TALIJANSKI DOPRINOS TURSKOJ PEDIJATRIJI ZA OSMANSKOG CARSTVA

The Ottoman Empire maintained close relations with the neighbouring Italian city states in the 16th and 17th century. Yacub Pasha (1425-1481), personal physician of Mehmed II the Conqueror, was an Italian Jew who advanced to the title of pasha and vizier. Domenico Hierosolimitano (ca. 1552–1622), the third physician to Sultan Murad III, was a Jerusalemite rabbi. His book is an important source about everyday life and medical practice in Istanbul at the time. Nuh bin Abd al-Mennab (1627-1707), also of Italian stock, was the Chief Physician of the Ottoman Empire, who translated a pharmacopoeia into Turkish. In the same century, two Italians, Israel Conegliano (Conian) and Tobia Cohen became private physicians to leading Ottoman pashas and the Grand Vizier. A. Vuccino (1829-1893) and Antoine Calleja Pasha (1806-1893) taught at the Istanbul Medical School. Italy was a favoured country for medical education during the early period of Ottoman westernisation. Sanizade Mehmet Ataullah Efendi (1771-1826) translated the first medical book printed in the Ottoman Empire from Italian into Turkish. Mustafa Behcet Efendi (1774-1833), chief physician to the Sultan and the founder of the first western medical school in Turkey, translated several medical books from Italian into Turkish. The first printed pharmacopeia in the Ottoman Empire was also originally Italian In the 19th century, Edouard Ottoni and his son Giuseppe Ottoni were well-known military pharmacists, both under the name of Faik Pasha. Probably the most influential physician of Italian origin was Giovanni Battista Violi (1849-1928), who had practiced paediatrics in Turkey for more than fifty years. Violi was the founder of the first children’s hospital, the first vaccine institute, and the first paediatric journal in the Ottoman Empire.U XVI. i XVII. stoljeću Osmansko je Carstvo bilo u bliskim odnosima sa susjednim talijanskim gradovima-državama. Osobni liječnik Mehmeda II. Osvajača, Jakub Paša (1425.– 1481.), bio je talijanski Židov koji je napredovao do titule paše, a poslije i vezira. Domenico Hierosolimitano (oko 1552.–1622.), treći liječnik sultana Murada III., bio je jeruzalemski rabin. Njegova je knjiga važan izvor saznanja o svakodnevnom životu u Istanbulu, koja opisuje i medicinsku praksu toga vremena. Nuh bin Abd al-Mennab (1627.–1707.), također talijanskog podrijetla, bio je glavni liječnik Osmanskog Carstva, koji je farmakopeju preveo na turski. U istom su stoljeću dva Talijana, Israel Conegliano (Conian) i Tobia Cohen, postali osobni liječnici najvećih turskih paša i velikog vezira. A. Vuccino (1829.–1893.) i Antoine Calleja Paša (1806.–1893.) predavali su na Medicinskom fakultetu u Istanbulu. Kad se Osmansko Carstvo počelo okretati Zapadu, Italija je bila najomiljenije odredište za medicinsko obrazovanje. Sanizade Mehmed Ataulah Efendi (1771.–1826.) preveo je s talijanskoga prvi medicinski udžbenik tiskan u Osmanskom Carstvu. Mustafa Behcet Efendi (1774.–1833.), glavni sultanov liječnik i osnivač prvoga medicinskog fakulteta zapadnoga tipa u Turskoj, preveo je nekoliko medicinskih udžbenika s talijanskog na turski. Prva tiskana osmanska farmakopeja također je prevedena s talijanskog. U XIX. su se stoljeću Edouard Ottoni i njegov sin Giuseppe Ottoni, obojica pod imenom Faik Paša, proslavili kao vojni ljekarnici. Vjerojatno najutjecajniji liječnik talijanskog podrijetla bio je Giovanni Battista Violi (1849.–1928.) koji je u Turskoj više od pola stoljeća držao pedijatrijsku praksu te osnovao prvu pedijatrijsku bolnicu i imunološki zavod te prvi pedijatrijski časopis

