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Kesebir J, Gozubatık Celik RG, Zenginler Y, Yüksel B, Sen A, Akinci B. Do proprioceptive neuromuscular facilitation techniques improve respiratory parameters and swallowing in people with multiple sclerosis: A randomized-controlled study. Mult Scler Relat Disord 2024; 85:105534. [PMID: 38489949 DOI: 10.1016/j.msard.2024.105534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/27/2024] [Accepted: 03/01/2024] [Indexed: 03/17/2024]
Abstract
AIM This study aims to investigate the effects of Proprioceptive Neuromuscular Facilitation (PNF) techniques on respiratory parameters, swallowing, functional capacity, fatigue, and quality of life in people with Multiple Sclerosis (PwMS). METHOD Thirty-four PwMS were included and randomized into the PNF Group (mean age: 43.23±10.55/years) or Control Group (mean age:38.47±8.18/years). In the PNF group, head-neck, upper extremity, trunk, and breathing techniques were applied three days/eight weeks. The control group continued home-based breathing exercises. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow (PEF), forced expiratory flow 25-75 % (%FEF 25-75), peak cough flow (PCF), maximal inspiratory (MIP) and expiratory pressures (MEP) were and two minutes walking test (2MWT) were measured. Dysphagia in Multiple Sclerosis (DYMUS), Eating Assessment Tool (EAT-10), Fatigue Severity Scale (FSS) and Multiple Sclerosis Quality of Life (MusiQoL) were questioned. RESULTS After treatment, MIP, MEP,%FEV1/FVCpred,%PEFpred,%FEF 25-75pred, PCF, DYMUS, EAT-10, FSS, and MUSIQoL were improved in the PNF group while MIP, MEP, PCF, DYMUS, EAT-10, MUSIQoL, and 2 MWT were improved in the control group (p < 0.05 for all). In the between-group analysis of the mean differences, the%FEV1pred was significantly different in favor of the PNF Group (p = 0.011), and MIP was significantly different in favor of the Control Group (p = 0.013). DISCUSSION The PNF techniques can improve respiratory muscle strength, respiratory functions, cough efficiency, swallowing functions, and quality of life in mild to moderate PwMS. However, these improvements were not superior except for%FEV1pred compared to home-based breathing exercises.
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Affiliation(s)
- Julide Kesebir
- Biruni University, Vocational School, Department of Occupational Therapy, Istanbul, Turkey
| | - Rabia Gokcen Gozubatık Celik
- Prof Mazhar Osman Bakırköy Psychiatric and Neurological Diseases Hospital, Department of Neurology, Istanbul, Turkey
| | - Yonca Zenginler
- Istanbul University-Cerrahpasa, Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Turkey
| | - Burcu Yüksel
- Prof Mazhar Osman Bakırköy Psychiatric and Neurological Diseases Hospital, Department of Neurology, Istanbul, Turkey
| | - Aysu Sen
- Prof Mazhar Osman Bakırköy Psychiatric and Neurological Diseases Hospital, Department of Neurology, Istanbul, Turkey
| | - Buket Akinci
- Biruni University, Faculty of Health Science, Department of Physiotherapy and Rehabilitation (English), Turkey.
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Demirhan O, Yüksel B, Yilmaz S, Cetinel N. Different Clinical Effects of Ectodermal Dysplasias in Four Generations. Actas Dermosifiliogr 2023; 114:918-920. [PMID: 37276991 DOI: 10.1016/j.ad.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 09/25/2022] [Accepted: 11/22/2022] [Indexed: 06/07/2023] Open
Affiliation(s)
- O Demirhan
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Çukurova, Adana, Turkey.
| | - B Yüksel
- Department of Pediatrics, Faculty of Medicine, University of Çukurova, Adana, Turkey
| | - S Yilmaz
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - N Cetinel
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Çukurova, Adana, Turkey
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Demirhan O, Yüksel B, Yilmaz S, Cetinel N. Different Clinical Effects of Ectodermal Dysplasias in Four Generations. Actas Dermosifiliogr 2023; 114:T918-T920. [PMID: 37716501 DOI: 10.1016/j.ad.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 09/25/2022] [Accepted: 11/22/2022] [Indexed: 09/18/2023] Open
Affiliation(s)
- O Demirhan
- Departamento de Medicina Biológica y Genética, Facultad de Medicina, Universidad de Çukurova, Adana, Turquía.
| | - B Yüksel
- Departamento de Pediatría, Facultad de Medicina, Universidad de Çukurova, Adana, Turquía
| | - S Yilmaz
- Departamento de Endodoncia, Facultad de Odontología, Universidad de Çukurova, Adana, Turquía
| | - N Cetinel
- Departamento de Medicina Biológica y Genética, Facultad de Medicina, Universidad de Çukurova, Adana, Turquía
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Koctekin B, Yüksel B, Durmaz D, Çilli MA, Tekindal MA, Çoban DT. Investigation of stereoacuity and the relationship of with retinal nerve fiber layer thickness and P100 latency in patients with multiple sclerosis with and without optic neuritis. tnd 2022. [DOI: 10.4274/tnd.2022.88555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Kunt R, Çınar BP, Yüksel B, Güllüoğlu H, Sayılır İ, Çeliker Uslu S, Özaydın Göksu E, Bülbül NG, Yıldız B, Öz D, Keskin AO, Korucu O, Akpınar ÇK, Solmaz V, Akpınar M, Altunç FZ, Elmas Z, Büyükuysal Ç, Ekici M, Güvendi G. Clinical-epidemiological and radiological characteristics of stroke patients: A multicentre study. Int J Clin Pract 2021; 75:e14963. [PMID: 34626055 DOI: 10.1111/ijcp.14963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/06/2021] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION AND AIM Stroke is the leading cause of disability in adults and the second most common cause of death, at a rate of 11.8% worldwide. The purpose of this study was to examine the aetiological, demographic, and clinical characteristics of patients admitted to hospital because of acute strokes. MATERIALS AND METHODS This multicentre study retrieved information for all patients admitted to hospital because of an acute cerebrovascular event over a six-month period, and sociodemographic, aetiological, and clinical characteristics were recorded. RESULTS A total of 1136 patients, 520 of whom were women (45.7%), with a mean age of 70.3 ± 12.8 years, were included in the study. Of these, 967 were diagnosed with ischaemic stroke (IS) (85.1%), 99 with haemorrhagic stroke (HS) (8.7%), and 70 with transient ischaemic attack (6.1%). The most common risk factor for stroke was hypertension (73%). Carotid disease and hyperlipidaemia rates were higher in patients with HS. Numbers of functionally dependent patients with severe neurological status according to the National Institutes of Health Stroke Scale and modified Rankin scale were significantly higher in the HS group (P < .001). When IS was classified according to the Trial of Org 10172 in Acute Stroke Treatment, small vessel disease emerged as the most common cause (41%). The most common lesion localisations were the parietal lobe (23%) in the IS group and the thalamus (35.3%) in the HS group. Eighty-eight patients (7.7%), 62 (6.4%) in the ischaemic subgroup, and 26 (26.3%) in the haemorrhagic subgroup, died within the first month. CONCLUSION Current and accurate evaluations of stroke aetiology are essential for stroke prevention and treatment planning. This study, shows that no change occurred in the aetiology of stroke and epidemiological characteristics and that accurate identification of modifiable stroke risk factors is still a major goal.
