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OBJECTIVE: Implementation of strategies to prevent vertical transmission is highly important steps in reducing the global burden of chronic hepatitis B. We conducted this prospective study to observe the clinical course and outcomes of untreated and treated HBV in pregnant.STUDY DESIGN: HBsAg-positive pregnants were prospectively enrolled from 2013 to 2016 and antiviral therapy was administered to eligible patients. Pregnancy and neonatal outcomes were determined in the treated (n=29) and untreated group (n=136). Active-passive immunoprophylaxis was administered to infants and they were tested for HBsAg.RESULTS: The risk factors for transmission (HBeAg positivity, history of previously-born HBsAg-positive child) were significantly higher in the treated group. All participants under treatment had sufficient viral suppression. Half of the pregnant women for whom the treatment was withheld at the postpartum period, experienced increased viral load. The treated group had significantly higher pre- and postpartum alanine aminotransferase levels more than the untreated group, although there were no significant differences in other biochemical parameters. There were no significant differences regarding fetal outcomes between the two groups. All infants were HBsAg-negative at seven months postpartum.CONCLUSION: While the untreated group included inactive carriers, there were more patients at risk for transmission of HBV to their offsprings in the treated group. Half of the pregnant women for whom the treatment was withheld at the postpartum period, experienced increased viral load. Antiviral therapy did not adversely affect the outcomes of infants. As a result, we successfully prevented perinatal HBV transmission by close monitoring of participant pregnant women and starting antiviral therapy when needed.

Background: healthcare-acquired infections (HAIs) in the neonatal period cause substantial morbidity, mortality, and healthcare costs. Our purpose was to determine the prevalence of HAIs, antimicrobial susceptibility of causative agents, and the adaptivity of the Centres for Disease Control and Prevention (CDC) criteria in neonatal HAI diagnosis. Methods: a HAI point prevalence survey was conducted in the neonatal intensive care units (NICUs) of 31 hospitals from different geographic regions in Turkey. Results: the Point HAI prevalence was 7.6%. Ventilator-associated pneumonia (VAP) and central line-associated bloodstream infections (CLABSI) and late onset sepsis were predominant. The point prevalence of VAP was 2.1%, and the point prevalence of CLABSI was 1.2% in our study. The most common causative agents in HAIs were Gram-negative rods (43.0%), and the most common agent was Klebsiella spp (24.6%); 81.2% of these species were extended spectrum beta-lactamase (ESBL) (+). Blood culture positivity was seen in 33.3% of samples taken from the umbilical venous catheter, whereas 0.9% of samples of peripherally inserted central catheters (PICCs) were positive. In our study, 60% of patients who had culture positivity in endotracheal aspirate or who had purulent endotracheal secretions did not have any daily FiO2 change (p = 0.67) and also 80% did not have any increase in positive end-expiratory pressure (PEEP) (p = 0.7). On the other hand, 18.1% of patients who had clinical deterioration compatible with VAP did not have endotracheal culture positivity (p = 0.005). Conclusions: neonatal HAIs are frequent adverse events in district and regional hospitals. This at-risk population should be prioritized for HAI surveillance and prevention programs through improved infection prevention practices, and hand hygiene compliance should be conducted. CDC diagnostic criteria are not sufficient for NICUs. Future studies are warranted for the diagnosis of HAIs in NICUs., NA

