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Background: In hypoxic newborns, cardiac troponin T (cTnT) was shown to be an indicator of cardiac damage and increased levels of nonprotein-bound iron (NPBI), an indicator of increased free radical production and perinatal brain damage. Objective: The aim of this study was to determine cord blood cTnT and NPBI levels in neonates of mild pre-eclamptic mothers. Methods: The study included 50 babies of mild pre-eclamptic mothers and 50 babies of healthy mothers. cTnT and NPBI levels were measured in cord blood. Results: The mean gestational age in the pre-eclamptic and healthy groups were 36.1 ± 3.5 and 38.1 ± 1.9 weeks, mean birth weights were 2,456 ± 945 and 3,059 ± 493 g. Cord blood median cTnT level was significantly higher in the pre-eclamptic group (0.024 vs. 0.015 ng/ml). Serum cTnT in the 95th percentile was 0.047 ng/ml in the healthy group. cTnT levels of preterm babies in the pre-eclamptic group was found to be significantly higher compared to term babies in the control group (0.038 vs. 0.013 ng/ml). It could not be demonstrated whether there is a statistically significant relation between cTnT levels and respiratory distress, gestation, type of delivery, sex and birth weight. The median NPBI level was higher in the control group (3.26 vs. 1.86 µmol/l). Conclusions: Increased levels of cTnT may be a biochemical marker of cardiac involvement in babies of mild pre-eclamptic mothers. In this study, no correlation was found between cTnT levels and NPBI levels.

The aim was to evaluate postnatal growth of preterm infants in childhood and to determine factors that have an effect on catch-up growth (CUG). Ninety-six (42F, 54M) preterm born children with a gestational age of 32.6+/-2.9 weeks and birth weight of 1815+/-668 g were evaluated at age 4.7+/-1.1 years. Preterm children with birth weight and/or length below 10th percentile were accepted as small-for-gestational age (SGA) and those above as appropriate-for-gestational age (AGA). Height SDS was similar (-0.5+/-1.0) in preterm AGA and SGA children. Both groups had low body mass index (BMI) SDS (-0.6+/-1.4 and -1.0+/-1.5, respectively). Of the preterm SGA children, 65.8% showed a CUG in height and 3.8% catch- down growth. These rates were 24.6% and 33.5% in preterm AGA children. CUG in height was best explained by birth length and mother's height and CUG in weight by birth weight and mother's weight. In conclusion, although most of the preterm SGA children show CUG, they reach a compromised height in childhood. A number of preterm AGA children show a catch-down growth.

BackgroundGhrelin, the natural ligand of the GH secretagogue receptor, has potent orexigenic effect. Ghrelin levels are negatively associated with insulin secretion, increased in anorexia, and reduced in obesity. Increased ghrelin levels may be associated with early postnatal growth in preterm born children.ObjectiveAim of this study was to evaluate ghrelin and insulin levels at prepubertal ages in preterm born children born appropriate for gestational age (AGA) or small for gestational age (SGA) and relationships with catch-up growth (CUG) in a prospective cross-sectional study.MethodsEighty-four preterm born children grouped as preterm SGA (n=28) and preterm AGA (n=56) were evaluated at age 4.7±0.2 and 4.7±0.1 years with respect to their ghrelin and insulin levels. Their data were compared with that of body mass index matched term SGA (n=35) and term AGA (n=44) children of age 4.6±0.2 and 3.8±0.1 years. All children had height appropriate for their target height. CUG was defined as the difference between birth size and recent size and expressed as Δ height and Δ weight SDS.ResultsPreterm SGA and preterm AGA children had similar ghrelin levels (1717.0±166.9 and 1656.5±103.8 pg/ml), although Δ height and Δ weight SDS in preterm SGA were significantly higher than in preterm AGA children (PPPConclusionsPreterm children have higher ghrelin levels at prepubertal ages regardless of the magnitude of their CUG. Term SGA children, on the other hand, behave differently and have lower ghrelin levels than preterm children at prepubertal ages, which may be related to elevated insulin levels in this group.

