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The Association of Carpenter Syndrome and Situs Inversus Totalis: First Case Report
(ORTADOGU AD PRES & PUBL CO, 2011) Altunhan, Hüseyin; Annagür, Ali; Örs, Rahmi
Carpenter syndrome (acrocephalopolysyndactyly type II) is a rare autosomal recessive disorder that classically consists of acrocephaly, facial dysmorphism, mental retardation, congenital heart disease and hypogenitalism. To the best of our knowledge, situs inversus totalis has not been demonstrated previously in Carpenter syndrome. We report here a 6-day-old boy with many abnormalities diagnosed clinically and also having situs inversus totalis. As far as we know, this is the first Carpenter syndrome case associated with situs inversus totalis in the literature.
Coexistence of Congenital Chylous Ascites and Congenital Hypothyroidism: Case Report
(ORTADOGU AD PRES & PUBL CO, 2012) Altunhan, Hüseyin; Annagür, Ali; Ertuğrul, Sabahattin; Yüksekkaya, Hasan Ali; Örs, Rahmi
Chylous ascites is a rare clinical entity occurring as the result of the extravasation of the chyle into the peritoneal cavity. A 20-day newborn admitted to our clinic with high level of thyroid stimulating hormone (TSH) and abdominal distension was diagnosed with chylous ascites and congenital hypothyroidism after paracentesis. Thyroid hormone supplementation, a diet containing middle-chain triglycerides and octreotide were started. To our knowledge, the patient who recovered completely with the treatment is the first case in the literature with chylous ascites accompanied by congenital hypothyroidism. Thus, in newborns with chylous ascites, congenital hypothyroidism should be considered and the diagnosis should be confirmed with paracentesis. This approach may be beneficial for early diagnosis and treatment. Chylous ascites can be treated successfully with a diet containing middle-chain triglycerides and octreotide.
Comparing the efficacy of nebulizer recombinant human DNase and hypertonic saline as monotherapy and combined treatment in the treatment of persistent atelectasis in mechanically ventilated newborns
(WILEY, 2012) Altunhan, Hüseyin; Annagür, Ali; Pekcan, Sevgi; Örs, Rahmi; Koç, Hasan
Background: The purpose of the present study was to compare the cost-effectiveness and efficacy of nebulizer recombinant human DNase (rhDNase) and hypertonic saline (HS) as monotherapy and combined treatment in neonatal atelectasis. Methods: Eighty-seven newborns with persistent atelectasis who did not respond to traditional treatment were studied retrospectively. Group 1 did not receive nebulizer drugs; Group 2 received 7% HS; Group 3 received rhDNase; and Group 4 received both 7% HS and rhDNase. Subjects' chest X-ray scores, partial pressure of CO2, respiratory rate, fraction of inspired oxygen (FiO2) peak inspiratory pressure, atelectasis healing rate, median duration of nebulizer treatment and costs were compared. Results: Percentages of improvement in atelectasis on Day 3 of treatment in Group 1, Group 2, Group 3 and Group 4 were 27, 70, 81 and 95%, respectively, while median duration of treatment was 8.1, 3.3, 2.9 and 2.4 days, respectively. Comparison of chest X-ray scores, partial pressure of CO2, respiratory rate, FiO(2) and peak inspiratory pressure values before and 48 h after treatment did not yield a significant difference for the control group (P > 0.05), while a marked improvement was observed in other groups for all parameters (P < 0.05). The most distinct improvement was in Group 4, followed by Group 3. Conclusions: Although both the combined treatment with HS and rhDNase and their monotherapies are effective in the treatment of persistent atelectasis in newborns receiving mechanical ventilation, their combined use produces higher efficacy. The efficacy of rhDNase is superior to monotherapy with HS. Use of these two treatments concomitantly reduces the cost. To the best of our knowledge, the present study is the first to use HS alone or in combination with rhDNase in newborn patients.