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Affiliation(s)
- Refik Kunt
- Department of Neurology, School of Medicine, İzmir Demokrasi University, İzmir, Turkey
| | - Bilge Piri Çınar
- Department of Neurology, School of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Burcu Yüksel
- Neurology Clinic, Antalya Training and Research Hospital, Antalya, Turkey
| | | | - İdris Sayılır
- Neurology Clinic, Samsun Training and Research Hospital, Samsun, Turkey
| | | | | | | | - Baykal Yıldız
- Neurology Clinic, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Didem Öz
- Neurology Clinic, Dokuz Eylül University, İzmir, Turkey
| | - Ahmet Onur Keskin
- Neurology Clinic, Eskişehir Yunus Emre State Hospital, Eskişehir, Turkey
| | - Osman Korucu
- Neurology Clinic, Keçiören Training and Research Hospital, Ankara, Turkey
| | | | - Volkan Solmaz
- Department of Neurology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Meliha Akpınar
- Department of Neurology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Fatma Zehra Altunç
- Neurology Clinic, Antalya Training and Research Hospital, Antalya, Turkey
| | - Zeynep Elmas
- Neurology Clinic, Medicalpark İzmir Hospital, İzmir, Turkey
| | - Çağatay Büyükuysal
- Department of Statistics, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey
| | - Mustafa Ekici
- Emergency Medicine Clinic, Atatürk State Hospital, Aydın, Turkey
| | - Güven Güvendi
- Department of Physiology, School of Medicine, İzmir Demokrasi University, İzmir, Turkey
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Özaydın Göksu E, Yüksel B, Doğan B, Ünal AC. Changes in Optical Coherence Tomography Parameters in Patients with Unilateral Carotid Artery Stenosis. tnd 2021. [DOI: 10.4274/tnd.2021.36675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Göksu EÖ, Yüksel B, Esin M, Küçükseymen E, Ünal A, Genç A, Yaman A. The value of STAF (Score for the Targeting of Atrial Fibrillation) in Patients with Cryptogenic Embolic Stroke. ACTA ACUST UNITED AC 2019; 56:119-122. [PMID: 31223244 DOI: 10.5152/npa.2017.19348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/02/2017] [Indexed: 11/22/2022]
Abstract
Introduction The aim of the present study was to predict paroxysmal atrial fibrillation (PAF) in acute ischemic stroke patients with presumed cryptogenic embolic etiology. Methods In this retrospective cohort study, demographics, blood tests, data of neuroimaging studies such as non-contrast computed tomography (NCCT), magnetic resonance imaging (MRI), standard 12-lead electrocardigraphy (ECG), 24-hour Holter ECG, echocardiography was collected. The diagnostic work-up to detect atrial fibrillation (AF) was either medical history of the patient or 12-lead ECG or 24-hour Holter ECG or continuous ECG monitoring. Score for the targeting of atrial fibrillation (STAF) was calculated for all patients. Cryptogenic ischemic stroke (CS) patients with and without documented AF were recorded. Results Between July 2014 and December 2015, a total of 133 of the 258 patients with CS were included in this study. Overall, 133 patients were enrolled and AF was detected in 30 (22.6%) patients. In univariate analysis gender (p<0.001), age (p=0.001), smoking habit (p=0.004), aortic and mitral valve insufficiency (p=0.014 and p=0.021), left ventricular systolic dysfunction (p=0.04), and left atrial dilatation (p=0.03) were predictors of AF but multivariate analysis showed that only gender and age were independent predictors of AF in patients with presumed cryptogenic ischemic stroke. According to ROC analysis, area under the curve was 70% and the sensitivity and specificity of STAF score of ≥5 was 86% and 71% respectively. Conclusion STAF score predicted with fair accuracy, and has a limited use for the risk of PAF in stroke patients.
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Affiliation(s)
| | - Burcu Yüksel
- Antalya Research and Training Hospital, Neurology Clinic, Antalya, Turkey
| | - Murat Esin
- Antalya Research and Training Hospital, Cardiology Clinic, Antalya, Turkey
| | - Elif Küçükseymen
- Antalya Research and Training Hospital, Neurology Clinic, Antalya, Turkey
| | - Ali Ünal
- Neurology Department, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ahmet Genç
- Antalya Research and Training Hospital, Cardiology Clinic, Antalya, Turkey
| | - Aylin Yaman
- Antalya Research and Training Hospital, Neurology Clinic, Antalya, Turkey
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Yüksel B, Küçükseymen E, Koç P, Özaydın Göksu E, Karaçay E, Yaman A, Biçer Gömceli Y. Cerebral Infarct due to Traumatic Carotid Artery Dissection. tnd 2016. [DOI: 10.4274/tnd.26937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Kaya Akyüzlü D, Kayaaltı Z, Yüksel B, Özdemir F, Söylemezoğlı T. Maternal MDR1 C1236T polymorphism and mercury levels in a triad of mother–placenta–fetus. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Yüksel B, Bora T. Optimzation and validation of a GC-FID method for analysis of cocaine. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kaya Akyüzlü D, Kayaaltı Z, Özdemir F, Yüksel B, Söylemezoğlu T. Effect of transferrin -576G/A and 3296G>A gene polymorphisms on blood iron and lead levels in beta-thalassemia major patients. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.2025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kayaaltı Z, Söylemez D, Kaya Akyüzlü D, Özdemir F, Yüksel B, Söylemezoğlu T. Does HFE H63D gene polymorphism has an effect on blood iron, lead and cadmium levels of Turkish beta-thalassemia major patients? Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Yüksel B, Kayaaltı Z. Analysis of blood lead and iron levels: Method validation and optimization. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.2109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kayaaltı Z, Akyüzlü DK, Özdemir F, Yüksel B, Söylemezoğlu T. Association between MDR1 C1236T polymorphism and blood, hair and urinary mercury levels in Turkish women. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kaya Akyüzlü D, Kayaaltı Z, Özdemir F, Yüksel B, Söylemezoğlu T. Effect of metallothionein polymorphism on blood, hair and urinary mercury levels in Turkish women. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kayaaltı Z, Kaya Akyüzlü D, Yüksel B, Özdemir F, Söylemezoğlu T. Is there a relationship between metallothionein polymorphism and mercury levels of maternal blood, placental tissue and cord blood? Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.2008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kayaaltı Z, Yüksel B, Kaya-Akyüzlü D, Tekin D, Söylemezoğlu T. Influence of maternal blood lead on newborns. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Baykara Z, Özocak H, Kuş A, Arslan Z, Yüksel B, Aksu C, Ertagin M, Solak M, Toker K. Are APACHE II scores better predictors of mortality than routine laboratory values? Crit Care 2013. [PMCID: PMC3643144 DOI: 10.1186/cc12411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Soysal A, Yüksel B, Czermin B, Aydemir S, Tuğcu B, Aysal F, Arpaci B. Case study of sporadic mitochondrial disease with myotonic discharges and optic atrophy. Muscle Nerve 2013; 47:308-9. [DOI: 10.1002/mus.23641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 08/16/2012] [Accepted: 08/17/2012] [Indexed: 11/09/2022]
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Keskin BC, Yuca E, Ertekin O, Yüksel B, Memon AR. Expression characteristics of ARF1 and SAR1 during development and the de-etiolation process. Plant Biol (Stuttg) 2012; 14:24-32. [PMID: 21973219 DOI: 10.1111/j.1438-8677.2011.00482.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
ARF1 (ADP-ribosylation factor 1) and SAR1 (secretion-associated RAS super family) are involved in the formation and budding of vesicles throughout plant endomembrane systems. The molecular mechanisms of this transport have been studied extensively in mammalian and yeast cells. However, very little is known about the mechanisms of coat protein complex (COP) formation and recruitment of COP-vesicle cargoes in plants. To provide insights into vesicular trafficking in Pisum sativum L., we investigated mRNA and protein expression patterns of ARF1 and SAR1 in roots and shoots at early growth stages and in the de-etiolation process. We showed that ARF1 was concentrated mostly in the crude Golgi fractions, and SAR1 was concentrated predominantly in the crude ER fractions of de-etiolated shoots. ARF1 and SAR1 proteins were several times more abundant in shoots relative to roots. In total protein homogenates, the expression level of SAR1 and ARF1 was higher in shoots of dark-grown pea plants than light-grown plants. In contrast, ARF1 was higher in roots of light-grown pea relative to roots of dark-grown pea. With ageing, the ARF1 mRNA in roots was reduced, while SAR1 expression increased. Unlike ARF1 transcripts, ARF1 protein levels did not fluctuate significantly in root and shoot tissue during early development. The relative abundance of SAR1 protein in root tissues may suggest a high level of vesicular transport from the ER to the Golgi. Experimental results suggested that white light probably affects the regulation of ARF1 and SAR1 protein levels. On the other hand, short-term white light affects SAR1 but not ARF1.
