ObjectiveTo investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey.Material and methodsA prospective cohort study was performed between April 1, 2016 and April 30, 2017. The study included VLBW infants admitted to level III NICUs. Perinatal and neonatal data of all infants born with a birth weight of ≤1500 g were collected for infants who survived.ResultsData from 69 NICUs were obtained. The mean birth weight and gestational age were 1137±245 g and 29±2.4 weeks, respectively. During the study period, 78% of VLBW infants survived to discharge and 48% of survived infants had no major neonatal morbidity. VLBW infants who survived were evaluated in terms of major morbidities: bronchopulmonary dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers.ConclusionThe present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs.

Neisseria meningitidis is one of the major causes of meningitis in children and adolescents, but it is rarely found during the neonatal period. Here, we describe a neonate with meningococcal sepsis who was admitted to the hospital on postnatal day 10, and we discuss the clinical features of neonatal infection with N. meningitidis in relation to the literature (analysis of a 97-year period). CASE REPORTO ur case, a 10-day-old male patient, was born by normal spontaneous delivery at term with a weight of 3,380 g. During pregnancy, his mother was regularly followed up. The natal history was unremarkable. He was breastfed and discharged without any problems on postnatal day 2. The neonate was admitted to the neonatal intensive care unit due to fever and difficulty breathing. An initial physical examination of the patient revealed cutis marmorata. He was hypotonic in general and exhibited poor sucking. The results of cardiovascular and respiratory examinations were normal. The patient did not exhibit organomegaly or eruptions. The capillary filling time was 2 s. The patient's initial vital findings were as follows: axillary temperature, 38.8°C; heart rate, 190/min; respiratory rate, 55/min; and arterial blood pressure, 100/60 mm Hg. The admittance weight of the neonate was 3,530 Ϯ 150 g. The results of a complete blood count and serum biochemical analysis did not reveal any abnormalities. The patient's C-reactive protein level was normal (0.2 mg/dl).A urinalysis and chest X-ray were normal. A peripheral blood smear revealed that the immature/total neutrophil ratio was 0.3. An analysis of arterial blood gases revealed both respiratory and metabolic acidosis.Blood and urine culture samples were obtained. The patient was diagnosed with sepsis and respiratory insufficiency based on the clinical and laboratory findings. He was intubated and given respiratory support with mechanical ventilation in SIMV (simultaneous intermittent mandatory ventilation) mode. Ampicillin (100 mg/kg of body weight/day) and cefotaxime (100 mg/kg/day) were administered. Intravenous fluid was given at an infusion rate of 150 ml/kg/day. Cranial, abdominal, and urinary ultrasound investigations done during clinical follow-up were evaluated as normal.To rule out meningitis, a lumbar puncture was done; the cerebrospinal fluid (CSF) biochemistry did not reveal any abnormalities.During the second hour of hospitalization in the intensive care unit, the patient's capillary filling time was found to be increased (5 s), and hypotension and bradycardia developed; thus, he was given a 10-ml/kg bolus of physiological serum twice. Because the patient's hypotension persisted, dopamine (10 g/kg/min) and dobutamine (10 g/kg/min) were given. However, during the fifth hour of admittance, a generalized purpuric eruption (Fig. 1) that enlarged and began to coalesce developed. Laboratory testing revealed leukopenia and thrombocytopenia, prolonged coagulation, and a rise in the C-reactive protein level (3.5 mg/dl). Vitamin K (1 mg) and fresh frozen plasma (15 ml/kg) we...

Purpose: The aim of the study was to assess the effect of a walking exercise program, three times a week for 8 weeks, on fatigue in people with chronic obstructive pulmonary disease (COPD). Design: This study was a randomized controlled trial. Methods: Walking exercise was applied to the intervention group three times a week for 8 weeks; no exercise was applied to the control group. Findings: No difference was seen between the points of pretest fatigue of the intervention and control groups (t = À0.788, p = .434). However, according to the posttest, the intervention group's point of fatigue was lower than the control groups, and this difference was statistically significant (t = À3.924, p = .001). Conclusion: It was found that a walking exercise program applied to patients with COPD affected the fatigue symptom positively. Clinical Relevance: Walking exercises programme can be used by nurses as a reference to monitor chronic obstructive pulmoner disease patients' health status.

