Effect of Fluid Supplementation on Serum Bilirubin Level During Phototherapy of Exclusively Breastfed Term Infants with Hyperbilirubinemia

Aim:This study compared the rates of decrease in serum bilirubin levels in severely jaundiced healthy term infants given oral or intravenous fluid supplementation during phototherapy.Materials and Methods:A randomized controlled study was carried out in the neonatal intensive care unit of Zeynep Kamil Maternity and Children Training and Research Hospital (Istanbul, Turkey) over a 4-month period. Fifty healthy term infants with hyperbilirubinemia were randomized to receive either solely breastmilk (n=25) or both breastmilk and intravenous fluid (n=25) during phototherapy.Results:There were no significant differences (p>0.05) in the mean birth weight, mean gestastional age, modes of delivery, mean time of admission age, mean serum osmolality, and hematocrit and reticulocyte count between the two groups. Similarly, there was no significant difference (p>0.05) in the mean indirect serum bilirubin level at the time of admission to the neonatal intensive care unit and at 4, 8, 12, 24, and 48 hours after commencement of phototherapy between the two groups. There was no significant difference (p>0.05) in the mean duration of phototherapy or in the median duration of hospitalization between the two groups.Conclusion:Based on our results, intravenous fluid support has no effect on the rate of decrease in serum bilirubin and decrease in duration of phototherapy in healthy term newborns with no dehydration. However, using the oral route avoided the need for intravenous cannula and their attendant complications. Insensible fluid loss is increased during phototherapy, so protection of hydration status with oral feeding is important for newborns

The effects of anti-HBs antibodies passed through transplacental route on immunization induced by HBV vaccine and natural course of passively transmitted HBs antibodies

Introduction: Hepatitis B infection is an important infection that concerns public health. In this study, we aimed to evaluate whether anti-Hbs antibodies born from mothers who are immune to hepatitis B virus with natural or vaccination and passed from mother to baby transplacentally affect the natural course of these passive anti-HBs antibody titers. Methods: In this study, 68 healthy term newborn babies were included. The immune status of the mothers of these newborn babies was evaluated. Babies were divided into three groups. Group 1, babies whose mothers were positive for AntiHBs antibody, anti-HBS titers were evaluated consecutively at 0, 1, 3, 6 and 8 months without HBV vaccine. In Group 2, babies whose mothers were positive for anti-HBs antibody were vaccinated with HBV vaccine at 0.1 and 6 months, and these babies were examined for anti-HBS titers at 0.1, 3, 6 and 8 months. In Group 3, babies whose mothers were negative of anti-HBs antibody were vaccinated with HBV vaccine at 0, 1 and 6 months, and babies were examined at 0.1, 3, 6 and 8 months. Results: Group 1 consisted of 22 babies, Group 2 consisted of 24 babies and Group 3 consisted of 22 babies. Percentages of anti-HBs titers falling below <10 mIU/mL at 1, 3, 6 and 8 months were found to be 40.9%, 50%, 59.09%, and 100% of nonvaccinated babies whose mothers were positive for anti-HBs antibody. Discussion and Conclusion: We found that the antibody response to HBV vaccine administered to infants with passive antibodies was similar to the antibody response in mothers vaccinated with their mothers HBsAg (-), anti-HBs (-), anti-HBcIgM (-) and the same vaccine calendar. Thus, it was found that anti-HBs antibodies that started this transplacentalntal pathway did not affect the antibody response produced by the HBV vaccine administered at 0, 1 and 6 month

Seasonal Change and Spatial Distribution of Traffic Noise in Seferihisar, Turkey

In this study, traffic noise in Seferihisar, which is a holiday resort by the Aegean Sea in the West of Turkey, was investigated. The noise occurring in summer and winter, on weekdays, and at weekends was mapped separately. Besides, land uses exposed to traffic noise were specified. In the carried out method, the land uses were primarily mapped by using the satellite images of the study area. Then, the noise was measured at 46 points during ten days in summer and winter, on weekdays and at weekends, and it was mapped by using Inverse Distance Weighting (IDW) method and by means of Geographic Information System (GIS) techniques. The measurements were taken in the daytime (07:00-19:00), in the evening (19:00-23:00), and at night (23:00-07:00) as stated in the Turkish Regulation of Assessment and Management of Environmental Noise. Since the time interval of the daytime measurements was large, the noise was measured in three different periods for the daytime measurements. In the formation of noise maps, logarithmic averages of all measurements taken at each point were used. The noise maps were overlapped with the land use maps by the help of the GIS techniques; the land use affected by the noise was analyzed. The results showed that the road traffic noise varied from summer to winter seasons in the study area depending on heavy or light traffic. The noise occurring in summer showed an increase both on weekdays and at weekends. While the limit value was exceeded in 49 of the measurement averages taken in winter, the limit value was exceeded in 96 measurements taken in summer. The noise maps formed according to the IDW method displayed that the areas in which the limit value was exceeded in the daytime in summer took up 14.27% of the study area while this rate went down to 4.06% in winter. The study area is one of the most important destinations for summer holiday. 20.12% of the area that exceeded the limit value in summer was builtup and 10.69% of them was tourism area. The noise together with population and traffic that increase in summer season is an important environmental problem against which some precautions should be taken. The findings of the study present significant results which might guide local governments in preventing and managing the noise. © Polish Academy of Sciences & Institute of Fundamental Technological Research (IPPT PAN) 2018.Firat University Scientific Research Projects Management Unit: ZF2013D13 National Council for Scientific Research: 112Y010This research was funded by The Scientific and Technological Research Council of Turkey-TUBITAK (No: 112Y010) and Scientific Research Projects Unit of Cukurova University (No: ZF2013D13)

