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Background:Colistin, a cationic polypeptide antibiotic of the polymyxin class has come back into use due to its potent antimicrobial activity against multidrug-resistant Gram-negative bacteria and the lack of new antibiotics. The purpose of this study was to assess the critically ill infants treated with colistin in our neonatal intensive care unit and to identify predisposing factors for the emergence of acute kidney injury (AKI) following colistin treatment.Methods:This was a retrospective case-control study that included infants with proven or suspected nosocomial infections in the neonatal intensive care unit of a University Hospital between January 2012 and March 2022. Over the same time period, the clinical and laboratory characteristics and outcomes of patients who received antibiotic combination with colistin were compared to patients who received antibiotic combination without colistin.Results:A total of 77 patients …

DiscussionExtrapulmonary manifestations of severe RSV infection requiring intensive care unit admission were first described in 1993. 6 Recent literature suggests that 1% to 7% of all children hospitalized with RSV infection experience neurological problems, including acute encephalitis/encephalopathy, complex seizures, and status epilepticus. 7 Saravanos et al 8 defined the characteristics of patients in this group by a young age, severe respiratory symptoms, and high frequency of prematurity. Our patient fits this definition as being a 32-day-old late preterm infant with recurrent apnea and hyponatremia.

To the Editor: The fresh expressed breast milk (FBM) can be safely stored at room temperature for 3–4 h, in the refrigerator for up to 72 h, and in deep freezers for six months [1]. This study aimed to investigate the impact of storage conditions on the viability of various cell types, including potential stem cells, in FBM. The study, designed as a single-center, prospective, experimental pilot study, obtained mature FBM samples (> 15th d) from healthy mothers. FBM samples were immediately analyzed (Control Group) and compared to those stored in a refrigerator at+ 4 C for three days (Group I) and frozen at-20 C for three months (Group II). Viability analyses using propidium iodide (PI), trypan blue staining and examination of CD90 and CD73 profiles were conducted through flow cytometry.The cell viability with total PI was 92% in the Control group and 83% and 78% in Groups I and II, respectively (p< 0.05). With trypan …

Functional gastrointestinal disorders (FGIDs) are characterized by a variety of symptoms that are frequently age-dependent, chronic, or recurrent and are not explained by structural or biochemical abnormalities. There are studies in the literature reporting different results regarding the relationship between prematurity and FGIDs. The main objective of this study was to compare the frequency of FGIDs between preterm and term infants. The secondary objective was to evaluate whether there was any association between neonatal characteristics and development of FGIDs. A multicenter prospective cohort study that included preterm infants born before 37 weeks of gestation and healthy term infants was carried out. At 1, 2, 4, 6, 9, and 12 months of age, infants were assessed for the presence of FGIDs using the Rome IV criteria. In preterm infants, an additional follow-up visit was made at 12 months corrected age. 134 …

Neonatal sepsis yaşamın ilk ayında enfeksiyona ait bulguların olduğu ve kan kültüründe özgül bir etkenin üretildiği klinik bir sendromdur. Kültür ile kanıtlanmış neonatal sepsis insidansı gelişmiş ülkelerde 1000 canlı doğumda 1-10 olarak bildirilmiştir. Annenin genital sisteminden asenden olarak ya da transplasental hematojen yayılımla mikroorganizma maruziyeti, prematüre doğum ve postnatal dönemde yenidoğan yoğun bakım ünitesinde yatmakta olan bebeklerin maruz kaldığı invaziv işlemlerin fazla olması enfeksiyon insidansının yaşamın diğer dönemlerine göre daha yüksek olmasına neden olur. Tanı ve tedavi yöntemlerindeki gelişmelerle ölüm oranı son 10 yılda %30-40’lardan %5-10’lara inmiştir. Ancak halen önemli bir morbidite ve mortalite nedeni olmaya devam etmektedir.Antibiyotikler sepsis tedavisinin temel unsuru olmasına rağmen bazı bebeklerde ölümleri önleyememektedir. Artan antibiyotik …

