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Introduction: Nasal continuous positive airway pressure (nCPAP) is one of the most commonly used non-invasive ventilation modes in neonates with transient tachypnea of the newborn (TTN). Non-invasive high frequency oscillatory ventilation (nHFOV) is an non-invasive ventilation mode that has been increasingly used in neonatal respiratory disorders. Based on the unique physiologic advantages that nHFOV offers, we hypothesized that nHFOV might result in a decrease in the duration of non-invasive positive pressure ventilation in neonates with TTN. Methods: Late preterm and term infants > 34 weeks’ gestation were included in the study. Infants were randomized into nHFOV or nCPAP groups. Treatment was started with standard settings in both groups. Infants who met treatment failure criteria were switched to nasal intermittent mandatory ventilation for further positive-pressure support. Results: Total of 60 infants were included in the study. Thirty of these infants were included in the nHFOV group and 30 were included in the nCPAP group. There was no difference between the groups in terms of duration of positive-pressure ventilation; however, it showed a decreasing trend in the nHFOV group (21 hours, IQR [16-68] vs 15 hours, IQR [11-33]; p=0.09). After adjusting for confounders, the nHFOV group had a shorter duration of positive-pressure ventilation compared with the nCPAP group (mean difference: 16.3 hours; 95% confidence interval [CI], 0.7 to 31.9; p=0.04). Conclusion: Non-invasive high frequency oscillatory ventilation can shorten the duration of positive-pressure ventilation and supplemental oxygen in TTN.

This study investigates the contribution of the sense of the uncanny to the intensification of mystery in Edgar Allan Poe’s short story titled “Morella” using Freudian ideas as a backcloth. This paper aims to look at how Poe makes use of the psychodynamics of the characters at the intersection of the (m)other, death and the uncanny. In this sense, typical of Poesque literature is that his work is marked by tales of horror, mystery, the macabre, and morbid imagery; the sense of the uncanny is an indispensable part of a plotline which includes semantic loopholes and narrative ruptures. The unnamed male narrator of the story offers a retrospective account of his past memories from his marriage to Morella up to the death of his daughter, which reveals that this unreliable narrator suffers from a psychic regression by establishing intrasubjectivity with his wife. Using Freudian ideas as the conceptual backcloth, this paper will also discuss the ways in which how the mysterious bond established between this couple generates its uncanny effect. Such a reading of the short story is especially useful because although much has been written on Poe’s representation of women and death, this paper aims to open up a discursive space to discuss the operations of the psychodynamics of characters within the framework of the Freudian uncanny, which has not received adequate scholarly attention from psychoanalytic circles.

BackgroundWe report our initial experience with the CatchView (CV) thrombectomy device in patients with acute ischemic stroke (AIS).MethodsA retrospective analysis of 53 of 284 AIS patients (mean age 66.6±14.8 years, range 37–94) treated with a CV device between January 2019 and February 2020 was performed. The baseline characteristics (gender, age, comorbidities, National Institutes of Health Stroke Scale (NIHSS) score, intravenous tissue plasminogen activator (IV-tPA) administration, and occlusion localization) of these subjects were recorded. Modified Thrombolysis in Cerebral Ischemia (mTICI) scores of 2b and 3 were considered to indicate successful recanalization, and subjects with a modified Rankin Scale score of ≤2 on day 90 was considered a good clinical outcomes.ResultsThe mean NIHSS score was 12.3±3. Successful recanalization was achieved in 45 subjects (84.90%), and the rate of good clinical outcomes on day 90 was 43.39%. The secondary distal embolus rate was 5.66%. Symptomatic hemorrhage was observed in 3.77% of the subjects, and the mortality rate was 13.2%.ConclusionsMechanical thrombectomy devices include a wide array of endovascular tools for removing clots in AIS patients. In terms of successful recanalization and good clinical outcomes on day 90, our initial experience with the CV devices was encouraging.