Zurnazen Mustafa Paşa

Zurnazen Mustafa Paşa, takriben 1595-1597 yılları arasında doğmuştur. Doğum yeri bilinmemekle birlikte kaynaklarda Arnavut asıllı olduğu yazılıdır. Sarayda yetiştirilip Mehterhane-i Amire’de zurnacı başının denetimi altında bölük arkadaşlarıyla birlikte zurna çaldığı bilinmektedir. Baş mimar Kasım Ağa’nın damadıdır. Payitahttaki ilk görevi kapıcubaşılık idi. Zurnazen Mustafa Paşa, Seyfiye ’de yetişip Kalemiye sınıfına geçmiştir. Yedi yıl içerisinde has odabaşılıktan sadrazamlığa kadar yükselmiştir. Has odabaşılıktan Rumeli Beylerbeyliğine geçmiş, oradan da sırasıyla belli süreler defterdarlık, Karaman ve Temeşvar Eyaletlerinde yöneticilik yapmış, Bozcaada’da muhafızlık görevinde bulunmuş, 1655 yılında Kaptan-ı Derya olmuştur. Kaptan-ı Derya iken çeşitli deniz seferlerine katılmıştır. 1656 yılında getirildiği sadaret makamında 6 saat kalmış ve azledilerek Erzurum’a vali olarak atanmıştır. Kısa bir süre sonra da vefat etmiştir. İkinci defa defterdarlık makamına getirildiğinde çok başarılı olduğu, devletin mali yapısına katkı sağladığı ve kaptan-ı deryalığının da çok başarılı olduğu yazmaktaydı. Mehterhanede zurna çaldığı için Zurnazen lakabını almıştır. Sultana özgü mehter bölüğü içinde görev yapardı. Ser mehteranlık ve emiri âlemlik görevlerinde bulunduğu da tahmin edilmektedir

Tatlısu ekosisteminde endişe yaratan kirleticiler: Türkiye’den bir vaka çalışması

The current study evaluated certain emerging contaminants in the Susurluk sub-basin, an area under significant anthropogenic pollution pressure. Polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), organochlorine insecticides, and microplastics were investigated both from surface and sediment samples collected in dry and wet seasons. γ-HCH and β-HCH were detected in the dry season from Kocaçay River reaching the Marmara Sea. Dieldrin concentrations were also very high in river sediments during the dry season. Nilüfer Stream is a significant waterway close to industrial and urban areas and under impact of pollution due to high concentrations of PCBs, DDT, and its’ metabolites. Sediment samples contained higher levels of contaminants: DDT and metabolites were found in sediments from almost all stations. According to the Hazard quotient coefficient, all detected pollutants were found to be >1, indicating a high risk in the river system. Fiber was the dominant microplastic. The water quality of Nilüfer Stream was poor/bad in quality both in dry and wet seasons, while Kocaçay River was moderate and poor/bad quality in dry and wet seasons, respectively. The findings of bacterial growth augmented and worsened water quality in the river basin with coliforms dominating, as assessed at the genus/species level and were very abundant.Bu çalışma, önemli antropojenik kirlilik baskısı altındaki bir alan olan Susurluk alt havzasında ortaya çıkan bazı endişe yaratan kirleticiler değerlendirmiştir. Kurak ve yağışlı mevsimlerde toplanan yüzey ve sediman örneklerinde poliklorlu bifeniller (PCBler), polibromlu bifeniller difenil eterler (PBDEler), organoklorlu insektisitler ve mikroplastikler araştırılmıştır. γ-HCH and β-HCH, Kocaçay Nehri’nin Marmara Denizi’ne dökülen bölgesinde kurak mevsimde tespit edilmiştir. Dieldrin konsantrasyonları da kurak mevsim boyunca nehir sedimanlarında çok yüksektir. Nilüfer çayı endüstriyel ve kentsel alanlara yakın olan önemli bir su yoludur ve yüksek konsantrasyondaki PCBler, DDT ve metabolitleri nedeniyle kirlilik etkisi altındadır. Sediman örnekleri daha yüksek seviyede kirletici içermektedir: DDT ve metabolitleri neredeyse tüm istasyonlardan alınan sediman örneklerinde bulunmuştur. Tehlike oranı katsayısına (Hazard Quotient) göre tesbit edilen tüm kirleticiler >1 olarak bulunmuş ve bu da nehir sisteminde yüksek risk olduğunu göstermiştir. Mikroplastikler içinde fiber en baskın olanıdır. Nilüfer Çayı’nın su kalitesi hem kurak hem de yağışlı sezonda kötü iken, Kocaçay Nehri’nin su kalitesi kurak mevsimde orta ve yağışlı mevsimde kötüdür. Cins/tür düzeyinde değerlendirildiğinde koliformların hakim olduğu ve çok miktarda olan bakteriyel büyüme bulguları da nehir havzasındaki su kalitesini kötüleştirmiştir

