with diagnosis of Hodgkin's lymphoma. Ultimately her diagnosis was corrected as KFD after second opinion of the pathology specimens. We herein provide a brief review about KFD and the importance of second opinion of the pathology specimens.
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Bicakcigil M, Aksu K, Kamali S, Ozbalkan Z, Ates A, Karadag O, Ozer HTE, Seyahi E, Akar S, Onen F, Cefle A, Aydin SZ, Yilmaz N, Onat AM, Cobankara V, Tunc E, Ozturk MA, Fresko I, Karaaslan Y, Akkoc N, Yücel AE, Kiraz S, Keser G, Inanc M, Direskeneli H. Takayasu's arteritis in Turkey - clinical and angiographic features of 248 patients. Clin Exp Rheumatol 2009; 27:S59-S64. [PMID: 19646348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Takayasu's arteritis (TA) is a chronic, inflammatory vasculitis affecting the aorta and its major branches. Although it is more prevalent in Far-East Asia, the distribution of the disease is worldwide with different vascular involvement patterns and clinical manifestations. The objective of this study was to evaluate the demographic, clinical, angiographic and prognostic features of TA patients in Turkey. METHODS Clinical and angiographic findings of 248 TA patients (228 female, 27 male) followed at 15 Rheumatology Centers were prospectively evaluated according to a predefined protocol. RESULTS The mean age was 40.1 years (30.2 years at the clinical onset). Clinical manifestations included constitutional symptoms in 66%, absent or diminished pulses in 88%, bruits in 77%, extremity pain in 69%, claudication in 48%, hypertension in 43% and cerebrovascular accidents (CVA) in 18% of the patients. Renal artery stenosis, aortic regurgitation and pulmonary hypertension were present in 26%, 33% and 12%, respectively. According to the new angiographic classification, type V (50.8%) and Type I (32%) were the most frequent types of involvement. Corticosteroids were the main treatment in 93% of the patients alone (9%) or in combination with immunosuppressive agents (84%). Most frequently preferred immunosuppressive agents were methotrexate (63%), azathioprine (22%) and cyclophosphamide (13%). Remission was observed at least once in 94% of the patients and sustained remission in 71% during follow-up. CONCLUSION The demographical, clinical and angiographic findings of TA patients in our series were similar to those reported from Japan, Brazil and Colombia. Combination therapies with immunosuppressive agents were the preferred choice of treatment in Turkey.
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Koklu E, Gunes T, Akcakus M, Ozturk MA, Kurtoglu S. Alpha-fetoprotein levels in the neonatal period. Eur J Pediatr 2008; 167:961-2; author reply 963. [PMID: 17952463 DOI: 10.1007/s00431-007-0621-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2007] [Accepted: 09/25/2007] [Indexed: 12/17/2022]
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Kurtoglu S, Ozturk MA, Koklu E, Gunes T, Akcakus M, Hatipoglu N. Serum insulin-like growth factor-I (IGF-I), IGF-binding protein-3, and growth hormone levels in collodion babies: a case-control study. J Pediatr Endocrinol Metab 2008; 21:689-94. [PMID: 18780604 DOI: 10.1515/jpem.2008.21.7.689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM Because growth failure occurs in many collodion babies, we investigated serum growth hormone (GH), insulin-like growth factor-I (IGF-I) and IGF binding protein-3 (IGFBP-3) levels in collodion babies admitted to Gevher Nesibe Hospital, Kayseri, Turkey between 1999 and 2006. PATIENTS AND METHOD The newborns diagnosed clinically as 'collodion baby' were included in the study group (group 1). Because collodion babies are usually born small for gestational age (SGA) and/or premature, a control group (group 2) was formed by selecting the first infant admitted immediately after each study infant who matched for gestational age (+/- 7 days) and birth weight (+/- 100 g). All infants' blood samples were collected within the first 2 h of life for measurements of serum GH, IGFBP-3 and IGF-I levels. RESULTS Group 1 consisted of 23 collodion babies (13 males and 10 females) with gestational ages ranging from 32 to 42 weeks, and birth weights ranging from 1,300 to 3,600 g. Ten were born premature and 16 were SGA. Serum IGF-I and IGFBP-3 levels were lower but serum GH levels were higher in collodion babies than in controls. Birth weight was positively correlated with serum IGF-I (r = 0.310, p = 0.046) and IGFBP-3 (r = 0.389, p = 0.011) levels. Serum GH level was negatively correlated with birth weight (r = -0.376, p = 0.014), serum IGF-I (r = -0.567, p <0.001) and IGFBP-3 (r = -0.444, p = 0.003). CONCLUSION Collodion babies had lower serum IGF-I and IGFBP-3 levels but higher serum GH levels than controls in the present case-control study. The underlying mechanism needs to be explored.
