H Altunhan

Serum ischemia-modified albumin levels at diagnosis and during treatment of late-onset neonatal sepsis

Abstract Sepsis is one of the most common infectious conditions in the neonatal period, and continues as a major source of morbidity and mortality. The aim of this study is to determine serum ischemia-modified albumin (IMA) levels in late-onset neonatal sepsis at the time of diagnosis and after therapy, and to show the meaningful on the follow-up. Also, it is aimed to compare serum IMA levels with serum C-reactive protein (CRP), procalcitonin (PCT) levels and white blood cell count. The study was performed on 33 premature babies with sepsis and 21 healthy premature controls at 7–28 days of age. In the sepsis group, biochemical parameters and blood culture samples were obtained from the blood at the onset and on the fifth day of treatment for each patient. Serum IMA, CRP, PCT and white blood cell count were significantly higher in the sepsis group before treatment when compared with the control group. In addition, the levels of IMA were positively correlated with white blood cell count, CRP and PCT in the sepsis group before treatment. In conclusion, serum IMA levels may be useful in late-onset neonatal sepsis at the time of diagnosis and after therapy. As far as we know this is the first report about the assesment of illness diagnosis and after therapy using serum IMA levels, and further studies are needed to confirm our results in larger groups of patients.

Total antioxidant and total oxidant states, and serum paraoxonase‐1 in neonatal sepsis

Paraoxonase‐1 (PON‐1) is an enzyme with a glycoprotein structure that depends on calcium and which is located in serum high‐density lipoprotein (HDL). The aim of this study was to evaluate PON‐1, and oxidant/antioxidant state, before and after treatment for neonatal sepsis, and to determine the usability of PON‐1 in neonatal sepsis treatment.

Comparison of urinary neutrophil gelatinase-associated lipocalin, C-reactive protein and procalcitonin in the diagnosis of late onset sepsis in preterm newborns

Abstract Abstract Objective: We aimed to determine the value of uNGAL levels in the early diagnosis of late-onset sepsis in preterms, and to compare CRP and PCT. Materials and Methods: Preterm infants admitted to the NICU between the ages of 7 to 28 days, were divided into two groups: 24 cases with clinical sepsis (gestational age 32.88±1.45w) and 20 cases as the control group (gestational age 33±1.49w). Laboratory analyses (CBC, uNGAL, CRP and PCT measurements) were performed at the onset of treatment in the two groups. In the sepsis group, the patients were re-evaluated. Results: On the first and seventh days of treatment in the sepsis group, CRP (median: 25.09mg/L vs 8.63mg/L), PCT (median; 17.11ng/ml vs 1.39ng/ml) and uNGAL levels were determined as 45.69±18.37ng/ml, 7.89±4.19ng/ml, respectively. We found significant differences in CRP, PCT and uNGAL levels between the groups. On the seventh day of treatment, CRP, PCT and uNGAL levels were found to have significantly decreased.We found the sensitivity, specificity, positive and negative predictive values, respectively as: for CRP, 58.3%, 80%, 77.8% and 61.5%; for PCT, 91.7%, 75%, 81.5% and 88.2%; and for uNGAL, 91.7%, 100%, 100% and 90.9% Conclusion: Urinary NGAL seems to be a more sensitive and specific, reliable biomarker than serum CRP and PCT. We believe that unlike other biomarkers, uNGAL does not require a blood sample, non-invasive and non-sterile conditions, and with small amounts of urine collection in newborn sepsis it may be an ideal biomarker.

Total Antioxidan Level, Total Oxidan Level and Serum Paraoxonase‐1 Levels in Neonatal Sepsis

Paraoxonase‐1 (PON‐1) is an enzyme with a glycoprotein structure that depends on calcium and which is located in serum high‐density lipoprotein (HDL). The aim of this study was to evaluate PON‐1, and oxidant/antioxidant state, before and after treatment for neonatal sepsis, and to determine the usability of PON‐1 in neonatal sepsis treatment.

Total oxidant, antioxidant, and paraoxonase levels in babies born to pre‐eclamptic mothers

The aim of this study was to investigate the oxidant‐antioxidant status in babies born to pre‐eclamptic mothers (BBPM).

Forearm compartment syndrome owing to being stuck in the birth canal: a case report

Neonatal compartment syndrome is a rare condition mainly involving the upper extremity associated with necrotic lesions. It is often initially misdiagnosed because the skin lesions mimic several other conditions of the newborn. Early diagnosis and timely intervention are of paramount importance to achieve the best outcome. In the present case, we describe a newborn with forearm compartment syndrome owing to being stuck in the birth canal.

