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Aim: Sepsis is an important cause of morbidity and mortality for newborn babies. Cardiac involvement plays an important role in the pathophysiology of sepsis and has a significant effect on prognosis. In this study, the relationship between cardiac biomarkers, such as troponin-I (cTnI) and creatine kinase-myocardial band (CK-MB) levels, and prognosis in neonatal sepsis were investigated.Methods: A total of 87 patients with culture positive sepsis (Group I, n = 26) or clinical sepsis (Group II, n =61) were included in the study. The control group (Group III) consisted of 42 non-septic otherwise healthy newborns. The demographic data of the cases (gestational age, postnatal age, gender, age at diagnosis) and laboratory examination results (complete blood count, C-reactive protein, cTnI, CK-MB, blood gases and lactate and culture-antibiogram results) were recorded in the previously prepared study forms. In addition, the outcome (survival or death), and short- and long-term prognosis of the cases (epilepsy, neuromotor disability, vision-hearing problems, etc.) were also recorded.Results: No statistically significant difference was found between the groups in terms of gender, gestational age and birth weight. CK-MB level was high in 77%, 74%, and 71% of cases for Group I, Group II and Group III, respectively. No statistically significant difference was found in the rates of CK-MB levels in the patients who died and survived (15.8% and 11.8%, respectively) (p > 0.05). The cTnI cut-off value for the newborns included in the study was found to be 0.13 ng/ml (sensitivity 89.5%, specificity 90.9%). It was observed that a 0.001 unit increase in cTnI value (p =0.012) increased the risk of death 1.4 times.Conclusion: There is a relationship between cTnI test abnormality and mortality in septic newborns. However, multi-center studies involving more cases are needed to determine the relationship between cTnI test abnormality and long-term prognosis of patients.

Amplitude-integrated electroencephalography (aEEG) is a method for continuous monitoring of brain activity that is increasingly used in the neonatal intensive care unit. aEEG is accessible by non-expert person, and offers continuous bedside cerebral function monitoring (CFM). In its simplest form, aEEG is a processed single-channel electroencephalogram that is filtered and time-compressed. Several classifications are currently in use to describe patient tracings, incorporating voltage criteria, pattern recognition, cyclicity, and the presence or absence of seizures. The main usage of the CFM currently is for monitoring term newborns after birth asphyxia. Another well-established indication for CFM is monitoring for seizure activity with an addition advantage of monitoring the treatment effect. Current evidences demonstrate that aEEG is useful to monitor cerebral background activity, diagnose and treat seizures and predict neurodevelopmental outcomes for newborns. Thus, the main advantages of this device are its simplicity for both application and interpreting on one hand and the possibility of continuous long-term monitoring with real time assessment of clinical events on the other. This review aims to explain the fundamentals behind aEEG and its clinical applications.

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.

The aim of this study was to present our experiences with, as well as the factors that affect, the treatment and outcome of patients with neonatal gastrointestinal perforations (GIPs). Thirty-eight newborn cases that were operated on for GIP in our hospital’s tertiary newborn intensive care unit between January 2005 and December 2015 were retrospectively evaluated. The patients were divided into the two following groups: group 1, perforations related to necrotizing enterocolitis (NEC), and group 2, non-NEC perforations. In total, 38 patients (16 males, 22 females) participated in this study. The perforations were related to NEC in 12 patients (group 1; 31.6 %), and the other 26 patients (group 2; 68.4 %) were classified as non-NEC perforation cases. The incidence of neonatal GIP was 0.53 % in all newborn patients, while the incidence of perforation in NEC cases was 20 %. Of all patients, 25 (65.7 %) were premature. Non-NEC pathologies were the most common cause of GIP (68.4 %) and included stomach perforation related to a nasogastric catheter (n = 5), volvulus (n = 4), intestinal atresia (n = 3), esophageal atresia and tracheoesophageal fistula (n = 2), cystic fibrosis (n = 2), Hirschprung’s disease (n = 2), appendicitis (n = 2), congenital stomach anterior wall weakness (n = 1), duplication cyst (n = 1), invagination (n = 1), incarcerated inguinal hernia (n = 1), and idiopathic causes (n = 2). Primary surgical repair was performed in all cases without a conservative approach. The mortality rate related to GIP in newborn cases was 47.3 %. While the mortality rate in group 1 was 66.6 %, it was statistically insignificantly lower in group 2 (38.4 %) (p > 0.05). In group 1, the mortality rate of those with intestinal and colorectal perforations was 45.6 and 20 %, respectively (p > 0.05). Non-NEC pathologies are the most frequent causes of GIP in newborns, and primary surgical repair is the primary treatment choice for neonatal GIP. However, GIP remains one of the most significant causes of mortality in newborns. While the prognosis for neonatal colon perforation is good, that for stomach and jejunoileal perforations is worse.

