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Ozturk MA, Koroglu M, Ayvaz MA. The efficacy of bismuth quadruple therapy, sequential therapy, and hybrid therapy as a first-line regimen for Helicobacter pylori infection compared with standard triple therapy. Niger J Clin Pract 2022; 25:1535-1541. [DOI: 10.4103/njcp.njcp_89_22] [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: 11/04/2022]
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Korkmaz L, Ozdemir A, Pamukçu Ö, Güneş T, Ozturk MA. Which Inotropic Drug, Dobutamine or Milrinone, Is Clinically More Effective in the Treatment of Postligation Cardiac Syndrome in Preterm Infants? Am J Perinatol 2022; 39:204-215. [PMID: 32781477 DOI: 10.1055/s-0040-1715118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to detect which of the two main medicines suggested in the treatment of postligation cardiac syndrome (PLCS)-dobutamine or mirinone-possesses a more therapeutic effect. While doing this, clinicians are provided with a broader perspective on the treatment and follow-up of cases. The desire was to increase the treatability and monitor ability of the cases in question and hence their survivability. STUDY DESIGN A retrospective review of a cohort of infants with PLCS was conducted between March 2012 and December 2018. In the treatment of infants with PLCS, dobutamine (dobutamine study group-DSG) or milrinone (milrinone study group-MSG) was used. The respiration, cardiac, echocardiography, and perfusion parameters of the cases were assessed both before and after ligation. Based on the data obtained, both the effects of the medicines on PLCS and the difference between their therapeutic effects were studied. The accuracy of prognostication was assessed with receiver operating characteristic analyses. RESULTS PLCS was detected in 29 (34.1%) of 85 patent ductus arteriosus ligation cases in total. Of all the PLCS cases, 13 (44.8%) were treated with dobutamine and 16 (55.2%) with milrinone. It was observed that the effects of the medicines on the respiratory system and cardiovascular system manifested in the third and 6th hour, respectively. It was detected that both medicines had more effect on the systolic blood pressure (SBP) (area under the curve [AUC]: 0.997/0.996, p = 0.001/0.002) than on the diastolic blood pressure (AUC: 0.911/0.843, p = 0.032/0.046). CONCLUSION Dobutamine and milrinone, two primary medicines that can be used in the treatment of cases with PLCS, possess similar therapeutic effects on this pathology. In addition, their postoperative therapeutic effects on the SBP are more in the foreground.
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Affiliation(s)
- Levent Korkmaz
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ahmet Ozdemir
- Neonatology Unit, Department of Pediatrics, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Özge Pamukçu
- Division of Pediatric Cardiology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Tamer Güneş
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Mehmet Adnan Ozturk
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey
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Esen FH, Secilmis Y, Dogan M, Tubas F, Esen A, Bayram A, Gökahmetoglu S, Ozturk MA. Influenza A as a Common Viral Cause of Complex Febrile Seizures. J PEDIAT INF DIS-GER 2021. [DOI: 10.1055/s-0041-1731408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Objective The most common childhood convulsive disorder happens to be febrile seizure (FS), which is an important health problem leading to economic burden and parental anxiety. Further investigation into the etiological causes of FS will guide us for appropriate measures during the follow-up period. The aim of study was to identify the percentage of viral and bacterial pathogens in the etiological causes of children with FS, and also if there is any difference between simple and complex FSs.
Methods This prospective study randomly enrolled 100 pediatric patients with FS between January 2017 and July 2017. Nasopharyngeal swabs were obtained from all children at presentation. The respiratory panel was performed with a multiplex real-time polymerase chain reaction method to detect the 21 most common viruses. A complete blood count, absolute neutrophil count, absolute lymphocyte count, C-reactive protein, erythrocyte sedimentation rate, procalcitonin, blood culture, throat culture, urine analyses, urinary culture, and stool tests analysis were performed in all the patients.
Results During the study period, at least one virus was detected in 87% of patients. Bacterial agents were detected in only 13% of patients. Coinfections of the viruses and bacterial pathogens were found in 24% of patients. The most frequently detected virus was influenza A (Inf A) (18%), followed by rhinovirus (12%). Coinfections of the viruses and bacterial pathogens, mixed viral infections, and Inf A were common in children who experienced complex FS. Inf A was detected in 16% of patients with simple FSs and 30% of patients with complex FSs and a significant difference between them (p < 0.01).
Conclusion The results of this study showed that respiratory viral and bacterial pathogens are important in the etiology of FS in children. It is considered that complex FSs may be triggered by Inf A. The fact is viral pathogens are very common; therefore, antibiotics must be carefully prescribed. These results also draw attention to the use of the quadrivalent influenza vaccine in the prevention of FS related to the flu.
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Affiliation(s)
| | - Yılmaz Secilmis
- Department of Pediatric Emergency, Erciyes University, Kayseri, Turkey
| | - Murat Dogan
- Department of Pediatric Emergency, City Hospital, Kayseri, Turkey
| | - Filiz Tubas
- Department of Pediatrics, Kayseri City Hospital, Kayseri, Turkey
| | - Aydın Esen
- Department of Pediatrics, Kayseri City Hospital, Kayseri, Turkey
| | - Ayse Bayram
- Department of Pediatric Neurology, Kayseri City Hospital, Kayseri, Turkey
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Babaoglu H, Atas N, Varan O, Satis H, Bilici Salman R, Guler A, Karadeniz H, Ozturk MA, Haznedaroglu S, Goker B, Tufan A. Frequency, characteristics, and clinical determinants of 'prodrome' in familial Mediterranean fever patients. Scand J Rheumatol 2019; 49:154-158. [PMID: 31478409 DOI: 10.1080/03009742.2019.1638449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Prodrome is defined by manifestations that precede a familial Mediterranean fever (FMF) attack and predict its emergence. We aimed to determine the frequency, characteristics, and clinical determinants of prodrome in patients with FMF.Method: This cross-sectional study was conducted in a tertiary rheumatology clinic. During the clinical interview, all patients completed a standardized questionnaire about the pre-attack period. Prodrome was defined as the presence of any recurrent pre-attack manifestation occurring at least 4 h before an attack. Patients were classified according to whether they had prodrome of any kind of attack.Results: The study enrolled 401 patients aged 37.7 ± 11.0 years (mean ± sd). Male gender, M694V/M694V, homozygous MEFV mutation, peritonitis, pleuritis, and arthritis were more frequent in prodrome-positive patients. Altogether, 141 patients (35.2%) had prodrome. Male gender and ever having attack types of peritonitis or arthritis were independent clinical determinants of prodrome [relative risk (95% confidence interval): 1.72 (1.07-2.76), p = 0.02; 4.27 (1.80-10.1), p = 0.001; 1.77 (1.04-3.04), p = 0.04, respectively]. Age, MEFV mutations, pleuritis, and erysipelas-like erythema were not clinical determinants.Conclusions: All FMF patients, particularly males and patients who had peritonitis or arthritis at any time, should be questioned about prodrome. Prodrome should be analysed in terms of elucidating the pathogenesis of FMF and as an opportunity for a secondary prevention strategy for impending attacks. This study may shed light on prodrome for future cytokine or drug studies with the purpose of developing new cost-effective treatment protocols irrespective of colchicine resistance.