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Affiliation(s)
- B Cevher Keskin
- Plant Molecular Biology Laboratory, TUBITAK, The Scientific and Technological Research Council of Turkey, Marmara Research Center, Genetic Engineering and Biotechnology Institute, Gebze, Kocaeli, Turkey.
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Cavusoglu AC, Bilgili S, Alaluf A, Doğan A, Yilmaz F, Aslanca D, Karaca B, Yüksel B, Topaloglu E. Vascular endothelial growth factor level in the serum of diabetic patients with retinopathy. ACTA ACUST UNITED AC 2007; 39:205-8. [PMID: 18025626 DOI: 10.1007/s12009-007-0037-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Revised: 11/30/1999] [Accepted: 03/27/2007] [Indexed: 10/22/2022]
Abstract
We determined serum levels of vascular endothelial growth factor (VEGF) at different stages of diabetic retinopathy before laser photocoagulation in 65 patients (31 nonproliferative (Group 1) and 34 proliferative (Group 2)) and in healthy controls (Group 3). VEGF levels in all groups were different. There was a significant correlation between VEGF concentration and HbA1c levels. VEGF may be involved in the prediction of diabetic retinopathy and contributes to endothelial damage in diabetics.
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Affiliation(s)
- A Celebiler Cavusoglu
- Clinical Biochemistry, The Ministry of Health, Izmir Education & Research Hospital, Izmir, Turkey.
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Darendeliler F, Berberoğlu M, Ocal G, Adiyaman P, Bundak R, Günöz H, Baş F, Darcan S, Gökşen D, Arslanoğlu I, Yildiz M, Ercan O, Ercan G, Ozerkan E, Can S, Böber E, Adal E, Sarikaya S, Dallar Y, Siklar Z, Bircan I, Bideci A, Yüksel B, Büyükgebiz A. Response to growth hormone with respect to pubertal status on increased dose in idiopathic growth hormone deficiency: an analysis of Turkish children in the KIGS database (Pfizer International Growth Study). J Pediatr Endocrinol Metab 2005; 18:949-54. [PMID: 16355808 DOI: 10.1515/jpem.2005.18.10.949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To compare the growth response to growth hormone (GH) treatment in patients with idiopathic GH deficiency (IGHD) who were prepubertal with the response of those who were pubertal at the onset of GH therapy on an increased GH dose. PATIENTS AND METHODS Among the Turkish patients enrolled in the Pfizer International Growth Study (KIGS) database with the diagnosis of IGHD, the growth data over 2 years of GH therapy were analyzed longitudinally of 113 (79 M) prepubertal (Group 1) and 44 (33 M) pubertal (Group 2) patients. Pubertal signs were reported to be present initially or to have appeared within 6 months of GH therapy in Group 2. Mean +/- SD age at onset of therapy was 8.7 +/- 3.5 and 13.5 +/- 1.8 years; height SDS -4.2 +/- 1.4 and -3.2 +/- 1.1 (p < 0.05) in Groups 1 and 2, respectively. Mid-parental height (MPH) SDS did not show a significant difference between the two groups (-1.5 +/- 1.1 vs -1.7 +/- 1.1). RESULTS Delta height SDS over 2 years of therapy was significantly higher in Group 1 (1.1 +/- 1.0) than in Group 2 (0.7 +/- 0.6) (p <0.05) in spite of a significantly lower dose of GH (14.6 +/- 3.3 in Group 1 vs 17.0 +/- 3.1 IU/m2/week in Group 2, p < 0.05). Ht--MPH SDS showed an increase from -2.4 +/- 1.7 to -1.4 +/- 1.5 in Group 1 and from -1.5 +/- 1.5 to -0.8 +/- 1.3 in Group 2. Overall delta height SDS showed negative correlations with age (r = -0.32), height SDS (r = -0.41) and height--MPH SDS (r = -0.40) at onset of therapy (p < 0.001). CONCLUSIONS These data show that in IGHD the slight increase (15-20%) in the dose of GH during puberty was not adequate to maintain height velocity at the same magnitude as in prepuberty, and thus was not cost effective.
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Affiliation(s)
- F Darendeliler
- Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Yüksel B, Paterson AH. Construction and characterization of a peanut HindIII BAC library. Theor Appl Genet 2005; 111:630-9. [PMID: 16049705 DOI: 10.1007/s00122-005-1992-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2004] [Accepted: 03/07/2005] [Indexed: 05/03/2023]
Abstract
Bacterial artificial chromosome (BAC) libraries have been an essential tool for physical analyses of genomes of many crops. We constructed and characterized the first large-insert DNA library for Arachis hypogaea L. The HindIII BAC library contains 182,784 clones; only 5,484 (3%) had no inserts; and the average insert size is 104.05 kb. Chloroplast DNA contamination was very low, only nine clones, and r-DNA content was 1,208, 0.66% of clones. The depth of coverage is estimated to be 6.5 genome-equivalents, allowing the isolation of virtually any single-copy locus. This rate of coverage was confirmed with the application of 20 overgos, which identified 305 positive clones from the library. The identification of multiple loci by most probes in polyploids complicates anchoring of physical and genetic maps. We explored the practicality of a hybridization-based approach for determination of map locations of BAC clones in peanut by analyzing 94 clones detected by seven different overgos. The banding patterns on Southern blots were good predictors of contig composition; that is, the clones that shared the same size bands and ascribed to the same overgos usually also located in the same contigs. This BAC library has great potential to advance future research about the peanut genome.
