COVID-19 PCR Pozitif ve Negatif Anneden Doğan Bebeklerin Sistemik İmmün İndekslerinin Karşılaştırmalı Değerlendirilmesi - Neonatal Etkiler Öngörülebilir mi?

Amaç: Dünya Sağlık Örgütü’nün 11 Mart 2020 tarihinde pandemi olarak ilan ettiği Koronavirüs hastalığı-2019 (COVID-19), Şiddetli akut respiratuvar sendrom-Koronavirüs-2’nin neden olduğu bir durumdur ve olgu sayısı her gün giderek artmaktadır. Çalışmanın amacı COVID-19 pandemisi döneminde hassas popülasyon olan COVID-19 polimeraz zincir reaksiyonu (PCR) pozitif anneden doğan yenidoğan bebeklerinin SİSTEMİK immün- enflamasyon indeksleri (Sİİ) normal popülasyona göre farklılıklarının araştırılmasıdır. Gereç ve Yöntem: Mart 2019 ve Kasım 2021 tarihleri arasında Ankara Şehir Hastanesi’nde doğumdan önceki iki haftada COVID-19 PCR testi pozitif saptanan annelerden, ?37 gestasyon haftasında doğan, nazal sürüntü ile alınan COVID-19 PCR testi negatif saptanan ve anne yanında olağan bakım verilen yenidoğanlar ile kontrol grubunda ?37 gestasyon haftasında COVID-19 PCR testi negatif anneden doğan sağlıklı yenidoğanların bazal hematolojik parametreleri karşılaştırıldı. Bulgular: COVID-19 PCR pozitif anne bebekleri grubunda (n=86) sezaryen yöntemiyle doğum oranı daha fazlaydı (p<0,05). Hemogram parametrelerine bakıldığında toplam beyaz küre, nötrofil, hemoglobin/hematokrit sayıları kontrol grubunda (n=94) daha düşük, trombosit/plateletkrit değerleri daha yüksekti (p<0,05). Nötrofil lenfosit oranı ve Sİİ COVID-19 PCR pozitif anne bebekleri grubunda istatistiksel anlamlı olarak yüksek, multivariate lojistik regresyon analizinde nötrofili ve nötrofil lenfosit oranı ise bağımsız prediktif değişkenler olarak saptandı (p=0,048 ve p=0,011). Sonuç: COVID-19 PCR pozitif anneden doğan bebeklerde vertikal viral geçişi gözlenmedi. Kontrol grubuna göre COVID-19 PCR pozitif anneden doğan bebeklerde nötrofil lenfosit oranı yüksekliği ve nötrofili maternal sitokin salınıma bağlı olabileceği düşünüldü. Çalışmamız bu durumun detaylandırılması ve daha uzun izlem için ileri araştırmalara ışık tutacaktır

Comparison of Mortality and Morbidities in Small and Appropriate For Gestational Age Preterm Infants

Aim:To compare morbidity and mortality in very low birth weight premature infants (VLBW) with small (SGA) and appropriate (AGA) for gestational age.Materials and Methods:The records of infants with VLBW who were followed up in our unit between 2013 and 2017 were retrospectively analyzed. SGA was defined as the birth weight being below the 10th percentile compared to the gestational week and the AGA birth weight being between the 10th and 90th percentile. A total of 96 SGA infants were identified as the study group and 204 AGA infants randomly selected and matched with the gestational week of the study group. Infants with major congenital anomalies and lack of data were excluded from the study.Results:The mean gestational age (28.3 ± 1.1–28.3 ± 1.2, p = 0.94) and birth weight (769 ± 144–1132 ± 190 g, <0.001, respectively) were in the SGA and AGA group respectively. Preeclampsia and cesarean delivery were significantly more frequent in the SGA group, whereas APGAR score was lower and CRIB score was significantly higher. The frequency of surfactant requirement, moderate-severe bronchopulmonary dysplasia, spontaneous intestinal perforation, periventricular leukomalacia, premature osteopenia, postnatal growth retardation, mortality and feeding intolerance were found to be significantly higher in SGA infants. Similarly, the duration of invasive ventilation and additional oxygen requirement and hospital stay were longer in SGA infants.Conclusion:The birth of premature babies with low birth weight according to gestational age causes premature morbidity and mortality

