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Objective: To evaluate the impact of preterm birth on bone health in preschool children. Methods: A total of 166 preschool children (aged 7-8 years) born preterm (n = 86, = 37 weeks of gestation) in our hospital were included in this prospective cross-sectional study. Data on antenatal, perinatal, and early postnatal characteristics and maternal obstetric history were obtained from medical records. Bone densitometry data including total bone mineral content (BMC), bone mineral density (BMD; total, lumbar, and femoral), z-scores, and bone loss were collected for each participant. Results: Current height, weight, and BMI values were significantly lower in the preterm group (p < .001). Serum calcium, phosphorus and alkaline phosphatase (ALP) levels did not differ among groups, whereas VitD3 levels were significantly higher in the preterm group (p = .039). The mean total BMC, total BMD, lumbar (L2-L4) BMD, femur BMD, total z-score, and L2-L4 z-score values were significantly lower for the preterm group, whereas the total, lumbar, and femoral bone loss were significantly higher (p < .001), regardless of the severity of prematurity. Intraventricular hemorrhage (IVH) and retinopathy were significantly associated with lower total BMC (p = .004, p = .012, respectively). Fortified breastfeeding was associated with lumbar bone loss (p = .043), and formula feeding was associated with both femur and lumbar bone loss (p = .006, p = .012, respectively). Conclusions: Our findings revealed long-term adverse effects of preterm birth on bone health, with significantly lower anthropometric values (weight, height, and BMI), lower scores for total BMC, BMD (total, lumbar, femoral), and z-scores (total, femur), along with higher bone loss (total, lumbar, femoral) and higher rates of osteopenia and osteoporosis in preschool children born preterm (whether moderate or very preterm) compared with those born at term. Exclusive breastfeeding appears to reduce the likelihood of long-term bone loss in preterm infants

This study compared the early-term outcomes of mechanical ventilation (MV)/surfactant treatment with nasal-continuous positive airway pressure (nCPAP) in preterm infants with respiratory distress syndrome (RDS).Data from newborns born between ≥24 and ≤32 weeks of gestation, hospitalized at our newborn intensive care unit, and diagnosed with RDS between January 2009 and February 2012 were analyzed.Of 193 newborns with RDS who were enrolled in the study, 113 were treated with nCPAP and 80 with MV at a level of 57.5% of nCPAP. Within the study group, 46.3% of the infants were female. The mean gestation of the continuous positive airway pressure (CPAP) group was 29.07 ± 1.99 weeks; that of the MV group was 28.61 ± 2.01 weeks. The birth weight was 1321.1 ± 325.4 g and 1240.3 ± 366.1 g; however, the difference between the two groups was not significant. MV was not required in 54.9% of the patients with nCPAP treatment. Bronchopulmonary dysplasia (BPD) developed in 20 (18.7%) patients in the nCPAP group and 18 (24.4%) patients in the MV group; the difference was not significant (p = .351). Between 2009 and 2012, nCPAP was used at a rate of 33.9, 70.8, 68.4, and 69%. The risk factors for developing BPD were low gestation week, duration of intubation, and proven sepsis (p = .0001, p = .004, and p = .011, respectively).Early nCPAP treatment in preterm infants (≤32 weeks of gestation) decreases both the need for MV and the use of surfactant, but without a significant effect on BPD development. (No. 2016/324).

