Search

Meningococcal infections are important health problems causing high morbidity and mortality. Neisseria meningitidis have 13 serogroups. A, B, C, Y and W135 are the most common causes of invasive disease among those serogroups. The distribution of the serogroups differs according to the geographical regions and the age groups. In this case report, two cases of meningococcemia infected with serogroup C and Y of N.meningitidis rarely seen in our country were presented. First case was a two and a half year-old female patient who has admitted to our pediatric emergency unit with fever and rash spreading from lower extremities to her body. The patient had diffuse purpuric rash with generalized weakness and tendency to sleep at admission. The patient has been suspected as meningococcemia because of the skin rash, tendency to sleep and hypotension. Antibiotics treatment was started immediately and lumber puncture was performed. In blood tests, leukocyte count: 3600/mm3 (61% neutrophils), hemoglobin: 11.1 g/ dl, platelet count: 127.000/mm3 , C-reactive protein: 10 mg/dl, erythrocyte sedimentation rate: 6 mm/ hour, prothrombin time: 28.8 seconds (normal value= 11-16), prothrombin activity: 36%, international normalized ratio (INR): 2.13 (normal value= 1-1.5), activated partial thromboplastin time: 57.7 seconds (normal value= 25-35 sec), fibrinogen: 246 mg/dl (normal value= 200-400 mg/dl) and in cerebrospinal fluid protein: 21 mg/dl and glucose: 62 mg/dl were found. There were eight cells in the microscopic examination. Skin rashes were increased and the patient became hypotensive. No microorganisms were isolated in blood and cerebrospinal cultures. N.meningitidis serogroup C was isolated from the cerebrospinal fluid of the patient using polymerase chain reaction (PCR). The patient suffered from immune-mediated arthritis in the sixth day of treatment and nonsteroidal anti-inflammatory drugs were given. The patient has recovered with antibiotics, fresh frozen plasma and inotropic treatment. Second case was a 13 year-old male patient who has admitted three days after the first case with a pre-diagnosis of malignancy because of pancytopenia and fever. The patient had generalized weakness and a few petechial purpuric rashes at the facial region at admission. After the admission general status of the patient has worsened rapidly and he has died as a result of cardiovascular arrest. Blood tests in admission showed leukocyte count: 6000/mm3 (79% neutrophils), hemoglobin: 17.3 mg/dl, platelet count: 16.000/mm3 , C-reactive protein: 8.63 mg/dl, prothrombin time: 92.6 seconds, prothrombin activity: 10%, INR: 6.78, activated partial thromboplastin time: 231.5 seconds. Cerebrospinal fluid obtained from postmortem lumbar puncture showed no growth (protein: 95 mg/dl, glucose: 35 mg/dl) and N.meningitidis serogroup Y was detected by PCR. Two meningococcemia cases caused by two different serogroups which are rarely seen in our region in recent years were presented at the same time period in the same hospital. This case report pointed out that surveillance has a great importance in such diseases.

Duplications of 6q and deletions of 6p have been reported in more than 30 cases of live born infants and given rise to widespread abnormalities recognizable as a specific clinical syndrome. Different phenotypes have been described with variable clinical signs. Most cases involve the coexistence of unbalanced translocations affecting one or the other of the chromosomes. However, duplication of both chromosome 6q and deletion of 6p regions have been reported in only a few cases. Here, we report the first duplication of chromosome band 6q23.3–q27 with deletion of 6p25.3. This is the first case in the literature involving changes to these specific chromosomal regions; a medium size duplication of the distal long arm and smaller deletion of the terminal short arm of chromosome 6. In the literature, there are no other cases where these two specific chromosomal aberrations are observed together. Conventional chromosome analysis was performed to investigate the patient. Chromosome structure was identified using fluorescence in situ hybridization for subtelomeric regions of chromosome 6 and array comparative genomic hybridization analysis (array-CGH).

