Serum thyroid hormones levels are significantly decreased in septic neonates with poor outcome.

The aim of this prospective study was to investigate the effects of thyroid hormone levels on the sepsis criteria and mortality in septic newborns. This study was performed at the Firat University Hospital Neonatal Intensive Care Unit. A group of septic newborns and a control group of healthy non-infected newborns were evaluated. Blood samples were obtained at onset from septic and healthy newborns and at 10th day of the antibiotic therapy from only septic newborns, and thereafter serum total T(3) (TT(3)), total T(4) (TT(4)), and TSH levels were determined. A total of 292 newborns were included in the study. Serum TT(3) levels at onset and at 10th day of the antibiotic therapy were 163.8±63.4 and 178.3±33.1 ng/dl, TT(4) levels were 6.9±2.2 and 11.0±2.6 mg/ml, and TSH levels were 3.8±2.1 and 4.0±2.5 µU/ml, respectively in septic newborns. Serum TT3 levels were 180.3±47.6 ng/dl, TT(4) levels were 10.9±2.3 mg/ml, and TSH levels were 4.1±2.2 µU/ml in healthy newborns. Serum TT(3), TT(4) levels of septic newborns were significantly decreased with respect to those of healthy newborns at onset and serum TT(4) levels was increased significantly after antibiotic therapy. To the best of our knowledge, this report is the first study to compare thyroid hormone levels in a large number of septic newborns and a healthy group. Our findings suggest that before and after treatment of neonatal sepsis a significant change is realized in thyroid hormone levels.

Antipyretic effect of ketoprofen.

OBJECTIVE: The aim of this study was to investigate the efficacy and side effect profile of ketoprofen as well as compliance with respect to the taste of the drug and compare these parameters with those of acetaminophen and ibuprofen. METHODS: A total of 301 patients between 1-14 years of age who applied to emergency rooms of three medical centers with the complaint of fever that required antipyretic therapy were included in the study. Fever was measured with the aid of a tympanic thermometer (Braun Kronberg 6014) and followed for 4-6 hours. The measurement was repeated at 30, 60, 120 minutes, and again 4-6 hours after the initial assessment. RESULTS: The mean age of the patients was 47.8+/-41.1 months. The patients randomly received 15 mg/kg/dose of acetaminophen (n=112 group 1), 0.5 mg/kg/dose of ketoprofen (n=105, group 2), or 10 mg/kg/dose of ibuprofen (n=84, group 3). Fever was 38.4+/-0.7 degrees C, 38.4+/-0.7 degrees C, and 38.5+/-0.5 degrees C at 30 minutes; 38.0+/-0.7 degrees C, 37.9+/-0.7 degrees C, and 38.0+/-0.6 degrees C at 60 minutes (p>0.05), 37.7+/-0.6 degrees C, 37.6+/-0.7 degrees C, and 37.7+/-0.5 degrees C at 120 minutes (p>0.05); 37.5+/-0.7 degrees C, 37.3+/-0.6 degrees C, and 37.4+/-0.6 degrees C at 4-6 hours after admission (p>0.05). The fever was significantly lower at 30, 60, and 120 minutes in all group s (p<0.05). Early vomiting after medication (<6 hours) was observed in 3.8%, 13.5%, and 9.6% whereas late vomiting (6-48 hours) occurred in 1.3%, 2.7%, and 5.8% respectively (p>0.05). Bad taste was expressed by 5.1%, 12.2%, and 5.8% early (<6 hours), and 3.9%, 8.1%, and 3.8% late (6-48 hours) (p>0.05). There were no differences between age groups for antipyretic effect, taste and adverse effect in three drugs (p>0.05). CONCLUSION: All three drugs were similar in terms of efficacy, adverse effects, and compliance within 48 hours of therapy. These results suggest that ketoprofen may be used for antipyresis as an alternative to acetaminophen and ibuprofen.