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Aim: Vancomycin-resistant enterococcus (VRE) is a concerning microorganism among hospitalized and intensive care patients. The aim of this study was to report the outbreak characteristics, the risk factors, and the outbreak control of VRE colonization in a neonatal intensive care unit and the effect of Lactobacillus reuteri on VRE colonization. Material and Method: Thirty- nine cases and seventy-eight controls were included in the case-control study between December 2012- June 2013. The primary outcome variable was the risk factors of VRE colonization. The secondary outcome was the effect of Lactobacillus reuteri on elimination of VRE. Results: Of 272 neonates, 39 (14.3%) were colonized with VRE. Multivariate analysis suggested that gestational age, shared use of ultrasonography, and receiving anti-methicillin resistant staphylococcus aureus drugs were the risk factors of VRE colonization. Twenty-six of the 39 VRE positive patients received Lactobacillus reuteri. Eleven (42.3%) of 26 patients became negative after the use of probiotics. The clearance time of VRE was 9.61 +/- 5.53 days. Discussion: Low gestational age, shared ultrasonography, and anti- methicillin resistant staphylococcus aureus drug exposure are major independent risk factors for VRE colonization. An effective Infection control programme should be implemented. To determine the effectiveness of probiotics in VRE colonization, further randomized controlled trials must be conducted.

Background/aim: We aimed to evaluate the association of the umbilical cord macrophage migration inhibitory factor (MIF) with the respiratory distress syndrome (RDS) in preterm infants. Materials and methods: A total of eighty six preterm infants (38 with RDS and 48 without RDS) were involved in the study. ELISA is the technique assaying MIF values. Results: The mean of the infants’ gestational ages and birth weights were significantly different (P = 0.0001). There were no significant differences in sex, delivery mode or exposure to antenatal steroid among the groups (P > 0.05). Umbilical cord MIF levels of the infants were not correlated with gestational age and birth weight (Spearman’s rho = –0.22 and 0.28 respectively, P > 0.05). There was no statistically significant difference in umbilical cord MIF levels of infants whether or not they were administered antenatal steroid (median:17.88 vs. median:17.60, Mann–Whitney U test, P = 0.42). Cord serum MIF levels were higher (mean, 17.09 ± 5.86 ng/mL) in the RDS group than in the non-RDS group (mean, 14.72 ± 4.18 ng/mL) (P = 0.005). Conclusion: This study shows that, MIF level is higher in the cord blood of the infants with RDS than of the infants without RDS. This supports that MIF expression begins in prior to the birth of the preterm infants and MIF has enhancing impact on the lung development of premature babies. With future studies, the assessment of the cord MIF levels at the bedside may be beneficial for the diagnosis and treatment of RDS, and taking actions to prevent long-term consequences. Bezmiâlem Vakıf Üniversitesi

To investigate cord arterial blood sample and the relationship between birth stress and intraocular pressure in infants at 5 min after delivery. The IOP measurements were taken using Tonopen-Avia tonometer to 158 newborns (158 eyes) at 5th min after birth, in a university hospital. Cord blood was collected within 3 min after delivery. Intraocular pressure, gender, gestation period, mode of delivery, and birth weight of newborns were noted from medical records. Sixty-two babies were delivered by normal vaginal delivery (NVD) and 96 by cesarian section (C/S). Mean IOP of NVD and C/S groups were 19.56 ± 3.84 and 17.42 ± 3.50, respectively. There was significant difference of mean IOP between two groups. (p

INTRODUCTION[|]To evaluate to changes and the reasons of the changes in intraocular pressure (IOP) and central corneal thickness (CCT) in the first 24 hours of life of full-term newborns.[¤]METHODS[|]IOP,CCT measurements were determined by using Tono-Pen XL tonometer,portable pachymeter.In this prospective study we evaluate IOP and CCT of the 32right eyes of 32 newborn infants by vaginal delivery.The data was included.IOP and CCTmeasurements taken at 5th minutes just after the delivery and 24th h of the first day of the post partum period.Infant weights,heights,gender APGAR scores and gestational ages were also obtained.[¤]RESULTS[|]The mean IOP and CCT of right eyes was decreased significantly from18.67 +- 3.28 mmHg and684.72 +- 58.79 µm at the fifth minute after delivery to16.10 +- 2.87 mmHg and 611.28 +- 49.41 µm at the 24th hour of the postpartum period(p < 0.0001).There was no statistically difference between right-left eyes in terms of IOP and CCT at any measurement point. [¤]DISCUSSION AND CONCLUSION[|]We found that the mean IOP and CCT was decreased significantly between the values at the fifth minute after delivery and the 24th hour of the postpartum period.There is a need for more research to investigate the changes and the causes in IOP and CCT of newborns.[¤]