Developments in perinatal and neonatal care have increased the survival rate of high-risk newborns but led to a rise in chronic diseases seen in these infants. A significant number of them attend primary and secondary health care centers after discharge; however, there are very few standard protocols for the long-term follow-up of these babies. Therefore, we aimed to establish a follow-up guideline that emphasizes on universal screening schemes and takes into consideration national data. The guide presented here provides brief recommendations for physicians in light of evidence-based data for the follow-up of high-risk newborn infants. The steps taken to monitor and solve the problems of all high-risk infants may vary. We hope the use of such a standard approach in evaluating each infant in daily routine will improve the life quality of these high-risk infants.Perinatal ve neonatal bakım alanındaki gelişmeler sonucunda riskli yenidoğanların yaşam oranı yükselmiş, ancak beraberinde bu bebeklerde görülen kronik hastalık oranı da artmıştır. Taburcu edildikten sonra birinci ve ikinci basamak sağlık merkezlerine başvuran hastaların önemli bir oranını oluşturmaya başlayan bu bebeklerin uzun süreli izleminin nasıl olması gerektiği ile ilgili ne yazık ki standart protokoller pek azdır. Bu nedenle evrensel izlem şemalarına ağırlık verdiğimiz ve ulusal verilerin de göz önüne alındığı bir izlem rehberi oluşturmayı amaçladık. Burada özetini sunduğumuz yüksek riskli bebek izlem rehberi uygulayıcıya kanıta dayalı veriler ışığında öneri niteliğinde bilgileri sunmaktadır. Tüm riskli bebekler için izlem ve sorunların çözümü için atılacak adımlar farklılıklar gösterebilir. Her bebeğin ayrı ayrı değerlendirildiği standart yaklaşımların güncel uygulamalarda kullanılmasının yüksek riskli bebeklerin yaşam kalitelerini artıracağını ummaktayız.

Beken, Serdar/0000-0002-8609-2684; BAS, AHMET YAGMUR/0000-0002-1329-2167; Bulbul, Ali/0000-0002-3510-3056; Karatekin, Guner/0000-0001-7112-0323, WOS: 000534242500056, PubMed: 31851725, Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey. Material and methods A prospective cohort study was performed between April 1, 2016 and April 30, 2017. the study included VLBW infants admitted to level III NICUs. Perinatal and neonatal data of all infants born with a birth weight of.1500 g were collected for infants who survived. Results Data from 69 NICUs were obtained. the mean birth weight and gestational age were 1137 +/- 245 g and 29 +/- 2.4 weeks, respectively. During the study period, 78% of VLBW infants survived to discharge and 48% of survived infants had no major neonatal morbidity. VLBW infants who survived were evaluated in terms of major morbidities: bronchopulmonary dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers. Conclusion the present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs., Turkish Neonatal Society [2-2016]; Turkish Neonatal Society, This study was supported by the Turkish Neonatal Society, http://www.neonatology.org.tr, number 2-2016, received by AYB. Turkish Neonatal Society funded the study's online registry system. the funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

WOS: 000484450300020, PubMed ID: 31236033, Disorders of sex development are defined as conditions in which the chromosomal, gonadal, and anatomic sex is discordant. Patients usually present with atypical appearing genitalia. In the assessment of neonates with disorders of sex development, first, it is important to determine whether this situation requires prompt evaluation, and then the karyotype, hormone levels, and underlying etiology should be determined as soon as possible. All these procedures should be performed in the guidance of a multidisciplinary team in reference centers. As the physical examination of the infant is extremely important, the physcian should suspect and then perform a detailed history and physical examinationi and lastly plan the required laboratory and imaging procedures for the definite diagnosis. It is important not to be hurried in the choice of sex. The aim of this article, which includes the diagnostic and therapeutic approaches in infants with ambiguous genitalia, was to provide a common practice for all pediatricians.

Synthetic cannabinoids or synthetic marijuana derivatives known as "Bonzai" in Turkey are addictive substances that affect the brain and have serious side effects. In recent years, the use of these substances has also been increasing in our country as well as all over the world. These substances present with various names and brands, the most common names in Turkey are "Bonzai" and "Jamaika". In this study, we aimed to evaluate the demographic and clinical findings of these patients. We retrospectively evaluated patients admitted to our pediatric emergency department between March 2013 and March 2015 due to the complaints developing after the use of "Bonzai" in terms of age, gender, admission date, complaint, clinical findings, laboratory findings, consuming method of the substance, additional substance use, observation durations, hospitalization status and mortality rates. The most common complaint was faintness and drowsiness. Changes in the state of consciousness, tachycardia, hypertension were the most common clinical findings. Most common consuming method of the drug was in the form of smoking. The rate of "Bonzai" use among adolescents is increasing every day. Physicians in emergency departments should be educated on this issue and it must be kept in mind that most of the patients admitted are with complaints related to changes in the cognitive state (of consciousness) but they can also apply with complaints about all other systems.

