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Objectives: Nucleus accumbens plays an important role in opioid addiction. Topiramate, increases postsynaptic gamma-aminobutyric acid receptor activity and antagonizes glutamatergic activity. Brain-derived neurotrophic factor (BDNF), which plays a key role in synaptic plasticity, is produced from proBDNF. The aim of this study is to investigate the effects of 100 μM topiramate applied into the lateral ventricle or nucleus accumbens on naloxone-induced morphine withdrawal and the BDNF/proBDNF ratio in the frontal cortex. Methods: In the study, 36 adult male Wistar rats weighing 250–350 g were used. Morphine dependence was created with morphine pellets following guide cannula implantations. Withdrawal findings were evaluated in naloxone-induced morphine withdrawal syndrome following topiramate administration, and locomotor activity measurements were performed simultaneously. The brains of sacrificed animals were removed for determination of BDNF/ proBDNF ratio. Results: Topiramate administered by either route significantly suppressed the number of jumps in morphine withdrawal. Topiramate applied into the nucleus accumbens significantly reduced stereotypical behavior in morphine withdrawal, but did not cause any changes in other locomotor activity behaviors. Topiramate applied into the lateral ventricle significantly decreased the BDNF/proBDNF ratio, whereas administered into the nucleus accumbens significantly increased this ratio. Conclusion: The findings of this study indicate that topiramate administered into the lateral ventricle and nucleus accumbens reduces naloxone-induced morphine withdrawal symptoms, stereotypical locomotor activity, and changes the BDNF/proBDNF ratio.

Introduction: Hyperpolarization-activated cyclic nucleotide-gated (HCN) channel currents of Ih and absence epilepsy seizures are associated, but studies reveal differential results. Objective: In our study, we aimed to investigate the role of the HCN channels on the expression of spike-and-wave discharges (SWDs) using the Genetic Absence Epilepsy Rats from Strasbourg (GAERS) model. Methods: HCN isoform levels from isolated brains of both naïve nonepileptic Wistar and GAERS groups were evaluated by enzyme-linked immunosorbent assay. ZD7288, an Ih inhibitor as well as an HCN channel antagonist, was administered intracerebroventricularly to the adult GAERS groups, and to evaluate their SWD activities, electroencephalography was recorded. The effect of ZD7288 on the cumulative total duration and number of SWDs and the mean duration of each SWD complex was evaluated. Results: The HCN2 levels in the cortex and hippocampus of the GAERS group were lower compared to the naïve nonepileptic Wistar group (p < 0.05). ZD7288 increased the number of SWDs at the 20th and 120th min with the highest administered dose of 7 μg (p < 0.05). Conclusion: The Ih inhibitor ZD7288 increased the number of SWDs in a genetic absence epilepsy rat model, although this increase may not be significant due to the inconsistent time-dependent effects. In GAERS, the cortical and hippocampal HCN2 channel levels were significantly lower compared to the control group. Further studies are needed with higher doses of ZD7288 to determine if the effects will increase drastically.

SUMMARY OBJECTIVE Vesicoureteral reflux (VUR) represents one of the most significant risk factors for acute pyelonephritis in children. Various intravesical and extravesical techniques have been described for the surgical correction of VUR. The aim of our study was to compare the results of open intravesical and extravesical procedures for unilateral primary VUR in children. METHODS Between January 2012 and August 2018, 38 children with primary VUR who underwent open ureteral reimplantation surgery were retrospectively reviewed. The Cohen (intravesical) and the Lich-Gregoir (extravesical) approach were grouped as groups A and B, respectively. The groups were compared for age, gender, preoperative reflux grade, presence of lower urinary tract symptoms, operation time, discomfort and pain, analgesic requirements, duration of hematuria, postoperative complications, and hospital stay. All the parameters were statistically compared. RESULTS There were 38 patients in this study. Group A had 18 patients, and group B had 20 patients. The mean operative time was significantly shorter in group B than in group A. The mean hospital stay was also shorter in group B. The urethral foley stay period was 4.7±0.9 days 2±0 days (p = 0.000*), respectively, for group A and B. Macroscopic hematuria was seen in group A. The objective pain scale was worse after intravesical surgery. Analgesic requirements were higher in group A (p =0.131). CONCLUSION Intravesical and extravesical ureteroneocystostomy methods are equally successful and feasible in the treatment of primary unilateral VUR. The Cohen technique is associated with a longer and more painful hospital stay, gross hematuria, and longer operative time, compared to the Lich-Gregoir technique. RESUMO OBJETIVO O Refluxo Vesicoureteral (RVU) representa um dos mais importantes fatores de risco para pielonefrite aguda em crianças. Diversas técnicas intra e extravesicais já foram descritas para a correção cirúrgica do RVU. O objetivo do nosso estudo é comparar os resultados de procedimentos extravesicais e intravesicais abertos para o tratamento de RVU primário unilateral em crianças. METODOLOGIA Entre janeiro de 2012 e agosto de 2018, 38 crianças com RVU primário foram submetidas a cirurgia aberta de reimplante ureteral. Esses casos foram retrospectivamente revisados. As abordagens de Cohen (intravesical) e Lich-Gregoir (extravesical) foram agrupadas nos grupos A e B, respectivamente. Os grupos foram comparados quanto à idade, sexo, grau de refluxo pré-operatório, presença de sintomas no trato urinário inferior, tempo de operação, desconforto e dor, necessidade de analgésicos, duração de hematúria, complicações pós-operatórias e tempo de internação. Todos os parâmetros foram comparados estatisticamente. RESULTADOS No total, 38 pacientes foram incluídos neste estudo. O grupo A teve 18 pacientes e o grupo B, 20. O tempo médio de operação foi significativamente menor no grupo B do que no grupo A. O tempo médio de internação também foi menor no grupo B. O tempo de uso do foley uretral foi de 4,7 ± 0,9 dias e 2±0 dias (p = 0,000*) , respectivamente, para o grupo A e B. Hematúria macroscópica foi observada no grupo A. A pontuação na escala objetiva de dor foi pior após a cirurgia intravesical. A necessidade de analgésicos foi maior no grupo A (p = 0,131). CONCLUSÃO As técnicas extravesicais e intravesical de ureteroneocistostomia são igualmente bem-sucedidas e viáveis para o tratamento de RVU primário unilateral. A técnica de Cohen está associada a um período de internação mais longo e mais doloroso, hematúria e maior tempo operatório, em comparação com a técnica de Lich-Gregoir.