Akut hipoksik-iskemik ensefalopati yenidoğan döneminde ölüm ve yaşam boyu sakatlığın en sık nedeni olmaya devam etmektedir. Terapötik hipotermi (TH) hipoksik iskemik ensefalopatinin neden olduğu neonatal ensefalopatide (NE) tek geçerli tedavi yöntemidir. Ancak 10 yılı aşan deneyim ve bilgi birikimi, yapılan randomize kontrollü çalışmalar ve yayınlanan klinik kılavuzlara rağmen klinisyenler günlük pratiklerinde TH uygulamasıyla ilgili cevaplanmamış pek çok soru ile karşı karşıya kalmaktadır; terapötik hipotermiye ne zamana kadar başlanabilir, ideal süre ve derinliği ne olmalı, yeniden ısıtma süresi ne kadar olmalı, NE’li preterm bebeklerde, perinatal enfeksiyon/inflamasyon varlığında ve hafif NE’li geç preterm ve term bebeklerde uygulanabilirliği nedir? Makalede bu sorulara cevap arayacağız.

Livedo racemosa (LRac) refers to violaceous, red, or blue netlike mottling of the skin in an irregular pattern caused by circulatory abnormalities. Central venous catheters (CVC) are widely used in neonates who require intensive care to offer steady intravenous access. CVCs are covered with a hydrophilic polymer gel that reduces friction between the sheath and the vessel wall, thereby minimizing vascular spasm, irritation, and aneurysm formation. However, the introduction of foreign material into the vein carries a risk of embolization. Recently, LRac was reported as a cutaneous manifestation of hydrophilic polymer gel embolization (HPE) in adults. We present a case of LRac in a newborn that developed following CVC insertion and resolved spontaneously after the catheter was removed.

Background Hypoxic ischemic encephalopathy (HIE) is a significant cause of mortality and short- and long-term morbidities. Therapeutic hypothermia (TH) has been shown to be the standard care for HIE of infants ≥36 weeks gestational age (GA), as it has been demonstrated to reduce the rates of mortality, and adverse neurodevelopmental outcomes. This study aims to determine the incidence of HIE in our country, to assess the TH management in infants with HIE, and present short-term outcomes of these infants. Methods The Turkish Hypoxic Ischemic Encephalopathy Online Registry database was established for this multicenter, prospective, observational, nationally-based cohort study to evaluate the data of infants born at ≥34 weeks GA who displayed evidence of neonatal encephalopathy (NE) between March, 2020 and April 2022. Results The incidence of HIE among infants born at ≥36 weeks GA (n = 965) was 2.13 per 1000 live births (517:242440), and accounting for 1.55% (965:62062) of all neonatal intensive care unit admissions. The rates of mild, moderate and severe HİE were 25.5% (n = 246), 58.9% (n = 568), and 15.6% (n = 151), respectively. Infants with severe HIE had higher rates of abnormal magnetic resonance imaging (MRI) findings, and mortality (p<0.001). No significant difference in mortality and abnormal MRI results was found according to the time of TH initiation (<3 h, 3–6 h and >6 h) (p>0.05). TH was administered to 85 (34.5%) infants with mild HIE, and of those born of 34–35 weeks of GA, 67.4% (n = 31) received TH. A total of 58 (6%) deaths were reported with a higher mortality rate in infants born at 34–35 …

BackgroundHypoxic ischemic encephalopathy (HIE) has different neurological outcomes.AimWe wanted to see if there was any developmental delay in neonates with hypoxia ischemic encephalopathy who were given therapeutic hypothermia.Study designRetrospective cohort study.MethodsThe Denver developmental screening test II (DDST-II) was performed to newborns who had been applied to therapeutic hypothermia.ResultsThere were 69 male and 36 female newborns. The mean 1-min and 5-min Apgar scores were 4.72 ± 2.51 and 7.03 ± 2.017, respectively. The mean pH and mean base excess were 6.92 ± 0.1 and −18.05 ± 5.72, respectively. The most common risk factors were meconium staining (17.1%). There were 67 patients with Stage I, 20 with Stage II, and 18 with Stage III. Diffusion restriction was seen in 13 patients. 28 patients had seizures. In aEEG, 12 patients had burst suppression …

