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Öğe Anaphylaxis in The Newborn with a Diagnosis of Cutaneous Mastocytosis: Case Report and Literature Review(Galenos Yayincilik, 2017) Tarakci, Nuriye; Konak, Murat; Daye, Munise; Altunhan, Huseyin; Ors, RahmiMastocytosis is carachterized by excessive mast cell accumulation in the skin and/or internal organs. Mastocytosis is divided into two groups; systemic and cutaneous. Symptoms depend on excessive cytokine release and their local and systemic affects. Symptoms may be mild or cause life-threatening anaphylactic reactions. In the literature anaphylactic reactions reported in systemic disease of adult and childhood mastocytosis. We here present an anaphylaxis in the newborn with a diagnosis of cutaneous mastocytosis.Öğe Comparison of Clinical and Neuroimaging Characteristics of Congenital and Possible Congenital Cytomegalovirus Infected Infants: A Retrospective Study(Georg Thieme Verlag Kg, 2019) Tarakci, Nuriye; Bulut, Cahide; Caksen, Huseyin; Ors, RahmiBackground To evaluate clinical and neurodevelopmental outcomes and neuroimaging results of patients diagnosed with congenital cytomegalovirus (cCMV) infection and those diagnosed with possible congenital CMV (possible cCMV) infection. Methods From January 2014 to January 2016, 24 patients were diagnosed with congenital CMV infection. Clinical and neuroimaging results of these patients were examined from their medical records. Results Of the 24 patients, 6 were diagnosed with cCMV, whereas 18 patients were diagnosed with possible cCMV. Petechia was the most common symptom observed in patients with cCMV infection, whereas microcephaly was more common in patients with possible cCMV. Of the 24 patients, 5 (20.8%) showed normal neuroimaging characteristics. The most commonly encountered abnormal findings in brain magnetic resonance imaging were hypoplasia of corpus callosum (16.7%) and hydrocephalous (16.7%). All of the patients had poor neurodevelopmental outcomes. Conclusions Early diagnosis of asymptomatic cCMV infection is difficult. This study suggests that possible cCMV infections are more prevalent compared with cCMV infections, and delays in diagnosis occur due to not keeping suspicion of CMV infection in early phase. Clinicians should consider long-term neurodevelopmental sequelae of cCMV and possible cCMV infections and remember to screen congenital CMV infection in suspected individuals.Öğe Comparison of left and right ventricular pulsed and tissue Doppler myocardial performance index values using Z-score in newborns with hypoxic-ischemic encephalopathy(Turkish Soc Cardiology, 2011) Alp, Hayrullah; Karaaslan, Sevim; Baysal, Tamer; Oran, Bulent; Ors, RahmiObjective: The aim of the study is determination of myocardial performance index (MPI/Tei index) using pulsed (PD) and tissue Doppler (TD) techniques to show cardiac response in newborns with hypoxic-ischemic encephalopathy (HIE) and healthy newborns and eventually evaluation of the differences between these two techniques. Methods: The study is a prospective observational study. Twenty term newborns diagnosed as perinatal asphyxia during postnatal 24 hours due to the defined criteria and fifty healthy term neonates as control group were included the study. Hypoxic group was divided into two groups with Sarnat stages, Sarnat Stage 1 and 2-3. MP's (Tei indexes) were calculated with PD and TO echocardiographic techniques in all groups after the 24 hours of birth and one year later. The statistical differences between same techniques were calculated with Kruskal-Wallis test and Z score was used to compare the superiority of two techniques. Results: The MPI values calculated by PD (0.41 +/- 0.04, 0.51 +/- 0.02) and TD (0.59 +/- 0.04, 0.51 +/- 0.02) during the first day of life in Sarnat Stage 2-3 in both ventricles were significantly higher than the control group (p<0.01, p<0.02, p<0.03). While the Z score, calculated for MPI measured by PD and TD methods, were found similar in both ventricles in Sarnat Stage 1 and control groups, it was significantly different in other groups of Sarnat stages. Conclusion: The degree of cardiac response in neonates with HIE is associated with the severity of hypoxia. MPI values are not different from the controls in newborns received mild hypoxia while they are higher in the patients who were received moderate or severe hypoxia. Any advantage