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Information on the use of high-frequency oscillatory ventilation in neonatal surgeries is very rare. In this report, we discuss two pre-term infants who had to receive high-frequency oscillatory ventilation as a rescue treatment due to severe pre-maturity. These two cases underwent successful bedside patent ductus arteriosus ligation under high-frequency oscillatory ventilation, and this shows us that patent ductus arteriosus ligation can be performed successfully in neonates even under high-frequency oscillatory ventilation.

Congenital rupture of tricuspid chordae tendinea leading to severe tricuspid insufficiency is an extremely rare pathology associated with signs and symptoms of congestive heart failure presenting at birth. If the diagnosis and treatment of this pathology are not made early in life fetal demise may become inevitable.We herein present a neonate with central cyanosis and congestive heart failure due to rupture of an anterior leaflet chordae resulting in severe insufficiency of the tricuspid valve who was treated with appropriate surgery.

WOS: 000428644300007 PubMed ID: 28320218 Purpose: To compare the antioxidant status of three cord clamping procedures (early clamping, delayed clamping and milking) by analyzing the thiol-disulfide balance. Patients and methods: This randomized controlled study enrolled 189 term infants who were divided into three groups according to the cord clamping procedure: early clamping, delayed clamping and milking. Blood samples were collected from the umbilical arteries immediately after clamping, and the thiol/disulfide homeostasis was analyzed. Results: The native and total thiol levels were significantly (p

Objective This study compares high flow nasal cannula (HFNC) with nasal continuous positive airway pressure (nCPAP) within the first hour of life as the primary respiratory support in neonates of ≤32 weeks of gestational age. Study Design This prospective, randomized study was conducted in infants with a gestational age of ≤32 weeks who had spontaneous respiration. HFNC or nCPAP was used as a first line respiratory support after admission to intensive care unit. Primary outcome was primary treatment failure. Secondary outcomes were duration of noninvasive respiratory support and oxygen treatment, maximum FiO2 level, length of hospital stay, intubation rate, rates of respiratory distress syndrome, pneumothorax, and bronchopulmonary dysplasia. Subgroup analysis was performed for infants ≤28 weeks of gestational age. Results We enrolled 107 infants, 53 in HFNC and 54 to nCPAP group. There was no difference in primary outcome between the two groups. There was no difference between the groups in aspect of secondary outcomes. Conclusion HFNC and nCPAP have no significant differences as a primary mode of respiratory support in preterm infants, in the time to wean off the devices and oxygen support, respiratory distress syndrome and bronchopulmonary dysplasia incidence, hospitalization duration, and rates of complications of prematurity.

Aim: To determine whether there is any association between platelet indices within the first hours of life and hemodynamically significant patent ductus arteriosus (hsPDA) in preterm newborns. Patient and methods: A total of 100 preterm infants, gestational age

AIM: Thymus size in neonates depend on many factors. We aimed to assess the thymus size radiographically in preterm neonates and its relationship with respiratory distress syndrome (RDS) and other complications of prematurity. METHODS: Thymus size was assessed by cardiothymic: thoracic ratio (CT/T), measuring the width of the cardiothymic shadow at the level of carina and dividing it by the width of the thorax at the costophrenic angles, from the first chest radiograph in patients less than 34 weeks gestational age. RESULTS: Neonates born between 30-34 weeks of gestation with RDS had smaller CT/T than non RDS group (0.34±0.1 vs 0.36±0.05, p = 0.045). Birth weight has positive correlation with CT/T (r = 0.166, p = 0.03). CONCLUSION: Thymus involution in the perinatal period is a complex process and the response is variable in different clinical situations. Activated hypothalamic-pituitary-adrenal (HPA) axis may be responsible for thymic involution in preterm infants between 30-34 weeks of gestation with RDS.

WOS: 000468003300001 PubMed ID: 30817090 PurposeThis study was designed as a randomized controlled trial to determine the effect of abdominal massage on bilirubin levels of newborn infants. Design and MethodsThe sample group consisted of 90 newborn infants (experimental group: 44; control group: 46) who were followed in a university hospital after birth between March and August 2017. The data were collected using an Information Form, Observation Form, and Transcutaneous Bilirubin Level Meter. Bilirubin levels were measured 1hr after the first breastfeeding in both groups. The abdominal massage was performed for 5min in each session, was continued in three sessions per day; was completed in totally six sessions for 2 days in infants in the experimental group. The second bilirubin measurements were repeated at the 48th hour after the birth and bilirubin levels were compared in two groups. The Student t test was used to evaluate the normally distributed data and the Mann-Whitney U test was used to carry out statistics in nonnormal distribution of quantitative data. ResultsThe bilirubin levels of the groups (experimental group: 1.060.92; control group: 1.01 +/- 0.98) were statistically similar before abdominal massage, t(88)=0.25, p=0.803. The difference of the bilirubin levels was compared in the groups before and after abdominal massage. The increase of bilirubin levels in the experimental group (1.96 +/- 1.69mg/dl) was statistically significantly lower compared with the control group (2.80 +/- 2.30mg/dl), t(88)=-1.974, p=0.048. Practice ImplicationsAbdominal massage is effective to reduce bilirubin levels of newborn infants.

