Background: Coronavirus disease 2019 (COVID-19) primarily affects adults and spares children, whereas very little is known about neonates. We tried to define the clinical characteristics, risk factors, laboratory, and imagining results of neonates with community-acquired COVID-19. Methods: This prospective multicentered cohort study included 24 neonatal intensive care units around Turkey, wherein outpatient neonates with COVID-19 were registered in an online national database. Full-term and premature neonates diagnosed with COVID-19 were included in the study, whether hospitalized or followed up as ambulatory patients. Neonates without severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) via reverse transcriptase-polymerase chain reaction testing or whose mothers had been diagnosed with COVID-19 during pregnancy were excluded. Results: Thirty-seven symptomatic neonates were included. The most frequent findings were fever, hypoxemia, and cough (49%, 41%, 27%, respectively). Oxygen administration (41%) and noninvasive ventilation (16%) were frequently required; however, mechanical ventilation (3%) was rarely needed. Median hospitalization was 11 days (1–35 days). One patient with Down syndrome and congenital cardiovascular disorders died in the study period. C-reactive protein (CRP) and prothrombin time (PT) levels were found to be higher in patients who needed supplemental oxygen (0.9 [0.1–8.6] vs. 5.8 [0.3–69.2] p = 0.002, 11.9 [10.1–17.2] vs. 15.2 [11.7–18.0] p = 0.01, respectively) or who were severe/critical (1.0 [0.01–8.6] vs. 4.5 [0.1–69.2] p = 0.01, 11.7 [10.1–13.9] vs. 15.0 [11.7–18.0] p = 0.001, respectively). Conclusions: Symptomatic neonates with COVID-19 had high rates of respiratory support requirements. High CRP levels or a greater PT should alert the physician to more severe disease.

Objective Herein, we measured the concentration of insulinlike growth factor I (IGF-I), IGF-II, leptin, adiponectin, ghrelin, resistin, and visfatin in the umbilical cord blood of newborns categorized as “small for gestational age” (SGA), “appropriate for gestational age” (AGA), and “large for gestational age” (LGA). Our aim was to elucidate the link between the levels of these proteins and fetal growth. Study Design A total of 96 term infants were included and categorized into three weight categories. Their venous cord blood samples were collected to measure the levels of IGF-I, IGF-II, leptin, adiponectin, ghrelin, resistin, and visfatin. Results IGF-I, visfatin, and leptin levels showed significant differences among the groups. Pairwise comparisons showed that adiponectin (p = 0.023), resistin (p = 0.025), and ghrelin (p = 0.005) levels were significantly lower in the SGA group than in the LGA group. Correlation analyses showed a strong association of IGF-1, IGF-II, and leptin levels with birth weight (r = 0.644, p < 0.001; r = 0.441, p < 0.001; and r = 0.404, p < 0.001, respectively). Conclusion SGA newborns showed a significantly higher visfatin concentration and lower ghrelin, leptin, resistin, and adiponectin levels than the AGA and LGA newborns did.

The literature on neonates with SARS-CoV-2 is mainly concerned with perinatal cases, and scanty data are available about environmentally infected neonates. To fill knowledge gaps on the course and prognosis of neonatal cases, we analyzed 1-year data from the Turkish Neonatal Society in this prospective cohort study of neonates with postnatal transmission. Data from 44 neonatal intensive care units (NICUs), of neonates with positive RT-PCR results at days 5-28 of life, were extracted from the online registry system and analyzed. Of 176 cases, most were term infants with normal birth weight. Fever was the most common symptom (64.2%), followed by feeding intolerance (25.6%), and cough (21.6%). The median length of hospitalization was 9 days, with approximately one quarter of infants receiving some type of ventilatory support. Myocarditis (5.7%) was the most common complication during follow-up. Among the clinical findings, cough (odds ratio [

