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Objective: Children born small for gestational age (SGA) are at risk of future obesity and associated comorbidities. Therefore the identification of risk factors and novel biomarkers which are associated with this risk are needed for early detection and to improve preventive strategies. Spexin (SPX), a novel neuropeptide that is involved in the regulation of obesity and fat metabolism, is a candidate biomarker for predicting obesity and related comorbidities at an early age. The aim of this study was to investigate serum levels of SPX in term infants born small, appropriate, and large for gestational age (LGA) and its association with newborn anthropometric measurements. Methods: One hundred and twenty term newborn babies classified as SGA, appropriate for gestational age (AGA), or LGA and their mothers were included. SPX, leptin and visfatin were measured in cord blood and maternal serum by enzyme-linked immunosorbent assay. Results: Fifty-six (46.7%) neonates were girls and 64 (53.3%) were boys. The mean birth weight was 3170.70±663 g, birth length was 48.9±2.79 cm, and head circumference was 34.5±1.67 cm. Birth weights, lengths, and head circumferences of the neonates in the SGA, AGA, and LGA groups were significantly different. Cord blood SPX and leptin levels in the SGA groups were significantly lower than those of both the LGA and AGA groups. Cord blood visfatin levels were significantly lower in the AGA group than the LGA and SGA groups. Maternal SPX levels of SGA babies were significantly lower than those of the mothers in both the LGA and AGA groups, but no significant difference was observed between the SGA and LGA groups. Maternal visfatin levels of the AGA babies were significantly higher than the maternal levels of SGA and LGA groups. There was no difference in terms of maternal leptin levels. Cord blood SPX and leptin levels were positively correlated with birth weight, length and head circumference. Birth weight increased significantly in line with maternal pregestational body mass index. Conclusion: The lowest SPX levels were found in the SGA babies and cord SPX level was significantly correlated with newborn length, weight, and head circumference. © 2022 by Turkish Society for Pediatric Endocrinology and Diabetes The Journal of Clinical Research in Pediatric Endocrinology published by Galenos Publishing House.

Amaç: Yenidoğan ünitesinde idrar yolu enfeksiyonu (İYE) tanısıyla izlenen bebeklerin retrospektif değerlendirilmesi. Gereç ve yöntem: 2015-2019 yılları arasında yenidoğan ünitemizde İYE tanısıyla (sonda ile alınan idrar kültüründe >10,000 cfu/ml mikroorganizma üremesi) izlenen 50 yenidoğan bebeğin klinik, laboratuvar bulguları ve prenatal-postnatal görüntülemeleri değerlendirildi. Bulgular: Çalışmaya alınan 50 olgunun 23’ü kız ve 27’si erkekti. Gebelik yaşları ortalamaları 34,3±4,6 haftaydı (minimum-maksimum:23-41). Çoğu olgu (n=42, %84) gebelik yaşına göre normal ağırlıktaydı. Yirmi (%40) olgu asemptomatikken, 30’u (%60) semptomatikti. Term bebeklerde ateş, prematürelerde apne daha sıktı. İdrar kültürlerinde en sık E.coli (n=24, %48) ve klebsiella pneumoniae (n=13, %26) üremesi saptandı. Eş zamanlı alınan kan kültürlerinin %24’ünde (n=12) üreme (koagülaz negatif stafilokok n=8, %16) saptandı. Olguların tümü postnatal üriner sistem ultrasonografiyle değerlendirildiğinde; %68’i (n=34) normal, %32’si (n=16) anormal (n=5, %31,2 hidronefroz; n=10, %68,8 nefrolitiazis, n=1, pelvikalisiyel ektazi) bulundu. Ultrason bulgusu anormal olan ve voiding sistoüretrografi yapılan 12 olgunun yarısında (n=6, %50) vezikoüreteral reflü saptandı.Sonuç: Yenidoğan ünitesinde İYE saptanan bebeklerin %40’ı asemptomatikken %60 semptomatikti ve idrar kültüründe en sık E.coli üredi. Bu olguların yaklaşık 1/3’ünde postnatal üriner sistem ultrasonuyla anormal bulgu, ultrasonu anormal olanların %31,2’sinde hidronefroz ve hidronefroz tanımlananların tamamında ileri derecede vezikoüreteral reflü saptandı. Sonuç olarak, İYE saptanan yenidoğanlar eşlik edebilecek üriner sistem malformasyonu açısından mutlaka ultrason ile değerlendirilmeli ve hidronefroz saptananlar vezikoüreteral reflü açısından araştırılmalıdır.

