PubMed Health⌕ Search

Biomedical subjects

N Duman

Publications and source records attributed to N Duman.

At least 19 recordsLinked to original sources
PubMed2005

Inhibition of vascular endothelial growth factor-induced retinal neovascularization by retinoic acid in experimental retinopathy of prematurity.

Vascular endothelial growth factor (VEGF) has an important role in the pathogenesis of retinopathy of prematurity (ROP) and inhibition of VEGF expression in the neovascular phase might prevent destructive neovascularization in ROP. It is suggested that retinoids exert a highly potent antiangiogenic activity by inhibiting VEGF expression. The aim of this study was to demonstrate the preventive effect of retinoic acid (RA) on the VEGF-induced retinal neovascularization in a rat model of ROP. Wistar albino rats were placed into incubators at birth and exposed to an atmosphere alternating between 50 % and 10 % O(2) every 24 hours. After 14 days, the animals were removed to room air and received either an intraperitoneal injection of RA (5 mg/kg/day) (n=9) or saline (n=4) daily for six days, and sacrificed at 21 days. Other rats (n=4) were raised in room air and served as age-matched controls. The globe of each eye was cut through the cornea and embedded in paraffin. Serial sections were stained with hematoxylin-eosin for quantification of neovascular nuclei. The avidin-biotin peroxidase method was performed for evaluation of VEGF expression. The average number of neovascular nuclei was significantly lower in the control group compared to that in the ROP groups. In addition, it significantly decreased in the RA-treated ROP group compared to that of the saline-administrated ROP group. VEGF immunostaining was overall negative in room air-exposed rats. The VEGF immunostaining score significantly decreased in the RA-treated ROP group compared to that in the saline-administered ROP group. RA treatment might be beneficial in preventing neovascularization resulting from oxygen-induced retinopathy by downregulation of VEGF expression.

Animals↗
PubMed2004

Immediate postimplant hemodialysis through a new "self-sealing" heparin-bonded polycarbonate/urethane graft.

BACKGROUND: Immediate accessibility of a newly implanted dialysis graft is desirable to avoid temporary catheters. The most commonly used dialysis graft, expanded polytetrafluorethylene (ePTFE), does not allow early access. This report presents the first clinical data regarding the immediate puncturability of a newly introduced "self-sealing" polycarbonate urethane graft (PUG). METHODS: Patients implanted with a PUG due to the need for immediate vascular access through their new grafts were followed prospectively for early and late complications. RESULTS: Five patients who were implanted with a PUG were dialyzed through their grafts within hours after surgery. Dialysis was continued three times per week in each patient, without a puncture-related problem. CONCLUSION: The availability of a self-sealing graft allowing immediate vascular access on the same day of the implant was achieved with the PUG system. Decreasing the need for temporary catheters may initiate some of the complications associated with hemodialysis.

Heparin↗
PubMed2004

Long-term follow-up of otherwise healthy term infants with marked hyperbilirubinaemia: should the limits of exchange transfusion be changed in Turkey?

AIM: To evaluate prospectively non-haemolytic term infants with marked hyperbilirubinaemia treated by phototherapy only for evidence of bilirubin toxicity at 2-6 y of age, and to determine the suitability for Turkish children of the exchange transfusion limits recently reported by the American Academy of Pediatrics. METHODS: The study group included a total of 30 children, aged 2-6 y, who had developed marked hyperbilirubinaemia (20-24 mg dl(-1), 342-410 micromol l(-1)) during the newborn period (gestational age >37 wk, birthweight >2500 g) and were treated without exchange transfusion because intensive phototherapy, instituted during the preparations for exchange transfusion, was successful in decreasing their serum bilirubin levels. The control group consisted of 30 children of the same age group without clinical jaundice in the newborn period. Physical and neurological examinations, brainstem auditory-evoked potentials (BAEPs) and developmental tests for Turkish children were performed in both the study and control children. RESULTS: There was no difference between the groups with regard to mean BAEP latencies and developmental scores. None of the infants had hearing loss, developmental delay or abnormal neurological findings. CONCLUSION: The results suggest that successful intensive phototherapy without exchange transfusion in otherwise healthy term newborn infants with marked hyperbilirubinaemia (20-24 mg dl(-1), 342-410 micromol l(-1)) might not increase the risk of bilirubin brain injury and that the conventional limit of 20 mg dl(-1) (342 micromol l(-1)) could be changed to 22-24 mg dl(-1) (376-410 micromol l(-1)) for healthy term infants in Turkey. These limits, however, address only infants who do not have haemolytic disease, and the data are not sufficient to draw conclusions on the safety of even higher bilirubin levels (i.e. >24 mg dl(-1), 410 micromol l(-1)) in this population.