Objectives: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly of the diaphragm with pulmonary hypoplasia and persistent pulmonary hypertension and has serious consequences. Despite recent diagnosis and treatment strategies, CDH is still a challenging condition. We aim to present our clinical experiences of CDH, and review of the literature. Methods: Data of CDH patients who were operated in our clinic between January 2010 and September 2018 were obtained from the patient's chart. The clinical course and results of the patients with Bochdalek type CDH were reviewed. Results: We performed diaphragmatic closure in 16 patients with Bochdalek CDH during study period. Fourteen (82%) cases were diagnosed antenatally. In 5 (29%) patients, preoperative pulmonary hypertension developed and nitric oxide was administered. Twelve of the sixteen patients (75%) underwent primary repair and 4 of them underwent prosthetic patch. Three patients were repaired thoracoscopically. Five (31%) patients died due to severe persistent pulmonary hypertension on postoperative period. There was no recurrence in our patients who were followed-up for a mean of 27 months. Conclusion: In the management of Bochdalek CDH, the clinical success has been increasing in parallel with the important developments with the application of new treatment modalities in the neonatal intensive care units and new surgical techniques in recent years.

Late-onset sepsis (LOS) remains an important cause of morbidity and mortality in preterm infants. In this study, our aim was to investigate the red-cell distribution width (RDW) levels during a LOS episode, and its association with the type of growing microorganism and mortality.Preterm infants with culture-proven sepsis during their neonatal intensive care unit stay were enrolled. Red-cell distribution width levels were obtained in the first 4 h of postnatal life and at the onset of the LOS episode, and compared for these time frames. The study cohort was divided into two groups according to the type of the growing microorganism. The RDW levels were then assessed in intra- and inter-group analyses.Eighty-six infants were included in the final analysis. RDW levels were increased in the study cohort after a LOS attack (P0.001). Infants with Gram-negative sepsis showed a significant increase in their RDW levels, but they remained unchanged in infants with Gram-positive sepsis (P0.001 and P = 0.4, respectively). An RDW cut-off of19.50% was related with a sensitivity of 87% and a specificity of 81% for predicting late-onset Gram-negative sepsis (P0.001). Logistic regression analysis showed a positive association of RDW with mortality when adjusted for covariants (adjusted odds ratio: 1.40; 95% confidence interval: 1.02-1.80; P = 0.03).Our findings show that RDW levels increased during a LOS episode in preterm infants, which was especially evident in Gram-negative infections. We believe that these findings may be of importance in the early diagnosis and prognosis of LOS in preterm infants.

Autoimmune encephalitis (AIE) and paraneoplastic syndromes (PNS) are both rare groups of neurological diseases that are difficult to diagnose.We aimed to determine the common and distinct aspects of these two aetiologies of encephalitis as well as the characteristics of our patient group.We respectively analysed the records of the patients including symptoms, demographic features, neurological examination, cranial-magnetic-resonance-imaging (MRI), electroencephalography (EEG) findings, cerebrospinal fluid results (CSF) findings. Autoimmune/paraneoplastic autoantibodies in blood and/or CSF were all documented.Forty-six patients fulfilled the diagnostic criteria. Thirty-eight of them were diagnosed with AIE, and 8 of them were diagnosed with PNS. The PNS group had higher nonconvulsive status epilepticus than the AIE (2/8 vs 0/38; p=0.027). PNS patients were diagnosed with a malignancy in their follow-ups more than those in the AIE group [4/38 vs 8/8] (p0.001). When the symptoms of antibody-positive and negative patients were compared in the AIE group, the rates of consciousness/memory problems (13/15 vs 11/23; p=0.020) and speech impairment (8/15 vs 2/23; p=0.004) were significantly higher in patients without antibodies (n: 15) than in antibody-positive patients (n: 23). In antibody-negative groups, the rates of memory problems in neurological examination (13/15 vs 12/23 p=0.028) and temporal findings on electroencephalography were more prominent than antibody-positive groups (1/23 vs 5/15; p=0.027). The number of patients with cerebellar signs was higher in antibody-positive patients (6/23 vs 0/15; p=0.038).Although the positivity of autoantibodies is critical in the diagnosis of AIE and PNS, even minor differences in clinical and laboratory findings of patients are helpful in the diagnosis, especially in the autoantibody-negative patients. Comparing the data with other population studies has shown that several inherited and environmental factors may contribute to the pathophysiology of AIE and PNS, as well as clinical and laboratory differences.

Introduction: This study aimed to determine the association between serum mannose-binding lectin (MBL) levels, gene polymorphisms and late-onset sepsis (LOS) in preterm infants. Methods: Infants with

Introduction: Glutathione synthetase (GSS) deficiency is an autosomal recessive disorder (frequency < 1/1,000,000) with different varyingly severe clinical manifestations that include metabolic aci...