Sayin Editor Patent duktus arteriyozus PDA ozellikle asiri dusuk dogum agirlikli erken dogan yenidoganlarda sik gorulen bir sorundur Patent duktus arteriyozus kapatilmasinda tibbi tedavi olarak indometazin ve ibuprofen kullanilmaktadir Bununla birlikte bu ilaclar bazi yan etkilere neden olabilmektedir Cerrahi kapatma tibbi tedavinin uygulanmasina bir engel oldugu veya basarisiz oldugu yenidoganlarda uygulanmaktadir Ancak cerrahi kapatma sirasinda veya daha sonra bazi komplikasyonlar gorulebilmektedir 1 2 Bu yazida agizdan uc kez ibuprofen verilmesine ragmen PDA rsquo;si kapanmayan ve cerrahi kapatma oncesi parasetamol tedavisi ile hemodinamik olarak duktusu belirgin kuculen ve cerrahi islemden kurtulan bir erken dogmus erkek bebek olgusu sunuldu Yirmi alti yasindaki annenin ilk gebeliginden erken dogum ve oligohidramniyos nedeniyle bir kez betametazon uygulandiktan 48 saat sonra hastanemizde 24 hafta bes gunluk olarak sezaryen ile 820 g dogan erkek olgunun birinci ve besinci dakika Apgar skoru sirasiyla 5 ve 7 idi Entube halde mekanik ventilatorde izlenen olgunun dogum sonrasi altinci saatinde bakilan hemograminda beyaz kure 74 600 micro;L hemoglobin 15 2 g dL trombosit 417 000 micro;L periferik yaymada 44 polimorfonukleer lokosit 18 lenfosit 12 bant olgunlasmamis olgun hucre orani 0 27 10 monosit 16 promiyelosit toksik granulasyon 30 normoblast saptanirken blastik hucre yoktu Lokomoid reaksiyon toksik granulasyon olgunlasmamis olgun hucre orani polimorfonukleer lokosit orani 0 27 saptanan olguda erken yenidogan sepsis dusunulerek duzenli kulturleri alinip ampisilin ve netilmisin damardan uygun dozda baslandi Radyolojik ve klinik olarak sikintili solunum sendromu dusunulmedi Kan biyokimyasal degiskenleri normal degerlendirilen olgunun izleminde kulturlerde ureme olmamasi ve enfeksiyon belirteclerinin negatif saptanmasi nedeniyle antibiyoterapi kesildi Dogum sonrasi dorduncu gunde ufurumu olmayan ancak femoral arter nabizlari sicrayici ve FiO2 gt; 40 seyreden hastada yapilan ekokardiyografi rsquo;de EKO kucuk sekundum atriyal septal defekt saptanirken duktus kapaliydi ve izlem onerildi Dogum sonrasi sekizinci gunde tum odaklarda 1 6 sistolik ufurum duyulan olgunun tekrarlanan EKO rsquo;sunda PDA 2 mm sol atriyum LA aort anulusu Ao orani 1 5 saptandi ve agizdan ibuprofen tedavisi baslandi Tedavinin ikinci gununde trombositopeni 28 000 micro;L gelismesi nedeniyle ibuprofen verilemedi Dogum sonrasi 11 gunde ufurumu devam eden trombosit 119 000 micro;L kreatinin 0 8 mg dL olan hastaya agizdan 10 5 5 mg kg gun dozda 24 saatlik araliklarla ilk ibuprofen tedavisi uygulandi Birinci tedaviden sonra yapilan EKO rsquo;da duktus capi 2 mm LA Ao orani 1 4 saptanan ve hemodinamik acidan anlamli olan olguya ayni dozda iki tedavi daha agizdan ibuprofen verildi Buna ragmen hemodinamik olarak anlamli PDA rsquo;si devam eden hastaya aileden yazili onam alinarak cerrahi girisimden once dogum sonrasi 20 gununde agizdan parasetamol tedavisi 15 mg kg doz alti sa araliklarla 72 sa verildi Parasetamol tedavisinden once ve sonra hemogram periferik yayma ve karaciger islev testleri normaldi Tedaviden sonra yapilan EKO rsquo;da duktus capinin 1 mm rsquo;ye LA Ao oraninin 1 1 rsquo;e geriledigi goruldu ve izlem onerildi Dogum sonrasi 47 gununde ufurum saptanmayan olguda 75 gunde duktus tamamiyle kapandi Tablo 1 Kafa ici kanamasi olmayan olgunun izleminde agir bronko pulmoner displazi ve evre 1 premature retinopatisi gelisti Olgu dogum sonrasi 108 gunde oksijensiz olarak oksijen doygunlugu gt; 90 taburcu edilip yenidogan poliklinik izlemine alindi Hemodinamik acidan anlamli EKO bulgusu LA Ao gt;1 4 duktus capi gt;1 4 mm saptanan bulgu veren PDA hastalarina tibbi tedavi baslanmaktadir 1 Indometazin gecici veya kalici bobrek islev bozuklugu nekrotizan enterokolit beyin oksijenlenmesinde azalma gibi komplikasyonlara yol acabildigi icin arastirmacilar daha guvenilir bir farmakolojik ajana yonelmislerdir 3 4 Diger bir siklooksijenaz inhibitoru olan ibuprofenin daha az beyin bobrek ve mezenterik yan etkilerinin oldugu; beyin kan akiminin otoregulasyonunu arttirdigi; hayvan deneylerinde oksidatif stresi takiben norolojik islevleri korudugu gosterilmistir 5 7 Ulkemizden yapilan bir calismada PDA rsquo;nin kapatilmasinda agizdan ibuprofen tedavisinin damardan indometazin tedavisi kadar hatta daha etkili oldugu bildirilmistir 8 Patent duktus arteriyozus kapatilmasinda tibbi tedavinin kontrendike oldugu veya tedavinin basarisiz oldugu durumlarda cerrahi yolla kapatma uygulanmaktadir Cerrahi kapatmaya bagli yineleyen laringeal sinir hasari silotoraks pnomotoraks sol ventrikul islev bozuklugu ve skolyoz gibi komplikasyonlar gorulebilmektedir 1 Tibbi ve cerrahi kapatma tedavilerinin olasi komplikasyonlari nedeniyle arastirmacilar PDA tedavisinde yeni arayislara yonelmislerdir Bu maksatla PDA tedavisinde yeni bir ajan olan parasetamol kullanilmaya baslanmistir 9 10 Parasetamol prostaglandin sentetazin peroksidaz bilesenini engelleyerek etkili olur Ilk kez Hammerman ve ark 9 iki kez ibuprofen ile PDA rsquo;si kapanmayan veya ibuprofenin verilmesine engel oldugu bes olguya alti saat araliklarla 15 mg kg doz rsquo;dan verilen agizdan parasetamol tedavisiyle ilk uc gunde olgularin tamaminda duktusun kapandigini veya kuculdugunu hicbir yan etkinin gorulmedigini bildirmislerdir Ikinci calisma ulkemizden yapilmis olup ayni gerekcelerle sekiz olguya uygulanan parasetamol tedavisiyle 87 5 oraninda basari saglandigi belirtilmistir 10 Biz de bu iki calismadan yola cikarak uc kez agizdan ibuprofen tedavisiyle PDA rsquo;si kapanmayan olgumuza cerrahi girisimden once parasetamol tedavisini ayni dozda 72 saat sureyle uyguladik Tedaviden sonra yapilan EKO rsquo;da duktusun hemodinamik olarak belirgin geriledigi ve kuculdugu goruldu Tedavi sirasinda herhangi bir yan etki saptanmadi Izlemde EKO kontrollerinde duktus acikligi kuculen ve hemodinamik acidan anlamli olmayan olguda duktusun dogum sonrasi 75 gunde tam olarak kapandigi saptandi Bu olgu sunumuyla tekrarlayan ibuprofen teavilerine ragmen PDA rsquo;si kapanmayan cok dusuk dogum agirlikli erken dogan yenidogan olgularina cerrahi girisimden once parasetamol tedavi sansinin verilmesi gerektigini dusunmekteyiz Yazisma Adresi Address for Correspondence: Dr Kazim Kucuktasci Pamukkale Universitesi Tip Fakultesi Cocuk Sagligi ve Hastaliklari Neonatoloji Bilim Dali Denizli Turkiye E posta: drkkucuktasci@gmail com Gelis Tarihi Received: 07 08 2012 Ka shy;bul Ta shy;ri shy;hi Ac shy;cep shy;ted: 17 09 2012 Kaynaklar 1 Hamrick SE Hansmann G Patent ductus arteriosus of the preterm infant Pediatrics 2010; 125 5 : 1020 30 2 Chiruvolu A Jaleel MA Therapeutic management of patent ductus arteriosus Early Hum Dev 2009; 85 3 : 151 5 3 Betkerur MV Yeh TF Miller K Glasser RJ Pildes RS Indomethacin and its effect on renal function and urinary kallikrein excretion in premature infants with patent ductus arteriosus Pediatrics 1981; 68 1 : 99 102 4 Edwards AD Wyatt JS Richardson C et al Effects of indomethacin on cerebral haemodynamics in very preterm infants Lancet 1990; 335 8704 : 1491 5 5 Kushnir A Pinheiro JM Comparison of renal effects of ibuprofen versus indomethacin during treatment of patent ductus arteriosus in contiguous historical cohorts BMC Clin Pharmacol 2011; 11: 8 6 Patel J Roberts I Azzopardi D Hamilton P Edwards AD Randomized double blind controlled trial comparing the effects of ibuprofen with indomethacin on cerebral hemodynamics in preterm infants with patent ductus arteriosus Pediatr Res 2000; 47 1 : 36 42 7 Su PH Chen JY Su CM Huang TC Lee HS Comparison of ibuprofen and indomethacin therapy for patent ductus arteriosus in preterm infants Pediatr Intern 2003; 45 6 : 665 70 8 Teksam O Yigit S Karagoz T Korkmaz A Yurdakok M Tekinalp G Yenidogan bebeklerde patent duktus arteriyozusun tedavisinde oral ibuprofen ve intravenoz indometazin: bir retrospektif calisma Cocuk Sagligi ve Hastaliklari Dergisi 2004; 47: 96 102 9 Hammerman C Bin Nun A Markovitch E Schimmel MS Kaplan M Fink D Ductal closure with paracetamol: a surprising new approach to patent ductus arteriosus treatment Pediatrics 2011; 128 6 : e1618 21 10 Oncel MY Yurttutan S Degirmencioglu H et al Intravenous paracetamol treatment in the management of patent ductus arteriosus in extremely low birth weight infants Neonatology 2012; 103 3 : 165 8

