An observational, multicenter, registry-based cohort study of Turkish Neonatal Society in neonates with Hypoxic ischemic encephalopathy

BACKGROUND: Hypoxic ischemic encephalopathy (HIE) is a significant cause of mortality and short- and long-term morbidities. Therapeutic hypothermia (TH) has been shown to be the standard care for HIE of infants ≥36 weeks gestational age (GA), as it has been demonstrated to reduce the rates of mortality, and adverse neurodevelopmental outcomes. This study aims to determine the incidence of HIE in our country, to assess the TH management in infants with HIE, and present short-term outcomes of these infants. METHODS: The Turkish Hypoxic Ischemic Encephalopathy Online Registry database was established for this multicenter, prospective, observational, nationally-based cohort study to evaluate the data of infants born at ≥34 weeks GA who displayed evidence of neonatal encephalopathy (NE) between March, 2020 and April 2022. RESULTS: The incidence of HIE among infants born at ≥36 weeks GA (n = 965) was 2.13 per 1000 live births (517:242440), and accounting for 1.55% (965:62062) of all neonatal intensive care unit admissions. The rates of mild, moderate and severe HİE were 25.5% (n = 246), 58.9% (n = 568), and 15.6% (n = 151), respectively. Infants with severe HIE had higher rates of abnormal magnetic resonance imaging (MRI) findings, and mortality (p0.05). TH was administered to 85 (34.5%) infants with mild HIE, and of those born of 34-35 weeks of GA, 67.4% (n = 31) received TH. A total of 58 (6%) deaths were reported with a higher mortality rate in infants born at 34-35 weeks of GA (OR 3.941, 95% Cl 1.446-10.7422, p = 0.007). CONCLUSION: The incidence of HIE remained similar over time with a reduction in mortality rate. The timing of TH initiation, whether [removed

Comparing the fatty acid levels of preterm and term breast milk in Turkish women

Aim: Lipids are the main source of calories and considered very important in infant growth. We aimed to compare fatty acid composition of term and preterm breast milk. This is the first study that compares the fatty acid levels of preterm and term breast milk in Turkish women. Materials and methods: Breast milk samples were obtained from mothers of term (n 15) and preterm (n 15) infants on postnatal days 3, 7, and 28. Fatty acid composition of human breast milk was determined longitudinally by gas-chromatography/mass spectrometry. Results: There were 31 fatty acids measured in the milk samples. In the first month, 17 fatty acid levels had significant differences. In group comparison, some fatty acids (C14:0, C16:0, C18:1 and C20:5) had significantly increased in the preterm group (P 0.041, P 0.046, P 0.027, P 0.033, respectively), whereas myristoleic acid (C14:1) and eicosanoic acid (C20:0) had significantly increased in the term group (P 0.015, P 0.048, respectively). Conclusion: Term and preterm milk have different compositions of fatty acids. Breast milk composition changes over time. As a general conclusion, breast milk provides the lipid requirements of infants

The protective effects of acetyl L-carnitine which added into HistidineTryptophan-Ketoglutarate solution on donor uterus

Objective: At the present times uterus transplantation is an alternative therapy for women with untreatable uterine-based infertility factors. Before transplantation, the donor organ must stored in some solutions, but they may not adequate for protection. In this study, we investigated the potential protective effects of acetyl L-carnitine, added into histidine-tryptophanketoglutarate (HTK) solution, on rat uterus. Methods: We divided 24 female Wistar Albino rats into four groups (n=6). Their uterine tissues were stored into four different solutions at different periods at 4oC ; Group 1 HTK, 4 hours; Group 2. HTK + acetyl L- carnitine, 4 hours, Group 3. HTK, 24 hours; Group 4. HTK + acetyl L- carnitine, 24 hours. Then tissues from uterus were used for histological and biochemical examination. Results: In the study the number of TUNEL positive cells in group 4 was lower than group 3. Biochemically evaluated TBARS and NOS levels were highest in group 3 however CAT level was highest in group 2. Conclusion: In conclusion, addition of acetyl L-carnitine to HTK solution reversed the histological alterations after 24 hours cold storage on rat uterus

Combination antifungal therapy with voriconazole for persistent candidemia in very low birth weight neonates

The purpose of this article is to report our experience with intravenous voriconazole therapy in the treatment of persistent Candida septicemia in very low birth weight (VLBW) neonates. Candidiasis was defined if an infant had a positive blood culture. Ten VLBW newborns developed Candida sepsis, and candidemia persisted in 6 of them despite 3 to 21 days of antifungal therapy with amphotericin B, either conventional or liposomal, and fluconazole. After the addition of voriconazole, clearance of Candida was achieved within 3-7 days of treatment. Antifungal therapy combination with liposomal amphotericin B and voriconazole was continued for at least two weeks after two negative cultures 48 hours apart. We conclude that considering the hazardous effects of Candida infections in preterm newborns, voriconazole can be added to the treatment of fungal sepsis in newborns who still have persistent candidemia despite conventional antifungal management. More clinical information is needed before voriconazole can be used as a first-line drug in antifungal therapy in newborns

Sisplatin ile İndüklenmiş Uterus Toksisitesinde Asetil L-Karnitinin Koruyucu Etkisinin Araştırılması