Comparison of urinary neutrophil gelatinase-associated lipocalin, C-reactive protein and procalcitonin in the diagnosis of late onset sepsis in preterm newborns
(TAYLOR & FRANCIS LTD, 2013) Ertuğrul, Sabahattin; Annagür, Ali; Kurban, Sevil; Altunhan, Hüseyin; Örs, Rahmi
[Abstract not Available]
Congenital hydrocephalus as a rare cause of severe type 1 plasminogene deficiency
(Kare Publishing, 2013) Annagür, Ali; Altunhan, Hüseyin; Özbek, Orhan; Öztürk, Banu Turgut; Örs, Rahmi
Severe type I plasminogen deficiency is a rarely seen autosomal recessive disease that causes chronic inflammation in mucous membranes, primarily eye membranes. The most commonly encountered clinical manifestation is ligneous conjunctivitis. In these patients, congenital occlusive hydrocephaly may rarely be observed. In this report, we presented a newborn who had hydrocephaly in the prenatal period and presence of severe plasminogen deficiency was detected after birth. We found that the same disease was present in two children of the family and in the aunt of the newborn and discussed this situation. It should be kept in mind that plasminogen deficiency may also be present in cases with occlusive hydrocephaly and especially in newborns with the diagnosis of ligneous conjunctivitis and with familial history of ligneous conjunctivitis.
Congenital Tuberculosis in Premature Twins After in Vitro Fertilisation
(BMJ Publishing Group, 2009) Altunhan, Hüseyin; Keser, Melike; Pekcan, Sevgi; Ural, Onur; Örs, Rahmi
Genital tuberculosis is a major cause of infertility in countries where tuberculosis is endemic. With recent advances in assisted reproductive technology, women with tuberculous endometritis may become pregnant and ultimately have children with congenital tuberculosis. In vitro fertilisation represents a useful treatment for infertility. Congenital tuberculosis is a rare and severe, rapidly progressive, disease. Making an early diagnosis of congenital tuberculosis is difficult, because it can mimic many neonatal illnesses. To the best of our knowledge, we report the first cases of premature twins with congenital tuberculosis following in vitro fertilisation. After the diagnosis of genital tuberculosis in the mother, the twins were screened and diagnosed for tuberculosis. The twins dramatically improved after anti-tuberculosis therapy. We also wish to draw attention to the importance of searching for genital tuberculosis as the possible cause of congenital infection, even if the mother is asymptomatic.
Distal Ekstremite Kısalığı ve Tek Atriumla Gözüken Bir Kondroektodermal Displazi (Ellis-van Creveld Sendromu) Olgusu
(2010) Ertuğrul, Sabahattin; Annagür, Ali; Altunhan, Hüseyin; Örs, Rahmi
Nadir görülen otozomal resesif bir bozukluk olan Ellis-van Creveld sendromu veya kondroektodermal displazi ilk olarak 1940 yılında Ellis ve van Creveld tarafından tanımlanmıştır. Bu kıkırdak ve ektodermal displazi, kısa kaburga, postaksiyal polidaktili, displastik tırnak ve diş anomalileri, büyüme geriliği ve konjenital kalp hastalığı ile karakterizedir. Hastaların yaklaşık %60’ında bir kardiak defekt olup, en sık atrial septal defekt, genellikle de tek bir atrium vardır. Bu yazımızda distal ekstremite kısalığının yanı sıra tek atriumu olan bir Ellis-van Creveld sendromu olgusu sunuldu.
Doğuştan hidrosefalinin nadir bir nedeni olarak tip-1 plazminojen eksikliği
(2013) Annagür, Ali; Altunhan, Hüseyin; Özbek, Orhan; Turgut, Banu Öztürk; Örs, Rahmi
Ciddi tip 1 plazminojen eksikliği otozomal çekinik geçen ve başta göz olmak üzere müköz membranlarda kronik enflamasyona neden olan nadir bir hastalıktır. En sık görülen klinik tablosu linyöz konjonktivittir. Bu hastalarda nadiren doğuştan tıkayıcı hidrosefali de görülebilir. Biz burada doğum öncesi hidrosefali tanısı konan ve doğumdan sonra ciddi plazminojen eksikliği olduğu gösterilen yenidoğan bir bebeği sunduk. Ailenin ilk çocuğunda ve iki teyzesinde de aynı hastalığın bulunduğunu saptayıp tartıştık. Tıkayıcı hidrosefali olgularında ve özellikle linyöz konjonktivit tanısı konan veya aile öyküsünde linyöz konjonktivit olduğu bilinen bebeklerde plazminojen eksikliğinin de olabileceği akılda bulundurulmalıdır.