Achondrogenesis is a group of rare and fatal disorders occurring in approximately one in every 40,000-60,000 newborns. Achondrogenesis is classified in three groups, as Achondrogenesis type 1A (Houston-Harris type or AC-G1A), Achondrogenesis type 1B (Parenti-Fraccaro type or ACG1B) and Achondrogenesis type 2 (Langer-Saldino type or ACG2), depending on clinical and radiological findings. Achondrogenesis Type 2 is a lethal skeletal dysplasia that is typically characterized by short arms and legs, a small chest with short ribs, lung hypoplasia, a prominent forehead, a small chin, and an enlarged abdomen that may accompanied by polydramnios and hydrops. This study contributes to the literature by presenting a patient who was admitted to the Level ΙΙΙ Neonatal Intensive Care Unit (NICU), Bursa, Turkey), with extremely short extremities, a small chest, abdominal distention and respiratory distress, who was diagnosed with ACG2. On the COL2A1 gene, genetic analysis with next generation sequencing (NGS), was revealed to have a heterozygous missense variation, c.2546G>A, p.Gly849Asp mutation, which is a different genetic variant that has not been previously described in the literature.

Objective: Preterm infants are prone to increased bilirubin burden and display adverse outcomes if left unmonitored; therefore, predicting an increased bilirubin production is of paramount ...

Introduction: We investigated the association between low 25-hydroxyvitamin D (25-OHD) levels and late-onset sepsis (LOS) in preterm infants (

Background Various non-pharmacologic methods are used to alleviate pain in preterm infants who spend their first days in neonatal intensive care units (NICU) because they are exposed to numerous painful interventions. Objective To determine the effects of Yakson and Gentle Human Touch (GHT) methods on pain and physiologic parameters during heel lancing procedures in preterm infants. Design and methods This was a randomised controlled trial. The study was conducted in a NICU between June 2018 and June 2019. A total of 90 preterm infants were divided into three groups: 30 infants in the Yakson group, 30 infants in the GHT group, and 30 infants in the control group. All preterm infants were randomly divided into groups. Pain responses were evaluated using the Neonatal Infant Pain Scale. Results It was found that pain scores and heart rates were significantly lower during and after heel lancing in preterm infants in the Yakson and GHT groups than in the control group, the difference was statistically significant (p Practical implications Yakson and GHT applied to preterm infants during heel lancing has positive effects on pain and physiologic parameters.

Hemifacial spasm (HFS) is a chronic disease that is characterized by involuntary tonic and clonic contractions of the muscles innervated by the ipsilateral facial nerve. Botulinum toxin (BTX) is the most effective medical treatment of this condition. The aim of our study was to evaluate stigma among patients diagnosed with HFS and to search quality of life and depression before and after BTX injection. Seven self-rating items (HFS-7) and seven questions related to stigmatization were administered to HFS patients. Participants also answered SF-36 health outcome measure and Beck depression inventory before and 4 weeks after the routine BTX injection. The severity of HFS was graded based on a five-point scale. Descriptive statistics and paired t test were applied. The level of significance was set at α = 0.05. Fourty HFS patients were prospectively included. Twenty-one (%52.5) were female and nineteen were male (47.5%) with a mean age of 57.1 (SD = 12.13; min–max = 27–78). 60% (n: 24) of patients were feeling themselves different from people without HFS. Beck depression inventory scores improved after BTX injection significantly (p

Background and purpose The aim of this study was to assess the impact of early stage of idiopathic Parkinson's disease (IPD) on caregiver burden with disease severity, duration, disability and psychiatric symptoms. Methods 30 IPD patient (15 female, 15 male) - caregiver (18 female, 12 male) pairs participated in the study. Hoehn and Yahr (H-Y) scale was used to provide the assessment of disease progression and Unified Parkinson's Disease Rating Scale (UPDRS) was used for assessing disability and impairment. Zarit Caregiver Burden Inventory (ZCBI) was used to ascertain the distress experienced by caregivers. Hospital Anxiety and Depression scale (HADS) was performed on both patient and caregiver groups to evaluate anxiety and depression. Depressive symptoms of both groups were also measured by Beck Depression Inventory (BDI). Patients' psychotic symptoms were assessed using the part 1- mentation, behavior and mood section of UPDRS. Mini-Mental State Examination (MMSE) was used to evaluate dementia symptoms and Short Form-36 (SF-36) was also used to assess quality of life. Results We found significant correlation between caregiver burden with disease severity and duration. There was a significant difference between high UPDRS scores and the caregiver's will for placing her/his patient in a long-term institution. Patients who had depression risk according to BDI had also high UPDRS scores. Patients with off period had higher UPDRS scores and lower SF-36 subdomains of general health, physical functioning, emotional role and social functioning. Conclusion IPD is a chronic, progressive neuro- degenerative disease and comprises substantial burden on patients, families of patients and caregivers. The disease duration and disability have a remarkable impact on caregiver burden. For the good quality of caregiving, protective therapies should be recommended for caregivers if needed.

