Bahri Ermis

Influence of Smoking on Serum and Milk Malondialdehyde, Superoxide Dismutase, Glutathione Peroxidase, and Antioxidant Potential Levels in Mothers at the Postpartum Seventh Day

The aim of the study was to investigate simultaneously serum and milk malondialdehyde (MDA) levels, superoxide dismutase (SOD), glutathione peroxidase (GPx) activities, and antioxidant potential (AOP) in active-smoking, passive-smoking, and nonsmoking mothers and to search if there is any difference between serum and milk oxidant/ antioxidant status caused by smoking. According to their smoking status, 60 mothers (age range: 20–35 yr) were classified into one of three groups: the active-smoking mothers (n=15), the passive-smoking mothers (n=22), and the nonsmoking mothers (n=23). Serum and milk MDA, SOD, GPx, and AOP values were determined in mothers on the postpartum seventh day by the spectrophotometric method. Serum Zn and Cu concentrations were determined by atomic absorption spectrophotometry (AAS). There was no significant difference in serum samples with respect to MDA (p=0.17), SOD (p=0.51) and AOP (p=0.36) levels, but there was a significant difference in serum GPx (p=0.002) levels among the study groups. The significant differences were also found in milk samples in terms of MDA (p=0.002) and SOD (p=0.011), but not in GPx (p=0.11) and AOP (p=0.29) levels among the study groups. No significant difference was seen in serum zinc concentration (p=0.49), but copper concentration differed significantly among the groups (p=0.005). These observations suggest that human milk is more vulnerable to oxidative stress and lipid peroxidation than serum samples in smoking mothers, even if they are passive smokers.

Severe congenital factor X deficiency with intracranial bleeding in two siblings

Congenital factor X deficiency is a rare autosomal recessive disorder that usually presents with variable bleeding tendency, prolonged prothrombin time and partial thromboplastin time. Therefore, it may be misdiagnosed as hemorrhagic disease of the newborn. Factor X level should be investigated for the definite diagnosis. We first report a new family whose two infants presented with severe intracranial bleeding at different times and were found to have congenital factor X deficiency. Plasma replacement therapy was not found to be efficacious in these infants. In conclusion, a possible factor X deficiency should be considered when a newborn presents with intracranial bleeding.

Effect of maternal smoking on colostrum and breast milk cytokines.

BACKGROUND Breast milk contains several immune modulator components. The transfer of numerous cytokines via mothers milk may add to an active stimulation of the infants immune system. There are many factors in breast milk that could either facilitate or inhibit cytokine activities. Smoking negatively influences the immune system and changes the concentrations of important cytokines. OBJECTIVE The objective of this study was to assess the effect of smoking during pregnancy on the cytokines found in colostrum and mature human milk. METHODS The study population included 25 smoker and 27 non-smoker nursing mothers who gave birth to a term healthy infant via cesarean section. Breast milk was collected from the mothers on the 2(nd)-3(rd) and 21(st)-25(th) days postpartum during visits to examine the newborns. Samples were analyzed for IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, TNF-α and TNF-β cytokines by flow cytometric bead array. RESULTS We first saw that concentrations of IL-1 β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IFN-γ, TNF-α, and TNF-β cytokines, but not IL-12, were measurable both in colostrum and in mature milk, being higher in colostrum. Next we observed that IL-1β and IL-8 levels were significantly lower in colostrum, and IL-6 was found to be significantly lower in the mature milk of smoking mothers. No significant effects of maternal smoking on breast milk concentrations of IL-2, IL-4, IL-5, IL-10, IFN-γ, TNF-α, and TNF-β were observed. CONCLUSIONS These findings indicate that maternal smoking alters the colostrum and mature milk levels of some cytokines. Therefore, it is thought that active smoking during pregnancy decreases the concentration of certain cytokines in breast milk, which might account for the newborns increased susceptibility to infections.

Influence of smoking on human milk tumor necrosis factor‐α, interleukin‐1β, and soluble vascular cell adhesion molecule‐1 levels at postpartum seventh day

Background:  The aim of this study was to investigate the effect of maternal smoking during pregnancy on human milk interleukin‐1β, tumor necrosis factor‐α (TNF‐α) and soluble vascular cell adhesion molecule‐1 levels at the postpartum seventh day.