Effect of Fluid Supplementation on Serum Bilirubin Level During Phototherapy of Exclusively Breastfed Term Infants with Hyperbilirubinemia

Amaç:Bu çalışmada fototerapi alan term yenidoğanlara intravenöz veya oral sıvı desteği verilerek serum bilirubin seviyelerinin düşüş oranları karşılaştırılmıştır.Materyal ve Metot:Zeynep Kamil Kadın Doğum ve Çocuk Eğitim ve Araştırma Hastanesi'nin (İstanbul, Türkiye) yenidoğan yoğun bakım ünitesinde 4 aylık bir süre içinde gerçekleştirilmiş randomize kontrollü bir çalışmadır. Elli sağlıklı term bebek, hiperbilirübinemi nedeniyle fototerapi alırken sadece anne sütü (n=25) veya hem anne sütü hem de intravenöz sıvı (n=25) alacak şekilde randomize edildi.Bulgular:Her iki grup arasında doğum ağırlığı, gestasyonel yaş, doğum şekli, hastaneye kabul yaşı, serum osmolalitesi, hematokrit ve retikülosit sayısı ortalamaları açısından anlamlı fark yoktu (p>0,05). Benzer şekilde, yenidoğan yoğun bakım ünitesine başvuru sırasında ve fototerapi başladıktan sonraki 4, 8, 12, 24 ve48. saatlerde serum total bilirubin düzeyi ortalamaları her iki grup için karşılaştırıldığında anlamlı fark yoktu (p> 0,05). Fototerapi süresi ve hastanede kalış süresi ortalamaları karşılaştırıldığında iki grup arasında anlamlı fark yoktu (p>0,05).Sonuç:Elde ettiğimiz sonuçlara göre, dehidratasyonu olmayan sağlıklı yenidoğanlara intravenöz sıvı desteği verilmesi serum bilirubin düşüş oranı ve fototerapi süresi üzerinde etkili değildir. Bununla birlikte, oral yolun kullanılması, intravenöz kanül gereksinimi ve bunlara ilişkin komplikasyonlardan kaçınmayı sağladı. Fototerapi sırasında insensibl sıvı kaybı artacağından oral beslenme ile hidrasyonun korunması çok önemlidir.Aim:This study compared the rates of decrease in serum bilirubin levels in severely jaundiced healthy term infants given oral or intravenous fluid supplementation during phototherapy. Materials and Methods:A randomized controlled study was carried out in the neonatal intensive care unit of Zeynep Kamil Maternity and Children Training and Research Hospital (Istanbul, Turkey) over a 4-month period. Fifty healthy term infants with hyperbilirubinemia were randomized to receive either solely breastmilk (n=25) or both breastmilk and intravenous fluid (n=25) during phototherapy. Results:There were no significant differences (p>0.05) in the mean birth weight, mean gestastional age, modes of delivery, mean time of admission age, mean serum osmolality, and hematocrit and reticulocyte count between the two groups. Similarly, there was no significant difference (p>0.05) in the mean indirect serum bilirubin level at the time of admission to the neonatal intensive care unit and at 4, 8, 12, 24, and 48 hours after commencement of phototherapy between the two groups. There was no significant difference (p>0.05) in the mean duration of phototherapy or in the median duration of hospitalization between the twogroups. Conclusion:Based on our results, intravenous fluid support has no effect on the rate of decrease in serum bilirubin and decrease in duration of phototherapy in healthy term newborns with no dehydration. However, using the oral route avoided the need for intravenous cannula and their attendant complications. Insensible fluid loss is increased during phototherapy, so protection of hydration status with oral feeding is important fornewborns