Two-Year Outcomes After Minimally Invasive Surfactant Therapy in Preterm Infants: Follow-Up of the OPTIMIST-A Randomized Clinical Trial

Importance: The long-term effects of surfactant administration via a thin catheter (minimally invasive surfactant therapy [MIST]) in preterm infants with respiratory distress syndrome remain to be definitively clarified. / Objective: To examine the effect of MIST on death or neurodevelopmental disability (NDD) at 2 years' corrected age. / Design, Setting, and Participants: Follow-up study of a randomized clinical trial with blinding of clinicians and outcome assessors conducted in 33 tertiary-level neonatal intensive care units in 11 countries. The trial included 486 infants with a gestational age of 25 to 28 weeks supported with continuous positive airway pressure (CPAP). Collection of follow-up data at 2 years' corrected age was completed on December 9, 2022. / Interventions: Infants assigned to MIST (n = 242) received exogenous surfactant (200 mg/kg poractant alfa) via a thin catheter; those assigned to the control group (n = 244) received sham treatment. / Main Outcomes and Measures: The key secondary outcome of death or moderate to severe NDD was assessed at 2 years' corrected age. Other secondary outcomes included components of this composite outcome, as well as hospitalizations for respiratory illness and parent-reported wheezing or breathing difficulty in the first 2 years. / Results: Among the 486 infants randomized, 453 had follow-up data available (median gestation, 27.3 weeks; 228 females [50.3%]); data on the key secondary outcome were available in 434 infants. Death or NDD occurred in 78 infants (36.3%) in the MIST group and 79 (36.1%) in the control group (risk difference, 0% [95% CI, -7.6% to 7.7%]; relative risk [RR], 1.0 [95% CI, 0.81-1.24]); components of this outcome did not differ significantly between groups. Secondary respiratory outcomes favored the MIST group. Hospitalization with respiratory illness occurred in 49 infants (25.1%) in the MIST group vs 78 (38.2%) in the control group (RR, 0.66 [95% CI, 0.54-0.81]) and parent-reported wheezing or breathing difficulty in 73 (40.6%) vs 104 (53.6%), respectively (RR, 0.76 [95% CI, 0.63-0.90]). / Conclusions and Relevance: In this follow-up study of a randomized clinical trial of preterm infants with respiratory distress syndrome supported with CPAP, MIST compared with sham treatment did not reduce the incidence of death or NDD by 2 years of age. However, infants who received MIST had lower rates of adverse respiratory outcomes during their first 2 years of life. / Trial Registration: anzctr.org.au Identifier: ACTRN12611000916943

Variation in grain Zn concentration, and the grain ionome, in field-grown Indian wheat

Wheat is an important dietary source of zinc (Zn) and other mineral elements in many countries. Dietary Zn deficiency is widespread, especially in developing countries, and breeding (genetic biofortification) through the HarvestPlus programme has recently started to deliver new wheat varieties to help alleviate this problem in South Asia. To better understand the potential of wheat to alleviate dietary Zn deficiency, this study aimed to characterise the baseline effects of genotype (G), site (E), and genotype by site interactions (GxE) on grain Zn concentration under a wide range of soil conditions in India. Field experiments were conducted on a diverse panel of 36 Indian-adapted wheat genotypes, grown on a range of soil types (pH range 4.5–9.5), in 2013–14 (five sites) and 2014–15 (six sites). Grain samples were analysed using inductively coupled plasma-mass spectrometry (ICP-MS). The mean grain Zn concentration of the genotypes ranged from 24.9–34.8 mg kg-1, averaged across site and year. Genotype and site effects were associated with 10% and 6% of the overall variation in grain Zn concentration, respectively. Whilst G x E interaction effects were evident across the panel, some genotypes had consistent rankings between sites and years. Grain Zn concentration correlated positively with grain concentrations of iron (Fe), sulphur (S), and eight other elements, but did not correlate negatively with grain yield, i.e. no yield dilution was observed. Despite a relatively small contribution of genotype to the overall variation in grain Zn concentration, due to experiments being conducted across many contrasting sites and two years, our data are consistent with reports that biofortifying wheat through breeding is likely to be effective at scale given that some genotypes performed consistently across diverse soil types. Notably, all soils in this study were probably Zn deficient and interactions between wheat genotypes and soil Zn availability/management (e.g. the use of Zn-containing fertilisers) need to be better-understood to improve Zn supply in food systems