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Affiliation(s)
- B Yüksel
- Plant Genome Mapping Lab, The University of Georgia, 111 Riverbend Road, Athens, GA 30605, USA
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Yüksel B, Bowers JE, Estill J, Goff L, Lemke C, Paterson AH. Exploratory integration of peanut genetic and physical maps and possible contributions from Arabidopsis. Theor Appl Genet 2005; 111:87-94. [PMID: 15809848 DOI: 10.1007/s00122-005-1994-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2004] [Accepted: 03/07/2005] [Indexed: 05/24/2023]
Abstract
Arachis hypogaea is a widely cultivated crop both as an oilseed and protein source. The genomic analysis of Arachis species hitherto has been limited to the construction of genetic maps; the most comprehensive one contains 370 loci over 2,210 cM in length. However, no attempt has been made to analyze the physical structure of the peanut genome. To investigate the practicality of physical mapping in peanut, we applied a total of 117 oligonucleotide-based probes ("overgos") derived from genetically mapped RFLP probes onto peanut BAC filters containing 182,784 peanut large-insert DNA clones in a multiplex experimental design; 91.5% of the overgos identified at least one BAC clone. In order to gain insights into the potential value of Arabidopsis genome sequence for studies in divergent species with complex genomes such as peanut, we employed 576 Arabidopsis-derived overgos selected on the basis of maximum homology to orthologous sequences in other plant taxa to screen the peanut BAC library. A total of 353 (61.3%) overgos detected at least one peanut BAC clone. This experiment represents the first steps toward the creation of a physical map in peanut and illustrates the potential value of leveraging information from distantly related species such as Arabidopsis for both practical applications such as comparative map-based cloning and shedding light on evolutionary relationships. We also evaluated the possible correlation between functional categories of Arabidopsis overgos and their success rates in hybridization to the peanut BAC library.
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Affiliation(s)
- B Yüksel
- Plant Genome Mapping Laboratory, The University of Georgia, 111 Riverbend Road, Athens, GA 30605, USA
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25
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Onenli-Mungan N, Yildizdas D, Yapicioglu H, Topaloglu AK, Yüksel B, Ozer G. Growth hormone and insulin-like growth factor 1 levels and their relation to survival in children with bacterial sepsis and septic shock. J Paediatr Child Health 2004; 40:221-6. [PMID: 15009554 DOI: 10.1111/j.1440-1754.2004.00342.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Despite improved supportive care, the mortality of sepsis and septic shock is still high. Multiple changes in the neuroendocrine systems, at least in part, are responsible for the high morbidity and mortality. A reduced circulating level of insulin-like growth factor and an elevated level of growth hormone are the reported characteristic findings early in the course of sepsis and septic shock in adults. The aim of this study was to evaluate the changes of growth hormone/insulin-like growth factor 1 axis in sepsis and septic shock and investigate the relationship between these hormones and survival. METHODS Fifty-one children with sepsis (S), 21 children with septic shock (SS) and 30 healthy, age- and sex-matched children (C) were enrolled in this study. Growth hormone, insulin-like growth factor 1 and cortisol levels of the sepsis and septic shock groups were obtained before administration of any inotropic agent. RESULTS Growth hormone levels were 32.3 +/- 1.5 microIU/mL (range 4-56), 15.9 +/- 0.6 microIU/mL (range 11-28) and 55.7 +/- 2.7 microIU/mL (range 20-70) in S, C and SS groups, respectively. The difference between the growth hormone levels of the S and C groups, S and SS groups, and C and SS groups were significant (P < 0.001). Non-survivors (54.7 +/- 1.6 microIU/mL) had significantly higher growth hormone levels than survivors (29.4 +/- 1.5 microIU/mL) (P < 0.001). Insulin-like growth factor 1 levels were 38.1 +/- 2.1 ng/mL (range 19-100), 122.9 +/- 9.6 ng/mL (range 48-250) and 22.2 +/- 1.9 ng/mL (range 10-46) in the S, C and SS groups, respectively, and the difference between the insulin-like growth factor 1 levels of the S and C, S and SS, and C and SS groups were significant (P < 0.001). Non-survivors (8.8 +/- 1.1 micro g/dL) had significantly lower cortisol levels than survivors (40.9 +/- 2.1 microg/dL) (P < 0.001). We detected a significant difference between the levels of cortisol in non-survivors (19.7 +/- 1.8 microg/dL) and survivors (33.9 +/- 0.9 microg/dL) (P < 0.01). CONCLUSIONS There were elevated levels of growth hormone with decreased levels of insulin-like growth factor 1 in children during sepsis and septic shock compared to healthy subjects. In addition, there were even higher levels of growth hormone and lower levels of insulin-like growth factor 1 in non-survivors than in survivors. We think that both growth hormone and insulin-like growth factor 1 may have potential prognostic value to serve as a marker in bacterial sepsis and septic shock in children. As there is insufficient data in the paediatric age group, more studies including large numbers of patients and additionally evaluating cytokines and insulin-like growth factor binding proteins are needed.
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Affiliation(s)
- N Onenli-Mungan
- Department of Pediatrics, Faculty of Medicine, Cukurova University, Adana, Turkey.
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26
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Yıldızdaş D, Önenli-Mungan N, Yapıcıoğlu Η, Topaloglu A, Sertdemir Y, Yüksel B. Thyroid Hormone Levels and their Relationship to Survival in Children with Bacterial Sepsis and Septic Shock. ACTA ACUST UNITED AC 2004. [DOI: 10.1515/jpem.2004.17.10.1435] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kinali M, Greenough A, Dimitriou G, Yüksel B, Hooper R. Chronic respiratory morbidity following premature delivery--prediction by prolonged respiratory support requirement? Eur J Pediatr 1999; 158:493-6. [PMID: 10378399 DOI: 10.1007/s004310051128] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED Neonatal chronic lung disease (CLD) is usually diagnosed if an infant remains oxygen dependent beyond 36 weeks postconceptional age (PCA). Our aim was to determine whether a shorter duration of respiratory support accurately predicted subsequent respiratory morbidity. A total of 103 infants, median gestational age 29 weeks (range 23-35), were followed prospectively for 5 years. They had a birth weight of < 1500 g or, if a birth weight of between 1500 and 2000 g, had required neonatal ventilatory support. Parents completed diary cards; their child had positive symptom status if, in any one year, they coughed and/or wheezed on at least 3 days per week for a 4-week period or for at least 3 days following each upper respiratory tract infection. Subsequent respiratory morbidity, positive symptom status in years 1 and 2 or all 5 pre-school years, was related to various definitions of prolonged respiratory support: intermittent positive pressure ventilation dependence > 7 days; oxygen dependence > 28 days and oxygen dependence > 36 weeks PCA. In years 1 and 2, 25 children were symptomatic and 22 in all 5 years. The patients with subsequent respiratory morbidity were distinguished from those without by requiring longer respiratory support (P < 0.05). Logistic regression analysis demonstrated only oxygen dependence beyond 28 days was independently related to subsequent respiratory morbidity (P < 0.01). The positive predictive values and likelihood ratios (95% confidence intervals) for positive symptom status in all 5 years were for intermittent positive pressure ventilation > 7 days 35% (16-53) and 19.5 (1.01-3.76), for oxygen dependency > 28 days 42% (23-61) and 2.20 (1.45-5.02) and for oxygen dependency >36 weeks PCA 35% (13-58) and 1.67 (0.65-4.31). CONCLUSION Oxygen dependency at 28 days of age remains a useful criterion on which to diagnose "neonatal" chronic lung disease.
