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Aim: To determine the reference values of strong ion difference (SID), effective SID (SIDe), unmeasured anions (UMA), tissue acids (TA), lactate and Chloride-Sodium (Cl-Na) ratio of umbilical cord blood, and to evaluate the impact of delivery mode on these parameters. Methods: This prospective study was performed on healthy term newborn infants that had normal progress throughout the first and second stages of labor during normal spontaneous delivery (NSD) and cesarean section (C/S). Immediately after birth, 1ml and 2 ml of umbilical venous cord blood samples were obtained for blood gas analysis and blood chemistry respectively. The Cl-Na ratio, anion gap (AG), albumin corrected AG (AGCorr), SID, SIDe, UMA and TA were calculated in NSD and C/S groups.. Results: A total of 181 healthy newborn infants were included the study. Fifty-one infants were delivered by NSD and 130 infants by C/S. The pH and PCO2 values were similar in both groups. The mode of delivery had a significant impact on the umbilical cord AG, AGCorr, SID, lactate, UMA, and TA levels. All these values were significantly higher in NSD than C/S group. Conclusion: Umbilical cord blood gas analysis is a common practice to evaluate fetal status at delivery. The calculation of blood gas parameters in perinatal problems according to Stewart’s method may lead further understanding how perinatal conditions of the mother influence the fetus and newborn infant.

Amac: Bu retrospektif calismanin amaci risk altindaki bebeklerde hipoglisemi insidansini belirlemek ve dogum sonrasi 48 saate kadar sonuclarini degerlendirmekti. Ayrica hipoglisemi olan ve olmayan bebeklerin demografik ozelliklerini karsilastirmayi amacladik. Yontemler: Hipoglisemi ICD kodu ile taranan yenidoganlar risk faktorleri acisindan degerlendirildi ve hastalar risk faktorlerine gore gruplandirildi. Risk altindaki tum bebekler dogum sonrasi 48 saate kadar tarandi. hipoglisemi, bebegin yasina bakilmaksizin kan sekeri konsantrasyonunun 47 mg / dl'nin altinda olmasi olarak tanimlandi. Bulgular: 823 bebekte hipoglisemi ICD kodu ile dogumdan 48 saat sonra kan sekeri konsantrasyonu olculdu. Bu bebeklerin 251'inde (% 30,4) hipoglisemi saptandi. 823 bebekten 215'i (% 26) hipoglisemi icin en az bir risk faktorune sahip oldugu icin tarandi. Bunlarin 149'unda (% 69,3) hipoglisemi saptandi. Diyabetik anne bebegi disinda risk altindaki tum bebeklerde hipoglisemi insidansi artmistir. Bununla birlikte, risk altindaki bebeklerin tamamina yakini ilk 24 saatte hipoglisemi gelistirmesine ragmen, 7'sinde (% 4,6) postnatal 24-48 saat icinde hipoglisemi tespit ettik. Hipoglisemik olan ve olmayan risk altindaki bebeklerin demografik ozelliklerinde istatistiksel olarak anlamli farkliliklar vardi. Tartisma: Hipoglisemi risk altindaki bebeklerde yaygindir. Erken ve zamaninda teshis ve tedavi olmadan, norolojik ve gelisimsel olumsuz sonuclara neden olabilir. Bu nedenle, etkisini azaltmak icin risk altindaki bebeklerde kan sekeri duzeyinin surekli olarak izlenmesi gerekir.

Giriş Erken neonatal sepsis ve solunum sıkıntısı sendromu, erken doğan bebeklerde yaşamın ilk günlerinde neonatal mortaliteye yol açmaktadır. Bu çalışmanın amacı, premature bebeklerde spot idrar albümin / kreatinin oranının erken neonatal sepsis ve solunum sıkıntısı sendromunun erken tanı göstergesi olup olmadığını belirlemektir. Yöntem 34. haftadan erken doğan 126 prematüre bebek prospektif olarak incelenmiştir.Bu çalışmada yaşamın birinci, üçüncü ve yedinci gününde serum albümin, kreatinin, C-reaktif protein (CRP) ve spot idrar albümin / kreatinin oranlarını değerlendirdik. Ayrıca bu parametrelerin, erken doğan bebeklerde yaşamın ilk günlerinde erken neonatal sepsis ve solunum sıkıntısı sendromu ile ilişkisini araştırdık. Bulgular Yaşamın ilk ve yedinci gününde spot idrar albümin / kreatinin oranı ile erken neonatal sepsis grubu arasında istatistiksel olarak anlamlı fark vardı (p = 0.01). Solunum sıkıntısı sendromu grubunda idrar albümin / kreatinin oranları istatistiksel olarak anlamlı değildi. Serum albümin konsantrasyonları ve spot idrar albümin / kreatinin oranı yaşamın ilk günlerinde korelasyon göstermemiştir. Ayrıca yaşamın ilk günlerinde gebelik yaşı, doğum ağırlığı ile spot idrar albümin / kreatinin oranı arasında ilişki yoktu. Sonuçlar Bulgularımız, Çalışmamız doğum sonrası erken dönemde spot idrar albümin / kreatinin oranının prematüre bebeklerde erken neonatal sepsisi tanımlayabildiğini göstermektedir.

