Sepsis in newborns with RDSy and asphyxia is essential; it is a life-threatening condition and still represents an important cause of mortality and morbidity. The aim of this study was to evaluate the predictive values of procalcitonin (PCT) as an early diagnostic and prognostic biochemical marker for sepsis in newborns with RDS and asphyxia. Material and methods: The study was designed as prospective and we examined 110 newborns with proven sepsis admitted in the Intensive Care Unit at the University Clinic of Pediatrics – Skopje in the period between December 2018 and Јanuary 2021. Procalcitonin levels were measured by using the immunoassay system Vidas based on the ELFA principles. The newborns with proven sepsis were divided into two groups. The first group comprised 55 newborns with RDS and proven sepsis and the second group included 55 newborns with asphyxia and proven sepsis. The statistical analysis confirmed significantly different values of PCT in the analyzed time period in first group of newborns with RDS and proven sepsis, p<0.001. The highest average values (40.37±53.79) were measured on admission with a high level of peak compared to the second group of newborns with asphyxia and proven sepsis. The statistical analysis confirmed significantly different values of PCT in the analyzed time period in the first group of newborns with RDS and proven sepsis with mechanical ventilation (MV) and bubble continuous positive airway pressure (BCPAP) compared to the second group of newborns with asphyxia and proven sepsis, p<0.001. PCT is a promising sepsis marker in newborns with RDSy, capable of complementing clinical signs and routine laboratory parameters suggestive of severe infection at the time of ICU admission.
Hydrocephalus is a condition resulting from disorder in absorption and circulation of the cerebrospinal fluid (CSF). It leads to a progressive ventricular dilatation and need of ventriculoperitoneal shunt (VP) placement.The aim of our study was to present our experience with infants with hydrocephalus, ventriculoperitoneal shunt placement, and early postoperative follow-up. A retrospective study was conducted comprising infants with hydrocephalus born between January 2019-January 2022 with ventriculoperitoneal shunt placement performed at the University Clinic for Neurosurgery in Skopje, Macedonia.Demographic and clinical characteristics, complications and the need for ventriculoperitoneal shunt were documented. Of twenty-three infants with hydrocephalus, 14 (60.8%) were preterm infants (median birth weight 2120 g; mean gestational age 33.1 weeks), 9 (39.1%) were term infants (mean birth weight 3600 g; mean gestational age 38.4 weeks).The etiology of hydrocephalus was: congenital hydrocephalus in 5 infants (21.7%), prematurity in 6 infants (26.08%), spina bifida in 2 infants (8.7%), systemic infection in 4 infants (17.3%), and intraventricular hemorrhage in 6 infants (26.08%).Ventriculoperitoneal shunt was placed in all 23 infants, at the mean age of 33.5 (30-43) days. Postoperative complications as a result of ventriculoperitoneal shunt placement were: ventriculitis manifested in 3 preterm (13%) infants, of which 2 (8.6%) died; five term infants (21.7%) had postoperative seizures, of which 2 infants (8.6%) died. Nineteen infants (82.6%) were discharged and transferred to the neonatology department. Ventriculoperitoneal shunt placement is a treatment of choice for infants with hydrocephalus, although postoperative complications in preterm infants increase the percentage of morbidity and mortality.
In the last three decades a neonatal cardiac surgery has improved the aproach and methods for adequate treatment of complex congenital heart defects. Although we have advances in fetal cardiac imaging and improved perioperative cardiac procedures, the postoperative outcomes in neonates are still present.We present our experience of operated neonates with congenital heart defects in a tertiary referral center, University Clinic for Pediatric Diseases, Neonatal Intensive Care Unit (NICU) in Skopje N. Macedonia. This is a retrospective study including neonates who underwent surgical intervention between January 2013 and December 2015. We analyzed perioperative and postoperative variables, duration of cardiopulmonaly bypass (CPB), and x-cross of aorta, duration of mechanical ventilation, intensive care unit stay and postoperative complications.Out of a total of 85 children, 15/85 (17.6 %) were neonates; the overall mortality was 1/15% (6.6%).There were 13/15 (86.6%) corrective procedures and 2/15 (13.3%) palliative ones. The mean duration of CPB was 46.6 min., duration of x-cross of aorta was 17.5 min. The mean duration of mechanical ventilation was 3.4 days, duration of inotropic support was 4.2 days, and ICU stay 5.8 days. Postoperative complications were confirmed in 3 neonates.Due to adequate cardiac surgery, signicant technological advances, devices and increasing experience in neonatal cardiac surgery we have improved postoperative outcomes.
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