The aim of this study was to evaluate the efficacy of presepsin in both diagnosis and follow-up of early-onset neonatal sepsis (EOS) and also to compare its effectiveness with C-reactive protein (CRP) and procalcitonin (PCT). A total of 29 term infants with EOS group and 40 term infants with control group were included in this study. Before initiating therapy, blood samples for whole blood count, CRP, PCT, presepsin, and culture were obtained from all neonates (T0). This procedure was repeated two times at 72 hours (T3) and day 7 (T7). Presepsin levels of sepsis group at T0 were significantly higher (704.27 ± 223.54 pg/mL) than the control group (508.33 ± 165.46 pg/mL). The sensitivity of CRP, PCT, and presepsin at T0 was found to be 83, 67, and 80%, whereas the specificity was found to be 75, 67, and 75%, respectively. The cutoff value for presepsin was 539 pg/mL with an area under the curve of 0.772. Presepsin may be used as a reliable and accurate marker for both diagnosis and follow-up of EOS. However, to increase the accuracy, presepsin may be used in combination with other markers such as CRP and PCT.

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The diagnosis of neonatal sepsis is usually difficult because the sign and symptoms are nonspecific. Although C-reactive protein (CRP) and procalcitonin (PCT) are the most commonly used auxiliary tests, they are not reliable enough markers to be used for diagnosis of neonatal sepsis. This study aimed to evaluate the efficacy of resistin in diagnosing early onset neonatal sepsis and to compare its effectiveness to CRP and PCT. This prospective study was performed in the neonatal intensive care unit of Medicine Hospital between June and September 2016. Twenty-nine infants in the sepsis group and 33 infants in the control group were recruited. The Töllner scoring system was used for clinical signs. The hematologic parameters were evaluated using the Manroe and Rodwell scoring systems. The blood samples for CRP, PCT, and resistin were collected at admission (T0), and at 72 hours (T3). Mean plasma resistin level at T0 was 54.20 ± 39.3 ng/mL in the sepsis group and 34.92 ± 6.9 ng/mL in the control group. The sensitivity at T0 for resistin was 76%, and the specificity was 67%. The values of area under the curve (AUC) for CRP, PCT, and resistin were 0.84, 0.66, and 0.72, respectively. We found the diagnostic value of resistin to be lower than CRP, although its plasma levels were elevated. Therefore, we propose that resistin has limited value in diagnosis and follow-up of early-onset neonatal sepsis.

Objective: Rotavirus (RV) is one of the most common and important causes of acute gastroenteritis (AGE) in newborns and children worldwide. The aim of this study was to evaluate the effect of the RV vaccine on the natural history of RV infections using the neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and systemic immune inflammatory index (SII) as hematological indexes, clinical findings, and hospitalization. Method: Children aged 1 month to 5 years who were diagnosed with RV AGE between January 2015 and January 2022 were screened, and 630 patients were included in the study. The SII was calculated by the following formula: neutrophil × platelet/lymphocyte. Results: Fever and hospitalization were significantly higher and breastfeeding was significantly lower in the RV-unvaccinated group than in the RV-vaccinated group. The NLR, PLR, SII, and CRP were significantly higher in the RV-unvaccinated group (p < 0.05). The NLR, PLR, and SII were significantly higher both in the non-breastfed group than in the breastfed group and in the hospitalized group than in the not hospitalized group (p < 0.05). CRP was not significantly different in either the hospitalization group or the breastfeeding group (p > 0.05). SII and PLR were significantly lower in the RV-vaccinated group than in the RV-unvaccinated group in both the breastfed and non-breastfed subgroups. For NLR and CRP, while there was no significant difference according to RV vaccination status in the breastfed group, there was a significant difference in the non-breastfed group (p value: <0.001; <0.001). Conclusions: Despite the low level of vaccine coverage, the introduction of RV vaccination had a positive impact on the incidence of RV-positive AGE and related hospitalizations in children. These results showed that breastfed and vaccinated children were less prone to inflammation because their NLR, PLR, and SII ratios were lower. The vaccine does not prevent the disease 100%. However, it can prevent severe disease with exsiccation or death.

Aim: This study evaluated the relationship between the systemic immune–inflammatory index (SII), neutrophil–to–lymphocyte ratio (NLR), and platelet–to–lymphocyte ratio (PLR) with clinical findings of respiratory syncytial virus (RSV) infection among children with a diagnosis of lower respiratory tract infection (LRTI). Methods: The study was conducted between 1 January 2020 and 1 January 2022 in a pediatric clinic. This retrospective study included 286 consecutive patients between 0 and 12 years of age, 138 of whom were RSV (+) (48.25%) and 148 of whom were RSV (−) (51.75%). The detection of the RSV antigen was carried out using the chromatographic immunoassay method on nasopharyngeal swabbing samples. Results: CRP content was significantly higher in patients with RSV (+) than in children with RSV (−), while NLR, PLR, and SII, as inflammatory parameters, were significantly lower. Fever, coughs, and wheezing were the most common symptoms in the RSV (+) groups (100%). RSV infections were the highest in November, October, and December, in that order. The AUC was statistically significant for parameters in all groups. AUC values were 0.841 (95%: 0.765–0.917) for leukocytes, 0.703 (95%: 0.618–0.788) for lymphocytes, 0.869 (95%: 0.800–0.937) for CRP, 0.706 (95%: 0.636–0.776) for NLR, 0.779 (95%: 0.722–0.836) for PLR, and 0.705 (95%: 0.633–0.776) for SII. CRP was found to have both high sensitivity (80.4%) and high specificity (82.4%) among all parameters. While the ROC analysis results showed similar results for children under two years old, only CRP and NLR were statistically significant in this group. Conclusion: CRP performed better than other blood parameters as a marker. The NLR, PLR, and SII index were significantly lower in LRTI patients with RSV (+) than in those with RSV (−), which implies a higher grade of inflammation. If the cause of the disease can be determined by this method, disease management will be easier, and unnecessary antibiotics could be avoided.

