Erzurum District Training and Research Hospital

Erzurum, Turkey

Erzurum District Training and Research Hospital

Erzurum, Turkey
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PubMed | Dr Sami Ulus Children Research And Training Hospital, Erzurum District Training and Research Hospital, Ankara University, Nenehatun Obstetrics Hospital and Denizli Tc Public Health Hospital
Type: Journal Article | Journal: Indian journal of clinical biochemistry : IJCB | Year: 2016

Infants with respiratory distress syndrome (RDS) may suffer from severe hypoxia, asphyxia. In this study, we aimed to evaluate serum ischemia-modified albumin (IMA) level as a diagnostic marker for hypoxia in preterm infants with RDS. Thirty-seven premature newborns with RDS were allocated as the study group and 42 healthy preterm neonates were selected as the control group. IMA was measured as absorbance unit (ABSU) in human serum with colorimetric assay method which is based on reduction in albumin cobalt binding. IMA levels were significantly higher in neonates with RDS as compared to the control group (P<0.001). Cut-off value of IMA (ABSU) was 0.72, the sensitivity level was 91.9%, the specificity was 78.6%, positive predictive value was 79.1% and negative predictive value was 91.7% at RDS. Area under curve values was 0.93 (P<0.001; 95% CI, 0.88-0.98) in the receiver operating characteristic curve. We concluded that elevated blood IMA levels might be accepted as a useful marker for hypoxia in newborn with RDS.


PubMed | Erzurum District Training and Research Hospital, Erzurum Nenehatun Obstetrics and Gynecology Hospital and Suleymaniye Maternity Training and Research Hospital
Type: Journal Article | Journal: Cardiology in the young | Year: 2015

Previous studies have shown that the underlying pathophysiologic mechanism in children with breath holding may be generalised autonomic dysregulation. Thus, we performed cardiac rhythm and heart rate variability analyses using 24-hour Holter monitoring to evaluate the cardiac effects of autonomic dysregulation in children with breath-holding spells.We performed cardiac rhythm and heart rate analyses using 24-hour Holter monitors to evaluate the cardiac effects of autonomic dysregulation in children during a breath-holding spell. Our study group consisted of 68 children with breath-holding spells - 56 cyanotic type and 12 pallid type - and 39 healthy controls.Clinical and heart rate variability results were compared between each spell type - cyanotic or pallid - and the control group; significant differences (p<0.05) in standard deviation of all NN intervals, mean of the standard deviations of all NN intervals for all 5-minute segments, percentage of differences between adjacent RR intervals >50 ms, and square root of the mean of the sum of squares of the differences between adjacent NN intervals values were found between the pallid and cyanotic groups.Holter monitoring for 24 hours and heart rate variability parameters, particularly in children with pallid spells, are crucial for evaluation of cardiac rhythm changes.


PubMed | Nenehatun Obstetrics and Gynecology Hospital, Erzurum District Training and Research Hospital, Dr Sami Ulus Children Research And Training Hospital, Atatürk University and Denzili Public Healt Hospital
Type: Journal Article | Journal: Indian journal of clinical biochemistry : IJCB | Year: 2016

Hemodynamically significant ductus arteriosus (hsPDA) may alter organ perfusion by interfering blood flow to the tissues. Therefore, in infants with hsPDA, hypoxia occurs in many tissues. In this study, we aimed to investigate the diagnostic significance of serum (ischemia-modified albumin) IMA levels as a screening tool for hsPDA, and its relation to the severity of the disease in the preterm neonates. For this purpose, seventy-two premature infants with gestation age <34weeks were included in the study. Thirty premature infants with hsPDA were assigned as the study group and 42 premature infants without PDA were determined as the control group. Blood samples were collected before the treatment and 24h after the treatment, and analyzed for IMA levels. IMA levels in the study group (1.260.36 ABSU) were found to be significantly higher than control group (0.650.12 ABSU) (p<0.05). In infants with hsPDA, a positive correlation was found between IMA and PDA diameter (=0.876, p=0.022), and LA/Ao ratio (=0.863, p=0.014). The cut-off value of IMA for hsPDA was measured as 0.78 ABSU with 88.89% sensitivity, and 90.24% specificity, 85.71% positive predictive, 92.5% negative predictive value [area under the curve (AUC)=0.96; p<0.001]. The mean IMA value of the infants with hsPDA before treatment was 1.260.36 ABSU, and the mean IMA value of infants after medical treatment was 0.670.27 ABSU (p=0.03). We concluded that IMA can be used as a marker for the diagnosis and monitoring of a successful treatment of hsPDA.


