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Amaç: Seftriakson yan etkileri nedeniyle yenidoğanda sınırlı kullanıma sahiptir. Yenidoğan enfeksiyonlarında kullanımı ile ilgili sınırlı sayıda çalışma vardır. Bu çalışma ile setriakson alan yenidoğanlarda seftriakson sonrası oluşabilecek yan etkilerin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çukurova Üniversitesi Tıp Fakültesi Balcalı Hastanesi Yenidoğan Yoğun Bakım Ünitesi’nde, 2015-2016 yılları arasında yatan bebeklerin seftriakson tedavisi öncesi ve sonrası klinik ve laboratuvar verileri retrospektif olarak incelenmiştir. Bulgular: Çalışmaya 30 olgu alınmıştır. Bu bebeklerin ortalama gebelik yaşı 37 ± 3,1 (30-41) hafta, seftriakson aldığı süre 7,2 ± 2,2 (2-12) gün bulunmuştur. 30 olgudan alınan idrar kültürlerinde; 17 (%56,6) bebekte üreme saptanmıştır. Bunların 11’inde (%36,6) Escherischia coli (E. coli), 5’inde (%16,7) diğer bakteriler üremiştir. Olguların seftriakson öncesi ve sonrası laboratuvar verilerinde kan üre azotu (BUN), total bilirubin (TB) ve hematokrit değerlerinde anlamlı düşüş saptanmıştır. Seftriakson kullanımına bağlı herhangi bir yan etki izlenmemiştir. Sonuç: Çalışmamızda seftriakson sonrası komplikasyon görülmemiş olması term veya terme yakın yenidoğanlarda seftriakson kullanımı için cesaret verici olabilir. Fakat, yenidoğanda seftriaksonun yan etkilerinin ve sıklıklarının kesinleştirilmesi ve yenidoğanda kullanılan diğer antibiyotiklere karşı alternatif olup olamayacağının belirlenmesi için daha fazla araştırmalara ihtiyaç vardır.

Ischemia-modified albumin (IMA) is a new biochemical marker of ischemia. We aimed to search blood IMA levels in neonates with congenital heart defects. During the study period, patients diagnosed with congenital heart disease and newborns with a diagnosis of hyperbilirubinemia as a control group were included in the study. IMA level was analyzed using the IMA absorbance unit (ABSU) method. In total, 57 newborns with congenital heart disease requiring cardiac operation for the study group and 38 newborns for the control group were included. There was no difference between the two groups in terms of gender, mode of delivery, and weeks of gestation. The average IMA values in the control group were 0.19 ± 0.09 ABSU. The prepostoperative mean IMA values of the patient group were 0.22 ± 0.07 and 0.23 ± 0.07 ABSU, respectively. Comparison of the postoperative IMA with the mean of the control group was statistically significant. Preoperative and postoperative IMA values of patients who have died due to primary heart disease and surgical complications were 0.21 ± 0.07 (0.08-0.32) ABSU and 0.25 ± 0.06 (0.12-0.36) ABSU, respectively. IMA levels were not statistically different between the two groups. Hypoxia and ischemia in congenital heart disease in the newborn period both preoperatively and postoperatively were important in prognosis. IMA was higher in the postoperative group. Many comprehensive studies are important in terms of preventing complications and decreasing mortality and morbidity by commenting on prognosis.· IMA is a new biochemical marker of ischemia.. · In the literature, there are no reports about the relation between congenital heart defects and IM.. · The exposure of CHD patients to hypoxia/asphyxia in the preintra and postoperative periods cause neurologic deficits.

Konjenital batın ön duvarı defektleri nadir görülen yapısal anomalilerdir. Bu olguların ve eşlik eden anomalilerin erken saptanması, bebeklerin doğumdan sonra yatırılarak izleminin ve bakımlarının erken başlanması prognozu etkilemektedir. Bu çalışma 4 yıllık süre içinde hastanemizde doğmuş ve yenidoğan yoğun bakım ünitemizde takip edilmiş batın ön duvarı defekti tanılı olguların canlı doğumlar içindeki sıklığını, prenatal tanı oranlarını, demografik ve klinik verilerini incelemek amacıyla yapılmıştır. Haziran-2015 ile Ekim 2019 tarihleri arasında batın ön duvarı defekti tanısı ile yatırılarak izlenen 23 hastanın demografik ve klinik verileri retrospektif olarak incelendi, föy oluşturulduktan sonra hasta dosyaları tarandı. Çalışmamızda hastanemize başvuran batın ön duvarı defektlerinin çoğu doğum sırasında teşhis edilmişti. Antenatal takip edilen sadece 5 olgu prenatal tanı ile yatırılmıştı. Çalışmadaki olguların çoğunluğunu takipsiz gebeliklerden olan bebekler oluşturmuştu. Olguların çoğunluğunu omfaloselli bebekler (%56.5) idi. Olguların toplam mortalite oranı %26.1 idi. Mortalite ve morbiditeyi etkileyen en önemli faktörün eşlik eden anomaliler olduğu görüldü. Batın ön duvarı defekti olan olguların çoğunluğunu omafaloselli hastalar oluşturuyordu. Bu olgularda prenatal tanı oranı oldukça düşüktü. Antenatal takip ve 3.-4. düzey yenidoğan yoğun bakım ünitelerinin olduğu merkezlerde doğumun yaptırılmasının, mortalite ve morbiditeyi azaltmada etkili olacağı düşünüldü.

