Gonca Sandal

Probiotics for the prevention of pediatric upper respiratory tract infections: a systematic review

Background: Acute upper respiratory tract infections (URTIs) contribute substantially to pediatric morbidity and mortality worldwide. Prevention of these infections in childhood is a very important public health challenge. Previous systematic reviews, including both adult and childhood populations, have reported that probiotics seem promising, but with modest evidence. This study aimed to focus on prophylactic probiotic use in the prevention of URTIs in childhood. Methods: Relevant trials on two databases were identified in a systematic review, from inception to June 2014. Study selection, data extraction and quality assessment were carried out by two reviewers. In this review, the effects of probiotics, particularly the Lactobacillus and Bifidobacterium strains, on the incidence and symptom scores of URTI in otherwise healthy children were evaluated for the first time. This review comprises 14 randomized controlled trials (RCTs) applied to a pediatric population with high-quality methodology. Results: This systematic review suggests that probiotics in immunocompetent children have a modest effect both in diminishing the incidence of URTIs and the severity of the infection symptoms. Conclusions: At least one beneficial effect of prophylactic probiotic was observed in the majority of RCTs. Even a minimal reduction of 5 – 10% in the incidence of URTIs would have an important clinical and economic mpact on societies. Furthermore, the long-term administration of probiotics appeared to have a good safety profile in childhood and none of the studies reported any serious adverse events related to the probiotic strain.

Low serum sclerostin levels in newborns with vitamin D deficiency

Abstract Background: Sclerostin is a glycoprotein produced by osteocytes that is being evaluated as a potential clinical marker of bone turnover. The aim of this study was to investigate the association between neonatal vitamin D status and levels of circulating sclerostin. Methods: Forty newborns were recruited for the study. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D3 [25(OH)D] concentration <20 ng/mL and the newborns were divided into two groups as vitamin D deficient and vitamin D sufficient groups. Calcium, phosphate, alkaline phosphatase and sclerostin were measured at birth. Results: Newborns with vitamin D deficiency had markedly lower 25(OH)D levels than vitamin D sufficient newborns (8.5±4.4 ng/mL vs. 35.3±10.6 ng/mL, p<0.001). Vitamin D deficient infants also had significantly lower serum sclerostin levels (188.4±21.9 vs. 282.3±30.4 pg/mL; p: 0.026) than vitamin D sufficient newborns at birth. However, we did not detect a significant linear association between neonatal sclerostin and maternal/neonatal 25(OH)D levels. Conclusions: Our data also demonstrated that vitamin D deficient newborns exhibited lower sclerostin levels than vitamin D sufficient newborns. The low sclerostin level might serve as a marker of decreased osteocyte activity in newborns with vitamin D deficiency.

Serum Sclerostin Levels in Newborns Born to Mothers With Vitamin D Deficiency.

Aim Sclerostin inhibits osteoblast functions, differentiations, and survival rates. The aim of this study was to investigate the association between circulating sclerostin (an emerging biomarker and important regulator of bone formation) and neonatal parameters in mothers with vitamin D deficiency. Method Forty-five mothers and their newborns were recruited in the study. The mothers were divided into 2 groups as vitamin D–deficient group 25(OH)D (25-hydroxyvitamin D3 < 20 ng/mL) and vitamin D–sufficient group 25(OH)D (>20 ng/mL). Their newborns had measurements of weight, height, calcium, phosphate, alkaline phosphatase, sclerostin, and 25(OH)D at birth. Results The mothers with vitamin D deficiency had significantly lower vitamin D levels than the mothers with vitamin D sufficiency (8.7 [3.4] ng/mL vs 26.7 [4.0] ng/mL, P < 0.001). There were no significant differences between women with vitamin D deficiency and women with vitamin D sufficiency for sclerostin concentrations (205.4 [64.8] pg/mL vs 291.6 [122.9] pg/mL). However, 25(OH)D (10.1 [8.1] ng/mL vs 33.4 [11.6] ng/mL, P < 0.001) and sclerostin concentrations (182.9 [15.3] pg/mL vs 288.8 [32.3] pg/mL, P = 0.01) were lower in newborns born by mothers with vitamin D deficiency compared and with newborns of mothers with vitamin D sufficiency. Circulating sclerostin measurements were not associated with 25(OH)D levels of both mothers and their newborns. Conclusions We found significantly lower sclerostin levels in newborns born by women with vitamin D deficiency compared with newborns of nondeficient mothers.