Bilirubin↗
PubMed2004

Synchronized ventilation of very-low-birth-weight infants; report of 6 years' experience.

OBJECTIVES: To evaluate the effects of long-term patient triggered ventilation (PTV) using assist/control or synchronized intermittent mandatory ventilation (SIMV) in very-low-birth-weight infants with respiratory distress. METHODS: Ninety-seven very-low-birth-weight infants who had undergone synchronized ventilation for respiratory distress or insufficiency were assessed from January 1995 to December 2000. Death, oxygen support, pneumothorax development while ventilated, intracranial hemorrhage, necrotizing enterocolitis, periventricular leukomalacia, retinopathy of prematurity and duration of ventilation were noted as the mean outcome measures. RESULTS: The mean birth weight was 1139 +/- 268 g (range 450-1500 g) and the mean gestational age was 29.0 +/- 2.8 weeks (range 23-36 weeks). Eighty-four per cent of 97 infants survived. Antenatal steroids were administered to only 20% of mothers. Surfactant was administered to all of the 67% of infants with respiratory distress syndrome. The mean duration of ventilator support was 4.7 +/- 7.3 days (1-43 days) for survivors and 8.9 +/- 11 days (1-45 days) for infants who died. No respiratory paralysis was necessary in any case during ventilation and pneumothorax was diagnosed in only eight infants. Severe intracranial hemorrhage (grade > or = III) and periventricular leukomalacia developed in 15% and 12% of infants, respectively. Necrotizing enterocolitis (Bell's classification stage > or = 2) and retinopathy of prematurity were noted in two infants. Four infants had evidence of chronic lung disease. The rate of survival without major morbidity was 83.5%. CONCLUSION: Patient-triggered ventilation, initially PTV with Asist/Control and subsequently with SIMV in very-low-birth-weight infants with respiratory distress is feasible, but optimization of trigger and ventilator performance with respect to respiratory diagnosis is essential.

Female↗
PubMed2004

Spontaneous intestinal perforation after oral ibuprofen treatment of patent ductus arteriosus in two very-low-birthweight infants.

AIM: To discuss intestinal side effects of ibuprofen in the treatment of patent ductus arteriosus, after having observed two cases of spontaneous intestinal perforation following ibuprofen treatment. METHODS: Clinical and laboratory records of two preterm infants, who developed intestinal perforation after ibuprofen administration, were evaluated. RESULTS: Gestational ages of infants were 29 wk (male) and 30 wk (female). Both infants developed intestinal perforations without signs of necrotizing enterocolitis. The perforations cured with Penrose drainage alone. CONCLUSION: Although ibuprofen is a reasonable treatment alternative to indomethacin, randomized controlled trials, which address potential adverse effects including spontaneous intestinal perforation, are needed.

Administration, Oral↗
PubMed2003

Long-term outcome of neonatal hyperbilirubinaemia: subjective and objective audiological measures.

Neonatal hyperbilirubinaemia is a common cause of early onset sensorineural hearing loss. There is no exact method to detect the extent of the neurotoxicity of bilirubin. On the other hand, the auditory pathway is known to be one of the most sensitive parts of the central nervous system (CNS) to this toxic agent. This prospective follow-up study was performed to evaluate and compare the factors related to the hearing of neonates with severe hyperbilirubinaemia and an age-matched control group. Both of these groups were tested using auditory brainstem response (ABR) as well as evoked otoacoustic emissions. Additionally, both of these groups of children were evaluated subjectively using an early speech-language-communication evaluation questionnaire. There was no significant difference in either objective (ABR and evoked otoacoustic emission) or subjective assessment (questionnaire) between the study and control groups. Furthermore, no correlation between serum total bilirubin levels and ABR latencies or thresholds was found within the study group.

