Tiroid fonksiyonunun prematüre bebeklerde patent duktus arteriozus üzerine etkisi

Amaç: Patent duktus arteriyozus PDA ile konjenital hipotiroidi arasındaki ilişkinin araştırılmasıdır. Gereç ve Yöntem: Çalışmaya Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi Yenidoğan Ünitesinde Ocak 2015- Aralık 2017 tarihleri arasında yatan, doğumda gestasyon haftas

PREMATÜRE BEBEKLERDE TRANSFÜZYON ÖNCESİ VE TRANSFÜZYON SONRASI NO, VEGF, IGF-1, IGFBP-3 DÜZEYLERİ VE PREMATÜRE RETİNOPATİSİ ÜZERİNE ETKİLERİ

ROP tüm tarama programlarına ve tedavi alanındaki gelismelere ragmen prematüre bebeklerin önemli bir körlük sorunu olarak yerini korumaktadır. Gelisimi multifaktöriel olan ROP için ilk tanımlandıgı 1942 yılından günümüze kadar birçok neden suçlanmıstır. Bunlardan bir tanesi de eritrosit transfüzyonu olup ROP olusumundaki etkisi tam olarak aydınlatılabilmis degildir. Eritrosit transfüzyonunun ROP gelisimine etkisinin oksidatif stres ve her eritrosit transfüzyonu ile bebeklerde artan demir yüküne baglı serbest radikaller yolu ile oldugu iddia edilmis ancak tam olarak aydınlatılamamıstır. Diger taraftan simdiye kadar ROP üzerine etkili oldugu bilinen ve sentez asamaları kan oksijen düzeyinden etkilenen mediatörler olan NO, VEGF, IGF–1, IGFBP–3’ ün eritrosit transfüzyonu ile düzeylerinin degisimi ve bu yolla ROP üzerine etkileri simdiye kadar arastırılmamıstır. Bu çalısmada mediatörlerin eritrosit transfüzyonu ile düzeylerinin degisimi ve ROP üzerine etkileri arastırılmıstır. Çalısmada mediatör düzeylerinin eritrosit transfüzyonu ile degismedigini, ancak eritrosit transfüzyonunun ROP sıklıgını artırdıgı gösterilmistir. Bu durumda eritrosit transfüzyonu ile ROP iliskisini arastırmak için yeni çalısmalara ihtiyaç oldugu sonucuna varılmıstır. Öte yandan ileri evre ROP gelismis olan bebeklerde erken dönemde ortalama IGF–1 düzeyi 30 ng/ml olan kritik düzeyin altında bulunmus ve erken dönemde beslenmenin önemi bir kez daha vurgulanmıstır.Despite all scanning programs and developments in treatment, retinopathy of prematurity (ROP) is still the major cause of visual loss in premature infants. Several factors have been claimed to be cause of multifactorial ROP since 1942 when first recognised. One the them is erythrocyte transfusion that its role in establishment of ROP has not yet been fully understood. Erythrocyte transfusion effect has been thought to depend on oxidative stress and free radicalls of increased iron load in erythrocyte transfused infants. Bu it has not been completely highlighted. On the other hand, NO, VEGF, IGF–1, IGFBP–3 level alteration that has been proven to be effective on ROP and affected from blood oxygen by erythrocyte transfusion and consequently their role on ROP establishment has not been investigated so far. n this study, we have analyzed the mediators variation through erythrocyte transfusion and their impact on ROP. n our investigation, we have realised that there is no mediator variation through erythrocyte transfusion, however, it augments the frequency of ROP incidence. So, we have recommended fresh works for better understanding of relationship between erythrocyte transfusion and ROP incidences. At the same time, in advanced phase infant ROP incidence subjects with early stage IGF–1 30 ng/ml has been found to be under critical level and stressed once again on the importance of early stage nutrition

Is Serum Procalcitonin Level A Reliable Indicator In Early Diagnosis Of Congenital Pneumonia?

The clinical signs in congenital pneumonia mimic other conditions like transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS). Differential diagnosis is difficult since laboratory findings have limited value. Procalcitonin (PCT) is an important and widely studied marker of infection. The aim of this study was to determine the diagnostic value of PCT in newborn patients hospitalized in the neonatal intensive care unit (NICU) with the diagnosis of congenital pneumonia. The infants with respiratory distress who were born at Hacettepe University between 2005-2015 and hospitalized in the NICU were included in the study. A total of 200 newborn infants; 54 (27%) infants with congenital pneumonia (Group-1), 42 (21%) infants with TTN (Group-2), 40 (20%) infants with RDS (Group-3) and 64 (32%) healthy infants (group-4), were included in the study. There was no statistically significant difference between the groups for serum C-reactive protein (CRP) levels, sampling time for PCT and CRP and the characteristics of the mother (p> 0.05). Mean serum PCT level was higher in the congenital pneumonia group than in the other groups (p< 0.001). Result of this study shows that procalcitonin is an important early marker in the diagnosis of congenital pneumonia.WoSScopu

Accidental Oral Administration of Povidone Iodine in A Newborn: Case Report

Iodine solutions are widely used as antiseptic for treating and preventing wound infections. Povidone iodine, one of the most common topical iodine solutions in emergency kits, can lead to several abnormalities as thyroid dysfunction. Povidone iodine poisoning is unusual and previously reported effects are mainly complications of topical usage during surgical procedures. Here we present the case of a newborn that was accidentally given oral povidone iodine, showing no signs or symptoms of toxicity after ingestion.WoSScopu

Perfusion Index and Pleth Variability Index in the First Hour of Life According to Mode of Delivery

