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Background Complete blood cell (CBC) counts and neutrophil-to-lymphocyte (NLR), lymphocyte-to-monocyte (LMR), and platelet-to-lymphocyte ratios (PLR) are simple measurements that are conducted as part of routine diagnostic procedures. Objective To determine the diagnostic importance, specificity, and sensitivity of these measurements for the diagnosis of neonatal infections and in discriminating between neonatal sepsis and various other infections. Methods We conducted a retrospective study of data from a consecutive series of 232 neonatal patients admitted to Yildirim Beyazit University Yenimahalle Training and Research Hospital in Ankara for 2 years from 2016 to 2018. We included patients with a diagnosis of or clinically suspected infection, and healthy neonates were included as controls. Data included CBC counts, and bacterial culture results, considered the criterion standard for the diagnosis of neonatal sepsis. NLR, LMR, and PLR were calculated. We compared data using independent Student t and Mann–Whitney U tests and determined the sensitivity, specificity, and likelihood ratio (LHOR) of the characteristics for neonatal sepsis using receiver operating characteristic curve analyses. Results We included data from 155 neonatal patients with a diagnosis or suspicion of infection and 77 healthy neonates. NLR was significantly higher in neonates with sepsis or fever due to dehydration (P < 0.001) than in neonates with other infections or healthy neonates. LMR was significantly higher in neonates with sepsis or viral infection than in those with other infections or healthy controls (P = 0.003). In neonates with early-onset sepsis (EOS), we found cut-off values of ≥4.79 [area under curve (AUC) 0.845, 95% confidence interval (CI) 0.76–0.93, LHOR 11.6, specificity 98.7%, sensitivity 15%] for NLR, ≥1.24 (AUC 0.295; CI 0.18–0.41, LHOR 1.02, specificity 2.6%, sensitivity 100%) for LMR, and ≥37.72 (AUC 0.268; CI 0.15–0.39, LHOR 0.86, specificity 7.8%, sensitivity 80%) for PLR. We found cut-off values of ≥4.94 (AUC 0.667; CI 0.56–0.77, LHOR 4.16, specificity 98.7%, sensitivity 5.4%) for NLR and ≥10.92 (AUC 0.384; CI 0.26–0.51, LHOR 6.24, specificity 98.7%, sensitivity 8.1%) for LMR in those with late-onset sepsis (LOS). Conclusions CBCs, NLR, LMR, and PLR may be useful for the differential diagnosis of EOS and LOS, and neonates with sepsis from those with other infection. NLR may be a useful diagnostic test to identify neonatal patients with septicemia more quickly than other commonly used diagnostic tests such as blood cultures. NLR has high specificity and LHOR, but low sensitivity.

Objectives This study aimed to assess awareness of anesthesiologists and neonatologists about oral complications occurring during and after the orotracheal intubation (OTI) in premature infants and their knowledge and behavior regarding protection methods from these complications in clinical practice. Methods This study included 94 neonatologists and 137 anesthesiologist. The final version of the questionnaire included 15 items in three main parts: (i) personal information; (ii) awareness about oral complications occurring during and after the OTI in premature infants; (iii) knowledge and behavior regarding protection methods from these complications in clinical practice. Results A total of 95.7% of neonatologists and 83.2% of anesthesiologists were aware of oral complications related to OTI. The most common complications the anesthesiologists encountered were oral, laryngeal, or pharyngeal region injuries (60.7%) and palatal groove (52.2%) for the neonatologists. The most preferred method for stabilization of the orotracheal intubation tube (OTT) was bonding to the perioral region with an adhesive tape (98.3%). The primary determining factor in the choice of OTT stabilization method was the ease of use (28.2%). A total of 23.8% of the participants were aware of the palatal stabilization device (PSD), whereas only 1.3% used it in their routine and 57.1% of them believed it can prevent complications. Conclusions The results showed that neonatologists were more aware of the OTI-related oral complications than anesthesiologists. The knowledge of the participants regarding prevention of these complications is insufficient. Study participants believe in the efficacy of PSD but do not use it in clinical practice for a number of reasons.