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.

Hemangiopericytoma is a rare mesenchymal tumor originating from capillary pericytes, known as Zimmermann pericytes. The adult form is not uncommon and generally malignant but tumor is found rarely in children. Here we describe an intracranial hemangiopericytoma in a preterm newborn whose had the tumor resected successfully shortly after birth.

Thyroid functions in the fetus and newborn carry importance in terms of the baby's health and development of the central nervous system. Maternaliodine deficiency, exposure to iodine, thyroid diseases (Hashimoto thyroiditis, Graves') and drugs used by the mother affect thyroid functions in the fetus. Reflections of these effects are observed immediately after delivery. Investigation of the mother in terms of thyroid diseases during pregnancy, recognition and appropriate assessment of the required conditions, screening of all newborns in the first days of life in terms of congenital hypothyroidism, timely and appropriate evaluation of the screening results, early diagnosis and appropriate treatment of cases of congenital hypothyroidism, assessment and management of cases of transient thyroid hormone disorders and close monitoring of the thyroid functions and development of patients in whom treatment has been initiated with a diagnosis of hypothyroidism are crucial in terms of developmental outcomes of the babies who have thyroid function disorders or hypothyroidism. This guideline was written with the objective of guiding pediatricians, neonatologists and pediatric endocrinologists in the issue of assessment, diagnosis and management of thyroid function disorders and thyroid diseases concerning the fetus and baby during gestation and neonatal period.Fetus ve yenidoğanda tiroid fonksiyonları bebek sağlığı ve merkezi sinir sisteminin gelişimi açısından önem taşımaktadır. Annede iyot eksikliği, iyoda maruziyet, tiroid hastalıkları (Hashimoto tiroiditi, Graves’ hastalığı), annenin kullandığı ilaçlar fetusun tiroid işlevlerini etkiler. Doğumdan hemen sonra da bu etkilerin yansımaları görülür. Gebelikte annenin tiroid hastalıkları açısından incelenmesi gereken hallerin tanınması ve sağlıklı değerlendirilmesi, tüm yenidoğanların yaşamın ilk günlerinde konjenital hipotiroidi için taranması, tarama sonuçlarının zamanında ve sağlıklı değerlendirilmesi, konjenital hipotiroidili olguların erken tanısı, erken ve yeterli tedavisi, geçici tiroid hormon bozukluklarının değerlendirilmesi ve yönetimi, hipotiroidi tanısı ile tedavi başlanan hastaların tiroid fonksiyon ve gelişimlerinin yaşamın ilk yıllarında yakın izlemi bu dönemde tiroid fonksiyon bozuklukları ya da hipotiroidisi olan bebeklerin gelişimsel sonuçları açısından son derece önemlidir. Bu kılavuz çocuk hekimleri, yenidoğan ve çocuk endokrinoloji uzmanlarına gebelik ve yenidoğan döneminde fetus ve bebeği ilgilendiren tiroid fonksiyon bozuklukları ve tiroid hastalıklarının değerlendirilmesi, tanısı ve yönetimi konusunda yol göstermek amacıyla kaleme alınmıştır.

Purpose: To investigate the longitudinal change in intraocular pressure (IOP) in premature infants and to establish a normative IOP value. Methods: Forty premature infants with a gestational age (GA) of 26 weeks were enrolled in this longitudinal study. Measurements were taken initially at 28 weeks postconceptional age (PCA) and at 2-week intervals up to 40 weeks PCA. Intraocular pressure was measured with a hand-held tonometer (Tono-Pen XL; Reichert Inc.). Results: From 40 (22 male, 18 female) premature Caucasian infants, seven (for each eye) IOP measurements were obtained. Mean GA was 26 weeks and mean birthweight was 820 ± 112 grams. The mean IOP was 15.1 ± 1.2 mm Hg and 14.9 ± 1.1 mm Hg for the right and left eyes, respectively. The mean IOP in both eyes for all measurements was 15.0 ± 1.1 mm Hg. At 28 weeks PCA, 9 (22.5%) preterm infants had IOP values greater than 20 mm Hg. The mean IOPs at 28 weeks, 30 weeks, 32 weeks, 34 weeks, 36 weeks, 38 weeks, and 40 weeks PCA were 18.7 ± 1.1 mm Hg, 16.9 ± 0.9 mm Hg, 15.3 ± 0.9 mm Hg, 14.1 ± 1.3 mm Hg, 13.7 ± 1.3 mm Hg, 13.4 ± 1.4 mm Hg, and 13.1 ± 1.3 mm Hg, respectively. A significant decrease in IOP measurements was found up to 34 weeks PCA, with no significant decline in IOP measurements after that point (F = 109.7, pConclusions: The mean IOP of premature infants was 15.0 ± 1.1 mm Hg and IOP values decreased significantly up to 34 weeks PCA, indicating a decline trend approaching the term period.