Duktus bağımlı konjenital kalp hastalıklarında oral prostaglandin E1 tedavisinin değerlendirilmesi
(2012) Altunhan, Hüseyin; Annagür, Ali; Ertuğrul, Sabahattin; Konak, Murat; Şap, Fatih; Karaaslan, Sevim; Örs, Rahmi
Amaç: İntravenöz prostaglandin E1 (PGE1) infüzyonu duktus bağımlı konjenital kalp hastalarında etkisi kanıtlanmış bir ilaçtır. Ancak intravenöz PGE1 oldukça pahallı, sürekli intravenöz infüzyon gerektiren ve her merkezce temini zor bir ilaçtır. Uzun süre kullanılması gerektiğinde bu sorunlar daha önemli hale gelmektedir. Bu çalışmada Oral PGE1in intravenöz PGE1 temin edilinceye kadar duktusun açık kalmasını sağlayıp sağlamadığını göstermek amaçlanmıştır. Yöntem: Yenidoğan yoğun bakım ünitesine duktus bağımlı konjenital kalp hastalığı tanısıyla yatırılıp intravenöz PGE1 temin edilinceye kadar oral PGE1 verilen 10 hasta retrospektif olarak incelendi. Hastaların oral PGE1 ve intravenöz PGE1 başlanmadan önce ve sonra arteryal kan gazında pO2 ve ciltten bakılan sO2 değerleri kaydedildi. Bulgular: Oral PGE1 tedavisine ortalama başlama yaşı 5.5 saat (0.525), verilme süresi 28 saat (1846) idi. Hastaların oral PGE1 başlandıktan 2 saat sonra alınan pO2 ve sO2 değerlerinin başlanmadan önceki değerlerine göre istatistiksel olarak anlamlı bir şekilde arttığı gözlendi. PO2 ve SO2 düzeyindeki düzelme intravenöz PGE1 başlanıncaya kadar devam etti. İntravenöz PGE1 başlandıktan 2 saat sonra bakılan PO2 ve SO2 değerlerinin intravenöz PGE1 başlanmadan önce bakılan değerlerine göre bir miktar daha artış gösterdiği gözlendi. Sonuç: Kısa süreli kullanımda intravenöz PGE1 oral PGE1den daha etkili olsa da oral PGE1de duktusun açık kalmasında yeterince etkilidir. Bu nedenle intravenöz PGE1 temin edilinceye kadar oral PGE1 alternatif bir seçenek olarak kullanılabilir. Uzun süreli kullanımda ise damar yoluna ve hastanede yatışa gerek duyulmadan, kullanımı kolay ve oldukça ucuz olan oral PGE1in intravenöz PGE1 yerine kullanılabileceğini düşünüyoruz. Ancak bunun için daha ileri çalışmalara ihtiyaç vardır.
Effects of phototherapy on serum paraoxonase activity and total antioxidant capacity in newborn jaundice
(Nobelmedicus, 2014) Kurban, Sevil; Annagür, Ali; Altunhan, Hüseyin; Mehmetoğlu, İdris; Örs, Rahmi; Erdem, Said Sami; Yerlikaya, Fatma Hümeyra
Objective: Phototherapy is an efficient and commonly used form of therapy for the treatment of neonatal hyperbilirubinemia. Paraoxonase 1 (PON1) is an antioxidative enzyme, which eliminates lipid peroxides. The aim of our study was to investigate the effect of phototherapy on serum PON1 activity and total antioxidant capacity (TAC) in hyperbilirubinemic full-term newborns.Material and Method: The study was performed on 40 full-term newborns between 3 to 15 days of age exposed to phototherapy.Serum PON1 activity and TAC levels of the babies were determinedbefore and after phototherapy by spectrophotometric assays.Results: We have found that PON1 activity was not significantly affected by phototherapy whereas TAC levels were decreased significantly after phototherapy (p<0.001).Conclusion: Our findings demonstrated that phototherapy has no direct effect on PON1 activity. Also, decreased TAC levels might have resulted from increased oxidative stress which may lead to consumption of antioxidant molecules. © 2014, Nobelmedicus. All rights reserved.