To determine the D-dimer reference intervals in the neonatal period.The research had been carried out in the obstetrics and gynecology clinic and neonatal outpatient clinic of a third level hospital. Healthy term newborns aged between 1 and 28 days were enrolled in the study. Venous blood samples were collected from peripheral veins in all babies and D-dimer, prothrombin time, activated partial thromboplastin time and platelet counts were measured. Reference intervals for D-dimer in the neonatal period were determined using 2.5th and 97.5th percentile values.A hundred and thirty four newborns (71 boys, 63 girls) were enrolled in the study. Mean D-dimer levels of infants aged 1-28 days was 1.74 ± 1.88 mg/L (reference range; 0.25-2.81 mg/L). D-dimer levels were between 2.44 and 2.45 mg/L, 1.71-1.76 mg/L, 1.26-0.89 mg/L and 0.88-0.66 mg/L in the first, second, thirth and fourth week of life,respectively. D-dimer values inversely correlated with postnatal age (r:-0.3, p 0.001). However, it remained above adult levels even in the last week. There was no statistically significant difference between the D-dimer levels of girls (1.93 ± 2.06 mg/L) and of boys (1.57 ± 1.71 mg/L).In this study, D-dimer levels in the neonatal period were found to be higher than adult levels stated in the literature. D-dimer levels gradually decreased overtime in the first month. It would be appropriate to use age-specific reference values in the evaluation of D dimer levels in the neonatal period.

Objectives: During breastfeeding, there are two natural hand positions used most often by the mother to introduce her breast to the baby (palmar grasp [C-hold position] and scissor grasp)....

Objective: The group of Herreros Fernández developed a new, safe, quick, and successful technique for collecting midstream clean-catch urine(MS-CCU) in newborns based on bladder stimulation and lumbar paravertebral massage maneuvers. The purpose of this study was to compare the contamination rates of catheter specimen urine (CSU) and MS-CCU by a lumbar/sacral stimulation technique in newborns. Materials and Methods: Full-term newborns ranging in age from 2 to 28 days who needed an investigation for a presumed urinary tract infection (UTI) were included in the study. Two samples, MS-CCU by lumbar/sacral stimulation technique and CSU, were collected consecutively for each patient. Suitable samples were obtained from 90 patients. Results: The contamination rate in MS-CCU cultures (n = 24/90, 26.66%) was higher than in CSU cultures (n = 9/90, 10%), and the difference was statistically significant (p = 0.039). Thirteen patients had UTI according to both samples (14.14%). In urine analysis, while there was no statistically significant difference in bacteriuria (p = 0.61) and nitrite positivity (p = 0.14) between patients with and without UTI, pyuria (p = 0.01) and leukocyte esterase positivity (p = 0.01) were higher in patients with UTI, and the difference was statistically significant. Conclusion: The contamination rate in MS-CCU cultures was two and a half times greater than in the CSU culture samples. Thus, MS-CCU cannot replace the catheter for the diagnosis of UTI.

