Endothelin 1 concentrations in infants with meconium stained amniotic fluid.

Plasma endothelin 1 concentrations were determined in infants with meconium stained amniotic fluid. Plasma endothelin 1 concentration in the study group (5.23 pg/ml) was statistically higher than that in the control group (1.12 pg/ml). Cord blood pH and base excess values were significantly lower in infants with meconium stained amniotic fluid when compared with the control group. There was no correlation between endothelin 1 concentrations and pH or base excess values. Results suggest that meconium passage is not a physiological event, even if meconium stained infants appear to be clinically healthy.

Earthquake related startle reaction and its EEG correlates.

The acute effect of traumatizing events on the human brain has long been studied. The major obstacles to this endeavor have been the severity and the delay from time of exposure to the traumatizing events. To avoid these issues, EEG and clinical examinations of 18 healthy, drug-free subjects were performed 2 weeks after an earthquake occurred in Turkey in 1999. It was found, for the first time to our knowledge, that EEG parameters can predict startle response in acute stress reaction correctly in 100% of the cases. EEG measures of the reactivity to eyes opening were especially important in this regard.

Serratia marcescens: an emerging microorganism in the neonatal intensive care unit.

As smaller babies survive in neonatal intensive care units, late-onset septicemia with unusual pathogens appears. Between 1 January and 31 December 1998, in Hacettepe University Ihsan Dogramaci Children's Hospital Neonatal Intensive Care Unit, seven infants had S. marcescens isolates. Four babies had septicemia with the microorganism. The case fatality rate was 50 percent in infants with S. marcescens septicemia. The combination of ceftazidime or imipenem with amikacin appears appropriate for the treatment of newborns with Serratia infection.

Cranial MRI in neonatal hypernatraemic dehydration.

Severe neonatal hypernatraemia is a life-threatening electrolyte disorder because of its neurological complications. These are brain oedema, intracranial haemorrhages, haemorrhagic infarcts and thromboses. There are few reports concerning the radiological findings in the central nervous system in severe neonatal hypernatraemia. Cranial MRI findings in hypernatraemia have been reported in an older child, but have not been described in newborn infants. We report the cranial MRI findings in a newborn infant with acute renal failure and severe hypernatraemia.

Neonatal morbidity and mortality associated with maternal HELLP syndrome.

The syndrome of hemolysis, elevated liver enzymes and low platelet count (HELLP syndrome) is a severe form of preeclampsia and eclampsia. To compare the impact of HELLP syndrome and hypertension in pregnancy (HIP) on neonatal morbidity and mortality, 11 infants born to mothers with HELLP syndrome were recruited between 1993 and 1997 from neonatal records. They were compared to 11 infants born to mothers with HIP and 11 control infants born to healthy mothers matched for gestational age, postnatal age and gender. Cesarean section rate was higher in the HELLP group than in the controls (p < 0.05). HELLP group infants had lower Apgar scores (54.5% < 1 at 5th min), than controls (9.1%) (p < 0.05). Both HELLP and HIP group infants showed a higher incidence of intrauterine growth retardation (63.6% and 54.5%, respectively) than the controls (9.1%) (p < 0.05). The incidence of respiratory distress syndrome (RDS) was similar in HELLP and HIP groups and was greater than that in controls (p = NS). Additionally, the neonatal death rate was the highest in the HELLP group (p = NS).

The influence of information on social and occupational outcome in mental illness on the attitudes of students in Turkey.

BACKGROUND: In this article, we have tried to evaluate the influence of a series of determinants of stigmatization of mental illness. METHOD: 700 final year students of a University in Istanbul were asked to read one of 14 different hypothetical case stories. The stories contained different combinations of characteristics assumed to play a role in stigmatization. Each vignette was presented to 50 students. The stories were collected after five minutes and the following scales were completed: Characteristics Scale and Skill Assessment Scale. Analysis was conducted on each scale. RESULTS: We found a statistically significant difference among the groups given different hypothetical cases (vignettes). According to the post-hoc analysis, only the subjects given the vignette in which social and occupational outcome information were lacking showed statistically significant difference from the rest of the population. CONCLUSION: This study suggests that information on social and occupational outcome of mental illness influences the general perception of the mentally ill.

Music effects on event-related potentials of humans on the basis of cultural environment.

Auditory oddball responses were recorded from Turkish subjects in a silent environment or superimposed on white noise, or music played with violoncello or a similar music played with ney, a reed flute frequently listened by the Turkish population. P3 amplitudes with ney music in the background were significantly larger than both the white noise and violoncello backgrounds. The topography of the P3 response changed significantly between the ney and silent background conditions, indicating a relatively higher participation of frontal areas during hearing ney. Our results showed that hearing music of a familiar style increases the allocation of attentional resources during memory updating processes which is supposed to determine the P3 amplitude, and therefore showed the effects of cultural environment on the cognitive processes.

Serum malondialdehyde concentration in babies with hyperbilirubinaemia.

AIM: To determine lipid peroxide concentrations in the first 10 days of life. METHODS: Malondialdehyde concentrations were investigated in neonates with or without hyperbilirubinaemia during the first 10 days of life. RESULTS: Serum malondialdehyde concentrations were higher in infants with hyperbilirubinaemia than in controls. A positive correlation was found between malondialdehyde and bilirubin concentrations in the study group. When the study group was categorised according to the presence of haemolysis, a significant correlation was found between malondialdehyde and bilirubin concentrations in those infants with hyperbilirubinaemia due to haemolysis. There was no such correlation in those without haemolysis. CONCLUSION: Exchange transfusion rapidly produces variable changes in pro-oxidant and antioxidant plasma concentrations in neonates, which may be responsible for free radical metabolism. The fall in malondialdehyde concentration is probably directly related to its exogenous removal by exchange transfusion.