Objective: This study aimed at assessing the serial carboxyhemoglobin (COHb) levels in preterm infants during the first week of life and their variation with late-onset sepsis (LOS). Study Design: ...

Objective: Mannose-binding lectin, which belongs to the collectin family, is an acute-phase reactant that activates the complement system. This study aimed to investigate the effect of MBL2 gene polymorphism on short-term outcomes in preterm infants. Method: Infants of

Purpose To evaluate the prognostic potential of systemic inflammatory index in the course of retinopathy of prematurity (ROP). Methods This is a retrospective case-control study. 303 infants with a gestational age of ≤35 weeks were screened with and without ROP at birth and 1 month after the birth of complete blood counts (CBC) were included in this study. Serum neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte (PLR), and systemic immune-inflammation index (SII) was calculated at birth and one month after. LMR was calculated by dividing the absolute lymphocyte count by the absolute monocyte count. NLR and PLR were determined by dividing the absolute neutrophil count or the absolute platelet count by the absolute lymphocyte count, respectively. The SII was calculated by the formula = neutrophilxplatelet/lymphocyte. All statistical analyses were performed using SPSS 22 (SPSS for Windows, version 22.0; SPSS, Inc. Chicago, IL, USA). Results A total of 303 infants were included 145 with ROP and 158 without ROP. The NLR, LMR, PLR and SII values were 0.56 ± 1.17/0.51 ± 1.04 (P = 0.997), 13.7 ± 18/9.49 ± 13.1 (P = 0.014), 31.69 ± 68/24.1 ± 37.7 (P = 0.268), 131.42 ± 326/124.66 ± 267 (P = 0.935) in with ROP and without ROP infant at birth respectively. The NLR, LMR, PLR, and SII values were 0.68 ± 1.27/0.34 ± 0.99 (P = 0.001), 2.58 ± 6.01/2.46 ± 14.5 (P = 0.706), 47.5 ± 78.33/33.55 ± 42.4 (P = 0.035), and 253 ± 681/114 ± 345 (P = 0.001), respectively in with ROP and without ROP infant at 1 month after birth. Conclusion The NLR, PLR, and SII seem an independent predictor of the development of ROP.

This contribution presents a simple, fast, and low-cost method to track in situ and in real time the evolution of the surface topography. The method combines an optical method (collimated light) with image analysis. The method was validated using a complex tribo-system; a reciprocal sliding of a rough cast iron counter-piece under mixed lubrication. We demonstrated that the optical method is well suited to observe the evolution of the contact areas during sliding. We also proved that the contact area occurs on the highest peaks of the surface roughness. Finally, we estimated the wear rate by combining the information of the contact area and the Abbott–Firestone curve obtained by profilometry. The wear rate was found to be 40 times higher in the early stage of sliding as compared to the steady-state. The running-in of this particular system was found to be approximately 10 h. In addition to be simple, fast and low-cost, the proposed method has other advantages. It is adaptable for real industrial tests conditions. The fast data analysis allows the wear rate of a tribo-system being determined in real-time. This method characterise the real contact areas of the observed piece, which is difficult, if not impossible, to obtain by profilometric observation alone.

