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    Ischemia-Modified Albumin May be a Novel Marker for the Diagnosis and Follow-up of Necrotizing Enterocolitis
    (Wiley, 2014) Yakut, Ibrahim; Tayman, Cuneyt; Oztekin, Osman; Namuslu, Mehmet; Karaca, Fahri; Kosus, Aydin
    Aim We investigate the efficacy of serial ischemia-modified albumin (IMA) measurements in diagnosis and follow-up of necrotizing enterocolitis (NEC), and compare its effectiveness with C-reactive protein (CRP), interleukin-6 (IL-6), in NEC. Methods Preterm infants, whose gestational age and weight matched each other, were grouped as control (n = 36) and NEC (n = 37). IMA, CRP, IL-6 levels were measured on the third day of life for the control group and on the day of diagnosis (first day), third, and seventh days of NEC. Results IMA, CRP, and IL-6 levels were significantly increased in NEC patients compared to the control group (P < 0.001) on the follow-up. IMA levels were significantly higher in infants with stage-III NEC than those in infants with stage-II NEC on the first, third, and seventh days (P < 0.001). The area under curve for IMA (0.815 at diagnosis, 0.933 at the third day, 0.935 at the seventh day) were significantly higher than CRP and IL-6 at all days for predicting perforation in infants with NEC (P < 0.001). Similarly, the area under curve for IMA (0.952 at diagnosis, 0.929 at the third day, 0.971 at the seventh day) was significantly higher than CRP and IL-6 at all consequent days of diagnosis for predicting mortality in infants with NEC (P < 0.001). Conclusion Ischemia-modified albumin was found to be superior to CRP and IL-6 in both diagnosis and follow-up of NEC.
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    Levels of Ischemia-Modified Albumin in Transient Tachypnea of the Newborn
    (Thieme Medical Publ Inc, 2015) Oztekin, Osman; Kalay, Salih; Tayman, Cuneyt; Namuslu, Mehmet; Celik, Huseyin Tugrul
    Aim The aim of the article is to evaluate ischemia-modified albumin (IMA) levels in infants with transient tachypnea of the newborn (TIN) and to find out its relation to the disease severity. Patients and Methods Infants with > 37 weeks of gestation, without any respiratory and cardiac symptoms and without any maternal health problems, and diagnosed as UN were allocated as the study group. Patients with obvious retractions, grunting, hypercarbia (PCO2 > 60 mm Hg) or hypoxia (oxygen saturation < 88% with FIO2 of 0.60) were managed with nasal continuous positive airway pressure (CPAP). During the postnatal 0 to 24 hours, blood samples were collected in 2 mL for IMA. Results A total of 47 patients were diagnosed TIN, and allocated as the study group. Of the 47 patients, 43 patients without respiratory symptoms were enrolled as the control group. IMA levels in TIN were found to be significantly higher (p < 0.05). In addition, IMA levels were significantly increased in the nasal CPAP group versus supplemental oxygen therapy groups (p < 0.05). IMA levels were determined to be significantly higher in the > 3 days of oxygen therapy group (p < 0.05). IMA levels with a cutoff point of 0.87 ABSU, sensitivity of 81.1% and specificity of 69.8% predicted UN (area under the curve [AUC] = 0.85; p < 0.05). IMA levels with > 0.98 ABSU, 78% sensitivity, and 86% specificity indicated the prediction of CPAP requirement (AUC = 0.86; p < 0.05). Conclusion IMA levels were significantly higher in infants with diagnosed TTN. Therefore, IMA may be used as a new marker for predicting UN and disease severity.
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    Serum Ischemia-Modified Albumin in Preterm Babies with Respiratory Distress Syndrome
    (Springer India, 2016) Kahveci, Hasan; Tayman, Cuneyt; Laoglu, Fuat; Celik, Huseyin Tugrul; Kavas, Nazan; Kilic, Omer; Aydemir, Salih
    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.