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    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) Ertugrul, Sabahattin; Annagur, Ali; Kurban, Sevil; Altunhan, Huseyin; Ors, Rahmi
    [Abstract Not Availabe]
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    Evaluation of Oral Prostaglandin E1 in Management of Ductus Dependent Congenital Heart Disease
    (Cukurova Univ, Fac Medicine, 2012) Altunhan, Huseyin; Annagur, Ali; Ertugrul, Sabahattin; Konak, Murat; Sap, Fatih; Karaaslan, Sevim; Ors, Rahmi
    Purpose: Intravenous prostaglandin E1 (PGE1) infusion is a treatment which has been proven to be effective in ductus dependent congenital heart disease. However, PGE1 is very expensive, needed continuous infusion and its supply is difficult by every center. When its long term use is necessary, these problems become more important. The aim of this study was to show whether oral PGE1could keep the ductus open or not till the supply of intravenous PGE1. Method: Ten patients, who were admitted to newborn intensive care unit with the diagnosis of ductus dependent congenital heart disease and received oral PGE1 till the supply of intravenous PGE1, were evaluated. The PO2 with the arterial blood gas analysis and SO2 levels with pulse oxymeter at skin were recorded before and after the administration of oral and intravenous PGE1. Results: The mean oral PGE1 initiation age was 5.5 hours (0.5-25), and mean administration period was 28 hours (18-46). It was observed that the PO2 and SO2 levels of patients measured 2 hours after the initiation of oral PGE1 were significantly increased compared to the levels before initiation of PGE1. The improvement in PO2 and SO2 levels continued till the initiation of intravenous PGE1. It was also observed that the PO2 and SO2 levels of patients measured 2 hours after the initiation of intravenous PGE1 were slightly increased compared to levels before initiation of intravenous PGE1. Conclusion: Although intravenous PGE1 is more effective than oral PGE1 in short term usage, oral PGE1 is also sufficiently effective in keeping the dustus open. For this reason until the intravenous PGE1 is supplied oral PGE1 may be used as an alternative treatment choice. We think that in long term use oral PGE1, which is cheaper and easy to use, could be used instead of intravenous PGE1 without need of admission to hospital and opening intravenous line. However for this further studies are needed to confirm this assumption.
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    Shaken Baby Syndrome Suggestive of The Diagnosis of Osteogenesis Imperfecta in Newborn
    (Modestum Ltd, 2013) Annagur, Ali; Altunhan, Huseyin; Annagur, Bilge Burcak; Ertugrul, Sabahattin; Ors, Rahmi
    Physical child abuse may occur in a broad range of disorders from a mild soft tissue injury to a severe brain damage leading to death. The head trauma resulted from physical abuse is the main reason for the severe and fatal injuries in children, and arises with the clinical triad of externally seen trauma signs, subdural hemorrhage and retinal hemorrhage. In this article, we report a case of shaken baby aged 20-day, who was referred to our clinic with the diagnosis of late neonatal sepsis and osteogenesis imperfecta. A 20-day-old baby was presented to the emergency department of an outer health center with the complaints of restlessness and non-breastfeeding was considered as sepsis, and subsequently when multiple fractures were detected in the radiological investigations, a diagnosis of osteogenesis imperfecta was also considered, and the baby was referred to our hospital. In the examination of the extremities, he had swelling, ecchymose and limited mobility in both arms and the left calf. The extremity radiograms revealed body fractures in both humeri and the left femur. Radiological investigations are very important for the diagnosis of physical abuse, which causes serious mortality and morbidity and is usually difficult to diagnose because of a wrong medical history given by family members or a history taken by the physician carelessly. Discordance between the history given by the family and the radiological findings should be warning for the physician, and the radiological findings must be assessed carefully.
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    Total antioxidant and total oxidant states, and serum paraoxonase-1 in neonatal sepsis
    (Wiley, 2015) Annagur, Ali; Ors, Rahmi; Altunhan, Huseyin; Kurban, Sevil; Ertugrul, Sabahattin; Konak, Murat; Uygun, Saime Sunduz
    BackgroundParaoxonase-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. MethodsA total of 35 neonatal sepsis patients and 35 healthy controls were included in the study. Activity of PON-1, total oxidant state (TOS) and total antioxidant state (TAS) were measured and oxidative stress index (OSI) was calculated. ResultsIn the neonatal sepsis patients, pre-treatment TAS, TOS and OSI were significantly higher than the post-treatment levels (P < 0.0001, P < 0.0001 and P < 0.0001, respectively), and PON-1 was significantly lower (P < 0.0001). Similarly, pre-treatment TAS, TOS and OSI in the sepsis group were also significantly higher than in the control group (P < 0.0001, P < 0.0001 and P < 0.0001, respectively) and PON-1 was significantly lower (P < 0.0001). Post-treatment TAS in the sepsis group was significantly higher than in the control group (P = 0.009), whereas post-treatment TOS, OSI and PON-1 in the sepsis group were not significantly different to the control group (P = 0.078, P = 0.597 and P = 0.086, respectively). ConclusionLow serum PON-1 was found in neonatal sepsis. Serum PON-1 is thought to be a useful biomarker to evaluate the effectiveness of treatment and recovery in neonatal sepsis.
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    Total oxidant, antioxidant, and paraoxonase levels in babies born to pre-eclamptic mothers
    (Wiley, 2013) Altunhan, Huseyin; Annagur, Ali; Kurban, Sevil; Ertugrul, Sabahattin; Konak, Murat; Ors, Rahmi
    Aim The aim of this study was to investigate the oxidant-antioxidant status in babies born to pre-eclamptic mothers (BBPM). Material and Methods The paraoxonase (PON)-1, total antioxidant status (TAS), and total oxidant status (TOS) levels were measured in the cord blood and venous blood (7th day) of BBPM (n=31) and babies born to normotensive mothers (n=25). Results The PON-1 and TOS levels in the cord blood and venous blood on the 7th day were not significantly different between the two groups; however, the cord blood TAS levels were higher in BBPM (P=0.001), and the TAS levels in the venous blood were higher in the control group (P=0.021). Furthermore, the cord blood PON-1 levels of babies born to severely pre-eclamptic mothers (n=18) were higher than those of babies born to moderately pre-eclamptic mothers (n=13) (P=0.042). There were no differences in the cord blood TAS and TOS levels and venous blood PON-1, TAS, and TOS levels between babies born to severely and moderately pre-eclamptic mothers. Conclusion The increased TAS levels found in the cord blood of BBPM indicate that the fetus is protected against oxidative damage caused by increased oxidative stress in the mother. To the best of our knowledge, this is the first study in the published work investigating PON-1 levels in BBPM.