Oxygen toxicity is believed to play a prominent role in the lung injury that leads to the development of bonchopulmonary dysplasia. L-carnitine (LCAR) is an antioxidant and prevents the accumulation of end products of lipid peroxidation, acts as a free radical scavenger and protects cells from reactive oxygen species. The aim of the present study was to evaluate the effects of LCAR on the histopathologic characteristics of oxygen-induced lung injury. Thirty one rat pups were divided into 4 groups: Healthy control group (group 1, n = 8), hyperoxia-exposed group (group 2, n = 7), hyperoxia-exposed and 100 mg kg(-1) LCAR-treated group (goup 3, n = 10), hyperoxia-exposed and 200 mg kg(-1) LCAR-treated group (goup 4, n = 6). Although in group given 100 mg kg(-1) LCAR together with hyperoxia-exposure, it was observed some improvement, histopathologic findings obtained from animals treated with 200 mg kg(-1) LCAR were similar to normal surprisingly. In conclusion, it should be focused on more the possible protective effect mechanism of LCAR and it should be made more effort to be able to use it in routine.

Apnea, cyanosis, lethargy and prolongation in capillary filling time developed on the postnatal 37(th) day in a preterm baby who was born at the 30(th) gestational week with a birth weight of 1 300 g. Acute phase reactants and immature/total neutrophil count ratio were found to be high. The patient who was diagnosed with sepsis was successfully treated with meropenem which was started empirically. In his blood culture Streptococcus pasteurianus grew. S. pasteurianus is in the subgroup of streptococcus bovis which is one of the D group streptococci and its previous name is S. bovis type II/2. In the literature, there are very few cases of neonatal infection related with this bacterium. As far as we know, this is first case of neonatal sepsis caused by S. pasteurianus in Turkey. In addition, we tried to determine the clinical properties of neonatal infections arising from S. pasteurianus by reviewing the literature.

Breastfeeding may be considered as a risk factor for aflatoxin M1 (AFM1) exposure in early infancy. Hence, AFM1 levels in maternal breast milk (MBM) and the correlation between moldy cheese consumption of lactating mothers and infant exposure to AFM1 were investigated in this study. MBM samples from 73 lactating women randomly selected in hospitals located in Eastern Turkey were analysed for the presence of AFM1 using competitive ELISA. Out of 73 lactating mothers, 44 of them had the habit of cheese consumption (at least once a week), while remaining 29 had no such habit. AFM1 was detected in MBM of 18 out of 73 samples (24.6%); 12 MBM of 44 lactating mothers with moldy cheese consumption habit (27.2%) and 6 MBM of 29 mothers with no such habit (20.6%) with the range of 1.3-6.0 ng/l. None of the samples exceeded the limit set by EU and Turkish legislations. Moldy cheese consumption habit of lactating mothers exhibited no significant correlation with the presence of AFM1 in their milk (p > 0.05). The results indicated that the relative risk of infant AFM1 exposure via MBM of moldy cheese consuming mother was not higher than MBM of mothers with no such habit. (C) 2014 Elsevier Ltd. All rights reserved.

Background: The aim of this study was to investigate the effect of maternal smoking during pregnancy on human milk interleukin-1β, tumor necrosis factor-α (TNF-α) and soluble vascular cell adhesion molecule-1 levels at the postpartum seventh day. Methods: Forty-four mothers (age range: 21–34 years) were enrolled in the study. Mothers were interviewed and classified according to their smoking status into one of two groups: the smoking mothers (n= 21) and the nonsmoking mothers (n= 23). Results: There were no significant differences between study groups with respect to human milk interleukin-1β (P= 0.12) and soluble vascular cell adhesion molecule-1 levels (P= 0.83). However, TNF-α levels were found to be significantly lower in the smoking mothers compared with the controls (P= 0.002). Conclusion: This study shows that maternal smoking during pregnancy affects the levels of TNF-α in milk. The protective effect of human milk against infections seems to be impaired in smoking mothers.

Purpose This study examines the levels of oxidative damage in patients with retinopathy of prematurity (ROP). Methods Fifty patients were recruited with a birthweight below 1500 g or gestational age below 32 weeks. The cases were classified into those who developed ROP (n=25) and those without ROP (n=25). The authors obtained blood and urine samples from each infant, for measuring 8-hydroxy 2-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) levels, at the time of the first examination at 4–6 postnatal weeks. Results A significant difference was observed in leukocyte and urine 8-OHdG levels in patients with ROP compared to those without ROP (pConclusions 8-OHdG in leukocyte DNA and urine levels in premature infants can be useful as an indicator for ROP screening.