Diabetes mellitus is one of the most common chronic systemic diseases seen in children. The increasing prevalence of Type 1 diabetes mellitus (T1DM) among children is alarming. Although olfaction has been found to be altered in some adult T1DM subjects, it is unknown whether this is the case in children and, if so, whether the dysfunction adversely influences their quality of life (QOL).Using the Pediatric Smell WheelThe PSW scores were lower in the T1DM patients than in the controls (9.17 vs 10.37; p 0.0001), although, in both cases, the scores fell within the normal range for individuals of their age (i.e., at or above 80%). Interestingly, such scores were lower in left-handed than in right-handed patients (8.00 vs 9.46; p = 0.001). Lower QOL indices were also found for the T1DM than for the controls for the domains of Emotional Function (p = 0.02), Social Function (p = 0.014), School Function (p = 0.011), and Psychosocial Status (p = 0.002). No significant associations were evident between PSW scores and disease duration and QOL scales.Our study demonstrates, for the first time, that modest decrements in smell function are evident in children with TIDM.

Aim: Adiponectin, which is mainly produced by adipocytes, has antidiabetic, antiatherosclerotic and anti-inflammatory activities. We analyzed serum adiponectin levels and their relationship with metabolic parameters, fever and acute phase reactants in children with nonspecific infections and tried to analyze whether adiponectin has a role in the processes of inflammation and fever during infections. Materials and Methods: In this study, we studied serum adiponectin levels in 42 prepubertal children admitted with fever≥38°C and symptoms of nonspecific infections. The children’s ideal body weights for their heights were within 100% and 110%. The venous blood samples were collected both in the first admission with fever and three days after the fever dropped (control visit) for the analysis of serum adiponectin levels, complete blood count, erythrocyte sedimentation rate, C reactive protein, High-sensitive CRP, fibrinogen, ferritin, glucose, and insulin levels. The glucose/insulin rate and Homeostasis model assessment of insulin resistance and body mass index were calculated. Results: The serum adiponectin levels of the children in the first admission were lower than those in the control visit (8.80±1.71µg/ml vs 12.04±2.38µg/ml)(p=0.000). The serum adiponectin levels were not correlated with the body temperature, body weight, ideal body weight for height, body mass index, Homeostasis model assessment of insulin resistance, and all other parameters analyzed in the study (p>0.05) in both admissions except the glucose/insulin ratio and leukocyte counts of the children in the first admission. The serum adiponectin levels were positively correlated with the glucose/insulin ratio and leukocyte counts in the first admission (r=0.338,p=0.029; r=0.304,p=0.05 respectively). Conclusion: It is not known why the serum adiponectin levels of the children were different in the admission with fever than those in the control visit during the recovery phase. The change in adiponectin levels during the acute infection have raised some questions regarding whether serum adiponectin levels may be an acute phase reactant and if it might be involved in the processes of inflammation and fever.

To examine asymmetric dimethylarginine (ADMA) level as an endothelial function parameter in addition to ultrasonographic evaluation of carotid arteries in babies born small for gestational age (SGA).Twenty-six neonates born SGA and 34 appropriate for gestational age (AGA) controls were included in the study. The serum levels of ADMA were measured. Intima-media thickness (cIMT) and resistive index (cRI) of the both carotid arteries were determined by ultrasonography.The mean ADMA level was higher in SGA neonates compared to AGAs (16 267.7 ± 6050 versus 12 810.2 ± 3302 ng/L; p = 0.01). The mean cIMT (0.34 ± 0.02 versus 0.31 ± 0.03 mm; p = 0.001) and cRI (0.66 ± 0.07 versus 0.61 ± 0.04, p = 0.003) were also higher in SGAs. Serum ADMA levels were positively correlated to the mean cIMT (r = 0.41, p = 0.001). Although there was a weak correlation between cIMT and mean cRI (r = 0.26, p = 0.04), no correlation was found between ADMA and mean cRI (r = 0.17, p = 0.18).Neonates born SGA have elevated cord blood ADMA level in addition to thicker IMT and higher RI of carotid arteries at birth. ADMA was correlated to cIMT, suggesting that higher ADMA levels might influence vascular health in later life in these neonates.

