Mustafa Tekin

Mean Platelet Volume and Ischemia Modified Albumin Levels in Cord Blood of Infants of Diabetic Mothers

BACKGROUND Gestational diabetes mellitus (GDM) is a risk for the health of both the pregnant women and her infant. Its unfavorable effects start in utero and continue after birth. It is known that GDM increases oxidative stress and decreases antioxidant enzyme activities. In this study we aimed to investigate cord blood mean platelet volume (MPV) and ischemia-modified albumin (IMA) levels of infants of diabetic mothers (IDM). METHODS Twenty-nine pregnant women with GDM between 37 and 41 gestational weeks who gave birth by spontaneous vaginal delivery were enrolled as study participants together with 20 healthy pregnant women as a control group. Weight, length, and head circumference of babies were measured by the same standard tape immediately after birth. Five milliliters of umbilical venous blood were obtained to study MPV and IMA levels. RESULTS There was statistically significant difference in levels of MPV (p = 0.037) and IMA (p < 0.001) between groups. They increased in IDM compared with their healthy peers. CONCLUSION Evaluation of MPV and IMA together is useful for representing the potential oxidative stress of IDM.

Passive smoking increases pain perception in children undergoing venous catheterization

To establish whether there is any association between passive smoking and pain perception in children, in the absence of existing studies into possible links.

Correlation of ischemia-modified albumin levels and histopathologic findings in experimental ovarian torsion

Objectives Ischemia modified albumin (IMA) levels significantly increased and may be used as a diagnostic marker in ovarian torsion. The aim of this study is to investigate whether there was any correlation between IMA levels and histopathologic changes in experimental ovarian torsion. Material and methods Fourteen Sprague-Dawley rats, each weighing 220–250 g were divided randomly into 2 groups; in Group 1, the control group (n = 7), only laparotomy was performed and in Group 2, the experimental group (n = 7), ovarian torsion was performed. Ischemia was performed for 3 h; following the ischemia period, the torsion was relieved by detwisting the adnexa and then the ovarian I/R protocol was applied for 3 h. Blood samples were taken from all of the rats to measure the IMA levels and the ovaries were surgically removed for histologic examination. A blinded pathologist examined and scored the samples. Results The median (minimum–maximum) IMA values were 921.00 (870.00–966.00) ABSUs in the ovarian torsion group and 853.00 (782.00–869.00) ABSUs in the control group. The difference was statistically significant. In the correlation analysis, a significant and strong correlation was found between IMA levels and histopathologic changes (Spearmans rho = +0.987, p < 0.001). Conclusion Positive correlation was found between the IMA levels and the histopathologic severity of the disease. This finding is important for both diagnosis of the disease and patient follow-up. As a new marker in ovarian torsion, IMA may also indicate the severity of the ovarian histopathology.

Relation between QT Variables and Left Ventricular Geometry in Athletes and Obese Children

INTRODUCTION We aimed to evaluate the relation between QT variables and left ventricular geometry in athletes and obese children. MATERIAL AND METHODS This study included 209 children and adolescents. Thirty-eight of them were obese, 140 were athletes and 31 were normal weighted. Children with history of functional and structural cardiovascular diseases (acquired and congenital), chronic systemic diseases, hypertension, sleep apnea, endocrinological disorders were excluded. All subjects underwent detailed electrocardiographic and echocardiographic examination. RESULTS QT dispersion was significantly higher in obese children, basketball players, football players and swimmers compared to control group (p < 0.05, p < 0.001, < 0.001 and < 0.01 respectively). Basketball players had the highest QT dispersion. Left ventricular endsystolic diameter (mm/m2) was higher in footballers, swimmers, wrestlers and tennis players compared to obese subjects. Interventricular septal thickness at diastole was highest in swimmers compared to control group (p < 0.001) and left ventricular posterior wall thickness was significantly higher in footballers and swimmers compared to healthy subjects (p < 0.01 and p < 0.001 respectively). Left ventricular geometry was normal in 84 patients (47.1%), but 34 patients (19.1%) had concentric remodelling, 20 (22.4%) had concentric hypertrophy and 40 (28.6%) had eccentric hypertrophy. No concentric and eccentric hypertrophy was observed in obese subjects. Left ventricle hypertrophy was prominent in dynamic and combined groups but it was not statistically significant (p = 0.204). QT dispersion was statistically higher in obese, dynamic sports and combined sports compared to control group (p < 0.05, p < 0.001 and p < 0.001 respectively). DISCUSSION In this study we determined that QT dispersion is elevated in dynamic and combined sports types and obese children. CONCLUSION QT dispersion is prolonged in obese and athletes who participate dynamic and combined sports.