BACKGROUND: Coronavirus disease 2019 (COVID-19) primarily affects adults and spares children, whereas very little is known about neonates. We tried to define the clinical characteristics, risk factors, laboratory, and imagining results of neonates with community-acquired COVID-19. METHODS: This prospective multicentered cohort study included 24 neonatal intensive care units around Turkey, wherein outpatient neonates with COVID-19 were registered in an online national database. Full-term and premature neonates diagnosed with COVID-19 were included in the study, whether hospitalized or followed up as ambulatory patients. Neonates without severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) via reverse transcriptase-polymerase chain reaction testing or whose mothers had been diagnosed with COVID-19 during pregnancy were excluded. RESULTS: Thirty-seven symptomatic neonates were included. The most frequent findings were fever, hypoxemia, and cough (49%, 41%, 27%, respectively). Oxygen administration (41%) and noninvasive ventilation (16%) were frequently required; however, mechanical ventilation (3%) was rarely needed. Median hospitalization was 11 days (1-35 days). One patient with Down syndrome and congenital cardiovascular disorders died in the study period. C-reactive protein (CRP) and prothrombin time (PT) levels were found to be higher in patients who needed supplemental oxygen (0.9 [0.1-8.6] vs. 5.8 [0.3-69.2] p = 0.002, 11.9 [10.1-17.2] vs. 15.2 [11.7-18.0] p = 0.01, respectively) or who were severe/critical (1.0 [0.01-8.6] vs. 4.5 [0.1-69.2] p = 0.01, 11.7 [10.1-13.9] vs. 15.0 [11.7-18.0] p = 0.001, respectively). CONCLUSIONS: Symptomatic neonates with COVID-19 had high rates of respiratory support requirements. High CRP levels or a greater PT should alert the physician to more severe disease.

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.

Urinary stones are extremely rare in the neonatal population. Most of the urinary stones in the neonate contain calcium. Nephrolithiasis in the neonate may be as urolithiasis and/or nephrocalcinosis. The incidence of nephrocalcinosis is not yet clear and can be differ in many researches due to the etiology. On the other hand, the incidence of urolithiasis in childhood is almost 10% of that in adults. Especially in the first decade, it is more common in boys. It may occur with inherited metabolic changes such as hypercalciuria, primary hyperoxaluria or cystinuria. Stone formation can be effected by iatrogenic causes such as hyperalimentation (parenteral nutrition), diuretic therapy (furosemide, acetazolamide) that is especially in the bronchopulmonary dysplasia. The stone formation may occur due to anatomic or functional obstructions and infections of urinary system. Most of the urinary stones in the neonatal period are diagnosed as a nephrocalcinosis. However there aren’t any exact differences between nephrolithiasis and nephrocalcinosis. Some authors suggested nephrocalcinosis is the initial step of urinary stone formation. On the other hand, the others purposed that both of them are different pathologies. In this review, we tried to summarized differences and similarities, in the context of urinary stones and the nephrocalcinosis in the neonates.