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MESH Headings
- Child, Preschool
- Chronic Disease
- Follow-Up Studies
- Humans
- Infant
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/epidemiology
- Infant, Premature, Diseases/physiopathology
- Infant, Premature, Diseases/therapy
- Morbidity
- Prospective Studies
- Respiration Disorders/epidemiology
- Respiration Disorders/physiopathology
- Respiration Disorders/therapy
- Respiration, Artificial
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Affiliation(s)
- M Kinali
- Children Nationwide Regional Neonatal Intensive Care Centre, King's College Hospital, London, UK
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Greenough A, Naik S, Itakura Y, Yüksel B, Cheeseman P, Nicolaides KH. Perinatal lung function measurements and prediction of respiratory problems in infancy. Physiol Meas 1998; 19:421-6. [PMID: 9735893 DOI: 10.1088/0967-3334/19/3/011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of this study was to determine which lung function test employed in the perinatal period gave the results most significantly associated with respiratory problems in infancy. The ratio of the proportion of time to reach peak tidal expiratory flow to total expiratory time (tPTEF:tE), thoracic gas volume (TGV) and airway resistance (R(aw)) (from which specific conductance (SG(aw)) was calculated) measurements were examined from 85 infants born at or near term. The infants were followed until at least one year of age and described as symptomatic if they wheezed for at least 24 hours. Twenty-three infants were symptomatic in the first year. The symptomatic group, compared to the asymptomatic, had a higher median FRC (p < 0.01) and R(aw) (p < 0.001); their median SG(aw) was lower (p < 0.001). It was possible to obtain tPTEF:tE results from only 61 infants; the median tPTEF:tE did not differ significantly between symptomatic and asymptomatic infants. Logistic regression analysis demonstrated a high R(aw) and FRC, but not a low tPTEF:tE, independently related to positive symptom status. A high R(aw) (>26 cm H2O (1 s(-1))(-1)) was the most sensitive (83%) predictor of subsequent respiratory problems, but all the tests examined had low positive predictive values.
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Affiliation(s)
- A Greenough
- Department of Child Health, King's College Hospital, London, UK
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29
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Abstract
Prematurely born children frequently have respiratory problems at follow-up. A non-invasive and easily performed lung function test would greatly facilitate their evaluation and appropriate treatment. We have, therefore, assessed whether the shape of the tidal breathing expiratory flow curve would give useful information in such a population. One hundred and twenty traces were randomly selected from plethysmographic measurements of thoracic gas volume and airway resistance made during a follow-up study of a prematurely born population. The children had a median gestational age of 29 (range 23-35, interquartile range 27-31) weeks and postnatal age at the time of measurement of 11 (range 6-24, interquartile range 7-13) months. From the flow and volume signals, the mean time to reach peak tidal expiratory flow as a proportion of the total expiratory time (tPTEF : tE) was determined for each child. The median tPTEF : tE differed significantly between children who, in the neonatal period, had or had not required mechanical ventilation (p < 0.001) and had or had not had an increased inspired oxygen requirement (p < 0.01), and who were or were not symptomatic at follow-up (p < 0.001). Logistic regression analysis demonstrated that a low tPTEF : tE ratio was independently associated with symptom status. These results suggest that assessment of a tidal breathing parameter during follow-up of prematurely born children may be useful. As tPTEF : tE can be measured without sedation, relatively quickly and with simple equipment, potentially large study populations could be investigated, and this technique should now be evaluated in a non-sedated group of young prematurely born children.
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Affiliation(s)
- A Greenough
- Department of Child Health, King's College Hospital, London, UK.
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Temoçin AK, Yüksel B, Tuncer R, Ozer G, Zorludemir U. A case of ambiguous genitalia with unilateral amelia and unilateral peromelia of the upper limbs. Acta Paediatr Jpn 1997; 39:631-3. [PMID: 9363668 DOI: 10.1111/j.1442-200x.1997.tb03656.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 7-year-old patient is reported with a 46,XY karyotype, ambiguous genitalia and unilateral amelia and unilateral peromelia of the upper limbs. The external genitalia had essentially a female configuration with labia majora, large clitoris, and narrow vaginal opening. Gonadal tissue was not palpable on either side. The levels of 17-OH progesterone dehydroepiandrosterone sulfate (DHEA-S), androstenedione and luteinizing hormone (LH) were normal, but the level of follicle stimulating hormone (FSH) was elevated minimally. Abdominal ultrasonography (USG) was normal. On pelvic USG, neither uterus nor ovaries were seen. Genitography showed a blind vagina. Gonads, Müllerian and/or Wolffian structures were not observed at laparotomy. Clitoral recession and cut-back vaginoplasty were performed. The occurrence of these findings suggests embryonic testicular regression syndrome with bilateral transverse defect of the upper limbs. The case has been presented because the pattern of the birth defects, including both ambiguous genitalia and unilateral amelia on one side of the upper limbs and unilateral peromelia on the other, have not been described previously.
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Affiliation(s)
- A K Temoçin
- Department of Medical Biology-Genetics Unit, Faculty of Medicine, University of Cukurova, Adana, Türkey
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31
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Abstract
BACKGROUND Second trimester amniocentesis has been associated with an excess of perinatal lung function abnormalities. Early amniocentesis might have a similar adverse effect, as could other invasive investigations carried out in the first trimester. METHODS Plethysmographic measurements of thoracic gas volume (TGV) and airway resistance (Raw), from which specific conductance (sGaw) was calculated, were made in the perinatal period in non-sedated infants. In addition, functional residual capacity (FRC) was measured using a helium gas dilution technique. Measurements were made in 47 infants whose mothers had undergone early amniocentesis, 19 whose mothers had undergone chorion villus sampling, and 25 controls whose mothers had undergone no invasive antenatal procedures. RESULTS The infants of mothers who had undergone early amniocentesis had higher TGV (95% CI -6.3 to 1.1 ml/kg) and Raw values (95% CI -10.68 to -5.23 cm H2O/l/s) and lower sGaw (0.11 to 0.84 l/cm H2O.s) and FRC (-5.17 to - 0.87 ml/kg) values than the controls. Infants whose mothers had undergone chorion villus sampling also differed significantly from the controls with higher Raw (-7.59 to -1.99 cm H2O/l/s) and lower sGaw values (0.11 to 0.24 l/cm H2O.s), and had lower Raw values than those in the early amniocentesis group (not significant). Logistic regression analysis, taking into account possible risk factors for abnormal lung function, showed that the procedures performed in the first trimester were independently associated with a high airways resistance. CONCLUSION These results suggest that invasive procedures performed in the first trimester of pregnancy have an adverse effect on perinatal lung function.
