Concentración de vitamina D en niños sanos de 12 a 24 meses que recibieron suplementación con vitamina D hasta el año en Turquía / Vitamin D levels of 12-24-month-old healthy children in Turkey who received vitamin D supplementation until the age of one year

Introducción. El objetivo fue evaluar la concentración de vitamina D en niños sanos de 12 a 24 meses suplementados con vitamina D (400 UI/día) durante el primer año.Métodos. Estudio descriptivo transversal entre junio de 2015 y mayo de 2016 en Estambul. Se incluyó a niños de 12 a 24 meses en seguimiento en la clínica del niño sano y con suplementación con vitamina D durante el primer año. Se midió calcio, fósforo, fosfatasa alcalina, hormona paratiroidea y 25-hidroxivitamina D [25(OH)D]. Se definió suficiencia (>20 ng/ml), insuficiencia (15-20 ng/ml) y deficiencia (<15 ng/ml) de vitamina D.Resultados. El estudio incluyó 197 niños. El 26,9 % (n = 53) siguió recibiendo suplementación después del año (dosis media: 491 ± 267 UI/día). La concentración media de 25(OH)D fue 38,0 ± 13,9 ng/ml. La ingesta regular de vitamina D en menores de un año (p = 0,008) y la continuación de suplementación después del año (p = 0,042) aumentaron la concentración de 25(OH)D en niños de 12 a 24 meses. Hubo deficiencia en 4,1 % e insuficiencia en 7,1 %. El nivel educativo materno (p = 0,009) y la leche maternizada (p = 0,012) fueron factores protectores contra deficiencia o insuficiencia.Conclusiones. La concentración de 25(OH)D era suficiente en el 88,8 % de los niños de 12 a 24 meses con suplementación con vitamina D (400 UI/día) durante el primer año. Los niños sanos de 12 a 24 meses con una suplementación correcta de vitamina D en el primer año podrían no requerir suplementación.

Introduction. The aim of this study was to evaluate vitamin D levels between 12-24 month-old healthy children supplemented with vitamin D (400 IU/day) during the first year.Methods. Descriptive-sectional study conducted between June 2015, and May 2016, in Istanbul (latitude 41ºN). Children aged 12-24 months followed up by the well-child clinic who had vitamin D supplementation in the first year were included in the study. The levels of calcium, phosphorus, alkaline phosphatase, parathyroid hormone and 25-hydroxyvitamin D [25(OH)D] were measured. Vitamin D status was defined as >20 ng/mL: sufficiency, 15-20 ng/mL: insufficiency and <15 ng/mL: deficiency.Results. The study was completed with 197 children. 26.9 % of children (n = 53) went on receiving supplementation after one year (mean dose 491 ± 267 IU/day). The mean 25(OH)D level was 38.0 ± 13.9 ng/mL. It was found that regular vitamin D intake under one year of age (p = 0.008) and continued support after one year of age (p = 0.042) increased level of 25(OH)D in children aged 12-24 months. Vitamin D deficiency was found in 4.1 % and vitamin D insufficiency in 7.1 %. Mother's education (p = 0.009) and use of formula (p = 0.012) were protective factors in relation to development of vitamin D deficiency or insufficiency.Conclusions. The level of 25(OH)D was sufficient in 88.8 % of children aged 12-24 months receiving 400 IU/day vitamin D supplementation in the first year. Vitamin D supplementation could not be required in healthy children aged 12-24 months who received properly vitamin D supplementation in the first year.

Healthcare-associated Infections in a Neonatal Intensive Care Unit in Turkey.

Objective: To determine the incidence, risk factors, mortality rate, antibiotic susceptibility and causative agents of healthcareassociated infections (HAIs) in the Neonatal Intensive Care Unit. Design: Prospective, cohort. Setting: A 38-bed, teaching, referral, neonatal intensive-care unit. Participants: All patients in the neonatal intensive care unit who did not have any sign of infection at admission and remained hospitalized for at least 48 hours. Methods: The study was conducted between January 2009 and January 2011. Healthcare-associated infection was diagnosed according to the criteria of CDC. Risk factors for HAI were analyzed with univariate and multivariate regression analysis. Results: The incidence of HAI was found to be 16.2%. Blood stream infection was observed as the most common form of HAI (73.2%). The mortality rate was 17.3%. Antenatal steroid use, cesarean section, male gender, low birth weight, parenteral R E S E A R C H P A P E R INDIAN PEDIATRICS 951 VOLUME 49__DECEMBER 16, 2012 nutrition, percutaneous and umbilical catheter insertion, mechanical ventilation and low Apgar scores were found to be related with HAI (P<0.05). A 10% reduction in infection rate as a consequence of the application of a new total parenteral nutrition guideline was observed. Coagulase negative staphylococci (44. 4%) and Klebsiella pneumoniae (25.9%) were the most common etiologic agents isolated from cultures. Methicillin resistance of coagulase-negative staphylococci and ESBL resistance of Klebsiella pneumoniae were 72% and 44%, respectively. Conclusions: Antenatal steroid was found to be associated with HAI. Newly applied total parenteral nutrition guidelines reduced the attack rate of infection. Efforts should be focused on developing more effective prevention strategies to achieve better outcomes.