Early cardiac abnormalities and serum N-terminal pro B-type natriuretic peptide levels in obese children

Abstract Objective: The aim of this study was to evaluate early cardiac abnormalities in obese children by the conventional echocardiography and to verify whether N-terminal pro B-type natriuretic peptide (NT-proBNP) differ between obese and healthy children. Methods: We started this study with 68 obese children and 35 healthy controls matched for age and sex. Body mass index (BMI) was calculated. Children with a BMI≥95th percentile were considered obese. Thirty children in the obese group were also diagnosed with metabolic syndrome, according to the International Diabetes Federation criteria. Standard echocardiographic study was performed on each patient and control subject. Diastolic filling parameters were evaluated using pulsed-wave tissue Doppler method. Blood samples were taken at 8 a.m. to study blood biochemistry tests, including insulin, lipids, glucose, and NT-proBNP. Serum NT-proBNP levels were measured by a solid-phase, enzyme-labeled chemiluminescent immunometric assay. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Children with HOMA-IR >3.16 were considered insulin-resistant. Results: There were diastolic filling abnormalities in obese children, as shown by a decreased mitral valve early filling (E) wave/late filling (A) ratio and a prolongation in E-wave deceleration time. The levels of NT-proBNP were not statistically different among the groups. The levels of NT-proBNP were not different between obese children with and without metabolic syndrome, those with and without hypertension, and those with and without insulin resistance, respectively. Conclusion: Although there were diastolic filling abnormalities in obese children, their NT-proBNP levels were not different from healthy controls. It seems that there is no diagnostic value in NT-proBNP levels between obese children and healthy controls

Pulmonary Hypoplasia in a Newborn with Goldenhar Syndrome

Figure. A, Facial asymmetry and ipsilateral ear anomalies. B, Chest radiograph showing nearly complete opacification of the left hemithorax, an ipsilateral mediastinal shift, an intact diaphragm, and vertebral anomalies. C, Chest computed tomography scan showing left lung hypoplasia and an ipsilateral cardiomediastinal shift. A female infant born to a 31-year-old mother (G2P2) by cesarean section at 35 weeks’ gestation was referred for facial asymmetry and facial paralysis (Figure, A). The parents are not relatives. The pregnancy was complicated by polyhydramnios with no known intrauterine teratogenic exposure. On physical examination, the infant appeared alert, active, and well. Her weight was 2280 g (50th percentile), length was 44 cm (10th to 50th percentile), and head circumference was 33 cm (50th percentile). The following dysmorphic features were noted: left facial hypoplasia, ipsilateral ear anomalies (i.e., malformed, low-set ear; microtia; preauricular tags; external auditory canal atresia), mandibular hypoplasia, and hypertelorism. A chest radiograph revealed nearly complete opacification of the left hemithorax, an ipsilateral mediastinal shift, an intact diaphragm, and vertebral anomalies (Figure, B). A chest computed tomography scan showed left lung hypoplasia and an ipsilateral cardiomediastinal shift (Figure, C). An echocardiogram demonstrated patent ductus arteriosus. Chromosomal analysis revealed a normal female karyotype. Goldenhar syndrome (also known as oculoauriculovertebral spectrum or OAV syndrome) is a rare congenital defect characterized by incomplete development of the ear, nose, soft palate, lip, and mandible, usually on one side of the body. The term is sometimes used interchangeably with hemifacial microsomia, although the latter is usually reserved for cases without internal organ/vertebrae involvement. Cardiac, renal, skeletal, and central nervous system involvement have been reported in Goldenhar syndrome. The association of pulmonary agenesis with facial microsomia also has been described in a few cases. Pulmonary agenesis/hypoplasia is considered a part of Goldenhar syndrome, and the syndrome with pulmonary agenesis is termed an expanded Goldenhar complex. Here we report another case that includes unilateral pulmonary hypoplasia with Goldenhar syndrome in a premature infant without respiratory distress. n

A Giant Cystic Hygroma on the Leg of a Newborn Infant Complicated by Hyponatremia

Cystic hygromas are large cystic masses resulting from failure of lymph drainage. The vast majority occur in the neck or axilla. Cases of cystic hygroma of the extremity are extremely rare. We present a newborn infant with a giant cystic hygroma on her left leg, complicated by severe hyponatremia.