Alpers-Huttenlocher syndrome (AHS) is an uncommon autosomal recessive mitochondrial DNA depletion disease. The classic clinical triad of progressive developmental regression, liver degeneration, and seizures helps define the disorder, but a wide range of clinical expressions occur. The most common mutations in childhood have been identified in the cytochrome c oxidase Ⅰ and Ⅳ genes. The 7706G˃A missense mutation in the Cox Ⅱ gene was previously reported in one case after postmortem histological study. Consequently, our patient is the first patient diagnosed with AHS with a 7706G˃A missense mutation in the Cox Ⅱ gene while alive. We proposed that 7706G˃A missense mutation is rare and should be more lethal than other mutations that cause Alpers-Huttenlocher syndrome., Alpers-Huttenlocher sendromu (AHS) nadir görülen otozomal resesif mitokondriyal DNA deplesyonu hastalığıdır. İlerleyici gelişimsel gerileme, karaciğer dejenerasyonu ve nöbetlerden oluşan klasik klinik triad, bozukluğu tanımlamaya yardımcı olur, ancak çok çeşitli klinik tablolar ortaya çıkabilir. Çocukluk çağında en yaygın mutasyonlar sitokrom c oksidaz Ⅰ ve Ⅳ genlerinde tanımlanmıştır. Cox Ⅱ genindeki 7706G˃A missense mutasyonu daha önce postmortem histolojik çalışma sonrasında bir olguda bildirilmiştir. Sonuç olarak, bizim hastamız Cox Ⅱ geninde 7706G˃A missense mutasyonu olan ve hayattayken AHS tanısı konulan ilk hastadır. 7706G˃A missense mutasyonunun nadir olduğunu ve Alpers-Huttenlocher sendromuna neden olan diğer mutasyonlardan daha ölümcül olabileceğini düşünmekteyiz.

Isolated restrictive foramen ovale (rFO) without complex heart defects is a rare pathology. There may be difficulties in managing this situation, which can lead to right heart enlargement, tricuspid regurgitation and hydrops findings in the foetus. We conducted a retrospective analysis of 8451 foetuses. 7883 (93.2%) had a structurally normal heart or minor heart disease, 18 (0.22%) of which had a diagnosis of isolated rFO. Nine patients with neonatal echocardiographic examination were included in the study. In 8 (88.8%) patients, it was stated that a decision to give birth should be made at the time of presentation. Evaluating postpartum echocardiographic examinations, 7 (77.7%) patients had normal or minor defects. The decision of delivery made at the right time during follow-up is critical to determine the prognosis.IMPACT STATEMENTWhat is already known on this subject? The data about the prenatal diagnosis of isolated rFO is limited.What the results of this study add? We conducted a retrospective analysis of 8451 foetuses. 7883 (93.2%) foetuses had a structurally normal heart or minor heart disease, 18 (0.22%) of which had a diagnosis of rFO. Nine patients with foetal and postnatal follow-up and echocardiographic findings were examined in the study. The group's median gestational age at admission was 35.0 weeks (range: 27.0-39.0 weeks). The delivery decision was made in 8 (88.8%) patients at the time of admission. Evaluating postpartum echocardiographic examinations, 7 (77.7%) patients had normal or minor defects. Additionally, one patient was diagnosed with cardiomyopathy, and the other patient was diagnosed with functional pulmonary atresia. No death occurred in any foetus during follow-up.What the implications are of these findings for clinical practice and/or further research? Isolated rFO, a rare condition in the foetus, is generally well-tolerated in foetal life. However, the right heart enlargement, tricuspid regurgitation, or hydrops findings can be seen in patients. The decision of delivery made at the right time during follow-up is critical to determine the prognosis.