The objective of this study is to investigate the effect of breast milk and sucrose on pain scores and perfusion index (PI) and to evaluate the alteration in pain and PI during retinopathy of prematurity (ROP) examination.This prospective randomized controlled study was conducted with preterm infants who were born in our hospital, hospitalized in the neonatal intensive care unit and whose gestational week was32 weeks and birth weight was1500 g. The preterm infants who would undergo ROP examination were allocated to three groups according to simple randomization method as follows: group 1: only local anesthetic eye drops, proparacaine HCl ophthalmic solution 0.5%, group 2: proparacaine HCl ophthalmic solution 0.5% plus breast milk, and group 3: proparacaine HCl ophthalmic solution 0.5% plus sucrose 24%. Postductal PI, transcutaneous oxygen saturation and heart rate (HR) values were measured before the eye examination (0), at the 30th, 60th, and 90th seconds (s) of the eye examination and 30 s after lasting of the examination in all infants. Pain was evaluated using Neonatal Infant Pain Scale (NIPS) during the examination.Fifty-one preterm neonates were prospectively enrolled into the study. The HR was higher during and after the examination in all infants according to before the examination (The present study indicates that alterations may be seen in PI during the ROP examination; in other words, peripheral tissue perfusion could be affected. We consider that eye examination is a very painful procedure, and administering breast milk, sucrose or local anesthetic is not sufficient for reducing pain.

Yenidoğan döneminde birleşik heterozigot Niemann-Pick Type C hastalığıNiemann-Pick Tip C hastalığı (NPC), esterifiye olmamış kolesterollerin lizozomlarda depolanması ile karekterize nörodejeneratif bir lizozomal depo hastalığıdır. Otozomal resesif kalıtılan bu hastalıktan NPC1 or NPC2 genleri sorumludur (1). Burada, kardeşi yenidoğan döneminde Niemann-Pick Tip C hastalığı tanısı alan ve NPC1 genetik analizi sonucunda birleşik heterozigot Niemann-Pick Tip C hastalığı saptanan yenidoğan olgusu sunuldu., Niemann-Pick Tip C hastalığı (NPC), esterifiye olmamış kolesterollerin lizozomlarda depolanması ile karekterize nörodejeneratif bir lizozomal depo hastalığıdır. Otozomal resesif kalıtılan bu hastalıktan NPC1 or NPC2 genleri sorumludur (1). Burada, kardeşi yenidoğan döneminde Niemann-Pick Tip C hastalığı tanısı alan ve NPC1 genetik analizi sonucunda birleşik heterozigot Niemann-Pick Tip C hastalığı saptanan yenidoğan olgusu sunuldu.

This study aimed to compare the integrity of the efferent auditory pathways of newborns that had high hyperbilirubinemia levels and required treatment due to these and healthy newborns.Term-born (37 weeks or later) infants that were brought to the Newborn Polyclinic of the Başkent University Hospital were included in the study. The study included a total of 84 infants including healthy newborns (n = 42) and those that had jaundice and were receiving phototherapy (n = 42). After conducting a general otorhinolaryngology examination on all newborns included in the study, Transient Otoacoustic Emission (TEOAE) test was carried out in the absence and presence of contralateral noise. The obtained contralateral suppression values were compared between the two groups.In the TEOAE test, the responses obtained at 1 kHz in the newborns receiving phototherapy were found to be lower. The difference between the groups was significant (p = 0.038). The rates of suppression presence at 2 kHz, 2.8 kHz and total OAE were found significantly higher (p 0.05) in the group not receiving phototherapy. Among the phototherapy-receiving infants, the hyperbilirubinemia levels of the infants in whom suppression was obtained in the contralateral suppression test did not show a statistically significant difference in comparison to those in whom suppression was not obtained (p 0.05).Based on the obtained data, hyperbilirubinemia may have a disruptive effect on the efferent auditory system in newborns. Consequently, we are of the opinion that, in addition to hearing screening in risky newborn infants, a MOC suppression test would be useful.

Giriş ve Amaç: Bu çalışmada, Başkent Üniversitesi Tıp Fakültesi Ankara Hastanesinde 1993-2016 yılları arasında organ nakli olan ve sonrasında gebelik nedeniyle izlenen annelerin bebeklerinin prenatal, natal ve postnatal izlem verilerinin retrospektif olarak değerlendirilmesi amaçlandı. Gereç ve Yöntem: Çalışmada 1993-2016 yılları arasında hastanemizde organ nakli yapılan ve organ nakli sonrasında takip edilen reproduktif yaştaki (15-49) 440 kadın hastanın dosyası incelendi. Organ nakli sonrası takip edilen 28 gebe çalışmaya dahil edildi. Maternal (tranplantasyon etiyolojisi, yaşı, nakil yaşı ve gebelik yaşı arasındaki süre, gebelik yaşı, zamanı ve türü, yardımcı üreme tekniği varlığı, gebelik süresince kullanılan ilaçlar ve dozları) ve neonatal (gebelik haftası, doğum ağırlığı, doğum salonu verileri, bebek antropometrik değerleri ile gebelik haftasına göre düşük (SGA), gebelik haftasına göre normal (AGA), gebelik haftasına göre fazla doğum ağırlıklı (LGA) bebek özellikleri ve doğum sonrası yenidoğan yoğun bakım-anne yanı izlem durumu değerlendirildi. İstatistiksel analizler SPSS paket programı kullanılarak yapıldı. Sürekli değişkenler ortalama ± standart sapma (SD) verildi. Kategorik değişkenler sıklık ve yüzdeler ile ifade edildi. Araştırma öncesi etik kurul izni alındı. Bulgular: Toplam 28 hastaya ait organ naklinin %71,4’ü (20/28) böbrek, %28,6’sı (8/28) karaciğer nakliydi. Organ nakillerinin %60,7’si (17/28) canlı, %39,3’ü (11/28) kadavradan nakildi. En sık görülen transplant etiyolojisi %21,9 ile glomerulonefrit idi. Gebeliklerin %78,6’sı (22/28) canlı doğum, % 21,4’ü (6/28) abortus ile sonuçlanmıştır. Bir kişide akut, iki kişide kronik rejeksiyon gözlenmiştir. En sık kullanılan tedavi protokolü %42,9 ile siklosporin+ prednizolon+ azatiyopurindir. Bebeklerin %40,9’u term, %40,9’u SGA, %59’u pretermdir. Bebeklerin 4’ünde (%18,1) RDS, 3’ünde (%13,6) prematüre retinopatisi (ROP), 1’inde (%4,5) NEK, 3 bebekte konjenital kalp hastalığı saptanmıştır. Bebeklerin %18,2’sinde resüsitasyon ihtiyacı olmuş, %45,4’ ü doğum sonrası anne yanına verilmiştir. Sonuç: Ülkemizdeki böbrek veya karaciğer nakli olmuş kadınların gebeliklerinden dünyaya gelen yenidoğan bebeklerin takibinde ortaya çıkan perinatal, neonatal morbidite ve mortaliteye ait sonuçların bilinmesi uygun yaklaşım açısından önem taşımaktadır.