Perfusion index (PI) is a relative assessment of the pulse strength at the monitoring site. The plethysmographic variability index (PVI, pleth variability index) is a noninvasive and continuous measure of the dynamic change in PI that occurs during respiratory cycles. In this study PI and PVI changes were compared in babies born with cesarean section (C/S) or spontaneous vaginal delivery (SVD); 125 healthy term infants were monitored with pulse oxymeter after first ten minutes of life. Data were recorded from this monitor on a personal computer and analyzed by generalized estimating equations (GEE) method. Pulse rate was lower in babies born via SVD. Perfusion index were higher in C/S group. Pleth variability index were higher in C/S group. Higher pulse rate, PI and PVI values in babies born via C/S may be indicative of more significant hemodynamic changes in these infants during early transitional period after birth.WoSScopu

Mineralogical and geochemical evidence of late epithermal alteration in the Kisladag porphyry gold deposit, Usak, Western Turkey

The Kisladag porphyry gold deposit is related to Miocene intrusive and sub-volcanic rocks that resulted from an extensional tectonic regime in western Anatolia. The main lithologies of the deposit are quartz-trachytes to quartz-latites and volcanoclastic rocks intruded by sub-volcanic porphyritic rocks. Three different intrusive phases which have been identified from their age, alteration grade and mineralization (IN-1: the oldest intrusion, intense potassic alteration, IN-212A: intense clay-quartz alteration, IN-3: the youngest intrusion, weak alteration). IN-1 contains quartz, illite and kaolinite, IN-2A has quartz, adularia, illite, kaolinite and smectite. Alunite, jarosite and tourmaline increase in IN-1 and IN-2A; whereas biotite and illite increase in IN-1 and IN-2A, respectively. The volcanoclastic rocks are composed of quartz, alunite and kaolinite/halloysite indicating advanced argillic alteration. Although the microscopic data confirms potassic and phyllic alterations in IN-1 and IN-2A, mineralogical (well crystallized 1M and poorly crystallized 1 M-d illite, kaolinite/halloysite, alunite, jarosite) and geochemical (K/Ar age data for different grain-sized illite indicating late overprinting at least 5 Ma) data indicate that the early stage alteration phases were overprinted by the late stage epithermal alteration

A Novel Mutation in the SLC19A2 Gene in a Turkish Female with Thiamine-responsive Megaloblastic Anemia Syndrome

Reported here is a 2-year-old girl who was diagnosed to have thiamine-responsive megaloblastic anemia during evaluations for her bilateral neurosensorial deafness. Besides reporting a new mutation on the gene SLC19A2 for the first time in the literature, we highlight the recognition of this syndrome-when megaloblastic anemia and diabetes mellitus coexists-and the role of thiamine replacement for the treatment of both disorders

Are serum nitric oxide and vascular endothelial growth factor levels affected by packed red blood cell transfusions?

Background: Nitric oxide (NO) and vascular endothelial growth factor (VEGF) are important mediators for hemodynamics and angiogenesis in the body. NO coming from endothelial cells and red blood cells is particularly effective in hypoxic vasodilation. VEGF has known effects on the induction of NO synthesis and is also known to be affected by blood product transfusions. The objectives of this study were to measure NO and VEGF levels before and after packed red blood cell (PRBC) transfusions. Study design and methods: Blood was drawn from preterm newborns before and 30 min after PRBC transfusions and samples were used for NO and VEGF measurements. NO end products nitrite and nitrate were measured by modified Greiss method, VEGF levels measured by double sandwitch ELISA method. Vital signs including heart rate and blood pressure were also recorded. Results: Thirty four newborns were included in the study and overall 54 transfusion episodes were assessed for mediator levels. No difference was observed between the mediator levels before and after PRBC transfusions. Vital signs were also unchanged. Conclusion: As there was no change in NO end product levels with PRBC transfusions, it might suggest that hypoxia was not severe enough to cause nitrite increase; however, other NO sources might still be active. VEGF levels were found to be unchanged and may reflect a delayed effect of transfusion on VEGF induction. Keywords: NO, VEGF, PRBC transfusio

Cost-effectiveness of rotavirus vaccination in Turkey

Background/Purpose: Cost-effectiveness studies about rotavirus (RV) vaccination programs were performed in many countries due to the severe economic burden of RV infections. This study is an economic evaluation performed to assess the potential for introducing the RV vaccine to the Turkish National Immunization Program. Methods: In this retrospective clinical study, the records and laboratory findings of a total of 4126 patients admitted to Turgut Ozal University Hospital, Ankara, Turkey with acute gastroenteritis were analyzed. A model described by Parashar et al. was used to obtain the annual episodes of diarrhea, hospitalization and outpatients visits in Turkey. Monovalent and pentavalent vaccination was assumed to protect in average 85\% of RV acute gastroenteritis. All costs are expressed in 2012 United States (US) \$, where US\$1 equals 1.8 Turkish Liras (TL). Losses of labor costs were not taken into consideration. Results: The vaccination program with 85\% coverage was cost effective and cost saving compared to no vaccination. A projected birth cohort of 1.25 million children was followed until 5 years of age; a routine vaccination could potentially avert 210,994 cases of diarrhea treated in outpatient hospital facilities and 42,715 hospitalizations. The RV associated economic burden was obtained as US\$17,909 million per year (US\$14.33 per birth annually) in medical direct costs by using the national level of RV diarrhea disease burden estimates. For monovalent and pentavalent vaccination, assuming a cost of US\$31.5 and US\$38 per vaccine course, the cost of the vaccination program was estimated to be approximately US\$37,878 million and US\$45,475 million, respectively. Conclusion: At a cost per vaccine course of US\$31.5 for monovalent and US\$38 for pentavalent vaccine, routine RV vaccination could be potentially cost effective and also cost saving in Turkey. National RV vaccinations will play a significant role in preventing RV infections. Copyright (C) 2016, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC