Assessment of novel biomarkers: STREM-1, pentraxin-3 and pro-adrenomedullin in the early diagnosis of neonatal early onset sepsis

BACKGROUND: Early onset bacterial sepsis in neonates (EOS) is recognized as an important health condition. Early diagnosis is crucial. However, blood culture results are released in 48-72 hours. Many biomarkers have been investigated but none have been accepted as the gold standard. This study aimed to investigate the diagnostic value of the molecules: soluble form of triggering receptor expressed on myeloid cells-1 (sTREM-1), pentraxin-3 (PTX-3) and pro adrenomedullin (pro-ADM) in EOS and compare with currently used biomarkers. METHODS: In this multicenter prospective study, patients were enrolled from different NICUs around the Turkey. Patient data were collected via web-based registry system from attending centers. Neonates, hospitalized with a suspicion of EOS were enrolled. Blood culture and routine blood tests were collected and a serum sample was obtained and kept in-80°C for studying the molecules. According to laboratory results, patients were divided into three groups as; proven sepsis, clinical sepsis and control group. Groups were compared in terms of demographic, clinical and laboratory findings. The primary outcome of the study was to assess any difference between groups in terms of the diagnostic value of the markers aforementioned. RESULTS: A total of 130 patients were enrolled; proven sepsis (n = 36), clinical sepsis (n = 53) and control (n = 41) groups. Groups were similar in terms of demographic findings; mean WBC (P = 0.445), procalcitonin (PCT) (P = 0.083) and IL-6 (P = 0.814) levels. Mean C-reactive protein (CRP) level was significantly higher in clinical sepsis and proven sepsis groups compared to control group (P 0.001). Mean PTX-3 (P = 0.547), pro-ADM (P = 0.766) and sTREM-1 (P = 0.838) levels were similar between groups. CONCLUSION: These promising molecules failed to help in early diagnosis of EOS. Their relation to correlation with disease progression may make more sense as they seem to be expressed in higher amounts with the progression of the disease in previous studies. CRP was the most frequently used biomarker for detecting the sepsis in our study population. © 2020-IOS Press and the authors. All rights reserved

Persistent hyperinsulinaemic hypoglycaemia of infancy: Case report

Hyperinsulinism, although rare, is the most common cause of persistent hyperinsulinaemic hypoglycaemia in infancy. Because of persistent hypoglycaemia, serious difficulties are encountered in the long term management of this condition. A male neonate, after an uncomplicated full-term pregnancy, had been admitted to another hospital with convulsions on the third post-natal day. Meningitis had been suspected at that time and treated with phenobarbital and he had been discharged from the hospital. At three-months old he was referred to our department for persistent convulsions and lethargy. His parents were of 1st degree consanguinity. His blood glucose level was found to be 24 mg/dl (1.33 retool/L). Because of the dangerously high insulin level during hypoglycaemia (insulin/glucose <0.3), the absence of ketonuria, and the need for a high dose of glucose infusion (< 15 mg/kg/min) to achieve normoglycaemia and a glycaemic response to glucagon despite the hypoglycaemia, a diagnosis of persistent hyperinsulinaemic hypoglycaemia of infancy was made. Since maximal doses of prednisone, glucagon, diazoxide, octreotide and high infusion of glucose were ineffective in achieving normoglycaemia, a subtotal (80%) pancreatectomy was done. Postoperatively intermittent hypoglycaemic episodes continued. These were controlled with low doses of octreotide. Histology revealed diffuse adenomatons hyperplasia (nesidoblastosis). The boy is now in the sixth post-operative month and developing normally

PERSISTENT HYPERINSULINAEMIC HYPOGLYCAEMIA OF INFANCY: CASE REPORT

Hyperinsulinism, although rare, is the most common cause of persistent hyperinsulinaemichypoglycaemia in infancy. Because of persistent hypoglycaemia, serious difficulties areencountered in the long term management of this condition. A male neonate, after anuncomplicated full-term pregnancy, had been admitted to another hospital withconvulsions on the third post-natal day. Meningitis had been suspected at that timeand treated with phenobarbital and he had been discharged from the hospital. At threemonthsold he was referred to our department for persistent convulsions and lethargy.His parents were of 1st degree consanguinity. His blood glucose level was found to be24 mg/dl (1.33 mmol/L). Because of the dangerously high insulin level during hypoglycaemia(insulin/glucose &gt;0.3), the absence of ketonuria, and the need for a high dose of glucoseinfusion (&gt; 15 mg/kg/min) to achieve normoglycaemia and a glycaemic response toglucagon despite the hypoglycaemia, a diagnosis of persistent hyperinsulinaemichypoglycaemia of infancy was made. Since maximal doses of prednisone, glucagon,diazoxide, octreotide and high infusion of glucose were ineffective in achievingnormoglycaemia, a subtotal (80%) pancreatectomy was done. Postoperatively intermittenthypoglycaemic episodes continued. These were controlled with low doses of octreotide.Histology revealed diffuse adenomatous hyperplasia (nesidoblastosis). The boy is nowin the sixth post-operative month and developing normally

Evaluation Of Smoking Cessation Services Approaches Of The Patients Applying To Hacettepe Adult Hospital

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