Giriş: Prematüre bebeklerde tiroid fonksiyon testlerindeki TFT bozukluğun sıklığı, etiyolojisi ve morbiditelerle ilişkisinin belirlenmesi.Gereç ve Yöntem: Bu çalışmaya Ocak 2009 ve Ocak 2012 yılları arasında Uludağ Üniversitesi yenidoğan yoğun bakım ünitesinde yatarak tedavi görmüş olan toplam 139 prematüre bebek alındı. Hastaların prenatal, natal ve postnatal özellikleri ve alınmış olan TFT değerleri kaydedildi. Tüm hastaların yaşamın 1. ve 3. haftasında TFT çalışıldı. Tiroid stimülan hormon TSH düzeyi 10 IU/L üzerindeki değerler yüksek kabul edildi. Serbest T3 ve T4 değerleri laboratuvar sınırları göz önüne alınarak değerlendirildi. Hipotiroidi tanısı olan ve olmayan tüm hastaların poliklinik izlemlerinden 6, 12 ve 18. aylardaki tartı, boy ve baş çevresi ölçümleri değerlendirmeleri kaydedildi.Bulgular: Çalışmamızda 41 hastanın %24 TFT’sinde anormallik tespit edilmiş olup olguların 22’sinde %53,6 geçici TSH yüksekliği, 9’unda %22 primer hipotiroidi, 9’unda %22 nontiroidal hastalık ve 1’inde %2,4 geçici hipotiroksinemi izlendi. Tiroid fonksiyon bozukluğu olan hastalarda respiratuvar distres sendromu sıklığı anlamlı derecede yüksek saptandı p=0,007 . Annesinde hipotiroidi olan bebeklerde tiroid fonksiyon bozukluğu oranı maternal hipotiroidi olmayan bebeklere göre anlamlı derecede yüksek saptandı p=0,049 . TFT’de bozukluk olan grupta 18. aydaki baş çevresi ortalaması TFT normal gruba kıyasla anlamlı olarak düşüktü p=0,047 .Sonuç: Prematürelerde tiroid fonksiyon bozukluğu sık görülen bir morbiditedir ve nöromotor gelişim açısından önemlidir. Maternal tiroid fonksiyon bozukluğu bebeklerde tiroid testlerinde bozulmaya yol açabilir. Tüm prematüre bebeklerde TFT’lerinde çalışılmalı ve hipotiroidi tedavi edilmelidir. Prematürelerde iyot maruziyetinin azaltılması TFT bozukluğu ve geçici hipotiroidi oranını azaltabilir, Introduction: To determine the rate, etiology and morbidity association of disorders of thyroid function tests TFTs in premature babies.Materials and Methods: A total of 139 premature babies who were admitted to Uludag University Faculty of Medicine Hospital Neonatal Intensive Care Unit between January 2009 and January 2012 were included in this study. Prenatal, natal and postnatal characteristics along with TFTs results were recorded. TFTs were performed for all patients in the first and third weeks of life. Thyroid stimulation hormone TSH values of >10 IU/L was considered elevated. Free T3 and T4 levels were evaluated according to laboratory cut-off values. Weight, height and head circumference values of all individuals with and without the diagnosis of hypothyroidism on the 6th, 12th, and 18th months of their polyclinic follow-ups Results: Abnormal TFTs were detected in 41 24% patients. Twenty two patients 53% had transient TSH elevation, 9 22% had primary hypothyroidism, 9 22% had non-thyroidal disease and 1 2.4% had transient hypothyroxinemia. Among morbidities, respiratory distress syndrome rate was found to be significantly higher in patients with thyroid function disorders p=0.007 . The rate of thyroid function disorders in patients with mothers with hypothyroidism was significantly more frequent compared to patients without maternal hypothyroidism p=0.049 . The mean head circumference in 18 month was significantly lower in patients with abnormal TFTs p=0.047 . Conclusions: Thyroid function disorders are common morbidities in premature babies and are important for neuromotor development. Maternal thyroid function disorder can lead to impairment of TFTs in infants. Thyroid function tests should be performed in all premature babies and hypotyhroidism should be treated. Avoidance of iodine exposure in premature infants can reduce the rate of abnormal TFTs and transient hypothyroidism.

