Rare Birth Defects in Pregnancies of Women with Pregestational Diabetes: Absent Radius

Diabetes mellitus (DM) is an important disease that negatively affects fetal development and women with pregestational diabetes have an increased risk for adverse pregnancy outcomes, including a markedly increased risk for birth defects. In this report, a newborn with absent radius associated with pregestational diabetes was presented. A male newborn was born at 40th gestational week from a 20-year-old mother by cesarean section. The patient had shortness in the limbs, hypoplastic right thumb and flexion contracture at his right hand besides respiratory distress.To our knowledge, with this case report, we would like to share the second case of diabetic mother's infant with absent radius in the literature

Evaluation of macronutrient content of fresh and frozen human milk over 6 months

###EgeUn###Aim: In this study; we aimed to see the time-dependent changes in the macronutrient content of early frozen breast milk and also to compare it with fresh breast milk in the first 6 months. Materials and method: We evaluated the milk samples of 43 mothers who delivered at term. Milk samples after the first 15 days following delivery were expressed and collected dividing into seven aliquots to be stored frozen at -20 degrees C. Every month freshly collected new milk samples were analyzed together with one aliquot of the stored samples, up to 6 months. The energy, protein, lipid, and carbohydrate contents of samples were analyzed by Miris Human Milk Analyzer. Results: In the first 3 months, fresh milk had higher caloric and lipid content when compared to frozen samples. The protein content of fresh milk decreased after 2 months and became lower than frozen samples. The energy and lipid content of frozen milk decreased over time but protein and carbohydrate contents stayed stable. Carbohydrate content of fresh and frozen samples did not show major changes. Conclusion: It may be more suitable to consume the frozen milk that was collected in the early weeks of delivery within first 2 months

Response to Verd et al. re: "Preterm Infants May Better Tolerate Feeds at Temperatures Closer to Freshly Expressed Breast Milk: A Randomized Controlled Trial"

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The effect of inhaled nitric oxide therapy on thromboelastogram in newborns with persistent pulmonary hypertension

WOS: 000342227700014PubMed ID: 24791933Studies about the effects of inhaled nitric oxide (iNO) on bleeding time and platelet aggregation in newborns are limited in number and have inconclusive results. Thromboelastogram (TEG) shows the combined effects of coagulation factors and platelet functions. In this preliminary study, we aimed to evaluate the effects of iNO on coagulation using TEG in newborns with persistent pulmonary hypertension (PPH). TEG assays were performed in 10 term infants receiving iNO treatment for PPH and 32 healthy term infants. Samples of the iNO group were collected before and during iNO. Clot reaction time (R), clot kinetics (K), maximum amplitude (MA), and alpha angle were obtained from the TEG tracing. TEG-R values were statistically higher during iNO treatment (7.75 +/- 3.34) when compared to the values before iNO (4.83 +/- 1.38) and the healthy controls (3.75 +/- 0.98). The alpha angle was lower in iNO treated infants at both periods (before iNO, 55.33 +/- 8.58; during iNO, 42.90 +/- 18.34) compared to the control group (64.95 +/- 6.88). MA values before iNO treatment were the lowest (44.43 +/- 14.09) and improved with the iNO treatment (48.40 +/- 9.49) despite still being lower compared to the controls (53.67 +/- 5.56). Conclusion: Both PPH and iNO may negatively effect in vitro coagulation tests. Therefore, newborns with PPH requiring iNO treatment should be closely monitored for coagulation problems

Early Immunomodulatory Effects of Different Natural Surfactant Preparations in Preterms With Respiratory Distress

BackgroundRespiratory distress syndrome (RDS) is the most common respiratory disease in premature infants. Exogenous natural surfactant preparations are used in the treatment of RDS. In recent years, it has become increasingly evident that surfactant plays an immunoregulatory role. ObjectivesThe aim of this study was to evaluate cytokine and chemokine response following three different regimens of natural surfactant treatment in preterm newborns with RDS. MethodsPremature newborns below 32 weeks of gestation who were intubated for RDS and given early surfactant rescue therapy were included in the study. Newborns were randomly divided into three groups and Beractant 100 mg/kg (B-100), Poractant alfa 100 mg/kg (P alpha-100) and Poractant alfa 200 mg/kg (P alpha-200) were administered intratracheally. Blood samples and transtracheal aspirates (TA) were collected just before and 4-6 h after the surfactant treatment. Total eosinophil count, inducible T Cell alpha chemoattractant (ITaC), macrophage inflammatory protein 3 beta (MIP3b), interleukins (IL) 5, 8, 9, 10, 13, immunoglobulin E (IgE), interferon gamma (IFN-gamma), eotaxin and tumor necrosis factor beta-1 (TGF-beta 1) were measured from blood and tracheal aspirate samples. ResultsA total of 45 infants, 15 in each group, were included in the study. Mean gestational age, birth weight, antenatal, demographic and clinical characteristics of the study groups were similar. IFN gamma concentration and eosinophil counts in TA decreased after surfactant replacement in all groups, especially in the infants treated with P alpha-100 and P alpha-200. Eotaxin, TGF beta and IL-8 concentrations in TA increased significantly in the infants treated with P alpha-100 and P alpha-200. IL-9 levels in TA decreased in the B-100 group but increased in the P alpha-100 and P alpha-200 groups. Blood levels of cytokines and chemokines showed significantly decreased levels of ITaC and MIP3b only in the B-100 group, but no significant change was observed in the P alpha-100 and P alpha-200 groups. ConclusionIn our study, the different immunomodulatory effects of natural surfactant preparations on newborn lung is proven. We found that Poractant alpha, one of the natural surfactant preparations, shifted the lung immune system toward TH2.Ege University Scientific Research Projects Unit [MY-13-TIP-030]This study was carried out with the financial support of the Ege University Scientific Research Projects Unit (MY-13-TIP-030)