Televizyon reklamlarında kullanılan arketipler ve otomobil reklamlarındaki uygulamaları

Günümüz reklamcılığı, kaynağı çok eskilere dayanan efsane bilimini yani mitolojiyi kullanmaktadır. Bu şekilde bir kullanıma gidilmesinin nedeni; hem seyircinin (tüketiciyi/potansiyel alıcıyı) reklamlardaki kahramanlarla özdeşleşerek kendisini bir Tanrı gibi hissedip büyülenmesine neden olmak hem de reklamın bir çeşit ikna ve ürün satma aracı olduğunu fark ettirmeden gerekli mesajın iletilmesini sağlamaktır. Mitoloji bilimi mitleri yani efsaneleri inceler. Efsanelerdeki en güçlü karakterler olarak bilinen Tanrılar özelliklerini arketiplerden alır. Bu nedenle, reklamlarda mitolojiden yararlanılması demek arketiplerden de yararlanmak demektir. Bu tezde, televizyon reklamlarındaki kadın ve erkek sunumları bağlamında hangi arketiplerden yararlanıldığı anlatılmıştır. Bu amaçla mitolojik arketipler ve psikolojik arketipler açıklanmıştır. Bu açıklamalar üzerinden, Ford markasının 2004-2006 yılları arasında televizyonda yayınlanmış olan otomobil reklamları incelenmiştir. Otomobil reklamlarının incelenmesinin nedeni hem kadınlardan hem de erkeklerden oluşan tüketici kitlesine seslenebilmesi ve sürekli olarak yenilendiği için güncelliğini koruyan reklamlar olmasıdır. İncelemenin sonuncunda reklamlarda kullanılan arketiplerden kadınları temsilen bakıcı, baştan çıkaran peri ve bakire; erkekleri temsilen de koruyucu, iş adamı ve kral arketiplerinin tercih edildiği ortaya çıkmıştır.ARCHETYPES WHICH ARE BEING USED IN TELEVISION COMMERCIALS END THEIR IMPLEMENTATION IN AUTOMOBİLE COMMERCIALSIt seems that commercials nowadays have a tendency of using mythology. The reason for this is to create magical atmospheres that provide the viewer s(potential customer) to feel identical to the superior characters in the commercials who are effected by the specialties of mythological gods. Therefore the viewers forget that the commercials are tools for persuading people and selling products. The source that affects the characteristics of mythological gods is called archetypes. It means ancient image, example or character. That’s why accepting that commercials have a tendency of using mythology means they have a tendency of using archetypes. In this thesis, archetypes in television commercials are studied. Therefore mythological archetypes and archetypes in psychology are examined. According to the findings, Ford’s television commercials of 2004 to 2006 are researched. The reason that automobile commercials are researched is that they target both males and females. Also they update themselves very often so their specialties are valid. Findings of this research is that, archetypes in commercials that are being used for women characters take form of nurturer, maiden or seductive muse; archetypes that are being used for men characters take form of businessman, protector or the king

Turkish Neonatal Society guideline on the management of respiratory distress syndrome and surfactant treatment

Respiratory distress syndrome is the leading cause of respiratory failure in preterm infants. The incidence and severity of respiratory distress syndrome are inversely related to the gestational age of the newborn. The major underlying pathophysiologic mechanisms are surfactant deficiency and anatomic, structural immaturity of the lung. Recent improvements such as antenatal steroid treatment to enhance pulmonary maturity, appropriate resuscitation facilitated by placental transfusion and immediate use of continuous positive airway pressure for alveolar recruitment, early rescue administration of surfactant, ventilation with gentler modes to minimize damage to the immature lungs, and the other supportive therapies have significantly decreased respiratory distress syndrome-related morbidity and mortality. This guideline was addressed to overview the mentioned improvements in order to standardize respiratory distress syndrome management in neonatal intensive care units in Turkey

Surfactant delivery via thin catheter in preterm infants: A systematic review and meta-analysis.