Dogru M.,Zeynep Kamil Woman and Childrens Diseases Training and Research Hospital | Suleyman A.,Erzurum District Training and Research Hospital
International Journal of Pediatric Otorhinolaryngology | Year: 2016

Objectives: The relationship between vitamin D and allergic diseases such as asthma and atopic dermatitis is shown in several studies. But there is a lack of knowledge about vitamin D status in children with allergic rhinitis (AR). We aimed to investigate serum vitamin D levels of children with AR or nonallergic rhinitis (NAR), to compare with normal subjects and to evaluate the relationship between vitamin D and the severity of AR. Methods: The study included a total of 141 children (76 patients with rhinitis and 65 control subjects), who applied to the Pediatric allergy immunology outpatient. Skin prick tests were performed using the same antigens for all patients. Serum 25-hydroxyvitamin D3 (25OHD3) levels were measured. AR was classified according to the ARIA guidelines. Results: Mean 25OHD3 levels were 18.07 ± 6.1 ng/mL in the AR group, 14.81 ± 4.86 in the NAR, and 24.03 ± 9.43 ng/mL in the control group. These differences among groups were statistically significant (p = 0.001). Vitamin D status was determined as deficient in 32 (66.7%) patients, insufficient in 14 (29.2%) and normal in 2 (4.2%) of the AR group. These frequencies for NAR and control groups are 25 (89.3%), 3 (10.7%), 0, and 25 (38.5%), 32 (49.2%), 8 (12.3%), respectively. Vitamin D status was found to be different among groups (p = 0.001). There were not any association between 25OHD3 levels and allergen sensitivity (p > 0.05). The comparison of the mean 25OHD3 levels according to the severity and duration of AR did not detect statistically significant difference among groups (respectively, p = 0.384, p = 0.23 Denburg J, Fokkens WJ, Togias A5). Conclusions: The mean serum 25OHD3 levels of the children both with AR and NAR were lower than control group. No association between 25OHD3 levels and allergen sensitivities was found in our study. We did not find any relationship between 25OHD3 levels and the severity and duration of allergic rhinitis. © 2015 Elsevier Ireland Ltd.


Yilmaz O.,Erzurum District Training and Research Hospital | Kilic O.,Erzurum District Training and Research Hospital | Ciftel M.,Erzurum District Training and Research Hospital | Hakan N.,Erzurum District Training and Research Hospital
Pediatric Emergency Care | Year: 2014

Hypocalcemia is a rare condition that causes dilated cardiomyopathy and can result in heart failure. Patients with hypocalcemia have been reported to recover in 3 to 12 months after calcium and vitamin D replacement therapy as well as treatment of heart failure. A 6-month-old male patient who presented with dyspnea was admitted to the intensive care unit with severe heart failure and dilated cardiomyopathy. Blood biochemistry revealed hypocalcemia and vitamin D deficiency. After administration of anticongestive treatment, positive inotropic support, as well as vitamin D and calcium supplementation, cardiac function returned to normal in a week. Our case is the first report of such a rapid improvement in cardiac morphology and function in a patient with hypocalcemic dilated cardiomyopathy and heart failure. Copyright © 2014 by Lippincott Williams and Wilkins.


Yilmaz O.,Erzurum District Training and Research Hospital | Olgun H.,Atatürk University | Ciftel M.,Erzurum District Training and Research Hospital | Kilic O.,Erzurum District Training and Research Hospital | And 4 more authors.
Cardiology in the Young | Year: 2015

Introduction: Dilated cardiomyopathy is usually idiopathic and may arise secondary to infections or metabolic or genetic causes. Another rare cause is hypocalcaemia. Owing to the fact that calcium plays an essential role in excitation and contraction of myocardial muscle, myocardial contractility may decline in patients with hypocalcaemia. Materials and Methods: Patients with symptoms of congestive heart failure and rickets-related hypocalcaemia were assessed clinically and by echocardiography in a paediatric cardiology clinic. Echocardiography was performed for all patients. Rickets was diagnosed according to the clinical, laboratory, and radiologic findings. Maternal lifestyle and living conditions were investigated, and the maternal 25-OH vitamin D3 blood level was measured. Results: We evaluated eight patients who developed heart failure as a result of severe hypocalcaemia associated with rickets between August, 1999 and June, 2012. The age distribution of the patients was 3-12 months. Laboratory results were consistent with advanced-stage rickets. Severe hypocalcaemia was detected in all patients. The maternal 25-OH vitamin D3 levels were low. Echocardiography revealed increased pre-treatment left ventricle end-systolic and end-diastolic diameters for age and reduced ejection fraction and fractional shortening. After clinical improvement, the patients were discharged. Conclusions: Severe hypocalcaemia associated with rickets must always be kept in mind among the causes of dilated cardiomyopathy and impaired cardiac function in infants. If diagnosed and treated in time, dilated cardiomyopathy and severe heart failure related to rickets respond well. © Cambridge University Press 2013.