Hyperbilirubinemia is one of the most widely seen cause of neonatal morbidity. Besides ABO and Rh isoimmunization, minor blood incompatibilities have been also been identified as the other causes of severe newborn jaundice. We report a newborn with indirect hyperbilirubinemia caused by minor blood group incompatibilities (P1, M, N, s and Duffy) whose hemolysis was successfully managed with intravenous immunoglobulin therapy. A thirty-two gestational weeks of preterm male baby became severely icteric on postnatal day 11, with a total bilirubin level of 14.66 mg/dl. Antibody screening tests revealed incompatibility on different minor groups (P1, M, N, s and Duffy (Fya ve Fyb)). On postnatal day thirteen, the level of bilirubin increased to 20.66 mg/dl although baby was under intensive phototherapy. After the administration of intravenous immunoglobulin and red blood cell transfusion, hemoglobin and total bilirubin levels became stabilised. Minor blood incompatibilities should be kept in mind during differential diagnosis of hemolytic anemia of the newborn. They share the same treatment algorithm with the other types hemolytic anemia. New studies revealed that intravenous immunoglobulin treatment in hemolytic anemia have some attractive and glamorous results. It should be seriously taken into consideration for treatment of minor blood incompatibilities.

WOS: 000460493000010, PubMed: 30660088, …, Turkish Neonatology Society, This research was supported by Turkish Neonatology Society (grant).

WOS:000366239700006 PubMed: 26742308 OBJECTIVE: To identify how acupressure on the acupoint Yintang (EX-HN 3) impacts oxygen saturation, pulse rate, and peripheral perfusion in term-born infants without underlying disease. METHODS: Infants born between weeks 37 and 42 of gestation were included in this study. The polyclinic's neonatology room was noise-controlled and made half-dark to prevent the perfusion index from being confounded. A pulse oximeter was linked to the baby's left lower extremity. Acupressure was applied on Yintang (EX-HN 3) for 30 s clockwise, held for 30 s, and then acupressure was applied for another 30 s counterclockwise. The baby's SaO(2), pulse rate, and perfusion index were recorded for each minute before and after acupressure. RESULTS: When pre- and post-acupressure pulse rate values were compared, a significant decrease in pulse rate values after acupressure application was observed. When pre- and post-acupressure oxygen saturation values were compared, a significant increase in post-acupressure oxygen saturation was observed. In addition, peripheral perfusion increased significantly after acupressure. CONCLUSION: Acupressure application has been used in traditional medicine for many years. However, it is not yet widely used in modern medicine. This study shows the impact of acupressure on neonatal skin perfusion, oxygen saturation, and pulse rate. (C) 2015 JTCM. All rights reserved.

Context Acupressure is an ancient Chinese healing art. In this pain-relieving method, the fingers are used to press key acupuncture points on the skin surface that stimulates the body׳s regulatory processes. Objective The aim of this study was to investigate the effect of acupressure at Kun Lun (UB60) and Taixi (K3) points for pain management in preterm infants prior to heel lancing for blood collection. Design This was a prospective, randomized controlled study. Setting The study setting was the neonatal intensive care unit at Baskent University Hospital in Turkey. Patients A total of 32 preterm infants between 28 and 36 weeks׳ gestational age were randomly assigned to one of two groups: an acupressure group ( n = 16) or a control group ( n = 16). Intervention In the acupressure group, immediately before the heel prick, acupressure was applied for three minutes at UB60 and K3 points. Main Outcome Measures A behavioral pain score was determined using the Premature Infant Pain Profile (PIPP) scale. Results There were no significant differences between the groups with respect to gestational age, birth weight, sex, mode of delivery, age at time of procedure, weight at time of procedure, or PIPP score. Mean duration of procedure and mean duration of crying were both shorter in the acupressure group (both P = .001). Conclusions Applying acupressure at the BL60 and K3 points before heel lancing was associated with shorter procedural time and shorter duration of crying in preterm infants.

Turan O, Anuk-Ince D, Olcay L, Sezer T, Gulleroglu K, Yilmaz-Celik Z, Ecevit A. Neonatal cerebral sinovenous thrombosis: Two cases, two different gene polymorphisms and risk factors. Turk J Pediatr 2017; 59: 71-75. Cerebral sinovenous thrombosis (CSVT) is a rare disease in the neonatal period and also the greatest risk of neonatal mortality and morbidity. In this report, we presented two cases with CSVT and different risk factors. One of these cases had methylenetetrahydrofolate reductase (MTHFR) C677T homozygous polymorphism and the other case had both MTHFR A1298C homozygous polymorphism, plasminogen activator inhibitor-1 (PAI-1) 4G/ 5G polymorphism and elevated lipoprotein a. Early diagnosis and prompt initiation of therapy of neonatal CSVT may prevent neonatal mortality and poor long-term neurodevelopmental outcomes.