ObjectiveSurfactant administration via a thin catheter (STC) is an alternative to surfactant administration post endotracheal intubation in preterm infants with respiratory distress syndrome (RDS); however, the benefits particularly in infants MethodsMedical databases were searched until December 2022 for randomized controlled trials (RCTs) assessing STC compared to controls that included intubation for surfactant or nCPAP in preterm infants with RDS. The primary outcome was bronchopulmonary dysplasia (BPD) at 36 weeks gestation in survivors. Subgroup analysis was conducted comparing STC to controls in infants ResultsTwenty-six RCTs of 3349 preterm infants, in which half of the studies had low risk of bias, were included. STC decreased the risk of BPD in survivors compared to controls (17 RCTs; N = 2408; relative risk (RR) = 0.66; 95% confidence interval (CI) 0.51 to 0.85; number needed to treat for an additional beneficial outcome (NNTB) = 13; CoE: moderate). In infants ConclusionsCompared to controls, STC may be a more efficacious and safe method of surfactant delivery in preterm infants with RDS, including infants < 29 weeks' gestation

Surfactant delivery via thin catheter in preterm infants: A systematic review and meta-analysis

Objective Surfactant administration via a thin catheter (STC) is an alternative to surfactant administration post endotracheal intubation in preterm infants with respiratory distress syndrome (RDS); however, the benefits particularly in infants Methods Medical databases were searched until December 2022 for randomized controlled trials (RCTs) assessing STC compared to controls that included intubation for surfactant or nCPAP in preterm infants with RDS. The primary outcome was bronchopulmonary dysplasia (BPD) at 36 weeks gestation in survivors. Subgroup analysis was conducted comparing STC to controls in infants Results Twenty-six RCTs of 3349 preterm infants, in which half of the studies had low risk of bias, were included. STC decreased the risk of BPD in survivors compared to controls (17 RCTs; N = 2408; relative risk (RR) = 0.66; 95% confidence interval (CI) 0.51 to 0.85; number needed to treat for an additional beneficial outcome (NNTB) = 13; CoE: moderate). In infants Conclusions Compared to controls, STC may be a more efficacious and safe method of surfactant delivery in preterm infants with RDS, including infants < 29 weeks’ gestation

Developmental outcomes of very low birthweight infants with non-hemorrhagic ventricular dilatations and the relationships thereof with absolute brain volumes measured via two-dimensional ultrasonography

Purpose: We calculated the brain volumes of preterm infants using two-dimensional cranial ultrasonography and explored the relationships thereof with neurodevelopment. Methods: Cranial measurements were derived using routine ultrasonographic scanning. The brain was considered to be an ellipsoid and estimated absolute brain volumes (EABVs) were calculated by substracting the volumes of the two lateral ventricles from the total brain volumes. Results: We enrolled preterm infants of mean gestational age 28 ± 2 weeks and mean birthweight 973 ± 187 g. Twenty-one exhibited dilated ventricles; their EABVs were lower than normal (206 ± 11 cm3 vs. 275 ± 17 cm3, p < 0.001). The mental development indices were similar (74 ± 5 vs. 78 ± 14, p = 0.069), but the psychomotor development indices (PDIs) differed significantly (77 ± 7 vs. 86 ± 17, p = 0.001). We found a slight positive correlation between the PDI and EABV (r = + 0.258, p = 0.012). Conclusion: The EABV can be calculated using two-dimensional measurements and low EABV found to be associated with poor neurological outcomes

PRISMA 2020 checklist.

ObjectiveSurfactant administration via a thin catheter (STC) is an alternative to surfactant administration post endotracheal intubation in preterm infants with respiratory distress syndrome (RDS); however, the benefits particularly in infants MethodsMedical databases were searched until December 2022 for randomized controlled trials (RCTs) assessing STC compared to controls that included intubation for surfactant or nCPAP in preterm infants with RDS. The primary outcome was bronchopulmonary dysplasia (BPD) at 36 weeks gestation in survivors. Subgroup analysis was conducted comparing STC to controls in infants ResultsTwenty-six RCTs of 3349 preterm infants, in which half of the studies had low risk of bias, were included. STC decreased the risk of BPD in survivors compared to controls (17 RCTs; N = 2408; relative risk (RR) = 0.66; 95% confidence interval (CI) 0.51 to 0.85; number needed to treat for an additional beneficial outcome (NNTB) = 13; CoE: moderate). In infants ConclusionsCompared to controls, STC may be a more efficacious and safe method of surfactant delivery in preterm infants with RDS, including infants </div