Background: Placental implantation defects are the most important causes of antepartum vaginal bleeding. In addition, the incidence of perinatal complications is also increased mainly due to preterm birth and small-forgestational-age fetuses. The other complications in neonates are intrauterine asphyxia, infections, respiratory distress. The aim of this study is to determine its association with adverse maternal and neonatal outcomes.Materials and Methods: Babies of the mothers with placental implantation defects followed in Neonatal Intensive Care Unit (NICU) in 2014-2015 were retrospectively sectional screened and involved in the study. Fetal loses, stillbirth fetuses, and live births were recorded. Neonatal evaluation included Apgar scores, birth weight, resuscitation in delivery room, respiratory distress, surfactant application, ventilator support, early and late onset neonatal sepsis, feeding tolerance, major anomalies and mortalities of the babies hospitalized in Neonatal Intensive Care Unit were investigated from hospital records.Results: There were 116 premature infants (90,62%) hospitalized in NICU and 9 infants (7,03%) had surfactant therapy for severe respiratory distress syndrome (RDS). Also, there were 68 infants hospitalized for respiratory distress due to pneumonia, transient tachypnea of neonate or RDS had ventilator support. NICU hospitalization incidence is higher in neonates of mothers with placental implantation defects. Conclusion: As well as antenatal careful follow up of mothers, it is also important that these pregnants give births in centers with third level neonatal intensive care units

Purpose: Nosocomial sepsis is the most common acquired infection. Despite appropriate antibiotic treatment, mortality and morbidity of sepsis are still high. We aimed to evaluate the effect of pentoxifylline on prognosis of neonatal nosocomial sepsis in premature infants hospitalized in the neonatal intensive care unit.Materials and Methods: Eighty newborns diagnosed as nosocomial sepsis were included in this study. Forty of them received pentoxifylline treatment in addition to antibiotics, while the other 40 did not receive additional treatment and formed the control group. The sex, mode of delivery, gestational age, birth weight, Apgar scores at the 1st and 5th minutes, surfactant therapy, ventilator therapy and presence of early onset sepsis were compared between the case group and the control.Results: There was no statistical difference between groups according to gestational week, gender, birth weight, mortality, neutrophil count or procalcitonin level at the time of diagnosis. Also, there was not any statistical difference according to duration of hospitalization between the bronchopulmonary dysplasia or necrotizing enterocolitis groups.Conclusion: Pentoxifylline has no significant impact on mortality and morbidity of preterm nosocomial sepsis.

PubMedID: 30177465 Background: Olive oil-soybean oil (OO/SO) based lipid emulsions (LE) lack ?-3 PUFAs eicosapentaenoic acid –EPA and docosahexaenoic acid- DHA, which have clinical benefits on inflammatory processes. Fish oil based LEs are good sources of DHA and EPA. Fish oil, MCT, Olive oil and Soya oil (FMOS) lipid is one of the fish oil containing LEs supplemented with high levels of ?-tocopherol and lower levels of phytosterol compared to OO/SO lipid emulsions. We investigated the effects of OO/SO and FMOS lipid preparations on cholestasis, levels of antioxidant enzymes and lipid peroxidation. Methods: Preterm neonates ?32 gestational weeks age and/or ?1500 g were randomly assigned to receive either FMOS or OO/SO in the first day of life. Catalase, superoxide dismutase (SOD), glutathione peroxidase (GPx) and thiobarbituric acid reactive substances (TBARS) levels in the first day of life, 7th day of lipid use and 28th day of life were measured and cholestasis during parenteral nutrition was recorded. Results: 34 and 33 patients were in FMOS and OO/SO lipid groups respectively. Although the TBARS levels were higher in the first day of life and 7th day of LEs in OO/SO lipid group (p=0.014 and p=0.022), on the 28th day of life TBARS level was similar and SOD level was higher (p=0.014) in OO/SO group. Cholestasis was significantly lower in FMOS lipid group (0% vs. 18.2%), (p=0.011) and neonates regained birth weight earlier (p=0.006). There was no significant difference in other morbidities. Conclusions: FMOS and OO/SO lipid emulsions have similar effects on lipid peroxidation on 28th day of life and on morbidities in short term period except for cholestasis. © 2018 Çukurova Üniversitesi: TTU-2015-4910 The authors declare that there is no conflict of interest. The study was funded by Çukurova University , Scientific Project Department, Project Code: TTU-2015-4910. Appendix A

