Derya Aldemir

Effect of Congenital Heart Disease on Renal Function in Childhood

Background: Nephropathy is a well-known complication of congenital heart disease (CHD), and the risk of developing renal impairment is particularly high in patients with cyanotic CHD. Most investigations of renal impairment in CHD have involved patients 20 years and older. This study investigated renal tubule function in pediatric patients with CHD, and compared findings in cyanotic and acyanotic groups. Methods: Twenty children with acyanotic CHD, 23 children with cyanotic CHD, and 13 healthy children were enrolled. Blood and early morning urine samples were collected from each subject to measure urinary concentrations of sodium, microalbumin, creatinine, β2-microglobulin, and N-acetyl-β-D-glucosaminidase (NAG). Results: The age and sex distributions in the three groups were similar. Median fractional excretion of sodium (FeNa) and urinary NAG/creatinine were significantly higher in the cyanotic group than in the control group (p = 0.022 and p = 0.002, respectively). There were no statistically significant differences among the groups with respect to urinary β2-microglobulin/creatinine, urinary microalbumin/creatinine or glomerular filtration rate. Conclusion: Tubular injury can be detected before glomerular injury occurs even within the first decade of life in patients with cyanotic CHD.

Which is responsible for the haemodynamic response due to laryngoscopy and endotracheal intubation? Catecholamines, vasopressin or angiotensin?

Background and objective: We have investigated the concentrations of epinephrine, norepinephrine, vasopressin and angiotensin converting enzyme activity to explore the role of these mediators in the neuroendocrine response to laryngoscopy and tracheal intubation. Methods: One hundred (50 male, 50 female) ASA I patients aged 20‐50 yr (mean ± SEM; 35.59 ± 0.99) were included in the study. They were undergoing elective surgery under standard anaesthesia induction and maintenance using tracheal intubation. Plasma concentrations of epinephrine, norepinephrine and vasopressin as well as plasma angiotensin converting enzyme activity were determined at four time points, before (T1) and after (T2) induction, and 2 (T3) and 5 min (T4) after intubation. Blood pressure and heart rate were recorded at corresponding times to reveal if any correlation existed between haemodynamic parameters and neuroendocrine response. Results: Heart rate increased after induction and intubation (P < 0.05) and decreased significantly at T4 (P < 0.05). Systolic blood pressure decreased significantly (P < 0.05) after induction and increased slightly after intubation decreasing to below baseline value (P < 0.05) at T4. Diastolic blood pressure increased slightly after intubation and decreased significantly (P < 0.05) at T4. Plasma epinephrine and norepinephrine concentrations decreased after induction and increased at T3 and T4 without reaching significance. Vasopressin concentrations increased slightly at T2 and T3 and decreased significantly at T4 (P < 0.05). Angiotensin converting enzyme activity was unaffected when compared with baseline values. Conclusions: Blood pressure, heart rate, plasma epinephrine, norepinephrine and vasopressin concentrations increased slightly in response to laryngoscopy and intubation, all returning to or below baseline 5 min later with no change in angiotensin converting enzyme activity in normotensive patients.

Effect of iron deficiency anemia on renal tubular function in childhood

Abstract.Little is known about renal function in children with iron deficiency anemia. The purpose of this study was to investigate renal tubular function in these children. We compared renal tubular function in 20 children with iron deficiency anemia with 20 healthy age-matched controls. Blood and urine samples were obtained for hematological and biochemical analysis. Mean fractional excretion of sodium and mean urinary N-acetyl-β-D-glucosaminidase/creatinine were significantly higher in the children with iron deficiency anemia than in controls (P<0.05). Hemoglobin levels were negatively correlated with urinary N-acetyl-β-D-glucosaminidase/creatinine (r= -0.44, P=0.015), but were not correlated with fractional excretion of sodium (r= -0.29, P=0.13). There was no correlation between urinary N-acetyl-β-D-glucosaminidase/creatinine and fractional excretion of sodium (r=0.32, P=0.09). The results suggest that children with iron deficiency anemia have impaired renal tubular function.

Increased Vulnerability to Oxidative Stress in Pediatric Migraine Patients

Little is known about the role of oxidative stress in the pathogenesis of pediatric migraine. The objective of the present study was to investigate, during a headache-free period, the activities of erythrocyte antioxidant enzymes in children and adolescents diagnosed with migraine. In all, 47 migraine patients (age range, 8-17 years; mean, 14.1 +/- 2.4 years, 14 with aura) and 35 control subjects were included. Superoxide dismutase, glutathione peroxidase, and catalase activities were measured in erythrocytes. Although superoxide dismutase activities did not differ between groups, both catalase and glutathione peroxidase activities were significantly lower in migraine patients (P = 0.001 and P = 0.009, respectively). Activities of all three antioxidant enzymes were similar across migraine subgroups; there was no correlation with age and sex. These results confirm vulnerability to oxidative stress in pediatric migraine. Further studies and search for new therapeutic agents with antioxidant properties are needed.