In the present study, the possible protective effect of the pyridoxine against glutamate-induced neurotoxicity in cerebellar granular cell culture of rat pups is investigated for its therapeutic potential. Glutamate (10-7 M) was administered to cerebellar granular cell cultures that were prepared from one-day-old Sprague-Dawley rats. The neuroprotective effect of pyridoxine was examined. Pyridoxine at the doses of 10-8, 10-7, 10-6, and 10-5 M was introduced into the culture flasks before inclusion of glutamate. Pyridoxine at the doses of 10-8 M and 10-7 M significantly reduced glutamate cytotoxicity. A 10-7 M dose of pyridoxine proved to be more effective than a 10-8 M dose. The present study demonstrates that pyridoxine may protect glutamate-induced neurotoxicity. Neuroprotective effect of pyridoxine, at least in part, may result from its anti-glutamatergic activity. Pyridoxine merits further investigation as a therapeutic option in hypoxic-ischemic brain injury.

Nicolau syndrome (NS) is a rare complication of intramuscular, intraarticular or subcutaneous injection of particular drugs leading to ischemic necrosis of the surrounding skin, soft tissue and muscular tissue. Benzathine penicilin one of the most widely used antibiotic for upper respiratory tract infections and has been rarely reported to cause NS. Here we describe a 4 year old boy with diagnosis of NS after the injection of benzathine penicillin who was successfuly treated with unfractionized heparin (enoxaparine) and pentoxifylline. The practitioners should pay attention for unnecessary use of benzathine penicillin to avoid from probable complications.El síndrome de Nicolau (SN) es una complicación rara de la inyección de ciertos fármacos por vía intramuscular, intrarticular o subcutánea, que produce necrosis isquémica de la piel, las partes blandas y el tejido muscular circundante. La bencilpenicilina benzatínica es uno de los antibióticos más ampliamente empleados para las infecciones de las vías respiratorias altas y raramente se ha notificado que produzca SN. En este artículo presentamos el caso de un niño de sexo masculino de cuatro años de edad diagnosticado con SN tras la inyección de bencilpenicilina benzatínica tratado satisfactoriamente con heparina fraccionada (enoxaparina) y pentoxifilina. Los médicos deben estar atentos al uso innecesario de bencilpenicilina benzatínica para evitar las probables complicaciones.

WOS: 000451979401455 Introduction: The aim of this study was evaluation of broncoscopic findings in children with congenital heart disease(CHD). Method: Bronchoscopy was performed in 37 patients with CHD who were followed between October 2012–December 2014 in our hospital. The data obtained from these patients were evaluated retrospectively. Results: Twenty-one of the patients were males and 16 were females, median ages 12.5 mo (1-36m). Twenty-seven patients (72.9 %) were operated for congenital heart disease. Twelve of the patients had pulmonary hypertension. Bronchoscopy was performed because of extubation failure, atelectasis, recurrent or persistant pneumonia, stridor and persistant cough; 17,7,7,4 and 2, respectively. Laryngomalacia, tracheomalacia, bronchomalacia, tracheal stenosis, airway branch anomalies, granulation tissue formation and pulsatile airway pressure was determined in flexible bronchoscopy, 13,12,8,4,17,7 and 10, respectively. Twenty-seven of the patients were followed with mechanical ventilation(MV). MV duration before and after bronchoscopy was median 30 and 12 days, respectively. Tracheostomy was performed in 15 cases. After bronchoscopy five of these patients were removed from tracheostomy. Eleven out of the patients had positive culture in bronkoalveolar lavage. Patients were discharged with room air, tracheostomy with room air, only with supplemental oxygen, tracheostomy with supplemental oxygen; 19(51.3%), 6(16.2%), 1(2.7%),1(2.7%), respectively. One patient was following intubated with ventilatory support. Nine patients died. Conclusions: Airway anomalies were more frequently encountered in patients with congenital heart disease.

WOS: 000216262100007 Neonatal cerebral infarct is a very rare entity and such infarcts could regress as a transient event or result in severe neurological injuries such as hemiplegic cerebral palsy. Here, we report a case of cerebral infarct in a term male infant presenting with convulsions within the first day of life. Difficulty at birthmight be one of the uncommon reasons of the infarcts. In this case, dystocia is supposed to be one of the associated events. The neurological deterioration was transient and no neurological deficit was noticed at 7 months after birth. The majority of neonates with large infarcts have a poor prognosis. Early imaging in this population may lead to prompt diagnosis, timely neuroprotection, rehabilitation, and improved outcome.