Brain Stem↗
PubMed2003

Outcome of very-low-birth-weight infants in a developing country: a prospective study from the western region of Turkey.

OBJECTIVE: To illustrate neonatal outcomes, including morbidity, birth weight and gestational age-specific mortality, and care practices for very-low-birth-weight infants admitted to our tertiary neonatal intensive care unit in Turkey and compare these with the corresponding data from recent reports from developed countries. METHODS: Perinatal data were collected prospectively from January 1996 to December 2000. Perinatal events and the neonatal course to 120 days of life, discharge, or death were evaluated. RESULTS: Of 173 infants, 82% survived until discharge to home or to 120 days of life. Survival was 13% for infants of 501-750 g at birth, 74% for those of 751-1000 g, 92% for those of 1001-1250 g and 87% for those of 1251-1500 g. Mortality rates were greater for male than for female infants (25% vs. 12%). The mean birth weight was 1218 (450-1500) g and the mean gestational age was 29.8 (23-36) weeks. The birth weight and gestational age distributions showed that the majority of infants (48%) weighed 1251-1500 g and were between 28 and 31 weeks' gestation (57%). Antenatal steroids were administered to only 19% of mothers. The overall Cesarean section rate was 77%. Respiratory distress syndrome was diagnosed in 36% and surfactant was administered to 98% of these infants. The rate of ventilator support was 54% for a mean duration of 9 days. Air leak syndromes were diagnosed in only nine infants (5%). Severe intracranial hemorrhage (grade > II) and periventricular leukomalacia developed in 9% of infants. Four infants had evidence of chronic lung disease. Retinopathy of prematurity (stage > II) was noted in only one infant, and proven necrotizing enterocolitis (Bell's classification stage > 2) was not observed. The rate of survival without major morbidity was 91%. The mean hospital stay was 40 days for survivors and 19 days for infants who died. CONCLUSION: Despite marked differences in socioeconomic conditions and tertiary care facilities, the mortality (except in the smallest babies) and morbidity rates were comparable with those of recent studies from developed countries.

Developing Countries↗
PubMed2003

Dermal bilirubin kinetics during phototherapy in term neonates.

AIM: To investigate dermal bilirubin kinetics during phototherapy in the presence of neonatal indirect hyperbilirubinaemia. METHODS: 33 neonates with non-haemolytic indirect hyperbilirubinaemia, who required phototherapy, were included in the study. Phototherapy modules containing four normal and four blue fluorescent lamps were used during the study. The transcutaneous bilirubin index (TcBI) was measured in an area of the forehead covered by a 2.5 cm diameter opaque patch and a nearby exposed site. The TcBI obtained from patched and unpatched areas and simultaneous serum bilirubin (SB) concentrations were measured before the start of phototherapy and after 6, 12, 18, 30, 42 and 66 h of phototherapy. RESULTS: SB concentration and the TcBI from the unpatched area decreased significantly during the first 6 h of exposure, while the TcBI obtained from the patched area decreased significantly after 12 h. The TcBI from the unpatched area was consistently lower than that from the patched area during phototherapy. After the onset of phototherapy, there was a weak, non-significant correlation between SB concentrations and the TcBI from patched and unpatched areas. CONCLUSION: Phototherapy was effective for both patched and unpatched areas, but the rate of decline was slower in patched areas, only becoming significant in the second 6 h of treatment. There was no significant correlation between the levels of SB and TcBI after the onset of phototherapy, and therefore the use of TcBI cannot be recommended as a surrogate measure of SB.

Bilirubin↗
PubMed2003

Analyses of polymorphism for UGT1*1 exon 1 promoter in neonates with pathologic and prolonged jaundice.