Objective The primary objective of the present study was to further elucidate the effects of oxcarbazepine (OXC) and levetiracetam (LEV) monotherapies on the bone health status of patients with epilepsy. Methods This study included 48 patients who attended our epilepsy outpatient clinic, had a diagnosis of epilepsy, and were undergoing either OXC or LEV monotherapy and 42 healthy control subjects. The demographic and clinical features of the patients, including gender, age, onset of disease, daily drug dosage, and duration of disease, were noted. Additionally, the calcium, ionized calcium, and 25-OH vitamin-D3 levels of the participants were prospectively evaluated. Results The 25-OH vitamin-D3, calcium, and ionized calcium levels of the patients taking OXC were significantly lower than those of the control group. These levels did not significantly differ between the patients taking LEV and the control group, but there was a significant negative relationship between daily drug dose and ionized calcium levels in the LEV patients. Conclusion In the present study, anti-epileptic drugs altered the calcium, ionized calcium, and 25-OH vitamin-D3 levels of epilepsy patients and resulted in bone loss, abnormal mineralization, and fractures. These findings suggest that the calcium, ionized calcium, and 25-OH vitamin-D3 levels of patients with epilepsy should be regularly assessed.

Aim: Late-onset sepsis (LOS) persists to be a crucial reason of morbidity and mortality in preterm infants. Studying the effect of neutrophil-lymphocyte ratio (NLR) value in predicting the LOS episode and relation with the type of the growing microorganism were the aim of this study.Material and Methods: Preterm infants were classified as two groups in accordance with having culture proven LOS during the stay in neonatal intensive care unit. Premature infants with culture proven LOS was defined as study group and infants with no-LOS as control group. Study group is consisting of two subgroups in terms of the growing microorganism type. NLR values were compared within and between the groups.Results: Overall, final analysis were applied to 116 infants. NLR values were raised in the study group during LOS episode (p0.001). NLR value of the Gram-positive sepsis group (Subgroup 1) was significantly higher in comparison to Gram-negative sepsis group (Subgroup 2) (median: 2.4 and 1.8, respectively, p = 0.02). ROC analysis showed that area under the curve (AUC) of NLR was 0.723 (p0.001) and cut-off point optimized for sensitivity of 68% and a specificity of 82% was stated as NLR ≥1.57 for conforming LOS.Conclusions: These findings demonstrated that in preterm infants, NLR values rise for the duration of a LOS episode. We believe that NLR value may be a helpful for the prediction of LOS in preterm infants.

Background & objective Preterm infants need nutritional and medical requirements in accordance with the physiologic maturity at birth and maintaining optimal postnatal corporal and cerebral growth is one of the main targets of medical caregivers. However, only a few strategies exist to improve the outcomes of infants in a pathogen-rich and nutrient-poor neonatal intensive care unit environment. In this pilot study, we hypothesize that synbiotics may enhance brain growth, which is reflected indirectly by an increase in head circumference through several signalling molecules. Methods A pilot study was conducted in preterm infants with a gestational age of ≤32 weeks and a birth weight of ≤1500 grams at neonatal intensive care unit of Uludag Univeristy Medical Faculty (NICU) for one-year period. Following the randomization of the infants, a prepared commercial synbiotic solution containing multi-combined probiotics and prebiotics was administered enterally to the study group. Results The odds of a patient having a lower body weight and head circumference below the 10th percentile were significantly lower in the probiotic group (p=0.001, p=0.03, respectively). Moreover, the infants in the synbiotics group had a more optimal head circumference (between the 50th and 90th percentiles, p=0.001). Conclusions Our results show that if we can maintain optimal gut microbiota, we might achieve better neuro-development via the beneficial effects of synbiotics on cytokines, neurotransmitters, and the cellular immunity of the nervous system. Further investigational models are needed to demonstrate the beneficial effects of synbiotics on the central nervous system.

Hanhart syndrome is a congenital disorder that causes an undeveloped tongue and malformed extremities and fingers. Small mouth, short or incompletely developed tongue (hypoglossia), absent or shortened fingers and/or toes, jaw abnormalities such as micrognathia, retrognathia or partially missing mandible (lower jaw), high-arched, narrow, palate, absent or unusually formed arms and/or legs. If the tongue and/or mouth are affected, this can worsen feeding difficulties that are already present due to the craniofacial abnormalities. A diagnosis of Hanhart syndrome is typically made based on the presence of characteristic signs and symptoms. To date, no specific disease-causing genes have been identified. We present the case of a 3000 g male infant who was born at 39 weeks' gestation to a 42-year-old gravida 2 para 2 mother via cesarean section. At the physical examination he was noted to have adactyly at two hands, micrognathia, incompletely developed tongue and high-arched palate. Tongue movements were inadequate because of the small size. When we looked at the pregnancy history the mother took thyroid drugs cause of hypothyroidism after thyroid surgery and there was no family history of congenital anomalies or consanguinity. Due to feeding difficulties he stayed at neonatal intensive care unit. Cranial and abdominal ultrasonographyic examination of the infant was otherwise normal. The infant was discharged home on full oral feedings on day 6.