This prospective single-blinded study was performed to evaluate general movements (GMs) in group of high-risk, low-birth-weight and preterm infants and to compare results with neurologic examination. All infants- neurologic examinations, Gross Motor Function Measurement (GMFM) and Bayley-III Scale were performed at the corrected age of 12 months. A total of 22 infants were included. Eight infants (group-1) (mean: 31.6 +/- 3.29 weeks, range: 25-36 weeks) had normal GMs in all recordings and were ultimately evaluated as -normal-; 12 (group-2) (mean: 31.6 +/- 3.29 weeks, range: 25-35 weeks) had abnormal GMs during writhing movements period but had normal GMs in subsequent recordings and were evaluated as -normal-; and 2 infants (group-3) (mean: 29.5 +/- 7.78 weeks, range: 24-35 weeks) with consistent abnormal GMs who were evaluated as -abnormal.- Complete agreement (kappa=1) was found between GMs and neurologic examination and significant agreement between GMs and cranial ultrasonography (kappa=0.76). When results of GMFM and Bayley-III were compared; statistically significant differences were found between group-1 and group-2 in -standing- parameter of GMFM (p

Caustic agents stored in ordinary containers can be ingested by children. These materials should be stored in soft distinctive bottles and in safe places. The probability of ingestion of a caustic agent is low in the newborn period, and caustic burns have been reported infrequently. In this case study, a newborn baby with severe respiratory insufficiency after ingestion of benzalkonium chloride is reported.

Aim To determine the exposure of VLBW infants to phthalates during their stay in the neonatal intensive care unit. Method Preterm infants ( 2 wks and had at least one invasive procedure were included. Urine samples were collected in the first 3 days and every 2 weeks until discharge. Phthalate contents of the medical devices, urinary excretion of phthalate metabolites. (diethylhexylphthalate-DEHP, monoethylhexylphthalate-MEHP, monoethyloxohexylphthalate-MEOHP, monoethylhydroxyhexylphthalate-MEHHP) and their relation to exposure intensity, gestational age, birthweight and postnatal age were analysed. Result Mean gestational age and birth weight of the patients (n=36) were 28.9±1.5wks and 1024±262g. DEHP was detected in umbilical catheters, intubation tubes, nasogastric tubes and nasal cannulas. Nasal cannulas had the highest content (201.7mg/0.5g). MEHHP was the most frequently detected metabolite (81.4%) in the urine samples (n=151) and its levels increased during the first 4 weeks (mean concentration: 319.5 ng/ml), were higher in patients who had continuing need of invasive procedures after 2 wks (255.32 ng/ml vs 65.85 ng/ml), were significantly higher in the first urine samples of patients Conclusion Phthalate metabolites could be detected in the urine samples of preterm infants very early after admission to the NICU. The levels were higher in the first weeks of intensive care when exposure intensity was highest and in babies

Objective To evaluate the thyroid functions of preterm infants. Methods Data about thyroid functions (fT4, TSH) were collected retrospectively from 428 preterm infants less than 34 weeks of gestation, who were born between 2006 and 2009. Results The mean gestational age of the study group was 30.5±2.4 (23.9–33.9) weeks, the mean birth weight was 1339±496 (496–3190)g. The study group was divided into three subgroups according to gestational weeks ( Conclusion Free T4 levels were lower in the early gestational age subgroups. SGA infants had lower fT4 levels.

Non-clinical safety evaluation using juvenile animals is becoming more important in development of medicinal products for paediatric use. It is considered that many physiological changes occur in juvenile animals during their development and this could affect toxicokinetics (TK) and toxicodynamics (TD) of some drugs. However, the changes in TK caused by physiological development have not been fully investigated. Our previous study showed many differences between juvenile and adult rats, in concentration of serum proteins, mRNA expression of CYP enzymes and transporters, and so on. In this study, TK analysis of single dose study in juvenile rats treated with quinidine, which binds mainly to a1-acid glycoprotein (AGP), was conducted to assess the impact on TK. Quinidine at a dose of 30mg/kg was administered intravenously to 14-, 21and 49-day-old rats (n=4/sex/age), and its concentration in plasma was analyzed. As a result, the AUCall of quinidine decreased with sex maturation between 21and 49-day-old rats from 10,500 to 6900ngh/mL (males), and from 8200 to 5710ngh/mL (females). This decrease is considered to be caused mainly by faster elimination of quinidine in 49-day-old rats because z, the elimination rate constant, increased with age between 21and 49-day-old rats from 0.290 to 0.660 (1/h) in males, 0.306 to 0.842 (1/h) in females. In this presentation, the mechanism of these differences and its impact on TK will be discussed.

Nephrocalcinosis is uncommon in childhood, and almost always develops outside the newborn period. Over the last decade, nephrocalcinosis due to multifactorial pathogenesis has increased in very low birth-weight infants. In this report a 23 day old full-term baby with nephrocalcinosis secondary to distal renal tubular acidosis is described.

Aim In this blind prospective study, we aimed to examine the utility of cardiac enzymes and the carinal angle measurement in detecting hemodynamically significant patent ductus arteriosus ( PDA), evaluating response to treatment and follow-up in preterm infants. Patients and Methods We evaluated 39 preterm infants < 32 gestational weeks. Every patient had an echocardiogram (ECHO) taken on postnatal day 3 by a cardiologist blinded to clinical findings and laboratory results. ECHO was repeated when necessary. N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), creatine kinase MB isoenzyme (CK-MB) levels were measured on postnatal days 0, 3 and 7. The carinal angle on chest radiographs taken on the same days was measured. Those with PDA deemed hemodynamically significant based on ECHO were referred to as ehsPDA group. Those in this group who also had clinical signs were referred as sPDA subgroup. Results The mean gestational age was 28.7 weeks; mean birth weight was 1120 g. Initial ECHO showed PDA in 27 patients (69.2%), 11 of which (40.7%) had ehsPDA. Eight patients had sPDA. When the ehsPDA and sPDA groups were compared to the rest, no statistically significant difference was found in terms of the carinal angle, NT-proBNP and cTnT. CK-MB levels were significantly low in ehsPDA and sPDA groups on postnatal days 3 and 7 (p=0.017, p=0.026, respectively). Conclusion NT-proBNP, cTnT, CK-MB and the carinal angle were not found useful in detection and follow-up of hemodynamically significant PDA.

Although intrauterine growth restriction (IUGR) has been suggested to involve oxidative stress, the relation of total oxidant status and antioxidant capacity with being small gestational age (SGA) in preterm and term infants has not been evaluated yet. In a prospective-controlled study, we aimed to determine the oxidant status of appropriate for gestational age (AGA) and SGA term and preterm infants and compare its relation with IUGR.

Late-preterm (group 1) and term (group 2) infants born in Marmara University Hospital between April 2009 and February 2010 were enrolled. Infants with a gestational age

Many well described complications can result from endotracheal intubation in neonates during resuscitation. Ingestion of a laryngoscope bulb is a rare event with potentially serious consequences. We are reporting this unusual complication in a neonate during delivery room resuscitation and point to the importance of checking the integrity of the equipment prior to resuscitative efforts.

Adrenal hemorrhage in newborns is not uncommon. The clinical presentation may be very protean and the diagnosis difficult. Ultrasonography is useful in making the diagnosis. A patient presenting with severe neonatal jaundice due to adrenal hemorrhage is described.

A case of neonatal suppurative parotitis due to Klebsiella pneumoniae is described. This is the first case reported in the last 20 years. Infection with unusual microorganisms should be taken into account when planning antibiotic treatment, especially in hospital acquired infections of the salivary glands in the newborn.