BACKGROUND Bronchopulmonary dysplasia (BPD) remains an important cause of morbidity and mortality in premature infants. There is currently no proven effective treatment modality for BPD, and inflammation and oxidative injury play an important role in the pathogenesis of this disease. This study investigated the histopathological and biochemical effects of bosentan, which is a non-specific endothelin receptor antagonist with known antioxidant and anti-inflammatory properties, on hyperoxia-induced lung injury (HILI) in neonatal rats. METHODS The experiment was performed on newborn rats from the 3rd to the 13th postnatal day. The rats were randomly divided into six groups: Group 1 (air-exposed + saline, n = 6); Group 2 (HILI, n = 8); Group 3 (air-exposed + bosentan, n = 7); Group 4 (HILI + saline, n = 7); Group 5 (HILI + early bosentan-treated group, n = 6), and Group 6 (HILI + late bosentan-treated group, n = 7). Bosentan was administered (30 mg/kg/day) intraperitoneally. The histopathological effects of bosentan on lung tissue were assessed by their alveolar surface area, fibrosis, and smooth muscle actin (SMA) scores, and the biochemical effects on lung tissue were assessed by interleukin-1 beta (IL-1β), IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α). RESULTS The alveolar surface area and fibrosis scores were found to be significantly higher in HILI groups compared with Group 1 (P

Tumor necrosis factor-alpha (TNF-α) has an important role in hypoxia/reoxygenation (H/R)-induced intestinal damage. It was shown that blocking TNF-α with infliximab has beneficial effects on experimental necrotizing enterocolitis and hypoxic intestinal injury. However, there is no data about the effect of adalimumab on H/R-induced intestinal damage. Therefore, we aimed to determine potential dose-dependent benefits of adalimumab in such damage in neonatal rats. Wistar albino rat pups were assigned to one of the four groups: control group, hypoxia group, low-dose adalimumab (5 mg/kg/day) treated group (LDAT), and high-dose adalimumab (50 mg/kg/day) treated group (HDAT). On the fourth day of the experiment, all rats except for the control group were exposed to H/R followed by euthanasia. Malondialdehyde (MDA), myeloperoxidase (MPO), TNF-α, total antioxidant capacity (TAC), and total oxidant capacity (TOC) were measured in intestinal tissue. TAC and TOC values were used to calculate the oxidative stress index (OSI). Histopathological injury scores (HIS) were also evaluated in the tissue samples. MDA levels were significantly lower in the LDAT and HDAT groups (p < 0.001). TNF-α levels were significantly lower in the LDAT group (p < 0.001). OSI was significantly higher in the H/R group than in the control and LDAT groups (p < 0.001). Mean HIS values in the LDAT group were significantly lower than those in the H/R and HDAT groups (p < 0.001). This experimental study showed that low-dose adalimumab appears to have a beneficial effect on intestinal injury induced with H/R in neonatal rats.

Âmirî, Kitâbu’l-Emed ale’l-Ebed isimli eserinde ruh-beden ilişkisini ele almıştır. Bu makale, felsefî bir problem olarak ölümden sonraki yaşam meselesini, filozof tarafından nasıl ele alındığını ortaya koymayı amaçlamaktadır. İnsan bedenini bir düalite üzerinden ele alan Âmirî’ye göre insan, beden ve nefsten müteşekkildir. İnsan nefsi de ikili bir tasnife tabi tutulmaktadır: Hissî nefs ve nutkî nefs. Cüz’î, mümkün ve zamanî olanı idrak edebilen hissî nefs, var olabilmek için bedene ihtiyaç duymaktadır. Tümel, zorunlu ve ebedî olanı idrak edebilen nutkî nefs, bedene ihtiyaç duymaz ancak onun, bedenle güçlü bir irtibatı vardır. Filozofun bedenle ilişkisini yukarıdaki gibi ifade ettiği nefs türlerinden nutkî nefs, ölümden sonraki süreçle ilişkilendirilmektedir. Kendi başına kâim olan ve var olmak için bedene ihtiyaç duymayan nutkî nefs, ölümle birlikte yok olmamaktadır. Âmirî, yaratıcı fikrine sahip olan her insanın ahiret hayatının varlığını kabul edeceğini dile getirmektedir. İnsanda var olan ebedî mükafat düşüncesi, bu iddiaya gerekçe oluşturmaktadır. Ahiret fikrine sahip olmayan grupların varlığına kısaca işaret eden filozof, ahiret hayatının varlığını kabul edenleri merkeze almaktadır. Bu noktadan hareketle felsefecilerin, diğer dinlere mensup olanların ve Müslümanların konu hakkındaki düşünceleri tartışılmaktadır. Âmirî, bu değerlendirmeleri sırasında Müslümanlar içerinde Mutezile haricindeki grupların görüşlerinde haklılık payı bulduğunu ifade etmektedir. Ancak filozofa göre bu mesele, aslî olarak kutsal kitap merkeze alındığında anlaşılırlık kazanabilecektir.

Objective: In the present study, we investigated the effects of promoter polymorphism and an exon-1 mutation (G71R) in the UGT1A1 gene in neonates with unexplained hyperbilirubinemia and direct Coombs-negative [DC(-)] ABO incompatibility. Methods: Two-hundred term neonates in their first week of life and without additional icterogenic factors were included in the study. Neonates with a serum total bilirubin (STB) level ≥17 mg/dL constituted the hyperbilirubinemia group (n = 100), while the control group comprised healthy neonates with a STB level 0.05). Conclusions: UGT1A1 gene promoter polymorphism and G71R mutation are possible risk factors for Turkish neonates with DC(-) ABO incompatibility and unexplained hyperbilirubinemia. © 2017 Informa UK Limited, trading as Taylor & Francis Group.

Introduction Available research has shown that breastfeeding reduces the frequencies of sepsis, necrotizing enterocolitis, retinopathy of prematurity, and bronchopulmonary dysplasia (BPD), shortens reaching full enteral feeding and hospital stay, and improves neurodevelopment. Although sucking from breast prolongs breastfeeding duration in very low birth weight (VLBW, ≤1500 g) infants, breastfeeding prevalence are still below the target levels. Methods According to unit protocol, all newborns are fed with their mothers’ milk if there is no medical obstacle. Breast milk is given via orogastric tube, bottle or cup to the infants who can not suck from the breast. Orogastric feeding is accelerated through kangaroo mother care, and the application of breast milk smell and taste. Breastfeeding is supported after discharge by educated nurses at outpatient clinic. Data of VLBW infants discharged from our hospital and referred to our outpatient clinic were collected from medical records and their mothers. Feeding practices recorded according to corrected age at discharge and postdischarge were classified in three categories: exclusive breast milk (EBM), exclusive formula, and mixed (a combination of breast milk and formula). Exclusive breast milk and mixed feeding were named as breastfeeding. Results This study included 115 VLBW infants discharged from our hospital (88) and referred to outpatient clinic (27). No significant difference was found between discharged and referred groups in terms of birth weight (1047±272 vs 1046±253 g), gestational age (28±2.9 vs 28±1.5 w), male gender (48.9% vs 51.9%), SGA rates at birth and on discharge [(15.9%, 30.7%) vs (7.4%, 40.7%)], moderate/severe BPD incidence (23.9% vs 40.7%), hospitalization duration (57±27 vs 78.2±31.7d], and mother education (high school% 48,9 vs 66.7%) (p> 0.05). At discharge, EBM (63.7% vs 18.5%) and breastfeeding rates (91.7% vs 77.8%) were significantly higher in discharged infants compared with referred infants (p Conclusion The policies supporting breastfeeding during hospitalization and after discharge increases breastfeeding rates in VLBW infants.