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Affiliation(s)
- H Babaoglu
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Gazi University, Ankara, Turkey
| | - N Atas
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Gazi University, Ankara, Turkey
| | - O Varan
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Gazi University, Ankara, Turkey
| | - H Satis
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Gazi University, Ankara, Turkey
| | - R Bilici Salman
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Gazi University, Ankara, Turkey
| | - A Guler
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Gazi University, Ankara, Turkey
| | - H Karadeniz
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Gazi University, Ankara, Turkey
| | - M A Ozturk
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Gazi University, Ankara, Turkey
| | - S Haznedaroglu
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Gazi University, Ankara, Turkey
| | - B Goker
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Gazi University, Ankara, Turkey
| | - A Tufan
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Gazi University, Ankara, Turkey
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Korkmaz L, Bastug O, Ozdemir A, Ceylan M, Gunes T, Ozturk MA, Korkut S. Can Platelet Mass Index Be a Parameter to Predict Intraventricular Hemorrhage in Very-Low-Birth-Weight Newborns? Am J Perinatol 2019; 36:1188-1197. [PMID: 30566999 DOI: 10.1055/s-0038-1676535] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Intraventricular hemorrhage (IVH) is an important problem in neonatal units not only in terms of its consequences but also its follow-up and the prediction of its emergence in newborns. In this study, we have compared platelet parameters such as platelet count (PC), mean platelet volume (MPV), and platelet mass index (PMI) in terms of IHV in very-low-birth-weight (VLBW) newborns. Thus, we have tried to determine platelet values to guide clinicians in both the prediction and follow-up of IVH. STUDY DESIGN This is a retrospective, multicenter, and case-controlled study. In this study, 386 cases of VLBW newborns (below 1,500 g) and gestational age below 32 weeks, hospitalized and monitored between August 8, 2012, and April 7, 2018, were included. The platelet values of the cases on their 12th hour postpartum (PC1, MPV1, and PMI1) and the platelet values on days 5 to 7 (PC2, MPV2, and PMI2) were recorded in their study cards. A p-value of <0.05 was accepted as statistically significant. RESULTS While there was no difference of PC1, MPV1, PMI1, PC2, or MPV2 values (p > 0.05), PMI2 values in the severe stage IVH group cases were found to be significantly lower compared with other platelet parameters (p < 0.05). CONCLUSION PMI2 values can provide clinicians with important knowledge that may aid them in recognizing important pathologies such as IVH.
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Affiliation(s)
- Levent Korkmaz
- Neonatalogy Unit, Malatya Training and Research Hospital, Malatya, Turkey
| | - Osman Bastug
- Neonatalogy Unit, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Ahmet Ozdemir
- Neonatalogy Unit, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Mahir Ceylan
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Tamer Gunes
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Adnan Ozturk
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Sabriye Korkut
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Bastug O, Fatih Sonmez M, Ozturk MA, Korkmaz L, Kesici H, Cilenk KT, Halis H, Korkut S, Ozdemir A, Bastug F, Gunes T, Kurtoglu S. Effects of Lycopene in Hyperoxia-Induced Lung Injury in Newborn Rats. INT J VITAM NUTR RES 2019; 88:270-280. [PMID: 31161929 DOI: 10.1024/0300-9831/a000238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this study was to evaluate the therapeutic effect of lycopene on a hyperoxia-induced lung injury model in rat pups. Full-term rat pups were included in the study 12-24 h after delivery. The pups were separated into 4 groups: normoxia control (NC), hyperoxia control (HC), hyperoxia + lycopene (HL), and normoxia lycopene (NL). The normoxia groups were housed in ambient air, and the hyperoxia groups in > 85% O2. HL and NL groups received 50 mg lycopene in oil/kg body weight/day delivered intraperitoneally (i.p.), the other groups received oil alone. On day 11, the rat pups were sacrificed and their lungs removed. Statistically significant injury was observed in all histological parameters measured (MLI, proliferating cell nuclear antigen (PCNA), and apoptosis) in the HC group (HC vs NC, p = 0.001). This injury could not be reversed with lycopene treatment (HC vs HL, 0.05; NC vs HL, p = 0.001). With hyperoxia, statistically significant decreases were observed in biochemical parameters in terms of SOD, MDA, and IL-6 values (HC vs NC: SOD, p = 0.02; MDA, p = 0.043; IL-6, p = 0.001). The use of lycopene did not provide any improvement in these values (HC vs HL, p > 0.05). Hyperoxia or lycopene had no effect on IL-1β and GPx (p > 0.05). When comparing NC and NL groups, negative effects were observed in the group given lycopene in terms of MLI, PCNA, apoptosis, and IL-6 (all parameters, p = 0.001). We observed that 50 mg lycopene in oil/kg body weight/day given via i.p. had no curative effect on the hyperoxia-induced lung injury in newborn rats and may even induce adverse effects.
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Affiliation(s)
- Osman Bastug
- 1 Neonatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Mehmet Fatih Sonmez
- 2 Histology and Embryology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | | | - Levent Korkmaz
- 1 Neonatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Hakan Kesici
- 3 Histology and Embryology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Kubra Tugce Cilenk
- 2 Histology and Embryology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Hulya Halis
- 1 Neonatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Sabriye Korkut
- 1 Neonatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Ahmet Ozdemir
- 1 Neonatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Funda Bastug
- 4 Pediatric Nephrology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Tamer Gunes
- 1 Neonatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Selim Kurtoglu
- 1 Neonatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
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Varan O, Kucuk H, Babaoglu H, Tecer D, Atas N, Bilici Salman R, Satıs H, Ozturk MA, Haznedaroglu S, Goker B, Tufan A. Chronic inflammation in adult familial Mediterranean fever patients: underlying causes and association with amyloidosis. Scand J Rheumatol 2019; 48:315-319. [PMID: 30786810 DOI: 10.1080/03009742.2018.1558282] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Chronic inflammation, as determined by persistently elevated acute-phase reactants in attack-free periods, can occasionally be observed in patients with familial Mediterranean fever (FMF) and is suggested to be a risk factor for the development of amyloidosis. We aimed to investigate the underlying causes of chronic inflammation in FMF patients and its association with amyloidosis in long-term follow-up. Method: Electronic medical records of FMF patients who had regular follow-up for ≥ 5 years in our cohort were utilized. As part of routine evaluation, detailed history, physical examination, and pertinent laboratory and radiographic investigations were performed in all patients to determine potential causes of elevated C-reactive protein (CRP) levels. Results: The study included 146 FMF patients who had no evidence of amyloidosis at baseline and had regular follow-up for ≥ 5 years. Thirty-seven patients (25.3%) were found to have chronic inflammation in the disease course. Twenty-five (67.5%) of them had either very frequent attacks or chronic manifestations of disease. In the entire study group, amyloidosis developed in five patients (3.42%) during the 5 year follow-up, four in the FMF with chronic inflammation group (10.8%), and only one of the 109 patients without chronic inflammation (odds ratio 13.09, 95% confidence interval 1.41-121.2). Conclusions: The results suggest that persistently high CRP levels during the attack-free periods may be a strong risk factor for the development of amyloidosis in patients with FMF. The vast majority of FMF patients with chronic inflammation had active FMF.