Objective: The aim of the study was to investigate the prophylactic effects of acetyl L-carnitine against to uterus induced by cisplatin. Methods: Twenty-four female Wistar albino rats were divided into four groups: group I (control) was administered with saline; group II was administered with acetyl L-carnitine; group III was administered with cisplatin; group IV was pretreated with acetyl L-carnitine before cisplatin intraperitoneal injection. After 72h of cisplatin injection uterine tissue was removed. Histological and immunohistochemical investigations were performed, respectively. Results: We found that the number of TUNEL and caspases positive cells were increased in the endometrial epithelium, subepithelial connective tissue, endometrial glands and stroma in group III compare to the other groups. Furthermore inflammation and edema were observed in uterus of rats in group III. Conclusion: We can concluded that pretreatment of acetyl L-carnitine administration has protective effect on histological alteration of uterus caused by cisplatin.Amaç: Bu çalışmanın amacı, asetil L-karnitinin, sisplatinin neden olduğu uterus hasarına karşı profilaktik etkilerini araştırmaktır. Yöntem: Yirmi dört adet Wistar albino cinsi dişi sıçanlar dört gruba ayrıldı: 1. gruba (kontrol) salin uygulaması yapıldı; 2. gruba asetil L-karnitin uygulaması yapıldı; 3. gruba sisplatin uygulaması yapıldı; 4. grup ise sisplatinin intraperitoneal enjeksiyonu öncesinde asetil L-karnitin ile ön tedaviye tabi tutuldu. Sisplatin enjeksiyonundan 72 saat sonra uterus dokusu çıkarıldı. Histolojik ve immünohistokimyasal incelemeler yapıldı. Bulgular: TUNEL ve kaspaz pozitif hücre sayılarının, diğer gruplara göre 3. grupta endometriyal epitelde, subepitelyal bağ dokusunda, endometriyal bezlerde ve stromada arttığını bulduk. Ayrıca 3. Gruptaki ratların uterusunda inflamasyon ve ödem gözlenmiştir. Sonuç: Asetil L-karnitin ön tedavi uygulamasının, sisplatin kaynaklı uterus histolojisinin değişikliği üzerinde koruyucu etkisi olduğu sonucuna vardık

Nitric Oxide Metabolites and Asymmetric Dimethylarginine Concentrations in Breast Milk

Objective: Nitric oxide plays a preventive role in the development of necrotizing enterocolitis. Oral nitrite and nitrate intake has gained importance with the discovery of the conversion of nitrite to nitric oxide in acidic medium out of the synthesis of nitric oxide from L-arginine. Objective of this study was to examine the breast milk concentrations of nitric oxide and asymmetric dimethylarginine which is a competitive inhibitor of nitric oxide and to compare these concentrations in terms of gestational age and maturity of breast milk. Study Design: Forty-one women were included in the study. Milk samples were collected from 3 groups of mothers as term, late preterm and preterm on the postpartum days 3, 7 and 28. Results: When breast milk concentrations of nitric oxide were compared according to the postnatal day of the milk independently from gestational age; nitric oxide concentration was higher in the colostrum than in the transition milk and mature milk (p=0,035; p=0,001; respectively). For the comparison of asymmetric dimethylarginine concentrations among these groups and days; no statistically significant difference was observed in terms of gestational age and maturity of the milk (p=0.865, p=0.115; respectively). Conclusion: The highest nitric oxide concentration was found in the colostrum, suggesting that colostrum is a valuable food for newborns. Plasma concentrations of asymmetric dimethylarginine were negatively correlated with nitric oxide and did not show a correlation with breast milk, suggesting that asymmetric dimethylargininedoesn’t make nitric oxide inhibition in breast milk

Original Article The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study

Background: Healthcare-acquired infections (HAIs) in the neonatal period cause substantial morbidity, mortality, and healthcare costs. Our purpose was to determine the prevalence of HAIs, antimicrobial susceptibility of causative agents, and the adaptivity of the Centres for Disease Control and Prevention (CDC) criteria in neonatal HAI diagnosis

An observational, multicenter, registry-based cohort study of Turkish Neonatal Society in neonates with Hypoxic ischemic encephalopathy

BACKGROUND: Hypoxic ischemic encephalopathy (HIE) is a significant cause of mortality and short- and long-term morbidities. Therapeutic hypothermia (TH) has been shown to be the standard care for HIE of infants ≥36 weeks gestational age (GA), as it has been demonstrated to reduce the rates of mortality, and adverse neurodevelopmental outcomes. This study aims to determine the incidence of HIE in our country, to assess the TH management in infants with HIE, and present short-term outcomes of these infants. METHODS: The Turkish Hypoxic Ischemic Encephalopathy Online Registry database was established for this multicenter, prospective, observational, nationally-based cohort study to evaluate the data of infants born at ≥34 weeks GA who displayed evidence of neonatal encephalopathy (NE) between March, 2020 and April 2022. RESULTS: The incidence of HIE among infants born at ≥36 weeks GA (n = 965) was 2.13 per 1000 live births (517:242440), and accounting for 1.55% (965:62062) of all neonatal intensive care unit admissions. The rates of mild, moderate and severe HİE were 25.5% (n = 246), 58.9% (n = 568), and 15.6% (n = 151), respectively. Infants with severe HIE had higher rates of abnormal magnetic resonance imaging (MRI) findings, and mortality (p6 h) (p>0.05). TH was administered to 85 (34.5%) infants with mild HIE, and of those born of 34-35 weeks of GA, 67.4% (n = 31) received TH. A total of 58 (6%) deaths were reported with a higher mortality rate in infants born at 34-35 weeks of GA (OR 3.941, 95% Cl 1.446-10.7422, p = 0.007). CONCLUSION: The incidence of HIE remained similar over time with a reduction in mortality rate. The timing of TH initiation, whether <3 or 3-6 h, did not result in lower occurrences of brain lesions on MRI or mortality. An increasing number of infants with mild HIE and late preterm infants with HIE are receiving TH; however, the indications for TH require further clarification. Longer follow-up studies are necessary for this vulnerable population