could not be found between two techniques according to the measurement values, but higher variability in the value of MPI, measured by TO method, calculated from moderate and severe hypoxia group was detected. (Anadolu Kardiyol Derg 2011; 11: 719-25)Öğe 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]Öğe A congenital cranial dysinnervation disorder: Mobius' syndrome(Aves, 2017) Albayrak, Hatice Mutlu; Tarakci, Nuriye; Altunhan, Huseyin; Ors, Rahmi; Caksen, HuseyinMbius' syndrome, also known as Mbius' sequence, is a nonprogressive cranial dysinnervation disorder characterized by congenital facial and abducens nerve paralysis. Here, we report a 5-day-old girl who was conceived after in vitro fertilization with poor suck and facial paralysis. She had bilaterally ptosis and lateral gaze limitation, left-sided deviation of the tongue, dysmorphic face, hypoplastic fingers and finger nails on the left hand, and was diagnosed as having Mbius' syndrome. Involvement of other cranial nerves such as three, four, five, nine, 9 and 12, and limb malformations may accompany this syndrome. However, several factors have been proposed for the etiology, some rare cases have also been reported with artificial reproductive technologies. Feeding difficulties and aspiration are the main problems encountered in infancy. The other cranial nerves should be examined further in newborns who present with congenital facial palsy, and other cranial dysinnervation disorders should be considered in the differential diagnosis.Öğe Congenital hydrocephalus as a rare cause of severe type 1 plasminogene deficiency(Aves, 2013) Annagur, Ali; Altunhan, Huseyin; Ozbek, Orhan; Ozturk, Banu Turgut; Ors, RahmiSevere 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.Öğe Congenital Nephrotic Syndrome: Case Report and Review of Literature(Cukurova Univ, Fac Medicine, 2012) Konak, Murat; Annagur, Ali; Altunhan, H.; Atas, Bulent; Ors, RahmiCongenital nephrotic syndrome (CNS) is a rare kidney disease which reveals itself after birth and characterized with severe proteinuria, hypoalbuminemia and edema. It is a genetic disorder that occurs with deterioration of glomerular filtration barrier especially as a result of mutation that develops in genes called nephrin and podocin. CNS could be as a result of perinatal infection as well as a part of a genetic syndrome. Immune suppressive treatment is ineffective in genetically originated CNS, however renal transplantation yields curative treatment. In many cases to prevent from life threatening edema, daily albumin infusion is needed. Additionally, high caloric diet, thyroxin and mineral supply are applied. Also prophylaxis of thrombolytic complications and opportunistic infection that could develop due to immune deficiency is needed. In this report we discussed a case with the review of literature by reporting a newborn which had CNS diagnosis as a result of persistent hypoalbuminemia and proteinuria without edema.Öğe EFFECTS OF PHOTOTHERAPY ON SERUM PARAOXONASE ACTIVITY AND TOTAL ANTIOXIDANT CAPACITY IN NEWBORN JAUNDICE(Nobel Ilac, 2014) Kurban, Sevil; Annagur, Ali; Altunhan, Huseyin; Mehmetoglu, Idris; Ors, Rahmi; Erdem, Said Sami; Yerlikaya, Fatma HumeyraObjective: 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.Öğe 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, RahmiPurpose: 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.Öğe From the Symptoms of an Undiagnosed Mother to the Infant with Congenital Myotonic Dystrophy(Derman Medical Publ, 2017) Gultekin, Nazli Dilay; Yilmaz, Fatma Hilal; Altunhan, Huseyin; Ors, RahmiCongenital myotonic dystrophia (CMD) is a disorder with a wide clinical spectrum, characterized by hypotonia, respiratory failure, and nutritional challenges in the neonatal period. Although familial history is important in the diagnostic process, diagnosing the infant in the neonatal period may, conversely, lead the mother, or rarely the father, to be diagnosed. Here, a male infant presenting with hypotonicity and respiratory failure in the neonatal period was diagnosed with CMD through genetic testing by looking at the complaints of fatigue, muscle pain, and hypersomnia in the mother. As in our case, it should be kept in mind that CMD can be diagnosed at an early stage only by focusing on the familial history in hypotonic infants.