Determination of persistent organic pollutants in water and sediment samples from Kızılırmak River

Yasaklanmalarının üzerinden onlarca yıl geçmesine rağmen kalıcılıkları nedeniyle hala doğada bulunabilen Kalıcı organik kirleticiler (KOK)’den organik klorlu pestisit (OCP), polibromlu difenileter (PBDE) ve poliklorlu bifenil (PCB)’ler sedimentte birikerek çevre ve iklim koşullarına bağlı olarak suya geri salınmaktadırlar. Kızılırmak Nehri ise İç Anadolu Bölgesi’nden doğarak Karadeniz’e dökülen on ilin sınırları içinden geçen Türkiye’nin en uzun nehridir. Kızılırmak Nehri’nin Kırıkkale sınırları içindeki bölümü üzerinde organize sanayi bölgesi, petrokimya ve silah tesisleri bulunmakta, şehrin kanalizasyon deşarjı da nehre yapılmaktadır. Bu nedenle suda bulunan ve sedimentte birikmiş olan KOK’ların miktarı nehrin suyunun kullanıldığı bölgeler için önem taşımaktadır. Bu çalışmada Haziran 2018 ile Mayıs 2019 tarihleri arasındaki 1 yıl boyunca toplanan 60 sediment ve 60 su örneğinde 9 OCP (α, β, γ-hekzaklorosiklohekzan, hekzaklorobenzen, heptaklor, 4,4’- diklorodifenil dikloroetan- 4,4’-DDE, 4,4’-diklorodifenil dikloroetilen- 4,4’-DDD, 2,4’-diklorodifenil trikloroetan- 2,4’-DDT, 4,4’-diklorodifenil trikloroetan- 4,4’-DDT), 7 PCB (28, 52, 101, 118, 138, 153, 180) ve 6 PBDE (17, 47, 66, 100, 153, 183) olmak üzere toplam 22 KOK’un miktarına bakılarak varsa mevsimsel değişikliklerin ortaya konulması amaçlanmıştır. Yapılan analizler sonucunda en sık tespit edilen KOK’un 4,4’-DDE, kalıntı konsantrasyonunun en yüksek olduğu ayın ise Ağustos olduğu belirlenmiştir.The organic chlorinated pesticide (OCP), polybrominated diphenylether (PBDE) and polychlorinated biphenyls (PCBs), which can be found in nature due to their persistence even decades after their prohibition, are deposited in sediment and released back to water depending on environmental and climatic conditions. Kızılırmak, the longest river of Turkey, passes through ten provinces and flows from the Central Anatolia to the Black Sea. There is an organized industrial zone, petrochemical and weapon facilities on Kızılırmak River within Kırıkkale border and the city’s sewage is discharged into the river. Therefore, the amount of persistent organic pollutants (POPs) present in water and deposited in sediment is important for the areas where river water is used. In this study, it was aimed to determine the seasonal changes, if any, by evaluating the total amount of 22 POPs; 9 OCPs (α, β, γ-hexachlorocyclohexane, hexachlorobenzene, heptachlor, 4,4'- dichlorodiphenyldichloroethane-4,4'-DDE, 4,4'-dichlorodiphenyldichloroethylene-4,4'-DDD, 2,4'- dichlorodiphenyl trichloroethane-2,4'-DDT, 4,4'-dichlorodiphenyl trichloroethane-4,4'-DDT), 7 PCBs (28, 52, 101, 118, 138, 153, 180) and 6 PBDEs (17, 47, 66, 100, 153, 183) in 60 sediment and 60 water samples collected for 1 year between June 2018 and May 2019. The most frequently detected POP was 4,4'-DDE and the highest residue concentration was in August

Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza- Tanzania

Neonatal sepsis is a significant cause of morbidity and mortality in neonates. Appropriate clinical diagnosis and empirical treatment in a given setting is crucial as pathogens of bacterial sepsis and antibiotic sensitivity pattern can considerably vary in different settings. This study was conducted at Bugando Medical Centre (BMC), Tanzania to determine the prevalence of neonatal sepsis, predictors of positive blood culture, deaths and antimicrobial susceptibility, thus providing essential information to formulate a policy for management of neonatal sepsis. This was a prospective cross sectional study involving 300 neonates admitted at BMC neonatal unit between March and November 2009. Standard data collection form was used to collect all demographic data and clinical characteristics of neonates. Blood culture was done on Brain Heart Infusion broth followed by identification of isolates using conventional methods and testing for their susceptibility to antimicrobial agents using the disc diffusion method. Among 770 neonates admitted during the study period; 300 (38.9%) neonates were diagnosed to have neonatal sepsis by WHO criteria. Of 300 neonates with clinical neonatal sepsis 121(40%) and 179(60%) had early and late onset sepsis respectively. Positive blood culture was found in 57 (47.1%) and 92 (51.4%) among neonates with early and late onset neonatal sepsis respectively (p = 0.466). Predictors of positive blood culture in both early and late onset neonatal sepsis were inability to feed, lethargy, cyanosis, meconium stained liquor, premature rupture of the membrane and convulsion. About 49% of gram negatives isolates were resistant to third generation cephalosporins and 28% of Staphylococcus aureus were found to be Methicillin resistant Staphylococcus aureus (MRSA). Deaths occurred in 57 (19%) of neonates. Factors that predicted deaths were positive blood culture (p = 0.0001), gram negative sepsis (p = 0.0001) and infection with ESBL (p = 0.008) or MRSA (p = 0.008) isolates. Our findings suggest that lethargy, convulsion, inability to feed, cyanosis, PROM and meconium stained liquor are significantly associated with positive blood culture in both early and late onset disease. Mortality and morbidity on neonatal sepsis is high at our setting and is significantly contributed by positive blood culture with multi-resistant gram negative bacteria

Proteomics Mapping of Cord Blood Identifies Haptoglobin “Switch-On” Pattern as Biomarker of Early-Onset Neonatal Sepsis in Preterm Newborns