EFFECTS OF PHOTOTHERAPY ON SERUM PARAOXONASE ACTIVITY AND TOTAL ANTIOXIDANT CAPACITY IN NEWBORN JAUNDICE
(NOBEL ILAC, 2014) Kurban, Sevil; Annagür, Ali; Altunhan, Hüseyin; Mehmetoğlu, İdris; Örs, Rahmi; Erdem, Said Sami; Yerlikaya, Fatma Hümeyra
Objective: Phototherapy is an efficient and commonly used form of therapy for the treatment of neonatal hyperbilirubinemia. Paraoxonase 1 (PON1) is an anti oxidative enzyme, which eliminates lipid peroxides. The aim of our study was to investigate the effect of phototherapy on serum PON1 activity and total antioxidant capacity (TAC) in hyperbilirubinemic full-term newborns. Material and Method: The study was performed on 40 full-tenn newborns between 3 to 15 days of age exposed to phototherapy. SerumPON1 activity and TAC levels of the babies were determined before and after phototherapy by spectrophotometric assays. Results: We have found that PON1 activity was not significantly affected by phototherapy whereas TAC levels were decreased significantly after phototherapy (p<0.001). Conclusion: Our findings demonstrated that phototherapy has no direct effect on PON1 activity. Also, decreased TAC levels might have resulted from increased oxidative stress which may lead to consumption of antioxidant molecules.
Effects of the storage of breast milk at different temperatures on total antioxidant capacity, total oxidant status, and paraoxonase-1 level
(TURKISH J PEDIATRICS, 2019) Konak, Murat; Minici, Murat; Tarakçı, Nuriye; Altunhan, Hüseyin; Toker, Aysun; Örs, Rahmi
Breast milk is a well-balanced ideal nutritional source with high bioavailability for infants. As being a fresh, biological and dynamic product, changes in the breast milk during these storage periods have been the subject of ongoing research. This study aims to evaluate total antioxidant capacity (TAC), total oxidant status (TOS), and paraoxonase-1 (PON-1) levels of fresh and freeze-stored breast milk. Ten cc of breast milk was obtained from the mothers as the days between 10 and 15 in the morning within a 1-hour period. TAC, TOS, and PON-1 levels were evaluated in the fresh breast milk. Collected breast milk samples were divided into two groups for storage at -20 degrees C or -80 degrees C. Stored samples were tested for TAC, TOS, and PON-1 levels after 72 hours. The highest TAC level was detected in fresh breast milk (p <0.05). The TOS levels of fresh breast milk showed a statistically significant reduction in rate after storage. The TOS levels at -20 degrees C and -80 degrees C were significantly lower at -80 degrees C (p <0.05). Our study results show that oxidant and antioxidant activities are at the maximum level in the fresh breast milk. In terms of antioxidant status the effect of freezing temperatures hasn't been determined. We conclude that it is more convenient to store the breast milk at -80 degrees C than to store at -20 degrees C in terms of preserving the storage TOS level.
A frontonasal dysplasia case with Absence of falx cerebri
(2013) Altunhan, Hüseyin; Annagür, Ali; Özbek, Orhan; Örs, Rahmi
Frontonasal dysplasia which is also called median cleft face syndrome, is a disease that presents with signs like hypertelorism, broad nasal base, formation defect of nasal edge, anterior cranium, bifidum occultum, microphtalmia in the face and head but with possible anomalies in any organ or system. Central nervous system anomalies like corpus callosum agenesis, lipomas of corpus callosum and encephalosel may also be seen in these cases. We presented a frontonasal dysplasia case without falx cerebri. According to our investigation, this is the first case of frontonasal dysplasia without falx cerebri.