Effects of ammonia on pentylenetetrazole-induced seizure threshold.

The effect of chronic perfusion of ammonia on the seizure threshold against pentylenetetrazol was studied. Ammonia plus sodium bicarbonate and saline (0.9%) was continuously administered to two groups of rats respectively. All animals were tested three times for seizure threshold, and were then decapitated and the brains removed for analysis of the amino acids. The results showed that the infusion of ammonia increased the seizure threshold, and this protective effect was accompanied by selective changes in brain glutamate and glutamine. Thus, continuous infusion of ammonia may cause an imbalance between excitatory and inhibitory systems in favor of inhibitory systems. These findings may provide insights into the basic mechanisms of seizures observed in hepatic failure, in other hyperammonemic states, and in epilepsy.

Congenital epulis of the newborn. A case report.

Congenital epulis of the newborn is a rare benign tumor, also known as a congenital gingival granular cell tumor. Although it is a benign lesion, the tumor may cause feeding and respiratory problems when too large or when multiple tumors exist. In this article, a case of congenital epulis is presented and its treatment is discussed.

Serum malondialdehyde concentration as a measure of oxygen free radical damage in preterm infants.

Lipid peroxidation was measured in 35 preterm infants by determining serum malondialdehyde (MDA) levels during the fist week of life. Serum concentrations of MDA were measured at one hour, 24 hours, 48 hours and one week of age. There were no correlations between gestational age, birth weight, and serum malondialdehyde levels at one, 24, or 48 hours, or on day seven. Serum MDA levels were higher in infants requiring mechanical ventilation compared to those breathing spontaneously, but the difference was not statistically significant. There were no correlations between MDA levels and corresponding fraction of inspired oxygen (FiO2) levels and arterial oxygen tension. No significant difference in serum MDA concentration was seen in relation to intravenous feeding with lipid emulsions. Serum MDA concentrations of infants with sepsis were not different at hours one, 24 and 48, but were significantly higher on day seven, when compared with infants without sepsis. MDA levels in the first and second serum samples were significantly higher in infants who were born after spontaneous vaginal delivery, compared to those born by cesarean section.

Preoperative use of octreotide in a newborn with persistent hyperinsulinemic hypoglycemia of infancy.

In this paper, we describe a newborn diagnosed with persistent hyperinsulinemic hypoglycemia of infancy (PHHI) at two days of age. She presented with severe asymptomatic hypoglycemia and required both a high rate of glucose infusion and diazoxide treatment. On the 9th hospital day, due to persistent and intractable hypoglycemia, subcutaneous octreotide treatment was initiated. This treatment reduced the rate and concentration of glucose needed to be infused but the hypoglycemia did not subside totally. On the 18th hospital day near-total pancreatectomy was performed. Tachyphylaxis resulting from continuous use of octreotide limited its effect but enabled us to keep the patient euglycemic preoperatively.

Toxic methemoglobinemia after injection of prilocaine in a newborn. A case report.

The acute onset of cyanosis in an infant is an alarming development. We report an infant who became cyanotic after injection of prilocaine. Prilocaine is a local anesthetic that is widely used in clinical practice, but usage in infancy easily causes methemoglobinemia. Acquired methemoglobinemia occurs in individuals exposed to an increased amount of agents that oxidize hemoglobin iron.

Relationship between maternal and neonatal iron stores.

In this study, hemoglobin (Hb), mean corpuscular volume (MCV) and serum ferritin (SF) levels were measured in 76 neonates and their mothers at delivery. Infants were grouped according to their gestational ages. Group I (< 34 weeks), group II (34-37 weeks) and group III (> 37 weeks) consisted of 15, 33 and 28 infants, respectively. Blood studies were repeated at two months of age in 50 neonates (26 from group II and 24 from group III). Among the three groups of infants, SF levels were lowest in group I, and among mothers, Group III had the lowest levels. There were positive correlations between maternal and neonatal SF levels in groups II and III. There was no difference between the SF levels of neonates born to mothers with depleted or adequate iron stores. Anemia with a normal SF level was present in 14.4 percent, subclinic iron deficiency (normal Hb and low SF level) in 11 percent and iron deficiency anemia (low Hb and low SF levels) in 7.8 percent of the mothers. At two months of age 38.4 percent of preterm and 16.6 percent of term infants had Hb concentrations less than 10 g/dl. Only one of these infants had a low SF level. There was a negative correlation between maternal SF levels and the Hb concentration of term infants at two months of age.

Intestinal lymphangiectasia in a patient with Zellweger cerebrohepatorenal syndrome.

Zellweger cerebrohepatorenal syndrome (ZWCHRS) is an autosomal-recessive disease, characterized by the absence or profound deficiency of peroxisomes. We report a case of ZWCHRS with intestinal lymphangiectasia, observed as an autopsy finding. This combination is previously unreported.

Nonketotic hyperglycinemia in a newborn infant.

A neonate with nonketotic hyperglycinemia who experienced apnea, hiccups and tonic-clonic seizures on the first day of life is reported. The physical findings and laboratory tests including arterial blood gases were normal. However, serial blood and CSF amino-acid analyses demonstrated elevated glycine levels. Serum and CSF glycine levels were 1949 mumol/L and 415.5 mumol/L, respectively. (Normal serum level is 104-254 mumol/L and CSF level is 5 +/- 2 mumol/L). The CSF/plasma glycine ratio was 0.11. Oral sodium benzoate and folic acid therapy was initiated. After two weeks of assisted ventilation and clinical improvement, the patient was discharged with a protein-restricted diet.