WOS: 000484452900003 PubMed ID: 30872923 Aim: To evaluate the effect of umblical cord clamping time on lymphocyte subgroups in term and late preterm infants. Material and Methods: Seventy-four infants between 34 and 41 weeks of gestation were included in the study. Of these, 37 were umbilical cord clamped immediately after birth and the remaining 37 were clamped after waiting one minute. Babies were divided into two groups as term and preterm. The prenatal, natal, postnatal characteristics of the infants were recorded. Hematologic and lymphocyte subgroups were investigated in cord blood and venous blood at day 7. Lymphocyte subgroups were evaluated using flow cytometry. Results: With the delay of cord clamping, the leucocytes count and the percentage of CD3+T lymphocytes in cord blood of preterm infants decreased and this decrease continued at day 7. On the contrary, CD19+B lymphocyte levels in the cord blood of preterm infants increased, and this increase continued at day 7. Also, the percentage of CD4+T lymphocytes of preterm infants decreased with the delay of cord clamping at day 7. There was no difference between groups for the rate of sepsis development. Conclusion: With the delay of cord clamping, the leucocytes count, the percentage of CD3+T, and CD4+T lymphocytes decreased, and the percentage of CD19+B lymphocytes increased in preterm infants. The delay in cord clamping time in term and preterm infants seems to have no impact on the rate of sepsis development. Larger series of studies are needed to assess the effect of these findings on the development of infection in late preterm infants who have delayed cord clamping. Cukurova University Scientific Research Project Development Fund The authors received financial support from Cukurova University Scientific Research Project Development Fund.

Dandy-Walker malformasyonu, serebellar vermis agenezisi veya hipoplazisi, 4. ventrikülün kistik dilatasyonu ve posterior fossa genişlemesi ile karakterize nadir bir konjenital malformasyondur. Hastaların yaklaşık %70-90’ında postnatal hidrosefali gelişir. Dandy-Walker malformasyonun postaksiyel polidaktili ile ilişkisi ise, olası bir otozomal resesif sendrom (OMIM 220220) olarak tanımlanmıştır. Bu vakada Dandy-Walker malformasyonu tanısı alan ve postaksiyel polidaktilisi olan bir infant nadir olması nedeniyle sunuldu., Dandy-Walker malformation is a rare congenital malformation, characterized by agenesis or hypoplasia of the cerebellar vermis, cystic dilatation of the 4th ventricle and enlargement of the posterior fossa. Postnatal hydrocephalus develops in approximately 70-90% of the patients. The relationship of Dandy-Walker malformation with postaxial polydactyl has been defined as a possible autosomal recessive syndrome (OMIM 220220). Here, we present an infant with postaxial polydactyl accompanying Dandy-Walker malformation because of rare.

BACKGROUND Intravenous lipid emulsions are commonly used as a part of parenteral nutrition in premature infants. The potential bilirubin-displacing effects of high free fatty acid (FFA) levels during lipid infusions are known. Levels of free bilirubin (FB) predict the risk of bilirubin neurotoxicity more accurately than indirect serum bilirubin levels. In the present study, we decided to compare the effect of two different lipid solutions on free bilirubin and free fatty acids levels in premature infants. METHODS Infants were grouped into two groups according to intravenous lipid preparations: Infants in Group 1 received lipid emulsion containing olive oil + soybean oil and Group 2 received containing olive oil + soybean oil + fish oil. The blood samples were gained when lipid intake was 3.5 g/kg/day and FFA and FB levels were analyzed. RESULTS Serum FFA and FB levels were similar in groups (p = 0.26 and 0.69 respectively). There were significant correlation between serum FFA and FB levels in Group 1 (r = 0.74, p

Purpose: Delaying the cord clamping for at least 30 seconds in infants who did not require cardiopulmonary resuscitation after birth has been recommended in the revised guidelines of American Academy of Pediatrics in 2015.We aimed to evaluate the effect of delayed cord clamping on hematological and biochemical parameters, need for hospitalization, oxygen, mechanical ventilation, phototherapy, and on sepsis, hyperbilirubinemia rate in late preterm and term infants.Material and Methods: This prospective study included 86 infants with a gestational age of 34 to 41 weeks. Infants were randomly included in one of two groups. While cords of 43 infants were clamped immediately after birth, cords of the other 43 infants were clamped after one minute. Hematological and biochemical values were evaluated both in cord blood and venous blood samples on 7th day of life. Results: Hemoglobin and hematocrit values were similar in two groups both in cord blood and on 7th day of life. Delayed cord clamping resulted in statistically significant decrease in the leukocyte and platelet coun and creatinine levels in the cord blood. Mechanical ventilation requirement was significantly lower in the delayed cord clamping group. Hospitalization rate, sepsis rate and hyperbilirubinemia rate were similar in both groups.Conclusion: Delayed cord clamping caused lower leucocyte, platelet counts and lower creatinine levels in cord blood. There seems a beneficial effect on respiratory status in late preterm and term infants., Amaç: Amerikan Pediatri Akademisi tarafından 2015 protokollerinde doğumdan sonra canlandırma ihtiyacı olmayan bebeklerde kord klemplenmesinin en az 30 dk geciktirilmesi önerilmiştir. Bu çalışmada term ve geç preterm bebeklerde geciktirilmiş kord klemplemenin, hematolojik ve biyokimyasal parametreler, hastaneye yatış, oksijen, mekanik ventilasyon, fototerapi ihtiyacına ve sepsis, hiperbilirubinemi hızına etkisini değerlendirmeyi amaçladık. Yöntem: Prospektif çalışmamıza 34-41 gebelik haftasındaki 86 bebek dahil edildi. Bebekler randomize olarak iki gruba ayrıldı. 43 bebeğin göbek kordonu doğumdan hemen sonra klemplenirken diğer 43 bebeğin kordonu doğumdan 1 dakika sonra klemplendi. Hematolojik ve biyokimyasal parametreler hem kord kanında hem de postnatal 7. günde alınan venöz örneklerde değerlendirildi.Bulgular: Hemoglobin ve hematokrit değerleri hem kord kanında hem de postanal 7. günde her iki grupta da benzerdi. Geciktirilmiş kord klemplenen grupta kord kanında lökosit ve tombosit değerleri istatistiksel olarak anlamlı düşüktü. Geciktirilmiş kord klemplenen grupta kord kanında kreatinin düzeyi anlamlı olarak düşük saptandı. Mekanik ventilasyon ihtiyacı kordu geç klemplenen grupta daha azdı. Hastaneye yatış, sepsis ve hiperbilirubinemi hızı her iki grupta da benzerdi.Sonuç: Geciktirilmiş kord klemplemesinin term ve geç preterm bebeklerde lökosit, trombosit ve kreatinin düzeylerinde düşüklüğe neden olduğu, solunum üzerine olumlu etkileri olduğu düşünüldü.