The aim of this study was to assess the impact of early stage of idiopathic Parkinson's disease (IPD) on caregiver burden with disease severity, duration, disability and psychiatric symptoms.30 IPD patient (15 female, 15 male) - caregiver (18 female, 12 male) pairs participated in the study. Hoehn and Yahr (H-Y) scale was used to provide the assessment of disease progression and Unified Parkinson's Disease Rating Scale (UPDRS) was used for assessing disability and impairment. Zarit Caregiver Burden Inventory (ZCBI) was used to ascertain the distress experienced by caregivers. Hospital Anxiety and Depression scale (HADS) was performed on both patient and caregiver groups to evaluate anxiety and depression. Depressive symptoms of both groups were also measured by Beck Depression Inventory (BDI). Patients' psychotic symptoms were assessed using the part 1- mentation, behavior and mood section of UPDRS. Mini-Mental State Examination (MMSE) was used to evaluate dementia symptoms and Short Form-36 (SF-36) was also used to assess quality of life.We found significant correlation between caregiver burden with disease severity and duration. There was a significant difference between high UPDRS scores and the caregiver's will for placing her/his patient in a long-term institution. Patients who had depression risk according to BDI had also high UPDRS scores. Patients with off period had higher UPDRS scores and lower SF-36 subdomains of general health, physical functioning, emotional role and social functioning.IPD is a chronic, progressive neuro- degenerative disease and comprises substantial burden on patients, families of patients and caregivers. The disease duration and disability have a remarkable impact on caregiver burden. For the good quality of caregiving, protective therapies should be recommended for caregivers if needed.A vizsgálat célja annak megállapítása volt, hogy hogyan alakul a korai stádiumú idiopathiás Parkinson-kórban (IPD) szenvedő betegek gondozóira nehezedő teher és a gondozók életminősége a betegség súlyosságával, időtartamával, a betegek rokkantsági fokával és pszichiátriai tüneteivel párhuzamosan.A vizsgálatban 30 IPD-beteg (15 nő, 15 férfi) és ezek 30 gondozója (18 nő, 12 férfi) vett részt. Hoehn- Yahr (H-Y) skálával mértük a betegség progresszióját, az Egységes Parkinson-kór Értékelő Skála (Unified Parkinson’s Disease Rating Scale, UPDRS) segítségével elemeztük a rok­kantság és az egészségromlás fokát. A Zarit és munkatársai által kidolgozott pontozási rendszert (Zarit Caregiver Burden Inventory, ZCBI) használtuk a gondozók által megélt distressz megállapítására. A betegek és gondozóik szorongását és depresszióját a Kórházi Szorongás és Depresszió Skála (Hospital Anxiety and Depression scale, HADS), valamint a Beck Depresszió Kérdőív (Beck Depression Inventory, BDI) segítségével mértük. A betegek pszichotikus tüneteinek elemzésére az UPDRS elmeállapotot, hangulatot és viselkedést felmérő első részét alkalmaztuk. Mini-Mental Teszttel (Mini-Mental State Examination, MMSE) értékeltük a dementia tüneteit, és SF-36 skálával az életminőséget.Szignifikáns összefüggést találtunk a gon­dozókra nehezedő teher és az általuk ápoltak betegség­súlyossága, valamint a betegségük időtartama között. Szignifikáns különbség volt a magas UPDRS-pontszámok és a gondozók szándéka között, hogy betegüket hosszú távú gondozást nyújtó intézménybe helyezzék. A BDI-értékek alapján magas depressziós kocká­zatúnak bizonyuló betegek egyben magas UPDRS-pontszámokkal is bírtak. Azon betegek esetében, akiknél off időszakok is jelent­keztek, magasabbak voltak az UPDRS- és alacsonyabbak az SF-36 skála általános egészségi állapotot, fizikai, emocionális és szociális funkciót mérő alskáláinak pontszámai.Az IPD krónikus, progresszív neurodege­neratív megbetegedés, ami jelentős terhet ró a betegekre, gondozóikra és családtagjaikra egyaránt. A betegség súlyossága, valamint fennállásának időtartama lényegesen befolyásolja a gondozókra nehezedő teher mértékét. A jó minőségű gondozás biztosítása érdekében szükség esetén támogató terápiákat kell a gondozóknak felajánlani.

