Effects of hypothermia on lung inflammation in a rat model of meconium aspiration syndrome

<div><p>Abstract Purpose: To evaluate the effects of hypothermia treatment on meconium-induced inflammation. Methods: Fifteen rats were instilled with human meconium (MEC, 1.5 mL/kg, 65 mg/mL) intratracheally and ventilated for 3 hours. Eight rats that were ventilated and not instilled with meconium served as a sham group. In MEC-hypothermia group, the body temperature was lowered to 33±0.5°C. Analysis of the blood gases, interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor (TNF)-α in bronchoalveolar lavage (BAL) fluid samples, and histological analyses of the lungs were performed. Results: The BAL fluid TNF-α, IL-1β, IL-6 and IL-8 concentrations were significantly higher in the MEC-hypothermia group than in the MEC-normothermia (p < 0.001, p < 0.001, p = 0.001, p < 0.001, respectively) and sham-controlled groups (p < 0.001, p < 0.001, p < 0.001, p < 0.001, respectively). Conclusion: Meconium-induced inflammatory cytokine production is affected by the body temperature control.</p></div

Early Life Markers to Predict the Risk for Frequent Wheezing in Infants; Going on a Mysterious Road with an Old Friend, "The Eosinophil"

Objective: In most cases of asthma, wheezing symptoms start in early childhood. Although there are studies evaluating the factors that play a role in the development of childhood asthma, the predictive markers for frequent wheezing in early childhood are still unclear. The aim of our study was to investigate the relation between the wheezing episodes and the familial, prenatal, and postnatal risk factors, and the sensitivity of serum eosinophilic cationic protein (ECP) and eosinophil levels for predicting frequent wheezing. Materials and Methods: Fifty-seven children with acute wheezing and fifty healthy children aged between 1-36 months were included in the study. The children who had >= 3 episodes of wheezing in the next year after presentation were classified as the frequent wheezing group and those with fewer episodes were classified as the infrequent wheezing group. Administration of a comprehensive questionnaire about risk factors for wheezing; blood sampling for serum total IgE, ECP, eosinophil count, food and inhaled specific IgE levels and RSV/adenovirus serology; and skin prick tests were performed. Oral provocation tests were applied in cases of suspected food allergy. Results: Male gender (p=0.024), low socioeconomic level (p=0.046), initiation of milk formula (p=0.009) and eggs (p=0.018) before the fourth month, the presence of mold / umidity at home (p=0.023), eczema (p= 7.9 mu g/L at enrollment had higher risk of frequent wheezing than those with serum ECP 7.9 mu g/L (p=0.008). The sensitivity of ECP >= 7.9 mu g/L for frequent wheezing was 75.9% and the specificity was 68.7%. Similarly, serum total IgE (>= 154 IU/ml) and total eosinophil count (>= 390 /mm3) were found to be significantly higher in infants in the frequent wheezing group than the other groups (p=0.049, p=0.019). The multivariate analysis showed that the risk of frequent wheezing was 6.6 fold higher in children with a serum ECP level >= 7.9 mu g /L and 5.3 fold higher in the presence of RSV / adenovirus infection (p=0.026, p=0.038, respectively). Conclusion: In conclusion, our study suggested that the increase in serum ECP levels and the presence of RSV / denovirus infection significantly increased the risk of frequent wheezing in children with acute wheezing attacks

