Semra Kara

Detection of cord blood hepcidin levels as a biomarker for early-onset neonatal sepsis.

Early-onset neonatal sepsis (EONS) continues to be a severe condition associated with a high mortality and morbidity. However, symptoms and laboratory markers of this serious condition are nonspecific and currently there are no available standard tests to provide perfect diagnostic accuracy. An early recognition and initiation of antimicrobial therapy are essential in order to prevent morbidity and mortality. Hepcidin, the key regulator of iron homeostasis, is also an acute-phase reactant, which has a critical role in inflammation and contributes to host defense by interfering with microorganisms access to iron. Since hepcidin expression is induced by interleukin-6 (IL-6), it also plays role in the innate immune system. Recently, endogenous expression of hepcidin by macrophages and neutrophils in response to bacterial pathogens confirmed its role in innate immunity. The clear link between the hepcidin molecule and innate immunity may be used for the detection of EONS. We hypothesized that an increased level of hepcidin in cord blood may be used as a reliable biological marker of EONS and designed a prospective cohort study to test this hypothesis and collected pilot data. Cord blood samples of all infants born between January 2009 and December 2010 at our university hospital were collected after parental consent and a total of 38 infants were enrolled in the study who fulfilled the sepsis criteria. The range of cord blood hepcidin was found to be significantly increased in newborns with EONS (min-max: 118.1-8400 ng/mL). To the best of our knowledge, this is the first study to investigate the pathophysiologic relevance of hepcidin in EONS and demonstrate increased levels of hepcidin in cord blood as an acute-phase reactant in response to sepsis.

Red cell distribution width (RDW) in the newborn: normative data

Aim: To evaluate the normal range of red blood cell distribution width (RDW) in term and preterm newborns dependent on gestational age. Material and methods: A total of 1,594 preterm and term neonates were admitted to our neonatology department. Infants were divided into two groups according to their gestational age. Group 1 consisted of infants with ≤34 weeks of gestation; group 2 consisted of infants with ≥35 weeks of gestation. Infants in Groups I and II were subdivided according to their gestational age. Gestational age, birth weight, sex, hemoglobin and hematocrit, MCV levels of all newborns were recorded, and RDW was compared between the groups. Results: A total of 1,594 newbornswere enrolled in the study. Group 1 (≤34 weeks) consisted of 725 newborns and Group 2 (≥35 weeks) consisted of 869 newborns. The mean normal range of RDW in Group 1 was 17.8 ± 2.1 and of group II was 16.7 ± 1.6 (P<0.05). The normal range for RDW values at 32–34 weeks was higher than at 35–36 gestational weeks, and at 37–42 weeks (P = 0.002 and 0.003). Conclusion: RDW values at ≤34 weeks in newborns are higher than at ≥35 weeks. This may be useful in the differential diagnosis of neonatal hematologic diseases together with other red cell parameters. J. Clin. Lab. Anal. 25:422–425, 2011.

Bohn's nodules: peculiar neonatal intraoral lesions mistaken for natal teeth

Inclusion cysts of transient nature during the neonatal period are developmental lesions, which are seen in the oral cavity of the newborn infant. These lesions are classified into three subtypes according to their localizations. When noticed by the anxious parents on the gingival surfaces, they are often mistaken for natal teeth, which lead to seeking medical attention. Herein, we describe a newborn infant with Bohn’s nodules to increase the awareness of the physicians to this benign, self-limiting lesion.

Children with food refusal: An assessment of parental eating attitudes and their styles of coping with stress

Background: In this study, we aimed to assess the eating attitudes and stress coping styles of parents whose children presented to the clinic complaining of food refusal. Methods: The parents of 31 children aged ≥3 years, presented to the clinic with the complaint of food refusal. The control group consisted of 30 healthy children with no prior history of food refusal, and their parents. In both groups, birth features, body mass indexes (BMIs), eating attitudes and stress coping styles of the parents were assessed. The parents of both groups were studied, in part utilizing the eating attitudes test (EAT), and the coping styles of stress scale (CSSS). Results: Our study found that body weights and BMI values of the fathers in the study group were significantly lower than fathers in the control group. There was no significant difference in EAT scores between the two groups; however, where the childrens body weight and height for age percentile was under 25%, the parents had significantly lower EAT scores. When CSSS scores were assessed, the optimistic approach score of the mother and the self‐confident score of the father were found to be significantly high in both groups. Conclusion: The parental perception and definition of eating problemsdoes not necessarily indicate the presence of an eating disorder in a child. In fact, the eating attitudes of the fathers were related to the low percentile weight and height values of the children, and a childs food refusal was not dependent on the stress coping style used by the parent.

Bone measurements of infants with hyperbilirubinemia by quantitative ultrasound: the influence of phototherapy

Abstract Objective: The purpose of the current study was to investigate the possible effects of phototherapy on bone status of term infants evaluated by measurement of tibial bone speed of sound (SOS). Materials and methods: The phototherapy group (n = 30) consisted of children who had undergone phototherapy for at least 24 h and the control group (n = 30) comprised children who had not received phototherapy. Blood samples were obtained from all infants for serum calcium, phosphorus, magnesium, alkaline phosphatase, parathyroid hormone and vitamin D concentrations. The left tibial quantitative ultrasound (QUS) measurements were performed using a commercial device. Results: There was no statistically significant difference between phototherapy-exposed and nonexposed infants in terms of Ca, P, ALP, PTH and vitamin D levels. Comparison of bone SOS between the phototherapy-exposed and control group revealed no statistically difference. Also, no significant difference in Z-score for SOS was observed between those with or without exposure. Conclusion: The data of our study indicate that phototherapy treatment has no impact on bone status in the hyperbilirubinemic infants. Although there is no statistically significant evidence of an excess risk of bone damage following phototherapy, studies with larger sample sizes and longer duration of follow-up are needed to gain a better understanding of its effects.

Una causa infrecuente de convulsión afebril: gastroenteritis por rotavirus

La gastroenteritis por rotavirus es la mas frecuente de las diarreas infecciosas y ocasiona una importante morbimortalidad en los ninos pequenos, ademas de deshidratacion grave y desequilibrios electroliticos; los signos extraintestinales son infrecuentes. Recientemente se han comunicado convulsiones afebriles asociadas con gastroenteritis por rotavirus, sin encefalopatia, deshidratacion, desequilibrio electrolitico o hipoglucemia. Comunicamos el caso de un paciente con convulsiones durante una gastroenteritis por rotavirus, una infeccion habitual en nuestro pais (Turquia), con diversas manifestaciones clinicas, entre ellas, las convulsiones, que pueden verse no solo en los ninos con enfermedades neurologicas o sistemicas sino tambien en los ninos sanos. Rotavirus is the most common infectious diarrhea that causes important mortality and morbidities in small children, severe dehydration and electrolyte imbalance. Extraintestinal signs are rare in rotavirus infections. Recently, afebrile seizures associated with rotavirus gastroenteritis but without encephalopathy, dehydration, electrolyte imbalance or hypoglycemia have being reported. In this article, the fact that rotavirus, which is seen commonly in our country, can be confronted with various clinical manifestations was emphasized by reminding that it can be seen not only in infants with neurologic and systemic disease but also in healthy infants.