In this study, we investigated whether a TATA box polymorphism in the promoter of the UGT1*1 exon I, the most common detected DNA polymorphism in Gilbert's syndrome, is a contributory factor in unexplained pathologic or prolonged jaundice. 38 neonates who had unexplained pathologic jaundice, 37 neonates who had unexplained prolonged jaundice, and 35 healthy, nonjaundiced neonates were enrolled in the study. Genotypes were assigned as follows: 6/6 (homozygous for a normal allele bearing the sequence [TA](6)TAA), 7/7 (homozygous for an abnormal allele with the sequence [TA](7)TAA), and 6/7 (heterozygous with one of each allele). Of the 110 infants, 10 (9%) had 7/7, 51 (46%) had 6/7, and 49 (45%) had 6/6 genotype; the differences between the three groups were not statistically significant. Also no differences were observed among different genotypes and mean serum total bilirubin concentrations. In conclusion, we showed that TA 7/7 and TA 6/7 genotypes are not rare in our population and that the presence of these polymorphisms alone does not play a significant role in the etiology of unexplained pathologic or prolonged neonatal hyperbilirubinemia.

Alleles↗
PubMed2001

Effect of fluid and sodium removal on mortality in peritoneal dialysis patients.

UNLABELLED: Effect of fluid and sodium removal on mortality in peritoneal dialysis patients. BACKGROUND: Adequacy of peritoneal dialysis (PD) traditionally is assessed using Kt/V(urea) and total creatinine clearance (TCC). However, this approach underestimates the importance of fluid and sodium removal. The aim of this study was to determine the effect of fluid and sodium removal on morbidity and mortality in PD patients. METHODS: One hundred twenty-five PD patients were monitored for three years from the beginning of the treatment. The effects of demographic features, comorbidity, peritonitis rate, blood pressure, medications, blood biochemistry, peritoneal membrane transport characteristics, residual renal function (RRF), Kt/V(urea), TCC, normalized protein nitrogen appearance (nPNA), and removal of sodium and fluid on mortality were evaluated. Total and cardiovascular hospitalization rates were also recorded. A Cox proportional hazards model was used to determine factors predicting mortality. RESULTS: In the Cox model, comorbidity, total sodium and fluid removals, hypertensive status, serum creatinine, and RRF were independent factors affecting survival. In contrast, Kt/V(urea) or TCC did not affect the adjusted survivals. Total sodium and fluid removal and hypertensive status also significantly influenced the hospitalization rate. Systolic and diastolic blood pressures were negatively correlated with total fluid (P < 0.001) and sodium removal (P < 0.001). CONCLUSIONS: Together, these findings suggest that removal of sodium and fluid is a predictor of mortality in PD patients, whereas Kt/V(urea) and TCC are not factors. Adequate fluid and sodium balance is crucial for the management of patients on PD.

Adolescent↗
PubMed2001

Polyglandular endocrine failure in a patient with amyloidosis secondary to familial Mediterranean fever.

Familial Mediterranean fever (FMF) is 1 of the major causes of secondary amyloidosis. Renal involvement is the main clinical complication and it mostly presents with nephrotic syndrome and chronic renal failure. Although deposition of amyloid has been reported in several endocrine glands such as the adrenal, thyroid, and testes, clinically significant functional impairment is uncommon. Herein, we describe a patient in whom the diagnosis of FMF was based on molecular screening and who presented with recurrent hypoglycemic attacks and extensive amyloid deposition affecting various organ function including adrenal, thyroid, parathyroid, testes, intestinal system, and the heart.

Amyloidosis↗
PubMed2001

Recognition of neurocognitive dysfunction in chronic hemodialysis patients.

We sought to determine the prevalence, recognition, and consequences of mental impairment among chronic hemodialysis patients. We administered the Mini Mental Status Exam (MMSE), a brief validated method for assessing cognitive mental status that is commonly used by clinicians, to 84 patients from our dialysis units. To determine the clinical implications of mental impairment, we obtained Kt/V, albumin, protein catabolic rate, blood pressure, and hematocrit values. We found that 21% of subjects had mild mental impairment (MMSE 18 to 23) and that 11% had moderate-severe mental impairment (MMSE 0 to 17). We found no relationship between MMSE score and years on dialysis, Kt/V value, hematocrit value, or erythropoietin use. On univariate analysis, MMSE score was associated with albumin, protein catabolic rate, inter-dialytic weight gain, number of co-morbid conditions, number of hospitalizations. Outcomes on univariate analysis were further analyzed by multivariate analysis. There was an independent relationship between decrement in MMSE score and lower protein catabolic rate and increased hospitalization number and number of co-morbid conditions. Based on our findings, we recommend that clinicians routinely screen hemodialysis patients for mental impairment and target impaired patients for interventions to improve mental status and associated adverse outcomes.