The influence of hepatitis C infection activity on oxidative stress markers and erythropoietin requirement in hemodialysis patients.

We sought to expose the possible effect of hepatitis C virus (HCV) infection on oxidative stress indicators, nutritional status, and erythropoietin (rHuEPO) requirements in maintenance hemodialysis (MHD) patients. A total of 111 MHD patients (69 males, 42 females; mean age 51.3 +/- 13.0 years; MHD duration 78.5 +/- 52.1 months) and 46 healthy controls were enrolled in the study. We excluded patients with hepatitis B infection or malignancy. Indicators for oxidative status were studied in plasma samples obtained at the beginning of a clinically stable MHD session. Measurements were performed for plasma superoxide dismutase, glutathione peroxidase (antioxidative agents), and malonyldialdehyde (MDA; oxidative agent) by spectrophotometric methods. All patients were analyzed for the presence of anti-HCV; positive patients were also evaluated for the presence of HCV RNA. MHD patients were divided into three groups according to HCV infection status: group I (anti-HCV-positive, HCV-RNA-negative; n = 22); group II (anti-HCV-positive, HCV-RNA-positive; n = 22), and group III (anti-HCV-negative; n = 67). According to the analyses, MHD patients showed higher plasma oxidative stress indicators and lower antioxidative indicator levels compared to controls (P < .0001). MHD patients also displayed lower albumin and higher C-reactive protein (CRP) levels compared to controls (P < .0001). Antioxidant levels were decreased significantly from group I to III (P < .0001). MDA levels significantly increased from group I to III (P < 0.01). HCV-RNA-positive patients showed lowest albumin and highest CRP levels and rHuEPO requirements. Although alanine transferase (ALT) levels were in the normal range, group II patients had significantly higher ALT levels than the other groups (P < .01). In conclusion, we observed negative effects of active HCV infection on oxidative stress and rHuEPO requirements. In contrast, we detected that clinically inactive HCV infection was associated with reduced oxidative stress and rHuEPO requirements compared with active HCV infection and HCV-negative patients.

Investigating the Effect of Black Tea Consumption During Pregnancy on the Oxidant/Antioxidant Status of Breastmilk

OBJECTIVE Black tea is associated with antioxidant properties. The objective of this study was to investigate the effect of the amount of black tea consumption during pregnancy on the oxidant/antioxidant status of breastmilk. SUBJECTS AND METHODS Breastmilk was obtained from 30 mothers and analyzed for lipid peroxidation based on levels of malondialdehyde (MDA) and of reduced glutathione (GSH). In a survey completed by all participants, daily black tea consumption during the pregnancy was reported. RESULTS No correlation was found between the amount of black tea consumed and levels of MDA (p=0.401) and/or GSH (p=0.473). The results of this study indicate that consumption of varying amounts of black tea does not affect the oxidant/antioxidant status of breastmilk. CONCLUSIONS The insensitivity of breastmilk to antioxidant contributions by black tea reflects the capacity of breastmilk to be resistant to the myriad of factors that otherwise affect a pregnant woman.

PO-0078 The Relationship Between Maternal And Neonatal 25(oh) Vitamin D Status

Background In this study we aimed to investigate the relationship between maternal and neonatal 25(OH)D levels. Methods The subjects were 58 mothers and their newborns who were born between February 2012 and April 2012. Blood specimens were obtained within 72 h of birth and from mothers. Serum 25(OH)D concentrations were measured. Vitamin D deficiency was defined as serum concentrations ≤20 ng/mL. Results The mean gestational age and birth weight of preterm infants were 33.06 ± 2.2 weeks and 2125.4 ± 546 g and for term infants were 38.84 ± 1 weeks and 3470.3 ± 451 g, respectively. Sociodemographic characteristics of mothers were not significantly different between groups. Twelve percent of infants born before 32 completed weeks, 16% infants born between 32–36 weeks and 28% of term infants had vitamin D deficiency. Vitamin D deficiency was found in 27% mothers of preterm infants and 42% mothers of term infants. Conclusion Vitamin D receptors plays an important role in calcium absorption and bone metabolism. In the literature there are reports that vitamin D deficiency during pregnancy had adverse gestational outcomes including risk of pre-eclampsia, gestational diabetes. The mean vitamin D levels were normal in infants whereas their mothers had low levels of vitamin D. When we consider that all mothers in the study received vitamin D supplements, we should give appropriate vitamin D prophylaxis during pregnancy. Also we should give adequate vitamin D supplementation to the infants without any delay.