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Halil H, Buyuktiryaki M, Atay FY, Oncel MY, Uras N. Reopening of the ductus arteriosus in preterm infants; Clinical aspects and subsequent consequences. J Neonatal Perinatal Med 2019; 11:273-279. [PMID: 30149471 DOI: 10.3233/npm-17136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Patent ductus arteriosus is a common problem frequently encountered in preterm infants. We aimed to study the risk factors associated with reopening of patent ductus arteriosus and their short term outcomes in preterm infants. METHODS A total of 162 preterm infants born between November 2013 and December 2015 with gestaional age less than 32 weeks and treated for hemodynamically significant patent ductus arteriosus are included in our study. RESULTS 113(69.8%) showed permanent closure and 49(30.2%) infants revealed symptoms of reopening after effective closure of patent ductus arteriosus. Low birth weight and small gestational age were more common in reopening group. Multivariete analysis showed that sepsis and multiple courses of drug treatment were independent factors affecting reopening of hemodynamically significant patent ductus arteriosus (OR: 3.01, 95% CI 1.48-6.13, p = 0.002) and (OR: 2.67, 95% CI 1.23-5.82, p = 0.013) respectively. Reopened group had a remarkable higher rate of developing necrotising nnterocolitis, bronchopulmonary dysplasia and retinopathy of prematurity than the closed group. (16.3% vs 4.4%, p = 0.01, 55.1% vs 28.3%, p = 0.001 and 55.1% vs 23.0%, p = 0.0001 respectively). CONCLUSION Late neonatal sepsis and the need of multiple drug courses to close patent ductus arteriosus are risk factors affecting the reopening of patent ductus arteriosus in preterm infants.
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Affiliation(s)
- H Halil
- Department of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
| | - M Buyuktiryaki
- Department of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
| | - F Yavanoglu Atay
- Department of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
| | - M Yekta Oncel
- Department of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
| | - N Uras
- Department of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
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Celik I, Yilmaz Y, Erdeve O, Demirel G, Suna Oguz S, Uras N, Dilmen U. The Acute-Phase Response in Differentiating Sepsis from Inflammation in Neonates Who Require Abdominal Surgery. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2012.11680841] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- I.H. Celik
- Division of Neonatology, Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, 06230 Cebeci, Ankara, Turkey
| | - Y. Yilmaz
- Division of Neonatology, Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, 06230 Cebeci, Ankara, Turkey
| | - O. Erdeve
- Division of Neonatology, Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, 06230 Cebeci, Ankara, Turkey
| | - G. Demirel
- Division of Neonatology, Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, 06230 Cebeci, Ankara, Turkey
| | - S. Suna Oguz
- Division of Neonatology, Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, 06230 Cebeci, Ankara, Turkey
| | - N. Uras
- Division of Neonatology, Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, 06230 Cebeci, Ankara, Turkey
| | - U. Dilmen
- Division of Neonatology, Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, 06230 Cebeci, Ankara, Turkey
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Sahin S, Kutman KHG, Bozkurt O, Canpolat FE, Uras N, Oguz SS, Topcu V, Ozdemir O, Dilmen U. A TRISOMY 13 CASE PRESENTING WITH CONGENITAL DIAPHRAGMATIC HERNIA AND MICROPHTHALMIA. Genet Couns 2015; 26:263-265. [PMID: 26349200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Bozkurt O, Kanmaz HG, Sahin S, Canpolat FE, Uras N, Oguz SS, Dilmen U. Cyclopia, proboscis and alobar holoprosencephaly representative for trisomy 13. Genet Couns 2014; 25:349-351. [PMID: 25365860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Bozkurt O, Bidev D, Sari FN, Dizdar EA, Ulu HO, Uras N, Oguz SS, Canpolat FE, Dilmen U. Fryns anophthalmia-plus syndrome: two rare cases. Genet Couns 2014; 25:395-398. [PMID: 25804017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Fryns anophthalmia-plus syndrome is a rare syndrome with clinical diversity primarily including anophthalmia/microphthalmia, facial clefts, cleft lip/palate, ear and nasal deformities. Here we present two different cases of APS with anopthalmia/microphthalmia, cleft palate, low set ears, ventriculomegaly and one of which had intestinal non-fixation anomaly not described in the literature before.
