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Background: The aim of this study is to investigate the diagnostic value of cerebrospinal fluid (CSF) and serum levels of the soluble form of triggering receptor-1 expressed on myeloid cells (sTREM-1) in neonatal meningitis. Methods: Serum sTREM-1 levels were measured in all neonatal sepsis patients at the start of antibiotic therapy and the 48th hour of treatment. At the beginning of antibiotic therapy, CSF samples were collected for sTREM-1 measurements. Control CSF samples were also collected from the patients with meningitis at the 48th hour of treatment. Results: A total of 77 preterm (50) and term (27) patients with neonatal sepsis were included in the study. There was no significant difference between the CSF sTREM-1 levels of patients with and without meningitis. The CSF sTREM-1 levels of preterm infants with meningitis decreased significantly after treatment (p = 0.038). Although the CSF/serum sTREM-1 ratios tended to increase in babies with meningitis, no significant difference was found between the groups. CSF/serum sTREM-1 ratios (mean ± SD) were 1.42 ± 0.91 and 1.14 ± 0.85 in preterm babies with and without meningitis and 1.15 ± 0.97 and 0.97 ± 0.55 in term babies with and without meningitis, respectively. Conclusions: Serum and CSF sTREM-1 levels increase in patients with neonatal sepsis. CSF s-TREM-1 levels decrease after treatment in preterm infants with meningitis. [ABSTRACT FROM AUTHOR]

(1) Background: This study aimed to determine whether standard-dose vitamin D supplementation could provide adequate levels in exclusively breastfed infants born with different cord 25(OH)D levels and to evaluate related neonatal morbidities. (2) Methods: A prospective cross-sectional study was designed in term infants. Three groups were formed based on cord 25(OH)D levels; Group1 Deficiency:25(OH)D < 12 ng/mL, Group2 Insufficiency:25(OH)D = 12–19 ng/mL, and Group3 Optimum:25(OH)D = 20–100 ng/mL. Cord and 1st month 25(OH)D levels, after receiving standard-dose vitamin D prophylaxis, neonatal outcomes and anthropometric measurements were compared. (3) Results: The study involved 86 infants. Group1 Deficiency had also significantly lower 25(OH)D levels at 1st month compared to the others (p < 0.001). There was a significant positive correlation between cord and 1st month 25(OH)D levels (r = 0.78, p < 0.001). Despite the fact that the mother's age and clothing style were similar, Group1 Deficiency mothers had higher parity numbers and used less vitamin D during pregnancy (p = 0.03, p = 0.04). Neonatal outcomes analysis revealed that newborns in Group1 Deficiency experienced more respiratory distress, transient tachypnea, and early-onset sepsis, as well as more and longer hospital stays in the first-month of life (p < 0.05). (4) Conclusions: Infants with low cord 25(OH)D levels had also lower 25(OH)D values in the 1st month of life and experienced higher rates of neonatal morbidities. Given its numerous biological activities and impact on neonatal morbidities, determining an individualized dose of vitamin D supplementation may be more accurate than using the standard approach. [ABSTRACT FROM AUTHOR]

Introduction: Patent ductus arteriosus (PDA) causes a substantial increase in morbidities in premature babies by causing changes in organ perfusion. Various echocardiographic parameters are used to diagnose PDA and determine whether it is hemodynamically significant (HsPDA). This study aimed to investigate the role of tissue oxygen saturation in the first 24 hours in predicting HsPDA in high-risk premature babies who received respiratory support because of respiratory distress syndrome. Materials and Methods: In this prospective, observational study, cerebral, renal, and mesenteric regional tissue oxygen saturation levels were monitored by near infrared spectroscopy (NIRS) for the first 24 hours of the lives of preterm babies at ≤ 28 weeks of gestation. The NIRS data of babies with and without HsPDA as diagnosed by echocardiographic examination were compared. Results: Eighty-one premature babies who had HsPDA were included in the study. In the control group 51 premature babies who had not HsPDA were evaluated. The median ± standard deviation (SD) gestational age of the babies included in the study was 26.9 ± 1 weeks, and the mean ± SD birth weight was 880 ± 218 g. Renal and mesenteric NIRS measurements during follow-up were lower in babies with versus without HsPDA, but the difference was not statistically significant. Conclusion: Low renal and mesenteric stO2 values detected on the first day of life in high-risk infants may be associated with HsPDA. More studies are needed to reveal the effects of HsDPA on organs in these vulnerable babies with NIRS monitoring. [ABSTRACT FROM AUTHOR]

Objective Portable X-rays remain one of the most frequently used diagnostic procedures in neonatal intensive care units (NICU). Premature infants are more sensitive to radiation-induced harmful effects. Dangers from diagnostic radiation can occur with stochastic effects. We aimed to determine the radiation exposure in premature infants and staff and determine the scattering during X-ray examinations in the NICU. Study Design In this prospective study, dosimeters were placed on premature infants who were ≤1,250 g at birth and ≤30 weeks of gestational age who stayed in the NICU for at least 4 weeks. The doses were measured at each X-ray examination during their stay. The measurements of the nurses and the doctors in the NICU were also performed with dosimeters over the 1-month period. Other dosimeters were placed in certain areas outside the incubator and the results were obtained after 1 month. Results The mean radiation exposure of the 10 premature infants, monitored with dosimeters, was 3.65 ± 2.44 mGy. The mean skin dose of the six staff was 0.087 ± 0.0998 mSV. The mean scattered dose was 67.9 ± 26.5 µGy. Conclusion Relatively high exposures were observed in 90% of the patients and two staff. The radiation exposure levels of premature infants and staff may need to be monitored continuously. Key Points The premature infants are exposed to radiation due to the bedside X-rays. The radiation exposure levels of premature infants and staff may need to be monitored continuously. Measures and alternative methods to reduce radiation exposure should be encouraged. [ABSTRACT FROM AUTHOR]