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Affiliation(s)
- O Varan
- a Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine , Gazi University , Ankara , Turkey
| | - H Kucuk
- b Department of Rheumatology , Erzurum Regional Education and Research Hospital , Erzurum , Turkey
| | - H Babaoglu
- a Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine , Gazi University , Ankara , Turkey
| | - D Tecer
- c Department of Rheumatology , Mehmet Akif İnan Education and Research Hospital , Şanlıurfa , Turkey
| | - N Atas
- a Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine , Gazi University , Ankara , Turkey
| | - R Bilici Salman
- a Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine , Gazi University , Ankara , Turkey
| | - H Satıs
- a Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine , Gazi University , Ankara , Turkey
| | - M A Ozturk
- a Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine , Gazi University , Ankara , Turkey
| | - S Haznedaroglu
- a Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine , Gazi University , Ankara , Turkey
| | - B Goker
- a Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine , Gazi University , Ankara , Turkey
| | - A Tufan
- a Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine , Gazi University , Ankara , Turkey
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Korkut S, Akin L, Hatipoglu N, Ozdemir A, Korkmaz L, Kendirci M, Dusunsel R, Gunes T, Ozturk MA, Kurtoglu S. Clinical Course and Follow-Up o Type 1 Pseudohypoaldosteronism. Erciyes Med J 2018. [DOI: 10.5152/etd.2018.0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Banerjee S, Califano R, Corral J, de Azambuja E, De Mattos-Arruda L, Guarneri V, Hutka M, Jordan K, Martinelli E, Mountzios G, Ozturk MA, Petrova M, Postel-Vinay S, Preusser M, Qvortrup C, Volkov MNM, Tabernero J, Olmos D, Strijbos MH. Professional burnout in European young oncologists: results of the European Society for Medical Oncology (ESMO) Young Oncologists Committee Burnout Survey. Ann Oncol 2018; 28:1590-1596. [PMID: 28449049 DOI: 10.1093/annonc/mdx196] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [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: 12/19/2016] [Indexed: 02/05/2023] Open
Abstract
Background Burnout in health care professionals could have serious negative consequences on quality of patient care, professional satisfaction and personal life. Our aim was to investigate the burnout prevalence, work and lifestyle factors potentially affecting burnout amongst European oncologists ≤40 (YOs). Methods A survey was conducted using the validated Maslach Burnout Inventory (MBI) and additional questions exploring work/lifestyle factors. Statistical analyses were carried out to identify factors associated with burnout. Results Total of 737 surveys (all ages) were collected from 41 European countries. Countries were divided into six regions. Results from 595 (81%) YOs were included (81% medical oncologists; 52% trainees, 62% women). Seventy-one percent of YOs showed evidence of burnout (burnout subdomains: depersonalization 50%; emotional exhaustion 45; low accomplishment 35%). Twenty-two percent requested support for burnout during training and 74% reported no hospital access to support services. Burnout rates were significantly different across Europe (P < 0.0001). Burnout was highest in central European (84%) and lowest in Northern Europe (52%). Depersonalization scores were higher in men compared with women (60% versus 45% P = 0.0001) and low accomplishment was highest in the 26-30 age group (P < 0.01). In multivariable linear regression analyses, European region, work/life balance, access to support services, living alone and inadequate vacation time remained independent burnout factors (P < 0.05). Conclusions This is the largest burnout survey in European Young Oncologists. Burnout is common amongst YOs and rates vary across Europe. Achieving a good work/life balance, access to support services and adequate vacation time may reduce burnout levels. Raising awareness, support and interventional research are needed.
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Affiliation(s)
- S Banerjee
- Gynaecology Unit Royal Marsden Hospital NHS Foundation Trust, Institute of Cancer Research, London
| | - R Califano
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - J Corral
- Department of Medical Oncology, University Hospital Virgen del Rocio, Seville, Spain
| | - E de Azambuja
- Department of Medical Oncology, Institute Jules Bordet, Brussels, Belgium
| | - L De Mattos-Arruda
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - V Guarneri
- Medical Oncology 2 and Department of Surgery, Oncology and Gastroenterology, Istituto Oncologico Veneto IRCCS, University of Padova, Padua, Italy
| | - M Hutka
- NHS Foundation Trust, University Hospital Southampton, Southampton, UK
| | - K Jordan
- Department of Internal Medicine V, Hematology, Oncology and Rheumatology, University Hospital of Heidelberg, Heidelberg, Germany
| | - E Martinelli
- Department of Experimental and Clinical Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - G Mountzios
- Department of Medical Oncology, University of Athens School of Medicine Clinical Therapeutics, Athens, Greece
| | - M A Ozturk
- Department of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - M Petrova
- Department of Medical Oncology, Military Medical Academy, Sofia, Bulgaria
| | - S Postel-Vinay
- Drug Development Unit, (DITEP), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - M Preusser
- Department of Medicine I, Vienna General Hospital (AKH) - Medical University of Vienna, Vienna, Austria
| | - C Qvortrup
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - M N M Volkov
- Oncology Department, Diagnostic Treatment Centre of International Institute of Biological Systems Dr. Sergey Berezin, St. Petersburg, Russian Federation
| | - J Tabernero
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D Olmos
- Prostate Cancer Clinical Research Unit, CNIO - Spanish National Cancer Research Center, Madrid.,Genitourinary Cancer Research Unit, Medical Oncology Department, CNIO-IBIMA Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Málaga, Spain
| | - M H Strijbos
- Department of Medical Oncology, AZ KLINA, Iridium Cancer Network, Brasschaat, Belgium
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Korkmaz L, Karaca C, Akin MA, Bastug O, Sahiner M, Ozdemir A, Gunes T, Ozturk MA, Kurtoglu S. Short-term Refractive Effects of Propranolol Hydrochloride Prophylaxis on Retinopathy of Prematurity in Very Preterm Newborns. Curr Eye Res 2017; 43:213-217. [PMID: 29135357 DOI: 10.1080/02713683.2017.1390769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Retinopathy of prematurity (ROP) is one of the major problems of surviving premature infants with several ophthalmic morbidities such as increased risk of refractive errors, strabismus, and cortical visual impairment. Use of propranolol hydrochloride (PH) for the prevention of ROP is a new promising treatment modality. However, long-term effects are still to be defined. In our study, we aimed to investigate the short-term refractive effects of PH used for ROP prophylaxis in very preterm newborns. METHODS This is a prospective, randomized, double-blind, placebo-controlled study. Very preterm newborns with a birthweight less than or equal to 1500 g and/or born prior to 32 gestational weeks were included in the study. The subjects were randomly divided into two groups: control group (CG, n = 37) given placebo and PH group (PHG, n = 34) given PH starting from 4 weeks after birth (27.1 ± 2.1 day). PHG patients received PH therapy for about 1 month (25.7 ± 7.8 day). Anthropometric measurements including weight, length, and head circumference were recorded before PH treatment (at birth) and during eye control (at corrected age). Cycloplegic refraction values were measured by retinoscopy at corrected age (CG: 10.3 ± 4.3 months, PHG: 11.4 ± 4.8 months). RESULTS Anthropometric measurements including gestational age, weight, length, and head circumference were similar at birth and corrected age in both groups. The mean level of spherical refraction was significantly less hyperopic in the PHG than in the CG (CG: 1.37 ± 1.40 D, PHG: 0.37 ± 1.44 D) (p = 0.005). CONCLUSION PH may lead to myopic shift by affecting the beta-adrenergic receptors in the choroid or ciliary body of the developing eye. Long-term refractive follow-up is required in order to elucidate the effects of PH on emmetropization process of these very preterm infants.