Amaç: Yenidoğan kliniğimizde çok düşük doğum ağırlıklı bebeklerin hastalık ve ölüm oranlarının zaman içerisindeki değişimini belirlemek. Gereç ve Yöntem: Ocak 2007 Aralık 2011 yılları arasında ikinci dönem Yenidoğan Yoğun Bakım Birimi rsquo;mize yatırılmış doğum ağırlığı 500 ile 1 500 g arasında ve gebelik yaşı lt;36 hafta olan bebeklerin dosyaları geriye dönük olarak incelendi Elde edilen bulgular ile kliniğimizin 2002 2006 birinci dönem yılları arasındaki sonuçları karşılaştırıldı Ayrıca ikinci dönemdeki bebeklerde doğum öncesi steroid uygulanmasının seyir üzerine etkileri araştırıldı.Bulgular: İki bin yedi 2011 yılları arasında çok düşük doğum ağırlıklı 246 bebek çalışmaya alındı Ortalama gebelik yaşları 28 9 plusmn;2 97 hafta ortalama doğum tartıları 1119 plusmn;283 g erkek cinsiyet oranı 46 7 olarak saptandı Her iki grubtaki bebeklerin ortalama doğum ağırlıkları ve cinsiyet oranları benzerken ortalama gebelik haftası 2 dönemde anlamlı olarak daha düşük saptandı p lt;0 001 Sezaryen ile doğum düzenli gebelik takibi ve doğum öncesi steroid uygulanması oranlarının ikinci dönemde anlamlı olarak arttığı görüldü sırasıyla p değerleri 0 011 0 002 0 001 İkinci dönemde ölüm oranının 35 7 rsquo;den 25 2 rsquo;ye gerilediği saptandı p=0 013 Sıkıntılı solunum sendromu nekrotizan enterokolit ventrikül içi kanama parenkim içi kanama prematüre retinopatisi ve sepsis oranları açısından dönemler arasında anlamlı farklılık saptanmadı p gt;0 05 İkinci dönemde doğum öncesi steroid tedavisi almış annelerin bebeklerinde ağır sıkıntılı solunum sendromunun evre 3 ve üzeri prematüre retinopatisinin anlamlı olarak daha az geliştiği görüldü.Çıkarımlar: Birimimizde zaman içerisinde 1 500 g altında doğan bebeklerin ölüm oranlarında belirgin azalma oldu Buna karşın erken dönem hastalıklarında anlamlı değişiklik gözlenmedi Doğum öncesi steroid uygulanmış anne bebeklerinde ağır sıkıntılı solunum sendromu ve ileri evre prematüre retinopatisi daha az oranlarda görüldü., Aim: The aim of this study is to determine mortality and morbidity changes in very low birth weight infants in the last decade in our intensive care unit Material and Method: Infants with birth weights of 500 1500 g and gestational age of lt;36 weeks admitted to our clinic between January 2007 and December 2011 2 period were examined retrospectively The obtained data were compared to the results of 2002 2006 1 period years In addition effects of antenatal steroids on the prognosis of the babies were also investigated in the last group Results: Two hundred fourty six very low birth weight infants between 2007 and 2011 were studied The mean gestational age birth weight and male ratio were 28 9 plusmn;2 97 weeks 1119 plusmn;283 g and 46 7 respectively Only the mean gestational age was significantly lower in the second period p lt;0 001 Cesarean delivery regular pregnancy monitoring and antenatal steroid usage rates were increased significantly in the present study p values are 0 011 0 002 0 001 respectively Compared with the previous period the mortality rate significantly decreased from 35 7 to 25 2 p=0 013 There was no significant difference between the two periods in terms of the incidence of respiratory distress syndrome necrotizing enterocolitis intraventricular hemorrhage parenchymal hemorrhage retinopathy of prematurity and sepsis p gt;0 05 Severe respiratory distress syndrome and advanced retinopathy of prematurity were observed with a significantly lower rate in infants whose mothers received antenatal steroids Conclusions: While early morbidity rates have not changed mortality rates have been reduced in infants under 1500 g over time Severe respiratory distress syndrome and advanced retinopathy of prematurity were observed less commonly in the babies whose mothers were given antenatal steroid Turk Arch Ped 2013; 48: 102 9

