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Öğe Antioxidant defense systems in newborns undergoing phototherapy(The Indian Journal of Pediatrics, 1999) Akisü M.; Yilmaz D.; Tüzün S.; Kültürsay N.This paper was designed to investigate whether phototherapy is an oxidative stress in newborn infants undergoing phototherapy. A day-light continuous phototherapy was given to jaundiced 20 term and 16 preterm newborns for 72 hours. We measured serum vitamin E and the activities of red blood cell anti-oxidation enzymes (superoxide dismutase, catalase and glutathione peroxidase) before and after 72 h of phototherapy. Serum vitamin E levels were not different before and after 72 h of phototherapy in both preterm and term infants. In several studies, antioxidant enzyme activities have been shown to increase in response to oxidative stresses. In this study, however, the antioxidant enzyme activities in the hemolysate were similar before and at the end of the phototherapy in both preterm and full term. In conclusion, the results of our in vivo study do not confirm the thesis that phototherapy is an oxidative stress in newborn infants. Therefore, phototherapy would preferably seem to be safe and efficient method of treatment for all neonates presenting with hyperbilirubinemia. (Indian J Pediatr 1999; 66 : 651-655).Öğe Ballard and new ballard scoring systems in the assessment of gestational age in preterm infants [Prematüre bebeklerde patent duktus arteriozusun tedavisinde enteral ibuprofen ve indometazinin etkinligi ve güvenilirligi](2001) Akisü M.; Ruhi Özyürek A.; Dorak C.; Parlar A.; Kültürsay N.This study was designed to investigate the efficacy and safety of enteral ibuprofen for the treatment of patent ductus arteriosus (PDA) and to compare it with enteral indomethacin. Twenty-three premature infants with gestational ages of less than 35 weeks with echocardiographically confirmed PDA were randomly assigned to receive either enteral indomethacin (3 × 0.2 mg/kg at 12 hour intervals) or enteral ibuprofen (1 × 10 mg/kg, followed by 5 mg/kg 24 and 48 hours later). PDA closed in eight of 11 patients (72%) from the indomethacin group and in 10 of 12 (83%) from the ibuprofen group in the first treatment. Five patients (three from indomethacin group, two from ibuprofen group) required a second treatment with the same drug. Ultimately, PDA closed in nine preterm infants from the indomethacin group (81%) and in 10 preterm infants from the ibuprofen group (83%). Ibuprofen patients had a better urinary output compared with the indomethacin group, an ibuprofen treatment was not associated with significant side effects. As a result, ibuprofen treatment seems to be as efficient as indomethacin in closing PDA in preterm infants, with fewer renal side effects.Öğe Effect of dietary n-3 fatty acids on hypoxia-induced necrotizing enterocolitis in young mice. n-3 fatty acids alter platelet-activating factor and leukotriene B4 production in the intestine(1998) Akisü M.; Baka M.; Çoker I.; Kültürsay N.; Hüseyinov A.Necrotizing entercolitis (NEC) is an important neonatal disease with a high mortality rate. Inflammatory mediators, such as mainly platelet-activating factor (PAF), leukotrienes (LT) and tumor necrosis factor play an important role in the genesis of NEC. Diets in ??3 (n-3) fatty acids appear to have an antiinflammatory effect, which is thought to be due to decreased active prostaglandins and leukotrienes production after incorporation of these fatty acids into cell membranephospholipids. We investigated the protective effect of fish oil (source of n-3 fatty acids) on hypoxia-induced model of NEC. Young mice were divided into three groups group 1 mice were fed standard chow (n-3 fatty acids-free), group 2 was fed a chow supplemented by 10% fish oil for 4 weeks. Group 3 mice served as control. We examined the intestinal lesions by light microscopy and measured intestinal tissue PAF and LB4 levels in hypoxia-induced model of NEC. Significantly increased intestinal PAF and LTB4 levels were found in group 1 mice when compared to group 2 and group 3 mice. The histopathology of the intestinal lesions in group 1 animals was characteristic of ischemic injury. In the n-3 fatty acids-supplemented animals these lesions were milder. The present study shows that endogenously released PAF and LTB4 play an important role in mediating hypoxia-induced intestinal necrosis. The present study also suggests that dietary supplementation with n-3 fatty acids suppress intestinal PAF and LTB4 generation in hypoxia-induced bowel necrosis. The intestinal protective effect of n-3 fatty acids in an experimental model of NEC may open new insight into the treatment and preventation of NEC in neonates.Öğe The Effect of L-Carnitine on Platelet Activating Factor Concentration in the Immature Rat Model of Hypoxic-Ischemic Brain Injury(1998) Akisü M.; Kültürsay N.; Çoker I.; Hüseyinov A.Recent data suggested that platelet-activating factor (PAF) could play a pathophysiologically important role in the progression of hypoxic-ischemic brain injury. We investigated brain tissue PAF concentration in the hypoxic-ischemic brain of immature rats. Endogenous PAF concentration in brain tissue showed a marked increase in hypoxic-ischemic pups (Group 1, 85.6 ± 15.5 pg/mg protein) when compared to that of the control (9.1 ± 3.1 pg/mg protein). In addition, we studied the effects of pretreatment with L-carnitine (5 days and 2 h before the hypoxia) on endogenous PAF concentration in the hypoxicischemic brain. Endogenous PAF concentration in the short-term pretreatment group (Group 2, 81.6 ± 9.7 pg/mg protein) was not different than in Group 1 rat pups. However, a significantly decreased PAF concentration was found in the group of pups that received carnitine pretreatment for 5 days (Group 3, 30.5 ± 11.0pg/mg protein). These results indicate that PAF is an important mediator in the immature rat model of cerebral hypoxic-ischemic injury. The suppressor effect of L-carnitine on PAF production may give new insight into the treatment of hypoxic-ischemic brain injury.