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Objective Understanding the reflections of prematurity is necessary for the management of neonatal complications. We focused on the impact of prematurity and related "maternal risk factors/obstetric complications" on buccal cells of the neonates via evaluation of the Wnt/β-catenin signaling pathway and apoptosis. Study Design This study consisted of "early preterm neonates (EPN) (≤34th gestational week [gw]) (n = 36)," "late preterm neonates (LPN) (34th– < 37th gw) (n = 46)," and "term neonates (control) (≥37th gw) (n = 56)." Cohort was also subclassified according to the presence of maternal risk factors, obstetric complications, and neonatal complications. Wnt/β-catenin signaling and caspase-3 activation pathways were studied immunocytochemically. Results Wnt/β-catenin signaling positivity was statistically more frequent at buccal smears of the EPN and LPN groups compared with controls (p < 0.001). The cutoff for gestational age at delivery in receiver operating characteristic curve with the best balance of sensitivity (67.4%) and specificity (67.3%) was 35.8th gw for determining the reduction of Wnt/β-catenin signaling positivity (p < 0.001). The study demonstrated that obstetric complications significantly affected the activity of signaling, while maternal risk factors do not have any effect on Wnt/β-catenin signaling pathway (p = 0.003 and p = 0.828, respectively). This study also demonstrated a significant relationship between Wnt/β-catenin signaling pathway and the presence of neonatal complications (p = 0.015). Conclusion Dynamic characteristics of buccal cells are influenced by prematurity and related obstetric and neonatal problems. Buccal smear is a good tool to investigate the impact of prematurity and obstetric problems on perinatal outcome. Key Points Neonatal buccal cells are affected by prematurity and related obstetric/neonatal problems. 35.8th gw is critical for determining the reduction of Wnt/β-catenin signaling positivity. Obstetric and neonatal complications significantly related to Wnt/β-catenin signaling activity. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Surgical treatment in the neonatal period is very significant. The neonatal surgery intensive care model has been applied in our hospital for about six years. This study aims to examine the data gathered from the neonatal intensive care unit of our hospital and to understand how this model contributed to the health improvement of newborns with surgical problems. STUDY DESIGN: The file records of newborns admitted to the neonatal intensive care unit were retrospectively analyzed from January 2014 to December 2019. The protocol was registered with Clinical Trials.gov identifier NCT04734002. RESULTS: The total number of newborns admitted to the neonatal intensive care unit was 5442. Surgery was performed on 546 of these patients. Two hundred and four patients were hospitalized due to congenital heart disease. Two hundred patients were operated on by pediatric surgeons whereas 142 were operated on by other surgery specialists. In the last six years, the mortality rate was 5.25% in babies without surgical diseases and 18.3% in those with surgical diseases (p<0.05). The hospitalization periods of the babies followed up in our neonatal intensive care unit in the last two years were evaluated. Thereupon, premature babies with other diseases were hospitalized for an average of 9.6 days; however, those patients who require surgery were hospitalized for 33.0 days (p<0.05). The term babies, who did not have any surgical diseases were hospitalized for an average of 4.8 days and those with surgical indications for 16.5 days (p<0.05). CONCLUSION: We believe that the neonatal surgery intensive care unit model should become widespread in Türkiye. We intend to draw attention to this matter through our study, sharing our own experience. [ABSTRACT FROM AUTHOR]