Objective: Cardiac catheterization is one of the basic procedures applied in the diagnosis and treatment of cardiovascular diseases. Development of thrombosis is a serious complication of catheterization. In this study, the frequency and the factors affecting the development of arterial thrombosis were prospectively evaluated in neonates who were subjected to diagnostic or interventional cardiac catheterization. Methods: Twenty newborns that received femoral artery catheterization within 6-month period were enrolled in this study. Blood samples were taken for complete blood count, prothrombin, activated partial thromboplastin time, INR ratio and mutations of factorV Leiden, prothrombin 20210A, methylenetetrahydrofolate reductase C667T and A1298 before the procedure. 100 U/kg bolus of heparin was infused during catheterization. 28 U/kg/hour infusion of heparin was given to the patients with clinically suspected thrombosis during first few hours after catheterization. Doppler ultrasonography was performed in all patients within 6 hours after catheterization. Results: The gestational age of patients ranged from 31 to 40 weeks (median 39). Mean birth weight was 2996 ± 589 (1880-4000 gr). Arterial thrombosis was detected in 10 patients by Doppler USG. On development of arterial thrombosis, patient age, gender, diagnosis, treatments, platelet count, hemoglobin, prothrombin and activated partial thromboplastin time values, FactorV Leiden, prothrombin 20210A, methylenetetrahydrofolate reductase C667T and A1298 mutations were found as not impacting (p>0.05). Those who were found to have thrombosis in Doppler ultrasonography had lower INR levels compared to others (p= 0.023). Conclusions: The rate of femoral arterial thrombosis in newborns after catheterization detected by Doppler ultrasonography was 50% in this study. Our data suggest that early clinical assessment for the diagnosis of thrombosis may be misleading but Doppler ultrasonography may be helpful early detection. Further studies are needed to prediction appropriate drugs and/or doses for prevention of thrombosis after arterial catheterization in newborns.

Objective To determine the changes in serum C-reactive protein (CRP) levels during therapeutic hypothermia. Study Design Between January 2011 and June 2013, 133 hypoxic-ischemic encephalopathy patients being followed up in the neonatal intensive care unit of Dr. Sami Ulus Maternity and Children's Hospital are prospectively evaluated. Group 1; patients that received therapeutic hypothermia (n = 74) and group 2; patients that did not required therapeutic hypothermia (n = 59). All the patients underwent serial complete blood cell count and CRP assessments; blood cultures were obtained from all the cases at the time of admission and when CRP levels were elevated. Results Positive blood cultures were encountered in five cases (6.7%) in group 1 while no blood culture–proven septicemia was encountered in group 2. The CRP levels elevated gradually reaching a peak level on the 4th day and then decreased during the therapeutic hypothermia in patients with no blood culture–proven septicemia in group 1. The CRP levels showed statistically significant changes reaching a peak level on the 7th day in patients with blood culture–proven septicemia in group 2. Also, the CRP levels showed no alteration with time in group 2. Conclusion Therapeutic hypothermia itself might be associated with CRP elevation rather than an actual infection.

Objective: Viruses are demonstrated to be an uncommon etiologic agent of early and late pneumonia. In this study we aimed to investigate the safety and affectivity of oseltamivir use for viral pneumonia in newborns. Methods: This was a retrospective study conducted in a single tertiary neonatal intensive care unit between September 2009 and April 2013. Demographic, clinical and laboratory data before and after treatment, duration of hospitalization, time of clinical improvement were recorded. Results: During the study period, a total of 69 newborn cases who were treated by oseltamivir for H1N1 swine flu (n=12) or suspicious influenza (n=57) were evaluated. Mean birth weight and gestational age were 3100±601 grams and 37.9±1.8 weeks, respectively. On admission, median postnatal age was 20.6 (7-47) days. Oseltamivir, along with supportive care, was administered as 3.0 mg/kg/dose twice a day for 5 days according to the recommendations of Food and Drug Administration (FDA). The median time of initiation of oseltamivir was 2.3 days (1-4) after admission and the median hospitalization day was 10.4 days (5-22). No adverse effects associated with oseltamivir were observed and all patients were discharged after full recovery. Conclusion: Oseltamivir use in addition to supportive therapy seems to be safe and effective in newborns with severe viral pneumonia.