Adolescent↗
PubMed2001

Association between serum macrophage colony-stimulating factor levels and monocyte and thrombocyte counts in healthy, hypoxic, and septic term neonates.

OBJECTIVE: Macrophage colony-stimulating factor (M-CSF) is a hematopoietic growth factor that mainly stimulates the growth, differentiation, and proliferation of cells of the monocyte-macrophage lineage. There are only limited numbers of studies about M-CSF levels in neonates, but high levels of serum M-CSF have been reported in septic and some thrombocytopenic adult patients. In this study, we investigated the serum M-CSF levels in healthy, septic, and hypoxic term neonates on the first day of life and examined the relationship of serum M-CSF levels and circulating monocyte and thrombocyte counts in these newborn infants. STUDY DESIGN: Three groups were defined in this prospective study: group 1, healthy neonates with no risk factors (n = 40); group 2, neonates who had severe hypoxia (n = 20); and group 3, neonates who fulfilled the criteria for early-onset sepsis (n = 18). Blood samples were collected for complete blood cell count and serum M-CSF levels by peripheral venipuncture from each infant in the first 24 hours after birth before any medical therapy. RESULTS: The gestational ages and birth weights did not differ significantly between the groups. Serum M-CSF levels of the septic neonates were significantly higher than of both healthy and hypoxic neonates, but did not differ significantly between the healthy and hypoxic neonates. There was no significant correlation between serum M-CSF levels and circulating monocyte counts, but there was a significant inverse correlation between serum M-CSF levels and thrombocyte counts. When this correlation was analyzed according to groups, we determined that this inverse correlation between M-CSF levels and thrombocyte counts was especially significant in the septic neonate group, but not significant in the healthy and hypoxic neonate groups. CONCLUSIONS: Serum M-CSF levels are significantly higher in neonates with sepsis. High serum M-CSF levels may have a possible role in the pathogenesis of thrombocytopenia in neonates with sepsis.

Asphyxia Neonatorum↗
PubMed2001

Renal Doppler ultrasonographic findings in earthquake victims with crush injury.

OBJECTIVE: In the Marmara earthquake, which occurred on August 17, 1999, 639 people had renal complications, and 477 needed hemodialysis treatment because of acute renal failure due to crush injury. Our objective was to use Doppler ultrasonography as a noninvasive procedure to provide renal hemodynamic information. METHODS: We evaluated 9 patients with severe crush injury by using Doppler ultrasonography to measure renal resistive indexes within 16 to 32 hours after the earthquake and 6 weeks later. All patients had acute renal failure and underwent hemodialysis. RESULTS: All measured initial resistive indexes were high (mean +/- SD, 0.83 +/- 0.08), and they were correlated with the number of hemodialysis sessions (r = 0.703; P = .034), the duration of hemodialysis treatment (r = 0.819; P = .007), and oligoanuria (r = 0.937; P < .0001). All patients recovered from the acute renal failure, and repeated Doppler ultrasonography showed significant decreases in resistive indexes (0.59 +/- 0.07; P < .01) and renal lengths (P < .05). CONCLUSIONS: In crush injury, measurement of renal resistive indexes can be useful for the prognosis of recovery from acute renal failure.

Adolescent↗
PubMed2001

Goldston syndrome: report of a case.

Cerebrohepatorenal malformation is a rare familial disorder characterized by typical renal lesions combined with Dandy-Walker malformation, and congenital hepatic fibrosis. In this case report, a male premie with the diagnosis of cerebrorenal syndrome or so called Goldston syndrome is presented. Besides the rarity of this syndrome, this case is the second reported patient diagnosed prenatally.

Abnormalities, Multiple↗