The non-Langerhans cell histiocytosis (non-LCH) is a group of diseases characterized by cutaneous involvement in the neonatal period. The non-LCH affects less than 1 in 200,000 children born each year. A definitive diagnosis is important for the treatment of the disease. Therefore, skin biopsies should be performed in neonates with cutaneous lesions as early as possible. Only in the presence of cutaneous involvement without systemic involvement, it does not require any treatment, because the lesions can mostly self-heal. Here, we present a neonate diagnosed with non-LCH following a skin biopsy. Keywords: Histiocytic disorders, Neonatal, non-Langerhans cell histiocytosis

OBJECTIVE: Understanding the etiologies of infant deaths and predicting risk begins with defining cases correctly. The collection and analysis of reliable statistical data are an essential part of comprehensive investigations on local and national levels. MATERIAL AND METHODS: This was a descriptive study. Diagnosis as a cause of infant death and other factors were examined. Data were analyzed using the SPSS 17.0 program. Frequencies and means were computed. RESULTS: According to the data of 35 227 live births and 288 infant deaths during the year, the infant mortality rate of Adana province was 8.2 per thousand. We found that the most common cause of infant death was sepsis (26.0%). Other causes of infant death included prematurity and problems related to prematurity (12.6%), congenital heart disease and complications (12.6%), respiratory problems (11.9%), congenital anomaly (9.8%), immaturity (

Molybdenum cofactor deficiency is a rare neurometabolic disease that is usually characterized by seizures, abnormal muscle tonus, developmental delay and poor nutrition, and is seen soon after birth. Pyloric stenosis causes serious vomiting in the first months of life. The presence of neurologic damage in molybdenum cofactor deficiency and possible abnormal innervations may cause pyloric stenosis; however, the pathogenesis is unclear. Pyloric stenosis with molybdenum cofactor deficiency has been described in two cases. Herein, we report the third case and suggest that hypertrophic pyloric stenosis should be kept in mind as a clinical manifestation of molybdenum cofactor deficiency.

Objective Understanding the etiologies of infant deaths and predicting risk begins with defining cases correctly. The collection and analysis of reliable statistical data are an essential part of comprehensive investigations on local and national levels. Material and Methods This was a descriptive study. Diagnosis as a cause of infant death and other factors were examined. Data were analyzed using the SPSS 17.0 program. Frequencies and means were computed. Results According to the data of 35 227 live births and 288 infant deaths during the year, the infant mortality rate of Adana province was 8.2 per thousand. We found that the most common cause of infant death was sepsis (26.0%). Other causes of infant death included prematurity and problems related to prematurity (12.6%), congenital heart disease and complications (12.6%), respiratory problems (11.9%), congenital anomaly (9.8%), immaturity (