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Affiliation(s)
- B Yüksel
- Department of Child Health, King's College Hospital, London, UK
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Abstract
The efficacy of a non-steroidal anti-inflammatory agent (nedocromil sodium, NS) has been assessed in young children born prematurely who had recurrent respiratory symptoms at follow-up. In a randomized, double-blind cross-over trial, either two puffs of NS (2 mg puff-1) or placebo were administered three times a day via a spacer device and face mask. Fifteen children, median gestational age 27 weeks, birthweight 1100 g and postnatal age 12 months were studied. The symptom score was lower in the last 2 weeks of the active period (median score 26) compared to the run-in period (median score 55) and the last 2 weeks of the placebo period (median score 50), P < 0.01. The maximum possible symptom score for a 2-week period was 210. Compared to the run-in period, children required fewer days of bronchodilator therapy in the last 2 weeks of the active treatment (P < 0.01), but not in the placebo period. Although results of functional residual capacity (FRC) measurements were available on only 13 of the 15 children, these did demonstrate a significant change in FRC over the active, but not the placebo, period. These data suggest that NS is a useful prophylactic agent for children born prematurely and who are symptomatic at follow-up.
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MESH Headings
- Administration, Inhalation
- Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
- Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
- Child, Preschool
- Cough/drug therapy
- Cough/physiopathology
- Cross-Over Studies
- Double-Blind Method
- Female
- Humans
- Infant
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/drug therapy
- Infant, Premature, Diseases/physiopathology
- Lung/physiopathology
- Male
- Nedocromil/administration & dosage
- Nedocromil/therapeutic use
- Residual Volume
- Respiratory Sounds
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Affiliation(s)
- B Yüksel
- Department of Thoracic Medicine, King's College Hospital, London, U.K
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Greenough A, Giffin FJ, Yüksel B, Dimitriou G. Respiratory morbidity in young school children born prematurely--chronic lung disease is not a risk factor? Eur J Pediatr 1996; 155:823-6. [PMID: 8874121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
UNLABELLED Children born prematurely and recruited into a prospective follow up study were examined at 5 years of age. Our aim was to determine aetiological associations of respiratory symptoms in such children and, in particular, to determine the importance of severe chronic lung disease (CLD, oxygen dependence beyond 36 weeks post conceptional age). Respiratory status was documented from parental history in 103 children of median gestational age 29 weeks (range 23-35), 17 of whom had suffered from severe CLD. In 90 of the 103 children lung function had been assessed at 1 year of age. Regression analysis revealed that neither severe CLD nor other perinatal variables, but only a family history of atopy, significantly related to a positive symptom status. A high airways resistance at 1 year also significantly related to positive symptom status. CONCLUSION Reduction in severe CLD (oxygen dependence beyond 36 weeks postconceptional age) may make relatively little impact on respiratory morbidity in young school children born prematurely.
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Affiliation(s)
- A Greenough
- Department of Child Health, King's College Hospital, London, UK
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34
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Abstract
Respiratory morbidity, recurrent cough and/or wheeze and lung function abnormalities are common even outside infancy in preschool children born prematurely. Throughout the first 5 years of life, adverse neonatal events such as immaturity at birth and a requirement for prolonged respiratory support are significantly associated with positive symptom status. In the older preschool child, however, there is some evidence to suggest that other factors, such as a family history of atopy, may be equally important. The development of recurrent symptoms even at 4 years of age can be predicted accurately from the results of lung function measurements made in infancy, and hopefully such data will facilitate the introduction of effective intervention strategies. Lung function abnormalities are more marked in symptomatic patients and, in older children, seem to reflect increased airway responsiveness rather than having a significant relationship to adverse neonatal events. The hospital readmission rate for respiratory disorders, however, is certainly adversely affected by extremely low birthweight and neonatal chronic lung disease, as well as current symptom status. These data highlight that strategies to reduce extremely premature delivery and its consequences should favourably influence respiratory morbidity in preschool children.
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Affiliation(s)
- A Greenough
- Department of Child Health, King's College Hospital, London, UK
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Maeda M, van Schie RC, Yüksel B, Greenough A, Fanger MW, Guyre PM, Lydyard PM. Differential expression of Fc receptors for IgG by monocytes and granulocytes from neonates and adults. Clin Exp Immunol 1996; 103:343-7. [PMID: 8565322 PMCID: PMC2200344 DOI: 10.1046/j.1365-2249.1996.d01-615.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The immature neonatal immune system is thought to result in increased risk of infection. Receptors for the Fc moiety of IgG (Fc gamma R) are important in antibody-mediated clearance of microbes by granulocytes and monocytes/macrophages. As an approach to understanding their role in neonatal life, we have compared the constitutive expression of the three Fc receptors--Fc gamma RI (CD64), Fc gamma RII (CD32) and Fc gamma RIII (CD16)--by neonatal and adult blood monocytes and granulocytes using quantitative immunofluorescence by flow cytometry. Our results confirm that there is a small subpopulation of Fc gamma RIII-positive monocytes in adult blood, and furthermore show that this is absent or at a low percentage in cord blood samples. However, the main population of cord blood monocytes expresses low, but significantly higher levels of Fc gamma RIII than adult monocytes. No differences were seen in the quantitative expression of Fc gamma RI and Fc gamma RII. Neonatal granulocytes expressed significantly higher levels of both Fc gamma RI and Fc gamma RII but significantly lower levels of Fc gamma RIII. The data are discussed in terms of the possible role of cytokines and susceptibility to infection.
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Affiliation(s)
- M Maeda
- Department of Immunology, UCL Medical School, London, UK
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Yüksel B, Noyan A, Anarat A, Gönlüşen G, Ozer G. Membranoproliferative glomerulonephritis associated with insulin-dependent diabetes mellitus. A case report. Nephron Clin Pract 1996; 73:716-7. [PMID: 8856282 DOI: 10.1159/000189171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Abstract
The aim of this study was to assess if advanced maternal age and cigarette smoking increased the requirement for admission to the neonatal intensive care unit (NICU) and if those factors acted synergistically. Retrospective analysis was made of 3518 singleton pregnancies receiving antenatal care and delivering at King's College Hospital from 1 January 1992 to 31 December 1992. The maternal age was greater than 35 years in 356 women (10.1% of the total) and 49 (13.8%) of those were cigarette smokers. There was an inverse relationship between maternal age and smoking. Two hundred and fifty-nine infants were admitted to the NICU. Logistic regression analysis revealed a significant relationship between maternal age and admission (p < 0.05), but no independent effect of maternal smoking. The proportion of infants from smoking mothers of advanced age (> 35 years) admitted to the NICU, however, was greater than that from young (< or = 35 years) smoking mothers (p < 0.05). Advanced maternal age does increase the requirement for NICU admission and this effect is enhanced by smoking.