Intra-amniotic infection and/or inflammation (IAI) are important causes of preterm birth and early-onset neonatal sepsis (EONS). A prompt and accurate diagnosis of EONS is critical for improved neonatal outcomes. We sought to explore the cord blood proteome and identify biomarkers and functional protein networks characterizing EONS in preterm newborns.We studied a prospective cohort of 180 premature newborns delivered May 2004-September 2009. A proteomics discovery phase employing two-dimensional differential gel electrophoresis (2D-DIGE) and mass spectrometry identified 19 differentially-expressed proteins in cord blood of newborns with culture-confirmed EONS (n = 3) versus GA-matched controls (n = 3). Ontological classifications of the proteins included transfer/carrier, immunity/defense, protease/extracellular matrix. The 1(st)-level external validation conducted in the remaining 174 samples confirmed elevated haptoglobin and haptoglobin-related protein immunoreactivity (Hp&HpRP) in newborns with EONS (presumed and culture-confirmed) independent of GA at birth and birthweight (P<0.001). Western blot concurred in determining that EONS babies had conspicuous Hp&HpRP bands in cord blood ("switch-on pattern") as opposed to non-EONS newborns who had near-absent "switch-off pattern" (P<0.001). Fetal Hp phenotype independently impacted Hp&HpRP. A bayesian latent-class analysis (LCA) was further used for unbiased classification of all 180 cases based on probability of "antenatal IAI exposure" as latent variable. This was then subjected to 2(nd)-level validation against indicators of adverse short-term neonatal outcome. The optimal LCA algorithm combined Hp&HpRP switch pattern (most input), interleukin-6 and neonatal hematological indices yielding two non-overlapping newborn clusters with low (≤20%) versus high (≥70%) probability of IAI exposure. This approach reclassified ∼30% of clinical EONS diagnoses lowering the number needed to harm and increasing the odds ratios for several adverse outcomes including intra-ventricular hemorrhage.Antenatal exposure to IAI results in precocious switch-on of Hp&HpRP expression. As EONS biomarker, cord blood Hp&HpRP has potential to improve the selection of newborns for prompt and targeted treatment at birth

Ambient air pollution and the fetus

There is a growing evidence on the hazards of ambient air pollution on fetal development. Several review articles have been published on the adverse fetal outcomes including low birth weight, preterm birth, small-for-gestational age, and congenital anomalies. Recent studies have linked ambient air pollution to gestational hypertension, and preeclampsia which may be related to the detrimental effect of ambient air pollution on placental growth and function. Short-term and long-term exposure to particulate air pollution may cause systemic inflammatory response which may trigger preterm delivery in pregnant women. Environmental toxic chemicals that alter intrauterine environment disregulates fetal epigenome causing epigenetic-mediated changes in gene expression that may be linked to later childhood and adulthood diseases. Exposure to ambient air pollution during the whole pregnancy especially in third-trimester may cause intrauterine vitamin D deficiency which is critical for the normal development of the lung, and immune system in fetus. However, more research is needed to understand the cause and effect interaction between air pollution and fetal development.   Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy) · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge researc

Neonatal maltreatment and brain development

The early childhood years are a period of rapid change in the brain. During early childhood, the brain forms and refines a complex network of connections through synaptogenesis, pruning, and myelination. The development of the brain is regulated by genes, which interact profoundly with early experience. There are sensitive periods for development of certain capabilities. These refer to critical windows of time in the developmental process when certain parts of the brain may be most susceptible to particular experiences during its development. Most functions of the human brain result from a complex interplay between genetic potential and appropriately timed experiences. Early postnatal experiences play a major role in shaping the functional capacity of the neural systems responsible for mediating our cognitive, emotional, social and physiological functions. When the necessary experiences are not provided at the optimal times, these neural systems do not develop in optimal ways. Adverse environments and experiences during the neonatal period can dramatically affect the development of the hypothalamic-pituitary-adrenal axis (HPA axis) that underlies adaptive behavioral responses. Early life stress programs HPA axis development and exerts profound effects on neural plasticity, with resultant long-term influences on neurobehavior. Animal studies show that not only are these neurobiological changes long lasting, but that they too can be passed on to future generations via non-genetic transmission. Olfactory, auditory, visual and tactile stimulation may serve as an important cue for brain development exerting specific effects on neuroendocrine systems regulating social and emotional behavior which may have consequences for subsequent generations of offspring.   Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy) · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgio