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Copyright of Acta Pediatrica de Mexico is the property of Instituto Nacional de Pediatria (INP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Alkaline phosphatase is perhaps the most important biochemical marker used in the diagnosis and follow-up of metabolic bone disease or osteopenia of prematurity (OP). The aim of this study was to investigate the percentiles of alkaline phosphatase (ALP) levels in premature infants compared to gestational age and to determine cut-off values for the diagnosis of osteopenia. Material Methods: All ALP results sent to our biochemistry laboratory between 2013-2018 were evaluated retrospectively. Of the total 2476 results, 1830 (74%) were found to belong to a separate infant born before 30 weeks of gestation. The results and demographic data of the patients whose clinical information could be reached were statistically analyzed. Results: The mean birth weight of the infants included in the study was 995 g±254 (450-1500 g) and the mean gestational week was calculated as 27±1.7 (24-29,6 weeks). The average alkaline phosphatase level was 510±225 U/L [median: 458 IU/L (159-1554)]. In serum ALP levels; 160.8 IU/L value 5. Percentile, 203 IU/L 10. percentile, 290 U/L 25. percentile 421 IU/L 50. percentile, 583 U/L 75. Percentile, 819 U/L formed 90th percentile and 969 U/L formed 95th percentile. Separate percentiles were also calculated for each gestational week interval. Conclusion: Although the infants included in the study were hospitalized premature infants, this is the reference range study with the largest number of patients in our country. Although the data is retrospective, these percentiles may be helpful in the evaluation and the diagnosis of osteopenia in premature infants. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the efficacy of orally administeredLactobacillus reuteri (L. reuteri)versus nystatin in prevention of fungal colonization and invasive candidiasis in very low birth weight infants. Methods: A prospective, randomized comparative study was conducted in preterm infants with a gestational age of ≤32 weeks and birth weight of ≤1500 g. Patients were randomized into two groups, to receiveL. reuterior nystatin. Skin and stool cultures were performed once a week for colonization and blood cultures for invasive infections. The trial was registered to ClinicalTrials.gov under identifier NCT01531192. Results: A total of 300 preterm infants were enrolled (n = 150, for each group). Gastrointestinal colonization and skin colonization rates were not significantly different between the groups (18.7% versus 16%,p = 0.54 and 14% versus 12%,p = 0.6, respectively). Invasive candidiasis was detected in two patients of the probiotic group and one patient of the antifungal group. Proven sepsis, feeding intolerance, and duration of hospitalization were significantly lower in the probiotics group than in the antifungal group. Conclusions: ProphylacticL. reuterisupplementation is as effective as nystatin, and more effective in reducing the incidence of proven sepsis in addition to its favorable effect on feeding intolerance. [ABSTRACT FROM AUTHOR]

Background: Surfactant administration traditionally involved endotracheal intubation and mechanical ventilation, which is associated with a risk of barotrauma and volutrauma.Objective: To compare the morbidity and mortality rates between LISA-treated and INSURE-treated premature babies with respiratory distress syndrome (RDS).Methods: We assessed retrospectively the medical records of preterm infants who were born at 250/7 to 296/7 weeks of gestation and were administered surfactant initially either with LISA or INSURE method over a five-year period.Results: Analysis of the data of 205 LISA-treated and 178 INSURE-treated infants revealed the mean gestational age as 28.1 ± 1.3 and 28 ± 1.3 weeks and mean birth weight as 1041 ± 205 and 1029 ± 222 g in LISA and INSURE groups, respectively. The mechanical ventilation requirement in the first 72 h of life (%26.8-%42.1, p = 0.002) and the incidence of moderate-severe BPD (%12.2-%21.9, p = 0.01) were lower in LISA-treated infants. LISA method was found as an independent factor in reducing mechanical ventilation requirement in the first 72 h of life and incidence of moderate-severe BPD [RR: -0.49 (%95 CI -0.28 to -0.85), p = 0.01].Conclusion: Data obtained from our five-year clinical experience are comparable with the recent literature. LISA is currently the most suitable method of surfactant administration and it should be the first choice in spontaneously breathing infants considering its favorable effects on respiratory morbidities in preterm infants with RDS. [ABSTRACT FROM AUTHOR]