A FRONTONASAL DYSPLASIA CASE WITH ABSENCE OF FALX CEREBRI
(NOBEL ILAC, 2013) Altunhan, Hüseyin; Annagür, Ali; Özbek, Orhan; Örs, Rahmi
Frontonasal dysplasia which is also called median cleft face syndrome, is a disease that presents with signs like hypertelorism, broad nasal base, formation defect of nasal edge, anterior cranium, bifidum ocultum, microphtalmia in the face and head but with possible anomalies in any organ or system. Central nervous system anomalies like corpus callosum agenesis, lipomas of corpus callosum and encephalosel may also be seen in these cases. We presented a frontonasal dysplasia case without falx cerebri. According to our investigation, this is the first case of frontonasal dysplasia without falx cerebri.
Fully automated simultaneous umbilical arteriovenous exchange transfusion in term and late preterm infants with neonatal hyperbilirubinemia
(TAYLOR & FRANCIS LTD, 2016) Altunhan, Hüseyin; Annagür, Ali; Tarakcı, Nuriye; Konak, Murat; Ertuğrul, Sabahattin; Örs, Rahmi
Objectives: The purpose of this study was to compare the efficacy and safety of two different catheterization techniques of exchange transfusion (ET) used in the therapy of newborn jaundice: fully automated two-way ET technique and the classical one-way ET.Patients and methods: The study included babies at gestational age of >34 weeks. In total, 107 ETs were performed on 86 babies. Totally, the umbilical vein (UV) group included 54 babies having undergone 69 ETs and the UV/UA group included 32 babies having undergone 38 ETs.Results: The declines in bilirubin levels right after ET (p=0.018) and 8h after ET (p=0.014) were higher in the fully automated UV/UA technique than in the classical UV technique. Furthermore, the duration of intensive phototherapy following ET was shorter in the UV/UA method than in the UV method (p=0.003). There was no difference between the two methods in terms of ET-associated complications (p=0.927).Conclusions: In neonatal hyperbilirubinemia, ET with fully automated UV/UA technique is more efficient than the classical ET technique, causing no additional side-effects. It is also more physiological than the classical technique, since it minimizes the fluctuations in the blood volume and intravascular pressure during ET.
Hipoksik iskemik ensefalopatili yenidoğanlarda sol ve sağ ventrikül “pulsed” ve doku Doppler miyokart performans indeks değerlerinin Z-skorla karşılaştırması
(2011) Alp, Hayrullah; Karaaslan, Sevim; Baysal, Tamer; Oran, Bülent; Örs, Rahmi
Amaç: Çalışmanın amacı; hipoksik iskemik ensefalopatili (HİE) ve sağlıklı term yenidoğan bebeklerde, kardiyak etkilenmeyi göstermek amacı ile pulsed (PD) ve doku Doppler (DD) tekniklerini kullanarak miyokart performans indeksini (MPİ/Tei indeksi) belirlemek ve bu iki teknik sonuçları arasında ortaya çıkan farklılıkları değerlendirmektir. Yöntemler: Çalışma prospektif gözlemsel bir çalışmadır. Postnatal ilk 24 saat içinde belirlenen kriterlere göre perinatal asfiksi tanısı konulan 20 term yenidoğan ve kontrol grubu olarak sağlıklı, 50 term yenidoğan bebek çalışmaya alındı. HİE grup Sarnat evrelemesine göre Sarnat Evre 1 ve 2-3 olmak üzere iki gruba ayrıldı. Kontrol ve hasta gruplarına doğumdan sonraki ilk 24 saat içerisinde ve bir yıl sonra, PD ve DD ekokardiyografi teknikleri uygulanarak MPI hesaplandı. Aynı ölçüm teknikler ile elde edilen veriler Kruskal-Wallis testi ile iki tekniğin birbirine üstünlüğü ise Z skoru olarak hesaplandı. Bulgular: Sarnat evre 2-3 grubunda, hayatın ilk gününde her iki ventrikülde PD (0.410.04, 0.510.02) ve DD (0.590.04, 0.510.02) ile bakılan bakılan MPİ kontrol grubuna göre anlamlı derecede yüksek bulundu (p0.01, p0.02, p0.03). Pulsed ve doku Doppler ile elde edilen MPİ için hesaplanan Z skoru, kontrol grubu ve Sarnat Evre 1 grubunda her iki ventrikül için benzer bulunurken, diğer Sarnat gruplarında anlamlı olarak farklı olduğu görüldü. Sonuç: Hipoksik iskemik ensefalopatili yenidoğanlarda kardiyak fonksiyonlar olumsuz yönde etkilenmekte olup bu durumun, hipoksinin ağırlığı ile ilişkili olduğu bulunmuştur. MPİ, hafif hipoksiye maruz kalan yenidoğanlarda kontrol grubundan farksız iken, orta ve ağır hipoksiye maruz kalmış yenidoğanlarda daha büyüktür. İki tekniğin ölçüm değerleri açısından birbirine üstünlüğü bulunamamış ancak orta ve ağır hipoksik grupta DD ile elde edilen MPİ’deki Z skor değişiminin daha büyük olduğu saptanmıştır. (Anadolu Kardiyol Derg 2011; 11: 719-25)