Freman-Sheldon sendromu, ıslık çalar şekilde küçük ağız, maske şeklinde yüz, eklem kontraktürleri (özellikle el ve parmaklarda), gelişmemiş burun kıkırdağı ile karakterize otozomal dominant (nadiren otozomal resesif olgular da bildirilmiştir geçiş gösteren bir hastalıktır. Diğer klinik bulguları; geniş alın, derin yerleşimli gözler, epikantal kıvrımlar, yüksek damak, H şeklinde çukurlaşan çene, ellerin ulnar deviasyonu, nöbetler ve kalça çıkığıdır. Yenidoğan yoğun bakım ünitemize 10 günlük erkek hasta sarılık ve yüksek ateş nedeniyle yatırıldı. Hastamızın 42,5°C ateşi, ıslık çalar şekilde küçük ağzı, maske şeklinde yüzü, parmaklarda eklem kontraktürleri, ellerinde ulnar deviasyonu vardı. Anne baba akraba idi ve 1 yaşında bir erkek çocuklarını intrakraniyal hemoraji nedeniyle kaybetmişlerdi. İngilizce literatür taramalarında 60 olgudan fazla Freman-Sheldon sendromu olgusu bulunduğu görülmekle birlikte olgumuz hemofili A ile birlikteliği olan ilk, anestezi almadan hipertermi görülen ikinci olgudur The Freeman-Sheldon syndrome (FSS) (whistling face) is a congenital autosomal dominant disease (rarely described in its autosomal recessive form) characterized by small "whistling" mouth, a flat masklike face, joint contractures (commonly involving the fingers and hands) and underdevelopment of the nasal cartilage. Other clinical features include full forehead, deep set eyes, epicanthal folds, high palate, H-shaped cutaneous dimpling on the chin, ulnar deviation of the hands, seizures, and dislocation of the hip. A 10-day-old male newborn was admitted to our neonatal intensive care unit with jaundice and hyperthermia. He had fever of 42.5°C, small whistling mouth, a flat mask-like face, joint contractures of the fingers, and ulnar deviation of the hands. The parents were consanguineous and one of the boys died when he was 1 years old due to intracranial hemorrhage. To our knowledge, there have been more than 60 cases diagnosed with FSS. This is the first reported case of Freeman-Sheldon syndrome associated with hemophilia A and the second case of FSS associated with fever without anesthesia

Bisphenol A (BPA) is known as an endocrine disruptor and it is supposed to have a role on the development of central precocious puberty (CPP). Kisspeptin, a hypothalamic peptide, is a neuromodulator of gonadotropin releasing hormone and it has an important role on regulation of the onset of puberty. The BPA levels in girls with CPP and premature thelarche (PT) and its relation with kisspeptin levels were investigated.Twenty-eight girls with CPP, 28 girls with PT and 22 prepubertal girls as a control group were enrolled to the study. Urinary BPA and serum kisspeptin levels were compared in the groups. Bivariate correlations were performed to evaluate the relations of BPA with kisspeptin and estradiol.There was no statistical difference between groups regarding BPA levels. Serum kisspeptin levels were higher in CPP group than controls [306.56 (interquartile range (IQR), 175.63–504.66) vs. 157.62 (IQR, 55.61–285.00) p: 0.008]. There were no correlations between BPA and kisspeptin levels (r: 0.088, p: 0.391) and between BPA and estradiol (r: –0.171, p: 0.144).The BPA levels did not differentiate between groups and it seems that the exposed amount of BPA in daily life did not affect kisspeptin levels in girls with CPP and PT.

Carbamoyl phosphate synthetase 1 (CPS1) deficiency due to CPS1 mutations is a rare autosomal-recessive urea cycle disorder causing hyperammonemia that can lead to death or severe neurological impairment. CPS1 catalyzes carbamoyl phosphate formation from ammonia, bicarbonate and two molecules of ATP, and requires the allosteric activator N-acetyl-L-glutamate. Clinical mutations occur in the entire CPS1 coding region, but mainly in single families, with little recurrence. We characterized here the only currently known recurrent CPS1 mutation, p.Val1013del, found in eleven unrelated patients of Turkish descent using recombinant His-tagged wild type or mutant CPS1 expressed in baculovirus/insect cell system. The global CPS1 reaction and the ATPase and ATP synthesis partial reactions that reflect, respectively, the bicarbonate and the carbamate phosphorylation steps, were assayed. We found that CPS1 wild type and V1013del mutant showed comparable expression levels and purity but the mutant CPS1 exhibited no significant residual activities. In the CPS1 structural model, V1013 belongs to a highly hydrophobic beta-strand at the middle of the central beta-sheet of the A subdomain of the carbamate phosphorylation domain and is close to the predicted carbamate tunnel that links both phosphorylation sites. Haplotype studies suggested that p.Val1013del is a founder mutation. In conclusion, the mutation p.V1013del inactivates CPS1 but does not render the enzyme grossly unstable or insoluble. Recurrence of this particular mutation in Turkish patients is likely due to a founder effect, which is consistent with the frequent consanguinity observed in the affected population. (C) 2014 Elsevier Inc All rights reserved.

Gastrointestinal stromal tumors (GISTs) are rare in the childhood period. The authors reported a case who was admitted to the neonatal intensive care unit (NICU) on a suspicion of intestinal obstruction. She was operated and a mass in a size of 6 xx 4.5 xx 4 cm was resected from the ileum. Histologic and immunohistochemical studies showed a GIST. CD34, small muscle actin (SMA), and desmin were positive. The baby was discharged on the 13th day after operation.