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Kurtoglu S, Ozturk MA, Koklu E, Gunes T, Akcakus M, Yikilmaz A, Buyukkayhan D, Hatipoglu N. Thyroid volumes in newborns of different gestational ages: normative data. Arch Dis Child Fetal Neonatal Ed 2008; 93:F171. [PMID: 18296580 DOI: 10.1136/adc.2007.130211] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Daysal GA, Goker B, Gonen E, Demirag MD, Haznedaroglu S, Ozturk MA, Block JA. The relationship between hip joint space width, center edge angle and acetabular depth. Osteoarthritis Cartilage 2007; 15:1446-51. [PMID: 17629513 DOI: 10.1016/j.joca.2007.05.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2007] [Accepted: 05/26/2007] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Radiographic parameters used to define acetabular dysplasia may be related to anthropological characteristics independent of dysplasia. The goal of the present study was to investigate the relationship between the minimal joint space width (JSW) of the hip and the parameters that define acetabular dysplasia, in clinically normal subjects. DESIGN One hundred and eighteen patients who underwent supine abdominal radiography for non-rheumatological indications and had no hip pain or history of hip arthritis were evaluated. JSW was quantified manually using dial calipers, and center edge (CE) angle and acetabular depth were measured for each hip. RESULTS CE angle, but not acetabular depth, correlated (inversely) with the minimal hip JSW (r=-0.26 and -0.20, P=0.005 and 0.038, R (right) and L (left) hips, respectively). CE angle inversely correlated with the pelvic width (r=-0.27 and 0.27, P=0.003 and 0.004, R and L hips, respectively) and acetabular depth correlated with subject's height (r=0.27 and 0.42, P=0.008 and <0.001 R and L hips, respectively) and leg length (r=0.27 and 0.45, P=0.008 and <0.001, R and L hips, respectively). Also, pelvic width correlated significantly with the JSW (r=0.27 and 0.20, P=0.003 and 0.033, for R and L hips, respectively). CONCLUSIONS The radiographic parameters used to define acetabular dysplasia, CE angle and acetabular depth, are strongly associated with anthropological variables and CE angle is associated with minimal JSW of the hip. It is important to recognize that height and limb length variability may affect radiographic parameters of acetabular dysplasia, and thus may falsely suggest the presence of anatomic abnormalities in some patients.
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Koklu E, Ozturk MA, Gunes T, Akcakus M, Kurtoglu S. Is increased intima-media thickness associated with preatherosclerotic changes in intrauterine growth restricted newborns? Acta Paediatr 2007; 96:1858; author reply 1859. [PMID: 17953731 DOI: 10.1111/j.1651-2227.2007.00531.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Koklu E, Gunes T, Ozturk MA, Kose M, Kurtoglu S, Yuksel F. A review of 116 cases of breastfeeding-associated hypernatremia in rural area of central Turkey. J Trop Pediatr 2007; 53:347-50. [PMID: 17496322 DOI: 10.1093/tropej/fmm026] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We aimed to assess the incidence, neurologic and neurodevelopmental outcome of breastfeeding-associated hypernatremic dehydration among hospitalized neonates in rural area of central Turkey. A retrospective study was conducted at Gevher Nesibe Hospital over a 6-year period, to identify otherwise healthy term and near-term (> or = 35 weeks of gestation) breastfed neonates (<29 days of age) who were admitted with serum sodium concentrations of >150 mEq/l and no explanation for hypernatremia other than inadequate milk intake. The incidence of breastfeeding-associated hypernatremic dehydration among hospitalized term and near-term neonates (n = 5592) was 2.1%, occurring for 116 breastfed infants. More than one half of the infants admitted with breastfeeding-associated hypernatremia exhibited abnormal development at 12 or more months of age. Increased efforts are required to establish successful breastfeeding.