Glucagon-like peptide-2 exhibits protective effect on hepatic ischemia-reperfusion injury in rats

Glucagon-like peptide-2 (GLP-2) has potent anti-inflammatory effects and protects against experimental ischemia/reperfusion (I/R) injury in pulmonary, intestinal, and myocardial tissue. However, its protective abilities against I/R injury in the liver are unknown. We investigated the potential role of GLP-2 pretreatment on hepatic I/R injury in rats. A total of 24 rats were randomly divided into three groups (n = 8). The first group was the control group; the second group was the vehicle-treated hepatic ischemia/reperfusion (HIR, vehicle saline-treated) group; and the third group was the GLP-2 pretreated I/R (GLP2-IR) group. Each rat in the third group was intraperitoneally administered 5 µg GLP-2 for 5 d before the procedure. A portal triad was created to induce ischemia with a vascular atraumatic clamp. After 40 min, the clamp was released to initiate hepatic reperfusion for 6 h. Blood samples and tissue specimens from the liver were obtained. Alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels significantly increased in the salinetreated HIR group (P < 0.001), whereas GLP-2 pretreatment significantly decreased their levels (P < 0.01). Our data suggested that GLP-2 pretreatment may have a protective effect on liver I/R injury. However, dose-response studies are necessary to determine the most effective dose.

Benign Acute Childhood Myositis due to Toxoplasmosis

To the Editor : A previously healthy 5-y-old boy was admitted to the emergency department with the complaint of leg pain and refusal to walk. Ten days ago he had a period of low-grade fever and fatigue that recovered spontaneously. Twenty-four hours before the admission the leg pain began and then he refused to walk. He was living in a village and had a history of contact with cats. On physical examination, he was well, afebrile and other vital signs were within normal limits. There was no lymphadenopathy or hepatosplenomegaly. Neurologic examination was normal. Extremity examination revealed bilateral calf tenderness on palpation. His gait was stiff-legged and flat-footed; he had difficulty in walking. Complete blood count and basic metabolic profile were normal. Creatine kinase (CK) increased to 809 U/L, three times normal (26–308 U/L). Urinalysis was normal and negative for myoglobin. Serology was performed to establish the etiology. It supported the acute toxoplasma infection and no other agent. His serologic results for T.gondii were as following; IgG Dye test was 6000 (positive ≥16), IgM ELISA was 10 (positive ≥2) and IgG avidity was 1.8 (low ≤20). He completely recovered and could walk independently on the 5th day of follow up. His CK returned to normal (126 U/L) and was diagnosed as benign childhood acute myositis (BCAM) after a toxoplasma infection. Benign childhood acute myositisis is a muscle syndrome that is most commonly seen after a viral infection [1]. The most common presentation of the disease is acute refusal to walk or altered gait during walking. Although the most common etiologic agents are influenza type A and B viruses, the other agents are also reported in the literature [2, 3]. Toxoplasmosis is mostly subclinical or asymptomatic infectious disease in healthy children. Myocarditis and myositis are reported as rare clinical findings [4]. The other clinical findings of BCAM are male predominance and serum CK increase. If the CK levels are too high, patient should be monitored in terms of rhabdomyolysis and renal failure [5]. Duration of symptoms are short and the recovery is spontaneous; therefore, further investigations are unnecessary unless the diagnosis is suspected [3]. In patients with acute gait disturbances if there are no alarming symptoms, BCAM should be considered certainly before unnecessary and invasive investigations. Viral serologic investigations are helpful in supporting the diagnosis.

