Successful Treatment of Arterial Thrombus in an Extremely Low-Birth-Weight Preterm Neonate

Arterial thromboembolism in the pediatric population frequently occurs secondary to arterial catheterization. Catheterization-related complications are more common in smaller and sicker infants, due to high prothrombotic activity, low levels of natural anticoagulants, and various fibrinolytic imbalances. Arterial thrombus management in neonates remains controversial. Recombinant tissue plasminogen activator is the most commonly used thrombolytic agent in children, however there is very little experience with recombinant tissue plasminogen activator therapy in small prematures, especially in the first week of life. This case study reports catheter-related femoral artery occlusion in an extremely low-birth-weight preterm infant. Despite continuous heparin infusion for 6 hours, no resolution of the thrombus was seen by clinicians. Heparin was stopped, and recombinant tissue plasminogen activator therapy enabled complete recovery from the thrombus. The risk of bleeding (including intracranial hemorrhage) with recombinant tissue plasminogen activator treatment, especially in small preterm neonates is unknown. However, in this extremely low-birth-weight preterm infant, recombinant tissue plasminogen activator therapy was effective, and limiting the infusion rate to ≤0.4 mg/kg/hour was safe

Bebeklerde ve çocuklarda yaygın fizyolojik sıkıntılar ve davranış sorunları: Birinci basamak hekimlerinin bilmesi gerekenler

While some parents arrive at the physician’s office with concerns about their child’s behavior, others are unaware of their child’s physiological and behavioral problems until they are asked specific questions about their child’s conduct. An understanding of the child’s physiological and temperamental factors, together with an assessment of the settings in which the behaviors occur are critical for the physician to provide a successful treatment plan, as are events preceding the behavior, and consequences of the behavior. Physicians must therefore ascertain potential problems and identify contributing factors in order to recommend specific interventions, or refer the child to the appropriate specialist. This article reviews common physiological and behavioral problems of children so that primary care physicians can effectively aid families in identifying problem behaviors and promoting appropriate behavior

Palm oil for infant feeding: What do we know?

Beslenmenin ana maddelerinden biri olan yağların temel fonksiyonunun enerji sağlamak olduğu bilinmektedir. Ancak son yıllarda özellikle bebeklik döneminde yağların başka önemli işlevlerinin de olduğu anlaşılmıştır. Önceki araştırmalarda miktar ve enerji/kilo alımı gibi konular üzerinde durulurken yağların içerik ve özelliklerini ele alan güncel çalışmalarda yağ kalitesinin büyüme, gelişme ve uzun süreli sağlık sonuçlarını etkilediği gösterilmiştir. Bebek mamalarında kullanılan hurma yağındaki palmitik asidin yapısal olarak anne sütünden farklı olması nedeniyle bebeklerde sindirim, emilim ile ilgili sorunlar gözlenebilmektedir. Bu sorunlar arasında a) yağ emilimi ve enerji alımının azalması; b) dışkı kıvamı ve sıklığının olumsuz etkilenmesi; c) kolik ve regürjitasyon benzeri sindirim sorunlarının ortaya çıkması ve d) kalsiyum emiliminin azalması ile mineralizasyon ve kemik kütlesi üzerinde olası olumsuz sonuçlar doğurması sayılabilir.The main function of fats as essential part of the diet is known to provide energy. However, in recent years, fats have been determined to have other important functions, particularly in infancy. While amount and calorie intake/weight gain constituted the focus of previous studies, recent studies concerning the content and properties of fats have showed the impact of fat quality on growth and development as well as long-term health outcome. Due to the fact that palmitic acid content of palm oil used in infant formulas structurally differs from the human milk content of palmitic acid, infant formulas containing palm oil may lead to digestion and absorption problems among infants. These problems may be mainly as follows: a) reduction in fat absorption and calorie intake; b) adverse effects on stool consistency and frequency; c) occurrence of digestive problems such as colic and regurgitation; d) adverse effects on bone mineralization and bone mass due to reduction in calcium absorption

Bronşiolit ve dilate kardiyomyopatisi olan bir bebekte sol koroner arterin pulmoner arterden çıkış anomalisi (ALCAPA)

The most common cause of dilated cardiomyopathy (CMP) is viral myocarditis. However, anomalous origin of the left coronary artery is a rare condition that should be evaluated with high suspicion in the differential diagnosis of an infant with dilated CMP. With early surgical correction, an anomalous coronary artery origin has a good prognosis. Awareness of this condition is essential for prompt diagnosis. This article reports a 5 months-old infant with dilated cardiomyopathy in the setting of RSV bronchiolitis. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) was the final diagnosis in the infant, who presented as viral myocarditis with RSV infection. She was operated successfully with the direct reimplantation of the coronary artery to the aorta.Dilate kardiyomyopatinin en yaygın nedeni viral myokardittir. Bununla birlikte sol koroner arterin pulmoner arterden çıkış anomalisi nadir bir durum olup dilate kardiyomyopatinin etiyolojisinde yüksek şüphe ile irdelenmelidir. Erken cerrahi düzeltme ile koroner arter çıkış anomalisinin prognozu iyidir. Bu bozukluğun farkındalığında olmak hızlı teşhis için önemlidir. Makalede 5 aylık bir süt çocuğunda RSV bronşioliti zemininde gelişen dilate kardiyomopati olgusu bildirilmektedir. RSV infeksiyonu ile viral myokardit geliştiği düşünülen bebekte kesin tanı sol koroner arterin pulmoner arterden çıkış anomalisi (ALCAPA) idi. Sol koroner arterin aortaya doğrudan reimplantasyon ameliyatı başarı ile sağlandı