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Gunes T, Koklu E, Yikilmaz A, Ozturk MA, Akcakus M, Kurtoglu S, Coskun A, Koklu S. Influence of maternal smoking on neonatal aortic intima-media thickness, serum IGF-I and IGFBP-3 levels. Eur J Pediatr 2007; 166:1039-44. [PMID: 17203279 DOI: 10.1007/s00431-006-0376-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2006] [Accepted: 11/14/2006] [Indexed: 10/23/2022]
Abstract
Epidemiological studies have reported associations between a range of cardiovascular risk factors such as smoking and intima-media thickness (IMT). Some reports indicate that the maternal tobacco smoking causes disturbances of the endocrine status of the foetus. There are several potential mechanisms by which insulin-like growth factor I (IGF-I) could modify atherosclerotic processes either locally or in a systemic manner. The aim of this study was to investigate the influence of maternal smoking on neonatal aortic IMT (aIMT), serum IGF-I and IGF-binding protein-3 (IGFBP-3) levels. Aortic intima-media thickness was measured in 28 neonates whose mothers smoked during the pregnancy and 28 control neonates. Mean and weight-adjusted aIMT were significantly greater in the neonates whose mothers smoked (0.455 +/- 0.009 mm and 0.151 +/- 0.005 mm/kg, respectively) than in controls (0.403 +/- 0.029 mm and 0.118 +/- 0.014 mm/kg, respectively). Birth-weight of newborns whose mothers smoked was less than that of the controls. The decreases in serum IGF-I and IGFBP-3 observed in the infants whose mothers smoked were non-significant. Mean aIMT was negatively associated with birth-weight and IGF-I level. In conclusion, neonates whose mothers smoked have significantly increased aIMT. It might play a role in the pathogenesis of atherosclerosis in adult life.
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Koklu E, Gunes T, Ozturk MA, Akcakus M, Buyukkayhan D, Kurtoglu S. Cutis laxa associated with central hypothyroidism owing to isolated thyrotropin deficiency in a newborn. Pediatr Dermatol 2007; 24:525-8. [PMID: 17958802 DOI: 10.1111/j.1525-1470.2007.00509.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cutis laxa is an uncommon entity characterized by laxity of the skin, which hangs in loose folds, producing an appearance of premature aging. It can be subdivided into congenital and acquired forms. Genetic forms of cutis laxa include at least three forms of recessive disease, an X-linked form also termed occipital horn syndrome and an autosomal dominant form. Isolated pituitary hormone deficiency can be induced by many causes including mechanical destruction of the hypothalamo-pituitary axis, neoplasm, inflammation, and injury and genetic defects of pituitary hormone production and secretion. Isolated-thyrotropin deficiency has been considered to be a rare disease. We report a newborn with autosomal recessive form of congenital cutis laxa, who had congenital hypothyroidism owing to isolated thyrotropin deficiency. To the best of our knowledge, this is the first instance of this association to be reported in the literature.