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Sandal G, Mutlu B, Uras N, Erdeve O, Oguz SS, Dilmen U. Evaluation of treatment with hydrocortisone on oxidant/antioxidant system in preterm infants with BPD. Eur Rev Med Pharmacol Sci 2013; 17:2594-2597. [PMID: 24142604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM Evidence that oxidative stress plays a role in the development of bronchopulmonary dysplasia (BPD). There is a close relationship between oxidative stress and inflammation. In this study, it is aimed to investigate influences of hydrocortisone used in the treatment of BPD on anti-oxidant system in preterm infants with BPD. PATIENTS AND METHODS The study enrolled 33 infants with severe BPD who were undergone inpatient treatment in neonatal intensive care unit (NICU) of our Hospital and received therapy with hydrocortisone. Total oxidant status (TOS) and total anti-oxidant capacity (TAC) levels of infants enrolled to the study before and one week after the hydrocortisone therapy were studies and oxidative stress index levels were calculated. Pre- and post-treatment TOS, TAC and OSI index levels were statistically compared. RESULTS In preterm infants with BPD, who were enrolled into the study, TOS and OSI index were found high, whereas TAC values were low. Following the treatment with hydrocortisone, statistically significant decrease in TOS and OSI index and statistically significant elevation in TAC levels were found in comparison with pre-treatment levels. CONCLUSIONS The treatment with hydrocortisone, which is used for BPD, improves anti-oxidant system and reduces oxidative stress in infants with BPD. There is need for further studies in order to clarify the physio-pathogenesis.
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Affiliation(s)
- G Sandal
- Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
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7
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Kara S, Tonbul A, Karabel M, Akca H, Uras N, Tatli M. The role of serum N-terminal pro-brain natriuretic peptide in transient tachypnea of the newborn. Eur Rev Med Pharmacol Sci 2013; 17:1824-1829. [PMID: 23852911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Transient tachypnea of the newborn (TTN), also known as wet lung disease, is a common cause of respiratory distress in the newborn. It has been demonstrated that, in alveolar type II cell cultures of the rat, receptors affected by the natriuretic peptides are expressed and that atrial natriuretic peptide (ANP) reduced amiloride-sensitive Na+ transport in these cells with a pattern similar to that in renal tubules, thereby inhibiting Na+ re-absorption in a concentration-dependent manner. Brain natriuretic peptide (BNP) is known to act on these receptors and it is suggested that it may be involved in fluid absorption by the lungs. The present study aimed to investigate the role of BNP in the pathogenesis of transient tachypnea of the newborn. PATIENTS AND RESULTS Serum NT-proBNP (N-terminal-proBNP) level measurements of 43 infants diagnosed with transient tachypnea of the newborn were compared to those of 29 healthy neonates. There were no statistically significant differences in NT-proBNP level between the study group and the control group. CONCLUSIONS NT-proBNP has no role in the pathophysiology of transient tachypnea of the newborn. Other factors which may potentially be involved in this etiology should be investigated.
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Affiliation(s)
- S Kara
- Neonatal Clinic of Fatih University, Beştepe, Ankara, Turkey.
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Demirel G, Moraloglu O, Celik IH, Erdeve O, Mollamahmutoglu L, Oguz SS, Uras N, Dilmen U. The effects of water birth on neonatal outcomes: a five-year result of a referral tertiary centre. Eur Rev Med Pharmacol Sci 2013; 17:1395-1398. [PMID: 23740455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE As scant information is present about the effect of water birth on newborns, we aimed to detect the fetal outcomes of water birth. MATERIALS AND METHODS A hundred and ninety one among totally 220 newborns who were born by water birth were enrolled. The demographic and clinical features of the patients, birth complications, infection rates and rates of neonatal intensive care unit attendance were evaluated. RESULTS The mean gestational week and birth weight were 39.2±1.3 weeks and 3326±409 g. 26% of the mothers was primiparous. Birth trauma was observed in three patients (1.6%) as one brachial nerve paralysis, one cord rupture and one cephal hematoma. Six of the patients (3.1%) were admitted to neonatal intensive care unit (NICU); four of whom had respiratory tract problems. CONCLUSIONS Water birth is a safe method of delivery for the neonates when certain criteria are met.
