Tubular calcium, magnesium, and phosphate excretion during therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy: A prospective study

Objectives: Hypocalcemia, hypomagnesemia, and hyperphosphatemia are common electrolyte disturbances in perinatal asphyxia (PA). Different reasons have been proposed for these electrolyte disturbances. This study investigated the effect of the urinary excretion of calcium (Ca), magnesium (Mg), and phosphorus (P) on the serum levels of these substances in babies who were treated using therapeutic hypothermia for hypoxic ischemic encephalopathy (HIE) caused by PA. This study sheds light on the pathophysiology that may cause changes in the serum values of these electrolytes

Long- and short-term effects of propranolol hydrochloride treatment on very preterm newborns

Background: While propranolol hydrochloride (PH) is being more widely used in adult patients, its administration in the neonatal period as well is progressively on the rise in our time. With the increasing use of PH in the neonatal age period, worries resulting from the potential adverse effects of the agent on vital organs, such as brain, in particular, have come to the fore. Such concerns increase even more when PH is used in treating preterm infants. Our study, aiming to clarify these increasing concerns, is the first clinical one of its kind in the literature, conducted on very preterm infants, the patient group most vulnerable to PH treatment. Aims: To investigate possible short- and long-term side effects of using PH during the neonatal period and to provide information to clinicians regarding such side effects. Study Design: Case-control study. Materials and Methods: This was a double-blind, randomized, and placebo-controlled trial. In the study, we included 36 very preterm infants subjected to PH treatment (0.5 mg/kg/6 h) initiated in the first postnatal month and lasting for approximately 1 month (PH group [PHG]) and 40 very preterm infants who received distilled water in place of PH (control group [CG]). The gestational age of all infants in the study was below 31+6 weeks, and their birth weight was under 1500 g. The patients' vital functions and physical development were monitored and recorded in patient follow-up forms. At approximately 1 year of age (CG: 9.73 +/- 4.56 months and PHG: 10.8 +/- 5.73 months), the Ankara Developmental Screening Inventory (ADSI) and the Denver Developmental Screening Test II (DDST-II) were used to assess the mental development of the children. Results: In the PHG patients, PH treatment was initiated at 27.0 +/- 2.7 days of life and lasted for 26.5 +/- 8.7 days. The newborns in the CG received distilled water for similar durations. A statistically significant difference in blood sugar levels was detected between CG (78.4 +/- 12.5) and PHG (65.6 +/- 7.5) (P = 0.006). However, no statistically significant difference was found between the two groups in terms of physical and mental development (ADSI and DDST-II) of the children at the end of the study (P > 0.05). Conclusions: When used on very preterm infants, PH may have some temporary effects on the patients' vital functions in the short term; however, no serious side effects were detected that may affect the physical and mental development in the long run

Omega-3 fatty acids may be harmful to thickness of aortic intima-media

There are several studies confirming an association between nicotine exposure and increase in aortic intima-media thickness (aIMT) as a pre-atherosclerotic lesion. The omega-3 FAs are on the other hand reported to have an anti-atherogenic effect. We aimed to evaluate histopathologically the effect of nicotine exposure during pregnancy and lactation period on fetal growth and aIMT at postnatal 45 days of age in rat pups living in the same conditions and to determine the protective effect of omega-3 FAs

A successful balloon angioplasty procedure in a 1050 gram premature infant with coarctation of the aorta

Surgery is the primary treatment of aortic coarctation in all newborns, including low birth weight premature infants. Balloon angioplasty procedure in the treatment of native coarctation of the newborn is controversial due to high rates of restenosis and complications such as increased risk of aneurysm formation and damage to the peripheral artery involved in the intervention. Balloon angioplasty is often performed as a palliative treatment particularly in newborns with impaired cardiac functions indicating high rates of mortality. We believe that this procedure may be performed as a palliative treatment for low birth weight infants in centers lacking adequate surgical experience. Herein, we define a successful balloon angioplasty procedure which we carried out using the femoral artery route in a low birth weight premature infant with coarctation of the aorta

Ovarian hyperstimulation syndrome treated by medroxyprogesterone acetate

The activation of the hypothalamic-pituitary-gonadal axis observed during the first month of life is thought to be a significant phase in the maturation of gonads and potentially be important for the development of reproductive functions. The preterm ovarian hyperstimulation syndrome (POHS) was first detected at postconception 36-39 weeks in a preterm female newborn with edema developing in the vulva, the hypogastric site, and the upper leg. The pathophysiology of this postnatal hormonal change is obscure. In this paper we would like to present a case developing POHS and to discuss possible pathophyslogical mechanisms. Abstract Abstract The activation of the hypothalamic-pituitary-gonadal axis observed during the first month of life is thought to be a significant phase in the maturation of gonads and potentially be important for the development of reproductive functions. The preterm ovarian hyperstimulation syndrome (POHS) was first detected at postconception 36-39 weeks in a preterm female newborn with edema developing in the vulva, the hypogastric site, and the upper leg. The pathophysiology of this postnatal hormonal change is obscure. In this paper we would like to present a case developing POHS and to discuss possible pathophyslogical mechanisms. PMID: 24859504 [PubMed - in process] &nbsp; &nbsp;</p

Compare the effects of intravenous and intraperitoneal mesenchymal stem cell transplantation on ultrafiltration failure in a rat model of chronic peritoneal dialysis