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Koklu E, Gunes T, Patiroglu T, Ozturk MA, Kontas O, Arsav V. Leukemia cutis following biphenotypic congenital leukemia. Pediatr Dermatol 2007; 24:587-8. [PMID: 17958830 DOI: 10.1111/j.1525-1470.2007.00539.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gunes T, Koklu E, Ozturk MA. Maternal and cord serum lipid profiles of preterm infants with respiratory distress syndrome. J Perinatol 2007; 27:415-21. [PMID: 17554390 DOI: 10.1038/sj.jp.7211775] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Lipid metabolism has an important role in fetal development during the late stage of gestation, including growth and fat accretion in utero, increasing amniotic fluid lecithin levels with maturation of pulmonary function and changes in the levels of minor phospholipids in amniotic fluid. OBJECTIVE The aim of this study was to compare the maternal and cord lipid profiles of preterm infants with respiratory distress syndrome (RDS) and a control group without RDS. METHOD The study groups consisted of 166 preterm infants with gestational ages ranging from 25 to 36 weeks, and birth weights ranging from 748 to 2495 g. Of these infants, 57 developed RDS and 109 infants served as controls. The infants were divided into four gestational age groups (34 to 36, 31 to 33, 28 to 30 and 25 to 27 weeks). Stepwise linear regression analyses were performed to determine independent contribution of each lipid parameter of the infants to their characteristics and mothers' variables. RESULT Total cholesterol, high-density and low-density lipoproteins (LDL) cholesterols levels were lower in infants with RDS and in their mothers than in controls, and maternal lipid profile was related to those of their infants (P<0.05). Pregravid body mass index (BMI) was related to triglyceride levels of the infants, and weight gain during pregnancy was related to LDL cholesterol levels of the infants (P<0.05). CONCLUSION RDS is accompanied with lipid alteration in infants and their mothers. Pregravid BMI and weight gain during pregnancy might have a prognostic significance in the prediction of respiratory distress in early neonatal period.
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Gunes T, Koklu E, Ozturk MA, Patiroglu T, Patiroglu T, Karakukcu M. A case of Langerhans cell histiocytosis presented with pneumothorax. J Pediatr Hematol Oncol 2007; 29:60-2. [PMID: 17230069 DOI: 10.1097/mph.0b013e318030abfd] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Pneumothorax (PTX) is an unusual complication of Langerhans cell histiocytosis (LCH) in childhood. Spontaneous PTX is rare in childhood, and it is very rare in infancy. There are no specific recommendations for the treatment of PTX from LCH described in the literature. We are presenting a 19-month-old boy, who suddenly developed left-sided PTX with infiltrations in both lungs. He presented with PTX and skin lesions. He had a prolonged cardiac arrest, and although resuscitation was successful he required continuing ventilatory support (intermittent positive-pressure ventilation). Because he suddenly developed right-sided PTX and died on the second day of the admission, his LCH diagnosis was made only postmortem. So, he did not receive chemotherapy. It is likely that intermittent positive-pressure ventilation during the operation induced the development of much more multiple lung bullae, which subsequently ruptured, and/or it facilitated the development of the right-sided PTX. The patients with PTX and skin lesions, including babies, most likely have LCH and specific chemotherapy should be started in emergency, even before the final diagnosis is achieved.
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Gunes T, Ozturk MA, Koklu E, Kose K, Gunes I. Effect of allopurinol supplementation on nitric oxide levels in asphyxiated newborns. Pediatr Neurol 2007; 36:17-24. [PMID: 17162192 DOI: 10.1016/j.pediatrneurol.2006.08.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Revised: 07/11/2006] [Accepted: 08/17/2006] [Indexed: 11/26/2022]
Abstract
This study aimed to investigate the effect of allopurinol in the management of cerebral hypoxia-ischemia by monitoring nitric oxide levels of serum and cerebrospinal fluid. Sixty asphyxiated infants were divided randomly into two groups. Group I infants (n = 30) received allopurinol (40 mg/kg/day, 3 days) within 2 hours after birth. Group II infants (n = 30) received a placebo. Twenty healthy neonates served as control subjects. Cerebrospinal fluid and serum nitric oxide levels were measured within 0-24 hours and 72-96 hours after birth. Both serum and cerebrospinal fluid concentrations of nitric oxide were higher in severely asphyxiated infants (40.86 +/- 8.97, 17.3 +/- 3.63 micromol/L, respectively) but lower in mildly asphyxiated infants (25.85 +/- 3.57, 5.70 +/- 2.56 micromol/L, respectively) than in moderately asphyxiated infants (35.86 +/- 5.38, 11.06 +/- 3.37 micromol/L, respectively) within the first 0-24 hours after birth. Serum nitric oxide levels in control subjects were lower than those of moderately and severely asphyxiated infants. Serum nitric oxide levels of Group I infants within 72-96 hours after birth decreased significantly from their corresponding levels within 0-24 hours after birth. The asphyxiated newborns treated with allopurinol had better neurologic and neurodevelopmental outcome at 12 or more months of age.