To raise awareness of the utility of flow cytometric detection of inflammatory markers in the early diagnosis of neonatal sepsis.In accordance with the Töllner scoring system, cases with ≥10 points are accepted as having "The levels of acute-phase reactants CRP and PCT were significantly higher in the study group than in the control group (In addition to acute-phase proteins, cell surface antigens such as CD11b, CD64, and HLA-DR should be used in routine investigations for the early diagnosis of neonatal sepsis. Such usage in combination with acute-phase reactants may enhance diagnostic accuracy.

Background: The aim of present study was to evaluate the indications, complications and outcomes of acute peritoneal dialysis (APD) in neonates at a referral university hospital during the previous 8 years. Methods: This retrospective analysis included a total of 52 newborn infants who underwent APD in a neonatal intensive care unit between January 2008 and March 2016. Demographic, clinical, laboratory and microbiological data were extracted from patients' medical files. Results: The primary causes for requiring APD were acute tubular necrosis (n = 36, 69.2%), inborn error of metabolism (n = 10, 19.2%), congenital nephrotic syndrome (n = 2, 3.9%), bilateral polycystic kidney (n = 2, 3.9%), renal agenesis (n = 1, 1.9%), and obstructive uropathy (n = 1, 1.9%). The mean duration of APD was 8.7 ± 15.87 days (range: 1–90 days). Procedural complications were mainly hyperglycemia (n = 16, 47.1%), dialysate leakage (n = 7, 20.6%), peritonitis (n = 3, 8.8%), catheter obstruction (n = 3, 8.8%), bleeding at the time of catheter insertion (n = 2, 5.9%), catheter exit site infection (n = 2, 5.9%), and bowel perforation (n = 1 2.9%). There were 40 deaths (76.9%), mainly due to underlying causes. Ten of the 12 survivors showed full renal recovery, but mild chronic renal failure (n = 1) and proteinuria with hypertension were seen (n = 1) in each of remaining patients. Conclusion: Peritoneal dialysis is an effective route of renal replacement therapy in the neonatal period for management of metabolic disturbances as well as renal failure. Although major complications of the procedure are uncommon, these patients still have a high mortality rate due to serious nature of the underlying primary causes. Key Words: acute peritoneal dialysis, complication, mortality, neonatal intensive care unit, newborn

Background To evaluate whether there is an association between single nucleotide polymorphisms in magnesium-permeable TRPM6 ion channel and development of meningomyelocele (MMC). Therefore, we examined a total of 150 children with MMC, along with age- and gender-matched controls. DNA collected from whole blood was analyzed for the presence of two polymorphisms, rs2274924 (A > G; K1579E; Leu1579Glu) and rs3750425 (G > A; Val1393Ile), in TRPM6. Serum Mg2+ and calcium levels were also examined. Results A statistically significant difference in the distribution of rs2274924 genotypes (p = 0.049) was observed between the groups. Decreases in the AA genotype, and increases in the AG heterozygous genotype were also detected in the study group. The distribution of polymorphisms in the rs3750425 genotype and alleles was not statistically different between groups. Serum Mg2+ levels were lower in the GG genotype of rs3750425 compared with the GA and AA genotypes (p = 0.003). Conclusions A statistically significant difference in rs3750425 genotypes was observed between the patients with MMC and the controls, which corresponded to lower serum Mg2+ concentrations in these patients. Taken together, these results suggest that genetic variations in the Mg2+-permeable TRPM6 ion channel may play a role in the etiopathogenesis of MMC during embryonic development.

We read with great interest the article by Valsami et al 1 that reported the importance of the direct antiglobulin test (DAT) in cord blood for predicting the development of hemolytic disease of the newborn (HDN). They concluded that, although ABO incompatibility remains the main cause of a positive DAT, other causes, such as alloimmunization and drug interactions should also be investigated. In addition, they suggested that the relevant impact of DAT positivity on the development of HDN should be considered. Although we agree with their conclusion, we think that the study has many limitations and therefore, we would like to make some constructive comments on their article. Firstly, although they mentioned that a positive DAT in ABO incompatibility is considered a major risk factor for the development of severe HDN, they didnot presentdata for a control group who had negativeDATs.Bycontrast,thepositivepredictivevalueofapositive DAT for the development of HDN is as low as 23%. 2 This is due to