Amaç: Doğumsonrası süreçte annelerde gözlenen depresif duygu-durum değişiklikleri anne,bebek ve toplum sağlığı bakımından önemlidir. Postpartum depresyon içingeliştirilen tarama testlerinin klinik kullanımları hastalığın önlenmesi, hastabireylerin erken tanınması ve tedavi edilmesinin sağlanması için önerilmektedir.Bu çalışma ile annelerde postpartum depresif duygusal bozukluklar üzerine etkieden risk faktörlerini ve depresif duygusal bozuklukların emzirme üzerineetkilerini değerlendirmek amaçlanmaktadır. Yöntem: ÇalışmayaNisan 2018- Ekim 2018 tarihleri arasında hastanemizde doğum yapan ve çalışmayakatılmayı kabul eden anneler ve bebekleri dahil edildi. Bu çalışma için yereletik komiteden onay alındı. Çalışmayakatılan annelerin yaşları, gebelik ve doğum sayıları, doğum şekilleri, maddidurumları, eğitim düzeyleri, eş destekleri, bebeklerinin cinsiyetleri, doğumağırlıkları ve gestasyon haftaları, bebeklerin başvuru sırasındaki vücutağırlıkları, beslenme şekilleri vehastane yatışlarının olup olmadığı kaydedildi. Tüm annelere EPDS testi ilepostpartum depresyon taraması yapıldı.Sonuçlar:Çalışmaya 100 anne- bebek çifti katıldı. Annelerin yaşları median 29 (19-39) ve çalışmada spontan vajinaldoğum oranı % 48 idi. Bebeklerin oğumağırlıkları median 3300 gr ( 1700 gr – 4500 gr), gestasyon haftaları median 38 hafta ( 34 hafta-41 hafta) idi.EPDS skorunun 10’un üzerinde olması ile anne yaşının büyük olması, anne sütüneek olarak mama verilmesi, gebelikte kayıp öyküsünün olması ve bebeğin hastanedeyatışının olması arasında istatistiksel olarak anlamlı pozitif ilişki saptandı.EPDS skoru 10’un altında olan 58 annenin 48’inin (%82,7) bebeklerini sadeceanne sütü ile beslediği, EPDS puanı 10 ve üzerinde olan 42 annenin 27’sinin (%64,2) bebeklerini sadece anne sütü ile beslediği saptandı. Bu farkistatistiksel olarak anlamlı bulundu ( p= 0,035).Tartışma:Postpartum depresyon açısından risk taşıyan bireylerin önceden belirlenmesi, buanneler için psikososyal desteğin daha erken ve güçlü verilmesi bakımındanönemlidir. Postpartum depresyon gelişimin önlenmesi bebeklerin anne sütü ilebeslenme oranlarını artıracaktır., Aim: Maternal depressive changes in postpartum period are important for mother, infant and community health. The clinical use of screening tests developed for postpartum depression is recommended for prevention of disease, early diagnosis and treatment of patients. The aims of this study are to evaluate the effective risk factors on postpartum depressive emotional disorders in mothers and to evaluate the effects of depressive emotional disorders on breastfeeding.Method: Between April 2018 and October 2018, mothers who gave birth in our hospital and who agreed to participate in the study and their babies were included. Approval was obtained from the local ethics committee for this study. Age of mothers, numbers of pregnancies and births, forms of birth, financial conditions, education levels, partner supports, genders of infants, birth weights and gestational weeks, the body weight of infants at the time of application, feeding patterns and whether or not hospitalizations were recorded. All mothers were screened for postpartum depression by EPDS test.Results: 100mother-infant couples participated in the study. Median ages of mothers was 29(19-39) and spontaneous vaginal birth rate was 48%. The median weight of theinfants was 3300 g (1700 g - 4500 g) and gestational weeks were median 38 weeks(34 weeks - 41 weeks). There was a statistically significant positivecorrelation between the EPDS score of more than 10 and maternal age, feeding ofbreast milk, the history of loss of pregnancy and the hospitalization of thebaby. It was found that 48(82.7%) of 58 mothers with EPDS score less than 10 had only breast milk and 27(64.2%) of 42 mothers with EPDS score of 10 or higher fed their babies onlywith breast milk. This difference was statistically significant (p = 0.035).Conclusion:The prediction of individuals at risk for postpartum depression is importantfor providing early and strong psychosocial support to these mothers. Preventionof postpartum depression will increase the feeding rate of infants with breastmilk.