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Affiliation(s)
- Levent Korkmaz
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Cagatay Karaca
- b Department of Ophthalmology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Mustafa Ali Akin
- c Division of Neonatology , Kayseri Training and Research Hospital , Kayseri , Turkey
| | - Osman Bastug
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Mustafa Sahiner
- b Department of Ophthalmology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Ahmet Ozdemir
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Tamer Gunes
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Mehmet Adnan Ozturk
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Selim Kurtoglu
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey
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Sarici D, Kurtoglu S, Sarici SU, Yikilmaz A, Akin MA, Gunes T, Ozturk MA, Narin N, Dündar M, Serdar M. Evaluation of aortic intima-media thickness in newborns with Down syndrome. ADV CLIN EXP MED 2017; 26:1253-1256. [PMID: 29264883 DOI: 10.17219/acem/68677] [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] [Indexed: 11/24/2022]
Abstract
BACKGROUND Health care programs for children with Down syndrome (DS) help improve the overall outcome and quality of life of these children. It is therefore very important to focus on the most common and serious problems of these patients, such as congenital heart defects and cardiac problems, and to keep medical guidelines updated with regard to these problems. OBJECTIVES The aim of this study was to evaluate aortic intima-media thickness (aIMT), lipid profiles and blood pressure in DS patients in comparison with a control group of ageand gender-matched neonates without DS. MATERIAL AND METHODS Serum concentrations of lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride), blood pressure and abdominal aIMT were measured in newborns with DS, and compared with the measurements from ageand gender-matched newborns without DS. RESULTS No statistically significant differences between the 2 groups of newborns were detected with respect to aIMT, lipid levels or blood pressure. CONCLUSIONS This study represents the first investigation of aIMT - one of the most important indicators of atherosclerosis - in DS patients, but neither a significantly increased aIMT, nor any significant changes in lipid profiles or blood pressure were detected in this group of patients. Whether aIMT differs according to the type of congenital heart defect (such as atrial septal defect, ventricular septal defect, patent ductus arteriosus, and atrioventricular septal defect) among DS patients remains to be determined in future studies.
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Affiliation(s)
- Dilek Sarici
- Division of Neonatology, Department of Pediatrics, Keçiören Training and Research Hospital, Ankara, Turkey
| | - Selim Kurtoglu
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Serdar Umit Sarici
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ufuk University, Ankara, Turkey
| | - Ali Yikilmaz
- Department of Radiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mustafa Ali Akin
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Tamer Gunes
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Adnan Ozturk
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Nazmi Narin
- Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Munis Dündar
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Muhittin Serdar
- Department of Biochemistry, Faculty of Medicine, Acıbadem University, Istanbul, Turkey
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Bastug O, Korkmaz L, Halis H, Memur S, Korkut S, Ozdemir A, Gunes T, Ozturk MA, Kurtoglu S. Thyroid status of iodine deficient newborn infants living in central region of Turkey: a pilot study. World J Pediatr 2017; 13:479-484. [PMID: 28194694 DOI: 10.1007/s12519-017-0017-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 09/22/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Iodine deficiency (ID) during the fetal and neonatal periods can lead to neonatal hypothyroidism. This study was conducted to evaluate the effect of ID on the thyroid hormone level of newborns living in Turkey. METHODS Between 1998 and 2013, 71 newborns with a urinary iodine concentration <100 μg/L were recruited into the study. Data on thyroid volume, free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), and thyroglobulin (Tg) were collected from all newborns, and on breast milk iodine from their mothers. Infants who were classified as having congenital hypothyroidism (TSH >40 mU/L and fT4 <8.5 pmol/L) were treated with levothyroxine (n=26, T group), while the remaining infants remained untreated (n=45, UT group). Thyroid hormones were subsequently measured 7-14 days later in a sub-sample of both treated and untreated infants. RESULTS The average values at the time of admission were as follows [median (min-max)]. fT3: 5.0 (2.8-7.1) pmol/L, fT4: 7.7 (0.13-19.1) pmol/L, TSH: 75 (14-426) mU/L, Tg: 464 (226-1100) ng/mL, urinary iodine concentration (UIC): 30 (0-61) μg/L, breast milk iodine levels: 21 (10-150) μg/L, thyroid ultrasound (USG): 1.10 (0.24-1.95) mL for the T group; and fT3: 5.7 (1.7-12.7) pmol/L, fT4: 16.2 (9.9-33.5) pmol/L, TSH: 5.4 (0.63-41.8) mU/L, Tg: 171 (15-2124) ng/mL, UIC: 39 (0-90) μg/L, breast milk iodine levels: 47 (10-120) μg/L, thyroid USG: 0.75 (0.35-1.72) mL for the UT group. A significant difference was found between groups in respect to fT3, fT4, TSH and Tg levels. No significant difference in thyroid ultrasonography, UIC, and breast milk iodine levels was found between the two groups. The Tg levels of 50 out of 71 patients were measured, 40 (80%) of whom had Tg levels above the normal range (101 ng/mL). CONCLUSIONS In our country, despite the use of iodized salt, congenital hypothyroidism due to ID remains a problem. The Tg level of newborns can be used as a good indicator of ID.