Pneumomediastinum is due to air penetration in to the mediastinum. In children it is mostly due to asthma, however in newborns pneumonia or meconium aspiration syndrome are the predisposing factors. Pneumomediastinum is recognised by chest radiography, in newborn babies -spinnaker sign- an upwards and outwards deviation of thymic lobes can be seen due to raising of thymus above the heart by pneumomediastinal air. Babies may be asymptomatic or they may have respiratory distress. Pneumomediastinum usually resorbs spontaneously over one or two weeks. Here we report two newborn babies with pneumomediastinum. Although pneumomediastinum was obvious in the chest X-rays, both babies had mild respiratory distress and mediastinal air resorbed spontaneously., Pnömomediastinum mediastene hava girişi ile oluşmaktadır. Çocuklarda genellikle astıma bağlıdır, ancak yenidoğanlarda pnömoni veya mekonyum aspirasyon sendromu predispozan faktörlerdir. Pnömomediastinum tanısı genellikle akciğer grafisi ile konur, yenidoğan bebeklerde pnömomediastinal hava ile kalbin üstündeki timik lopların yukarı ve dışa doğru sapmasıyla timusun yükseldiği yelken işareti görülür. Bebekler asemptomatik olabildiği gibi solunum sıkıntısına da neden olabilir. Pnömomediastinum genellikle bir veya iki haftada kendiliğinden resorbe olur. Burada pnömomediastinumlu iki yenidoğan bebek sunulmuştur. Her iki bebeğin göğüs filminde belirgin pnömomediastinum olmasına rağmen, solunum sıkıntısı orta düzeyde idi ve mediastinal hava spontan resorbe oldu.

Konjenital hipotiroidizm yenidoğanlarda önemli bir sorundur. Şiddetli hipotiroidizm vakalarında çeşitli kardiyak anormallikler tanımlanmıştır. Hipotiroidizm yaygın olarak sinüs bradikardisi, düşük QRS kompleksleri, uzun QT aralığı ve iletim blokları ile ilişkilidir, ancak nadiren aritmilere neden olabilir. Supraventriküler aritmiler hipertiroidizmin sıradan özellikleri olmasına rağmen; Bu çalışmanın amacı supraventriküler taşikardi ve hipotiroidizm arasındaki olası etyolojik bağın altını çizmektir. Literatürde hipotiroidizm ve taşiaritmi birlikteliği olan birkaç erişkin olgu daha önce bildirilmiş olmasına rağmen, bilgimize göre yenidoğanlarda bildirilen vakalar sadece bunlardır., Congenital hypothyroidism is a significant issue in neonates. A variety of cardiac abnormalities have been described in cases of severe hypothyroidism. It is commonly associated with sinus bradycardia, low QRS complexes, prolonged QT interval and conduction blocks but may rarely cause arrhythmias. Although supraventricular arrhythmias are ordinary features of hyperthyroidism, the aim of this report is to underline the possible etiological link between supraventricular tachycardia and hypothyroidism. Although a few adult cases with hypothyroidism and tachyarrhythmia have been previously reported in the literature, to our knowledge, these are the only neonatal cases reported.

PubMedID: 30999804 Background/aim: Systemic to pulmonary shunts (SPS) have proven to be highly effective for the palliation of neonates with cyanotic congenital heart disease. Mortality after SPS surgery in neonates has multifactorial basis. We aimed to investigate the clinical results of the SPS in relation to the underlying cardiac disease and to identify the risk factors contributing to an adverse outcome. Material and method: All neonates who underwent first shunt insertion for cyanotic congenital heart disease during the study period from 1 January 2014 to 31 December 2017 were included. A retrospective review of patient records was done. Patients were grouped into two different categories: survived with or without any reintervention and death before or after any reintervention till discharge. Result: During the study period, 47 patients underwent SPS shunt placement. Patients who survived with or without any reintervention were in Group 1 and patients who died before or after any reintervention till discharge were in Group 2. Preoperative epinephrine requirement and mechanical ventilation and postoperative erythrocyte transfusion need were statistically significant. Conclusion: Although primary cardiac pathology is the most important prognostic factor, some other preoperative and postoperative factors like preoperative epinephrine requirement, and postoperative erythrocyte transfusion might also affect the prognosis. As there are very few centers in the region that specialize in pediatric cardiac surgery, a multicenter approach will be helpful in reaching reliable conclusions. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

PubMedID: 29463139 Background: Organophosphates, pythyreoids, carbamate pesticides and fungicides are heavily used in agriculture. They may have dangerous effects on newborn health especially on immune system and growth via prenatal transmission by placenta or postnatal transmission by breastfeeding. Methods: In 2015, 144 non-persistent pesticides in 64 milk samples of 32 mothers were studied by OuEChERS method in liquid chromatography/tandem mass spectrometer in neonatal Intensive Care Unit in Adana, a city in Cukurova region which is an important agricultural area in Turkey. Results: Pesticides were detected in milk samples of 11 mothers (34.3%) and 21 (32.8%) of milk samples. In five mothers, fungicides (in 5/10 samples propicanozole-PP, in 4/10 samples bromucanozole-BM), in five mothers, organophosphates (in 10/10 samples primyphosphomethyl-PPM), in one mother, both organophosphates and fungicide (in 1/2 samples PPM and in 1/2 samples buprimate) were detected. However, the estimated daily intakes (EDI) were less than acceptable daily intakes (ADI) for PPM, PP and BM, respectively. Conclusions: Although pesticides levels in human milk did not exceed the ADIs, we suggest monitoring pesticides in human breast milk especially for newborn health. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. TF2014BAP9 The study was funded by Cukurova University, Scientific Project Department, Project number TF2014BAP9.