Blackhairy tongue (Lingua villosa nigra) is a benign and asymptomatic clinicalcondition characterized by marked accumulation of keratin on the filiformpapillae. It is rare in childhood. Although the etiology of the disease is notclear, various drugs, infections and poor oral hygiene are consideredresponsible. Here, we present a case of black hairy tongue which is thought tobe due to systemic antibiotic use and candida infection in a nine year old malepatient., Siyahkıllı dil (lingua villosa nigra), filiform papilla üzerinde belirgin keratinbirikimi ile karakterize, benign ve asemptomatik bir klinik durumdur. Çocukluk çağında ender görülür. Hastalığınetiyolojisi net olmamakla birlikte çeşitli ilaçlar, enfeksiyonlar ve kötü ağız hijyeni sorumlu tutulmaktadır. Burada,dokuz yaşında bir erkek hastada sistemik antibiyotik kullanımına ve kandida enfeksiyonuna bağlı geliştiğidüşünülen siyah kıllı dil olgususunulmaktadır.

Objective: Although both delayed umbilical cord clamping and intact umbilical cord milking (I-UCM) provide the effective placental transfusion at birth, these procedures may not be used in neonates needing resuscitation. The aim of this study is to investigate the effect of cut umbilical cord milking (C-UCM), which permits resuscitation during an immediate transition period (ITP). Methods: Sixty-two healthy term infants were randomly divided into C-UCM and I-UCM groups at birth. Approximately 30-cm length of cord was milked towards the baby 2-4 times within 20 seconds after birth in both C-UCM and I-UCM groups while the umbilical cord was cut in the former, and intact in the latter. Heart rate, arterial oxygen saturation (SpO(2)), cerebral regional oxygen saturation (crSO(2)) (2nd-15th min), blood pressure (BP) (within 15-30 min), residual placental blood volume (RPBV), and hemoglobin levels (at the sixth hour) were monitored during ITP. Results: There were no significant differences in terms of mean gestational age (w) [(39.0 ± 1.2) versus (38.8 ± 1.1)], birth weight (g) [(3351.45 ± 254.30) versus (3256.94 ± 285.52)], Apgar scores at the 5th min (10 ± 0 versus 10 ± 0), first breathing time (sec) (5.4 ± 3.8 versus 5.7 ± 4.1), SpO(2), crSO(2), BP (mmHg) [(52.9 ± 6.9) versus (51.8 ± 5.7)], hemoglobin levels (g/dl) [(17.7 ± 1.8) versus (18.4 ± 1.4)], and RPBV (ml/kg) [(23.9 ± 4.7) versus (22.9 ± 5.4)] between C-UCM and I-UCM groups (p > .05). Conclusion: This study showed that C-UCM is as effective as I-UCM on cerebral oxygenation, hemodynamic and hematological adaptation of term infants in ITP. We suggest that C-UCM can provide additional placental transfusion in term neonates exposed to early cord clamping.

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.

Neonatal Bartter syndrome (NBS) is a rare autosomal recessive renal tubular disorder. This disease is characterized by hypokalemia, hypochloremia, and metabolic alkalosis that is often associated with failure to thrive and recurrent episodes of dehydration. The combination of BS and cholelithiasis in an infant is very rare. Herein, we report a premature male infant with NBS who developed cholelithiasis and hydrocephalus on clinical follow up. We recommend that periodic routine hepatobiliary ultrasonograpic screening for cholelithiasis should be performed in patients with NBS.

Objective: Unconjugated bilirubin (UCB) may cause neurotoxicity in preterm neonates due to immaturity of UGT1A1 leading to bilirubin accumulation in the brain. Caffeine used in the treatment of apnea of prematurity was reported to decrease mechanical ventilation requirement, the frequencies of bronchopulmonary dysplasia, patent ductus arteriosus, cerebral palsy and neurodevelopmental disorders in very low birth weight infants. However, the effect of caffeine on hyperbilirubinemia was not yet clarified. Methods: We used astrocyte cell cultures obtained from 2-day-old Wistar albino rats via modified Cole and de Vellis method. UCB concentration toxic to 50% of astrocytes, and caffeine concentration increasing cell viability 100% were used in experiments. While no medication was applied to the control group, UCB (50 μM) and caffeine (100 μM) were applied to the bilirubin and caffeine groups for 24 h. Prophylactic and therapeutic caffeine groups were treated with caffeine 4 h before and after UCB exposure. The effects of caffeine were investigated in rat astrocytes exposed to UCB in terms of cell viability, apoptosis, antioxidant defense, proinflammatory cytokines, and Toll-like receptor (TLR)s. Results: Compared to the control group, UCB increased apoptosis, malondialdehyde (MDA), tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, total nitrate/nitrite, and TLR4 levels, and decreased cell viability, catalase (CAT), glutathione peroxidase (GPx), superoxide dismutase (SOD) activities, glutathione, and TLR9 levels (for all p

Background: Pre-eclampsia (PE) carries an increased risk for maternal and/or fetal mortality or serious morbidity. PE is associated with ischemia and increased oxidative stress in the placenta, which may lead to modification of plasma albumin to ischemia-modified albumin (IMA). The aim of this study was to investigate IMA and hematological parameters in mothers and in premature infants in normal and in pre-eclamptic pregnancies. Methods: Twenty-five pregnant women with PE and their premature newborns were categorized as the PE group, and 25 normotensive pregnant women and their premature newborns as the control group. Preterm infants are classified as small for gestational age (SGA) or non-SGA according to the Fenton preterm growth chart. Serum IMA, complete blood count (CBC), liver function tests (LFT), renal function tests (RFT), albumin, and C-reactive protein were measured in the mothers immediately before birth, and in the cord blood and serum of the newborns at 6 and 24 h after birth. Clinical and demographic data were recorded for both groups. Results: While IMA, LFT and RFT were significantly increased in the PE group compared with the control group, albumin and CBC were significantly lower in the PE group. A total of 40% of PE newborns were SGA, 30% of whom had severe SGA (birthweight

Introduction Congenital intracranial tumours constitute 0.5%–1.5% of childhood brain tumours and most of them are immature teratoma. The cystic or calcified structure of tumour can be evaluated with prenatal ultrasonography, the size/location of tumour can be assessed and differentiated from hematoma with magnetic resonance imaging (MRI). The definite diagnosis can be made with histopathological examination. Even if the tumour is diagnosed prenatally, the prognosis of these tumours is very poor. In this case report, a premature infant, detected a giant intracranial mass prenatally and diagnosed with immature teratoma by histopathological examination postnatally, is presented. Case A 29 week estimated gestational age, twin male fetus were delivered by caesarean section due to congenital brain tumour and hydrocephalus. His Apgar scores were 5/7 and birthweight was 2700 g (his twin weighed 1200 g). On the prenatal ultrasonographic examination at the 23th week, an intracranial mass and ventriculomegaly were observed in one of the twins. At the same week, fetal MRI showed an irregularly contoured mass measuring 27 × 23 mm which caused compression to the third and fourth ventricles on the midline, and dilatation in both lateral ventricles and third ventricle. The mass progressed rapidly (87 × 70 mm) at the 26th week. Macrocephaly (50.5 cm,>95p), prominent cranial vasculature, widening of sutures and appearance of sunset sign in the eyes and low set ears were observed on physical examination. The other system examinations were normal. Haemoglobin was 7.9 g/dL. Cranial tomography showed intracranial calcifications, the mass with hypodense fat densities (9 × 8 cm), hydrocephalus and significant thinning of brain parenchyma. Cranial MRI revealed a large mass measuring 89x95 × 95 mm with haemorrhagic areas and cystic structures, hydrocephalus, an appearance consistent with hydranencephaly. When he was 3 day old, the patient, operated with the preliminary diagnosis of immature teratoma after the consent of the family, died during operation. Histopathology was reported as immature teratoma. Conclusion Even if immature teratoma was diagnosed prenatally, the prognosis of this disease is quite poor, therefore, multidisciplinary team approach including neonatologist, neurosurgeon and also family members should be necessary for the management.