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Affiliation(s)
- Osman Bastug
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Talas Street, Kayseri, 38039, Turkey.
| | - Levent Korkmaz
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Talas Street, Kayseri, 38039, Turkey
| | - Hulya Halis
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Talas Street, Kayseri, 38039, Turkey
| | - Seyma Memur
- Department of Neonatology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Sabriye Korkut
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Talas Street, Kayseri, 38039, Turkey
| | - Ahmet Ozdemir
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Talas Street, Kayseri, 38039, Turkey
| | - Tamer Gunes
- Department of Neonatology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Mehmet Adnan Ozturk
- Department of Neonatology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Selim Kurtoglu
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Talas Street, Kayseri, 38039, Turkey
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Abstract
OBJECTIVES To identify endocrinologic problems, particularly those concerning growth, in collodion babies (CBs). METHODS Clinically identified newborn CBs were included in the study group (group 1). Because CBs are generally born premature, small for gestational age (SGA), or both, a control group matched to the study group in terms of gestational age and birthweight (group 2) was also established. Blood specimens were collected from both groups for thyroid function tests and to measure serum growth hormone (GH), insulinlike growth factor 1 (IGF-1) and IGF binding protein-3 (IGFBP-3) levels. RESULTS Group 1 consisted of 42 CBs (25 male, 17 female) with gestational ages of 32 to 42 weeks and birthweights of 1,400 to 4,000 g. Twelve were assessed as premature and 17 as SGA. Serum IGF-1 and IGFBP-3 levels were lower and serum GH levels higher than in controls. Primary hypothyroidism was diagnosed in 10 patients in the study group, subclinical hypothyroidism in 2, and central hypothyroidism in 1. A statistically significant difference was determined between the groups in terms of primary hypothyroidism (p = 0.01). Serum GH levels were weakly negatively correlated with birthweight (correlation coefficient [r] = -0.32, p = 0.04) and serum IGF-1 (r = -0.38, p = 0.001) and IGFBP-3 (r = -0.36, p = 0.002) levels. CONCLUSION Premature birth and SGA are common in CBs. GH levels are high and IGF-1 and IGFBP-3 levels low at birth as a sign of GH resistance in these patients. The greater prevalence of hypothyroidism in these children is also significant.
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Affiliation(s)
- Ahmet Ozdemir
- Division of Neonatology , Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Sabriye Korkut
- Division of Neonatology , Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Selim Kurtoglu
- Division of Neonatology , Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey.,Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Nihal Hatipoglu
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Tamer Gunes
- Division of Neonatology , Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Adnan Ozturk
- Division of Neonatology , Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Kose M, Bastug O, Sonmez MF, Per S, Ozdemir A, Kaymak E, Yahşi H, Ozturk MA. Protective effect of vitamin D against hyperoxia-induced lung injury in newborn rats. Pediatr Pulmonol 2017; 52:69-76. [PMID: 27291304 DOI: 10.1002/ppul.23500] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/20/2016] [Accepted: 05/23/2016] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Preterm infants have risks of developing vitamin D deficiency. Thus we aimed to investigate the effect of vitamin D on hyperoxia-induced lung injury in newborn rats. METHODS Full term rat pups were included in the study 12-24 hr after delivery. The pups were randomly divided into eight groups as follows: normoxia control group (NC), normoxia plus vitamin D group (ND1, 1 ng/gr/day vitamin D), normoxia plus vitamin D group (ND2, 3 ng/gr/day vitamin D), normoxia plus vitamin D group (ND3, 5 ng/gr/day vitamin D), hyperoxia control group (HC), hyperoxia plus vitamin D group (HD1, 1 ng/gr/day vitamin D), hyperoxia plus Vitamin D group (HD2, 3 ng/gr/day vitamin D), hyperoxia plus vitamin D group (HD3, 5 ng/gr/day vitamin D). The histopathological effects of vitamin D were assessed by alveolar surface area (with mean linear intercept (MLI) method), apoptosis index and proliferating cell nuclear antigen (PCNA) index. RESULTS MLI values were significantly lower among three groups (HD1: 83.93 ± 1.95 μm, HD2: 81.76 ± 1.68 μm, and HD3: 82.33 ± 1.87 μm) when compared with HC group (92.98 ± 2.09 μm) (P = 0.001, P = 0.0004, P = 0.002, respectively). Apoptotic cell index were significantly lower among three treatment groups (HD1: 1.455 ± 0.153, HD2: 0.575 ± 0.079, and HD3: 0.700 ± 0.105) when compared with HC group (2.500 ± 0.263) (P = 0.001, P = 0.001, P = 0.001, respectively). Although PCNA positive cell index did not change in HD1 group (0.132 ± 0.008) (P > 0.05), there were significant increases in HD2 (0.277 ± 0.026) and HD3 (0.266 ± 0.018) group when compared with HC group (0.142 ± 0.010) (HD2 P = 0.001, HD3 P = 0.001). CONCLUSION Vitamin D seems to protect hyperoxia-induced lung injury in newborn rats. Pediatr Pulmonol. 2017;52:69-76. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Mehmet Kose
- Division of Pediatric Pulmonology Unit, Department of Pediatrics, Erciyes University, Kayseri, Turkey
| | - Osman Bastug
- Division of Neonatology, Department of Pediatrics, Kayseri Training and Research Hospital, Kayseri, Turkey
| | | | - Sedat Per
- Department of Biology, Bozok University, Yozgat, Turkey
| | - Ahmet Ozdemir
- Division of Neonatology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
| | - Emin Kaymak
- Department of Histology, Erciyes University, Kayseri, Turkey
| | - Hande Yahşi
- Department of Histology, Erciyes University, Kayseri, Turkey
| | - Mehmet Adnan Ozturk
- Division of Neonatology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
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Serdar Kutuk M, Bastug O, Ozdemir A, Adnan Ozturk M, Tuncay Ozgun M, Basbug M, Gunes T, Kurtoglu S. Relationship between maternal c-reactive protein level and neonatal outcome in patients with preterm premature rupture of membranes treated with Ampicillin and Azithromycin. J OBSTET GYNAECOL 2016; 36:772-777. [DOI: 10.3109/01443615.2016.1162772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Gunes T, Yildirim S, Ozdemir A, Gokahmetoglu S, Korkut S, Ozturk MA, Kurtoglu S. Maternal and cord blood hepcidin levels based on gestational weeks in term and preterm infants. Pediatric Hematology Oncology Journal 2016. [DOI: 10.1016/j.phoj.2016.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Artiran S, Atalay A, Gökahmetoglu S, Ozturk MA, Balci N, Cakir N, Kilic H, Durmaz R. Investigation of Rotavirus with Various Methods in Children with Acute Gastroenteritis and Determination of Its Molecular Epidemiology in Kayseri Province, Turkey. J Clin Lab Anal 2016; 31. [PMID: 27451970 DOI: 10.1002/jcla.22030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 06/21/2016] [Accepted: 07/01/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND In this study, the fresh stool samples from 254 children under 5 years of age with acute gastroenteritis which were delivered between October 2012 and December 2013 were collected. METHODS In the stool samples, rotavirus antigens were investigated using two different immunochromatographic methods which are routinely used at different times, namely the RIDA® QUICK Rotavirus/Adenovirus Combi Test (R-Biopharm AG, Germany) and the Genx® Rotavirus Test (Diamed-Lab, Turkey), in addition to the Rotavirus Ag (Stool) ELISA (DRG, Germany) kit. The results were compared with reverse transcriptase PCR (RT-PCR). RESULTS When the Genx® Rotavirus Test and RIDA® QUICK Rotavirus/Adenovirus Combi Test immunochromatographic methods were compared with RT-PCR, their sensitivity and specificity were found as 97.1%, 100%, and 80.4%, 72%, respectively. As to the Rotavirus Ag (Stool) ELISA method, on the other hand, its sensitivity was found to be 95.1% and its specificity was 86.5%. The most common genotype was G9P[8] (40%), which was followed by the G1P[8] (18.7%) and G3P[8] (9.6%) genotypes. CONCLUSION Consequently, it was revealed that the sensitivity of ELISA and immunochromatographic methods, which provide results in a short time and are used in the investigation of rotavirus antigen, was high and their specificity was low; further studies to determine the distribution of G and P genotypes will contribute to establishing strategies for vaccine development for rotavirus in the world.