GirişÜlkelerin neonatal ve perinatal ölüm oranları sosyal ve ekonomik gelişmişlik düzeyini yansıtan en önemli göstergelerdendir. Dünya Sağlık Örgütünün 2013 yılı raporlarına göre 5 yaş altı ölümlerin %45'i yenidoğan döneminde meydana gelmektedir ve bu raporda 1990 yılında 1000 canlı doğumda 33 olarak bildirilen neonatal mortalite hızı 2013 yılında %40 azalarak 1000 canlı doğumda 20'ye gerilemiştir. Her yıl dünyada 2,8 milyon bebeğin yenidoğan döneminde kaybedildiği tahmin edilmektedir (1). ÖZET Amaç:Hastanemiz yenidoğan servisinde yatırılan ve izlem sırasında kaybedilen bebeklerin demografik özelliklerinin ve mortalite nedenlerinin saptanarak bu bilgilerin daha sonra yapılacak çalışmalara kaynak oluşturması amaçlanmıştır. Gereç ve Yöntem:Bu çalışmada yenidoğan yoğun bakım ünitemizde 1 Ocak 2012-31 Aralık 2014 tarihleri arasında yatırılan ve izlemleri sırasında kaybedilen bebekler, yerel etik kurul izni alındıktan sonra retrospektif olarak değerlendirilerek, mortalite oranları, risk faktörleri ve ölüm nedenleri belirlenmiştir. Bulgular:Ünitemizde üç yıllık sürede 1074 hasta takip edildi. Hastalardan 31'i izlem sırasında kaybedildi. Bu hastaların 22'si (%71) preterm, 9'u (%29) termdi. Mortalite oranı %2,8 bulundu, bebeklerin 22'si (%71) ilk bir haftada, 9'u (%29) 1. haftadan sonra kaybedildi. Ölüm nedenleri incelendiğinde prematürite ve respiratuar distres sendromu (RDS) (%32), konjenital anomaliler (%29), sepsis'in (%16) ilk üç sırayı aldığı belirlendi. Bunları solunum sistemine ait diğer sorunlar (%9), doğumsal kalp hastalıkları (%6), perinatal asfiksi (%6) ve doğumsal metabolik hastalıkların (%3) izlediği saptandı. Sonuç:Yenidoğan ölümlerinin önemli bir kısmı prematüre doğum, enfeksiyon ve konjenital anomalilere bağlı olarak görülmektedir. Bu nedenle önlenebilir ölüm nedenlerini ve oranlarını azaltmak için gebelik takip programlarının yaygınlaştırılması, yeterli antenatal bakımın sağlanması, doğum ve doğum sonrası bakımın uygun koşullarda sağlanması gereklidir.Anahtar Kelimeler: Neonatal mortalite, prematürite, ölüm nedenleri ABSTRACT Objective: The aim of this study was to determine the rate of neonatal mortality and also to establish the possible causes of mortality in our neonatal intensive care unit (NICU). Material and Methods:In this study, neonates who died during hospitalization in NICU between 1st January 2012 and 31st December 2014 were evaluated retrospectively. Risk factors, causes and rate of neonatal mortality were determined.Results: During the three years, 1074 patients admitted in our clinic and 31 of them died. The proportion of premature neonates 71%, proportion of term neonates 29% were determined. Mortality rate was 2.8%. The proportion of neonates who died in the first week was 71%, who died after first week was 29%. The common causes of neonatal mortality were prematurity and Respiratory Distress Syndrome (32%), congenital anomalies (29%), sepsis (16%), and other causes were respiratory problems (9%), congenital heart diseases (6%), perinatal asphyxia (6%), and metabolic diseases (3%). Co...

Biomarker studies are becoming increasingly interesting for many fields ofmedicine. The use of biomarkers in medicine is involved in detecting diseases andsupporting diagnosis and treatment decisions. New research and new discoveries on themolecular basis of the disease show that there may be a number of promising newbiomarkers for use in daily clinical practice. Clinical trials in children lag behind adultresearch both in quality and quantity. The number of biomarkers validated to optimizepediatric patient management is limited. In the pathogenesis of many diseases, it shouldnot be extrapolated to the pediatric clinical setting, taking into account that biomarkersthat are effective in adults are clearly different in children and that ontogeny directlyaffects disease development and therapeutic response in children. The search for idealbiomarkers or markers that can make an early and definitive diagnosis in neonatalsepsis is still ongoing. The ideal biomarker for pediatric diseases should be costeffective,noninvasive, applicable to pediatric specific diseases, and its results shouldcorrespond to age-related physiological changes. Lactate, troponin and B-typenatriuretic peptide are valuable biomarkers in the evaluation and management ofcritically ill children with cardiac disease. Tumor markers in children are biochemicalsubstances used in the clinical treatment of pediatric tumors and to detect the presenceof cancer (regression or progression). In this chapter, current and brief informationabout biomarkers and their clinical applications used in the diagnosis and monitoring ofpediatric diseases is presented.