Background: Oxidative stress may play an important role in the pathophysiology of preeclampsia. An increase in lipid peroxidation products and a decrease in antioxidant activity in preeclamptic women have been reported in many papers. The objective of this study was to evaluate oxidative stress in infants born to preeclamptic mothers. Methods: Malondialdehyde (MDA) and glutathione (GSH) levels and glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities were measured in cord plasma of infants born to preeclamptic (n = 18) or normotensive (n = 9) mothers. Results: Gestational age was similar in both groups. The mean birth weight was significantly lower in the preeclamptic group (P = 0.007). Maternal age, primigravidity, antenatal steroid use, premature rupture of the membranes, clinical chorioamnionitis and adverse neonatal outcomes including sepsis, respiratory distress syndrome and neonatal mortality did not differ between groups. Cesarean delivery was significantly higher in the preeclamptic group. There was no significant difference in cord plasma levels of MDA and GSH, and activity of GPx between the preeclamptic and control groups. SOD was found to be increased in preeclamptic group (P = 0.03). Conclusions: We concluded that although cord plasma MDA levels were similar in both the preeclamptic and control groups, increased SOD activity might be an indicator of increased oxidative stress in infants born to preeclamptic mothers.

Maternal smoking is considered to be a risk factor for low birth weight. It is hypothesized that alteration in leptin concentration may be associated with reduced fetal growth. In this study, we assess the effect of smoking during pregnancy on maternal and neonatal serum leptin concentrations, and also on breast milk leptin levels. When the infants were brought to routine physical examination at 7 days old, blood samples and breast milk specimens were taken for leptin measurement from mothers who smoked during pregnancy and their newborns. Nonsmoking mothers and their infants were recruited randomly over the same period as a control group. Maternal age, number of pregnancy, weight of the mothers, birth weight, and gestational age of the infants were similar in both groups (p > 0.05). There was no significant difference between groups in maternal serum and breast milk leptin levels (p = 0.14 and p = 0.96, respectively). However, serum leptin levels were found significantly lower in neonates born to smoking mothers compared with infants born to nonsmoking mothers (p = 0.02). Our findings suggest that maternal smoking dose not have an effect on maternal serum and breast milk leptin levels but decreases neonatal serum leptin concentration independent of birth weight. Copyright © 2005 Taylor & Francis, Inc.

Chloral hydrate is a sedative commonly used in pediatric medicine. It was evaluated for genotoxicity in cultured peripheral blood lymphocytes of infants who were given chloral hydrate for sedation. Sister chromatid exchange and micronucleus frequencies were determined before and after chloral hydrate administration. After treatment, the frequencies of sister chromatid exchange and micronuclei were significantly increased, suggesting that chloral hydrate has moderate genotoxic potential in infants.

Yılmaz-Semerci S, Demirel G, Taştekin A. Wickerhamomyces anomalus blood stream infection in a term newborn with pneumonia. Turk J Pediatr 2017; 59: 349-351. The incidence of invasive candidiasis is high in neonates admitted to neonatal intensive care unit and is associated with significant morbidity and mortality rates. Candida albicans is the most common fungal agent pathogenic to neonates but invasive fungal infections caused by uncommon fungi have increased in recent years. Wickerhamomyces anomalus is a very rare pathogen causing blood stream infection in neonates, which has reportedly caused only few cases in the literature. Here we report a case of blood stream infection caused by a fungal agent Wickerhamomyces anomalus in a term male infant.

Hypernatremic dehydration in neonates is a condition that develops due to inadequate fluid intake and it may lead to cerebral damage. We aimed to determine whether there was an association between serum sodium levels on admission and aEEG patterns and prognosis, as well as any association between aEEG findings and survival rates and long-term prognosis.The present study included all term infants hospitalized for hypernatremic dehydration in between January 2010 and May 2011. Infants were monitored by aEEG. At 2 years of age, we performed a detailed evaluation to assess the impact of hypernatremic dehydration on the neurodevelopmental outcome.Twenty-one infants were admitted to the neonatal intensive care unit for hypernatremic dehydration. A correlation was found between increased serum sodium levels and aEEG abnormalities. Neurodevelopmental assessment was available for 17 of the 21 infants. The results revealed that hypernatremic dehydration did not adversely affect the long-term outcomes.The follow-up of newborns after discharge is key to determine the risks associated with hypernatremic dehydration. Our results suggest that hypernatremic dehydration had no impact on the long-term outcome. In addition, continuous aEEG monitoring could provide information regarding early prognosis and mortality.