Öğe Hyperpyrexia Associated with Congenital Long QT Syndrome(Cukurova Univ, Fac Medicine, 2014) Tarakci, Nuriye; Konak, Murat; Altunhan, Huseyin; Alp, Hayrullah; Ors, RahmiCongenital long QT syndrome (CLQTS) is a genetic disorder presented with prolonged QT interval. In these patients, risk of sudden cardiac death due to ventricular tachyarrhythmias is high. Bradycardia may exhibit as a result of intrauterine fetal atrioventricular block, sinus bradycardia, tachycardia in these patient. Prolonged QT interval and multisystem involvement such as sensorineural hearing loss, muscle paralysis, immune deficiency, syndactyly have been reported in these patient. We have detected hyperpyrexia without clinical immunodeficiency and infection in our patient. To our knowledge, our patient is the first case in the literatureÖğe Is Maternal Depressive Symptomatology Effective on Success of Exclusive Breastfeeding During Postpartum 6 Weeks?(Mary Ann Liebert, Inc, 2013) Annagur, Ali; Annagur, Bilge Burcak; Sahin, Akkiz; Ors, Rahmi; Kara, FatihAim: The aim of this prospective study was to examine the relationship between success of exclusive breastfeeding and postpartum depressive symptomatology. Our hypothesis was that mothers with depressive symptoms initially fail exclusive breastfeeding. Subjects and Methods: One hundred ninety-seven mothers were enrolled in the study. The participants were interviewed twice. The first visit was within the first 48 hours after birth. The Edinburgh Postnatal Depression Scale (EPDS) was completed by the participants. The second interview was performed at 6 weeks. Participants answered questions regarding methods of breastfeeding for 6 weeks, any methodological problems, and nipple pain. The EPDS was again completed by the participants at 6 weeks. All newborns were term infants. Results: All the participants were divided into two groups: exclusive breastfeeding and mixed-feeding (partial breastfeeding and/or bottle feeding). Both groups were compared in terms of features, such as mode of delivery, parity, prevalence of depressive symptomatology (at 48 hours and 6 weeks), and delayed onset of lactation within the first 48 hours. Statistical significance was found for only three variables: delayed onset of lactation within the first 48 hours, gestational age, and the problems related to breastfeeding methods. Conclusions: Clinicians should pay special attention to any lactation difficulty during the first week postpartum. Early lactation difficulties are associated with greater risk of early termination of breastfeeding and lower breastfeeding success.Öğe Is myocardial performance index useful in differential diagnosis of moderate and severe hypoxic-ischaemic encephalopathy? A serial Doppler echocardiographic evaluation(Cambridge Univ Press, 2012) Karaarslan, Sevim; Alp, Hayrullah; Baysal, Tamer; Cimen, Derya; Ors, Rahmi; Oran, BulentIntroduction: 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.Öğe Is myocardial performance index useful in differential diagnosis of moderate and severe hypoxic-ischaemic encephalopathy? A serial Doppler echocardiographic evaluation (vol 22, pg 335, 2012)(Cambridge Univ Press, 2012) Karaarslan, Sevim; Alp, Hayrullah; Baysal, Tamer; Cimen, Derya; Ors, Rahmi; Oran, Bulent[Abstract Not Availabe]Öğe Lneonatal meningitis due to streptoccocus dysgalactiae subspecies equisimilis: a case report and literature review(Derman Medical Publ, 2018) Tarakci, Nuriye; Yilmaz, Fatma Hilal; Gultekin, Nazli Dilay; Altunhan, Huseyin; Ors, RahmiStreptococcus dysgalactiae subsp. equisimilis (SDSE) was firstly reported as a toxon among human streptococcal pathogens in the year 1996. Diseases caused by SDSE may vary from milder skin involvements including wound infection, erysipelas, and cellulitis to life-threatening clinical pictures as streptococcal toxic shock syndrome and necrotizing fasciitis. We describe a case of SDSE sepsis and meningitis in a 2-day-old newborn. He was referred to our intensive care unit (ICU) with fever, respiratory distress, seizures, peripheral cyanosis, and somnolence. SDSE grew out of the CSF and blood cultures obtained on admission to the ICU. SDSE cases reported in the literature are frequently older patients with an underlying disease. Also, SDSE may cause serious neonatal infections.