Iktiyozlar klinik ve etiyolojik olarak hererojen derinin bir grup kalitsal keratinizasyon bozuklugudur. Yaygin cilt kurulugu, ciltte soyulma ve pullanma, bazen eritrodermi ve histopatolojik olarak hiperkeratoz ile karakterizedir. Iktiyozis vulgaris ve X’e bagli iktiyoz, iktiyozun en yaygin gorulen tipleridir. Konjenital iktiyozlar daha seyrek gorulur. Lameller iktiyoz, konjenital iktiyoziform eritrodermi ve harlequin iktiyozu konjenital iktiyozlar arasinda yer alir. Lamellar iktiyoz genelikle dogumda mevcuttur ya da kisa bir sure sonra baslar. Bebekler tum vucudu kaplayan parsomen kagidi benzeri yapisi olan seffaf bir membranla (kollodion zar) dogarlar. Dehidratasyon, sepsis, elektrolit dengesizligi ve pnomoni gibi komplikasyonlarin onlenmesi sag kalim acisindan buyuk onem tasir. Tedavideki temel amac sivi kaybinin onlenmesi, derinin nemlendirilmesi ve stratum korneumun yumusakliginin saglanmasidir. Sundugumuz olgumuzda klinik ozellikleri ile lameller iktiyoz tanisi konulan cok dusuk dogum agirlikli premature bebek sadece topikal ajanlarla basari ile tedavi edilmistir. Bu vaka nedeni ile konjenital iktiyozlu premature bebeklerin yenidogan yogum bakim unitesindeki bakimi gozden gecirilmistir.

Subkutan yag nekrozu nadir gorulen, eritematoz nodul ve plaklarla seyreden adipoz dokunun inflamatuvar bir hastaligidir. Subkutan yag nekrozu siklikla zamaninda ve zamanindan sonra dogmus bebeklerde yasamin ilk haftalarinda gorulmektedir. Hipoksik dogum ve mekonyum aspirasyon sendromu nedeni ile postnatal 15. saatinde hastanemize gonderilen erkek bebekte ilk basvuruda hipokalsemi, hipoglisemi ve trombositopeni mevcuttu. Dort gunlukken sirtta ve kollarda subkutan yag nekrozu ile uyumlu lezyonlari gelisti, hastada gorulen hipoglisemi, hipokalsemi ve trombositopeninin hipoksi ile iliskili oldugu dusunuldu. Subkutan yag nekrozu genellikle kendiliginden iyilesen bir durum olmasina ragmen, komplikasyonlari acisindan yakin izlemi onemlidir.

Aim Despite extensive research, there is still controversy regarding the time at which sucking and swallowing functions mature in preterm infants. This study aimed to evaluate maturation using the noninvasive method of swallowing sound. Methods We compared 52 preterm infants of between 27 and 36 weeks' gestational age with a control group of 42 healthy full-term infants. Feeding performance was based on swallowing data collected during two-minute audio recordings. The following variables were generated for each evaluation: total number of swallows, total number of rhythmic swallows, total number of resting intervals, average time between resting intervals, average time between swallows, average time between rhythmic swallows, maximum number of rhythmic swallows and volume of milk ingested. The dependency of the variables on postmenstrual age was also investigated. Results The volume of milk ingested by the preterm infants and the maximum number of rhythmic swallows were positively correlated with postmenstrual age (PMA). The preterm infants reached the 10th percentile of the control infants at 34–35 weeks' PMA and were not significantly different from the control infants at 38–40 weeks' PMA. Conclusion Swallowing sound can be used to assess feeding maturation in preterm infants during neonatal intensive care unit follow-up.

Purpose: We aimed to evaluate the possible risk factors for the development of retinopathy of prematurity(ROP) Patients and Methods: A retrospective study was conducted between January 2012- and May 2013 for premature infants aged 34 weeks or younger who were screened for premature retinopathy. Fifty nine infants were included into the study. Birth weight, gestational age and other risk factors were evaluated.. Results: Birth weights were between 750 and 3590g (mean 1960g) gestational ages between 24 and 34weeks (mean 31.9w). ROP with various stages was observed in 7 (%11.8) patients. Birth weight and gestational age were found to be inversely related to the presence of ROP. Continuous positive airway pressure, blood transfusions were directly related to the development of ROP . Conclusion: Increased survival rate of low gestational age and low birth weights infants with better standards in neonatal intensive care units, the incidence of ROP. Efficient screening and treatment must be used to prevent the permanent visual loss associated with ROP [J Contemp Med 2013; 3(3.000): 161-165]

Background:This study aimed to examine the differences between arterial and inferior caval vein oxygen saturation, fractional oxygen extraction, and the shunt index, which were calculated in the diagnosis of patent ductus arteriosus.Methods:Twenty-seven preterm infants were included in this study and were divided into two groups according to patent ductus arteriosus. Among them, 11 (41%) infants had haemodynamically significant patent ductus arteriosus and 16 (59%) did not have significant patent ductus arteriosus. Synchronous arterial and venous blood gases were measured during the first post-natal hours after the insertion of umbilical catheters. The differences between arterial and inferior caval vein oxygen saturation, inferior body fractional oxygen extraction, and the shunt index were calculated. Echocardiography was performed before the 72nd hour of life in a selected group of patients who had haemodynamically significant patent ductus arteriosus. Ibuprofen treatment was administered to patients with patent ductus arteriosus. Echocardiography was performed on the 72nd hour of life in preterm infants without any clinical suspicion of patent ductus arteriosus.Results:The early measured differences between arterial and inferior caval vein oxygen saturation and inferior body fractional oxygen extraction were found to be lower and the shunt index was found to be higher in the haemodynamically significant patent ductus arteriosus group than in the group without haemodynamically significant patent ductus arteriosus.Conclusion:We found that the shunt index, calculated in the first hours of life as ≥63%, predicted haemodynamically significant patent ductus arteriosus with a sensitivity of 78% and specificity of 82% in preterm newborns.