1182 Total Oxidative Status, Total Anti-Oxidative Status and Paraoxonase-1 Levels in Neonatal Sepsis

Aim Paraoxonase-1 (PON-1) is a calcium dependent glycoprotein enzyme that is found on the high density lipoprotein (HDL) in serum. PON-1 has been shown to protect low-density lipoprotein (LDL) and high-density lipoprotein (HDL) against oxidation and can reduce oxidative stres. In sepsis increases oxidative stres and decreases HDL concentrations. The aim of this study was to evaluate oxidant/anti-oxidant status in neonatal sepsis before and after therapy and to determine whether PON-1 could be used to monitor the treatment of neonatal sepsis. Method Thirty-five patients with neonatal sepsis and 35 healthy controls were included in the study. PON-1 activities, total oxidant status (TOS), total anti-oxidant status (TAS) groups were measured and an oxidative stres index (OSI) was calculated. Results Plasma levels of TOS, TAS and OSI were significantly higher in patients with neonatal sepsis before therapy as compared to after treatment (p<0.000, p<0.000 and p<0.000, respectively), plasma PON-1 level was significantly lower (p<0.000). Plasma levels of TOS, TAS and OSI were significantly higher in patients with neonatal sepsis before therapy as compared to the control group (p<0.000, p<0.000 and p<0.000, respectively) and plasma PON-1 level was significantly lower (p<0.000). TAS levels in after treatment were significantly higher than in the control group (p = 0.009), while TOS, OSI and PON-1 levels were similar in after treatment compared to control group (p = 0.0.078, p=0.597, p=0.086, respectively).

1774 Cause of Respiratory Distress in Neonatal Intensive Care Unit: A Retrospective Evaluation

Purpose To determine the demographic characteristics of the newborns with respiratory difficulties, frequency of neonatal disease, analyze of the prognostic factors and effectiveness of treatment who were hospitalized in NICU of our hospital between 2008 and 2009. Methods In this study, file records of the newborns who were hospitalized in NICU of Selcuk University, Meram Medical School were analyzed retrospectively. Results Of the 771 newborns, 225 who admitted due to respiratory distress in 2008 and of the 692 newborns, 282 who admitted due to respiratory distress in 2009.Mean birth weight was 1954±972gr in 2008, and 2140±1009gr in 2009. Mean pregnancy weeks were 32.4±5.0 in 2008 and 33.4±4.9 in 2009. Diagnosis of patients were sepsis (77.8%), respiratory distress syndrome (RDS) (40.4%), pneumothorax (20.9%), patent ductus arteriosus (PDA) (12.4%), meconium aspiration syndrome (MAS) (6.2%), intraventricular hemorrhage (IVH) (5.3%), pneumonia (3.6%), retinopathy of prematurely (ROP) (3.1%), bronchopulmonary dysplasia (BPD) (2.7%) and transient tachypne of newborn (TTN) (2.2%) in 2008. In 2009, percentage of the diagnosis was 69.5% sepsis, 33.3% RDS, 17.0% PDA, 16.0% pneumothorax, 10.3% pneumonia, 8.2% IVH, 6% TTN, 5.3% BPD, 3.2% MAS and 3.2% ROP. 33.7% of the patients were died in 2009 and 43.6% of them in 2008. Conclusion The newborns with respiratory distress who admitted to the hospital must be evaluated according to the pregnancy week, way of birth and accompanying problems during first examination and convenient transportation of the ones who need to be cared in advanced center where an intensive care support can be applied to decrease mortality and morbidity of newborns distress.

1368 Perinatal Mortality Rate of SelÇUK ÜNiversity Faculty of Medicin in Year of 2008

Objective Our purpose was to determine the perinatal mortality rate of our hospital in 2008. Material and Methods We evaluated newborns who were born alive or dead with a birth weight of more than 500 grams and a gestational age over 22 weeks between January 2008 and December 2008 in our hospital. Results In 2008, 3019 babies were born alive or dead with a birth weight of more than 500 grams and a gestational age over 22 weeks. Of these, 49 babies died in the perinatal period. Perinatal mortality rate was 36.7%, stillbirth rate was 20.5%, early neonatal mortality rate was 16.5%. The causes of deaths according to a modified Wigglesworth classification were stillbirths, congenital malformations and prematurity and its complications, respectively. Conclusion In our hospital, perinatal mortality rate has been declining in recent years. As a result, the some of neonatal deaths were due to complications of premature labor. Prevention of premature labor, sufficient antenatal maternal care and establishment of good delivery conditions to decrease neonatal infections and medical care after delivery could help to decrease neonatal mortality rates.

1290 Postpartum Depression in Mothers of Infants with Very Low Birth Weight

Objective Giving birth to an infant with very low birth weight (VLBW) is a major life event for a mother. Several studies have shown that mothers of these infants are at greater risk of psychological distress. The aim of this study was to investigate the level of depressive symptoms and to determine the associated factors among mothers who have infants with VLBW. Methods The sample consisted of 105 subjects: 35 mothers of VLBW infants (< 1500 g), 35 mothers of low birth weight (LBW) infants (1500–2500 g), and 35 mothers of healthy term infants (> 2500 g). The Edinburgh Postpartum Depression Scale (EPDS) was used to detect maternal depressive symptoms. Maternal social support was assessed by the Multidimensional Scale of Perceived Social Support (MSPSS). Results The mean EPDS score and the number of mothers with high depressive scores (EPDS>12) were significantly higher in mothers of infants with VLBW than in mothers of LBW and term infants. EPDS score was negatively correlated with birth weight, gestational age, and perceived social support and positively correlated with duration of hospital stay in mothers of infants with VLBW. Low birth weight and long hospital stay were found as predictors of postpartum depression in mothers of infants with VLBW. Conclusion The birth and subsequent hospitalization of an infant with very low birth weight evoke psychological distress in mothers. Pediatricians should be more careful about depressive symptoms of mothers of infants with VLBW and should refer for counseling when it is necessary.