Background: Noninvasive transcutaneous carbon dioxide monitoring has been shown to be accurate in infants and children, limited data are available to show the usefulness and limitations of partial transcutaneous carbon dioxide tension (PtCO2) value. Objectives: The current study prospectively determines the effectiveness and accuracy of PtCO2 measurements in newborns. Materials and Methods: Venous blood gas sampling and monitoring of the PtCO2 level (TCM TOSCA, Radiometer) were done simultaneously. All measurements are performed on mechanically ventilated infants. Partial venous carbon dioxide tension (PvCO2) values divided into three groups according to hypocapnia (Group 1: < 4.68 kPa), normocapnia (Group 2: 4.68–7.33 kPa), hypercapnia (Group 3: > 7.33 kPa) and then PvCO2 and PtCO2 data within each group were compared separately. Results: A total of 168 measurements of each PvCO2 and PtCO2 data were compared in three separated groups simultaneously (13 in Group 1, 118 in Group 2, and 37 in Group 3). A bias of more than ± 0.7 kPa was considered unacceptable. PtCO2 was related to PvCO2 with acceptable results between the two measurements in hypocapnia (mean difference 0.20 ± 0.19 kPa) and normocapnia (0.002 ± 0.30 kPa) groups. On the other hand in hypercapnia group PtCO2 values were statistically significant (P < 0.001) and lower than PvCO2 data (mean difference 0.81 ± 1.19 kPa) Conclusions: PtCO2 measurements have generally good agreement with PvCO2 in hypocapnic and normocapnic intubated infants but there are some limitations especially with high level of CO2 tension. Monitoring of PtCO2 is generally a useful non-invasive indicator of PvCO2 in hypocapnic and normocapnic infants.

Amaç: Yenido¤an Yo¤un Bak›m Birimi’nde 2008 y›l›nda hastane kökenli kan ak›m enfeksiyon h›z›n›, etkenlerini, antibiyotik duyarl›l›¤›n›, zaman›ndan önce ve zaman›nda do¤mufl bebeklerde risk etkenlerini incelemek.Gereç ve Yöntem: Hastalar›n dosyalar› geriye dönük olarak incelendi. Zam›ndan önce ve zaman›nda do¤mufl bebekler için risk etmenleri “multivariate logistic regression” analizi ile de¤erlendirildi. Bulgular: Bir y›ll›k süre içerisinde 807 hasta 72 saatten daha uzun süre yatt›. Kan kültüründe üreme say›s› 97 idi. Üreme olanlar›n %65,6’s› erken do¤mufl, %34,4’ü zaman›nda do¤mufl bebeklerdi. En s›k elde edilen mikrorganizmalar koagülaz negatif stafilokok ve Klebsiella pneumonia türüydü. Kan ak›m enfeksiyon h›z› 5,9:1000 gün, katetere ba¤l› kan ak›m› enfeksiyon h›z› 9,6:1000 gün, ventilatörle iliflkili pnömoni h›z› 13,8:1000 gün olarak bulundu. Gram pozitif mikroorganizmalarda glikopeptit direnci görülmedi. Hastane enfeksiyonu için hastane yat›fl süresi, mekanik ventilasyon ve kateter varl›¤›n›n anlaml› risk etmenleri oldu¤u saptand›. Kan kültüründe üreme olanlarda ölüm oran› %12,5 idi. Çıkarımlar: Hastane enfeksiyonlar› yenido¤an yo¤un bak›m biriminde önemli hastal›k ve ölüm nedenidir. Zaman›ndan önce ve zaman›nda do¤mufl bebeklerde risk etmenlerinin azalt›lmas› sa¤kal›m üzerine önemli katk›lar sa¤layacakt›r. (Türk Ped Arfl 2011; 46: 137-43), Aim: The aim of this study was to evaluate the risk factors for term and pretem newborns etiological agents antibiotic susceptibility and rate of hospital acquired bloodstream infections in newborns hospitalized in our Neonatal Intensive Care Unit during 2008

Pseudohypoaldosteronism type 1 (PHA-1, MIM #264350) is caused by defective transepithelial sodium transport. Affected patients develop life-threatening neonatal-onset salt loss, hyperkalemia, acidosis, and elevated aldosterone levels due to end-organ resistance to aldosterone. In this report, we present a patient diagnosed as PHA-1 who had clinical and laboratory findings compatible with the diagnosis and had genetically proven autosomal recessive PHA-1. The patient received high doses of sodium supplementation and potassium-lowering therapies; however, several difficulties were encountered in the management of this case. The aim of this presentation was to point out the potential pitfalls in the treatment of such patients in the clinical practice and to recommend solutions. Conflict of interest:None declared.