The main purpose of this study was to evaluate the impact of drip versus intermittent feeding on splanchnic oxygenation in preterm infants with intrauterine growth restriction. The second objective was to assess the relationship between fetal splanchnic circulation parameters and splanchnic oxygenation during the first week of life. A single-center, prospective, randomized study with 51 fetuses/infants was conducted. Fetal Doppler measurements including umbilical artery, middle cerebral artery, and superior mesenteric artery (SMA) were recorded in IUGR fetuses. After preterm delivery, the infants were randomly assigned to one of two feeding modalities: drip (3-h continuous) or intermittent (bolus in 10 min). Continuous regional splanchnic saturation (rSO2S) monitoring was carried out during the first week of life, simultaneously with continuous oxygen arterial saturation (SaO2) monitoring, and the infants’ fractional …

Beslenme intoleransı özellikle preterm bebeklerde görülen gastrik rezidü, abdominal distansiyon ve/veya kusma ile kendini gösteren, sıklıkla beslenme planının değişmesine neden olan sindirim bozukluğudur. Amino asit bazlı formüla (ABF) larda protein amino asitlere kadar parçalanmıştır, alerjenitesi çok düşüktür ve kolay absorbe olur. Bu olgu serisinde Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Yenidoğan Yoğun Bakım Ünitesinde 2018-2019 yılları arasında dirençli beslenme intoleransı nedeniyle ABF ile beslenen 5 olgu değerlendirilmiştir. Minimal enteral beslenmeyi dâhi tolere edemeyen, çok düşük ve aşırı düşük doğum ağırlıklı preterm bebeklerde, geçici süre ile ABF kullanımı enteral beslenmenin kademeli artırılarak tam enteral beslenmeye geçişini sağlamıştır. ABF kullanımı sonrasında parenteral beslenme süresinin kısaldığı, günlük kilo alım hızının arttığı ve sepsis atak sayısının azaldığı gözlemlenmiştir. Preterm bebeklerde enteral beslenmenin toleransı gastrointestinal sistemin maturasyon (motilite, enzimatik sindirim, hormonal yanıt, bakteriyal kolonizasyon, lokal immunite) derecesine bağlıdır. Tam enteral beslenmeye geçiş sonrası tekrar anne sütü ile beslenmeye devam edilebilmesi nedeniyle bu geçici durumun patofizyolojisinde protein alerjisinden farklı olarak enzimatik immatüritenin olduğu düşünülmüştür.

ObjectiveThe prone position was found to improve oxygenation and pulmonary functions in neonates receiving respiratory support. However, how this improvement changes brain tissue oxygenation has not been studied. We aimed to investigate how prone position effects regional cerebral oxygen saturation (rScO2) and cerebral fractional oxygen extraction (FOE) in preterm neonates during noninvasive ventilation (NIV).MethodsPreterm neonates < 37 weeks gestational age (GA) stable on NIV were enrolled. NIV was defined as nasal continues positive airway pressure or intermittent positive pressure ventilation via binasal prongs. Near infrared spectroscopy was used to measure rScO2. Monitoring was started when the infant was lying supine for at least 1 h and continued at the same body position at least for 1 h. Later the infant was changed to prone position and monitored for additional 3 h. Arterial oxygen …

Congenital diaphragmatic hernia (CDH) is a serious life-threatening birth defect characterized by abnormal development in the muscular or tendinous portion of the diaphragm during embryogenesis. Despite its high incidence, the etiology of CDH hasn't been fully understood. Genetic factors are important in pathogenesis; however, few single genes have been definitively implicated in human CDH. SLIT1, SLIT2, and SLIT3 (slit guidance ligand) are three human homologs of the drosophila Slit gene. They interact with roundabout (Robo) homolog receptors to affect cell migration, adhesion, cell motility, and angiogenesis and play important roles in cell signaling pathways including the guidance of axons. In this report, we presented dizygous twin babies with CDH related to the SLIT3 gene variant. Previous studies showed that Slit3 null mice had congenital diaphragmatic hernias on or near the ventral midline portion …