The Evaluation of Liver Steatosis with Transient Elastography in Metabolic Syndrome and the Relationship Between Serum Endorphin Levels

Objective: Studies in recent times researching the correlation between serum endotrophinlevel and Type 2 DM have focused on the association of fatty liver with metabolic syndrome.This study aims to research the correlation between serum endotrophin levels, defined asa marker of metabolic dysregulation, with nonalcoholic fatty liver in metabolic syndromepatients, with increasing prevalence.Methods: Our prospective study included 40 patients (24 females and 16 males) with metabolicsyndrome attending the internal medicine clinic and 20 healthy volunteers (ten femalesand ten males). Evaluation of patients in terms of liver steatosis used transabdominal ultrasonographywith a Toshiba 500 Aplio brand model ultrasound device with 10 MHz convexprobe with transient elastography method. Fatty Liver Index and Hepatic Steatosis Index(HSI) were calculated on the basis sample analyses. The endotrophin levels were studiedwith a Sunred enzyme-linked ımmunosorbent assay kit.Results: Endotrophin levels were found to be lower in the group with metabolic syndromecompared to the healthy group and results were statistically significant different (p<0.001).When the mean elastography results for the groups (in m/s and kPa) are compared, therewere statistically significant differences found (p=0.001, p<0.001). There were statisticallysignificant differences between HSI score with serum insulin levels and homeostasis modelassessment results.Conclusion: In our study, a correlation was not found between endotrophin levels and fattyliver. Endotrophin is a parameter with newly discovered effects and is being researched forapplicability and reliability in clinical practice

Effect of standardized hands-on-training in caregivers of children with tracheostomy

Introduction: The pediatric tracheostomy related mortality mostly occurs due to accidental decannulation and cannula obstruction. The caregivers may be discharged with inadequate knowledge. Aims and objectives: Simulation training can highlight skills regarding tracheostomy care. Our aim is to investigate if a standardized hands-on-training improves knowledge and skills among caregivers. Methods: Before the traning, we applied a pretest to caregivers in order to assess their knowledge and current practises. Skills were evaluated by two simulation scenarios in a patient model: cannula change and aspiration. After one hour theoretical and practical hands-on training, the same post-test was applied, skills were reevaluated regarding cannula change and aspiration with practical tests. Results: The multicenter study included 65 caregivers of patients with tracheostomy. The median score of the theoretical test including 23 questions improved from 12 to 18 (p<0.001). The specific knowledge questions that were considered critical for tracheostomy care including minimum number of aspiration per day, required frequency of tracheostomy cannula change, solutions recommended for tracheostomy skin care, the pressure for the aspiration, mean duration of aspiration and the depth of aspiration also improved significantly after the education (p<0.001 for all of the specific questions). There was a significant improvement in both cannula change and aspiration skills regarding median scores of correct steps in procedures (p<0.001). Conclusions: A standardized hands-on training is highly effective to increase the rate of proper practices for tracheostomy care and should be implemented for all centers

Epidemiologic and clinical characteristics of neonates with late-onset COVID-19: 1-year data of Turkish Neonatal Society

© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.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 [OR]: 9.52, 95% confidence interval [CI]: 4.17–21.71), tachypnea (OR: 26.5, 95% CI: 9.59–73.19), and chest retractions (OR: 27.5, 95% CI: 5.96–126.96) were associated with more severe clinical disease. Also, there were significant differences in the C-reactive protein level, prothrombin time (PT), partial thromboplastin time, international normalized ratio, and days in the NICU (p = 0.002, p = 0.012, p = 0.034, p = 0.008, and p < 0.001, respectively) between patients with mild-moderate and severe-critical presentations. A PT above 14 s was a significant predictor of severe/critical cases, with a sensitivity of 64% and specificity of 73%. Conclusions: Our data showed that late-onset COVID-19 infection in neonates who need hospitalization can be severe, showing associations with high rates of ventilatory support and myocarditis. Cough, tachypnea, and retractions on admission suggest a severe disease course. Trial registration: ClinicalTrials.gov identifier: NCT04401540.What is Known:• Neonatal cases of COVID-19 infection are mainly reported as perinatal COVID-19 cases.• Neonates with perinatal transmission have a mild course and favorable prognosis.What is New:• Among symptomatic neonates with late-onset COVID-19 infection, fever was the most common symptom, and almost one quarter of hospitalized cases needed some type of respiratory support. Myocarditis was the most common complication.• The presence of cough, tachypnea, retractions, and a PT above 14 s were associated with an increased risk of severe COVID-19