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Affiliation(s)
- G Demirel
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
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Celik IH, Demirel G, Oguz SS, Uras N, Erdeve O, Dilmen U. Compassionate use of voriconazole in newborn infants diagnosed with severe invasive fungal sepsis. Eur Rev Med Pharmacol Sci 2013; 17:729-734. [PMID: 23609355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Invasive fungal sepsis has become the third most common cause of late-onset infections in many neonatal intensive care units (NICU). The prevalence rate ranges from 2.6% to 16.7% among very-low-birth-weight infants and from 5.5% to 20% among extremely low-birth-weight infants. Despite the development of several new antifungal agents in the past few years, the management of serious fungal infections in the newborn continues to be problematic. MATERIALS, METHODS AND RESULTS Voriconazole treatment was given to 17 newborns with invasive fungal sepsis, in initial doses of 2-3 mg/kg twice daily. In spite of the complications of cholestasis and liver function abnormality in 2, the dose regimen was 4-6 mg/kg (loading dose), followed by initial doses of 2-3 mg/kg twice daily. Drug cessation did not occur, and no permanent side effects were observed. In the end, 12 patients had been cured with antifungal treatment. CONCLUSIONS Voriconazole at this dosage common with other antifungal agents or alone appears to be a safe and effective antifungal agent for neonatal invasive fungal sepsis. Based on relevant literature, to the best of our knowledge, ours is the largest case series to underline this issue. However, further studies are required to determine the pharmacokinetics (e.g. serum half-life, concentration, time of peak concentration, and distribution) of voriconazole use in newborns.
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Affiliation(s)
- I H Celik
- Division of Neonatology, Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, Cebeci, Ankara, Turkey.
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Say B, Guzoglu N, Uras N, Candemir Z, Akin I, Dilmen U. Partial trisomy 3p and partial monosomy 11q associated with double outlet right ventricle and septum pellucidum et vergae: a case report. Genet Couns 2013; 24:387-391. [PMID: 24551981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Su Partial trisomy 3p and partial monosomy 11q are rare chromosomal disorders with a deletion of part of chromosome 11 combined with a duplication of part of chromosome 3. These are usually inherited from a parent who carries a balanced translocation involving chromosome 3, which can result in the unbalanced translocation trisomy 3p in a child. In this paper, we report a newborn who has dysmorphic facial features, double outlet right ventricle, hypotonia, hypospadias, neonatal thrombocytopenia, hydroureteronephrosis, talipes equinovarus and septum pellucidum et vergae. Cytogenetic investigation revealed 46,XY,der(11)t(3;11)(p22.2;q23.3) and the karyotype of his father showed a balanced translocation, 46XY,t(3;11)(p22.2;p23.3).
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Affiliation(s)
- B Say
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
| | - N Guzoglu
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
| | - N Uras
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
| | - Z Candemir
- Division of Genetics, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
| | - I Akin
- Duzen laboratory, Ankara, Turkey
| | - U Dilmen
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
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Uras N, Oguz SS, Zergeroglu S, Akdag A, Polat B, Dizdar EA, Dilmen U. CD31 and Factor VIII in angiogenesis of normal and pre-eclamptic human placentas. J OBSTET GYNAECOL 2012; 32:533-6. [PMID: 22779955 DOI: 10.3109/01443615.2012.677875] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We aimed to evaluate normal and pre-eclamptic placental vasculature by using CD31 and Factor VIII. We evaluated placentas of 37 pre-eclamptic women by using immunohistochemical staining with CD31 and Factor VIII antibodies. Individual microvessels in the placental tissues were counted at × 100 and × 400 magnification. Microvessel counts were lower in placentas of pre-eclamptic patients compared with healthy controls after staining with CD31 (26.5 ± 5.7 vs 103.9 ± 8.2, p < 0.001) and Factor VIII (24.8 ± 6.7 vs 98.7 ± 10.3, p < 0.001). Balance between proangiogenic and antiangiogenic factors seems to be shifted in favour of anti-angiogenic factors in pre-eclampsia.