Introduction Cystic changes in the lung due to congenital/perinatal cytomegalovirus (CMV) infection have been reported in a few cases in the literature. In this case report, we presented a preterm infant with congenital CMV infection developed lung cysts during her clinical follow-up. Case A female neonate was delivered by caesarean section at 35 gestational week due to fetal distress. Her birthweight was 1870 g (10-50th percentile) and Apgar scores 7 and 9, first and fifth minutes, respectively. She was transferred to our intensive care unit because of the prematurity and ventriculomegaly. It was reported that fetal ultrasonography revealed bowel hyperechogenicity at the 18th week of gestation. The serologic examination was negative for CMV IgM. Fetal magnetic resonance imaging was normal and fetal karyotype was 46, XX. The lateral ventricles were observed to be dilated in the repeated ultrasonography performed at 34th week. On physical examination she was well-appearing, there was no abnormality except for hepatosplenomegaly (3 cm below costal margin) and bilateral chorioretinitis. She failed auditory-brainstem-response test. Cranial ultrasonography performed after birth revealed bilateral ventriculomegaly and germinal matrix haemorrhage. Complete blood count showed thrombocytopenia. CMV IgM was reactive and CMV PCR was positive (7.60E+4 cp/mL) in serologic examination. Chest radiography was normal. Intravenous ganciclovir therapy was initiated to the patient at the dose of 12 mg/kg/day due to symptomatic congenital CMV infection. At the postnatal 20th day, a cystic lesion was detected in the basal part of the left lung on the abdomen radiography performed for nutrition intolerance and abdominal distension. Thoracic computed tomography revealed pulmonary cavitary lesions, the largest of them was located in the left lower lobe posterior basal segment. No signs of respiratory distress were detected during this period, infection parameters and blood culture were negative. Cystic lesions in the lung regressed during her clinical follow-up. She was discharged with oral valganciclovir treatment when she was 55 days old. Conclusion It should be kept in mind that congenital CMV infection may cause lung cysts.

Introduction Biologically active forms of riboflavin, which is an important factor in myelin synthesis, are important cofactors of carbohydrate, amino acid, and lipid metabolism. The mutations in the riboflavin transporter genes (SLC52A2, SLC52A3) cause riboflavin transporter deficiency (Brown-Vialetto-Van Laere syndrome, BVVLS). BVVLS is a rare neurodegenerative disease that can be treated. Herein, a premature infant, who has signs of hypotonia and right diaphragmatic eventration, and pre-diagnosed spinal muscular atrophy with respiratory distress (SMARD) syndrome, however; patient’s genetic analysis revealed autosomal recessively inherited riboflavin transporter deficiency, is presented. Case A girl infant, referred to our unit at the second day, was born 2400 g at 33 rd week from a consanguineous marriage. Apgar score was 5/7 at 1 st and 5 th minute and she was intubated due to irregular respiration and hypotonia. The history of the patient revealed that the pregnancy was normal and her first brother diagnosed with hypotonic infant and died when he was six months old. Physical examination showed paradoxical respiration, severe hypotonia, decreased deep-tendon reflexes, generalised muscle weakness. Right diaphragmatic eventration was shown on her chest x-ray. Biochemical evaluations, creatine kinase, blood gas, lactate, pyruvate, ammonia, urine-blood amino acids and urine organic acid analysis were normal. Tandem-MS revealed high levels of C5 and C6. SMN1 gene deletion was not detected, so, diagnosis of SMA was excluded. Auditory brainstem response test was normal. The patient was considered as SMARD due to hypotonia and diaphragmatic eventration. A neuromuscular panel which screens 443 neuromuscular disease genes was tested for genetic diagnosis. The patient was extubated when she was 80 days old. She was discharged with enteral tube feeding when she was 110 days old. The patient was diagnosed with BVVLS with mutations in the SLC52A2 gene (c.-110–1G> A, c.297G> C). Oral riboflavin was initiated at the dose of 10–40 mg/kg/day to the patient. Spontaneous movements in the patient’s lower limbs started and swallowing dysfunction regressed with the therapy of riboflavin. She is still under clinical following-up. Conclusion If it could not be diagnosed in hypotonic infants performed to primary investigations, molecular genetic analyses should be kept in mind to diagnosis for rare neuromuscular diseases such as riboflavin transporter deficiency.

Introduction Prune-Belly syndrome (PBS) is characterised by abdominal wall absence/hypoplasia, urinary system anomalies, and bilateral undescended testicle triad. The incidence is one in 30,000–50,000 live births, and 95% of the cases are male. Herein, we introduced a preterm infant with atypical PBS presented with fetal urinary ascite, abdominal wall defect, and bilateral undescended testicle. Case A male twin premature neonate was born 2800 gr (10–50p) at 34 weeks gestation by caesarean section due to preterm labour and fetal distress. His Apgar score is 6 and 8 at postnatal 1 st and 5 th minute. His parents were non-consanguineous. It was learned the presence of fetal ascite at 21 st gestational age. On physical examination, abdominal distension due to fluid, bilateral undescended testicle were detected; abdominal muscles could not be palpated; eye examination and hearing test were normal. The abdominal ultrasonography (US) of the patient showed diffuse ascites, hypoplasia of the abdominal wall muscles, and bilateral testes in the inguinal canal. On his abdominal magnetic resonance imaging, ascites was detected. Transfontanel US, portal vein doppler US and voiding cystourethrography were normal. Echocardiography revealed patent ductus arteriosus, ventricular and atrial septal defect. Pericardial effusion was not observed. There were no anomalies of extremities and vertebra on his radiograms. The patient’s karyotype (male, 46, XY), routine biochemical evaluation, ferritin levels, viral serologies (TORCH, parvovirus B19) and metabolic scans were normal. While urea and creatinine levels were 19 mg/dl and 0.49 mg/dl in the serum, their levels were 23 mg/dl, and 0,55 mg/dl in the ascite fluid evacuated by paracentesis so, ascite fluid was considered urinary ascite in this case. The patient was discharged at 21 days of age. Conclusion Fetal urinary ascite may be seen even if there is no coexisting urinary anomaly in the cases with PBS.

Background and aims Evaluation of the modes of feeding and the influencing factors in the late preterm infants at the corrected age of the 6th month. Methods In our baby-friendly hospital, breastfeeding support is given to all mothers after birth in the obstetrics and gynaecology service, in the neonatal intensive care unit (NICU), and in outpatient clinics during follow-up. The late preterm infants, born in our hospital between May 2015 and May 2016, were included in the study. The demographic and clinical data of infants and their mothers were obtained from their files and the modes of feeding of infants at the sixth month and the influencing factors for successful breastfeeding were learned via telephone or face to face interviews. Breastfeeding in the first hour was considered as ’early breastfeeding’ and feeding only with breast milk at the sixth month was considered as ’successful breastfeeding’. Results In the study, 77 infants monitored in the NICU and 114 infants monitored in the obstetrics service were included. The frequency of late prematurity was 17.1%. Mean birth weight was 2632.67±529.48 g (1060–3790), caesarean sections frequency was 90.6%. Early and successful breastfeeding rates were found as 58.6% and 74.9%, respectively. Types of delivery, maternal age, mother’s education level, working status, monthly income, chronic illness, smoking in pregnancy were not associated with early and successful breastfeeding (p>0,05). Early and successful breastfeeding was significantly lower in the infants born in multiple pregnancies (p=0.004, p=0.0001), monitored in the NICU (p=0.0001, p=0.001), and when their birth weights decreased (p=0.0001, p=0.0001), respectively. Early breastfeeding (p=0.0001) and regularly expressing breastmilk of the mothers whose infants were monitored in the NICU (p=0.006) increased to successful breastfeeding while smoking in the breastfeeding period decreased (p=0.027). It was found that 76.6% of infants monitored in the NICU were breastfed at discharge, 91.7% of them were in successful breastfeeding group. Successful breastfeeding was significantly increased (p=0.0001) when the late preterm infants breastfed at NICU discharge. Conclusion This study showed that early breastfeeding and breastfeeding at NICU discharge in the late preterm infants were significantly increased the successful breastfeeding.