OBJECTIVES: The goal was to investigate the effect of orally administered synbiotics on outcome of infants with cyanotic congenital heart disease (CCHD). METHODS: A prospective, blinded, randomized controlled trial was conducted to evaluate the effect of synbiotics on outcome of infants with CCHD. The infants with CCHD were assigned randomly to 2 groups. Infants in the study group were given synbiotic (Bifidobacterium lactis plus inulin) added to breast milk or mixed feeding until discharge or death. Infants in the placebo group were fed with breast milk or mixed feeding. The outcome measurements were nosocomial sepsis, necrotizing enterocolitis (NEC; Bell stage ≥2), length of NICU stay, and death. RESULTS: A total of 100 infants were enrolled in the trial: 50 in each arm. There were 9 cases of culture-proven sepsis (18%) in the placebo group and 2 cases (4%) in the synbiotic group (P = .03). Length of NICU stay did not differ between the groups (26 [14–36] vs 32 days [20–44], P = .07]. There were 5 cases of NEC (10%) in the placebo group and none in the synbiotic group (P = .03). The incidence of death was lower in synbiotic group (5 [10%] of 50 vs 14 [28.0%] of 50, respectively; P = .04). CONCLUSIONS: Synbiotics administered enterally to infants with CCHD might reduce the incidence of nosocomial sepsis, NEC, and death.

We aimed to report newborns with thrombosis and needed fibrinolytic treatment.This was a retrospective study conducted on 27 newborns with thrombosis followed-up in a neonatal intensive care unit between December 2007 and December 2012. The patients were divided into two groups according to treatment protocol; Group 1 (n = 15): recombinant tissue-type plasminogen activator (r-tPA) and Group 2 (n = 12): streptokinase (STK). The groups were compared in terms of the efficacy and complications of the treatments.In Group 1, flow restoration was complete in nine (60%) patients, partial in two (13.3%), and absent in four (26.7%). In Group 2, flow restoration was complete in seven (58.3%) patients, partial in three (25%), and absent in two (16.0%). The incidence of complete/partial recovery was similar in the groups. There was no difference between the two groups with regard to the duration of thrombus resolution. Fibrinolytic treatment was terminated in seven patients (46.7%) in Group 1, while in three patients (25%) in Group 2 due to the complications. The most common complications were minor or major bleedings. There was no statistically significant difference with regard to all bleedings complications between the two groups (P = .08), although the incidence of skin hemorrhages was higher in Group 1 (P = .007). There was no significant difference between the mortality rates.Even though the use of STK is not further recommended because of its potential undesirable side effects in newborns, its efficacy and safety appears to be similar to those of r-tPA.

Prostaglandin E1 infusion is widely used to maintain patencyof ductus arteriosus in newborns with duct-dependentcongenital heart disease until surgery. ProstaglandinE1 is a lifesaving drug, but it has many side effects includingfever, apnea, bradycardia, hypotension, convulsion,edema, and cortical hyperostosis. The gastrointestinaltract has not been recognized as a major site of seriousadverse effects of prostaglandin E1 infusion, althoughdiarrhea is a well-recognized side effect that usually respondsto dose reduction. In this report, we present acase of intestinal intussusception presumably induced byprostaglandin therapy in a newborn with duct-dependentcongenital heart disease.Key words: Prostaglandin E1, newborn, gastrointestinal

Uzm. Dr. Banu Aydin, Babur Cad. Altindag, Ankara, Turkiye Tel. 0505 591 24 40 Email. b_ay_yz@yahoo.com Gelis Tarihi: 08.10.2013 • Kabul Tarihi: 12.02.2014 ABSTRACT Vomiting of infants may result from an ineffi caciously functioning gastroesophageal junction or it may be associated with numerous serious diseases. Segmental bulbus dilatation of duodenum is a very rare gastrointestinal system pathology that can trigger vomiting by causing either motility disorder or gastroesophageal refl ux. In the case here presented, endoscopic examination showed a severely dilated bulbus duodeni with decreased motility. In contrast with the previous cases reported in literature, the condition was treated medically with success.

Two new sensitizers for dye sensitized solar cells have been designed consisting of thiophene units asymmetrically functionalized by N-aryl carbazole. The di(tert-butyl) carbazole moieties acts as an electron donor group, the thiophene chain as a bridge group, and the cyanoacrylic acid as an anchoring and electron acceptor group. An increase of the conjugation length produces two main effects: first, it leads to a red-shift of the optical absorption of the dyes, resulting in an improved overlap of the absorption with the solar spectrum. Second, the oxidation potential decreases. The photovoltaic performance of this set of dyes as sensitizers in mesoporous TiO2 solar cells was investigated using electrolytes containing the iodide/triiodide redox couple. The dye with the best absorption characteristics showed the highest photocurrent but lower open circuit voltage due to more losses by recombination. A trend between structure (molecule dyes size) and recombination is demostrated using an analysis procedure ...

We report here electrochemical synthesis of novel soluble donor–acceptor (D–A) polymer with suitably functionalized perylenetetracarboxylic diimide dye derivative covalently linked to carbazole moiety (Cbz-PDI). The band gap, Eg was measured using UV–Vis spectroscopy and compared with that obtained by cyclic voltammetry (CV). Efficient intramolecular electron transfer from carbazole-donor to perynediimide-acceptor leads to remarkable fluorescence quenching of the perylene core. Furthermore, spectroelectrochemical property and surface morphology of the polymer film were investigated. Characteristic monoanion and dianion radical bands on the UV–Vis absorption spectra attributed to the electrochemical reduction of the neutral polymer were observed. During the reduction process, red color of the film turned into blue and violet, respectively. Finally, the photovoltaic performance of the D–A double-cable polymer was checked and nearly 0.1% electrical conversion efficiency is obtained under simulated AM 1.5 solar light with 100 mW/cm2 radiation power. © 2009 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 47: 6280–6291, 2009

Multiple pregnancies are characterized by significantly higher rates of intrauterine and perinatal morbidities and fetal death compared to singleton pregnancies. It is well known that the death of a co-twin during the second and third trimester can cause damage in the other fetus. Here we report two newborn cases presenting with renal failure probably caused by intrauterine death of their co-twins shortly before birth.

