Ayşe Sevim Gökalp

Intravenous Immunoglobulin in the Treatment of Salmonella Typhimurium Infections in Preterm Neonates

The purpose of this study was to determine the role of intravenous immunoglobulin (IVIG) administration in preterm neonates with S. typhimurium infection. A randomized trial of 47 preterm neonates with intestinal or extraintestinal S. tymphimurium infection was performed. Neonates were randomly divided into two groups: 22 neonates were only given cefoperazone (group 1); 25 neonates were given cefoperazone plus IVIG (group 2). IVIG was given at a dose of 500 mg/kg on days 1, 2, 3, and 8 after entry into the study. Following treatment, bacteremia, complications, mortality rate, recovery time, and duration of antimicrobial therapy were evaluated in two groups. Bacteremia was found in 31.4% in group 1 and 8% in group 2 (P<.05); complications developed in 81.8% in group 1 and 16% in group 2 (P<0.01); mortality was 40.9% in group 1 and 12% in group 2 (P<.05). Recovery took 15 days in group 1 and 8 days in group 2 (P < .01). The duration of antimicrobial therapy was 20 days in group 1 and 14 days in group 2 (P<.01). We conclude that IVIG treatment in combination with antibiotics in preterm neonates with S. typhimurium infection reduces the complications, mortality rate, and duration of therapy.

Early prognostic significance of umbilical cord troponin I in critically ill newborns. Prospective study with a control group

Abstract Aim: To determine the value of cord blood cardiac troponin I levels (cTnI) as an early prognostic factor in critically ill newborns, and to compare cord cTnI levels with the prognostic value of the score for neonatal acute physiology (SNAP). Methods: Cord arterial samples were collected routinely for blood gas analysis, and cord venous samples for cTnI and cardiac-specific creatine kinase assay. The study group (n=109) comprised critically ill newborns who required mechanical ventilation. The control group (n=96) comprised newborns who were either completely healthy (n=48) or were followed in a level I neonatal care unit due to moderate-severity problems. Results: The critically ill newborns had significantly higher cTnI levels than control babies (median [min-max] 1.4 [0–13] vs. 0 [0–1.8] ng/mL, respectively; P<0.001). In critically ill newborns, non-survivors had significantly higher cTnI levels than survivors (median [min-max] 6.6 [1.3–13.0] vs. 1.3 [0–8.0] ng/mL, respectively; P<0.001). Receiver-operator curve analysis revealed that, compared with SNAP, cTnI was a more sensitive predictor of mortality in critically ill newborns (area under curve=0.96; 95% CI=0.90–1.02). Conclusion: Significantly elevated cord cTnI may be a valuable predictor of mortality in critically ill newborns.

Acute renal failure related to infectious disease in infancy and childhood

In this prospective study done between 1983 and 1989, of 109 children with acute renal failure in Sivas, Turkey, infectious disease was found in 94. This was related mainly to preventable disease such as acute gastro-enteritis, sepsis and post-streptococcal acute glomerulonephritis. Within this infectious disease group, the highest incidence rate was found in sepsis.

Neonatal hyperbilirubinemia and organic anion transporting polypeptide-2 gene mutations.

The aim of this study was to investigate the genotypic distribution of organic anion transporting polypeptide 2 (OATP-2) gene mutations and the relationship with hyperbilirubinemia of unknown etiology. Polymerase chain reaction, restriction fragment length polymorphism, and agarose gel electrophoresis techniques were used for detection of OATP-2 gene mutations in 155 newborn infants: 37 with unexplained hyperbilirubinemia, 65 with explained hyperbilirubinemia, and 53 without hyperbilirubinemia. In the OATP-2 gene, we identified A→G transitions at nucleotide positions 388 and 411 and observed six polymorphic forms. The 388/411-411 mutation was the most common form (43%) in subjects with hyperbilirubinemia of unknown etiology. Male sex [odds ratio (OR): 3.08] and two polymorphic forms of the OATP-2 gene [the 388/411-411 A→G mutation (OR: 3.6) and the 388-411 mutation (OR: 2.4)] increased the risk of neonatal hyperbilirubinemia. In male infants with the 388 A→G mutation of the OATP-2 gene, the levels of unconjugated bilirubin in plasma were significantly increased compared with those observed in females. The polymorphic forms of 388 nucleotide of the OATP-2 gene were identified as risk factors for hyperbilirubinemia of unknown etiology.

Umbilical Cord Clamping Time in Premature Infants

This paper provides a brief overview of benefits of delayed cord clamping according to the early clamping after birth. Introduction: Optimal timing of cord clamping has long been a controversial issue. Recently many studies have shown that delayed cord clamping leads to remarkable decreases in risks of morbidity such as intraventricular haemorrhage, necrotising enterocolitis, hypoperfusion, need for transfusion and optimal haemoglobin haematocrit levels in preterm infants. Conclusion: Delayed clamping of the umbilical cord will ensure more positive outcomes in preterm neonates.