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Affiliation(s)
- N Uras
- Neonatal Intensive Care Unit, Zekai Tahir Burak Maternityand Teaching Hospital, Ankara, Turkey
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Celik IH, Yilmaz Y, Erdeve O, Demirel G, Oguz SS, Uras N, Dilmen U. The acute-phase response in differentiating sepsis from inflammation in neonates who require abdominal surgery. Acta Chir Belg 2012; 112:292-296. [PMID: 23008994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION In neonates, the influence of surgery on the inflammatory response has not been fully characterized and it remains difficult to differentiate an inflammatory response from sepsis. In this study, we evaluated changes in interleukin-6 (IL-6) and C-reactive protein (CRP) in neonates undergoing different major abdominal surgeries who had a normal postoperative course without infection. MATERIAL AND METHODS In total, 43 neonates undergoing major abdominal surgery owing to congenital malformations involving the gastrointestinal tract, and who did not show blood culture positivity were enrolled in the study. As a control group, 40 neonates with proven sepsis were enrolled in the study over the same period. Blood samples for IL-6, CRP, and white blood cell count (WBC) determination were drawn before surgery and 48, 96, and 144 h [postoperative days (POD) 2,4, and 6] after surgery. RESULTS There was a statistically significant increase in IL-6 concentrations on POD 2 compared with preoperative levels (p < 0.05). After POD 2, IL-6 levels decreased to preoperative levels. There was a statistically significant increase in CRP concentrations on POD 2, 4, and 6 (p < 0.05). Levels of CRP tended to be higher after surgery, and began to fall by the 6th day, but were still statistically higher than preoperative levels. In the sepsis group, CRP concentrations on day 6 were lower than in the surgery group (p < 0.05). White blood cell counts did not show statistically significant differences preoperatively versus postoperatively. CONCLUSIONS In contrast to previous studies, our results show high levels of IL-6 on POD 2 and CRP on POD 6. It is important to differentiate between the diagnoses of sepsis and postoperative inflammation, because of the need to treat the infection. High levels of IL-6 and CRP are not always associated with sepsis after major abdominal surgeries, but may instead be associated with the inflammatory response and multiorgan dysfunction. Further studies are needed to better differentiate sepsis from inflammatory responses in patients undergoing other surgeries.
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Affiliation(s)
- I H Celik
- Division of Neonatology, Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, 06230 Cebeci, Ankara, Turkey.
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Demirel G, Celik IH, Aksoy HT, Erdeve O, Oguz SS, Uras N, Dilmen U. Transfusion-associated necrotising enterocolitis in very low birth weight premature infants. Transfus Med 2012; 22:332-7. [PMID: 22738152 DOI: 10.1111/j.1365-3148.2012.01170.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 05/11/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Our aim was to determine the relationship between red blood cell transfusion and necrotising enterocolitis (NEC) in all admitted very low birth weight (VLBW) infants with or without transfusion. STUDY DESIGN All VLBW neonates were categorised into five groups: (i) subjects that developed NEC <48 h after transfusion (n = 15); (ii) subjects that developed NEC >48 h after transfusion (n = 31); (iii) subjects that were never transfused but developed NEC, (n = 50); (iv) subjects that were transfused but did not develop NEC, (n = 250) and (v) subjects that were neither transfused nor developed NEC (n = 301). RESULTS A group of 647 infants were enrolled in the study. Mean gestational age and birth weight of the patients were 29 ± 3.1 weeks and 1157 ± 237 g, respectively. The mean age at the onset of NEC in the NEC groups were 20 ± 2.3 days, 12 ± 3 days and 11 ± 2.6 days, respectively (P < 0.05). The mean interval from the last transfusion to the onset of NEC was 16.8 ± 8.8 h in group 1 and 240 ± 50 h in group 2 (P < 0.05). CONCLUSION In this study, we sought to evaluate all VLBW infants, whether they received a transfusion or not. We suggest that transfusion associated NEC exists, but many other factors influence this multifactorial disease. The age of NEC onset was later in transfused vs non-transfused patients, whereas the interval between transfusion and NEC was shorter in transfused vs non-transfused patients.
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Affiliation(s)
- G Demirel
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
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Guzoglu N, Kanmaz HG, Dilli D, Uras N, Erdeve O, Dilmen U. The impact of the new Turkish regulation, imposing single embryo transfer after assisted reproduction technology, on neonatal intensive care unit utilization: a single center experience. Hum Reprod 2012; 27:2384-8. [DOI: 10.1093/humrep/des171] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ozdemır R, Sarı FN, Tunay ZO, Erdeve O, Canpolat FE, Oguz SS, Uras N, Dılmen U. The association between respiratory tract Ureaplasma urealyticum colonization and severe retinopathy of prematurity in preterm infants ≤1250 g. Eye (Lond) 2012; 26:992-6. [PMID: 22562187 DOI: 10.1038/eye.2012.77] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AIM To evaluate the association between respiratory tract Ureaplasma urealyticum (Uu) colonization and development of retinopathy of prematurity (ROP) requiring treatment. METHODS The infants with birthweight (BW) ≤1250 g born in a third-level neonatal intensive care unit between March 2009 and May 2010 were prospectively identified. Nasopharyngeal swabs for Uu colonization were taken in postnatal first 3 days. Culture-positive patients were reevaluated on the twelfth day by nasopharyngeal swabs for Uu. The primary outcome was to define whether there was an association between respiratory tract Uu colonization and severe ROP requiring treatment. Independent sample's t-test or Mann-Whitney U-test was used to compare continuous variables and Chi-square test or Fisher's exact test for categorical variables. Multivariate (backward) logistic regression analysis was performed to simultaneously measure the influence of the independent variables with ROP as the dependent variable. RESULTS A total of 25 (12.1%) infants developed severe ROP requiring treatment among 206 infants who underwent ROP screening. Mean BW and gestational age of total cohort were 1013±159 g and 27.9±1.6 weeks, respectively. Multivariate analysis demonstrated that BW (OR: 0.64 (95% Cl 0.47-0.88); P=0.006), duration of mechanical ventilation (OR: 1.17 (95% Cl 1.06-1.28); P=0.001), premature rupture of membrane >18 h (OR: 3.83 (95% Cl 1.2-12.2); P=0.02), and Uu positivity in both cultures (OR: 5.02 (95% Cl 1.8-13.9); P=0.002) were independent risk factors for the development of severe ROP requiring treatment. CONCLUSIONS Respiratory tract colonization with Uu was independently associated with severe ROP requiring treatment.