Hypoxic ischemic encephalopathy (HIE) is an important cause of permanent injury of central nervous system leading to neonatal death, cerebral palsy and developmental delay. Whole-body cooling therapy is the only effective treatment for HIE today. Subcutaneous fat necrosis during cooling period is rarely seen. A female newborn was born to 33-year-old gravida three parity two mother at 39 weeks of gestation by an emergent cesarean section due to fetal distress. The pregnancy course was complicated with gestational diabetes mellitus, mother received insulin therapy during the last trimester. On admission, she had abnormal neurological findings including hypotonia and absent neonatal reflexes. The patient was treated with postnatal hypothermia in the sixth hour of the method of whole body cooling. Forty-eight hours of treatment, subcutaneous fat necrosis was diagnosed and on the follow-up, the patient developed hypercalcemia and treated with pamidronate. Postnatal twenty-fifth day, patient was discharged with normal physical and neurological examination. Subcutaneous fat necrosis is a rare condition that can be seen during hypothermia period. Close monitoring of these patients because of hypercalcemia risk is important during follow-up., Hipoksik iskemik ensefalopati (HİE), neonatal ölüm, serebral palsi ve ileri dönemde gelişimsel gerilikle sonuçlanabilen merkezi sinir sisteminin kalıcı hasarının önemli bir sebebidir. Tüm vücut soğutma tedavisi HİE'de günümüzdeki tek etkin tedavi yöntemidir. Tüm vücut soğutmaya bağlı subkutan yağ nekrozu gelişimi nadir görülen bir yan etkidir. Otuz üç yaşındaki annenin 3. gebeliğinden 2. yaşayan olarak sezaryen ile 3500 gram olarak doğan kız bebek postnatal 4. saatinde solunum sıkıntısı, hipotonisite ve konvülsiyon nedeni ile yenidoğan yoğun bakım ünitesine (YYBÜ) kabul edildi. Öyküden, annenin gestasyonel diyabet nedeni ile gebelikte son trimesterde insülin tedavisi aldığı öğrenildi. YYBÜ'ne kabulde, hasta entübe, genel durumu kötü ve hipotonikti. Hastaya postnatal 6. saatinde tüm vücut soğutma yöntemiyle hipotermi tedavisi başlandı. Tedavinin 48. saatinde subkutan yağ nekrozu ile uyumlu lezyonları gelişen hastanın izlemde hiperkalsemisi gelişti ve pamidronat tedavisinden fayda gördü. Hasta genel durumu iyi, lezyonları iyileşmiş ve nörolojik muayenesi normal olarak postnatal 25. günde taburcu edildi. Hipotermi tedavisinin komplikasyonları arasında subkutan yağ nekrozu nadir görülen bir durumdur. Subkutan yağ nekrozu genellikle kendiliğinden iyileşen bir patoloji olmakla birlikte hiperkalsemi riski nedeniyle hastaların yakından izlenmesi önemlidir.

To test the efficacy of probiotic and prebiotic, alone or combined (synbiotic), on the prevention of necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants.A prospective, randomized, controlled trial was conducted at 5 neonatal intensive care units in Turkey. VLBW infants (n = 400) were assigned to a control group and 3 study groups that were given probiotic (Bifidobacterium lactis), prebiotic (inulin), or synbiotic (Bifidobacterium lactis plus inulin) added to breastmilk or formula for a maximum of 8 weeks before discharge or death. The primary outcome was NEC (Bell stage ≥2).The rate of NEC was lower in probiotic (2.0%) and synbiotic (4.0%) groups compared with prebiotic (12.0%) and placebo (18.0%) groups (P.001). The times to reach full enteral feeding were faster (P.001), the rates of clinical nosocomial sepsis were lower (P = .004), stays in the neonatal intensive care unit were shorter, (P = .002), and mortality rates were lower (P = .003) for infants receiving probiotics, prebiotics, or synbiotic than controls. The use of antenatal steroid (OR 0.5, 95% CI 0.3-0.9) and postnatal probiotic (alone or in synbiotic) (OR 0.5, 95% CI 0.2-0.8) decreased the risk of NEC, and maternal antibiotic exposure increased this risk (OR 1.9, 95% CI 1.1-3.6).In VLBW infants, probiotic (Bifidobacterium lactis) and synbiotic (Bifidobacterium lactis plus inulin) but not prebiotic (inulin) alone decrease NEC.