Objectives: The aim of this randomised study was to investigate whether early or late clamping of the cord influences the status of micro-elements and thyroid hormone levels in newborns. Material and methods: The study participants were randomised into two groups: Group 1, in which cord clamping was performed within 10 s (n = 32) and Group 2, in which clamping was performed at the 60 th second (n = 28). Sociodemographic parameters were recorded; maternal and neonatal levels of free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulant hormone (TSH), urinary iodine concentration levels (UIC) folate and vitamin B12 were measured. Results: Of the maternal and neonatal thyroid hormone values examined, a significant difference was determined between the groups only in respect of the FT4 and FT3 values of the newborns in the first 24 hours (p = 0.037, p = 0.009, respectively). The FT4 values in the first 24 hours were determined to be lower than normal in 15.6% (n: 5) of the newborns in Group 1 and in 0% of Group 2. The FT3 values in the first 24 hours were determined to be lower than normal in 62.5% (n: 20) of the newborns in Group 1 and in 28.5% of Group 2. Vitamin B12 values below the normal limit were determined at a significantly higher rate in Group 1 (p = 0.009). A statistically significant positive correlation was observed between the maternal and neonatal vitamin B12 levels (r: 0.334, p = 0.009). Conclusions: Late clamping of the umbilical cord may contribute to erythrocyte synthesis by allowing passage of vitamins such as B12 and folic acid to the newborn.

This study was conducted to determine the neutrophil/lymphocyte ratio, lymphocyte/monocyte ratio, platelet/lymphocyte ratio; and to evaluate the effect of phototherapy on the peripheral blood cells in newborns with indirect hyperbilirubinemia. A total of 180 newborns consisting of 119 hyperbilirubinemic newborns, who received phototherapy; and 61 healthy newborns were included in the study. A statistically significant difference was present only between the patient group and healthy newborn white blood cell values after phototherapy. The differences found for pre-phototherapy neutrophil/lymphocyte ratio and lymphocyte/monocyte ratio values were statistically significant, but no statistical significance was present for the values after phototherapy. These results suggest that phototherapy may have an effect on peripheral blood cells by directly decreasing both the cytokine and bilirubin levels. The decrease in neutrophil/lymphocyte ratio and lymphocyte/monocyte ratio after phototherapy could potentially be used in the evaluation of phototherapy's effect on peripheral blood cells. New studies on this subject are, therefore, required. Key Words: Newborn, Phototherapy, Inflammation, Peripheral blood cells.

Objectives: We wanted to investigate whether hyperbilirubinemia (significant or physiological) has an effect on breastfeeding, milk intake, infant's wakefulness, and if any, which level of bilirubi...

Amac: Calismada, AB0 uygunsuzluguna bagli indirekt hiperbilirubinemi (IHB) gelisen yenidoganlarda, fototerapi gereksinimini ilk gun saptayabilecek belirtecler arastirildi. Gerec ve Yontemler: Anne-bebek arasinda AB0 uygunsuzlugu olan, zamaninda dogmus, ek hastaligi olmayan saglikli yenidoganlar ileriye donuk izlem amaciyla calismaya alindi. Olgularin ilk 6. ve 24. saatlerinde hemoglobin (Hgb), bilirubin ve laktat dehidrogenaz (LDH) duzeylerine bakildi. Olgularin ilk 15 gun Bhutani nomogramina uygun siklikta serum bilirubin duzeyleri takip edildi ve fototerapi gereksinimi Amerikan Pediatri Akademisi’nin onerdigi sinirlar kullanilarak belirlendi. Fototerapi sinirini gecerek fototerapi uygulanan bebeklerle, fototerapi sinirinin altinda kalanlarin sonuclari karsilastirildi. Bulgular: AB0 uygunsuzlugu nedeniyle calismaya alinan 83 bebekten 18’inde B0 (%21.7), 65’inde (%78.3) A0 uygunsuzlugu saptandi. Bebeklerin 44’unde (%53) direkt antiglobulin testi (DAT) pozitifti. DAT pozitif olan yenidoganlarin 13’u (%33.3), DAT negatif olanlarin ise 12’si (%27.3) izlemde IHB nedeniyle fototerapi aldi. Iki grup arasinda yatis sikligi acisindan anlamli fark yoktu (p=0.58). Indirekt hiperbilirubinemi nedeniyle fototerapi uygulanan ve uygulanmayan gruplar arasinda 6. ve 24. saat Hgb ile LDH duzeyleri arasinda anlamli fark saptanmadi (p>0.05). Ancak, fototerapi gereksinimi olan hiperbilirubinemili bebeklerde 24. saat bilirubin duzeyleri, fototerapi ihtiyaci olmayanlara gore daha yuksek bulundu (p=0.03). Sonuc: Yenidoganlarda AB0 uygunsuzluguna bagli IHB nedeniyle fototerapi gereksiniminin belirlenmesinde, 24. saat Hgb, DAT ve LDH duzeylerinin prediktif degeri yoktur, ancak 24. saat bilirubin duzeyi prediktif olabilir. AB0 uygunsuzluguna bagli hemolitik hastalik spektrumunun genis olmasi nedeniyle, AB0 uygunsuzlugu olan yenidoganlarin yakin izlenmeleri gerektigi dusunulmustur.