Aim: The purpose of this study was to compare the possible healing effects of intraperitoneal (IP) and intravenous (IV) mesenchymal stem cell (MSC) transplantation on ultrafiltration failure (UFF) in a chronic rat model of peritoneal dialysis (PD). Methods: Rats were initially divided into two groups. The UFF-group received once-daily IP injections of 20 mL of 3.86% glucose PD solution for six weeks to stimulate the development of UFF, and a control group received no injections. The UFF group was sub-divided into four groups: an UFF-C group, a MSC-IP group, a MSC-IV group and a placebo (P) group. Peritoneal equilibration tests (PETs) and peritoneal biopsies were performed in the control and UFF-C groups. MSCs were administered by IP injection in the MSC-IP group and by IV injection in the MSC-IV group. The P group received IP injection of placebo. PETs and peritoneal biopsies were performed in the MSC-IP, MSC-IV and P groups at the three weeks after receiving MSCs or placebo. Results: When compared with the control group, ultrafiltration capacity significantly decreased, and the submesothelial thickness increased in the UFF-C and P group, but there were no differences between the control and MSC-IP and MSC-IV groups. The rate of glucose transport was high in the UFF-C and P group compared with the control group, and D/P-Cr rates in the UFF-C and P group were lower than in the control group. However, D/D0(glucose) was higher and D/P-Cr was lower in the MSC-IP group than in the UFF-C and P groups, but D/D0(glucose) rate of MSC-IV group similar to UFF-C and P groups and there was no difference between MSC-IV group and the other groups in terms of D/P-Cr rates. The MSC-IP, MSC-IV and P groups had significantly decreased tumor necrosis factor alpha concentrations compared with the UFF-C group. MSC-IP group had lower levels of TGF-beta 1 compared with the P group; MSC-IP group had also lower levels of interleukin-6 compared with UFF-C group. Conclusion: The UFF group had a high permeability UFF. These results showed that IV and IP MSC transplantation exerted positive effects on UFF in a chronic rat model of PD. However, healing effect of small solute transport in MSC-IP group was better than MSC-IV group. IP MSC transplantation may be more effective than IV MSC transplantation for the renewal of the peritoneum in chronic PD patients with UFF

The Comparison of Thyroxine versus Thyroxine plus Oral Iodine in the Treatment of Congenital Hypothyroidism due to Iodine Deficiency

Aim: Iodine deficiency is one of the most important causes of congenital hypothyroidism. In addition to thyroid hormone replacement, iodine supplementation is also given to newborns with congenital hypothyroidism due to iodine deficiency. We aimed to determine whether it is beneficial to administer iodine supplementation in addition to the L-thyroxine (L-T-4) treatment of newborns with congenital hypothyroidism due to iodine deficiency. Materials and Methods: Of 51 newborns, 26 who were diagnosed with congenital hypothyroidism due to iodine deficiency were treated with L-T-4. The remaining 25 cases were given L-T-4 plus 100 g/day of oral iodine. Free triiodothyronine (fT(3)), free thyroxine (fT(4)), thyroid-stimulating hormone (TSH), thyroglobulin (TG), thyroid volume, urine iodine and breast milk iodine levels were measured in the first and third months of treatment, and the data were compared between the two groups. Results: First-and third-month values of fT(3), fT(4), TSH, TG and thyroid volume for both groups were statistically similar. There was no significant difference between the two groups in respect to falling levels of fT(3) and TSH, the rate of increase of fT(4) levels or the shrinkage rate of thyroid volume. Conclusion: In this study, the addition of oral iodine to L-T-4 treatment provided no benefit compared to treatment with L-T-4 alone. (C) 2014 S. Karger AG, Basel &nbsp; Abstract AIM: Iodine deficiency is one of the most important causes of congenital hypothyroidism. In addition to thyroid hormone replacement, iodine supplementation is also given to newborns with congenital hypothyroidism due to iodine deficiency. We aimed to determine whether it is beneficial to administer iodine supplementation in addition to the L-thyroxine (L-T4) treatment of newborns with congenital hypothyroidism due to iodine deficiency. MATERIALS AND METHODS: Of 51 newborns, 26 who were diagnosed with congenital hypothyroidism due to iodine deficiency were treated with L-T4. The remaining 25 cases were given L-T4 plus 100 &mu;g/day of oral iodine. Free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), thyroglobulin (TG), thyroid volume, urine iodine and breast milk iodine levels were measured in the first and third months of treatment, and the data were compared between the two groups. RESULTS: First- and third-month values of fT3, fT4, TSH, TG and thyroid volume for both groups were statistically similar. There was no significant difference between the two groups in respect to falling levels of fT3 and TSH, the rate of increase of fT4 levels or the shrinkage rate of thyroid volume. CONCLUSION: In this study, the addition of oral iodine to L-T4 treatment provided no benefit compared to treatment with L-T4 alone. &nbsp;</p

A harmful traditional practice in newborns with adrenocorticotropic hormone resistance syndrome: branding

Branding refers to a traditional practice of creating 'herapeutic' burns with hot iron rods over the skin in order to treat various diseases. Although branding is a harmful practice for the body, it has been used for various illnesses including physiologic jaundice in newborns, pneumonia, and convulsions. It causes serious morbidity and delays seeking proper medical care in neonates. Innovations of modern medicine and the use of evidence-based medicine should be preferred instead of these traditional practices. We present a branded mature newborn baby who was diagnosed as having adrenocorticotropic hormone resistance syndrome. This problem is very rare in Turkey; however, it is a very important health issue and has social aspects. Therefore, this case is presented to increase awareness

Mesenchymal stem cell transplantation may provide a new therapy for ultrafiltration failure in chronic peritoneal dialysis

The purpose of this study was to investigate possible healing effects of intraperitoneal (IP) mesenchymal stem cell (MSC) transplantation on ultrafiltration failure (UFF) in a chronic rat model of peritoneal dialysis (PD)