Takcı Ş, Anuk-İnce D, Louha M, Couderc R, Çakar N, Köseoğlu RD, Ateş Ö. A rare large mutation involving two exons of the SP-B gene in an infant with severe respiratory distress. Turk J Pediatr 2017; 59: 483-486. Hereditary surfactant protein-B (SP-B) deficiency is a rare autosomal recessive disease of newborn infants causing severe respiratory failure and death within the first year of life. The most common cause of SP-B deficiency is a frameshift mutation in exon 4 (121ins2) in the gene encoding SP-B. We report a term infant with unremitting respiratory distress who was unresponsive to all treatment modalities. The parents were consanguineous and a term sibling of the infant had died due to respiratory failure without a certain diagnosis. In the first step of the diagnostic work-up, common genetic mutations for SP-B, surfactant protein C and ATP-binding cassette s3 were absent, however sequencing of SP-B gene revealed a large homozygous genomic deletion covering exon 8 and 9. In this case report, we aimed to emphasize further genetic evaluation in all cases suggestive of surfactant dysfunction, even if common mutations are absent.

Intestinal mucus accumulation is a very rare situation observed in some solid tumors, intestinal inflammation, mucosal hyperplasia, elevated intestinal pressure, and various other diseases. However, it has never been described in acute myeloblastic leukemia. The pathogenesis of intestinal mucus accumulation is still not clear. Here, we report a 14-year-old girl with acute myeloblastic leukemia and febrile neutropenia in addition to typhlitis. She was also immobilized due to joint contractures of the lower extremities and had intestinal mucus accumulation, which was, at first, misdiagnosed as intestinal parasitosis. We speculate that typhlitis, immobilization and decreased intestinal motility due to usage of antiemetic drugs might have been the potential etiologic factors in this case. However, its impact on prognosis of the primary disease is unknown.İntestinal mukus birikimi, solid tümörler, intestinal inflamasyon, mukozal hiperplazi, intestinal basınç artışı gibi çeşitli hastalıklarda nadiren görülen bir durumdur. Ancak, bu durum akut miyeloblastik lösemili hastalarda bildirilmemiştir. İntestinal mukus birikiminin patogenezi ise hala tam olarak bilinememektedir. Burada, 14 yaşında akut miyeloblastik lösemili, febril nötropenili ve tifilitli bir kız hastayı sunduk. Hastamız, ayrıca alt ekstremite eklem kontraktürü nedeniyle immobilize idi. İntestinal mukus birikimi nedeniyle başlangıçta intestinal parazitoz tanısı almıştı. Biz burada, tiflit, immobilizasyon ve kullanılan antiemetikler nedeniyle barsak hareketlerinin azalmasının potansiyel etyolojik faktörler olabileceğini düşündük. Ancak, bu durumun primer hastalığın prognozu üzerine etkisi bilinmemektedir.

Aim: Respiratory distress syndrome (RDS) is a lung failure that starts after birth. Because of deficiency of surfactants in alveoli, this becomes one of the most important causes of morbidity and mortality in preterm neonates. In this study, we tried to compare the outcomes of two types of natural surfactant, derived from same animal and aimed to manage the anxiety of clinicians while they are choosing the most appropriate preparate for RDS treatment.Material and Methods: Newborns hospitalized in Baskent University Ankara Hospital Neonatal Intensive Care Unit between January 2017 and August 2018 and administrated with calfactant and beractant for RDS treatment were retrospectively examined.Results: A total of 57 neonates were enrolled into the study. It was indicated that 38 (66.7%) of neonates were administered beractant and 19 (33.3%) were administered calfactant. We did not find any significant difference between beractant and calfactant groups, according to their genders, gestational weeks, their intubation situations, the duration of the oxygen requirement, antibiotic usages and the durations of mechanical ventilation. It was determined that calfactant-administered neonates needed statistically more repeat dose, than those in the beractant group (p= 0.029). Conclusions: We examined two natural surfactant preparates derived from same animal. Calfactant which has some conflicting reports was newly introduced to our unit for RDS treatment. This study aimed to identify the most appropriate treatment modality for RDS. It would be more instructive to plan larger and more creative studies to examine possible differences among natural surfactant preparates.

WOS: 000361632500007, PubMed ID: 25792430, To date, no study has evaluated changes in oral labial angle as preterm infants mature. The main purpose of this study was to document goniometer measurements of the labial angle of the mouth in preterm infants, to assess changes with development, to compare to findings in healthy term infants, and also evaluate oral motor reflexes in these groups. Seventy-eight preterm infants and 45 healthy term infants were recruited for the prospective study. Labial angle was assessed via goniometer, and oral motor reflexes and the volume of milk ingested were evaluated. There was significant difference between term and preterm infants' labial angles (P < .01). The distribution of preterm infants' angles were similar to term infants' by 36 to 40 weeks' postmenstrual age. Goniometer measurements of the oral labial angle may reveal oral motor performance in preterm infants and may be relevant for feeding skills assessment in this group of infants.