The incidence of congenital anomalies associated with cleft palate/cleft lip and palate in neonates in the Konya region, Turkey
(CHURCHILL LIVINGSTONE, 2012) Altunhan, Hüseyin; Annagür, Ali; Konak, Murat; Ertuğrul, Sabahattin; Örs, Rahmi; Koç, Hasan
Additional congenital anomalies have often been found in patients with orofacial clefts. We wanted to find out the incidence and type of congenital malformations that may accompany cleft palate (CP) and cleft lip and palate (CLP) in babies born in the Konya region. A total of 121 newborn babies with CP or CLP were prospectively included in the study, and all were assessed in detail for congenital anomalies. Of 121 babies, 86(71%) had CLP and 35 (29%) had CP. There was at least one congenital malformation in 80 (66%) of the cases. Additional congenital malformations were seen in 26 (74%) of the 35 with isolated CP, and 54 (63%) in the 86 patients with CLP (p < 0.05). The most common congenital malformation was congenital heart disease, followed by head and neck anomalies. The most common congenital heart disease was atrial septal defect. A serious chromosomal anomaly was found in 18/121 patients with CP or CLP (15%). Of the 80 babies in whom congenital malformations were found, 31 (39%) had dysmorphic features. While 21 (68%) of dysmorphic cases had isolated CP, 10 (32%) had CLP (p < 0.05). The rates of premature delivery, intrauterine growth retardation, and consanguinity between parents were higher in patients with CP or CLP. The neonatal mortality was 20% (n = 24). Our results indicate that at least one congenital anomaly is also present in about two-thirds of newborn babies with CP and CLP, and these anomalies significantly increase their morbidity and mortality. All newborn babies with CP and CLP should be screened for additional congenital anomalies, particularly of the cardiovascular system. (c) 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Is Myocardial Performance Index Useful in Differential Diagnosis of Moderate and Severe Hypoxic-İschaemic Encephalopathy? A Serial Doppler Echocardiographic Evaluation
(Cambridge Univ Press, 2012) Karaarslan, Sevim; Alp, Hayrullah; Baysal, Tamer; Çimen, Derya; Örs, Rahmi; Oran, Bulent
Introduction: The aim of this study was to investigate the importance of myocardial performance index as an additive criterion to Sarnat criteria in differential diagnosis of newborn babies with moderate and severe hypoxic-ischaemic encephalopathy. Methods: Our study group included 50 healthy term newborn babies and 20 newborn babies with hypoxic ischaemic encephalopathy. The 20 newborn babies with hypoxic-ischaemic encephalopathy were scored using Sarnat grades. Left and right ventricular functions were determined on the first day and thereafter in the 1, 3-4, 6-7, and 11-12 months of life by M-Mode and pulsed Doppler. Results: Myocardial performance indexes of the left ventricle were significantly higher in the severe hypoxic ischaemic encephalopathy group than in the control group during the first, second, and third analyses (p = 0.01, p = 0.02, p = 0.02, respectively) and only during the first analysis (p = 0.01) in the moderate hypoxic-ischaemic encephalopathy group. In addition, the myocardial performance indexes of the right ventricle were significantly higher during the first, second, and third analyses in both severe and moderate hypoxic-ischaemic encephalopathy groups than in the control group (p = 0.01, all). Hypoxia-induced alterations last longer in the right ventricle than in the left ventricle in the moderate group, as during the second and third analyses myocardial performance index continues to be higher than the control group. Conclusion: Myocardial performance indexes for the left and right ventricles were significantly higher in both severe and moderate hypoxic-ischaemic encephalopathy groups than in the control group during the first analysis, and myocardial performance index greater than or equal to 0.5 can be used in order to distinguish moderate and severe hypoxic-ischaemic encephalopathy babies according to Sarnat grades as a discriminative additive criterion.