Early diagnostic clues in neonatal chronic gastric volvulus.

PurposeNeonatal gastric volvulus (GV) is a rare clinical entity with a challenging diagnosis. In this study, we aimed to identify clinical and radiological findings to aid in early diagnosis in neonatal GV.Materials and methodsThe medical records of all neonates with GV were retrospectively reviewed. Diagnosis was made based on clinical findings and radiological images, and was documented by an upper gastrointestinal (UGI) contrast study.ResultsA total of eight neonates were included in the study. The most common clinical presentations were non-bilious vomiting and epigastric distention. The findings highly suggestive for GV in plain radiographs include gastric double bubble, abnormal gastric distention despite a nasogastric tube, distended stomach lying in a horizontal plane and an air-fluid level in the epigastrium.ConclusionGV should be suspected in any newborn with non-bilious vomiting and epigastric distention. It is also important to focus on the clues in the plain radiographs. Gastric double bubble, abnormal gastric distention despite a nasogastric tube, distended stomach lying in a horizontal plane and an air-fluid level in the epigastrium must alert the physicians to the possibility of GV.

Mini Epidemic of Acinetobacter Junii in a Neonatal Intensive Care Unit: Risk Factors and Control Procedures

206 Ya z›fl ma Ad re si/Ad dress for Cor res pon den ce Dr. Gonca Sandal, Süleyman Demirel Üniversitesi Tıp Fakültesi, Neonatoloji Anabilim Dalı, Isparta, Türkiye Tel.: +90 246 211 93 06 E-posta: kocabasgonca@mynet.com Ge liş ta ri hi/Re cei ved: 06.04.2015 Ka bul ta ri hi/Ac cep ted: 15.07.2015 1Süleyman Demirel Üniversitesi Tıp Fakültesi, Neonatoloji Anabilim Dalı, Isparta, Türkiye 2Acıbadem Üniversitesi Tıp Fakültesi, Pediatrik Enfeksiyon Hastalıkları Bilim Dalı, İstanbul, Türkiye 3Süleyman Demirel Üniversitesi Tıp Fakültesi, Mikrobiyoloji Anabilim Dalı, İstanbul, Türkiye Gonca Sandal1, Hasan Çetin1, Metehan Özen2, Ayşe Aynalı3

Acquired Bartter-like syndrome association with netilmicin therapy in an extremely low birth weight infant.

Abstract Aminoglycosides are commonly used antibiotics with excellent renal parenchymal penetration. Their clinical effectiveness is counter balanced with the risk of renal toxicity, which develops in a dose-dependent fashion. Aminoglycoside-induced renal tubular dysfunction could result in diffuse damage or manifest as a Fanconi-like syndrome, Bartter-like syndrome (BLS), or distal renal tubular acidosis.1–4 Although tubulopathy associated with amikacin and gentamicin was reported in adults and rarely children, to the best of our knowledge, netilmicin-associated BLS neither in adults nor in children has been reported in the literature. We here report a 30-week, 770 g male preterm infant who developed BLS just after netilmicin treatment for neonatal sepsis and recovered 6 weeks after the drug cessation.

Unilateral Renal Vein Thrombosis and Adrenal Hemorrhage in A Newborn with Homozygous Factor V Leiden and Heterozygous Of MTHFR-677T, MTHFR-1298C Gene Mutations.

Renal vein thrombosis (RVT) occurs as an acute and life-threatening event in neonates. RVT is the most common non–catheter-related thrombosis in infancy and occurs primarily in the newborn period. Non-catheter-related abdominal thrombosis on neonates has a higher incidence of genetic prothrombotic risk factors. RVT and adrenal hemorrhage can both be encountered in the neonatal period and they may occur at the same time (Bokenkamp et al., Eur J Pediatr 159:44–8, 2000; Lau et al. Pediatrics 120:1278–84, 2007). We report a case of unilateral RVT and adrenal hemorrhage in a newborn with homozygous factor V Leiden mutation and heterozygous of the methylene tetrahydrofolate reductase (MTHFR) gene mutations.