Parenteral nutrition (PN) has been widely used in preterm infants. The lipid solutions used for PN, however, are associated with oxidative stress and morbidity. The aim of this study was to compare the effectiveness of a new-generation lipid emulsion (SMOFLipid) and olive-oil based lipid emulsion for prevention of PN-associated oxidative damage.Preterm infants 32 weeks of gestational age were included in this prospective randomized study. All infants were randomized to SMOFlipid or olive-oil based lipid emulsion (ClinOleic). Lipid peroxidation products were evaluated in all infants. In addition, total antioxidant capacity (TAC), and both pro- and anti-inflammatory cytokines were studied at days 0, 7 and 14.A total of 89 infants (SMOFlipid, n = 42; ClinOleic, n = 47) were enrolled. TAC was higher in the SMOFlipid group compared with the ClinOleic group at all time points, and the difference on day 7 was statistically significant. Although the anti-inflammatory cytokine interleukin-10 was higher in the SMOFlipid group, this difference was not significant. Bronchopulmonary dysplasia (BPD) was lower in the SMOFlipid group (14.1%) than in the ClinOleic group (31.2%), but this finding was non-significant p 0.05. The rate of severe BPD was significantly lower in the SMOFlipid group.To our best of knowledge, this is the first study to suggest that SMOFlipid might decrease oxidative damage and oxidative-stress-associated morbidity compared with olive oil-based emulsion in preterm infants.

A 2590 g female infant was born at 39 weeks' gestation to a 34-year-old gravida 4 para 4 mother via cesarean section. Upon delivery she was noted to have an absence of skin on the huge part of the trunk. Lesion was unilateral, gelatinous and covered by a thin membrane. The pregnancy history was unremarkable, the mother denied having taken any drugs and there was no family history of congenital anomalies or consanguinity. The physical examination of the infant was otherwise unremarkable. Conservative treatment was recommended by dermatologist with gentle cleansing and application of local antibiotics. Ultrasonographic evaluation of abdomen and kranium, echocardiographic evaluation and detailed genetic assessment were normal. The patient was discharged home on full oral feedings on day 6 and recommended follow up at the outpatient dermatology clinic. Definition of aplasia cutis congenita (ACC) is, complete or partial absence or scarcity of skin at birth. ACC can occur anywhere in the body but majority of cases occur on the scalp. In most cases ACC is an isolated skin defect but some cases might be seen with congenital malformations involving the cardiovascular, gastrointestinal and central nervous systems. ACC is a rare condition with an incidence of 1/10,000 to 3/10,000 births and the exact mechanism is still unknown. Several factors like genetics, teratogens, intrauterin infections can lead to this condition. Most cases occur sporadically but rare familial cases have been reported. Physicians should remember the possible co-occurrence of other congenital anomalies in these infants.

Meconium peritonitis is a sterile chemical peritonitis caused by intestinal perforation in-utero or shortly after birth and perforation usually occurs due to intrauterine obstruction. Its incidence is approximately 1 in 35,000 births and the mortality was reported to be 60-80%. The radiographic findings of meconium peritonitis are pneumoperitoneum, intestinal obstruction and abdominal calcifications. The classic eggshell calcification occurs owing to the defensive mechanism of the body against the inflammation in an effort to surround the meconium in the abdominal cavity. In a newborn with abdominal distension, meconium peritonitis should be kept in mind, especially if calcified foci are seen on plain abdominal radiographs, since timely diagnosis and surgery improves the survival rates. We present the case of a female newborn of 34 weeks' gestational age was admitted to the neonatal intensive care unit (NICU) with marked abdominal distension. The pregnancy was complicated by maternal polyhydramnios and a cesarean section was performed due to fetal distress. The infant was noted to have a grossly distended abdomen; however, the physical examination was otherwise unremarkable. The abdominal radiograph revealed distension of the bowel loops and free air with multiple peritoneal calcifications (Figure 1). Surgery, performed on day 1 of life, demonstrated ileal atresia and perforation in the distal part of the ileum. Solid meconium, which leaked into the abdominal cavity was removed and the atresic bowel was resected and anastomosed. The infant regained bowel function on postoperative day 7 and discharged home on the third week after gradual advancement to full enteral feeding.