Erken aminoasit desteğinin çok düşük doğum ağırlıklı bebeklerin büyüme ve nörolojik gelişimi üzerine etkisi Özgün Araştırma

Ozet Amac: Erken aminoasit desteginin 32 gebelik haftasinin altinda dogan bebeklerde postmenstruel 36 hafta ve duzeltilmis yasa gore 18 aylarinda norolojik gelisim ve buyume uzerine etkilerini degerlendirmektir nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; Gerec ve Yontem: Hayatlarinin ilk bes gununde ge;3 gr kg gun parenteral aminoasit alan bebekler erken grubu 3 gr kg gun rsquo;den daha az alanlar gec grubu olusturdu Agirlik boy bas cevresi olcumleri postmenstruel 36 hafta ve duzeltilmis yas 18 ayda yapildi Norolojik degerlendirmede Bayley gelisim testi uygulandi nbsp; Bulgular: Erken ve gec gruplar arasinda dogum agirligi arasinda fark varken diger temel belirgin ozellikler acisindan fark saptanmadi 36 gebelik haftasinda ve duzeltilmis yasa gore 18 aylarinda her iki grup arasinda boy bas cevresi ve agirlik acisindan fark saptanmadi Erken grupta kizlarin 36 hafta ve 18 ayda bas cevre olcumlerinin daha iyi oldugu goruldu Bayley mental ve psikomotor gelisim indeksi ile norogelisimsel bozulma yonunden farklilik saptanmadi Cikarimlar: Erken grupta dogum agirliginin dusuk olmasina ragmen 36 haftada ve 18 ayda gec grup seviyelerini yakalamis olmasi ve kizlarda daha iyi bas cevresinin elde edilmesinin erken aminoasit desteginin buyume ve norogelisim uzerine olumlu etkisinin oldugunu dusundurmektedir Turk Ped Ars 2010; 45: 111 8 Anahtar sozcukler: Erken dogmus bebek erken parenteral aminoasit erken dogmus bebegin buyumesi sinir sistemi gelisimi nbsp;

Yenidoğan Ünitemizde Takip Edilen Hastalar ve Gözlenen Özellikleri

The neonatal period constitutes the most important period of childhood since it has the highest rate of mortality In this study it has been aimed at investigating the distribution per year he most frequent problems congenital malformations and causes of death of 2999 neonates hospitalized in our Neonatology Unit between January 1986 and June 1995 Key words: Neonate Mortality

Bir Yenidoğanda Florokinolon Artropatisi

Florokinolonlar genis spektrumlu ve hucre ici penetrasyonu kuvvetli olan DNA replikasyonunu onleyen bakterisid etkili bir antibiyotik grubudur Uzun yillardir kinolonlara bagli kikirdak toksisitesi deneysel olarak immatur hayvanlarda ispatlanmis ve prepubertal hastalarda kullanim kontrendikasyonu yaratmis olmakla birlikte multirezistan Enterobacter cloace septisemili ve ventrikulitisli prematur yenidoganlarda basarili sonuclar elde edilmistir Bu makalede Cumhuriyet Universitesi Pediatri Bolumu Neonatoloji Unitesinde neonatal sepsis tanisi konan ve florokinolon ile tedavi edilen bir olgu sunulmustur Anahtar kelimeler: Florokinolonlar Artropati

Role of Lipid Peroxidation in Phototoxic Effects of Tin-Porphyrin in neonatal rats 17

Background: Metalloporphyrine are inhibitors of heme oxygenase enzyme. Tin-protoporphyrin (Sn-PP) is one such compound, which potently supress billirubin production. However Sn-PP is a potential pohotosensitizers and could react with ambient fluorescent lights or sunlight to lead to tissue damage. This effect of Sn-PP may be due to lipid peroxidation. Ain: We investigated the role of lipid peroxidation in Sn-PP mediated photoxicity. Methods: Twenty-two neonatal rats were administered intraperitoneal injections of 40μmol/kg of Sn-PP (4mM). Twelve of them were exposed to sunlight for 3 hours(Group I) and ten of them kept in the dark (Group II) Control group (ten rats) were given injections of equal volume of normal saline (Group III). Blood samples were analyzed for malondialdehyde (MDA) as indices of lipid peroxidation. Results: Mean MDA level was significantly increased in group I (1.4550±0.087) compared with group II(1.0978±0.080) and group III (1.0282±0.057). There was no significant difference in mean MDA level between group II and III (p>0 017)Conclusion: Lipid peroxidation can play a significant role in Sn-PP mediated phototoxicity in neonatal rats.

Sivas Yöresinde Preterm Bebeklerde Peri İntraventriküler Kanama

The aim of this study was to determine the prevalence of peri intraventricular hemorrhage in pretem infants aged between 28 37 gestational weeks in Sivas province The study was carried out on 47 preterm infants in the unit of neonatology of Cumhuriyet University Hospital The mean gestational age of the study group was 34 2±2 4 weeks Birth weights ranged from 600 gr to 2350 gr mean 1443±429 gr Of the 47 preterm infants 44 were evaluated by cranial ultrasonography and 3 were evaluated by cranial computed tomography Perintraventricular hemorrhage was detected in 19 of the 47 infants 40 4 The gestational ages and birth weights of the infants with peri intraventricular hemorrhage were significantly low Respiratory distress syndrome was the statistically significant factor among the neonatal factors in relation to peri intra ventricular hemorrhage The mortality rate of peri intraventricular hemorrhage was 78 9 percent Key words: Peri Intraventricular Hemorrhage Cranial Ultrasonographyx