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Affiliation(s)
- R Ozdemır
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Neonatal Intensive Care Unit, Ankara, Turkey.
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Gokmen T, Oguz SS, Bozdag S, Erdeve O, Uras N, Dilmen U. A controlled trial of erythromycin and UDCA in premature infants during parenteral nutrition in minimizing feeding intolerance and liver function abnormalities. J Perinatol 2012; 32:123-8. [PMID: 21566568 DOI: 10.1038/jp.2011.56] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To compare the effectiveness of oral erythromycin versus ursodeoxycholic acid (UDCA) treatment in preventing feeding intolerance and liver function abnormalities. STUDY DESIGN A prospective, double blind, randomized, controlled trial in which three groups of preterm infants (birth weight <1500 g) were randomized to erythromycin (12.5 mg kg(-1) per day), UDCA (5 mg kg(-1) every 6 h) or placebo treatment. During the period 352 infants were admitted to our unit of which 75 infants whose parents accepted participation were enrolled in the study. Full enteral feeding or intestinal failure-associated liver disease was considered as the primary outcome measures. RESULTS Time to achieve full feeding after beginning the treatment was significantly shorter in the erythromycin group (P=0.014). γ-Glutamyl transpeptidase levels in the placebo group were significantly higher than in the intervention groups (P=0.001). GTT level was slightly lower in UDCA groups than erythromycin. CONCLUSION Oral erythromycin was most effective in facilitating enteral feeding and UDCA was most effective in preventing cholestasis in very low birth weight infants. Prophylactic usage of UDCA could be considered in infants with prolonged parenteral nutrition.
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Affiliation(s)
- T Gokmen
- Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, Turkey.
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Demirel G, Oguz SS, Celik IH, Erdeve O, Uras N, Dilmen U. A case of Keutel syndrome diagnosed in the neonatal period: associated with Binder phenotype. Genet Couns 2012; 23:25-30. [PMID: 22611639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Keutel syndrome is a rare autosomal recessive disorder, characterized by brachytelephalangia (short, broad distal phalanges), midfacial hypoplasia, abnormal cartilage calcifications, peripheral pulmonary stenosis and hearing loss. Binder profile is a well known maxillonasal dysplasia composed of midfacial hypoplasia with absence of anterior nasal spine and facial dysmophism (short nose, flat nasal bridge, perialar flatness, convex upper lip). Here we report a Keutel syndrome presenting with Binder phenotype, abnormal calcifications, hearing loss and respiratory insufficiency in the newborn period. Keutel syndrome should be considered in the differential diagnosis of children with tracheobronchial calcifications, midfacial hypoplasia and stippled epiphysis.
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Affiliation(s)
- G Demirel
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
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Cattoli M, Bianchi V, Bonu MA, Sciajno R, Lappi M, Borini A, Rubino P, Cotarelo RP, Alteri A, Antinori E, Colicchia A, Giannini P, Piscitelli C, Greco E, Oudi M, Omani Samani R, Bellavia M, Wunder D, Bay B, Bruun-Petersen G, Guzoglu N, Kanmaz HG, Uras N, Erdeve O, Dilli D, Dilmen U. ETHICS AND LAW. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Akar M, Dilli D, Yilmaz Y, Erdeve O, Oguz S, Uras N, Dilmen U. A case of fetal carbamazepine syndrome with right hemihypoplasia of the entire body. Genet Couns 2012; 23:19-24. [PMID: 22611638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Anticonvulsant drugs taken by pregnant women to prevent seizures are among the most common causes of potential harm to the fetus. It has been suggested that carbamazepine was less teratogenic than the other drugs. Here, we report a case of fetal carbamazepine syndrome presenting with facial dysmorphism, congenital heart defect, skeletal abnormalities, renal agenesis, ambiguous genitalia, anal atresia, and right hemihypoplasia of the entire body. To the best of our knowledge this is the most severe case of fetal carbamazepine syndrome in the literature. This case can provide useful data about teratogenicity of carbamazepine therapy during the pregnancy.