Correlation between transient tachypnea of the newborn and wheezing attack

Background: Transient tachypnea of the newborn (TTN) is the most common cause of respiratory distress in newborns. Although associated with some morbidity, it is generally believed that once TTN resolves, there is no further increased risk for respiratory disease. However, in limited studies frequency of wheezing attacks is found to be increased in patients who had TTN diagnosis during the newborn period, in comparison to patients who had no respiratory problem. Thus, the question arises as to whether TTN is an innocent disease. Methods: This study was done retrospectively. We recorded the demographic characteristics of 103 infants born between 17 October 2003 and 17 October 2004 at Zeynep Kamil Hospital and hospitalized because of TTN in the neonatal intensive care unit. In the second phase, we telephoned the parents of the 103 infants and asked about wheezing attacks. A total of 103 other infants, born during the same period, with no health problems during the newborn period, were included in the study as the control group and the same procedures were applied to them. Results: The rate of wheezing attack among patients with TTN diagnosis was found to be significantly higher than that in patients who had no TTN diagnosis (P < 0.01). TTN was found to be an independent risk factor for wheezing attack (OR, 2.378; 95% CI, 1.20-4.70). Conclusion: In conclusion, we established that TTN is an independent risk factor for wheezing. In addition we also hypothesized that genetic and environmental interactions synergistically predisposed these children for future wheezing

The knowledge of pediatricians about developmental hip dysplasia in a training hospital

Giriş: Kalçanın en sık rastlanan doğumsal patolojisi olan gelişimsel kalça displazisi (GKD) erken tanı ve tedaviyle tamamen iyileştirilebilir. Erken tanı ve tedavi, sağlık çalışanlarının konu ile ilgili yeterli bilgiye sahip olmasıyla sağlanabilir. Çalışmamızda, bir eğitim hastanesinde görev yapan çocuk hekimlerinin GKD hakkında bilgi düzeylerinin değerlendirilmesi ve güncel bilgilerin gözden geçirilmesi amaçlanmıştır. Gereç ve Yöntem: Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi’nde görevli çocuk hekimlerinin GKD hakkında etiyopatogenez, risk faktörleri, fizik muayene, tanı ve tedaviyle ilgili çoktan seçmeli sorulardan oluşturulmuş anket formunu yanıtlaması istendi. İstatistiki değerlendirme için NCSS 2007® USA paket programı kullanıldı. Bulgular: Çalışmaya 39 asistan, 21 uzman toplam 60 çocuk hekimi katıldı. Ailede GKD varlığı, kundaklama, makat geliş, kız cinsiyet ve oligohidramnios hekimlerin ≥%70’inin bildiği risk faktörleriydi. Metatarsus adduktus, Larsen sendromu ve konjenital diz çıkığı en az oranda (≤%10) bilinen risk faktörleriydi. Asistan ve uzman hekimler arasında risk faktörlerinden tortikollis, çoğul gebelik, birinci bebek, metatarsus adduktus’un bilinme oranlarında istatistiksel anlamlı (p<0,05) fark saptandı. GKD tanısında uzman hekimler fizik muayene ve direkt grafi gibi konvansiyonel yöntemleri, asistan hekimler ise bilgisayarlı tomografi ve manyetik rezonans görüntüleme gibi ileri görüntüleme yöntemleri seçme eğilimindeydi. Uzman hekimlerden anlamlı farklı olarak asistan hekimlerin %30,7’si asetabulum gelişiminde femur başı mekanik uyarısı dışındaki faktörleri en önemli etmen olarak düşünmekteydi (p<0,05). Asistanlık süresi, uzmanlık süresi ve çocuk sahibi olma ile bilgi düzeyleri arasında anlamlı ilişki bulunmadı. Sonuç: Çocuk hekimlerinin GKD hakkında mevcut bilgi düzeylerinin arttırılması ve güncellenmesi GKD’yi önleme, tanı ve tedavide başarı oranlarını artıracaktır.Introduction: Developmental dysplasia of the hip (DDH) is the most common hip pathology which can be prevented with early diagnosis and treatment. Prevention, early diagnosis and treatment can be achieved if health professionals are endowed with adequate knowledge. Here, we aimed to evaluate the knowledge level of pediatric trainees and specialists in an education and training hospital and to review the up-to-date information about DDH. Materials and Methods: A multiple choice questionnaire about etiopathogenesis, risk factors, diagnosis and treatment of DDH was answered by the pediatric trainees and specialists in Zeynep Kamil Maternity and Children Education and Training Hospital, İstanbul. NCSS 2007®, USA Software Program is used for statistical analysis. Results: Thirty-nine pediatric residents and twenty-one pediatric specialists were enrolled to the study. Person with DDH in the family, swaddling, breech presentation, female gender, oligohydroamnios were risk factors known with rate ≥70%. Metatarsus adductus, Larsen syndrome, congenital knee dislocation were the least known risk factors (≤10%). The recognition rates of residents and specialist about torticollis, multiple gestation, first born baby and metatarsus adductus as risk factors were statistically different (p<0.05). For the diagnosis of DDH, specialist tended to use conventional methods like physical examination and direct radiographs while residents chose computerized tomography and magnetic resonance imagining. Pediatric residents thought cigarette smoking (48.7%) and factors other than mechanic pressure of femoral head for the acetabular development (30.7%) as most responsible factors (p<0.05). There was no relationship between duration of residency, duration of being specialists, bearing children and knowledge about DDH. Conclusions: The actual knowledge of pediatricians about DDH should be improved and updated for the success of prevention, diagnosis and treatment of DDH