Treacher Collins syndrome (TCS) is an autosomal dominant disorder of craniofacial development with an incidence of 1/50,000 live births. Mutations of the TCOF1 gene have been found to be responsible for most cases of this mandibulofacial disorder. Here we report TCS in an individual who has a heterozygous c.1021_1022delAG deletion in exon 7 of the TCOF1 gene (NG_011341.1). This is the second Turkish patient with a severe TCS phenotype resulting from a de novo c.1021_1022delAG mutation

Aim: To assess the neurodevelopmental and psychiatric outcomes of very preterm vs preterm infants at 1 3 years of corrected age Material and Method: Between years 2005 2008 premature infants followed up in the NICU designated as Group 1 lt;32 wks;n=36 were evaluated in comparison to Group 2 33 37wks; n=56 with the approval of Ethics Committee TUTFEK 2008 083 in terms of neurodevelopmental and psychiatric development by using Denver developmental screening test the brief infant toddler social emotional assessment childcare provider version Mothers rsquo; psychiatric symptoms were assessed by the brief symptom inventory Socioeconomic status was determined by using SES scale t test or Mann Whitney U tests chi square and Spearman tests were used for statistical analysis Results: In Group 1 paternal education level and psychodevelopmental score was lower than group 2 abnormal outcome in Denver developmental test was more frequent Psychiatric problem score was higher in boys whereas psychodevelopmental score was higher in girls Psychosocial developmental score was lower in those infants with intraventricular hemorrhage and this score showed positive correlation with Denver developmental test results There was no difference between the two groups in terms of brief symptom inventory Conclusions: Although very preterm infants more frequently showed abnormal neuropsychological development they were not significantly different with regard to psychiatric problems Girls were more advantegous than boys in terms of psychodevelopment We conclude that these findings should be validated by larger and further studies Turk Arch Ped 2011; 46: 280 5

SummaryObjectivesNeonatal leukemoid reaction (NLR) is relatively rare and considered as a white blood cell (WBC) count ≥50×109/l . The aim of this study was to investigate the association of NLR with neonatal morbidity and mortality and maternal chorioamnionitis in low birth weight infants.MethodsIn this case-controlled retrospective study, the medical records of 1200 newborn infants with a birth weight

Summary Background Leukoerythroblastosis is characterized by the presence of leukocytosis and erythroid and myeloid blast cells in the peripheral blood. The most common etiological factors of leukoerythroblastosis occurring during early childhood are viral infections, juvenile myelomonocytic leukemia, and osteopetrosis. To our knowledge, an association with parvovirus B19 infection has only been reported in a preterm infant. Human parvovirus B19 has been associated with red cell aplasia, leukopenia, and thrombocytopenia. Case report The case of a very low birth weight preterm infant with transient leukoerythroblastosis associated with parvovirus B19 infection is described. Conclusions Leukoerythroblastosis has to be kept in mind if a very high leukocyte count is detected in the neonatal period, and parvovirus B19 infection should be taken into consideration as the etiological factor for this entity.

Amaç: Günümüzde gebelik döneminde verilen e¤itimin; emzirmenin bafllang›c›n›, oran›n› ve süresini etkiledi¤i gösterilmifltir. Bu yaz›da, do¤um öncesi dönemde verilen e¤itimle anne adaylar›n›n anne sütü ve emzirme konusunda bilgilendirilmesi ve e¤itimin yararlar›n›n vurgulanmas› amaçlanm›flt›r. Gereç ve Yöntem: Anne sütüyle ilgili e¤itimler gebelere haftada iki gün düzenlenmifltir. Her anne aday›na do¤um öncesinde bir kez e¤itim verilmifltir. Veriler, anne sütü ve emzirme ile ilgili haz›rlanan 42 sorudan oluflan bir anket arac›l›¤› ile toplanm›flt›r. ‹statistiksel analizler Statistica 7,0 paket program› kullan›larak yap›ld›. Sonuçlar ortalama ± standart sapma ya da say› (%) olarak ifade edildi. ‹statistiksel anlaml›l›k s›n›r› p, @font face { font family: Times ; }p MsoNormal li MsoNormal div MsoNormal { margin: 0cm 0cm 0 0001pt; font size: 12pt; font family: Times New Roman ; }div Section1 { page: Section1; }

Summary Ochrobactrum anthropi is a non-fermenting Gram-negative rod that was identified as a pathogenic microorganism during the past decade. O. anthropi is extensively distributed in the environment, and has been found in hospital and environmental water sources. O. anthropi infection is rare in childhood. We report a case of O. anthropi bacteremia in a preterm infant with a peritoneal lavage catheter and meconium peritonitis.

Bilateral congenital choanal atresia is a relatively rare anomaly of the upper airway, which may cause life-threatening respiratory emergency and require rapid diagnosis and treatment. This condition usually occurs sporadically, but has also been rarely described in siblings. We present monozygotic premature twin infants with identical findings of bilateral choanal atresia and no other associated anomalies. To our knowledge, this is the first report of such an occurrence.