Objective: Immune thrombocytopenia (ITP) is an autoimmune disease, and it has become evident that T lymphocytes play an important role in the pathogenesis of ITP. We investigated the role of T helper (Th) intracellular IL-2, IL-4, IL-6, IFN-γ, and T lymphocyte apoptosis in the pathogenesis of acute ITP and the effect of glucocorticoid treatment on cytokine profile. We investigated also P-glycoprotein (P-gp) and glucocorticoid receptor (GCR) expression as a possible mechanism for glucocorticoid resistance. Material and Methods: The study includes 20 children with acute ITP having a platelet count <20,000/mm3 and 20 healthy children as a control group. Patients with acute ITP were treated with megadose methylprednisolone (MDMP) (MDMP in the dose of 30 mg/kg/d between day 1 and 3 and 20 mg/kg/d between day 4 and 7). Th intracellular IL2, IL-4, IL-6, and IFN-γ percentages, T-cell P-gp expression, T-cell and monocyte GCR expression, and T-cell apoptosis were evaluated before and after treatment in acute ITP patients and in the control group. Results: Acute ITP patients had significantly higher Th IL-2, IL-4, IL-6, and IFN-γ percentages compared with the control group (P<0.05). Th IL-2 and IFN-γ percentages were significantly lowered with MDMP treatment (P<0.05). IFN-γ/IL-4 ratio was also lowered with the MDMP treatment (P<0.05). T-lymphocyte P-gp expression and T lymphocyte and monocyte GCR expression were all similar between acute ITP pretreatment and control groups (P>0.05). T-lymphocyte P-gp expression was higher in the posttreatment group than in the pretreatment group (P<0.05). Both T lymphocyte and monocyte GCR expression percentages were not different in the pretreatment and posttreatment groups (P>0.05). Early apoptosis in T lymphocytes was significantly lower in the pretreatment acute ITP group than in the control group (P<0.05). Necrotic apoptosis in T lymphocytes was significantly increased with MDMP treatment (P<0.05). Conclusions: Th1 and Th2 cytokine profile is observed in acute ITP pathogenesis, and MDMP treatment causes Th1 to Th2 cytokine profile shift and induction of T-lymphocyte apoptosis. There is a need to have a greater number of resistant cases in order to better evaluate the P-gp and GCR expression in glucocorticoid resistance in acute ITP.

Objective: Maternal urinary tract infection is associated with intrauterine growth restriction, preterm delivery and low birth weight. The purpose of this study was to evaluate whether maternal urinary tract infection is related to neonatal urinary tract infection. Materials and methods: The present prospective study included 230 singleton neonates. The participants were divided into two groups based on in utero exposure to maternal urinary tract infections. The study group (exposure to maternal urinary tract infection) included 115 neonates and the control group (without exposure to maternal urinary tract infection) included 115 healthy neonates. Physical examination, urinalysis, urine culture and urinary system ultrasonography were carried out for all neonates. Results: There were 153 deliveries by cesarean section and 77 vaginal births. There was no statistically significant difference between the groups in terms of gender distribution, maternal age, birth weight, mode of delivery, gravida and gestational age. Although the difference was not significant, the incidence of low birth weight and preterm delivery were higher in the study group in comparison to that in the control group. There was a statistically significant higher rate of neonatal urinary tract infection in the study group compared with control group (25.2% vs. 7.8%, p<0.001). The most commonly discovered pathogens were Escherichia coli, followed by Klebsiella spp., Proteus spp., and Serratia spp. in the study group. Conclusion: The results of this study showed that the presence of maternal urinary tract infection may contribute to increased urinary tract infection frequency in the neonatal period. Neonates at risk for a urinary tract infection should be regularly monitored due to nonspecific clinical presentation.