Health Related Quality of Life and the Quality of Sleep in School Aged Children with Functional Constipation

ABSTRACT The aim of the present study was to investigate the sleep quality and health related quality of life in children with functional constipation. Fifty patients (7–13 years) attended to our general pediatric outpatient clinic and diagnosed with functional constipation and 50 healthy controls were enrolled in this case-control study. Health-related quality of life was assessed by using Kid-KINDL inventory and sleep quality was assessed by using PSQI. Children with functional constipation had lower scores of quality of life compared to healthy controls. Although the total score was not statistically significant the physical well-being scores of constipated children was significantly lower than control group. The Pittsburgh Sleep Quality Index score for children with functional constipation was significantly higher than controls (2.5 ± 2.4 and 0.5 ± 0.6, respectively; p < 0.05). School-aged children with functional constipation had lower quality of life and quality of sleep compared to their healthy peers. Physical well-being was especially impaired in constipated children affecting daily activities negatively. Assessment of quality of sleep as well as quality of life should be a part of management of functional constipation in childhood.

Effect of delivery mode on postpartum neonatal body temperatures

Abstract Objective: It is known that general and local anesthesia practices disrupt the delicate balance of thermoregulation center which is already sensitive to very tiny differences of temperatures in a normal subject. We aimed to evaluate and compare the rectal temperatures of newborns born with normal vaginal delivery and cesarean section. Methods: We performed a prospective study of 106 term newborn – 40 born with normal vaginal delivery (group 1) and 66 born with cesarean section [51 spinal anesthesia (group 2), 15 general anesthesia (group 3)]. Only term babies were included in the study. Babies of eclamptic, pre-eclamptic and diabetic mothers and babies with chronic systemic diseases were excluded. Pregnants who underwent elective cesarean section were included in the study. Adolescent pregnants, pregnants with increased risks and pregnants with complicated operations were excluded. Mothers’ temperatures were measured before and after the interventions. Rectal temperatures of the babies were measured immediately after birth. Results: Environmental temperature was maintained at 22–24 °C. Pre-operative mother temperatures were 36.31 ± 0.30 °C in group 1, 36.36 ± 0.26 °C in group 2 and 36.39 ± 0.19 °C in group 3 (p = 0.414). Post-operative mother temperatures were 36.39 ± 0.27 °C in group 1, 36.29 ± 0.31 °C in group 2 and 36.25 ± 0.28 °C in group 3 (p = 0.215). Rectal temperatures of the babies born with normal vaginal delivery were significantly higher than the others. It was lowest in the general anesthesia group (37.5 ± 0.6 °C, 37.2 ± 0.2 °C and 36.8 ± 0.4 °C in group 1, 2 and 3, respectively). The temperature differences between groups were statistically significant p < 0.001). Conclusions: In conclusion, it is worthy to note that temperatures of the newborns can differ according to the delivery mode. Physicians and health professionals that take care of the newborns should be aware of this difference.

Protective effect of glucagon‐like peptide‐2 in experimental corrosive esophagitis

Corrosive esophageal injuries are one of the life-threatening morbidities leading to esophageal stricture and perforation affecting all age groups but especially children due to accidental ingestions in this age group. Glucagon-like peptide-2 (GLP-2) is an intestinal polypeptide with potent anti-inflammatory effects. Its effects are studied in various studies but not in corrosive esophagitis. We aimed to investigate whether it has protective effect in experimental corrosive esophagitis, in the absence of existing studies into possible links. Twenty-four Wistar-albino rats, weighing 220-240 g, were randomized into three groups (n = 8 in each). First group is control, second one is sham operated, and the third one is treatment group. Median laparotomy was made in all groups. In sham and treatment groups, esophagus was loosened and suspended from 1 cm proximal to the esophageal junction. The esophagus segment between suspenders was exposed to 0.1 mL 5% NaOH for 10 seconds. In the treatment group, rats were given GLP-2 for 7 days intraperitoneally. After 7 days, all rats were sacrified and esophagi were totally removed. In the histopathologic examination, esophageal tissues were compared in terms of inflammation, muscularis mucosa injury, and collagen deposition of tunica muscularis. Histopathologic changes in the esophageal tissues of groups were compared. Histopathologic injury in the GLP-2 treated group was significantly less than sham group (P < 0.05). There was statistically significant healing in the GLP-2 treatment group. It is concluded that GLP-2 has a preventive effect on inflammation and collagen accumulation in an experimental corrosive esophagitis. In the light of the information that initial lesions in the early phase are predictors of complications, GLP-2 is a promising agent that has an anti-inflammatory effect in caustic injuries.