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Aydemir O, Akar M, Uras N, Eras Z, Erdeve O, Oguz SS, Dilmen U. Total antioxidant capacity and total oxidant status in perinatal asphyxia in relation to neurological outcome. Neuropediatrics 2011; 42:222-6. [PMID: 22144010 DOI: 10.1055/s-0031-1295480] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
This study aimed to investigate the global oxidant/antioxidant status of infants with perinatal asphyxia and its relation to neurological outcomes. A prospective controlled study including term infants with perinatal asphyxia was conducted. Blood samples were obtained from patients and controls at 6-24 h and on the 3rd day of life for TAC and TOS measurement and OSI values were calculated. Neurodevelopment was evaluated at 12 months of age in survivors using Bayley scales of infant development II (BSID II). 17 term infants with perinatal asphyxia and 17 healthy controls were enrolled. On the first day of life TAC, TOS and OSI were significantly higher in patients with perinatal asphyxia (p<0.001). Total antioxidant capacity decreased significantly on day 3 compared to first day of life in the patient group (p=0.04). Infants with seizures and abnormal amplitude-integrated electroencephalography recordings had higher TOS and OSI levels in the 1st day. There was no correlation between TAC, TOS and OSI levels and BSID II scores. In conclusion oxidant/antioxidant balance is disturbed in favour of oxidants in perinatal asphyxia. Degree of oxidative stress is related to severity of neurological involvement in the first days of life.
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Affiliation(s)
- O Aydemir
- Department of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
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21
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Ozdemir R, Erdeve O, Süslü N, Akyol U, Yurttutan S, Uras N, Oguz SS, Dilmen U. Treatment of congenital nasal cavity stenosis by balloon dilatation in a newborn: a case report. Int J Pediatr Otorhinolaryngol 2011; 75:960-2. [PMID: 21524805 DOI: 10.1016/j.ijporl.2011.03.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 03/28/2011] [Accepted: 03/29/2011] [Indexed: 11/29/2022]
Abstract
Neonates are obligate nasal breathers, and any form of neonatal nasal obstruction may have serious consequences. Prompt diagnosis and appropriate treatment are essential to avoid severe hypoxia. Congenital bony nasal stenosis (CBNS) is an extremely rare cause of neonatal nasal airway obstruction and can easily be confused with choanal atresia or stenosis. This is a paper to describe a balloon dilatation technique that can be an effective alternative to surgery for the treatment of congenital nasal cavity stenosis, with minimal stress to the patient.
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Affiliation(s)
- R Ozdemir
- Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
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22
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Aydemir O, Sarikabadayi YU, Aydemir C, Tunay ZO, Tok L, Erdeve O, Oguz SS, Uras N, Dilmen U. Adjusted poor weight gain for birth weight and gestational age as a predictor of severe ROP in VLBW infants. Eye (Lond) 2011; 25:725-9. [PMID: 21378993 DOI: 10.1038/eye.2011.29] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AIM To analyze relative weight gain by 2-week intervals up to 6 weeks after birth in order to predict the development of retinopathy of prematurity (ROP) requiring treatment among very low birth weight (BW) infants. METHODS A prospective study including infants with BW ≤1500 g born in a single tertiary intensive care unit over 1-year period was conducted. Body weight measurements were recorded weekly and relative weight gains (g/kg/day) were calculated. The main outcome was development of ROP requiring treatment. RESULTS Mean BW and gestational age (GA) of the whole cohort were 1165±223 g and 29.3±2.3 weeks, respectively. Relative weight gain at 2 weeks and 4 weeks postnatal age were significantly lower in infants with severe ROP (P=0.041 and P=0.017, respectively). Relative weight gain at 6 weeks was not different between groups. Infants with severe ROP gained 6.7±4 g/kg/day in the first 4 weeks of life, compared with 9.3±4.5 g/kg/day for those with mild or no ROP. After adjusted for BW and GA in logistic regression poor relative weight gain in the first 4 weeks was found to be related to severe ROP (P=0.015). When all the other risk factors significant for severe ROP were included in the logistic regression poor weight gain did not arise as an independent risk factor. CONCLUSION Poor postnatal weight gain in the first 4 weeks of life is the end result of several comorbidities rather than being an independent risk factor. Poor weight gain can be an additional predictor of severe ROP in very low BW infants.