No abstract

Nekrotizan enterokolit (NEK), prematüre bebeklerde en sık görülen gastrointestinal problemdir. Bu çalışmanın amacı, NEK modeli oluşturulan yenidoğan sıçanlarda silimarin (SLY)'nin koruyucu ve antioksidan etkilerini değerlendirmektir. Yirmi sekiz Sprague-Dawley sıçanı çalışmaya dahil edildi. Sıçanlar rastgele dört gruba ayrıldı: kontrol (C), C+SLY, NEK ve NEK+SLY. NEK, hiperosmolar enteral formül beslenmesi ile indüklendi, yavru sıçanlar hipoksi ve soğuk stresine maruz bırakıldı. Bağırsak dokusunun makroskopik skorlaması değerlendirildi ve biyokimyasal, histopatolojik inceleme için doku örnekleri alındı. Süperoksit dismutaz (SOD), glutatyon peroksidaz (GPx), nitrik oksit (NO), malondialdehit (MDA), total antioksidan status (TAS), total oksidan status (TOS) ve oksidatif stres indeksi (OSI) düzeyleri biyokimyasal olarak değerlendirildi. NEK+SLY grubunda doku TAS (p = 0,007), SOD (p = 0,004) ve GPx düzeylerinde önemli artış ve NO düzeylerinde azalma vardı. NEK grubunda doku MDA, TOS (p = 0,001) ve OSI (p = 0,001) değerleri anlamlı derecede yüksek saptandı. NEK + SLY grubundaki sıçanların bağırsak dokusu, değerlendirildiğinde NEC grubundaki sıçanlardan daha iyi histopatolojiye sahipti. Silimarin, neonatal sıçanlarda NEK'e karşı faydalı etkilere sahiptir. SLY'nin serbest radikal düzeylerini ve oksidatif stresi azalttığı, antioksidan kapasiteyi arttırdığı ve NEK'e bağlı bağırsak hasarının şiddetini iyileştirdiği görülmektedir.

Yenidoğan sepsisi tanı ve tedavideki son yıllarda olan gelişmelere rağmen halen önemli bir morbidite ve mortalite nedenidir. Yardımcı tanı yöntemleri olarak çeşitli hematolojik parametreler kullanılmaktadır. Özellikle trombositle ilgili parametrelerin enfeksiyonların klinik seyrinde ve tedavi etkinliğinin değerlendirilmesinde kullanılmasıyla ilgili çalışmalar yapılmaktadır. Bu çalışmada, geç neonatal sepsis tanısında trombosit parametrelerinden trombosit sayısı (PLT), ortalama trombosit hacmi (MPV), MPV/trombosit oranı(MPR)ile trombosit/ lenfosit oranı (PLR), nötrofil /lenfosit oranı (NLR)düzeylerinin araştırılması amaçlanmıştır. GEREÇ VE YÖNTEM: Yenidoğan yoğun bakım ünitesinde Ocak 2014-Haziran 2016 tarihleri arasında, klinik sepsis tanısı alan veya kan kültüründe pozitiflik saptanan 48 yenidoğan çalışmaya dahil edildi. Tedavi öncesinde alınan tam kan sayımı sonuçlarından PLT, MPV, MPR ve PLR, NLR parametreleri değerlendirildi. Kontrol grubu başka nedenlerden dolayı kan alınmış 60 sağlıklı yenidoğanlardan oluşturuldu. BULGULAR: Gruplar arasında PLT, MPV, MPR, NLR bakımından istatiksel olarak (p<0.05) anlamlı fark saptandı. Sepsis grubunda MPR ile platelet ve PLR arasında negatif yönlü korelasyon bulundu. Sepsisi ayırt etmede MPR ve NLR ölçümleri anlamlı bulunurken, MPV ve PLR değerlerinde istatistiksel olarak anlamlı bir fark bulunmadı. SONUÇ: Çalışma sonucunda sepsis grubunda MPV, MPR değerlerinde yükseklik saptanmışken PLR değerinde ise istatiksel olarak fark bulunmamıştır. Trombosit parametrelerinin farklı mikroorganizmalara karşı yanıtlarını tanımlamak için geniş örneklemlerle, çok merkezli, prospektif çalışmalara ihtiyaç vardır.