Objectives: Diabetes is a disease that effects fetal development during pregnancy and leads metabolic disorders in newborns. In this study, we aimed to evaluate the problems of infants of diabetic mothers and to determine risk factors of mothers during pregnancy. Material and Methods: The morbidity rates of 31 infants of diabetic mothers who were born and followed in neonatal intensive unit between January 2013 and December 2013 at Gaziosmanpasa University and demographic properties of mothers were retrospectively evaluated. Results: A total of 31 infants were included. The incidence of insulin dependent diabetes mellitus was %22,6 and the incidence of gestational diabetes was 77,4%. Mothers’ mean age was 32,6±7,9 years and HbA1c level was 5,4±1 (4,2-10,2). The mean gestational age of infants was 37,5±1,5 weeks and the mean birth weight of infants was 3322,5± 695,8 g. Macrosomia was present in 32.2% of infants. Hypoglycemia was present in 9,7% of infants, hypocalcemia was seen 3.2%, polycytemia was seen 6.5%, anemia was seen 6.5%, thrombocytopenia was seen 9.2%, hyperbilirubinemia was seen 41.9%, respiratory distress syndrome was seen 12.9%, congenital anomaly was seen 3.7% of all infants. There was no correlation between HbA1c levels of mothers and hypoglycemia, hypocalcemia, anemia and respiratory distress syndrome. Conclusion: Many complications may be prevented with appropriate management, obstetric care and neonatal management in infants of diabetic mother. It is possible to reduce morbidities with the identification of gestational diabetes and metabolic control of hyperglycemia, the determination of risk factors, the close contact between the diabetic mother and her infant in the first hours of delivery and the close follow-up of infants of diabetic mothers with rooming-in who do not need neonatal intensive care unit care., Amaç: Diyabet gebelikte fetal gelişimi etkileyen ve yenidoğanlarda metabolik bozukluklara yol açan bir hastalıktır. Çalışmamızda diyabetik anne bebeklerinin yenidoğan sorunlarının annelerinin gebelik takipleri ile birlikte değerlendirilmesi amaçlanmıştır.Gereç ve yöntem: Çalışmada Gaziosmanpaşa Üniversitesi Tıp Fakültesi Hastanesinde Ocak 2013- Aralık 2013 tarihleri arasında doğan ve yenidoğan yoğun bakım ünitesinde izlenen 31 diyabetik anne bebeğinin morbidite oranları ve annelere ait demografik özellikleri retrospektif olarak değerlendirildi.BulgularÇalışmaya 31 diyabetik anne bebeği alındı. Annelerden 7’si (%22,6) insuline bağımlı diyabet ve 24’ü (%77,4) gestasyonel diyabet tanısı ile takip edilmekte idi. Annelerin ortalama yaşı 32,6±7,9 yıl, ortalama glikolize hemoglobin (HbA1c) değerleri % 5,4±1 (4,2-10,2) saptandı. Bebeklerin ortalama gebelik haftaları 37,5±1,5 hafta, ortalama doğum ağırlığı 3322,5± 695,8 gr. idi, makrozomi sıklığı %32,2 idi. Bebeklerde hipoglisemi %9,7, hipokalsemi %3,2, polistemi %6,5, anemi %19,4, trombositopeni %9,7, hiperbilirubinemi % 41,9, respiratuar distres sendromu %12,9, doğuştan anomali %3,7 oranında bulundu. Annenin HbA1c düzeyi ile hipoglisemi, hipokalsemi, polistemi, anemi, respiratuar distres sendromu arasında ilişki bulunmadı (p>0,05).SonuçDiyabetik anne bebeklerinde uygun medikal yaklaşım, obstetrik bakım ve neonatal yaklaşım ile görülebilecek çoğu komplikasyonun önlenmesi mümkündür. Gestasyonel diyabetin tanımlanması, hipergliseminin kontrol altına alınması ile konjenitalanomaliler ve perinatal ölümler azaltılabilir.Anahtar kelimeler: diyabetik anne bebeği, komplikasyon anomaliler ve perinatal ölümler azaltılabilir.

In neonatal medicine, it is important to assess tissue oxygenation due to hypoxia, as hyperoxia can have adverse effects. Usually, measurements of arterial oxygen tension (PaO2) and arterial oxygen saturation (SaO2) are used for clinical decisions regarding oxygen therapy in neonates. However, this approach cannot explain the complete physiological economy of oxygen (1–3). Some recommend measuring venous oxygen to evaluate tissue perfusion and response to therapy (1, 3–8). Umbilical venous catheters are widely used in neonatal intensive care units for medication, fluid and nutrition administration. Mixed venous oxygenation can be measured by inserting an umbilical venous catheter into the inferior vena cava (IVC) (3). The advantages of measuring IVC oxygenation are not affected by atrial right-left shunting (3, 4). Monitoring of mixed venous oxygen saturation (Svo2) shows the residual oxygen after tissue oxygen extraction and also represents the combined sufficiency of arterial oxygen content, cardiac output and tissue oxygen consumption (2, 9, 10). Right atrial SvO2 was used for monitoring, in contrast to using SaO2 alone in an animal model (7). True mixed venous blood is derived from a pool of blood entering the pulmonary artery via the great veins in the chest. It contains blood that has passed through all systemic capillary beds capable of extracting oxygen, and is thoroughly mixed in the right ventricle (11). However, catheterization of the pulmonary artery or right atrium is hazardous for neonates and is not routinely applied (3, 12). Umbilical venous catheters are frequently used in neonatal intensive care units due to their lower complication rates. Umbilical venous catheterization is not affected by intracardiac shunting that leads to mixing of systemic and pulmonary venous blood (3, 4, 13). The measurement of venous oxygen saturation has been used in several studies of sepsis and septic shock, and during the perioperative period of major surgery because it shows major derangements in oxygen balance (13–16). Umbilical venous oxygen saturation pointed a great similarity to arterial oxygen saturation in some premature infants in our clinical practice that it was hypothesized as a sign of severe ductal shunt predicting patent ductus arteriosus (PDA). In this study, on the basis of this clinical observation, the course of IVC oxygen saturation was measured in preterm infants as an indicator of mixed venous oxygenation in the first three days of life; and differences between infants with and without PDA were investigated.

