Betül Siyah Bilgin

Association of vitamin D receptor gene polymorphisms and bronchopulmonary dysplasia

Background:Vitamin D and its receptor (VDR) have important roles in perinatal lung development. The aim of this study was to investigate the relationship between VDR gene polymorphism and bronchopulmonary dysplasia (BPD) in preterm infants.Methods:VDR Fok I, Bsm I, Apa I, and Taq I polymorphisms were genotyped using restriction fragment length polymorphism in 109 preterm infants (47 with BPD, 62 without BPD).Results:In univariate analysis, Ff (odds ratio (OR) = 3.937, P = 0.022, 95% confidence interval (CI) = 1.22–12.69) and ff (OR = 5.23, P = 0.004, 95% CI = 1.69–16.23) genotypes of Fok I were associated with the increased risk of BPD; whereas tt genotype of Taq 1 was associated with a protective effect against BPD (OR = 0.30, P = 0.04, 95% CI = 0.09–0.94). In multivariate logistic regression analysis, variant Fok 1 genotype increased risk of BPD (OR = 4.11, 95% CI = 1.08–15.68, P = 0.038) independent of patent ductus arteriosus, sepsis, mechanical ventilation, and surfactant treatment. Taq 1, Bsm 1, and Apa 1 polymorphisms did not have any effect.Conclusion:After adjusting for multiple confounders, VDR Fok 1 polymorphism was associated with the increased frequency of BPD. Further studies are needed to assess the contribution of VDR signaling to the pathogenesis of BPD and to determine if VDR polymorphisms may be suitable for identifying infants at high risk for BPD.

Bronchiolitis Obliterans and Bronchiolitis Obliterans Association with Gastroesophageal Reflux Disease in Children

Objective: Bronchiolitis obliterans (BO) is a rare chronic lung disease characterized by an obstructive and inflammatory reaction that occurs after severe damage to the lower respiratory tract. The presence of wheezing, cough, rales, and mosaic perfusion, vascular attenuation, central bronchiectasis findings in high resolution computed tomography which last six weeks after pneumonia, are considered. Recurrent aspiration in patients with gastroesophageal reflux (GER) can lead to chemical and infectious damage in the lungs. We aimed to investigate the presence of GER and effect of GER on the prognosis of patients who were followed up for recurrent wheezing and diagnosed with bronchiolitis obliterans with the clinical and radiological findings. Material and Methods: Among the persistent wheezy patients, 84 patients who had a BO diagnosis created the study group; and a control group was selected by choosing 25 GER (+) and 25 GER (-) patients of the same age and gender. Clinical and radiological improvement was evaluated after 6 months follow-up.

Reference values of anthropometric measurements in healthy late preterm and term infants

Background/aim Geographical distribution, ethnicity, and other socioeconomic factors may affect anthropometric measurements, and for that reason each society should determine their own measurements accounting for those factors. In this study, we aimed to determine the anthropometric measurements of healthy late preterm and term infants to compare the results with other national and international studies. Materials and methods This sectional study was carried out among 1197 infants born with a gestational age of ≥35 weeks. Chest circumference, ear length, foot length, palmar length, middle finger length, philtrum distance, inner and outer canthal distances, and palpebral fissure length were measured in the first 24 h of life. Results All measurements of late preterm infants were smaller than those of term infants (P ˂ 0.05). Compared with male infants, the chest circumference, ear length, foot length, palmar length, philtrum distance, and inner canthal distances of the female infants were lower (P ˂ 0.05). No significant differences were found between male and female infants’ middle finger length, outer canthal distance, and palpebral fissure length measurements. Percentile values for all measurements of 35–42-week male and female infants were described. Conclusion These measurements of male and female infants born between 35 and 42 weeks may be useful for early detection of syndromes by detecting anatomical abnormalities in our population.

Feeding Intolerance and Vomiting Caused by Duodenal Pancreatic Heterotopia in a Neonate

211 ABS TRACT Öz Pancreatic heterotopia (PH) is a congenital abnormality defined by the presence of an ectopic pancreatic tissue outside the usual anatomic location of the pancreas. The frequency of the disorder is reported to be 0.2-15% in autopsies, 1-2% in laparotomies. The most common locations are the stomach, duodenum and jejunum. The symptoms develop as per the localization particularly in the elderly. We presented a term neonate with a birth weight of 4460 gr hospitalized due to bilious vomiting 10 days after birth. The neonate presented 17% of dehydration, jaundice, and hypochloremic alkalosis on admission. Upper gastrointestinal contrast study demonstrated delayed passage. A mass of lace appearance in the second part of the duodenum was observed by endoscopy and was surgically excised. The diagnosis of PH was made through histopathological analysis. We want to highlight that although relatively rare, PH should be considered in the differential diagnosis of neonates with vomiting and feeding intolerance. The mass must be excised, if the symptoms develop.