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.

PubMedID: 28969449 The human major histocompatibility complex class I chain-related gene A and B (MICA and MICB) is one of the genes in chromosome 6. As MIC expression is inducible by heat, viral infection, inflammation and DNA damage, the molecules have been thought to be stress markers for the cells. We aimed to find the level of mRNA concentrations of MICA and MICB in neonates without any evidence of early onset infection. © 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group.

Aim: Children requiring intensive care in the neonatal period have more fine motor injuries, learning difficulties, eating disorders and sleeping problems. Sleep disorder rate is about 10-30% in children who had no problem in newborn period. We aimed to investigate the rate of sleep disorder in children who were hospitalized in the neonatal intensive care unit during the neonatal period. Material and Methods: Fourty-six patients hospitalized in neonatal intensive care unit and still followed in outpatient policlinic at Cukurova University were enrolled in to the study. Children’s Sleep Habits Questionnaire was performed to evaluate sleep resistance, delay in fall into sleep, duration of sleep, sleep anxiety, parasomnia, midnight awakening and daily sleepiness.Results: Children were 6.64±1.18 years old. They were healthy and had no neurological sequela. None of the parents complained about sleep disorders. However, 20 of the 46 (43.47%) children had sleep disorder (Sleep disorder group). Twenty-six children had no sleep disorder (No sleep disorder group). There isn’t any statistically difference between the groups that terms of gestational age, birth weight, ventilator support, gender (p>0.05).Conclusion: Although there isn’t any significant difference between groups, sleep disorder rate is higher compared to normal population’s rates reported in the previous studies. Infants discharged from neonatal intensive care unit should be under evaluation also for sleep disorder.

Yapicioglu-Yildizdas H, Ece U, Sucu M, Yurdakul G, Simsek H, Ozlu F. Twin reversed arterial perfusion syndrome in a monochorionic monoamniotic twin pregnancy. Turk J Pediatr 2017; 59: 724-727. Twin reversed arterial perfusion syndrome is mostly seen in monochorionic diamniotic twin pregnancies with an estimated incidence of 1/9500-11000 pregnancies. One of the twins is acardiac with various abnormalities especially with upper part of the body, and mortality is 100%. The other twin functions as a pump twin and mostly has polyhydramnios and heart failure; and mortality rate is high due to prematurity and heart failure. Herein we report a TRAP syndrome and the prognosis of pump twin who was born at 30 weeks gestational age.

Purpose: The effect of magnesium sulphate (MgSO4) to mothers with imminent premature birth at, Amaç: 34 gestasyonel haftadan once doğan bebeklerin annelerine yapılan antenatal magnesiyum sulfatın, bebeklerdeki intraventriküler kanama, beslenme intoleransı, retinopati ya da bronkopulmoner displazi gibi morbiditeler üzerine etkisi henüz tam açıklığa kavuşturulmamıştır. Biz antenatal uygulanan magnezyum sulfatın prematüre bebeklerde erken ve geç morbidite ve mortaliteye etkisini retrospektif olarak araştırmayı amaçladık.Gereç ve Yöntem: Antenatal magnesiyum alan 108 prematüre bebek Mg (+) grubu, ve antenatal magnesiyum almayan 172 prematüre bebek Mg(-) grubu,oluşturdu.Bulgular: Respiratuar Distres sendromu, intraventriküler kanama, ağır intraventriküler kanama (evre 3 ve 4), premature retinopatisi, bronkopulmoner displazi Mg (+) grupta daha düşük saptanmasına ragmen sadece Respiratuar Distres sendromu için istatistiksel olarak anlamlı idi.Sonuç: Bu retrospektif çalışmada antenatal magnezyum uygulamasının premature bebeklerde morbidite ve mortalite üzerine istatistiksel anlamlı bir yararı gösterilemedi.