Dilation of one or both ventricles and systolic dysfunction occur dilated cardiomyopathy. Hypocalcemia is a rare cause of reversible heart failure and dilated cardiomyopathy. A seventeen-day old male infant was brought to our clinic with complaints of poor feeding and convulsion. On physical examination, the patient had worse general appearance and was apathetic. Examination of cardiovascular system revealed 2/6 diastolic murmur and signs of congestive heart failure. The value of serum calcium was 4.8 mg / dL. Cerebrospinal fluid examination was unremarkable. Echocardiographic evaluation showed enlarged heart chambers and globally hypokinetic left ventricular wall. Left ventricular ejection fraction was 39% and shortening fraction was 17%. After the treatment of calcium gluconate, a clinically dramatic improvement was observed. On the second day of hospitalization, the echocardiographic examination was normal. Therefore, we suggest that sermon calcium level in newborn with cardiomyopathy should be measured.

In this study, we aimed to clarify the following questions: 1) Does phototherapy (PT) cause genotoxicity in full-term newborn babies undergoing PT as a result of neonatal jaundice?, 2) if genotoxic effect occurs, is there any relationship between the duration of PT and genotoxicity?, and 3) is genotoxic effect temporary or not? The frequency of sister chromatid exchange (SCE) was determined in jaundiced newborns before, during, and after phototherapy, then determined again in childhood (approximately 3.5 years old). Mean frequency of SCE of 22 full-term jaundiced babies significantly increased during the PT procedure and in every single day, compared to the previous day, in comparison to the pre-PT basal value (6.20 +/- 0.57;); mean SCE frequencies at 24, 48, 72, and 96 hours were 7.75 +/- 0.40, 8.16 +/- 0.47, 8.50 +/- 0.40, and 9.36 +/- 0.55, respectively (all P-values < 0.01). In childhood, no significant difference was found between the mean SCE value (4.9 +/- 0.9) of 20 of 22 children, who received PT in the neonatal period, and the mean SCE value (4.7 +/- 0.6) of 20 coevaluated healthy children (P = 0.40). This study demonstrates that the negative effect of PT on SCE is a temporary effect.

Hemophagocytic lymphohistiocytosis (HLH) is a rare, fatal disease. Neonatal cholestasis exhibits symptoms similar to those seen in several newborn diseases. HLH is rapidly fatal; therefore, an effective and prompt differential diagnosis is vital. A 10-hour-old newborn with icterus was referred to our clinic. Laboratory examination revealed direct bilirubinemia and pancytopenia, and cholestasis developed. HLH findings were observed in the bone marrow aspiration. Induction chemotherapy as described in the HLH-2004 protocol was initiated. Despite notable improvement in clinical signs and laboratory findings, the infant died, probably due to sepsis, one week after start of chemotherapy HLH should be kept in mind in the differential diagnosis of all cholestatic patients with recently developed cytopenia. For definitive diagnosis of HLH, clinical signs and laboratory findings of the patient should be evaluated, hyperferritinemia and hypertriglyceridemia should be searched and bone marrow aspiration materials should be examined carefully.

Purpose: The aim of this study was to investigate the effect of the application of the odor of breast milk in preterm infants during gavage feeding on the period of transition to total oral feeding. Design: This prospective experimental study was performed on a total of 80 preterm infants: 40 infants in the study group and 40 in the control group. Methods: This experimental study was performed in eastern Turkey at the Neonatal Intensive Care and Premature Unit of a university hospital between September 2007 and December 2008. The demographic data were collected via a questionnaire, and an intervention and follow-up table was prepared by the researcher based on relevant literature. The study was approved by the local institution, and written informed consent was obtained from all parents. Findings: The findings of the study indicated that the preterm infants who were stimulated by the odor of breast milk during gavage feeding transitioned to oral feeding 3 days earlier than control subjects. Moreover, the mean hospitalization time of these infants was 4 days shorter. Conclusions: The results show that stimulation with breast milk odor is an effective method for decreasing transition of preterm infants from gavage to oral feeding. Clinical Relevance: Nurses can train mothers to pump their breast milk, stimulate their infants with the odor of their breast milk, and feed it to their infants in the premature unit. This may lead to a quicker transition to oral feeding.

WOS: 000208870100266, …

The aim of this study was to investigate the effect of maternal smoking during pregnancy on human milk interleukin-1beta, tumor necrosis factor-alpha (TNF-alpha) and soluble vascular cell adhesion molecule-1 levels at the postpartum seventh day.Forty-four mothers (age range: 21-34 years) were enrolled in the study. Mothers were interviewed and classified according to their smoking status into one of two groups: the smoking mothers (n= 21) and the nonsmoking mothers (n= 23).There were no significant differences between study groups with respect to human milk interleukin-1beta (P= 0.12) and soluble vascular cell adhesion molecule-1 levels (P= 0.83). However, TNF-alpha levels were found to be significantly lower in the smoking mothers compared with the controls (P= 0.002).This study shows that maternal smoking during pregnancy affects the levels of TNF-alpha in milk. The protective effect of human milk against infections seems to be impaired in smoking mothers.