Kahveci H.,Erzurum District Training and Research Hospital | Yilmaz O.,Erzurum District Training and Research Hospital | Avsar U.Z.,Atatürk University | Ciftel M.,Erzurum District Training and Research Hospital | And 3 more authors.
Pediatric Pulmonology | Year: 2014

Objective: This study was performed to examine the effectiveness and safety of oral sildenafil and inhaled iloprost in term newborns with persistent pulmonary hypertension of the newborn (PPHN).Results: Iloprost appeared to be more effective than sildenafil in the treatment of PPHN with regard to time to adequate clinical response, ventilatory parameters, duration of drug administration, duration of mechanical ventilation, duration of return to normal values of respiratory failure indices, use of MgSO4 as a second vasodilator and requirement for support with inotropic agents. We observed no side effects on blood pressure or homeostasis in any of the patients in the iloprost group. Systemic hypotension was significantly elevated in the sildenafil group. Four and three infants died of PPHN in the sildenafil and iloprost groups, respectively. Pulmonary systolic arterial pressure decreased to normal levels in the remaining 40 patients, and they were discharged from hospital.Patients and Methods: Oral sildenafil and inhaled iloprost were administered to 27 and 20 neonates, respectively, for treatment of persistent pulmonary hypertension. All patients were term infants at 37 gestational weeks or older. In the sildenafil group, 14 patients had meconium aspiration syndrome, 8 had asphyxia (hypoxic ischemic encephalopathy stages II and III), 3 had congenital pneumonia, 1 had transient tachypnea, and 1 had idiopathic PPHN. In the iloprost group, 9 patients had meconium aspiration syndrome, 7 had asphyxia (hypoxic ischemic encephalopathy stages II and III), 3 had congenital pneumonia, and 1 had transient tachypnea. Sildenafil citrate was administered via an oral feeding tube. Iloprost was administered endotracheally to patients on mechanical ventilation using a jet nebulizer.Conclusion: We suggested that inhaled iloprost may be a safe and effective treatment choice in newborn infants with persistent pulmonary hypertension. In cases where treatment with inhaled iloprost, ECMO or INO is not possible, oral sildenafil can be an alternative therapy option in the treatment of PPHN. © 2014 Wiley Periodicals, Inc.


Gokce I.,Erzurum District Training and Research Hospital
JPMA. The Journal of the Pakistan Medical Association | Year: 2012

We treated 2 very low birth weight (VLBW) infants with respiratory distress syndrome suffering from refractory hypoxic respiratory failure complicated with severe pulmonary hypertension with inhaled iloprost. The first infant was an 800 gram male and the second case was a 920 gram female. Echocardiography revealed a right to left shunt through patent duct in the first case; suprasystemic pulmonary arterial pressure was estimated by using tricuspid regurgitation of moderate severity in the second case. Inhaled iloprost was started in those infants when conventional therapies including the administration of exogenous surfactant and high-frequency oscillatory ventilation failed. After the commencement of therapy, the clinical condition of the infants improved dramatically. Pulmonary arterial pressure returned to normal levels within five days. We suggest that inhaled iloprost may be helpful by improving oxygenation and reducing the need for aggressive mechanical ventilation in some cases of severe hypoxaemic respiratory failure in VLBW infants.


PubMed | Erzurum District Training and Research Hospital
Type: Journal Article | Journal: Pakistan journal of medical sciences | Year: 2015

Foreign body ingestion is a frequently observed condition in children. However, migration of an ingested foreign body from the gastrointestinal tract toward any abdominal organ is extremely rare. We report herein a case of a 2-year-old female patient in whom an ingested sewing needle was palpable by rectal examination and was determined to have migrated from within the sigmoid colon to outside of the lumen. The needle was surgically removed. In cases of foreign body ingestion, both physical examination and radiological follow-up should be performed.


PubMed | Erzurum District Training and Research Hospital, Atatürk University and Nenehatun Obstetrics and Gynecology Hospital
Type: Case Reports | Journal: Cardiology in the young | Year: 2015

Dilated cardiomyopathy is usually idiopathic and may arise secondary to infections or metabolic or genetic causes. Another rare cause is hypocalcaemia. Owing to the fact that calcium plays an essential role in excitation and contraction of myocardial muscle, myocardial contractility may decline in patients with hypocalcaemia.Patients with symptoms of congestive heart failure and rickets-related hypocalcaemia were assessed clinically and by echocardiography in a paediatric cardiology clinic. Echocardiography was performed for all patients. Rickets was diagnosed according to the clinical, laboratory, and radiologic findings. Maternal lifestyle and living conditions were investigated, and the maternal 25-OH vitamin D3 blood level was measured.We evaluated eight patients who developed heart failure as a result of severe hypocalcaemia associated with rickets between August, 1999 and June, 2012. The age distribution of the patients was 3-12 months. Laboratory results were consistent with advanced-stage rickets. Severe hypocalcaemia was detected in all patients. The maternal 25-OH vitamin D3 levels were low. Echocardiography revealed increased pre-treatment left ventricle end-systolic and end-diastolic diameters for age and reduced ejection fraction and fractional shortening. After clinical improvement, the patients were discharged.Severe hypocalcaemia associated with rickets must always be kept in mind among the causes of dilated cardiomyopathy and impaired cardiac function in infants. If diagnosed and treated in time, dilated cardiomyopathy and severe heart failure related to rickets respond well.

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