Kursat Fidanci

Endocan and Soluble Triggering Receptor Expressed on Myeloid Cells-1 as Novel Markers for Neonatal Sepsis

BACKGROUND Neonatal sepsis is an important cause of neonatal morbidity and mortality in the neonatal intensive care unit. Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) has been evaluated in sepsis and septic shock, and it was found to be valuable in distinguishing septic cases from nonseptic cases. Endocan is constitutively expressed by endothelial cells, and high levels of endocan may be of relevance for the promotion of systemic inflammation. The aim of this study was to investigate whether the levels of sTREM-1 and endocan were increased in late-onset neonatal sepsis. METHODS Patients were classified into septic and nonseptic groups. Blood was collected from a peripheral vein of all septic newborns and healthy newborns at the time of initial laboratory evaluation before any treatment, and within 48-72 hours after initiation of treatment. Serum sTREM-1 and endocan measurements were performed when the study was finished. RESULTS The study population comprised of 50 neonates: 20 nonseptic neonates and 30 septic neonates. The groups were similar with regards to baseline characteristics. The initial measurements of interleukin-6 (IL-6), sTREM-1, endocan, and immature/total neutrophil ratio (I/T ratio) were significantly higher in septic neonates in comparison with nonseptic neonates. Receiver operating characteristic (ROC) curve analyses revealed that IL-6, sTREM-1, endocan, and I/T ratio resulted in significant areas under the curve (AUC) with respect to early identification of septic neonates. Soluble TREM-1 and IL-6 performed best to distinguish septic neonates from nonseptic neonates. Univariate logistic regression analysis showed that increased IL-6 and sTREM-1 were strong predictors of neonatal late-onset sepsis. CONCLUSION Serum sTREM-1, IL-6, endocan levels, and I/T ratio increased in septic neonates. However, the diagnostic accuracy of circulating sTREM-1 seemed to be better than endocan and I/T ratio, but lower than IL-6.

Diagnostic value of elevated CXCR4 and CXCL12 in neonatal sepsis

Abstract Objective: Neonatal sepsis remains a major cause of morbidity and mortality in newborns. The chemokine CXCL12 and its receptor CXCR4 are now known to play an important role in inflammatory states. However, it is unclear how chemokines respond to late-onset neonatal sepsis. Methods: Patients were classified into the groups of septic and non-septic ones. Samples of venous blood were obtained from all septic and non-septic newborns at the beginning and within 48–72 h after initiation of treatment. Serum levels of CXCR4 and CXCL12 were measured. Results: Concentrations of IL-6, CXCR4 and CXCL12 at the time of diagnosis were significantly higher in the septic neonates compared with the non-septic ones. Additionally, there were statistically significant differences in septic neonates between the first and the second levels of IL-6, CXCR4, CXCL12 and I/T ratio. ROC curve analyses revealed that IL-6, CXCR4, CXCL12 and I/T ratio resulted in significant AUC with respect to early identification of septic neonates. Univariate logistic regression analysis showed that increased IL-6, CXCR4 and CXCL12 were strong predictors of neonatal LOS. Conclusions: Serum CXCR4 and CXCL12 levels increase in septic neonates and that both chemokines decrease within 48–72 h of treatment. Serum concentrations of both chemokines represent promising novel biomarkers for neonatal sepsis.

Metabolic and Histopathological Effects of Fructose Intake During Pregestation, Gestation and Lactation in Rats and their Offspring

Objective: Studies have demonstrated a significant relationship between maternal fructose intake and metabolic outcome in their offspring. However, there is a paucity of data about the long-term effects of fructose intake on the offspring of fructose-fed dams. Therefore, we planned a study to evaluate the long-term effects of fructose intake on the offspring of dam rats fed a high-fructose diet. Methods: Sixteen virgin female Sprague-Dawley rats were divided into two groups. Group 1 received a regular diet and Group 2 a high-fructose diet. Both groups received their experimental diets for 8 weeks before conception. They were mated and continued to feed with their experimental diet during mating and during their pregnancy and lactation periods. After weaning, the offspring from each group were divided into two groups. Group 1A received a regular diet, Group 1B - a fructose diet, Group 2A - a regular diet and Group 2B received a fructose diet. After weaning, the offspring were anesthetized and blood samples were collected for biochemical analysis. Liver, kidney and retroperitoneal adipose tissue were harvested for histopathological examination. Primary antibodies against inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) were determined as early inflammation markers. Results: After weaning, while daily water consumption was found to be significantly higher in Groups 2B and 1B (p<0.01), daily laboratory chow consumption was significantly lower in Groups 1A and 2A (p<0.01). Body weight was significantly higher in Groups 1B and 2B (p<0.01). Serum glucose, triglyceride, low-density lipoprotein cholesterol and very low-density lipoprotein cholesterol levels were found to be increased and high-density lipoprotein cholesterol levels decreased in Group 2B (p<0.05). The intensities of iNOS staining in the retroperitoneal adipose tissue, COX-2 staining in the liver and both iNOS and COX-2 staining in the kidney were higher in Group 2B (p<0.05). Conclusion: Based on our findings, we believe that the offspring of dams which received a high fructose intake during their pregestation, gestation and lactation periods are at risk of developing metabolic syndrome in their later life only if they continue to receive a high intake of fructose. We therefore propose that the risk of developing metabolic syndrome can probably be reduced by modifying the diet of the offspring after weaning.