Objective To investigate the effect of phototherapy (PT) on WBC parameters and neutrophil volume, conductivity and scatter (VCS) parameters. Study design Comparative cross-sectional study. Place and duration of study Kecioren Training and Research Hospital, Turkey, from October 2016 and January 2017. Methodology Term newborns who had received PT for indirect hyperbilirubinemia were inducted. Total serum bilirubin, neutrophil, eosinophil, basophil, monocyte, lymphocyte counts, and neutrophil VCS parameters before and after PT were compared. Results The mean age of the neonates at admission was 6.05 ±3.7 days. The mean gestational age at the time of birth was 37.44 ±2.09 weeks. The mean duration of PT was 46.37 ±17.00 hours. PT was associated with a significant increase in eosinophil (p=0.039) and basophil counts (p=0.034), a significant decrease in leucocyte (p=0.036) and neutrophil counts (p=0.031). There was no significant change in monocyte (p=0.79) and lymphocyte counts (p=0.93). There was a significant decrease in neutrophil volume values and a significant increase in neutrophil scatter values after PT. There was no effect of PT on neutrophil conductivity values. Conclusion PT affects some WBC components and neutrophil volume and scatter parameters. There is a need for further prospective clinical researches on this topic before starting to use neutrophil VCS parameters in the diagnosis of sepsis.

Hyperhomocysteinemia is a known risk factor for cerebrovascular, peripheral vascular, coronary heart disease, and thrombosis. Several data related to total homocysteine concentrations for children and adolescents were reported from different populations. But no data are available comparing homocysteine levels analyzing according to age ranges in Turkish children. So, we aimed to achieve a reference range for total homocysteine in Turkish children. Plasma total homocysteine concentrations were measured in 177 healthy children within three groups according to age range (1-6, 7-11, 12-17 y). Mean tHcy concentrations were determined (7.77 ± 4.13 μmol/L). Homocysteine were lowest in younger children and increased with age: 1-6 y (3.87 ± 1.44 μmol/L), 7-11 y (8.70 ± 1.40 μmol/L), and 12-17 y (13.54 ± 1.49 μmol/L). We observed no significant differences in tHcy values between girls and boys in all groups. We suggest that total homocysteine levels must be evaluated in children according to age.Hiperhomosisteinemi serebrovasküler, periferik vasküler, koroner kalp hastalıkları ve tromboz için bilinen bir risk faktörüdür. Total homosistein düzeyleri ile ilgili olarak farklı topluluklarda çocuk ve erişkinlerden çeşitli bildirimler yapılmıştır. Ancak Türk çocuklarında belirli yaş aralıklarında homosistein düzeylerini karşılaştıran çalışma yoktur. Bu nedenle, biz Türk çocukları için referans aralıklarını belirlemeye çalıştık. Sağlıklı 177 çocuk, yaş aralıklarına göre (1-6, 7-11 ve 12-17) gruplandırıldı ve plazma total homosistein düzeyleri (tHcy) ölçüldü. Ortalama tHcy belirlendi (7.77 ± 4.13 mmol/L). Homosistein genç çocuk ve adölesanlarda düşük iken yaşla artmakta idi. 1-6 y (3.87 ± 1.44 mmol/L), 7-11 y (8.7 ± 1.4 mmol/L) ve 12-17 y (13.54 ± 1.49 mmol/L). Tüm gruplarda erkek ve kız çocuklar arasında fark saptamadık. Bu verilere göre çocuklarda homosistein düzeyleri yaşa göre değerlendirilmelidir.