The aim of this study was to evaluate the relationship between neonatal mortality-morbidity and pregnancies with preterm premature rupture of membranes (PPROM), particularly those complicated by histologic chorioamnionitis (HCA), in preterm infants. A retrospective study was conducted on 58 preterm neonates born to 46 pregnant women with PPROM. Maternal characteristics, placental examination, and neonatal morbidity and mortality were analyzed. Of 1,392 deliveries, 46 (3.3%) pregnancies and 58 newborn infants were complicated with PPROM. HCA was present in 21 (1.5%) cases, and 15 of them were28 weeks of gestational age. In the HCA (+) group, 8/21(38%) neonates had 5-minute Apgar scores of5, 12/21 (57.1%) infants had patent ductus arteriosus (PDA), and 16/21 (76.1%) infants had respiratory distress syndrome (RDS). The latency period was significantly longer and the rate of chorioamnionitis and percentage of major neonatal morbidity and mortality were significantly higher in preterm infants with gestational age28 weeks. Respiratory distress syndrome, perinatal hypoxia and PDA were significantly associated with HCA in preterm infants.

Purpose: We aimed to evaluate the possible risk factors for the development of retinopathy of prematurity(ROP) Patients and Methods: A retrospective study was conducted between January 2012- and May 2013 for premature infants aged 34 weeks or younger who were screened for premature retinopathy. Fifty nine infants were included into the study. Birth weight, gestational age and other risk factors were evaluated.. Results: Birth weights were between 750 and 3590g (mean 1960g) gestational ages between 24 and 34weeks (mean 31.9w). ROP with various stages was observed in 7 (%11.8) patients. Birth weight and gestational age were found to be inversely related to the presence of ROP. Continuous positive airway pressure, blood transfusions were directly related to the development of ROP . Conclusion: Increased survival rate of low gestational age and low birth weights infants with better standards in neonatal intensive care units, the incidence of ROP. Efficient screening and treatment must be used to prevent the permanent visual loss associated with ROP, Amaç: Prematürite retinopatisi (PR) gelişimi için muhtemel risk faktörlerini değerlendirmek amaçlandı Gereç ve Yöntem: Ocak 2012-Mayıs 2013 arasında 34.gestasyonel haftasında veya daha küçük olan prematüre bebekler retrospektif olarak değerlendirildi. 59 bebek çalışma kapsamına alındı. PR gelişimi ile doğum ağırlığı, gestasyonel yaş ve diğer risk faktörleri arasındaki ilişki araştırıldı. Bulgular: Olguların doğum ağırlıkları ise 750-3590gr (ortalama 1960gr) gestasyonel yaşları 24-34hafta(ortalama 31.9hafta) arasındaydı. Çeşitli evrelerde PR, 59 bebeğin 7sinde (%11.8)saptandı. Doğum ağırlığı ve gestasyonel yaş ile PR gelişimi açısından ters orantı tespit edildi. Sürekli pozitif havayolu basıncı ile oksijen kullanımı, kan transfüzyonu gibi risk faktörleri ile PR arasında istatistiksel olarak anlamlı bir ilişki bulundu. Sonuç: Yenidoğan ünitelerindeki koşulların iyileşmesi ile birlikte bebeklerin yaşam şanslarının artması PR görülme sıklığını arttırmaktadır. Prematür retinopatisinin neden olduğu kalıcı görme kayıplarının önlenmesi için etkin takip ve tedavinin yapılması gerekmektedir

Congenital hyperinsulinism is the most frequent cause of persistent hypoglycemia in infancy. We present the case of a preterm, large-for-gestation-age infant with congenital hyperinsulinism who was found to have a novel p.Q392H homozygous mutation in the ABCC8 gene. The patient had severe brain damage, despite early diagnosis and appropriate management. The new mutations may provide an understanding of the prognosis and treatment of the disease. In addition, the data will help the family make informed decisions about future pregnancies.

Aim: ABO incompatibility is a common condition occurring in about 15-25% of all maternal/fetal pairs. The features of ABO incompatibility range from asymptomatic through to severe hemolysis with hyperbilirubinemia and anemia. The aim of this study is to assess the clinical course of ABO incompatibility and to evaluate the effect of blood groups on the severity of neonatal jaundice. Material and Methods: Neonates with ABO hemolytic disease of newborn were retrospectively studied. Risk factors for the severity of jaundice were recorded. Demographic, clinic, and laboratory features were compared in infants with blood groups A and B. Results: Within 13 months, 165 term infants with neonatal jaundice were treated. 32 (19.4%) of these patients had jaundice due to maternal-fetal ABO incompatibility. The O-A group included 23 infants (71.9%) while the O-B group included for 9 infants (28.1%). All the infants received phototherapy while none of the cases required exchange transfusion. Mean total bilirubin level was 15.6p4.5 mg/dl on the 2.9p2.1 days of mean age after the initiation of treatment. There were no differences between the infants with blood group A or B in terms of demographics, initial bilirubin level, anemia in first 24 hours, the rate of hemolysis, and direct Coombs test. Conclusion: ABO incompatibility may have risks of significant hyperbilirubinemia and hemolysis in infants. Neonatal jaundice due to ABO incompatibility can be successfully managed with early admission of intensive phototherapy through close follow-ups. Blood type has no effect on the severity of jaundice. Key words: Neonate; Jaundice; ABO Incompatibility; Blood Group; Phototherapy.

Multiple systemic risk factors are associated with retinopathy of prematurity (ROP). We analyzed the role of low weight gain (WG) to predict the development of stage 3+ ROP among preterm infants. This study included 126 newborns with birth weight ≤1500 g and gestational age32 weeks. Preterm newborn infants were divided into two groups according to severity of ROP as: preterm infants without ROP or mild ROP (Group 1) and preterm infants with stage 3+ ROP (Group 2). WG and WG proportion were measured at completed 4 and 6 weeks of life. The patients under the cut-off point according to receiver operating characteristic curve were classified as low WG patients. WG and WG proportion were significantly lower in Group 2 than in Group 1 at the 4th and 6th weeks of life. We concluded that low WG and WG proportion at the 4th and 6th weeks of life were predictive for the development of stage 3+ ROP. Preterm babies with low birth weight and low WG should be followed closely for severe ROP.