GİRİŞ ve AMAÇ: Büyük çocuklarda sıklıkla üst solunum yolu enfeksiyonu etkeni olan respiratuvar sinsisyal virüs (RSV), süt çocuklarında ve yenidoğanlarda genellikle bronşiolit veya pnömoni gibi alt solunum yolu enfeksiyonu (ASYE) nedenidir. Kronik akciğer hastalığı, konjenital kalp hastalığı ve prematüre doğum ağır RSV enfeksiyonu için önemli risk faktörleridir. Bu çalışmada, ASYE nedeniyle yenidoğan yoğun bakım ünitesi (YYBÜ)’ye yatırılan ve RSV saptanan yenidoğan olgular literatür eşliğinde tartışılarak; yenidoğanlarda RSV enfeksiyonunun önemine dikkat çekilmesi amaçlanmıştır.YÖNTEM ve GEREÇLER: Çalışmada, ASYE tanısı ile Şubat-Mart 2014 tarihleri arasında YYBÜ’ye yatırılan, nazofaringeal sürüntü örneklerinde PCR yöntemi ile RSV saptanan olguların demografik özellikleri, klinik ve laboratuvar bulguları değerlendirildi. BULGULAR: On bir olgunun yedisinin nazofaringeal sürüntü örneği solunum panelinde RSV-A saptandı; bunların birinde rinovirüs birinde ise koronavirüs birlikteliği vardı. Diğer dört olgunun birinde sadece adenovirüs, birinde koronavirüs pozitif saptanmış olup; kalan iki olgunun solunum panelinde etken bulunamadı. RSV-A pozitif olguların üçü prematüre ve ikisi konjenital kalp hastasıydı. ASYE kliniği ile başvuran bu olgularda %28.5 ko-infeksiyon saptandı. Uygun semptomatik tedavi ile kısa sürede şifayla taburcu edilerek ayaktan izleme alındılar.TARTIŞMA ve SONUÇ: RSV enfeksiyonu hem preterm hem de term yenidoğanlarda ASYE'nin önemli nedenlerinden biridir. Prematüre doğum ve konjenital kalp hastalığı olanlarda daha ağır klinik seyir görülse de erken tanı ve uygun tedaviyle başarılı sonuçlar alınabilmektedir., INTRODUCTION: Although respiratory syncytial virus (RSV) is a frequent agent in upper respiratory tract infections in children and adults, it usually causes lower respiratory tract infections (LRTI) such as bronchiolitis or pneumonia in newborns and infants. Chronic lung disease, congenital heart disease and premature birth are important risk factors for severe RSV infection. In this study, newborns hospitalized and treated in neonatal intensive care unit (NICU) due to LRTI and who had an identified infection with RSV were retrospectively evaluated and discussed with literature.METHODS: In this study, demographic and clinical characteristics of newborns admitted in NICU because of LRTI due to RSV infection between February-March 2014 were evaluated. The presence of RSV was investigated with the method of PCR in nasopharyngeal swab specimens of the cases, and the results were compared with clinical and laboratory data.RESULTS: Seven of eleven patients with nasopharyngeal swab specimens were detected RSV-A positive in the respiratory panel, and among these, a rhinovirus concurrence was detected in one patient, and a coronavirus concurrence was detected in another patient. One of the other four cases showed only adenovirus positivity, one patient was detected only coronavirus and the remaining two patients had normal respiratory panel. Three of the RSV-A positive patients were premature and two of them had congenital heart disease. In these cases with the clinical symptoms of LRTI, 28.5% of co-infection was detected. After appropriate hydration and oxygenation, they were discharged with healing in a short time and followed as an outpatient.DISCUSSION AND CONCLUSION: RSV infection is an important cause of LRTI in both preterm and term newborns. Although patients with premature birth and congenital heart disease show more severe clinical course, they can be successfully treated with early diagnosis and appropriate therapy.

Endotracheal intubation is a common daily procedure used for sustaining life in premature and term neonates in the neonatal intensive care unit. This procedure can be associated with some iatrogenic complications. One of these complications is ingesting a laryngoscope light bulb, and it is an extremely rare complication in neonates. The consequences of ingestion or aspiration may be serious and life-threatening. Herein, a male premature neonate, ingested a laryngoscope light bulb during endotracheal intubation because of surfactant replacement therapy, is reported. This case re-affirms the importance of checking the integrity of equipment before intubation effort. © 2015, Turkish Journal of Pediatrics. All rights reserved.

Background: The purpose of this study is to investigate the protective effects of Ginkgo biloba extract (EGb 761) in rat pups with hypoxia/ reoxygenation (H/R)-induced bowel injury. Methods: One-day-old Wistar albino rat pups (n = 21) were randomly divided into 3 groups: group 1 (control, untreated and not exposed to H/R, n = 7), group 2 (untreated but exposed to H/R, n = 7), and group 3 (EGb 761 + H/R, n = 7). Ginkgo biloba extract was administered (100 mg/kg per day, subcutaneously) to group 3 for 3 days. On the fourth day, all animals except controls were exposed to H/R and were killed 6 hours after H/R. Histopathologic injury scores (HIS), malondialdehyde, glutathione (GSH), GSH-peroxidase (Px) activities, and nitric oxide (NO) levels were measured on intestinal samples. Results: Although the control group had normal HIS, group 2 had grade 3 HIS. In contrast, group 3 had minimal HIS, and these results were significantly better than those of group 2 (P < .001). Malondialdehyde and NO levels of group 3 were significantly lower than those of group 2 (P < .01). Glutathione and GSH-Px activities of group 1 were higher than those of groups 2 and 3 (P < .05). However, there were no significant differences for GSH and GSH-Px activities between groups 2 and 3. Conclusions: This study showed that hypoxia and NO contributed to the pathogenesis of H/R-induced intestinal injury and that prophylactically administered EGb 761 had a protective effect on bowel injury. © 2011 Elsevier Inc. All rights reserved.

This study was designed to determine the role of oxidative stress, nitric oxide (NO), and glutathione-related antioxidant enzymes in rat pups with hypoxia/reoxygenation (H/R)-induced bowel injury and to evaluate the potential benefits of prophylactic clarithromycin.One-day-old Wistar albino rat pups (N = 21) were randomly divided into 3 groups: group I (control), group II (exposed to H/R), and group III (clarithromycin + H/R). Clarithromycin was administered (40 mg/kg) subcutaneously to group III for 3 days. On the fourth day, all rats except controls were exposed to H/R and were killed at 6 hours after H/R. Histopathologic injury scores (HIS), malonyldialdehyde, glutathione (GSH), glutathione-peroxidase (GSH-Px) activities, and NO levels were measured on intestinal samples.Whereas there was no difference for malonyldialdehyde levels among groups, HIS and NO levels were higher in group II than groups I and III (P.05). However, GSH and GSH-Px activities were lower in group II than groups I and III (P.05). Clarithromycin significantly increased GSH and GSH-Px activities and reduced HIS and NO levels in group III.This study showed that oxidative stress and NO contributed to the pathogenesis of H/R-induced bowel injury and that clarithromycin had a protective effect on bowel injury owing to anti-inflammatory and antioxidant effects.