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Ozturk MA, Gunes T, Koklu E, Cetin N, Koc N. Oral nystatin prophylaxis to prevent invasive candidiasis in Neonatal Intensive Care Unit. Mycoses 2006; 49:484-92. [PMID: 17022766 DOI: 10.1111/j.1439-0507.2006.01274.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The use of oral nystatin to prevent fungal colonisation and infection in neonates in the Neonatal Intensive Care Unit (NICU) is still an open question and not yet recommended as a standard of care. To determine whether prophylactic oral nystatin results in a decreased incidence of invasive candidiasis in the newborn infants, a total of 3991 infants were divided randomly into two groups. Group A infants (n = 1995), only those neonates who were identified as yeast carriers (oral moniliasis) were treated with oral nystatin. Group B infants, all neonates who were admitted to the unit received oral nystatin, was routinely administered three times a day. Group A was divided into groups A1 and A2 (who were treated only if identified as yeast carriers). Urine and rectal cultures were taken on admission and then weekly thereafter. There were 215 (14.2%), 27 (5.6%) and 36 (1.8%) patients positive for invasive candidiasis in groups A1, A2 and B respectively. Oral nystatin prophylaxis significantly reduced the invasive candidiasis (P = 0.004) in extremely low-birth weight (ELBW) and very low-birth weight (VLBW) infants. Prophylactic administration of oral nystatine to the ELBW and VLBW infants results in a decreased risk of invasive candidiasis.
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Ozturk MA, Gunes T, Koklu E, Erciyes A. Free carnitine levels in respiratory distress syndrome during the first week of life. Am J Perinatol 2006; 23:445-9. [PMID: 17009198 DOI: 10.1055/s-2006-951305] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Antenatal carnitine administration has been shown to induce fetal lung maturity by increasing pulmonary surfactant in animal and human studies. The aim of this study was to investigate serum free carnitine (FC) levels in preterm infants with respiratory distress syndrome (RDS) and controls during the first week of postnatal life. The study groups consisted of 76 preterm infants with gestational ages ranging from 28 to 36 weeks, and birthweights ranging from 1046 to 2352 g. Serum FC levels were measured in preterm infants (group A, 37 with RDS; group B, 39 controls without RDS) within the first 6 hours after birth, on days 3 and 7. For specific analyses, serum FC levels were determined for gestational ages 28 to 31 weeks and 32 to 36 weeks in both groups. Initial FC levels were decreased insignificantly in group A (22.5 +/- 7.3 micromol/L) compared with group B (23.5 +/- 6.8 micromol/L; P > 0.05). On days 3 and 7 of life, serum FC levels were significantly lower in group A (18.3 +/- 6.1 and 10.2 +/- 3.3 micromol/L, respectively) than in group B (23.4 +/- 7.1 and 22.8 +/- 3.7 micromol/L, respectively; P < 0.05 and P < 0.05, respectively) on days 3 and 7 of life, respectively. Serum FC level remained stable in the non-RDS group ( P > 0.05), but it decreased significantly in the RDS group during the first week of postnatal life ( P < 0.05). No differences were seen between the corresponding gestational age groups. Serum FC levels in RDS infants decreased from days 1 to 7. Decreased neonatal serum carnitine levels in preterm infants with RDS during the first week of life might be caused by increasing consumption of carnitine in lung tissue for surfactant synthesis.
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