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Affiliation(s)
- Sukran Artiran
- Department of Medical Microbiology, Faculty of Medicine, University of Erciyes, Kayseri, Turkey
| | - Altay Atalay
- Department of Medical Microbiology, Faculty of Medicine, University of Erciyes, Kayseri, Turkey
| | - Selma Gökahmetoglu
- Department of Medical Microbiology, Faculty of Medicine, University of Erciyes, Kayseri, Turkey
| | - Mehmet Adnan Ozturk
- Department of Paediatrics, Faculty of Medicine, University of Erciyes, Kayseri, Turkey
| | - Nurgul Balci
- Department of Medical Microbiology, Faculty of Medicine, University of Erciyes, Kayseri, Turkey
| | - Nuri Cakir
- Department of Medical Microbiology, Faculty of Medicine, University of Erciyes, Kayseri, Turkey
| | - Huseyin Kilic
- Department of Medical Microbiology, Faculty of Medicine, University of Erciyes, Kayseri, Turkey
| | - Riza Durmaz
- Molecular Microbiology Research and Application Laboratory, Refik Saydam National Public Health Agency, Ankara, Turkey
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Korkmaz L, Baştuğ O, Ozdemir A, Korkut S, Karaca C, Akin MA, Gunes T, Kurtoglu S, Ozturk MA. The Efficacy of Propranolol in Retinopathy of Prematurity and its Correlation with the Platelet Mass Index. Curr Eye Res 2016; 42:88-97. [PMID: 27260268 DOI: 10.3109/02713683.2016.1158272] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Retinopathy of Prematurity (ROP) is a proliferative vitreoretinopathy which is one of the most frequent causes of blindness in children. In an attempt to find a solution to this important problem in preterm children, the search for new, effective treatment modalities with fewer side effects is underway. In our study, which was planned for this reason, we aimed to investigate the effects of propranolol treatment applied to cases of ROP in various stages during the second phase (known as the neovascularization-hypoxia phase) and to determine the correlation of these effects with the platelet mass index (PMI). METHOD A total of 171 preterm infants at risk of ROP were selected randomly for inclusion in the study. All of the patients were classified according to their stage of ROP and were divided into control and treatment groups. While the cases in the control group were administered physiological saline solution, those in the treatment group were administered propranolol in the period that corresponded to the second stage of the disease. The thrombocyte and PMI values in the first and second stages of each study group were recorded. RESULTS A significant difference was found between the control and treatment groups of the stage 2 ROP study subjects. In the stage 2 ROP study group, no significant difference was detected between the control and treatment cases in terms of platelet counts in phase 1 or in the PMI values and the thrombolytic counts in phase 2. On the other hand, in phase 2 of the stage 2 ROP study subjects significant differences were detected between the control and treatment group in terms of PMI values. CONCLUSION In the study, it was found in the stage 2 ROP study group that propranolol reduced the need for laser photocoagulation significantly. Also, in parallel to the efficacy of propranolol in this study group, a decrease was observed in PMI values.
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Affiliation(s)
- Levent Korkmaz
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Osman Baştuğ
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Ahmet Ozdemir
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Sabriye Korkut
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Cagatay Karaca
- b Department of Ophthalmology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Mustafa Ali Akin
- c Division of Neonatology , Kayseri Training and Research Hospital , Kayseri , Turkey
| | - Tamer Gunes
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey.,d Division of Pediatric Intensive Care , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Selim Kurtoglu
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey.,e Division of Pediatric Endocrinology , Erciyes University Medical Faculty , Kayseri , Turkey
| | - Mehmet Adnan Ozturk
- a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey.,f Division of Pediatric Emergency , Erciyes University Medical Faculty , Kayseri , Turkey
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Kuşkonmaz ŞM, Mercan R, Ozturk MA. A case of chronic lymphocytic leukemia still taking etanercept for ankylosing spondylitis. Acta Reumatol Port 2016; 41:90-91. [PMID: 27115116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The possible risk of hematologic malignancies in anti TNF users is a matter of debate. Whether associated with the drug or not, how to behave when a hematologic malignancy is discovered in the course of anti TNF treatment remains unanswered. Here we present a 66 year old male patient who had AS for 30 years and had been on etanercept for the last two years and who is diagnosed with B cell chronic lymphocytic leukemia (CLL) stage 1. The patient is still on etanercept for 5 years after the diagnosis without any progression in CLL.
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Ozturk MA, Kardas Z, Kardas F, Gunes T, Kurtoglu S. Effects of L-carnitine supplementation on respiratory distress syndrome development and prognosis in premature infants: A single blind randomized controlled trial. Exp Ther Med 2015; 11:1123-1127. [PMID: 26998047 DOI: 10.3892/etm.2015.2964] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 01/05/2015] [Accepted: 11/25/2015] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to investigate the efficacy of L-carnitine therapy on the occurrence and prognosis of respiratory distress syndrome (RDS). A single blind, randomized controlled trial study was conducted on 130 infants with gestational ages of 28-36 weeks. Infants were assigned to experimental groups (groups 1 and 2) and control groups (groups 3 and 4). Groups 1 and 3 consisted of infants with RDS, and groups 2 and 4 groups were composed of infants without RDS. The experimental groups were treated with carnitine. No statistically significant differences in serum carnitine levels were detected between the study and the control groups on day 1 of treatment (P=0.06). However, on day 7 of treatment, serum carnitine levels in the experimental groups were significantly increased (P=0.02), as compared with the control groups. The surfactant requirement value, which is how many rounds of surfactant therapy were required, was 1.56±0.97 in group 1, and 2.12±0.99 in group 3 (P<0.001). The mean duration of mechanical ventilation required was 3.04±3.60 days in group 1, and 4.73±5.63 days in group 3 (P<0.001). The present results indicate that carnitine supplementation in premature infants with RDS may help to increase carnitine levels, thus decreasing the duration of mechanical ventilation and surfactant requirement.