Background/aim: Peritoneal dialysis (PD) is generally considered the practical dialysis modality for neonates in the treatment of acute kidney injury (AKI) and metabolic disturbances. The aim of this study was to evaluate the indications, complications, and outcomes of PD between January 2011 and December 2016. Materials and methods: This study included all 56 neonates that underwent PD over six years in our neonatal intensive care unit (NICU). A retrospective chart review was performed for all patients in our institution. Results: The incidence of PD was 1.32% (56/4230 patients) during this period. Mean birth weight of the patients was 2267.77 ± 1060.63 (540–5050) g. Thirty-four (60.7%) patients were premature. Fourteen patients (25%) were in the postoperative period of cardiac surgery due to congenital cardiac defects, fourteen patients (25%) were diagnosed with metabolic diseases, one patient had hypoxic ischemic encephalopathy, and another patient had severe pulmonary hypertension. Conclusion: In the acute setting of a neonatal intensive care unit, PD performed in a neonate provides a technically simple method of steady fluid, solute removal, and correction of electrolyte abnormalities. A trocar catheter appears safe even in premature babies, and closed three-way stopcock system seems to be reliable at the bedside in NICUs.

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Ozlu F, Tuluce M, Satar M, Ozbarlas N, Kozanoglu B, Yucel A. Togetherness of Ebstein anomaly and giant hairy nevus in a neonate: first case in the literature. Turk J Pediatr 2018; 60: 744-746. Ebstein anomaly is a congenital heart defect in which the septal and posterior leaflets of the tricuspid valve are displaced through the apex of the right ventricle. Giant congenital melanocytic nevi originate from melanocytes. It is usually seen after birth. Here we present the first neonate with prenatally diagnosed with Ebstein anomaly with giant hairy nevus in the literature.

Midaortic syndrome is an uncommon disease characterized by segmental or diffuse narrowing of abdominal or distal descending thorasic aorta. Majority of the cases are idiopathic but some are secondary to fibromuscular dysplasia, giant cell arteritis, Moyamoya disease or genetic diseases such as neurofibromatosis, Williams’ syndrome and Alagille syndrome. It is very rare in newborn period. Here we present a 40 days old infant who admitted to hospital for respiratory distress, hypertension, heart failure and was diagnosed as midaortic syndrome. She had medical treatment but unfortunately died due to heart failure when she was two months old age. Midaortik sendrom nadir bir hastalık olup abdominal veya distal inen aortanın segmental veya difüz darlığı ile karakterizedir. Olguların çoğu idiyopatik olmakla birlikte bir kısmı da fibromüsküler displazi, dev hücreli aterit, Moyamoya hastalığı veya nörofibramatozis, Williams’ sendromu ve Alagille sendromu gibi genetik hastalıklara ikincildir. Burada 40 günlük iken hastaneye solunum sıkıntısı, kalp yetmezliği tablosunda başvuran ve midaortik sendrom tanısı alan bir olgu sunulmuştur. Olguda medikal tedavi tercih edilmiş ancak bebek iki aylık iken eksitus olmuştur.

Yenidogan bebeklerde hiperamonemi, hipotoni, letarji, nobetler ve koma ile karakterize ensefalopati tablosuna yol acabilir. Akut dekompanse olmus hiperamonemi tedavisinde devamli venovenoz hemodiafiltrasyon tedavi secenegi olabilir. Burada hipotoni, konvulziyon ve hiperamonemi olan uc yenidogan olgusu sunulmustur.yasamlarinin ilk uc gununde amonyak degerleri 4609, 1023, 1949 microgram/ml idi. Devamli venovenoz hemodiafiltrasyon ile basarili bir sekilde tedavi edilerek tedavinin ilk 24 saatinde amonyak degerleri 268, 164 65 microgram/ml'ye azaltildi.hafif hipotermi ve anemi komplikasyon olarak saptandi.

PubMedID: 26729223 Prune Belly syndrome (PBS), comprises a triad of anomalies that include abdominal wall flaccidity, urologic anomalies and bilateral cryptorchidism in males. The abdominal musculature hypoplasia predisposes to respiratory problems, respiratory infections secondary to impaired cough mechanism, and cause chronic constipation secondary to ineffective valsalva ability. Here, the authors present a newborn baby with Prune Belly syndrome who had respiratory and gastrointestinal problems which resolved after corset use. To the authors knowledge, this is the first case of corset usage in the treatment of PBS in a newborn infant. © 2016, Dr. K C Chaudhuri Foundation.

Akcali M, Yapicioglu H, Akay E, Ozlu F, Kozanoglu B, Erdogan K, Gonlusen G, Satar M. A congenital soft tissue Ewing sarcoma in a newborn patient. Turk J Pediatr 2017; 59: 76-79. < p < Congenital Ewing sarcoma is extremely rare. Here we present a newborn baby born with a mass on the left shoulder. Immunohistochemical staining showed congenital Ewing sarcoma. Chemotherapy and then surgical operation were planned, however the patient died before initiation of chemotherapy on the 30th day of life.