Amac: Son yillarda gec preterm bebeklerde kademeli bir artis sozkonusudur Gec pretermler daha kucuk erken dogmus bebeklere gore daha az riskli olmalarina ragmen son calismalar bu bebeklerin zamaninda dogmus bebeklere gore daha fazla hastalik ve olum oranina sahip olduklarini dusundurmektedir Bu calismada hastanemizdeki tum dogumlar icindeki gec preterm dogum oranini belirlemek bu bebeklerin yenidogan hastalik ve olum oranini saptamak ve sonuclarini zamaninda dogmus yenidoganlarla karsilastirmak amaclandi Gerec ve Yontem: Ileriye donuk olarak planlanan bu calisma icin hastanemiz Kadin Dogum Klinigi rsquo;nde 1 Mayis 2009 1 Mayis 2010 tarihleri arasinda canli dogan tum bebeklerin gestasyonel yaslari annenin son adet tarihi ve yeni Ballard testi kullanilarak degerlendirildi Gec premature 34 0 7 36 6 7 gestasyon haftasinda dogan bebekler arasindan secilen 220 bebek calisma grubumuzu ayni tarihlerde dogan 200 zamaninda dogmus bebek ise kontrol grubumuzu olusturdu Olgular 72 saatte ve haftalik kontrollerle bir aylik olana kadar izlendi Buyuk olcude anomalili bebekler ailesi onam vermeyenler calismaya dahil edilmediler Hastalar Yenidogan Yogun Bakim Birimi rsquo;nde yatis hipotermi solunum sorunlari metabolik sorunlar polistemi enfeksiyon apne konvulziyon acisindan degerlendirildi Calismada elde edilen bulgularin istatistiksel analizleri NCSS 2007 programi ile yapildi Sonuclar anlamlilik p lt;0 05 duzeyinde 95 rsquo;lik guven araliginda degerlendirildi Calisma icin etik kurul onayi alindi no:44 04 05 2009 Bulgular: Calisma suresinde hastanemizde dogan 2 582 bebegin 412 rsquo;si 15 2 gec preterm idi Yenidogan Yogun Bakim Birimi rsquo;ne yatis sayi ve oranlari zamaninda dogmus bebeklerde ve gec pretermlerde sirasiyla 28 14 ve 172 54 5 bulundu Gec pretermlerde zamaninda dogmus yenidoganlara gore solunum sorunu anlamli olarak daha sik goruldu 31 8 rsquo;e karsi 2 Gec pretermlerin 20 9 rsquo;unda mekanik ventilasyon gereksinimi saptandi; zamaninda dogmus yenidoganlarda mekanik ventilasyon gereksinimi olmadi Gec pretermlerde zamaninda dogmus yenidoganlarla karsilastirildiginda daha fazla beslenme sorunlari 19 1 rsquo;e karsi 0 5 tedavi gerektiren sarilik 44 1 rsquo;e karsi 7 5 hipoglisemi 6 4 rsquo;e karsi 1 hipotermi 0 rsquo;a karsi 14 5 ve enfeksiyon 15 9 karsi 0 saptandi Olum orani gec preterm bebeklerde 5 5 zamaninda dogmus bebeklere 0 5 gore 11 kat daha fazla bulundu Cikarimlar: Gec preterm yenidoganlar zamaninda doganlara gore anlamli olarak daha yuksek hastalik ve olum oranina sahiptirler Gec preterm yenidoganlar sik gorulen hastaliklar ve hastaneye yatis riski acisindan yakin izleme alinmalidirlar Turk Ped Ars 2013; 48: 17 22

Nonphysiologic hyperbilirubinemia of unexplained cause is prevalent among Turkish newborns, suggesting that there might be genetic risk factors in this population. Mutation of the UGT1A1 gene, glycine to arginine at codon 71 (G71R), is related to the development of neonatal jaundice in East Asian populations but the frequency of this mutation is rare among Caucasian populations. There are insufficient data on the G71R mutation in Turkish newborns with hyperbilirubinemia. The aim of this study was to investigate the genotypic distribution of the G71R mutation and its relationship with nonphysiologic hyperbilirubinemia of unexplained cause in Turkish newborns.Polymerase chain reaction, restriction fragment length polymorphism and agarose gel electrophoresis techniques were used for detection of G71R mutation in 109 newborn infants: 39 with hyperbilirubinemia and 70 without hyperbilirubinemia.The genotypic distribution for the mutation was 70 G/G, 32 A/G, 7 A/A genotypes and the mutated allele frequency was 0.22. The frequency of G71R mutation was 33.3 % (n = 13) A/G, 7.7% (n = 3) A/A in the hyperbilirubinemia group and 27.1% (n = 19) A/R, 5% (n = 4) A/A in the nonhyperbilirubinemia group. The difference between the groups was not statistically significant.Our results suggest that G71R mutation of UGT1A1 is not rare; however, an association between G71R mutation and hyperbilirubinemia of unexplained cause has not been shown in Turkish newborns.