Purpose To evaluate the safety of peripherally inserted central venous catheters (PICCs) and their complications in critically ill premature neonates. Methods A retrospective collection of data of infants with very low birth weight (VLBW) who underwent PICC placement over a 2-year period. Gestational age, birth weight (BW), sex, site of catheter placement, reason for catheter removal, duration of the catheter use, proven sepsis, type of the reported organism and the rate of complications were collected. The infants were classified into two groups according to BWs: Group 1–-VLBW infants (BW between 1,000 and 1,500 g) and Group 2–-BW Results During the study period, 90 VLBW infants were admitted to the neonatal intensive care unit. PICCs were attempted in 71 patients. A PICC was successfully inserted into 62 patients (87.3%). Totally, 68 PICCs were inserted into 62 infants. PICCs placed in either the upper or the lower extremity have no differences in complication rates. The median time of catheter insertion was 10 (1-22) days for Group 1 and 16 (1-47) days for Group 2 (p=0.001). The median duration of PICCs was 9 (2-18) and 12.0 (3-30) days, respectively (p=0.012). There were no significant differences between groups for the reasons for removal (p=0.859). Conclusions PICCs are convenient for the administration of long course antibiotics and parenteral nutrition for both VLBW and ELBW infants. The risk of catheter complications did not increase in ELBW infants. Although the technique of insertion is easy and using PICCs has many benefits, serious and fatal complications may occur in premature neonates in critical states.

Recent investigations have shown that late preterm infants have increased risk for attention deficit hyperactivity disorder, neurosensory impairment, and emotional, behavior and learning problems. Vestibular evoked myogenic potential (VEMP) abnormality may partly contribute to these problems. Our aim was to measure VEMP in late preterm infants and to compare the findings between late preterm and term infants. Seventeen late preterm infants (mean gestational age: 35.11 weeks +/- 0.78) postnatal aged 8 weeks and 17 full-term (mean gestational age: 38.05 weeks +/- 0.96) infants postnatal aged 4 weeks underwent cervical (c)VEMP test without sedation. Mean latencies of p13 were calculated in all study subjects. cVEMPs were elicited in all late preterm and term infants. Mean latencies of p13 in late preterm and term infants were 14.53 and 13.34 ms, respectively. Mean latencies of n23 were determined as 23.18 ms and 19.92 ms for late preterm and term infants, respectively. There were statistically significant differences between late preterm and term infants for latency of p13 (p0.001) and latency of n23 (p0.000). Abnormal VEMP results might be related to a delay in the maturation of the sacculocollic pathways in late preterm infants.

Objective: Black tea is associated with antioxidant properties. The objective of this study was to investigate the effect of the amount of black tea consumption during pregnancy on the oxidant/antioxidant status of breastmilk. Subjects and Methods: Breastmilk was obtained from 30 mothers and analyzed for lipid peroxidation based on levels of malondialdehyde (MDA) and of reduced glutathione (GSH). In a survey completed by all participants, daily black tea consumption during the pregnancy was reported. Results: No correlation was found between the amount of black tea consumed and levels of MDA (p=0.401) and/or GSH (p=0.473). The results of this study indicate that consumption of varying amounts of black tea does not affect the oxidant/antioxidant status of breastmilk. Conclusions: The insensitivity of breastmilk to antioxidant contributions by black tea reflects the capacity of breastmilk to be resistant to the myriad of factors that otherwise affect a pregnant woman.

Objective To evaluate analgesic effects of acupuncture in preterm neonates during minor painful procedures. Methods Ten preterm neonates requiring heel prick for blood gas analysis were enrolled in the study, which had a crossover design. Oxygen saturation, systolic and diastolic blood pressure, respiratory rate, heart rate, and crying duration were recorded before and after heel prick. Babies were given expressed breast milk before each procedure. Patients were randomly assigned to receive acupuncture or not, and the groups were crossed over on the following day, so that patients who had received acupuncture received only breast milk, and the previous breast milk only group received both acupuncture and breast milk. The neonatal infant pain scale (NIPS) was used for pain evaluation. Results Crying duration and NIPS pain scores during heel prick were lower in the neonates who had received acupuncture. Conclusion Acupuncture is an effective method for the treatment of pain in neonates.

Background: Bronchopulmonary dysplasia (BPD) is a multifactorial disease of preterm infants that is characterized by airway injury, inflammation, and parencymal remodeling. Activation of the coagulation cascade leads to intraalveolar fibrin deposition in many inflammatory pulmonary disorders. Increased fibrin formation or decreased fibrinolysis may cause extravascular fibrin deposition. Extravascular fibrin deposits in septae and alveoli due to the altered fibrin turnover are the pathological hallmarks of BPD, which strongly indicate the importance of the imbalance in the competing activities of coagulation and fibrinolysis. Objective: We investigated the predictive value of variations in plasminogen activator inhibitor-1 (PAI-1) and angiotensin-converting enzyme (ACE) genes as molecular determinants for BPD in neonates. Methods: The study group comprised 98 preterm infants with BPD and a control group including 94 preterm infants without BPD. Restriction fragment size analyses were performed by visualizing digested polymerase chain reaction products for ACE and PAI-1 genotypes. Results: No significant associations were found between ACE, PAI-1 gene polymorphisms, and BPD phenotype in our population. Conclusions: The two gene polymorphisms (PAI-1 and ACE) had no role in the development of BPD in our study. Further studies with other genes are required for the identification of molecular predisposing factors for BPD that may help in the development of new treatments.