Enterococci are microbiota microorganisms that normally have low virulence; however, under some conditions they may cause community-acquired urinary tract and even hospital-acquired serious infections. Vancomycin-resistant enterococci (VRE) can cause aggressive infections in immunosuppressive patients; especially in newborns in intensive care units. Asymptomatic gastrointestinal system carriers are important sources of VRE. Asymptomatic patients colonized by VRE can infect both other patients and the environment. Prevention of gastrointestinal colonization of VRE is an important issue to prevent VRE infection, and for rational use of hospital source. This study was carried out at Hacettepe University, Faculty of Medicine in Newborn Intensive Care Unit between November 2015 and March 2017. The newborn infants who were find as colonized by VRE during weekly surveillance VRE rectal stool culture screening were taken into the study. A single dose of one million colonies of Lactobacillus rhamnosus GG (LGG®) was given to the study group daily. The probiotic supplement continued until consecutive three negative cultures were detected or maximum 6 months. Control group received conventional treatment. In the study group, VRE eradication was successful in 21 patients out of 22 within 6 months and 1 patient was still VRE positive at 6 months. In the control group, VRE was eradicated in 12 patients out of 23 and 11 patients continued to be colonized by VRE at 6 months. There was a statistically significant difference between the groups (p <.05). Lactobacillus rhamnosus GG use is associated with early clearance of vancomycin-resistant enterococcus in newborn patients. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare the presence of eosinophilia and basophilia between two groups with and without bronchopulmonary dysplasia in preterm infants and, to investigate whether there was a correlation between the bronchopulmonary dysplasia severity and degree of eosinophilia. STUDY DESIGN: In this retrospective cohort study, we have evaluated premature babies who were admitted between 2007 and 2017 to the Neonatal Intensive Care Unit of Hacettepe Hospital. Hospital records were scanned and 85 preterm infants diagnosed with bronchopulmonary dysplasia formed the study group while 89 babies without bronchopulmonary dysplasia formed the control group. Necessary demographic, neonatal, and laboratory data were withdrawn from the electronic registry and patient files. RESULTS: In the study group, there was a statistically significant difference in the severity of eosinophilia and basophilia in the first day, first week, second week, third week, and fourth week compared to the control group (p<0.05). According to the mixed effect model, after adjusting results for gestational age and birth weight there was a statistically significant difference between groups in terms of eosinophil and basophil values (p<0.05). CONCLUSION: The number of eosinophils and basophils increased in patients with bronchopulmonary dysplasia without an increase in the number of leukocytes. [ABSTRACT FROM AUTHOR]

Congenital esophageal web is a very rare type of esophageal atresia (EA) and is considered as Type IV atresia in Kluth's classification. Type IV EA is further classified into subgroups according to the location of web and the presence of tracheoesophageal fistula (TEF). Herein, we present a newborn having Type IV1a EA who was initially suspected as isolated EA and has co‐existing malrotation together with the review of the literature. A newborn having congenital esophageal web was admitted with antenatal ultrasonography revealing polyhydramnios, dilated stomach, and duodenum. Abdominal X‐ray revealed a gasless abdomen suggesting isolated EA. The upper gastrointestinal series confirmed complete obstruction at the lower esophagus. Bronchoscopy performed excluding TEF. Laparotomy revealed intestinal malrotation and the absence of another GI webs. Gastrotomy was performed and mucosal web at GEJ was seen by pushing nasogastric catheter. Web excision and Ladd procedure were performed. Congenital esophageal web is an extremely rare type of esophageal anomaly that can be only classified in Kluth classification. A high index of suspicion is required for diagnosis especially in newborns with the gasless abdomen and esophageal obstruction at the level of GEJ. Preoperative bronchoscopy is mandatory to exclude an associating TEF. Surgical exploration via laparotomy is beneficial for exploring additional GIS anomalies. [ABSTRACT FROM AUTHOR]

Aim: To investigate markers of sepsis/inflammation in twin neonates according to placental, demographic, neonatal, and twinrelated complications. Materials and Methods: In this retrospective study, we compared these parameters in twins with suspected sepsis for whom laboratory data on infection markers were available on the first postnatal day. Sepsis was later ruled out in all the neonates. After obtaining institutional ethics committee approval, twin pairs who were admitted to the neonatal intensive care unit of Hacettepe University IhsanDogramacı Children's Hospital between 2005 and 2017 were screened for inclusion. Data on the twins’ sepsis markers, complete blood counts, immature to total neutrophil (I/T) ratios, procalcitonin and CRP levels, and blood culture results in the first 24 h of life were recorded. Results: In total, 194 twin pairs (388 neonates) were included in the study. Of the 194 twin pairs, 50 were monochorionic twins (25.8 %), and the remaining 144 (74.2 %) were dichorionic twins. Monochorionic and dichorionic twins, twin-to-twin transfusion syndrome with twins and discordant twins showed no significant differences in I/T ratio, procalcitonin, or CRP values in the first 24 h (p>0.05). Conclusion: Based on our findings, chorionicity (monochorionic/dichorionic placenta), twin-to-twin transfusion syndrome, and size discordance were not related to any significant differences in the CRP level, procalcitonin level, or I/T ratio. [ABSTRACT FROM AUTHOR]