Congenital chylothorax, an abnormal accumulation of chylous fluid in the pleural space, is a common cause of pleural effusion in the neonatal period. The traditional management of chylothorax is conservative. Conservative therapy includes chest drainage, cessation of breast feeding, and using of medium chain triglycerides or total parenteral nutrition. Recently, octreotide, a long-acting somatostatin analog reduced lymphatic fluid production, has been used as a new treatment strategy in the therapy of chylothorax. In a full term newborn with right pleural effusion diagnosed by prenatal ultrasound, congenital chylothorax is confirmed after birth. This patient was initially treated with chest tube insertion. Afterward a mediumchain- triglyceride-enriched formula was initiated. Subcutaneous octreotide was administered to the patient because of non-responded to conservative therapy. The chylothorax resolved promptly with no observed side effects. Octreotide appears to have a good safety drug in newborn infants and remains a promising alternative therapy to surgery for intractable cases with chylothoraces. © The Journal of Current Pediatrics, published by Galenos Publishing.

Alcohol intoxication is extremely rare in the neonatal period. Clinical presentation may be occurred by lethargy, tremor, mild fever, hypoglycemia, hypotonia, respiratory depression and coma. Intoxication usually appears as giving the baby alcohol with neglect of family or accident. The basic principle of therapy is support therapy and provision of clinical stabilization of the baby the elimination of alcohol from the body until it does. When the drops of 70% ethyl alcohol that her mother thought the gas drops unintentional was dripped to baby's mouth, lid of drug cover was opened and poured abundantly. Afterward, a 25 days old female case was presented to our hospital emergency service. Her physical examination was normal, serum ethyl alcohol level was 3.12 mg/dl (0.12 per mil). This case, that was provided clinical stabilization and applied only supportive therapy, was discharged four days later. In this report, we wanted to emphasize that family and/or caregivers should be well-trained drug administration in neonates. © The Journal of Current Pediatrics, published by Galenos Publishing.

Objective. - This study was aimed at finding the prevalence, associated factors, and symptomatology of migraine among 5 to 8 grades off secondary and 9 to 11 grades of high school children (age range between 11 and 18 years old) in the Denizli urban area in the western part of Turkey. Background. - Data from the developed countries indicate that migraine is the most common cause of recurrent headaches in children. Also, childhood migraine is sufficiently severe to prevent the half of the suffering children from carrying on their usual daily activities. Methods. - A cross-sectional school-based study was conducted between May 2060 and June 2000. There were 2,490 participants selected by a multistage stratified clustered sampling procedure. A validated self-administered questionnaire designed according to the International Headache Society criteria was given to the school children of age between 11 and 18 years. Results. - Overall migraine prevalence was 8.8%; it was 6.7% in boys and 11.0% in girls (OR: 1.7; 95% CI: 1.3 to 2.3). Among girls, the highest prevalence (17.7%) occurred at 15 years of age, but among boys, the highest prevalence (11.9%) occurred at 16 years of age. Of children with migraine, 56.5% had a positive family history, and only 29.1% visited a doctor for headache. Conclusion. - Migraine is a common health problem among school children in Denizli urban area and it often goes underdiagnosed.

AMAÇ: Bu çalışma ile pnömotoraks nedeniyle hastanemiz pediatri ve çocuk cerrahisi yenidoğan yoğun bakım ünitelerinde tedavi edilen hastaların değerlendirilmesi amaçlanmıştır.YÖNTEMLER: Ocak 2008-Mayıs 2013 yılları arasında tedavi edilen hastaların kayıtları incelenmiştir. Hastaların demografik özellikleri, risk faktörleri, tedavi detayları ve sonuçları değerlendirilmiştir.BULGULAR: Pnömotoraks nedeniyle tedavi edilen 30 (17E, 13K) hastanın ortalama doğum ağırlığı 2497±781 g (800-3900 g), ortalama gebelik yaşı 34.7±3,8 (26-41) hafta idi. Hastaların %63,3’ü prematür olup sezaryen ile doğum oranı %70 idi. %76,7’sinde pnömotoraks ilk 48 saatte meydana gelmiştir. Hastaların 10 (%33,3)’unda doğumda resüsitasyon uygulanmış, yarısında mekanik ventilatörde iken pnömotoraks gelişmişti. Hastaların on ikisinde yenidoğanın geçici taşipnesi, onunda RDS, ikisinde pnömoni ve üçünde konjenital kalp hastalığı var idi. Bir aort koarktasyonu, iki PDA ameliyatı olmak üzere üç hastada postoperatif pnömotoraks saptanmıştır. Pnömotoraks hastaların 12’sinde sağ, 12’sinde sol ve 6’sında bilateral idi. 13 (%43,3) hastaya sürfaktan uygulanmıştır. 27 hastaya toraks tüpü takılmış, üç hasta konservatif izlenmiştir. Ortalama tüp torakostomi süresi 4.9±2,5 (1-11) gün idi. Yalnız üç hasta (%10) kaybedilmiştir.SONUÇ: Hastalarımızda yenidoğanın geçici taşipnesi ve RDS pnömotoraksın en sık nedeni olarak bulunmuş olup mortalite oranının düşüklüğü dikkat çekicidir., OBJECTIVE: The purpose of this study was to evaluate of newborn with pneumothorax treated in neonatal intensive care units in departments of pediatrics and pediatric surgery. METHODS: Newborn with pneumothorax treated from January 2008 to May 2013 were reviewed. Patient demographics, risk factors, details of treatment and outcomes were examined.RESULTS: 30 newborns (17M, 13F) were treated. Mean birth weight was 2497±781 (800-3900) g, and gestational age was 34.7±3,8 (26-41) weeks. 63,3% of patients were premature. Cesarean section rate was 70%. 76.7% of pneumothorax occurred in the first 48 hours of life. 10 patients (33,3%) underwent cardiopulmonary resuscitation at birth. Pneumothorax occured in half of the patients during mechanic ventilation. Twelve patients had transient tachypnea of newborn, ten respiratory distress syndrome, two pneumonia and three congenital heart disease. Postoperative pneumothorax was found in three patients, including two PDA surgery and one aortic coarctation. Pneumothorax was in right hemithorax in 12, in left in 12 and bilateral in six patients. 13 (43,3%) patients administered surfactant. Chest tube drainage was performed in 27 patients and three were treated conservatively. Mean chest tube drainage time was 4.9 ± 2,5 (1-11) days. Only three patients (10%) died.CONCLUSION: The most common risk factors of our patients are transient tachypnea of newborn and RDS. The low mortality rate in our patients is remarkable.

Patent ductus arteriosus (PDA) remains a common problem in premature infants. Treatment options include pharmacologic therapy and surgical ligation, but these are associated with potentially significant adverse effects. This report describes the effect of administering oral paracetamol to premature neonates with PDA. The study enrolled seven premature neonates followed up with the diagnosis of hemodynamically significant PDA (hsPDA) between February and December 2012 and treated with oral paracetamol. Patients with hsPDA were given at least two or more courses of ibuprofen treatment. If this therapy failed to promote ductal closure, the patients with clinical symptoms who had hsPDA defined by echocardiography were treated with oral paracetamol (15 mg/kg every 6 h). If these patients did not respond to paracetamol therapy, the PDA was closed by surgical ligation. The mean gestational age of the seven patients in this study was 26.1 weeks, and their mean birth weight was 936 g. Paracetamol treatment was started at 36.2 ± 11.6 days. The mean internal ductal diameter was 2.0 ± 0.2 mm, and the left atrium-to-aorta ratio was 1.5 ± 0.2. All the patients were administered oral paracetamol because of no response to ibuprofen treatment. The hsPDA was successfully closed with oral paracetamol in five (71.4 %) of the seven patients. The remaining two patients had surgical ligation performed, but one of them died. No side effects related to paracetamol were observed. Oral paracetamol may be used as an alternative drug for the management of hsPDA in premature neonates when ibuprofen treatment is unsuccessful and the only other therapeutic option is surgery. © 2013 Springer Science+Business Media New York.