Background: Povidone‐iodine (10%; PI) and 2% chlorhexidine in 70% isopropyl alcohol (CHG‐IA) solutions are among the most widely used disinfectants in the neonatal intensive care units. This study compares the use of these disinfectants and helps decide which is superior to the other for neonatal use. Methods: All term and preterm infants born and hospitalized in Bursa Uludag University Hospital between July 2018–March 2020 were included. The infants were randomized into two disinfectant groups before birth. The application site was cleaned with the assigned disinfectant before intervention. The infants were screened for rates of neonatal sepsis, thyroid‐stimulating hormone (TSH) levels, free thyroxine (fT4) levels, skin reactions to the assigned solution, and acute neurological side effects. Results: We enrolled 208 term and preterm infants (PI:104 vs. CHG‐IA: 104) in the study. The prematurity rates were identical (PI: 74.0%; CHG‐IA: 72.1%; p = 0.755). Neonatal sepsis rates among these groups were not statistically different (PI: 8.7%; CHG‐IA: 4.8%; p = 0.406). The median TSH value of the PI group was high (4.05 mIU/L) in comparison with that of the CHG‐IA group (3.09 mIU/L; p = 0.016). No cutaneous or neurological side effects were recorded in patients treated with CHG‐IA solution. Conclusions: Although these two solutions were equally protective against infections, the CHG‐IA solution was a better alternative to PI for neonatal use. Considering that the PI solution may be responsible for impaired thyroid function, the CHG‐IA solution is a good alternative because it provides sufficient protection with a safer adverse effect profile. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Insulin-like growth factor-1 (IGF-1) is important for fetal and postnatal development. After premature births, serum IGF-1 concentrations rapidly decrease and can stay at much lower levels than during the intrauterine period. In this study, we aimed to ascertain whether IGF-1 is associated with morbidities of prematurity such as bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), and necrotizing enterocolitis (NEC), and is a useful predictor of these diseases. METHODS: We enrolled newborn infants born at a postmenstrual age of ≤32 weeks in this prospective observational cohort study. Serum IGF-1 levels were measured serially in blood samples on the 1st, 3rd, 7th, 21st, and 28th day. RESULTS: A total of 93 infants were enrolled in the study. All these infants had the following characteristics at birth: weight 1236.11±354.06 g, and gestational age 29.43±2.10 weeks. All of the IGF-1 levels were significantly lower in the group which developed BPD or ROP (p<0.001). The patients who developed IVH and NEC also had lower IGF-1 levels. DISCUSSION and CONCLUSION: Strong correlations have been found between low serum IGF-1 levels during the first four weeks and development of BPD and ROP. [ABSTRACT FROM AUTHOR]

Background: Parenteral nutrition (PN) has been widely used in preterm infants. The lipid solutions used for PN, however, are associated with oxidative stress and morbidity. The aim of this study was to compare the effectiveness of a new‐generation lipid emulsion (SMOFLipid) and olive‐oil based lipid emulsion for prevention of PN‐associated oxidative damage. Methods: Preterm infants < 32 weeks of gestational age were included in this prospective randomized study. All infants were randomized to SMOFlipid or olive‐oil based lipid emulsion (ClinOleic). Lipid peroxidation products were evaluated in all infants. In addition, total antioxidant capacity (TAC), and both pro‐ and anti‐inflammatory cytokines were studied at days 0, 7 and 14. Results: A total of 89 infants (SMOFlipid, n = 42; ClinOleic, n = 47) were enrolled. TAC was higher in the SMOFlipid group compared with the ClinOleic group at all time points, and the difference on day 7 was statistically significant. Although the anti‐inflammatory cytokine interleukin‐10 was higher in the SMOFlipid group, this difference was not significant. Bronchopulmonary dysplasia (BPD) was lower in the SMOFlipid group (14.1%) than in the ClinOleic group (31.2%), but this finding was non‐significant p > 0.05. The rate of severe BPD was significantly lower in the SMOFlipid group. Conclusion: To our best of knowledge, this is the first study to suggest that SMOFlipid might decrease oxidative damage and oxidative‐stress‐associated morbidity compared with olive oil‐based emulsion in preterm infants. [ABSTRACT FROM AUTHOR]

Introductıon: Congenital diaphragmatic hernia (CDH) is a rare abnormality with high mortality and long-term comorbid conditions. Our aim, in this paper, was to describe demographics and birth characteristics, treatment, and outcomes of consecutive patients with CDH treated at our institution. Methods: The present study represents a retrospective cohort study of neonates with CDH who were treated at Uludag University Medical Faculty, Neonatal intensive care unit, Bursa. We identified the medical records of all patients with CDH who were admitted for treatment to our neonatal intensive care unit from January 2007 to December 2016. We reviewed the medical, surgical records, demographics and birth characteristics. We also recorded presence of pulmonary hypertension, whether or not the liver and, stomach also herniated into the thorax, other associated congenital malformations, and type of mechanical ventilation. Results: Forty patients were included in this study. The overall mortality was 67.5% (27/40). Survival for those who had surgical correction of CDH was 61% (13/21). Low birth weight, low gestational age, low APGAR scores and, high oxygen need at baseline was found to be associated with mortality, in patients with CDH. Among survivors, the median duration of hospitalization was 23 (14--35) days. Chronic gastrointestinal, pulmonary disorders and, failure to thrive were the most comorbid conditions after discharge. Dıscussıon And Conclusıon: KDH still has high mortality and morbidity. The birth of patients with prenatal diagnosis at appropriate centers will increase their chances of successful intervention. [ABSTRACT FROM AUTHOR]