BACKGROUND: The objective of this study is to evaluate the obstetric outcomes of pregnancies with congenital diaphragmatic hernia (CDH). METHODS: Fifty one pregnancies prenatally diagnosed with CDH at our institution between January 1, 2002 and August 31, 2018 were retrospectively evaluated. The pregnancies were divided into two groups according to neonatal survival. Demographic features, clinical characteristics and prognostic factors were compared between the neonatal survival (n = 16) and non-survival (n = 28) groups. Cut-off values of fetal lung area to head circumference ratio (LHR), observed/expected LHR (o/e LHR) and observed/expected total fetal lung volume (o/e TFLV) for neonatal survival were calculated. RESULTS: Thirty six (70.6%) and fifteen (29.4%) fetuses had left and right sided CDH respectively. Seven patients chose termination of their pregnancies (13.7%). Statistically significant differences were found between survival and non-survival groups in terms of parity, median gestational week at diagnosis, polyhydroamniosis rate, CDH type, stomach position, liver position, median LHR, o/e LHR, o/e TFLV, median 5th minute Apgar score and neonatal operation rate values (p values were 0.03,<0.001, 0.02, 0.006,<0.001, 0.006,<0.001,<0.001,<0.001, 0.04 and <0.001 respectively). According to ROC curve analysis, 1.05 (82% sensitivity, 74% specificity) for LHR, 22.5 (78.6% sensitivity, 73.9% specifity) for o/e LHR and 23.5 (85.7% sensitivity,74.2% specificity) for o/e TFLV were determined to be cut-offs for neonatal survival, respectively, with highest sensitivity and specificity. CONCLUSION: Earlier gestational week at diagnosis, right sided CDH, presence of liver herniation, supradiaphragmatic stomach position, lower LHR, o/e LHR and o/e TFLV were associated with decreased rates of neonatal survival. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the significance of renal pelvis aspiration (RPA) in the management of antenatal hydronephrosis (AHN). This study enrolled 15 AHN cases (one twin pregnancy) that necessitated RPA for AHN. Chromosomal abnormalities, gene disorders, and additional life‐threatening congenital abnormalities were eliminated prior to intrauterine interventions. Urine analysis were performed for the evaluation of renal function. Normal renal function was observed in six neonates/infants (40%) (group 1), whereas impaired renal function and various type of urinary system anomalies were observed in 9 neonates/infants (60%) (group 2) during the short‐term and longitudinal follow‐up periods. There were statistically significant differences in the oligohydroamniosis rate, mean fetal urine sodium value, mean fetal urine β2‐microglobulin, mean gestational week at birth, and mean birthweight values between the groups (P = 0.007, P < 0.001, P = 0.035, P < 0.001, and P = 0.001, respectively). Renal pelvis aspiration and urine analysis were substantial for the management of AHN in necessary cases. β2‐microglobulin and sodium are clinically useful markers to detect the presence of severe renal damage due to obstructive uropathy and thus, important adjuvants in the proper selection of fetuses for further antenatal interventions. [ABSTRACT FROM AUTHOR]

Aim: Irisin is a newly identified myokine that is released from skeletal muscles after exercise and has a regulatory role on energy metabolism. Low serum irisin causes glucose metabolism disorder and metabolic syndrome. The aim of this study was to assess neonatal irisin levels in infants born to mothers with and without gestational diabetes mellitus (GDM). Material and Methods: Hundred neonates born at gestational ages of 26-40 weeks were included in the study. Neonates born to mothers with GDM comprised one group; neonates born to mothers without GDM were evaluated in three groups: appropriate for gestational age (AGA), small for gestational age (SGA), and large for gestational age (LGA) infants. Peripheral blood samples were obtained at postnatal 48 hours and analyzed for serum irisin levels by ELISA. Results: Serum irisin levels in infants born to GDM mothers were significantly lower (mean 0.81 ng/ml) than AGA newborns of healthy mothers (mean 1.21 ng/ml) (p=0.017). Serum irisin levels were not correlated with gestational age, birth weight, Z-score, or BMI (p>0.05). Conclusion: This study show that serum irisin levels are lower in infants born to GDM. Lower irisin levels in the neonatal period may increase the risk of obesity, metabolic syndrome, and glucose metabolism disorder later in life. [ABSTRACT FROM AUTHOR]