An association between thromboembolic events and Down syndrome (DS) has been increasingly reported in the literature. It is not clear whether patients with DS have increased risk for thrombotic disorders or there is a coincidence. We present a case of giant right ventricular thrombus in a neonate with DS. Risk factors for thrombosis in the present case were neonatal sepsis and dehydration. There was no congenital heart anomaly. The patient was treated successfully using recombinant tissue plasminogen activator. Recombinant tissue plasminogen activator seems to be a safe and effective thrombolytic therapy in neonates.

Ors, Rahmi/0000-0002-9089-1067 WOS: 000239401200005 PubMed: 16516423 There is growing evidence that glutamate receptor-mediated injury plays a crucial role in bilirubin neurotoxicity. L-carnitine (LC) has been shown to prevent glutamate-induced toxicity in neuronal cell culture. The purpose of this study is to assess whether LC is able to prevent bilirubin neurotoxicity. Unconjugated bilirubin at different concentrations was administered to cerebellar granular cell cultures prepared from 1-day-old Sprague-Dawley rats. The neuroprotective effect of LC was examined. LC at doses of 10(-6), 10(-5), 10(-4) and 10(-3) M was applied to culture flasks. LC at a dose of 10-4 M Significantly blocked bilirubin neurotoxicity. On the other hand, LC significantly increased bilirubin toxicity at a higher dose (10(-3) M). LC at the doses of 10(-5) and 10(-6) M was found to be ineffective. 10(-4) M LC decreased bilirubin-induced neuronal cell death from 47.72 +/- 3.68 to 27.23 +/- 5.14%, (P = 0.003). The present study demonstrates, for the first time, that LC protects against bilirubin neurotoxicity in a dose-dependent manner in cerebellar granular cell culture of rats. Further research is needed to confirm our findings and to clarify the mechanisms responsible for the protective effect of LC. (c) 2006 Elsevier B.V. All rights reserved.

This cohort study investigated postnatal serum malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPx) levels in 14 active-smoking, 14 passive-smoking, and 15 non-smoking mothers and their newborns on day 7 post-partum. No significant differences were noted among the study groups with respect to MDA (p = 0.63) or SOD levels (p = 0.98) in either the mothers or their infants. However, there were significant differences among the study groups with respect to serum GPx activities in both the mothers (p = 0.028) and the infants (p = 0.039). When GPx activities were analyzed separately in both mothers and infants, a significant difference was noted only between the infants of smoking mothers and the infants of non-smoking mothers (p = 0.015). In conclusion, there was a significant increase in GPx activities of smoking mothers and their infants, suggesting that they may have been exposed to more oxidant stress.

WOS: 000230740800004, PubMed: 16034151, The aim of the study was to investigate simultaneously serum and milk malondialdehyde (MDA) levels, superoxide dismutase (SOD), glutathione peroxidase (GPx) activities, and antioxidant potential (AOP) in active-smoking, passive-smoking, and nonsmoking mothers and to search if there is any difference between serum and milk oxidant/ antioxidant status caused by smoking. According to their smoking status, 60 mothers (age range: 20-35 yr) were classified into one of three groups: the active-smoking mothers (n=15), the passive-smoking mothers (n=22), and the nonsmoking mothers (n=23). Serum and milk MDA, SOD, GPx, and AOP values were determined in mothers on the postpartum seventh day by the spectrophotometric method. Serum Zn and Cu concentrations were determined by atomic absorption spectrophotometry (AAS). There was no significant difference in serum samples with respect to MDA (p=0.17), SOD (p=0.51), and AOP (p=0.36) levels, but there was a significant difference in serum GPx (p=0.002) levels among the study groups. The significant differences were also found in milk samples in terms of MDA (p=0.002) and SOD (p=0.011), but not in GPx (p=0.11) and AOP (p=0.29) levels among the study groups. No significant difference was seen in serum zinc concentration (p=0.49), but copper concentration differed significantly among the groups (p=0.005). These observations suggest that human milk is more vulnerable to oxidative stress and lipid peroxidation than serum samples in smoking mothers, even if they are passive smokers.