Objective The objective of this study was to compare the perfusion index (PI) variability in premature infants with respiratory distress syndrome (RDS) following administration of two different natural surfactant preparations. Study design This was a prospective study on 92 preterm infants with RDS. Patients were randomized into two groups. Group 1 ( n = 46) received beractant; Group 2 ( n = 46) received poractant alfa. Oxygen saturation, PI, and heart rate were measured by Masimo Rainbow SET Radical-7 pulse oximeter (Masimo Corp., Irvine, CA) before and after surfactant. The effects of the two treatment regimens on PI and oxygenation were compared. Results Repeated doses were more needed in beractant group ( p = 0.04). Median oxygenation index (OI) before surfactant were similar, but improvement in OI was more prominent at 6th hour of surfactant in Group 2 ( p = 0.001). Both groups had similar preductal PI values before surfactant. PI was higher at 6th hour of surfactant in Group 2 ( p = 0.001). Pulmonary hemorrhage, intraventricular hemorrhage, patent ductus arteriosus, necrotizing enterocolitis, and mortality were more frequent in infants whose PI values lower than 0.7 within the first 5 days of life ( p = 0.001). Conclusion Poractant alfa resulted in more prominent improvement in PI and OI. Low PI values measured at early postnatal period may predict poor clinical outcome in preterm infants with RDS.

Newborns with jaundice requiring or not requiring phototherapy (PT) are at greater risk of developing asthma later in life. In this study, we investigated the effect of PT treatment on eosinophil and eosinophilic cationic protein (ECP) levels in newborns with severe hyperbilirubinemia. Thirty newborns diagnosed with severe hyperbilirubinemia and exposed to light-emitting diode (LED) PT were enrolled into the study. Total serum bilirubin (TSB) levels, complete blood count and serum ECP concentrations were measured before and after PT. TSB and hemoglobin (Hb) counts were lower after PT (p = 0.001). There was no difference between leukocyte, lymphocyte, neutrophil and platelet count before and after PT. Eosinophil levels were increased after PT, although not significantly. ECP levels were higher after PT (p = 0.006). It may be speculated that newborns treated with LED PT, increased ECP might play a role in developing allergic diseases later in life.

Acemi, Arda/0000-0003-0270-8507 WOS: 000335674900006 Amsonia orientalis Decne. (Apocynaceae), is a rare and threatened plant species which is located only in a constricted area in northeast of Greece and northwest of Turkey in the world. Although phylogenetic analysis depending on nucleotide sequences of genes from different sources (nucleus, mitochondria and chloroplast) became a major tool for classification of plant species, there is still a big lack of information about A. orientalis in the international molecular data bases such as NCBI. In the current study, we phylogenetically analyzed three commonly used molecular markers (18S rDNA, 18S-28S rDNA-ITS region and trnL-F intergenic spacer) from A. orientalis samples collected from Turkey to determine the genetic diversity and also to question the systematic position of A. orientalis. As a result, A. orientalis samples clearly showed close relation with Alyxieae tribe rather than Vinceae. And this result brings the necessity to reconsider the morphological characters that have used to delimit the tribes of Rauvolfioideae.

Introduction: Respiratory syncytial virus (RSV) is a major cause of pneumonia in infants worldwide. We aimed to evaluate the clinical course of community-acquired RSV pneumonia in newborns hospitalized in neonatal intensive care unit. Materials and Methods: All the newborns diagnosed as pneumonia were prospectively evaluated for RSV infection between November 2010 and April 2011. Fifty-four specimens of nasopharyngeal secretions were tested in parallel with the RAT and the multiplex real time polymerase chain reaction (RT- PCR). Downes’ score was used to assess the disease severity in patients with pneumonia. Results: RAT has a sensitivity of 90% and a specificity of 78.5%, as the PCR technique target assay. Four of the patients with RSV pneumonia had secundum atrial septal defect (ASD) and all of four needed mechanical ventilation support. The first day Downes’ score was positively correlated with time of intravenous fluid requirement (p= 0.001, r= 0.48), total oxygen need (p= 0.000, r= 0.63), and re-enteral feeding (p= 0.001, r= 0.46). Blood pH (p= 0.031, r= 0.46) were negatively correlated with Downes’ score. The second day Downes’ score was higher in patients with ASD than those of without ASD (3.8 ± 2.6 vs. 2 ± 1.1, p= 0.01). The most possible risk factor for longer hospital stay was the higher second day Downes’ score (p= 0.02 OR: 1.9, CI 95% (1.1-3.2). All infants were discharged from hospital in a good health. Conclusion: RAT is sensitive and specific in detecting RSV infections in newborns. Physicians may use Downes’ score for evaluation of disease severity in infants with RSV pneumonia. In these patients, ASD has increased the disease severity.