Öğe Normal values of left and right ventricular function measured by M-mode, pulsed doppler and Doppler tissue imaging in healthy term neonates during a 1-year period(Elsevier Ireland Ltd, 2012) Alp, Hayrullah; Karaarslan, Sevim; Baysal, Tamer; Cimen, Derya; Ors, Rahmi; Oran, BulentBackground: The measurements of left and right ventricular functions change after birth due to the influence of several hemodynamic changes upon the immature myocardium. Aim: The aim of this study was to investigate the changes in left (LV) and right ventricular (RV) functions of healthy term newborns using conventional and Doppler echocardiography during a 1-year period. Subjects and methods: Fifty healthy term newborns were examined prospectively on the first day, 3-4, 6-7, 9-10 and 11-12 months of their lives by M-mode, pulsed Doppler (PD) and Doppler tissue imaging techniques (DTI). PD velocities were obtained from mitral and tricuspid valves while DTI velocities were obtained from the lateral annuluses of atrioventricular valves. Results: EF and FS did not change significantly by time. Early (E) flow velocity and early myocardial (Em) velocity were higher than late (A) flow velocity and atrial systolic (Am) velocity for LV, while A and Am velocities were higher than E and Em velocities for RV, respectively during the study period. E. A, Em, Am, Sm velocities and Em/Am ratios increased while E/Em ratios decreased significantly by time (P<0.05) for both ventricle. However, E/A ratios of LV and RV did not change significantly by time. Myocardial performance index (MPI), obtained by PD for RV and by DTI for LV, decreased significantly by time (P<0.05) and these DTI values were higher than PD values during the study period. Conclusions: Due to hemodynamic and maturation change of myocardium PD and DTI velocity changes took place during the first year of life which reflects differences in ventricular adaptation. (C) 2012 Elsevier Ireland Ltd. All rights reserved.Öğe Persistent Nasal Bleeding Due to Nasal CPAP Application in 2 Premature Newborns Successfully Treated With Topical 'Ankaferd Blood Stopper''(Sage Publications Inc, 2011) Altunhan, Huseyin; Annagur, Ali; Tokgoz, Huseyin; Caliskan, Umran; Ors, Rahmi[Abstract Not Availabe]Öğe Postpartum Depression in Mothers of Infants with Very Low Birth Weight(Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2013) Herguner, Sabri; Annagur, Ali; Clcek, Erdinc; Altunhan, Huseyin; Ors, RahmiBackground: 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. (Archives of Neuropsychiatry 2012; 50: 30-33)Öğe Respiratory Distress in Neonatal Intensive Care Unit: A Retrospective EvaluationA(Cukurova Univ, Fac Medicine, 2012) Annagur, Ali; Altunhan, Huseyin; Aribas, Semra; Konak, Murat; Koc, Hasan; Ors, RahmiPurpose: 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 neonatal intensive care unit (NICU). Methods: In this study, file records of the newborns who were hospitalized in NICU of 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 +/- 972 gr in 2008, and 2140 +/- 1009 gr 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.Öğe Role of Subgroup Incompatibility in Newborn Jaundice Requiring Exchange Transfusion(Modestum Ltd, 2014) Annagur, Ali; Altunhan, Huseyin; Konak, Murat; Koc, Hasan; Ors, RahmiWe aimed to determine the role of exchange transfusion related complications, treatment, and etiology as well as subgroup incompatibility in patients subject to ET (exchange transfusion) due to newborn jaundice. 82 patients hospitalized due to newborn jaundice and exposed to exchange transfusion between August 2007 and August 2011 were retrospectively studied. Before ET mean total serum bilirubin was 29,2 +/- 9,83. The most frequent cause of ET was ABO incompatibility (31%) followed by Rh incompatibility (19%) and subgroup incompatibility (17%), respectively. In 46% of all patients and in 71% of the patients presenting with subgroup incompatibility, direct combs test was detected to be (+). 49% of the patients were administrated with intravenous immunoglobulin. 5 of the patients who were exposed to ET presented with hydrops fetalis. Of these patients 3 had Rh, 1 had ABO while the other had subgroup incompatibility. Although ABO and Rh incompatibility are substantial underlying reasons of severe jaundice requiring exchange transfusion, particularly widespread use of RhoGAM thereby enabling the prior identification and precautions, ET need was reduced compared to previous cases. On the contrary, SGU related severe hemolytic jaundice relatively enhanced, however.