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Affiliation(s)
- Mehmet Adnan Ozturk
- Department of Pediatrics, Division of Neonatology, Erciyes University, School of Medicine, Kayseri 38039, Turkey
| | - Zehra Kardas
- Department of Pediatrics, State Educational and Research Hospital of The Government, Kayseri 38039, Turkey
| | - Fatih Kardas
- Department of Pediatrics, Division of Pediatric Nutrition and Metabolism, Erciyes University, School of Medicine, Kayseri 38039, Turkey
| | - Tamer Gunes
- Department of Pediatrics, Division of Neonatology, Erciyes University, School of Medicine, Kayseri 38039, Turkey
| | - Selim Kurtoglu
- Department of Pediatrics, Division of Neonatology, Erciyes University, School of Medicine, Kayseri 38039, Turkey
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Bastug O, Gunes T, Korkmaz L, Elmali F, Kucuk F, Adnan Ozturk M, Kurtoglu S. An evaluation of intra-hospital transport outcomes from tertiary neonatal intensive care unit. J Matern Fetal Neonatal Med 2015; 29:1993-8. [DOI: 10.3109/14767058.2015.1072158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Sarici D, Gunes T, Yazici C, Akin MA, Korkmaz L, Memur S, Kurtoglu S, Ozturk MA, Sarici SU. Investigation on malondialdehyde, S100B, and advanced oxidation protein product levels in significant hyperbilirubinemia and the effect of intensive phototherapy on these parameters. Pediatr Neonatol 2015; 56:95-100. [PMID: 25261050 DOI: 10.1016/j.pedneo.2014.06.006] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 05/25/2014] [Accepted: 06/19/2014] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND The parameters of oxidative stress [advanced oxidation protein products (AOPPs), malondialdehyde (MDA), and S100B] and the effect of intensive phototherapy (PT) on these parameters have not been studied extensively in newborns with significant hyperbilirubinemia (SH). We aimed to measure the levels of MDA, S100B, and AOPPs in newborns with SH, and to compare newborns with healthy control newborns without hyperbilirubinemia on the basis of these parameters of oxidative stress. In addition, we investigated the effect of intensive PT on these parameters during the treatment of SH and report our findings for the first time in the literature. METHODS The study was performed in newborns (n = 62) who underwent intensive PT because of SH. Newborns without jaundice constituted the control group (n = 30). Both groups were compared with respect to demographic characteristics and biochemical (laboratory) parameters including MDA, AOPPs, and S100B. MDA, AOPPs, and S100B were also compared before and after intensive PT in the PT group. In the study group, a correlation analysis of demographic characteristics; MDA, AOPP, and S100B values; and changes occurring in MDA, AOPPs, and S100B values due to the effect of intensive PT was performed. RESULTS Serum total bilirubin, S100B, and MDA levels in the PT group before performing PT were significantly higher than those in the control group. In newborns receiving PT serum total bilirubin, MDA and AOPP levels decreased significantly after intensive PT. In correlation analysis, a statistically significant negative correlation was found only between the amount of bilirubin decrease with PT and AOPP levels after PT in the study group. CONCLUSION Whether the significant decrease in MDA levels, which was higher prior to PT, is due to the decrease in serum bilirubin levels or due to the effect of intensive PT itself remains to be determined in further studies. The decrease in AOPP levels after PT implies that intensive PT has protective effects on oxidative stress.
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Affiliation(s)
- Dilek Sarici
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey.
| | - Tamer Gunes
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Cevat Yazici
- Department of Biochemistry, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Mustafa Ali Akin
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Levent Korkmaz
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Seyma Memur
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Selim Kurtoglu
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Mehmet Adnan Ozturk
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Serdar Umit Sarici
- Division of Neonatology, Department of Pediatrics, Ufuk University Faculty of Medicine, Ankara, Turkey
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Kose M, Elmas T, Gokahmetoglu S, Ozturk MA, Ekinci D, Elmali F, Halis H, Bastug O. Predictive value of gelsolin for the outcomes of preterm neonates: a pilot study. Pediatr Int 2014; 56:856-859. [PMID: 24862494 DOI: 10.1111/ped.12391] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/02/2014] [Accepted: 05/13/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Plasma gelsolin is a circulating actin-binding protein that has a protective role against tissue injuries. Our aim was to compare the baseline levels of gelsolin in premature infants with neonatal outcomes. METHODS A total of 32 preterm neonates born at 23-32 weeks of gestation were enrolled in the study. RESULTS Plasma gelsolin levels at 72 h were significantly lower in patients with respiratory distress syndrome, in patients who were administered surfactant therapy and in patients who developed sepsis (P < 0.05). Plasma gelsolin levels at 28 days were significantly lower in patients who developed bronchopulmonary dysplasia and retinopathy of prematurity (P < 0.05). CONCLUSIONS Low plasma gelsolin levels in the first postnatal month may be associated with poor outcomes in premature infants.
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Affiliation(s)
- Mehmet Kose
- Department of Pediatrics, Division of Pediatric Pulmonology Unit, Erciyes University, Kayseri, Turkey
| | - Tuba Elmas
- Department of Pediatrics, Division of Pediatric Pulmonology Unit, Erciyes University, Kayseri, Turkey
| | | | - Mehmet Adnan Ozturk
- Department of Pediatrics, Division of Neonatology, Erciyes University, Kayseri, Turkey
| | - Duygu Ekinci
- Department of Pediatrics, Division of Pediatric Pulmonology Unit, Erciyes University, Kayseri, Turkey
| | - Ferhan Elmali
- Department of Biostatistics and Bioinformatics, Erciyes University, Kayseri, Turkey
| | - Hulya Halis
- Department of Pediatrics, Division of Neonatology, Erciyes University, Kayseri, Turkey
| | - Osman Bastug
- Department of Pediatrics, Division of Neonatology, Erciyes University, Kayseri, Turkey
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Kurtoglu S, Bastug O, Daar G, Halis H, Korkmaz L, Memur S, Korkut S, Gunes T, Ozturk MA. Effect of iodine loading on the thyroid hormone level of newborns living in Kayseri province. Am J Perinatol 2014; 31:1087-92. [PMID: 24683071 DOI: 10.1055/s-0034-1371701] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Excessive iodine exposure during the fetal and neonatal periods can lead to neonatal hypothyroidism. This study was conducted to evaluate the level of iodine loading among newborns living in Kayseri province. A total of 59 newborns, who were admitted due to disorders in thyroid hormone levels, were included in the study. Materials and METHODS Among the patients who applied with thyroid hormone dysfunction, newborns with a spot urine iodine level ≥ 20 μg/dL were included in the study between the years 2003 and 2013. Free T3 (fT3), free T4 (fT4), thyroid stimulating hormone (TSH), thyroglobulin (Tg), breast milk iodine, thyroid ultrasonography, and control measurements of fT3, fT4, TSH, and Tg levels were obtained accordingly from both groups of patients who received or did not receive treatment. RESULTS The average age of the patients was 15 days with a 36/23 girl to boy ratio. Statistically, no significant difference was noticed between all the girls and boys with respect to all the measured values. The etiologic search showed that out of 59 cases, in 18 cases (30.5%) only the mother and in 19 cases only the newborns (32.2%) had a history of povidone iodine exposure; in 8 cases both mothers and their babies had exposure to povidone iodine (13.6%). In 14 cases (23.7%), the source of iodine loading could not be determined. Levothyroxine (L-thyroxine) treatment was initiated in 56% of the patients (n = 33). Out of 33 patients who were under treatment with L-thyroxine, in 13 cases only the mother had history of povidone iodine exposure; in 12 cases, only the baby had a history of povidone iodine exposure; in 1 case, both mother and her baby had a history of povidone iodine exposure, but the etiology could not be found in 7 cases. CONCLUSION The use of antiseptics-containing iodine for mothers before and after birth and for newborns, especially for umbilical cleansing, can lead to iodine loading and hypothyroidism. If transient hypothyroidism develops within this period, then it may not be detected promptly. This can later lead to retardation in psychomotor development and disorder in learning skills during the childhood period.