Introduction: Jeune syndrome affects an estimated 1 in 100.000 to 130.000 people. The syndrome causes breathing disorders and upper or lower respiratory tract infections because of thoracic cage which is smaller and narrower than usual. Case: Here we report a male newborn presented with narrow thoracic cage and short limbs. Radiological evaluation with PA chest graphy showed abnormal short ribs. 3D CT showed decreased antero-posterior diameter of chest cavity, horizontally located round ended ribs, and shallow acetabular cavity. Abdomen ultrasonography detected bilateral small kidneys accompanied by left pelvi-caliectasis and milimetric intraparanchimal liver calcification. Following recurrent lower respiratory tract infections, the baby expired within fourth month. The final diagnosis was Jeune syndrome. Conclusion: Jeune syndrome is a rare seen congenital anomaly. Radiological evaluation is essential for the diagnosis. Characteristic findings include many skeletal abnormalities on costochondral junctions, clavicles, iliac bones, long bones of the extremities, and phalanges of both hands and feet. About 60% to 70% of children with this condition die from respiratory failure as babies or young children which are the problem. Early diagnosis to decrease mortality is highly dependent on the early diagnosis of this syndrome.

Severe neonatal hyperbilirubinemia can be prevented by screening for neonatal jaundice. Transcutaneous bilirubin (TcB) measurement is a noninvasive method for screening neonates. The aim of this study was to examine the correlation between TcB measurement (using the JM-103 bilirubinometer) and total serum bilirubin (TSB) measurement. To our knowledge, this is the first study evaluating the usefulness of the JM-103 bilirubinometer in Turkish neonates. Two hundred and fifty healthy infants in our well-baby nurseries and follow-up clinic with a gestational age of ≥36 weeks who were ≤15 days old were enrolled in this study. TcB measurements were taken usinng the JM-103; almost simultaneously, TSB was checked using a spectrophotometric method. The mean±SD TSB level was 11.2±4.6 mg/dl (range, 0.9-27.0 mg/dl); 17.2% of cases had TSB15 mg/dl. There was good correlation between transcutaneous bilirubin and total serum bilirubin measurements (Pearson's correlation coefficient 0.87 for TcB from the forehead, 0.88 for TcB from the sternum; p0.001). The transcutaneous bilirubin measurement tended to underestimate the value with increasing discrepancy at higher TSB values. The mean difference between serum bilirubin and transcutaneous (from the sternum and forehead) bilirubin values was significantly lower in cases not requiring phototherapy than in those requiring phototherapy [2.6 mg/dl (sternum) vs 4.8 mg/dl, 2.9 mg/dl (forehead) vs. 5.2 mg/dl, respectively; p0.001] Although the JM-103 bilirubinometer tends to underestimate serum bilirubin, especially in patients with high bilirubin levels, it is a suitable screening tool to identify jaundiced infants that require a serum bilirubin check and may reduce the need for TSB measurements.

Bart's syndrome, first described by Bart in 1966, consists of congenital localized absence of skin, congenital epidermolysis bullosa, and associated nail abnormalities. A newborn infant with Bart's syndrome is reported since it is a very rare condition, especially when associated with pyloric and concomitant choanal atresia. To the best of our knowledge, this is the first report presenting a case of Bart's syndrome associated with choanal atresia.

The association of congenital central hypoventilation syndrome (also known as Ondine's curse) and Hirschsprung's disease is termed Haddad syndrome, which is an extremely rare disorder. Recent studies have described that the PHOX2B gene mutation was responsible for congenital central hypoventilation syndrome. We report a term newborn male infant with clinical manifestations of recurrent hypoventilation with hypercapnia and bowel obstructions. These clinical manifestations were compatible with congenital central hypoventilation syndrome and Hirschsprung's disease. PHOXB direct sequencing showed a heterozygous in-frame duplication of 21 bp leading to an expansion of +7 alanines within the 20 alanine stretch of the PHOX2B gene and confirmed our diagnosis. In addition to a high index of clinical suspicion, testing for PHOX2B mutation can assist iq the diagnosis of congenital central hypoventilation syndrome and in the prediction of disease progression. Infants presenting with congenital central hypoventilation syndrome should also be screened for Hirschsprung's disease.