Öğe Neonatal Klebsiella pneumonia sepsis and imipenem/cilastatin(Springer, 1998) Oral R.; Akisü M.; Kültürsay N.; Vardar F.; Tansug N.Efficacy and safety of imipenem/cilastatin in neonatal ]Klebsiella pneumonia sepsis was investigated in 45 infants compared to 39 control infants on conventional antibiotic regimen. Sensitivity to imipenem was 94% followed by cephoxitin (88%), quinolons (80%), and amikacin (52%) according to susceptibility results in the study group. Treatment duration of surviving infants was 16.5 ± 4.6 and 20.3 ± 6.4 days in the study and control groups respectively (p < 0.05). Five infants (11%) vs 27 (69%) were unresponsive (septic deaths) to treatment in the study and control groups respectively (p < 0.001). The cure rates were 73% and 28% respectively (p < 0.001). Sequelae free discharge rates were 67% and 23% respectively (p < 0.001). The most frequent adverse effects of imipenem/cilastatin were Candida albicans superinfection (20%); Candida albicans colonisation (10%); impairment of liver and renal functions (19% and 10% respectively); seizures (5%); thrombocytosis (3%); thrombophlebitis (3%); urine discoloration (3%); and Stapylococcus epidermidis colonisation (2%). Imipenem is considered a good alternative for neonatal Klebsiella pneumonia sepsis with these results, however, one must be aware of the increased risk of Candida albicans superinfection.Öğe A newborn successfully treated with cardioversion for congenital atrial flutter: Case report [Konjenital Atriyal Flatter Nedeniyle Kardiyoversiyon Uygulanarak Başaryla Tedavi Edilen Yenidogan Olgusu](2012) Köroglu O.A.; Yildiz B.; Bulut O.; Yalaz M.; Can D.; Levent E.; Akisü M.; Özyürek R.; Kültürsay N.Fetal and neonatal arrhytmias may demonstrate life threatening features. Atrioven tricular re entry mechanism is thought to be effective in the development of these rhytm disorders that present as either increased or decreased heart rate. Benign atrial extrasistoles are among the most common arrhytmias in this age group; in whom supraventricular tachycardia is seen as a frequent cause of tachycardia. Atrial flutter is a very rare cause of fetal and neonatal tachycardia. These arrhythmias due to different etiologies have a wide range of clinical symptoms ranging from feeding difficulties to heart failure that necessitates urgent treatment. We hereby; present a term newborn without any cardiac malformation, successfully treated with cardioversion for congenital atrial flutter. Copyright © 2012 by Türkiye Klinikleri.Öğe Platelet-activating factor is an important mediator in hypoxic ischemic brain injury in the newborn rat. Flunarizine and Ginkgo biloba extract reduce PAF concentration in the brain(1998) Akisü M.; Kültürsay N.; Coker I.; Hüseyinov A.Hypoxic-ischemic encephalopathy is still a very important cause of neonatal mortality and morbidity. Recently, platelet-activating factor (PAF) has been accused of being responsible for the neuronal damage in hypoxic-ischemic brain. We investigated tissue PAF concentrations in hypoxic-ischemic brain injury in immature rats. Endogenous PAF concentration in brain tissue showed a marked increase in hypoxic-ischemic pups (85.6 ± 15.5 pg/mg protein) when compared to that of control (9.05 ± 3.1 pg/mg protein). In addition, we examined the effects of flunarizine, a selective calcium channel blocker, and Ginkgo biloba extract (EGb 761) on endogenous PAF concentration in hypoxic-ischemic brain injury. Endogenous PAF concentrations in both flunarizine-pretreated (16.6 ± 4.8 pg/mg protein) and EGb 761-pretreated (33.5 ± 8.9 pg/mg protein) pups were significantly lower than the untreated group. These results indicate that PAF is an important mediator in immature rat model of cerebral hypoxic-ischemic injury. The suppressor effect of flunarizine and EGb 761 on PAF production may open new insight into the treatment of hypoxic-ischemic brain injury.Öğe Serum lipid and lipoprotein composition in infants of diabetic mothers(The Indian Journal of Pediatrics, 1999) Akisü M.; Darcan S.; Oral R.; Kültürsay N.Diabetes mellitus (DM) alters carbohydrate and lipid metabolism to a great extent. This study was planned to determine whether infants of insulin dependent and gestational diabetic mothers have abnormal lipid metabolism. Three groups of newborns were included in the study; group I consisted of 7 infants of diabetic mothers (IDM) with insulin dependent DM (Type 1 DM), group II of 18 infants of gestational diabetic mothers and group III of 20 control neonates whose mothers had no history of DM. Total cholesterol (TC), triglyceride (TG) and high density lipoprotein-cholesterol (HDL-C) values in groups I and II were no different compared to those in group III (p > 0.05). However, low density lipoprotein-cholesterol (LDL-C) and LDL-C/HDL-C ratio were similar between groups I and II (p > 0.05) but significantly higher in both infants of type I diabetic mothers and gestational diabetic mothers compared to control infants (p < 0.05). Apolipoprotein A-I (Apo A-1) and apolipoprotein B (Apo B) levels, Apo A-I/Apo B and HDL-C/Apo A-I ratios were similar in between groups. However, Apo B/LDL-C ratio was significantly lower in groups I and II compared to control group (p < 0.05). In conclusion, diabetes in pregnant women causes a tendency to LDL hypercholesterolemia in the offspring. These infants should be longitudinally followed up to assess whether this observation imposes an increased risk for atherosclerosis for advanced ages.