Congenital anomalies are one of the important reasons of mortality and morbidity in newborns. The aim of this study is to determine the incidence, distribution and the mortality of the congenital anomalies in a single neonatal intensive care unit (NICU) from Turkey.A retrospective analysis was performed between 2005 and 2012 in NICU using a computerized database. Variables including the type of anomaly, antenatal and postnatal history, gestational age, birth weight, consanguinity and other demographic, clinical and related laboratory variables were extracted from the computerized database using ICD-10 codes. Congenital anomalies were classified according to involved organ systems and also classified as single and multiple anomalies.A total of 1024 newborns with congenital anomaly (CA) (13.7%) were identified among the 7450 hospitalized newborns in NICU. The most affected system was the cardiovascular system (68.8%). Most of the anomalies (67.1%) were single anomalies. Of all, 59.4% had single major, 7.7% had single minor, 9% had single major plus single minor, 18.4% had multiple major and 2% had multiple minor anomalies. On the other hand, 96.3, 1.9, 0.1 and 1.7% of the newborns had malformation, deformation, disruption and dysplasia, respectively. Chromosomal analysis was only performed 24.8% of the newborns with CA and among them, 65.3% of these were in normal limits. The most frequently detected chromosomal abnormality was trisomy 21. Overall, mortality rate was 15.5% among the newborns with CA.In conclusion, the most common and mortal CA was cardio-vascular malformations in our hospital. The overall prevalence of cardio-vascular malformations among the newborn was higher than previously reported studies in Turkey. Further, studies with larger sample size are needed to determine CA in Turkey.

To determine the role of mean platelet volume (MPV) and uric acid levels in the diagnosis of neonatal sepsis (NS). A total of 146 newborns with suspected NS were prospectively included in the study and infants without NS (n = 142) were assigned as controls. The patients were divided into three groups: Group I (n = 64): clinical NS, Group II (n = 82): culture-proven NS, and Group III (n = 142): healthy controls. The patients in Group II had the highest C-reactive protein (CRP) levels (54.6 ± 5.4 mg/L), lowest platelet counts (199,329 ± 135,952/mm3) and lowest uric acid levels (2.6 ± 1.8 mg/dL) when compared to Groups I and III (p

Objective: It was aimed to determine the risk factors for the development of retinopathy of prematurity (ROP) in premature infants. The factors affecting the need of laser photocoagulation (LP) were also investigated. Methods : The study was prospectively conducted at a tertiary neonatal intensive care unit (NICU) between March 2011 and August 2012. A total of 113 premature infants born at 2 ROP. LP was performed on 18 (33.9%) patients. While the mean birth weight and gestational age were lower, the rates of associated disorders, use of prophylactic or therapeutic caffeine for apnea, and need of red blood cell transfusion were higher in Group 1 compared to Group 2 (p

Neonatal sepsis is one of the leading causes of neonatal morbidity and mortality in the newborn period. The purpose of this study was to compare a rapid bed-side test against central laboratory analysis for CRP in newborn infants with suspicion of sepsis.We included 23 newborn infants with suspected or proven sepsis (group 1). Age and gender matched 40 infants without sepsis were assigned as controls (group 2). A total of 116 blood samples (58 samples from each group) were drawn from the peripheral vein for C-reactive protein (CRP) measurements. For the NycoCard CRP tests, 5 microL of whole blood and the same amount of serum was used to determine the CRP value (wCRP-N and sCRP-N). As the reference CRP test, serum concentrations of CRP (CRP-Lab) were simultaneously measured by immunonephelometric method requiring 1 mL of serum sample. CRP valuesor = 10 mg/L were considered positive for all three tests.It was found that the median values of wCRP-N (18.9 mg/L), sCRP-N (25 mg/L), and CRP-Lab (22.2 mg/L) of group 1 were higher than group 2 (wCRP-N: 1.1 mg/L, sCRP-N: 5 mg/L, and CRP-Lab: 2.9 mg/L) (p0.001). Nycocard-CRP were positively correlated with CRP-Lab. With considering CRP-Lab positive at10 mg/L, both CRP-NycoCard tests have high sensitivity and specificity, although sCRP-N has slightly higher predictive values. Passing-Bablok regression and Bland-Altman analysis showed that NycoCard tests have no statistically significant systematic proportional bias.Nycocard-CRP tests have high predictive values, require a very small amount of blood, and results can be obtained quickly. Determinations of CRP concentrations by NycoCard-CRP test seems to be helpful in distinguishing septic and aseptic newborns.

Cupriavidus pauculus is a gram-negative, aerobic, non-spore forming, non-fermentative motile bacillus. The bacillus can be isolated from water, bottled mineral water, and water from ultrafiltration systems in hospital setting. C. pauculus rarely causes human infections, however it may be an infectious agent especially in immunocompromised individuals. In this report, we present the first case of community acquired pneumonia caused by C. pauculus in a previously healthy newborn who was hospitalized in neonatal intensive care unit on postnatal day 16 because of respiratory distress.

Fluconazole is a broadly used drug, especially in critically ill newborns hospitalized in neonatal intensive care units. The drug is safe and effective in both prophylaxis and treatment of fungal infections in newborns. In children, the most common side effects of fluconazole are associated with the gastrointestinal tract or skin. It can induce QT prolongation, which may lead to torsade de pointes and sudden death in adults, although rarely. We present lengthening of the QT interval in a newborn treated with fluconazole. To our knowledge, this is the first case of QT prolongation caused by fluconazole in this age group.