Ors, Rahmi/0000-0002-9089-1067 WOS: 000234199200007 PubMed: 16310592 Glutamate mediated intracellular calcium accumulation and free radical generation are thought to be major mechanisms that contribute to cell death in hypoxic-ischemic brain injury. For this reason, various glutamate receptor antagonists and antioxidants have been investigated for their therapeutic potential. To assess whether L-carnitine, a possible antioxidant, is able to prevent glutamate- and kainic acid (KA)induced neurotoxicity. Glutamate (10(-7) M) and one of its receptor agonists, KA (10(-4) M) were administered to cerebellar granular cell cultures that were prepared from I-day-old Sprague-Dawley rats. The neuroprotective effect Of L-carnitine was examined. L-carnitine at doses of 10(-6), 10(-5), 10-4, 10(-3) M was applied to culture flasks. L-carnitine at doses of 10(-4) and 10(-3) M significantly blocked glutamate-induced neurotoxicity. 10(-4) M dose Of L-carnitine proved to be more effective than 10(-3) M. L-carnitine also blocked KA-induced neurotoxicity only at the dose of 10(-4) M. 10(-4) M L-carnitine, the most effective dose in both glutamate- and KA-induced neurotoxicity, decreased glutamate-induced neuronal cell death from 36.14 +/- 2.95% to 17.59 +/- 2.25%; (P < 0.001) and KA-induced neuronal cell death from 21.4 +/- 0.41 to 13.4 +/- 1.38%; (P < 0.001). The present study demonstrates that L-carnitine protects against glutamate- and KA-induced neurotoxicity. Protective effect Of L-carnitine may result from its antioxidant activity because free radical generation is a common result in either glutamate- or KA-induced neurotoxicity. L-carnitine merits further investigation as a therapeutic option in hypoxic-ischemic brain injury of newborn. (c) 2005 Elsevier B.V. All rights reserved.

Congenital factor X deficiency is a rare autosomal recessive disorder that usually presents with variable bleeding tendency, prolonged prothrombin time and partial thromboplastin time. Therefore, it may be misdiagnosed as hemorrhagic disease of the newborn. Factor X level should be investigated for the definite diagnosis. We first report a new family whose two infants presented with severe intracranial bleeding at different times and were found to have congenital factor X deficiency. Plasma replacement therapy was not found to be efficacious in these infants. In conclusion, a possible factor X deficiency should be considered when a newborn presents with intracranial bleeding. (C) 2003 Elsevier B.V. All rights reserved.

Cystic hygromas are large cystic masses resulting from failure of lymph drainage. The vast majority occur in the neck or axilla. Cases of cystic hygroma of the extremity are extremely rare. We present a newborn infant with a giant cystic hygroma on her left leg, complicated by severe hyponatremia.

Benzathine penicillin G (BPG) is effective for secondary prophylaxis of rheumatic fever (RF). However, interval between injections a remains a controversial matter. In a study population of 74 patients, following the initial diagnosis of RF, 3-weekly BPG (1.2 million units) regimen was started. During the first three-week period, serum penicillin concentrations were examined on the 7th, 14th and 21st days and throat culture done for group-A b hemolytic streptococcal (GABHS) infection. Ten patients (13.5%) at 21st day of injection had low serum penicillin concentration after the first BPG. GABHS was isolated in 5 patients during this period. Although two of these 5 patients had symptoms of respiratory tract infection, according to laboratory data, the other three were accepted as carriers. All 74 patients were then followed-up for rheumatic recurrence (RR) during long-term period (6 to 60 months, mean 25 +/- 5 months). There was no RR among regular (missing no more than one injection a year) group. We concluded that 3-weekly BPG regimen was satisfactory for secondary prophylaxis in RF, even though serum penicillin level was inadequate during the third week in some of the patients.

PubMed: 23860075, Vaginal agenesis is known as one of the Müllerian anomalies. Müllerian anomalies occur during gonadal development and differentiation, and may lead to complex outcomes. McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by Müllerian anomalies with hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female newborn that developed hydronephrosis and respiratory distress due to compression of the cystic mass and underwent surgery on postpartum day 3. Pull-through vaginoplasty was performed with an abdomino-perineal approach. We report the unique treatment approach in this case.

BACKGROUND: There are limited data about the results of repeated oral ibuprofen (OIBU) treatment. This study aimed to describe patent ductus arteriosus (PDA) closure rates and adverse events after repeated courses of OIBU in premature infants with PDA. METHODS: Preterm infants with hemodynamically significant (hs)PDA were enrolled in the study. If the first course of OIBU treatment failed, a second and, if required, third course was administered. RESULTS: A total of 100 patients received OIBU. In six patients, treatment could not be completed due to death (n=3) and side effects (n=3). In three patients, adverse effects related to OIBU (thrombocytopenia and impairment of renal function) developed during the first course. During the second and third courses, no new adverse event occurred. After all courses, the PDA closure rate was determined as 88%. The rate was 71% after the first course, 40% after the second course, and 35% after the third course. Although the second course resulted in a significant increase in the closure rate (p0.05). The mean postnatal age at the start of the first dose of OIBU was not significantly different among the responders and non-responders to the first course (p>0.05). Clinical characteristics did not affect the closure rate significantly. The number of courses did not have a significant effect on death, when gestational age and birth weight were used as covariates [p=0.867, Exp(B)=0.901, 95% confidence interval=0.264-3.1]. CONCLUSION: A second course of OIBU seems effective and safe for use in preterm infants with hsPDA. Although a third course of OIBU results in PDA closure in some additional patients, the difference is not significant. Thus, surgical ligation should be considered after the second course, especially in patients with signs of severe heart failure.