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Affiliation(s)
- O Aydemir
- Department of Neonatology, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, Turkey.
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23
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Dizdar EA, Aydemir C, Erdeve O, Sari FN, Oguz S, Uras N, Dilmen U. Respiratory syncytial virus outbreak defined by rapid screening in a neonatal intensive care unit. J Hosp Infect 2010; 75:292-4. [PMID: 20299133 PMCID: PMC7132464 DOI: 10.1016/j.jhin.2010.01.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2009] [Accepted: 01/13/2010] [Indexed: 11/20/2022]
Abstract
Palivizumab is currently licensed for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in infants and children with chronic lung disease, with a history of preterm birth, or with haemodynamically significant congenital heart disease, but its routine use during outbreaks in neonatal intensive care units (NICUs) is not currently recommended. Here we report an outbreak in a NICU detected during a screening trial for RSV infection using a rapid antigen test (Respi-Strip®). Eleven preterm infants in our NICU tested positive for RSV during January 2009. Subsequent testing of the remaining infants in the NICU revealed two additional asymptomatic cases. In addition to precautions against cross-infection, palivizumab prophylaxis was administered to the remaining 37 premature infants. Two days after treatment, RSV was detected in two additional infants who had become symptomatic. To our knowledge this is the largest RSV outbreak in a NICU to be identified at an early stage by rapid testing and effectively controlled by infection control measures and palivizumab prophylaxis.
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Affiliation(s)
- E A Dizdar
- Neonatal Intensive Care Unit, Zekai Tahir Burak Women's Health and Education Hospital, Hamamonu, Ankara, Turkey.
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24
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Demirel G, Oguz SS, Celik IH, Yilmaz Y, Uras N, Erdeve O, Dilmen U. Fryns syndrome with atypical findings--with large midline cleft on forehead but normal cranial MRI findings. Genet Couns 2010; 21:405-409. [PMID: 21290970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We report a newborn with Fryns syndrome and atypical findings like a large midline cleft on forehead. Abnormal findings included congenital left diaphragmatic hernia, prominent forehead, hypertelorism, broad nasal bridge, anteverted nostrils, cleft palate, low set ears, tapered fingers, macrocephaly, congenital heart defect, midline defects and renal anomalies. This is the first case that has a midline cleft on forehead with normal cranial MRI findings.
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Affiliation(s)
- G Demirel
- Zekai Tahir Burak Maternity Teaching Hospital, Neonatology Department, Ankara, Turkey.
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25
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Demirel G, Oguz SS, Celik IH, Sandal G, Uras N, Erdeve O, Dilmen U. A trisomy 13 case with Robertsonian translocation presenting with atypical findings. Genet Couns 2010; 21:293-297. [PMID: 20964120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A trisomy 13 case with Robertsonian translocation presenting with atypical findings: Trisomy 13 is an autosomal trisomy caused by the presence of an extra copy of chromosome 13. Anomalies associated with this syndrome are severe mental retardation, coloboma, hypotonia, skeletal anomalies, midline anomalies, facial defects, holoprosencephaly, cardiac defects, omphalocele and polydactyly. Here we report a case of trisomy 13 with Robertsonian translocation, 160 day old, presenting with atypical findings like posterior fusion defect of the vertebra, hyperplasia of the right lobe of the liver, dilatation at pelvicalyxial system, scoliosis and complex heart disease including cardiomyopathy.
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Affiliation(s)
- G Demirel
- Zekai Tahir Burak Maternity Teaching Hospital, Neonatology Department, Ankara, Turkey.
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26
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Uras N, Sandal G, Oguz S, Aydemir O, Erdeve O, Dilmen U. Toriello-Carey syndrome in a Turkish newborn. Genet Couns 2009; 20:243-247. [PMID: 19852430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Toriello-Carey syndrome in a Turkish newborn: Toriello-Carey syndrome is characterized by agenesis of the corpus callosum, telecanthus, short palpebral fissures, small nose with anteverted nares, retrognathia, abnormal ears, laryngeal and cardiac anomalies, brachydactyly, and hypotonia. We describe the findings in a Turkish newborn, presumed to be another example of the Toriello-Carey syndrome, which extends the phenotype of the syndrome.