Assessment of autonomic functions in children with familial Mediterranean fever by using heart rate variability measurements.

The aim of this study is to analyze possible autonomic nerve system alterations and assess the efficacy of heart rate variability (HRV) analysis in anticipation of cardiovascular risks in pediatric patients with familial Mediterranean fever (FMF).

Parents' Expectations and Satisfaction on Pediatrics Clinic

Parents whose child is in hospital are generally in anxiety because of the foreign environment and child’s disease. This condition of uncertainty also makes them worried. Therefore, the expectations of parents of hospitalized children and how much of this expectation in the hospital were met must be set forth. The aim of this study; is to investigate what the expectations of parents about their childs care were, how care and treatment practices affect parents’ satisfaction and what kind of a relationship between the expectation and the satisfaction. The research was implemented during the timeframe of January-April 2008 by using face-to-face interviews with the parents of children at the age of 0-18 years in pediatrics clinic by means of two questionnaires. Parents completed one questionnaire immediately after their child’s admission and the second after hospital discharge. As a result, mothers are mostly satisfied with the approach of doctors and nurses except the expectation “caring about children’s home routines”. Supportive approach of health care personal adds a big deal to satisfy parents’ expectations. Keeping communication channels open, answering their questions and giving the best care available are respective ways to catch better standards in health care

Kommerell diverticulum is a rare phenomenon: Aberrant left subclavian artery in association with right aortic arch and ventricular septal defect. -

Kommerell´s diverticulum can occur in a number of anomalies of the aortic arch system that can, but do not always, cause symptoms of tracheal or esophageal compression. The diverticulum is most frequently present in cases of right aortic arch with an aberrant left subclavian artery. In this anomaly, the left subclavian artery arises from the right-sided aortic arch as the 4th branch and extends behind the esophagus to the left arm. The descending aorta can be right sided or left sided. We report a 5-year-old girl with Kommerel diverticulum, minor left upper extremity anomalies and restrictive perimembranous ventricular septal defect.

The Relationship between Blood Pressure and Sleep Quality among Obese Adolescents Patients

Objective: To clarify the relation between blood pressure and sleep quality in obese adolescents. Methods: The study was designed and performed as descriptive study. Sleep quality questionnaire, 24hr ambulatory systemic blood pressure monitoring and anthropometric measurements were performed in both study and control groups (age range 10-18, n=22). Demographic data, Pittsburgh Sleep Quality Index and blood pressure measurements were compared. Results: No statistically meaningful association between blood pressure and sleep quality was found. Obese patients (n=30) had been found to have difficulty breathing in their sleep (p=0.001). There were no statistical differences between the obese and non-obese groups with their means of Pittsburg Sleep Quality Index (p=0.059). Conclusions: On contrary to other studies we found that sleep quality does not affect blood pressure in obese adolescents. We concluded that obese adolescents have trouble breathing in their sleep.

P01-038 – QT and JT dispersion in children with FMF

Familial Mediterranean Fever (FMF) is an autoimmune, autosomal recessive inherited disorder, and characterized by recurrent episodes of peritonitis, ploritis and arthritis. Patients with inflammatory disease are at increased risk of cardiovascular complications due to rhythm disorders. QT and JT dispersions are simple and non-invasive arrhythmogenic markers and can be used to assess the homogeneity of cardiac repolarization.

PReS-FINAL-2227: QT and JT dispersion in children with FMF

Familial Mediterranean Fever (FMF) is an autoimmune, autosomal recessive inherited disorder, and characterized by recurrent episodes of peritonitis, ploritis and arthritis. Patients with inflammatory disease are at increased risk of cardiovascular complications due to rhythm disorders. QT and JT dispersions are simple and non-invasive arrhythmogenic markers and can be used to assess the homogeneity of cardiac repolarization.

1884 Parents’ Expectations and Satisfaction in Pediatrics Wards

Objective The aim of this study is to investigate the expectations of parents about their child’s care, the effects of care practices on parents’ satisfaction and the relationship between the expectation and the satisfaction. Design and Methods The research was implemented by using face-to-face interviews with the 256 parents of children at the age of 0–18 years in pediatrics clinic by means of two questionnaires. Parents completed one questionnaire immediately after their child’s admission and the second after hospital discharge. Results As a result mothers are mostly satisfied with the approach of doctors and all their expectations except caring about children’s home routines are satisfied by nurses. Supportive approach of health care personal adds a big deal to satisfy parents’ expectations. Conclusion Keeping communication channels open, answering their questions and giving the best care available are respective ways to catch better standards in health care.