Yenidoğanın hemolitik hastalığı, maternal eritrosit antikorlarının fetus eritrositlerini direkt etkilemesi sonucu görülen ağır bir durumdur. Çoğunlukla Rh ve ABO uygunsuzluğuna bağlı görülmekle birlikte, nadiren subgrup uyuşmazlığı nedeniyle de karşımıza çıkabilir. Subgrup uyuşmazlığında, hafif hiperbilirubinemiden kan değişimine ihtiyaç gösterecek kadar ciddi hemolitik reaksiyonlar görülebilmektedir. Biz bu yazıda, anti-E’ye bağlı yenidoğanın hemolitik hastalığı gelişen iki olgu sunduk. Birinci olgu, doğumdan sonra yoğun fototerapi ve intravenöz immunglobulin (İVİG) ile tedavi edildikten sonra taburcu edildi. Otuz üç günlükken ağır anemi ve sarılık ile yeniden hastanemize başvuran hastaya eritrosit transfüzyonu, fototerapi ve İVİG tedavisi uygulandı. İkinci olgu, postnatal ikinci gün total bilirubin 21 mg/dL ile hastanemize sevkedildi. Yoğun fototerapi ve İVİG verilen olgunun izleminde hemoliz komplikasyonu gelişmedi. Hemolytic disease of newborn is a severe disease, resulting from maternal red blood cell (RBC) alloantibodies directed against fetal RBCs. This is mostly due to Rh (D), ABO incompatibility and also rarely due to subgroup incompatibility. Mild hyperbilirubinemia to severe hemolytic reactions requiring exchange transfusion therapy can occur in subgroup incompatibility. In this article, we report two patients who developed hemolytic disease of the newborn due to anti-E. Case 1 was treated with intensive phototherapy and IVIG immediately after birth. This case was readmitted to the hospital at 33rd day of life because of jaundice and severe anemia and treated with IVIG, phototherapy and erythrocyte transfusion. Case 2 was referred to our hospital at postnatal second day because of total bilirubin levels of 21 mg/dL. This case was also treated with IVIG, intensive phototherapy and no any complications of hemolysis developed during clinical follow up.

Congenital leukemia is a rare disease. The majority of cases of this disease are acute myelogenous leukemia (AML). Congenital acute lymphoblastic leukemia (ALL) is rare and most often is of B cell lineage. Rarely, some cases have been designated biphenotypic or mixed phenotype acute leukemia (MPAL). Herein, we report a preterm newborn referred to us as a result of the appearance of blue-violaceous dermal nodules on her body at birth. She was a twin and the product of an in vitro fertilization (IVF) pregnancy. Physical examination showed jaundice, hepatosplenomegaly, and peripheral facial nerve palsy in addition to dermal nodules. Bone marrow aspiration showed 40% blasts of lymphoid lineage; skin biopsy and its immunohistochemistry revealed myeloblastic infiltration of the dermis. Cytogenetic analysis (46,XX), fluorescence in situ hybridization (FISH) analysis, and cranial magnetic resonance were normal. The patient was diagnosed with congenital MPAL, and an association between IVF and congenital leukemia was suggested. Copyright © 2013, Taiwan Pediatric Association.

The p63 gene is a transcription factor and a member of the p53 family. Heterozygote mutation of the p63 gene is suggested in a number of human syndromes including limb development and/or ectodermal dysplasia. The EEC syndrome, consisting of ectrodactyly (E), ectodermal dysplasia (E) and cleft lip (C) with or without cleft palate, is the prototype of these syndromes with the presence of heterozygote mutation in the p63 gene in most of the patients. Nonsyndromic split hand/foot malformation (SHFM) is one of the EEC-like syndromes, and the p63 gene mutation was reported in only a few patients. Five different loci have been mapped to date, but the etiology is yet to be explained in the rest of the patients. Here, we report two cases. Case 1, diagnosed with EEC syndrome, had type 2 urogenital sinus and a new heterozygous mutation of 934GA (D312N) in exon 8 of the p63 gene. Case 2 was diagnosed as SHFM with no mutation in the p63 gene. Genotype and phenotype correlation of these two cases among the reported patients is discussed in this report.

Pseudohypoparathyroidism (PHP) is a heterogenous group of disorders characterized by hypocalcemia with hyperphosphatemia, increased serum concentration of parathyroid hormone (PTH), and insensitivity to the biological activity of PTH. Calcinosis cutis, the cutaneous deposition of calcium salts in the dermis, is a rare clinical symptom in infancy. The deposition of calcium in the skin may be classified as dystrophic, metastatic, idiopathic, and iatrogenic. Although a few infants with PHP and calcinosis cutis have been reported, to the authors' knowledge, the combination of neonatal transient PHP and calcinosis cutis associated with calcium treatment has not been previously reported. The authors report a newborn boy with transient PHP presenting with early hypocalcemia, hyperphosphatemia, increased PTH levels, and calcinosis cutis after intravenous treatment of calcium gluconate. © 2011 Dr. K C Chaudhuri Foundation.

The etiology of pathological jaundice can not be identified in almost half of the cases. The effect of promoter polymorphism in the UDP-glucuronosyltransferase 1A1 (UGT1A1) gene was investigated in healthy breast-fed Turkish neonates with unexplained and direct Coombs'-negative ABO incompatible hyperbilirubinemia. Newborns whose peak serum bilirubin levels wereor = 17 mg/dl andor = 12.9 mg/dl within the first week of life formed the idiopathic hyperbilirubinemia (n: 50) and control (n: 54) groups, respectively. Thymine-adenine (TA) repeats in the promoter region of the UGT1A1 gene were investigated by polymerase chain reaction (PCR)-based non-radioactive DNA sequencing. In the idiopathic hyperbilirubinemia group, higher peak bilirubin levels, higher heterozygous and variant homozygous genotypes, higher TA7 allele frequencies, and shorter peak time were observed (p0.001, p0.001, p0.001, p0.05, respectively). In conclusion, healthy breast-fed Turkish neonates who carry heterozygous and variant homozygous genotypes in the UGT1A1 gene are at high risk of developing significant hyperbilirubinemia without additional icterogenic factors.

Congenital cystic adenomatoid malformation (CCAM) is characterized by disorganized, hamartomatous and adenomatoid proliferation of primary bronchiole and occurs with the frequency of 1/11000-1/35000. Histopathologically, there are three types of CCAM, differing in the number and size of the cysts. Usually, surgical management for the symptomatic cases and clinical follow up for the asymptomatic cases are recommended. In this article, a 35-week-old premature infant with CCAM presenting with respiratory distress on postnatal fifth day was reported. A mass covering the 2/3 of the right lung and pushing the mediastinum to the left was determined by the chest radiography and the thorax computerized tomography. When the infant was 12 days old, right upper lobectomy and right lower lobe posterobasal segmentectomy were performed. Histopathologic examination was consistent with CCAM type I. The postoperative period was uneventful. On account of this patient, the importance of early surgical treatment for the symptomatic cases with CCAM was emphasized. © 2010 by Türkiye Klinikleri.

Methyldopa is known to cause the production of autoantibodies against red blood cells (RBCs), leading to a positive direct antiglobulin test (DAT) and hemolytic anemia. In about 20% of patients taking methyldopa, IgG autoantibodies develop against RBCs. However, most of the patients do not have hemolysis. A small percentage of such DAT-positive patients, about 2% of those taking methyldopa, develop an autoimmune hemolytic anemia (AIHA). The fact that the DAT is positive in the newborn with unconjugated hyperbilirubinemia is considered as an isoimmune hemolytic disease caused by blood group incompatibility. In this article, a newborn with jaundice and positive DAT without hemolysis is reported. Her mother had the history of taking methyldopa in her pregnancy. Thus, when newborns are detected with positive DAT and jaundice, without blood group incompatibility, mothers should be questioned regarding drugs used in their pregnancy.