Purpose The aim of the study is to determine daytime sleepiness in university students and its relationship with internet addiction as the determinant. Method A descriptive cross-sectional design was used. Study population consisted of 1,150 first- and fourth-year students studying in some faculties at a university located in the Central Anatolia Region of Turkey. Findings In this study, it was determined that the students obtained a mean score of 5.9 ± 2.1 points from the daytime sleepiness scale and the rate of those with daytime sleepiness problem was 17.9%. Furthermore, 52.3% of the students had a sleep duration of 7–8 hours. An increase in internet addiction mean score increases the risk of daytime sleepiness approximately one time. Conclusions Increase of internet addiction score increases the risk of daytime sleepiness approximately one time.

Amaç: Hastanemiz yenidoğan kliniğinde yatırılarak izlenen ve izlem sırasında kaybedilen bebeklerin demografik özelliklerinin sunulması amaçlanmıştır. Gereç ve Yöntem: Yenidoğan Kliniğimizde beş yıllık süre içerisinde (1 Ocak 2007-31 Aralık 2011), kaybedilen bebeklerin kayıtları retrospektif olarak incelenerek; neonatal mortalite oranları, perinatalmaternal risk faktörleri ve ölüm nedenleri belirlendi. Bulgular: Çalışma süresince kliniğimize yatan hasta sayısı 5491 iken bu bebeklerin 167'si kaybedildi ve mortalite oranı %3,04 olarak saptandı. Kaybedilen bebeklerin %15,6'sı ilk 24 saat içerisinde, %74,9'u ise ilk 7 gün içerisinde kaybedilmişti. Kaybedilen bebeklerin %46,8'i kız, %53,2'si erkek idi. Akraba evliliği sıklığı %28,1 ve anne yaşı <19yaş olma oranı %2,3 ve >35 yaş olma oranı %14,3 olarak belirlendi. Kaybedilen bebeklerin %61,6'sı 37 gebelik haftasının altında, %29,9'u 28 gebelik haftası ve altında doğmuştu. Doğum ağırlığına göre ise %37,1'i 1000 g altında ve %64,6'sı 2500 g altında idi. En sık saptanan yenidoğan ölüm nedenleri; respiratuar distres sendromu ve immatürite %24,6, neonatal sepsis %14,9 ve konjenital anomaliler %10,2 olarak belirlendi. Diğer nedenler ise sırasıyla; perinatal asfiksi %9, diğer solunum problemleri (pnömotoraks, mekonyum aspirasyon sendromu, konjenital diyafragma hernisi v.b) %9, siyanotik konjenital kalp hastalığı %8,4, metabolik hastalıklar %7,7, intraventriküler kanama %7,7, nekrotizan enterokolit %3,6 ve diğer nedenler %4,9 olarak belirlendi. Sonuç: Yenidoğan bebeklerin ölüm nedenleri arasında immatürite ve konjenital anomaliler günümüzde önemli bir sıklıkta yer almaktadır. Bebeklerin önlenebilir ölüm nedenlerinin saptanarak bunları azaltmaya yönelik çabalar yenidoğan bebeklerin ölüm oranlarını azaltmada belirli oranda faydalı olacaktır.

Amaç: Preeklampsinin çok düşük doğum ağırlıklı bebeklerin erken dönemdeki morbidite ve mortalite oranları üzerine etkisini araştırmak.

No abstract

Early nCPAP treatment in preterm infants (≤32 weeks of gestation) decreases both the need for MV and the use of surfactant, but without a significant effect on BPD development. (No. 2016/324).