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Affiliation(s)
- N Uras
- Division of Neonatology, Zekai Tahir Burak Women's Education and Research Hospital, Ankara, Turkey.
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27
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Uras N, Karadag A, Odemis E, Mete E, Degirmencioglu H, Turkay S, Tatli MM. Aortic and pulmonary valve stenosis in a neonate: a new finding of prune belly syndrome? Genet Couns 2007; 18:125-7. [PMID: 17515309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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28
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Karadag A, Odemis E, Uras N, Gunlemez A. Soy formulas and hypothyroidism. Arch Dis Child 2004; 89:1077. [PMID: 15499073 PMCID: PMC1719703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Avci Z, Koktener A, Uras N, Catal F, Karadag A, Tekin O, Degirmencioglu H, Baskin E. Nephrolithiasis associated with ceftriaxone therapy: a prospective study in 51 children. Arch Dis Child 2004; 89:1069-72. [PMID: 15499067 PMCID: PMC1719698 DOI: 10.1136/adc.2003.044156] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Ceftriaxone, a third generation cephalosporin, is widely used for treating infection during childhood. The kidneys eliminate approximately 33-67% of this agent, and the remainder is eliminated via the biliary system. Ceftriaxone may bind with calcium ions and form insoluble precipitate leading to biliary pseudolithiasis. The aim of this study was to assess whether ceftriaxone associated nephrolithiasis develops by the same mechanism, and whether this condition is dose related. METHODS The study involved 51 children with various infections. Of these, 24 were hospitalized with severe infection and received 100 mg/kg/day ceftriaxone divided into two equal intravenous doses. The other 27 patients received a single daily intramuscular injection of 50 mg/kg/day. Serum and urine parameters were evaluated before and after treatment, and abdominal ultrasonographic examinations were also carried out before and after treatment. RESULTS Serum urea, creatinine, and calcium levels were normal in all patients before and after treatment. Post-treatment ultrasound identified nephrolithiasis in four (7.8%) of the 51 subjects. The stones were all of small size (2 mm). Comparison of the groups with and without nephrolithiasis revealed no significant differences with respect to age, sex distribution, duration of treatment, or dose/route of administration of ceftriaxone. The renal stones disappeared spontaneously in three of the four cases, but were still present in one patient 7 months after ceftriaxone treatment. CONCLUSIONS Conclusions: The study showed that children taking a 7 day course of normal or high dose ceftriaxone may develop small sized asymptomatic renal stones. The overall incidence of nephrolithiasis in this study was 7.8%.
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Affiliation(s)
- Z Avci
- Department of Pediatrics, Faculty of Medicine, Bakent University, Ankara, Turkey
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Abstract
Ionization and dissociation reactions play a fundamental role in aqueous chemistry. A basic and well-understood example is the reaction between hydrogen chloride (HCl) and water to form chloride ions (Cl(-)) and hydrated protons (H(3)O(+) or H(5)O(2)(+)). This acid ionization process also occurs in small water clusters and on ice surfaces, and recent attention has focused on the mechanism of this reaction in confined-water media and the extent of solvation needed for it to proceed. In fact, the transformation of HCl adsorbed on ice surfaces from a predominantly molecular form to ionic species during heating from 50 to 140 K has been observed. But the molecular details of this process remain poorly understood. Here we report infrared transmission spectroscopic signatures of distinct stages in the solvation and ionization of HCl adsorbed on ice nanoparticles kept at progressively higher temperatures. By using Monte Carlo and ab initio simulations to interpret the spectra, we are able to identify slightly stretched HCl molecules, strongly stretched molecules on the verge of ionization, contact ion pairs comprising H(3)O(+) and Cl(-), and an ionic surface phase rich in Zundel ions, H(5)O(2)(+).
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Affiliation(s)
- J P Devlin
- Department of Chemistry, Oklahoma State University, Stillwater, Oklahoma 74078, USA
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Affiliation(s)
- J. Rzepkowska
- Industrial Chemistry Research Institute, Rydygiera 8, 01-793 Warsaw, Poland
| | - N. Uras
- Fritz Haber Institut for Molecular Dynamics, Hebrew University, Jerusalem, 91904, Israel, and Department of Chemistry, Oklahoma State University, Stillwater, Oklahoma 74078
| | - J. Sadlej
- Department of Chemistry, University of Warsaw, Pasteura 1, 02-093 Warsaw, Poland
| | - V. Buch
- Fritz Haber Institut for Molecular Dynamics, Hebrew University, Jerusalem, 91904, Israel
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