Placenta, Secret Witness of Infant Morbidities: The Relationship Between Placental Histology and Outcome of the Premature Infant

Objective: The microscopic and macroscopic features of the placenta can contribute to the clinical understanding of premature delivery. The aim of our study was to figure out the relationship between the histopathological findings of the placentas of premature deliveries and its effects on neonatal morbidity and mortality. Material and Method: The placentas of 284 singleton preterm infants with <35 weeks of gestation were examined. three groups created as the normal, chorioamnionitis and vasculopathy according to histopathological findings in placentas subjects. Results: The mean gestational age of the infants in the study group was 30.5 ± 3.2 weeks, and the mean birth weight was 1588 ± 581 g. The pathology was normal in ninety-six (33.8%), vasculopathy in 153 (53.9%) and chorioamnionitis in 35 (12.3%). The gestation age of the infants was lower in the chorioamnionitis group. Moreover, retinopathy of prematurity, early onset neonatal sepsis, and duration of respiratory support were found to be higher in the chorioamnionitis group. In the vasculopathy group, preeclampsia and small for gestational age were found to be significantly higher. Conclusion: Histopathological findings of the placentas from preterm deliveries provided important data in determining the etiology of preterm delivery and outcomes of infants. Infants delivered by mothers with chorioamnionitis were particularly found to be more preterm, and these preterm infants would have a longer hospital stay, higher respiratory support requirement, and more serious morbidities

GAZİ ÜNİVERSİTESİ TIP FAKÜLTESİ YENİDOĞAN YOĞUN BAKIM ÜNİTESİNDE İZLENEN BEBEKLERİN MARUZ KALDIKLARI GÜRÜLTÜ DÜZEYLERİNİN BELİRLENMESİ

Gazi Üniversitesi Tıp Fakültesi (GÜTF) Yenidoğan Yoğun Bakım Ünitesinde (YDYBÜ) yatırılan prematüre ve zamanında doğmuş bebeklerin yatışları boyunca maruz kaldıkları gürültünün frekans (Hertz) ve şiddetinin (desibel) belirlenmesi ve bebeklerin yaşamsal bulgular, oksijenasyon, hastanede yatış süresi ve enteral beslenme başarısı ile kilo alımları gibi klinik parametreler arasındaki olası ilişkiyi de araştırmak amacıyla YDYBÜ &#8216;ne yatan 57 yenidoğan bebek çalışmaya dahil edilmiştir. Hastalar üç farklı markadaki küvözde izlenmiş olup yattıkları süre boyunca kayıt alınmıştır, ortalama kayıt süresi 133,73 ± 112,9 saattir. Vizit saatlerinde gürültünün daha yüksek olduğu tespit edilmiştir. Maksimum ve ortalama gürültü 8-16 saatleri arasında en fazla bulunmuştur. Miad ve prematüre arasında maruz kalınan maksimum ve ortalama gürültü düzeyleri arasında istatistiksel olarak anlamlı fark bulunamamıştır. Hastalar solunum desteği alırken daha fazla gürültüye maruz kaldığı saptanmıştır. Hastaların yatışları sırasında gürültünün en yüksek olduğu saatlerde kalp hızlarının, sistolik ve diastolik kan basıncının yükseldiği, satürasyonların düştüğü ve solunum sayısının etkilenmediği tespit edilmiştir (p<0,05). Hastaların maruz kaldıkları gürültü düzeyleri ile doğum ağırlıkları arasında negatif korelasyon bulunmuştur (r=0,028, r=0,048). YDYBÜ&#8217;deki gürültü düzeylerinin önerilen düzeylerin üzerinde olduğu yatış sürelerinin ortalama %28,6&#8217;ında AAP&#8217;ın 45 dB sınırının üzerinde olduğu bulunmuştur. Sonuç olarak; YDYBÜ&#8217;de gürültünün önerilenin üzerinde olduğu, doğum ağırlığı azaldıkça maruz kalınan gürültünün arttığı, gürültünün asıl kaynağının küvöz olduğu saptanmıştır. YDYBÜ&#8217;deki gürültüyü azaltmak için küvöz bakımlarında gürültü düzeyine, personel eğitimine, YDYBÜ&#8217;de kullanılan aletlerin kullanım esnasında çıkaracağı gürültü açısından dikkat edilmesi gerekmektedir. Bu konuda önlemler alınabilmesi için daha fazla çalışmaya ihtiyaç vardır

The influence of airway supporting maneuvers on glottis view in pediatric fiberoptic bronchoscopy

Introduction: Flexible fiber optic bronchoscopy is a valuable intervention for evaluation and management of respiratory diseases in both infants, pediatric and adult patients. The aim of this study is to investigate the influence of the airway supporting maneuvers on glottis view during pediatric flexible fiberoptic bronchoscopy

Assessment of Right Heart Functions in Children with Mild Cystic Fibrosis

Background Cystic fibrosis (CF) is a multisystemic disease that prevalently involves the lungs. Hypoxemia occurs due to the existing of progressive damage to the pulmonary parenchyma and pulmonary vessels. The condition may cause systolic and diastolic dysfunction to the right ventricle due to the effects of high pulmonary artery systolic pressure (PASP). The study aimed to determine echocardiographic alterations in PASP, right ventricle (RV) anatomy, and functions in mild CF children

Geographical barriers to timely diagnosis of cystic fibrosis and anxiety level of parents during newborn screening in Turkey

Background Despite the availability of cystic fibrosis (CF) screening countrywide, diagnostic delay is still a crucial issue. The objectives of this study were to explore the stages of the NBS process, determine the risk factors associated with diagnostic delay and evaluate parent anxiety and experience throughout the process. Methods This is a multicenter cross-sectional study. A questionnaire was completed by parents of newborns diagnosed with CF via NBS in 17 centers. Socio-demographic characteristics, parent knowledge and experiences related to NBS, sweat test availability in the region of residence, and time to the definitive CF diagnosis were assessed through this questionnaire. Parents' anxiety levels were evaluated through the State-Trait Anxiety Inventory scales 1 and 2. Delayed diagnosis (DD) was defined as a definite CF diagnosis beyond the 8th week of life. Predictors of delayed CF diagnosis were evaluated by univariate and multivariate analysis. Results A total of 220 CF patients diagnosed via NBS were enrolled; 82 (37.3%) babies had DD. Multivariable analysis indicated that residence in the Southeast Anatolia region of Turkey (OR = 10.79, 95% CI = 2.37-49.2) was associated with a higher incidence of DD compared with other regions in Turkey. Of the total, 216 (98.1%) of the caregivers regarded the NBS program as useful and 180 (82%) reported high anxiety levels. Conclusion The organization of newborn screening should take into account regional and socio-cultural characteristics to improve the early diagnosis of CF and also reduce the anxiety level of parents

The success of the Cystic Fibrosis Registry of Turkey for improvement of patient care

Background Cystic fibrosis (CF) registries play an essential role in improving disease outcomes of people with CF. This study aimed to evaluate the association of newly established CF registry system in Turkey on follow-up, clinical, growth, treatment, and complications of people with this disease. Methods Age at diagnosis, current age, sex, z-scores of weight, height and body mass index (BMI), neonatal screening results, pulmonary function tests, history of meconium ileus, medications, presence of microorganisms, and follow-up were evaluated and compared to data of people with CF represented in both 2017 and 2019 registry data. Results There were 1170 people with CF in 2017 and 1637 in 2019 CF registry. Eight hundred and fourteen people were registered in both 2017 and 2019 of whom z-scores of heights and BMI were significantly higher in 2019 (p = 0.002, p =0.039, respectively). Inhaled hypertonic saline, bronchodilator, and azithromycin usages were significantly higher in 2019 (p =0.001, p = 0.001, p = 0.003, respectively). The percent predicted of forced expiratory volume in 1 sec and forced vital capacity were similar in 2017 and 2019 (88% and 89.5%, p = 0.248 and 84.5% and 87%, p =0.332, respectively). Liver diseases and osteoporosis were significantly higher, and pseudo-Bartter syndrome (PBS) was significantly lower in 2019 (p = 0.011, p = 0.001, p = 0.001, respectively). Conclusions The z-scores of height and BMI were higher, the use of medications that protect and improve lung functions was higher and incidence of PBS was lower in 2019. It was predicted that registry system increased the care of people with CF regarding their follow-up. The widespread use of national CF registry system across the country may be beneficial for the follow-up of people with CF

The success of the Cystic Fibrosis Registry of Turkey for improvement of patient care

Background Cystic fibrosis (CF) registries play an essential role in improving disease outcomes of people with CF. This study aimed to evaluate the association of newly established CF registry system in Turkey on follow-up, clinical, growth, treatment, and complications of people with this disease. Methods Age at diagnosis, current age, sex, z-scores of weight, height and body mass index (BMI), neonatal screening results, pulmonary function tests, history of meconium ileus, medications, presence of microorganisms, and follow-up were evaluated and compared to data of people with CF represented in both 2017 and 2019 registry data. Results There were 1170 people with CF in 2017 and 1637 in 2019 CF registry. Eight hundred and fourteen people were registered in both 2017 and 2019 of whom z-scores of heights and BMI were significantly higher in 2019 (p = 0.002, p =0.039, respectively). Inhaled hypertonic saline, bronchodilator, and azithromycin usages were significantly higher in 2019 (p =0.001, p = 0.001, p = 0.003, respectively). The percent predicted of forced expiratory volume in 1 sec and forced vital capacity were similar in 2017 and 2019 (88% and 89.5%, p = 0.248 and 84.5% and 87%, p =0.332, respectively). Liver diseases and osteoporosis were significantly higher, and pseudo-Bartter syndrome (PBS) was significantly lower in 2019 (p = 0.011, p = 0.001, p = 0.001, respectively). Conclusions The z-scores of height and BMI were higher, the use of medications that protect and improve lung functions was higher and incidence of PBS was lower in 2019. It was predicted that registry system increased the care of people with CF regarding their follow-up. The widespread use of national CF registry system across the country may be beneficial for the follow-up of people with CF