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Affiliation(s)
- B Yüksel
- Department of Child Heath, King's College School of Medicine and Dentistry, King's College Hospital, London, U.K
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38
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Affiliation(s)
- D Altintaş
- Department of Pediatrics, Cukurova University, Adana, Turkey
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39
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Abstract
The associations between parental smoking habits during pregnancy, family history of allergy, and IgE levels in cord-serum IgE (cIgE) were investigated prospectively in 1251 infants. Mean cIgE levels were similar in infants with positive and negative family history of allergy (0.50 and 0.54 kU/l, respectively). In infants with a positive family history of allergy whose mothers smoked more than 10 cigarettes a day, however, the mean cIgE level was significantly higher (0.78 kU/l) than that in infants of nonsmoking mothers (p = 0.011). Similarly, the mean cIgE level was significantly higher in boys (0.61 kU/l) than in girls (0.51 kU/l) of nonsmoking parents (p = 0.03). However, in infants of smoking parents, there was no significant difference in the mean cIgE level between boys and girls. A total of 178 (14%) mothers and 477 (38%) fathers were current smokers, and in 128 (10%) cases, both parents were active smokers. The mean cIgE level tended to be slightly higher in infants of smoking mothers, especially when the mother consumed more than 10 cigarettes a day (0.63 vs 0.54 kU/l) (p > 0.05). Thus, cIgE levels were higher only in genetically prone babies whose mothers consumed more than 10 cigarettes a day.
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Affiliation(s)
- A Atici
- Department of Pediatrics, Cukurova University Faculty of Medicine, Adana, Turkey
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40
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Alhan E, Bozdemir N, Yüksel B, Onenli N, Kocabaş E, Aksaray N. Epidemiology of meningococcal infections in children in mid-southern part of Turkey. Eur J Epidemiol 1995; 11:393-6. [PMID: 8549705 DOI: 10.1007/bf01721223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
59 patients were treated for meningococcal infections in Cukurova University Faculty of Medicine, Division of Pediatric Infectious Diseases. 50.8% of patients were male, 33.9% were under two years of age and 61% were under five. 78% of patients were admitted to hospital in winter and spring time. Meningococcal meningitis (MM) was present in 39% of patients on admission, however, meningococcemia in 27.1% and meningococcemia and meningococcic meningitis (Meningococcemia + MM) in 33.9%. Fatality rate was 18.6% and no association was found between mortality and clinical type of disease (p > 0.05), but mortality ratio decreased with an increasing age (p < 0.01). No deaths occurred among the 12 patients who received i.v. penicillin treatment shortly before admitting to hospital, on the other hand 11 of 47 patients (23.4%) without such a previous treatment died.
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Affiliation(s)
- E Alhan
- Department of Pediatrics, Faculty of Medicine, Cukurova University, Adana, Turkey
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41
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Abstract
BACKGROUND Ethnic origin has an important influence on the lung function of adults and young children but its effect during infancy, particularly following premature delivery, is unclear. METHODS The results from infants of pure Afro-Caribbean (subjects) and pure Caucasian (controls) descent, all of whom were born prematurely (median gestational age 28 weeks), were compared. Fifty subjects were each retrospectively matched with a control for gestational age, sex, and requirement for neonatal ventilation. Lung function measurements were performed at similar postnatal ages in each pair. The median postnatal ages of the two groups at the time of study was seven and eight months, respectively. Lung function was assessed by measurement of functional residual capacity (FRC) by a helium gas dilution technique and plethysmographic measurement of thoracic gas volume (TGV) and airways resistance (Raw), from which specific conductance (sGaw) was calculated. RESULTS No differences were found between the subjects and controls regarding FRC or TGV, but Raw was higher and sGaw lower in the subjects. The mean Raw of the subjects was 50.3 cm H2O/1/s and of the controls was 44.1 cm H2O/1/s (95% confidence intervals of the difference 1.5 to 10.9). CONCLUSIONS Prematurely born infants of Afro-Caribbean origin have more severe lung function abnormalities at approximately 7-8 months of age than those of Caucasian origin. This merits further investigation.
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Affiliation(s)
- B Yüksel
- Department of Child Health, King's College Hospital, London
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42
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Abstract
Gas trapping has been suggested to be common in healthy newborns in the immediate postnatal period. To determine the veracity of that finding, functional residual capacity (FRC) and thoracic gas volume (TGV) were measured in such a population and the FRC:TGV ratios were related to measurements of airway resistance (RAW). FRC was assessed by a helium gas dilution technique, TGV and RAW by plethysmography. Twenty-four healthy infants born at term were studied at a median age of 2 days (range 1-5 days). None had respiratory problems, nor had their mothers undergone invasive antenatal procedures. Their median FRC, which was 27.1 (range 23.8-32.0) ml kg-1, was significantly lower than their TGV (median 29.8, range 26-33 ml kg-1, P < 0.01). The mean 'within subject' difference between FRC and TGV was 2.5 (range 0.3-5.5) ml kg-1. The median FRC:TGV ratio was 0.93 (range 0.82-0.99). Eight infants had an FRC:TGV ratio less than 0.9, two of whom were studied on the first postnatal day. No infant with a low (< 0.9) FRC:TGV ratio had an abnormal RAW. The differences between FRC and TGV demonstrated in this study were smaller than documented in earlier series, suggesting the degree of gas trapping may previously have been over-estimated.
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Affiliation(s)
- B Yüksel
- Department of Child Health, King's College Hospital, London, U.K
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43
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Abstract
Infants born prematurely who develop chronic lung disease frequently suffer acute respiratory deteriorations. In a randomized trial, we assessed if treatment of such relapses with the antiviral agent Ribavirin increased the speed of recovery and improved lung function at follow-up. During the acute deterioration and its treatment, respiratory rate and requirement for respiratory support were recorded. Once discharged from hospital, respiratory symptoms and admissions for chest-related illnesses were documented. Infants were recalled at 6 months of age for lung function measurements. Forty-four infants (23 given Ribavirin), median gestational age of 26 weeks, completed the trial and had lung function measurements at 6 months. Although viral infections were identified in relatively few patients, the interim analysis demonstrated Ribavirin administration for 3 days was associated with a greater reduction in respiratory rate and inspired oxygen concentration (P < 0.02). At follow-up, there was no significant difference between groups in the proportion of infants who were symptomatic or required re-admission to hospital for chest-related illnesses; the Ribavirin group, however, had lower airways resistance (P < 0.01) and higher specific conductance (P < 0.02). We conclude that antiviral therapy seems to speed the rate of recovery from acute respiratory deteriorations seen in preterm infants with chronic lung disease; this is associated with improved lung function, but not lower respiratory morbidity, at follow-up.
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Affiliation(s)
- F J Giffin
- Department of Child Health, King's College Hospital, London, UK
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44
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Abstract
Six patients with Bardet-Biedl syndrome who have been followed in our clinics for the last 5 years are reported in this study. Of the five classic features of this syndrome; obesity and mental retardation were present in all cases, retinal disturbances were present in five, polydactyly in three and hypogenitalism was observed in all four male patients. Renal involvement, often suggested as a cardinal feature of this syndrome, was described in two patients. Iron deficiency anemia occurred in three patients, two patients were of short stature, one patient presented with an empty sella, and in two patients clinodactyly was detected. The results are compared to previously published literature and discussed.