Neonatal nonketotic hyperglycinemia: Report of two cases

Giriş: Nonketotik hiperglisinemi glisin yıkımında meydana gelen bir bozukluk sonucunda gelişen otozomal resesif geçişli doğumsal bir metabolizma hastalığıdır. Olgu 1: Üç günlük kız bebek morarmasının fark edilmesi üzerine bir devlet hastanesinin acil servisine götürülmüş ve yeniden canlandırma işlemlerinin uygulanmasının ardından hastaneye yatırılmıştı. Yedinci günde mekanik ventilasyon ihtiyacı devam eden bebek hastanemize sevk edildi. Doğum sırasında herhangi bir sorunu olmayan bebek, doğumdan sonra emmemişti. Soy geçmişinde anne ve baba arasında dördüncü derece akrabalık vardı. Bebek hipotonik ve letarjikti, yenidoğan refleksleri alınamıyordu. Hastanın uzun süren hıçkırıkları ve myoklonik konvülziyonları vardı. Tam kan sayımı, biyokimyasal incelemeleri, tandem mass ve idrar organik asit incelemesi normaldi. Kraniyal magnetik rezonans görüntülemede korpus kallosumda incelme saptandı. Elektroensefalografide baskılanma- boşalma görünümü izlendi. BOS glisin düzeyinin plazma glisin düzeyine oranı 0,32 idi. Bu bulgularla hastaya neonatal nonketotik hiperglisinemi tanısı kondu ve dekstrometorfan ve sodyum benzoat tedavisi başlandı. Olgu 2: Bir devlet hastanesinde doğan erkek bebek, doğumdan sonra emmemesi ve morarması üzerine yenidoğan yoğunbakım ünitesine yatırılmıştı. İkinci gününde myoklonik konvülziyonları gözlenmiş ve hastanemize sevk edilmişti. Soygeçmişinde anne ve baba arasında üçüncü derece akrabalık vardı. Bebek hipotonik ve letarjikti, yenidoğan refleksleri alınamıyordu. Tam kan sayımı, biyokimyasal incelemeleri, tandem mass ve idrar organik asit incelemesi normaldi. Kraniyal magnetik rezonans görüntülemede korpus kallosum ince görünümdeydi. Kraniyal magnetik rezonans spektroskopide 3,56 ppm de glisin piki saptandı. BOS glisin düzeyinin plazma glisin düzeyine oranı 0,21 idi. Bu bulgularla hastaya neonatal nonketotik hiperglisinemi tanısı kondu ve dekstrometorfan ve sodyum benzoat tedavisi başlandı. Tartışma: Her iki olgumuzda da olduğu gibi yenidoğan döneminde açıklanamayan hipotoni, konvülziyon, letarji, koma durumunda neonatal nonketotik hiperglisinemi akla gelmelidir.Introduction: Nonketotic hyperglycinemia is an autosomal recessive disorder of glycine metabolism caused by a defect in the the glycine cleavage system. Case 1: A 3-day-old female baby was admitted to emergency room of a public hospital due to cyanosis and was hospitalized after resuscitation. She was transferred to our hospital on the seventh day of mechanical ventilation. Her delivery was uneventful but she refused feeding after birth. Her parents were consanguineous with a fourth degree of relationship. She was hypotonic and lethargic and had unresponsive neonatal reflexes. She had persistent hiccups and myoclonic convulsions. Complete blood count, biochemical parameters, tandem mass and urinary organic acid analysis were within normal limits. Cranial magnetic resonance imaging showed a thin corpus callosum. Electroencephalographic monitoring revealed burst suppression pattern. The CSF- to-plasma glycine concentration ratio was 0.32. According to these findings, our patient was diagnosed as neonatal nonketotic hyperglycinemia and was treated with dextromethorphan and sodium benzoate. Case 2: A male baby, born at a public hospital, was admitted to newborn intensive care unit due to poor feeding and cyanosis. On the second day of life, myoclonic convulsions were observed and he was transferred to our hospital. Her parents were consanguineous with a third degree of relationship. He was hypotonic and lethargic and had unresponsive neonatal reflexes. Complete blood count, biochemical parameters, tandem mass and urinary organic acid analysis were within normal limits. Cranial magnetic resonance imaging showed a thin corpus callosum. Cranial magnetic resonance spectroscopy revealed an elevated glycine peak at 3.56 ppm. The CSF- to-plasma glycine concentration ratio was 0.21. According to these findings, our patient was diagnosed as neonatal nonketotic hyperglycinemia and was treated with dextromethorphan and sodium benzoate. Conclusion: Nonketotic hyperglycinemia should be considered in newborns with unidentified hypotonia, convulsions, lethargy and coma

Nosocomial infections in neonatal units in Turkey: epidemiology, problems, unit policies and opinions of healthcare workers

WOS: 000276572900008PubMed ID: 20402067Turkish Neonatal Society Nosocomial Infections Study Group. Nosocomial infections in neonatal units in Turkey: epidemiology, problems, unit policies and opinions of healthcare workers. Turk J Pediatr 2010; 52: 50-57. The epidemiology of nosocomial infections in Turkish neonatal intensive care units (NICUs) shows that nosocomial sepsis is an important problem, especially for very low birth weight (VLBW) infants, and gram-negative agents, particularly Klebsiella species, are still the major causes of nosocomial infections. Sepsis frequency was 6.4%, ranging from 2.1 to 17%, in 16 centers in Turkey. Sepsis frequency was 22% in infants 2500 g. Sepsis-related mortality was 24.4 for 100 sepsis cases, ranging from 0 to 75 for 100 cases. Ventilator-associated pneumonia frequency was 1.7%, catheter-related infection frequency was 0.14% and urinary tract infection frequency was 3.7%. Healthcare workers (HCWs) complain of the inadequacy of some basic facilities and of staffing; however, they are aware of the causes and solutions and are willing to overcome this major health problem. We conclude that Turkish neonatal HCWs are quite optimistic about preventing neonatal nosocomial infections