Ischaemia-modified albumin levels in newborn jaundice before and after phototherapy
(WILEY, 2011) Erdem, Said Sami; Kurban, Sevil; Altunhan, Hüseyin; Annagür, Ali; Örs, Rahmi; Yerlikaya, Fatma Hümeyra; Gökçe, Reşat
The aim of our study was to assess the effect of phototherapy (PT) on ischaemia-modified albumin (IMA) and malondialdehyde (MDA) levels in hyperbilirubinemic full-term newborns. The study was performed on 36 full-term infants exposed to PT. The babies were aged 3 to 13 days. IMA and MDA levels of the babies were determined before and after PT, by a colorimetric assay. IMA levels before and after PT were found as 0.424 +/- 0.290 and 0.531 +/- 0.262 absorbance units, respectively. Although IMA levels after PT were slightly higher, the difference was not statistically significant (p > 0.131). MDA levels before and after PT were found as 8.4 +/- 1.8 mu mol/l and 9.4 +/- 1.5 mu mol/l, respectively. Serum MDA concentrations were significantly higher after PT than before PT (p < 0.000). In previous studies, conflicting findings have been reported about the effect of PT on oxidant and antioxidant systems. However, we have found no study investigating IMA levels in hyperbilirubinaemia in newborns before and after PT. Our results shows that PT does not affect IMA levels significantly. IMA increases as a result of oxidative stress. We believe that the lack of significant difference between our IMA levels before and after PT may resulted from hyperbilirubinaemia, which has antioxidant effect. Copyright (C) 2011 John Wiley & Sons, Ltd.
Klasik galaktozemili bir yenidoğanda Candida albicans menenjiti
(2012) Altunhan, Hüseyin; Annagür, Ali; Konak, Murat; Ertuğrul, Sabahattin; Yüksekkaya, Hasan Ali; Örs, Rahmi
Klasik galaktozemi nadir görülen bir karbonhidrat metabolizma bozukluğudur. Galaktozemili hastalarda sepsis sıklığı belirgin derecede artmıştır. En sık görülen sepsis etkeni E. coli’dir. Mantar sepsisi galaktozemi hastalarında nadiren bildirilmiştir. Kandida sepsisi yenidoğan yoğun bakım ünitelerinde özellikle prematürite ve düşük doğum ağırlığı gibi altta yatan bir risk faktörü olan bebeklerde önemli bir sepsis nedenidir. Galaktozemi hastalarında en sık sepsis etkeni E. coli olmasına rağmen altta yatan bir risk faktörü olmasa da kandidiyazisin de bu hastalarda bir sepsis ve menenjit etkeni olabileceği akılda tutulmalıdır. Ayrıca kandidiyaziste klinik ve laboratuar bulgular silik olabilir. Bu nedenle özellikle neonatal kandida menenjitinde erken tanı ve tedavi için şüphe indeksini yüksek tutmak gerekir. Böyle hastalarda BOS analizi, kültürü ve beyin görüntülenmesi mutlaka yapılmalıdır. Çünkü erken tanı ve tedavi hayat kurtarıcı olacaktır. Bu yazıda yatışının dördüncü gününde alınan kan kültüründe Candida albicans üreyen ve menenjit tanısı konan bir klasik galaktozemi olgusu sunuldu.

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