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Affiliation(s)
- G Ozer
- Department of Pediatrics, Metabolism and Endocrinology, Medical Faculty of Cukurova University, Adana, Turkey
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45
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Abstract
The growth and development of 280 hypothyroidic patients who were diagnosed from 1979 to 1991, has been evaluated by standardized anthropometric criteria. According to the chronologic age during the diagnosis, the patients were divided into five groups of 0-6, 7-12, 13-24, 25-60 and 61-144 months. In these groups, the rates of the patients' weights and heights which were found below the 5th percentile, were as follows; for height 44%, 69%, 71%, 85%, 80% and for weight 38%, 68%, 70%, 55%, 60% respectively. Height age, weight age, head circumference age, and bone age were found to be significantly lower than chronologic age in all the groups, with the exception of the head circumference age in the 0-6 months group. The bone age was found to be significantly retarded compared to the height age in all the groups.
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Affiliation(s)
- G Ozer
- Department of Pediatrics, Endocrinology and Metabolism, Cukurova University Faculty of Medicine, Adana, Turkey
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46
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Abstract
It has been suggested that in infants born at term thoracic gas volume (TGV) may be more accurately estimated in a plethysmograph if end-inspiratory (TGVl) rather than end-expiratory (TGVE) occlusions are used. The aim of this study was to assess whether the timing of occlusion affected TGV results in patients born very prematurely. Fifteen children with a median gestational age of 28 weeks (range 23-34) and postnatal age of 10 months (range 6-24) were studied. Measurements of TGV and airway resistance (R(aw)) were made in a whole body plethysmograph after sedation with chloral hydrate. End-expiratory and end-inspiratory occlusions were performed randomly in each subject. Overall, TGVl was significantly lower than TGVE (median, TGVl 233 mL; range, 130-498. Median TGVE 250 mL; range, 132-604; P < 0.05; 95% confidence intervals for the difference, 4-50 mL). In 13 infants, TGVl was lower than TGVE; the remaining two patients did not differ significantly from the rest of the group and neither had neonatal chronic lung disease. In only five infants did TGVl lie below the 95% confidence intervals of TGVE, however, two-way analysis of variance with replicated measurements showed a significant difference between TGVE and TGVl (P < 0.05). The median R(aw) was 55 cmH2O/L/s (range, 36-71). A significant positive correlation was found between R(aw) and TGVE-TGVl (r2 = 0.5, P < 0.01). We conclude that in children born very prematurely and with high R(aw) occlusion at end-expiration rather than end-inspiration yields higher TGV results at follow-up.
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Affiliation(s)
- B Yüksel
- Department of Child Health, King's College School of Medicine and Dentistry, King's College Hospital, London, United Kingdom
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47
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Giffin F, Greenough A, Yüksel B. Relationship between lung function results in the first year of life and respiratory morbidity in early childhood in patients born prematurely. Pediatr Pulmonol 1994; 18:290-4. [PMID: 7898967 DOI: 10.1002/ppul.1950180505] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The relationship between lung function results at 6 months and 1 year of age to respiratory symptoms in the first 3 years of life in prematurely born population has been determined. In 88 infants (median gestational age, 29 weeks) thoracic gas volume (TGV) and airway resistance (R(aw)) was measured and specific conductance (SGaw) calculated at 6 months and 1 year of age. During 3 years of prospective follow-up neither TGV measured at either 6 months or 1 year, nor R(aw) and SGaw at 6 months, differed significantly between infants who were asymptomatic or symptomatic. At 1 year, however, R(aw) and SGaw were significantly higher and lower respectively in patients who were symptomatic than in those who were asymptomatic in any of the 3 years. An elevated R(aw) (> or = 50 cmH2O/L/s) measured at 1 year, but not at 6 months, was associated with a significant relative risk of symptoms in the first, second, and third year of life. We conclude that in prematurely born patients an abnormal airway resistance at 1 year predicts symptoms in early childhood.
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MESH Headings
- Age Factors
- Airway Resistance/physiology
- Blood Gas Analysis
- Child, Preschool
- Female
- Follow-Up Studies
- Humans
- Infant
- Infant, Newborn
- Infant, Premature, Diseases/blood
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/epidemiology
- Infant, Premature, Diseases/physiopathology
- Male
- Morbidity
- Predictive Value of Tests
- Prospective Studies
- Respiration Disorders/blood
- Respiration Disorders/diagnosis
- Respiration Disorders/epidemiology
- Respiration Disorders/physiopathology
- Respiratory Function Tests
- Risk Factors
- Time Factors
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Affiliation(s)
- F Giffin
- Department of Child Health, King's College School of Medicine and Dentistry, King's College Hospital, London, United Kingdom
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48
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Abstract
Between May 1988 and November 1992 the data from 52 patients with tuberculous meningitis (TBM) were noted down for their symptoms and signs, BCG vaccines, PPD tests; clinical, laboratory, radiologic and microbiologic findings. These data were discussed by means of literature knowledge. Cranial computed tomography (CT) demonstrated hydrocephalus (HC) in 98% of the patients. There was a statistically significant difference among the clinical stages on admission in respect to prognosis (P < 0.05). In addition, there was also a significant relationship between prognosis and HC (P < 0.05). However, we did not find any significant relationship between parenchymal involvement, basilar meningitis and prognosis (P > 0.05).
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Affiliation(s)
- S Altunbaşak
- Department of Pediatric Neurology, Medical School of Cukurova University, Adana, Turkey
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49
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Abstract
Nebulized ipratropium bromide reduces airways resistance in young children born prematurely, but that response is not invariable. We have assessed whether postnatal age or baseline lung function influences the effect of ipratropium bromide. Forty-five children, median gestational age 28 weeks (range 23-34) were studied at a postnatal age of 10 months (range 6-18). Twenty-four were symptomatic at follow-up. Airways resistance (Raw) was measured using a whole body plethysmograph before (baseline) and 20 min after nebulized ipratropium bromide. Sixteen patients had a significant improvement in Raw (a reduction in Raw greater than twice the coefficient of variation of the measurement). The baseline Raw of those 16 infants was significantly higher than the baseline Raw of the other 29 infants (P < 0.01). Multiple regression analysis, after taking into account baseline lung function and symptom status, demonstrated there was a significant relationship between the change in Raw following ipratropium bromide and postnatal age (P < 0.01). We conclude that both baseline lung function and postnatal age influence the response to nebulized ipratropium bromide in young children born prematurely.
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Affiliation(s)
- B Yüksel
- Department of Child Health, King's College Hospital, London, U.K
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50
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Abstract
OBJECTIVE To determine whether the hospital readmission rate of infants born prematurely was greatest in those whose birth weight was less than 750 g. DESIGN A prospective cohort study. SETTING Regional neonatal intensive care unit. PATIENTS Consecutive very-low-birth-weight (< 1500 g) infants admitted to the neonatal intensive care unit; infants with congenital abnormalities were excluded. Two-year follow-up was completed for 109 (90.8%) of these patients. MEASUREMENTS/MAIN RESULTS Following discharge from the neonatal intensive care unit, infants were seen at 6-month intervals at which time a detailed history was taken and examinations were performed. Hospital admissions were documented and confirmed from the medical records. Infants with birth weights of less than 750 g and those of very-low gestational age (< or = 28 weeks) made up the greatest number of admissions and had the longest hospital stays. In the first year of life, the duration of stay was inversely related to birth weight. CONCLUSION Increased survival of extremely low-birth-weight infants has important implications for resource allocation of pediatric beds.
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Affiliation(s)
- B Yüksel
- Department of Child Health, King's College Hospital, London, England
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