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Affiliation(s)
- Selim Kurtoglu
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Osman Bastug
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ghaniya Daar
- Department of Pediatrics, Bozok University Medical Faculty, Yozgat, Turkey
| | - Hulya Halis
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Levent Korkmaz
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Seyma Memur
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Sabriye Korkut
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Tamer Gunes
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Mehmet Adnan Ozturk
- Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey
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Kose M, Ozturk MA, Poyrazoğlu H, Elmas T, Ekinci D, Tubas F, Kurt T, Goktas MA. The efficacy of nebulized salbutamol, magnesium sulfate, and salbutamol/magnesium sulfate combination in moderate bronchiolitis. Eur J Pediatr 2014; 173:1157-60. [PMID: 24687251 DOI: 10.1007/s00431-014-2309-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/24/2014] [Accepted: 03/24/2014] [Indexed: 11/28/2022]
Abstract
UNLABELLED The aim of this paper is to compare the effect of nebulized magnesium sulfate to nebulized salbutamol and salbutamol/magnesium sulfate on successful discharge from the emergency department. A total of 56 infants were included in this double-blinded, prospective study. Infants were grouped according to the nebulized treatment they received: group 1-salbutamol/normal saline, group 2-magnesium sulfate and normal saline, and group 3-salbutamol plus magnesium sulfate. Heart beat, bronchiolitis, clinical severity scores (CSS), and oxygen saturation of the patients were determined before and after nebulization (0, 1, 4 h). The patients were monitored for adverse reactions. Post-treatment mean CSS results were significantly lower than pre-treatment scores in all groups at 4 h with no significant difference within groups. CSS scores were lower in the salbutamol/magnesium sulfate group when compared with the magnesium sulfate and salbutamol groups (3.4 (2.4-4.3), 4.7 (3.8-5.7), 4.0 (3.2-4.3)). CSS were significantly lower than those from the magnesium sulfate group. CONCLUSION Nebulized magnesium sulfate plus salbutamol may have additive effects for improving the short-term CSS.
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Affiliation(s)
- Mehmet Kose
- Department of Pediatric Pulmonology, Erciyes University Faculty of Medicine, Pediatric Pulmonology Unit, Kayseri, 38000, Turkey,
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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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- O O Eren
- Department of Medical Oncology, Yeditepe University Hospital, Istanbul, Turkey.
| | - M A Ozturk
- Department of Internal Medicine, Yeditepe University Hospital, Istanbul, Turkey
| | - O Sonmez
- Department of Medical Oncology, Yeditepe University Hospital, Istanbul, Turkey
| | - B Oyan
- Department of Medical Oncology, Yeditepe University Hospital, Istanbul, Turkey
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- M A Ozturk
- Erciyes University Medical Faculty, Department of Neonatology, Kayseri, Turkey
| | - O Bastug
- Erciyes University Medical Faculty, Department of Neonatology, Kayseri, Turkey
| | - H Halis
- Erciyes University Medical Faculty, Department of Neonatology, Kayseri, Turkey
| | - L Korkmaz
- Erciyes University Medical Faculty, Department of Neonatology, Kayseri, Turkey
| | - S Memur
- Erciyes University Medical Faculty, Department of Neonatology, Kayseri, Turkey
| | - D Sarici
- Erciyes University Medical Faculty, Department of Neonatology, Kayseri, Turkey
| | - A Kara
- Erciyes University Medical Faculty, Department of Pediatrics, Kayseri, Turkey
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Esad Koklu
- Department of Paediatrics, School of Medicine, Erciyes University, Kayseri, Turkey.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Tamer Gunes
- Division of Neonatology, Department of Paediatrics, School of Medicine, Erciyes University, Kayseri, Turkey.
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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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Affiliation(s)
- Dilek Sarici
- Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- M Ozbek
- Department of Endocrinology and Metabolism, Dıskapı Y.B. Education and Research Hospital, Ministry of Health, Ankara, Turkey
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Derya Buyukkayhan
- Department of Neonatology, Cumhuriyet University School of Medicine, Sivas, Turkey.
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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. J BUON 2009; 14:511-514. [PMID: 19810147] [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] [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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Affiliation(s)
- M A Ozturk
- Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey.
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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. J BUON 2009; 14:309-311. [PMID: 19650184] [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] [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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Affiliation(s)
- F Dane
- Division of Medical Oncology, Department of Pathology, Marmara University School Medicine, Istanbul, Turkey.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- M Bicakcigil
- Department of Rheumatology at Yeditepe University, Faculty of Medicine, Istanbul, 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] [What about the content of this article? (0)] [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] [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 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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Affiliation(s)
- Selim Kurtoglu
- Department of Paediatrics, Division of Neonatology and Paediatric Endocrinology & Metabolism, School ofMedicine, Erciyes University, Kayseri, Turkey.
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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] [What about the content of this article? (0)] [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] [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: 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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Affiliation(s)
- G A Daysal
- Gazi University, School of Medicine, Department of Internal Medicine, Ankara, Turkey
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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] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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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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Affiliation(s)
- Esad Koklu
- Department of Paediatrics, School of Medicine, Erciyes University, Kayseri, 38039, Turkey.
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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] [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: 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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Affiliation(s)
- Tamer Gunes
- Department of Paediatrics, Division of Neonatology,, School of Medicine, Erciyes University, Kayseri, Turkey
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Esad Koklu
- Division of Neonatology, Erciyes University, Kayseri, Turkey.
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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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Affiliation(s)
- T Gunes
- Division of Neonatology, Department of Paediatrics, School of Medicine, Erciyes University, Kayseri, Turkey
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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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Affiliation(s)
- Tamer Gunes
- Department of Pediatric Intensive Care, Division of Hematology and Oncology, Erciyes University, School of Medicine, 38039 Kayseri, Turkey.
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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] [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: 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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Affiliation(s)
- Tamer Gunes
- Erciyes University, School of Medicine, Department of Pediatrics, Division of Neonatology, Department of Biochemistry, Kayseri, Turkey
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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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Affiliation(s)
- Mehmet Adnan Ozturk
- Department of Paediatrics, Division of Neonatology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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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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Affiliation(s)
- Mehmet Adnan Ozturk
- Department of Pediatrics, Division of Neonatology, Erciyes University, School Medicine, Kayseri, Turkey
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