Henoch-Schonlein purpura (HSP) is a common systemic vasculitis of childhood, and may affect the kidney. Endothelial cell dysfunction and fibrosis is an important part of HSP vasculitis and may account for renal involvement in HSP. Insulin-like growth factor (IGF)-1 enhances the cytokine-induced expression of adhesion molecules in endothelial cells (EC). Besides, IGF-1 may stimulate angiogenesis, fibrosis and tubular formation in EC and IGF-1 increases glomerular filtration rate. We, therefore, investigated the role of IGF-1 and IGF-binding protein-3 (IGFBP-3) in HSP. The study included 44 patients with HSP (30 boys and 14 girls), including 13 patients with proteinuria, 15 patients with hematuria and 16 patients with positive stool occult blood (SOB), and 26 healthy children. Serum levels of IGF-1 and IGFBP-3 levels were significantly higher in HSP than in the controls (147.9 +/- 121.6 vs 95.7 +/- 67.8 ng/ml, p = 0.024 and 4.4 +/- 2.2 vs 2.3 +/- 0.9 microg/ml, p = 0.001, respectively). Serum IGF-1 levels were significantly higher in HSP with proteinuria than those without proteinuria and controls (p = 0.001 and p = 0.001, respectively). Also, IGFBP-3 levels were greater in HSP with proteinuria compared to those without proteinuria and controls (p = 0.005 and p = 0.0001). Serum immunoglobulin-A/complement-C3 ratio was higher in HSP than in the controls (p = 0.0001) but this ratio did not change according to proteinuria, hematuria or positive SOB. In conclusion, IGF-1 and IGFBP-3 levels could be new markers for determination of renal involvement in HSP.

Ağrı, hemen her bireyin yaşamı boyunca belirli zamanlarda deneyimlediği, yaşam aktivitelerindeki bağımsızlık dengesini ve yaşam kalitesini olumsuz etkileyen gerçek ya da potansiyel bir doku hasarıyla ilişkili duyusal ve duygusal bir durumdur. Ağrının tedavisinde ve yönetiminde, günümüzde büyük oranda farmakolojik yöntemler kullanılsa da bütüncül ve disiplinler arası tedavi yaklaşımlarına göre uygun beslenme müdahaleleri ile hastaların genel sağlık sonuçları iyileştirilmekte, sistemik inflamatuar durumları azaltılmakta ve böylece ağrı tedavisine destek sağlanmaktadır. Besinlerin içerdikleri antioksidanlar, vazokonstriktör veya vazodilatör maddeler, beslenme durumunun metabolizmadaki inflamatuar ve oksidatif etkileri, bazı besin öğelerinin, ağrının iletim ve algılanma yollarındaki nörofizyolojik rolleri, ağrı ile beslenme ilişkisini önemli kılmaktadır. Dengesiz beslenmeyle oluşan adipozite artışı, doymuş yağ ve basit karbonhidrat oranı yüksek olan diyetler, beslenmenin vitamin, mineral ve antioksidan içeriğinin yetersiz olması sistemik inflamatuar süreçleri tetikleyerek, santral ve periferik sinirlerde ağrı duyarlılığını artırır, ağrının patolojik bir hâl almasına zemin hazırlar. Ağrılı bireylerin beslenme durumlarının düzeltilmesiyle, ağrıyı teşvik eden besin öğe/gruplarının diyetten elemine edilmesi/azaltılmasıyla ve bazı besinsel faktörlerin/takviyelerin kontrollü bir şekilde beslenmeye dâhil edilmesiyle ağrılı durumlarda iyileşme sağlanabilir, bireylerin yaşam kaliteleri ve işlevselliklerigeliştirilebilir. Beslenme durumunun, diyet modifikasyonlarının, besin öğeleri ve diğer besinsel faktörlerin ağrıyla ilişkilendirildiği çalışmalar, güncel araştırma konuları arasında önemli yer tutmaktadır. Bu çalışmada da beslenme ve diyeti, ağrıyla ilişkilendiren araştırmaların bir derlemesi sunulmaya çalışılmıştır. Pain is a sensory and emotional condition associated _x000D_ with a real or potential tissue damage that negatively affects the balance of independence and quality of life in life activities that almost _x000D_ every individual experiences at certain times during her life. Although pharmacological methods are widely used in the treatment _x000D_ and management of pain, according to holistic and interdisciplinary _x000D_ treatment approaches; appropriate nutritional interventions improve _x000D_ the overall health outcomes of patients, reduce their systemic inflammatory state and thus support pain management. Foods contain _x000D_ antioxidants, vasoconcentrators or vasodilators; inflammatory and _x000D_ oxidative effects of nutritional status on metabolism; the neurophysiological roles of some nutrients in the transmission and perception _x000D_ of pain make the relationship between pain and nutrition important. _x000D_ Increased adiposity caused by unbalanced nutrition, diets with high _x000D_ saturated fat and simple carbohydrate rates, insufficient vitamin, mineral and antioxidant content of the diet trigger systemic inflammatory _x000D_ processes, increasing pain sensitivity in central and peripheral _x000D_ nerves, and paving the way for pain to become pathological. By improving the nutritional status of painful individuals, eliminating painpromoting nutritional groups from the diet, and including some _x000D_ nutritional supplements in a controlled manner, improvement in _x000D_ painful conditions can be achieved, and individuals' quality of life _x000D_ and functionality can be improved. Nutritional status, dietary modifications, food items and other nutritional factors that are associated _x000D_ with pain study occupies an important place among the topics of current research. In this study, a review of the studies that relate nutrition and diet to pain is presented.