Evaluation of Incidence and Characteristics of Necrotizing Enterocolitis in Neonatal Intensive Care Unit

1Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim ve Araştırma Hastanesi, Ankara, Türkiye 2Ege Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Neonatoloji Bilim Dalı, İzmir, Türkiye 3Ege Üniversitesi Tıp Fakültesi, Çocuk Cerrahisi Anabilim Dalı, İzmir, Türkiye Betül Siyah Bilgin1, Demet Terek2, Özge Altun Köroğlu2, Mehmet Yalaz2, Mete Akısü2, Ahmet Çelik3, Orkan Ergün3, Nilgün Kültürsay2 J Pediatr Res 2016;3(4):196-202 DO I: 10.4274/jpr.88700

Treatment of Congenital Complete Atrioventricular Heart Block With Permanent Epicardial Pacemaker in Neonatal Lupus Syndrome

Introduction: Neonatal lupus syndrome (NLS) is a passively acquired autoimmune condition due to the transplacental passage of maternal anti-Ro/SSA and anti-La/SSB antibodies in mothers with systemic lupus erythematosus (SLE), and congenital complete heart block (CHB) is its most serious manifestation. Skin and hepatic involvement may occur in later infancy. Case Presentation: A term infant with fetal bradycardia, detected at the 23rd gestational age, was diagnosed with CHB due to NLS and was successfully treated with a permanent epicardial pacemaker. The patient was reported here due to rarity of the procedure in neonatal period. Conclusions: Mothers with SLE should be screened and closely followed up during pregnancy for the development of fetal atrioventricular (AV) block.

61 Association of Vitamin D Receptor Gene Polymorphisms and Bronchopulmonary Dysplasia

Background and aims Vitamin D is considered as an important regulator of fetal lung development and innate immune system. Its functions involved in susceptibility and resistance to infections and pulmonary diseases may be important for the occurrence of bronchopulmonary dysplasia (BPD). The aim of the study was to investigate the relationship between Vitamin D receptor gene polymorphism and BPD in preterm infants. Methods Fok I, Bsm I, Apa I, and Taq I polymorphisms in the Vitamin D Receptor (VDR) gene were genotyped using restriction fragment length polymorphism in109 preterm infants (47 with BPD, 62 without BPD) born at gestational age ≤ 32 weeks and admitted to NICU at Ege University Hospital. Results The univariate analysis showed Ff (OR=3.937, p=0.022, 95% CI= 1.22–12.69) and ff (OR=5.238, p=0.004, 95% CI= 1.69–16.23) genotypes of Fok I polymorphism were associated with increased risk of BPD; whereas tt genotype of Taq 1 polymorphism; was associated with a protective effect against BPD (OR=0.30, p=0.04, 95% CI= 0.098–0.094). In a multivariate logistic regression analysis of the model including variant Fok1 genotype with significant PDA, clinical and culture proven sepsis, mechanical ventilation and surfactant treatment; variant Fok 1 genotype increased the risk of BPD (OR=4.115, CI=1.080–15.686, p=0.038) independent from these factors. Taq 1, Bsm 1 and Apa 1 polymorphisms did not have any effect in the same model. Conclusion Fok1 polymorphism was associated with increased frequency of BPD after adjusting for multiple confounders. VDR gene polymorphisms may be suitable for prediction of infants at high risk for BPD.

1330 Association of Transcutaneous Carbon Monoxide and Bilirubin Levels in Healthy Term Newborns

Background and Aims End tidal measurement of carbonmonoxide (CO) as a side product of hemoglobin turn over may be an indicator of bilirubin production and hemolysis. We aimed to evaluate the association of transcutaneus CO measurement and bilirubin levels in healthy term newborns as an alternative to end tidal CO. Methods A total number of 390 infants were recruited in the study. Infants who were born in our hospital (n=340) were followed by daily transcutaneus CO and capillary bilirubin measurements starting from birth to discharge. Remaning 50 infants were admitted for hyperbilirubinemia treatment after 72 hours of life. Transcutaneous CO measurements were done by Masimo pulse oxymeter. Results Capillary bilirubin and transcutaneus CO levels on 24 and 48 hours of life were positively correlated (Spearman correlation coefficients r=0.21 and 0.87 respectively, p values for both analyses < 0.001). Bilirubin levels and transcutaneous CO measurements were levels were also positively correlated in infants admitted for hyperbilirubinemia (Spearman correlation coefficient r=0.41, p<0.001). Conclusion Our data showed positive and statistically significant correlations between bilirubin and transcutaneous CO measurements not in only healthy term newborns but also in newborns with hyperbilirubinemia. Therefore transcutaneous CO measurement deserves attention in order to obtain threshold levels for prediction of severe hyperbilirubinemia.