Evaluation of cord blood irisin levels in term newborns with small gestational age and appropriate gestational age.

BACKGROUND: Most recently, a novel myokine, named irisin, was identified in human that expressed by skeletal muscle after exercise. Irisin increases energy expenditure by turning white adipose tissue into brown adipose tissue. Thus improves carbohydrate homeostasis in humans. Irisin is considered as a potential biomarker for obesity and metabolic syndrome. In recent years, numerous studies have been conducted about irisin with adults, although number of studies with newborns is limited. OBJECTIVE: To evaluate cord blood irisin level with small gestational age (SGA) and appropriate gestational age (AGA) in term newborns. METHODS: A cross-sectional study of 34 AGA and 34 SGA term newborns who were born in (1-30) December 2015 in Fatih University Hospital. Estimated fetal weight were calculated using the Hadlock formula by gynecologists to pregnant women in second trimester. All the babies were classified at birth as SGA or AGA. SGA was defined according to the Lubchenco scale for gender and gestational age. We collected umbilical cord blood at the time of delivery. Cord blood irisin levels were measured using commercial enzyme-linked immunosorbent assays in our hospital laboratory. RESULTS: Cord blood irisin levels were significantly lower in SGA group [median 30 (25 ± 8) ng/ml] than in AGA group [median 40 (39 ± 13) ng/ml, p < 0.001]. No statistically significant differences were observed among the groups in terms of the demographic features (gender, mode of delivery, gestational weeks, 1-5 min Apgar score) (p > 0.05). Mothers with gestational diabetes, hypertension, asthma, chronic disease, use of drug or a history of smoking exposure were excluded from the study. When the study data were evaluated, Yates Continuity Correction and Fisher's exact tests were used in descriptive statistical methods and for comparison of qualitative data. CONCLUSION: Our results support the idea that irisin have a physiologic role in neonates. Low level of irisin is associated with the impaired carbohydrate metabolism in term infants with SGA. However, further studies with larger series are warranted to confirm this.

Retinopathy of prematurity: incidence, risk factors, and evaluation of screening criteria.

BACKGROUND/AIM: The goal of this study was to investigate the incidence of retinopathy of prematurity (ROP) and the relationship between risk factors and disease in premature newborns in our neonatal intensive care unit. MATERIALS AND METHODS: A total of 219 premature subjects were retrospectively evaluated for retinopathy. Demographic information, clinical data, and risk factors were reviewed. RESULTS: The gestational ages of the infants included in the study ranged between 25 and 36 weeks, and the birth weights ranged between 670 and 4460 g. In this study, the incidence of ROP was 20.1% (44) in preterm infants: 16 had stage 1 (36.4%), 15 had stage 2 (34.1%), 11 had stage 3 (25%), 1 had stage 4 (2.3%), 1 had stage 5 (2.3%), and 6 had plus (+) disease (7.2%). The risk factors associated with the development of ROP included low birth weight, ventilation treatment, bronchopulmonary dysplasia, and maternal preeclampsia. The risk factors were analyzed with logistic regression analysis. The odds ratios were 5.952 (95% confidence interval [CI]: 2.030-17.447), 20.070 (95% CI: 4.213-95.600), 5.879 (1.916-18.037), and 3.200 (95% CI: 1.002-11.535), respectively. CONCLUSION: In this study, birth weight, ventilation treatment, bronchopulmonary dysplasia, and maternal preeclampsia were the most important risk factors for the development of ROP.

The Effects of Inhaled ß-Adrenergic Agonists in Transient Tachypnea of the Newborn.

Aim. To investigate the efficacy of an inhaled ß-adrenergic agonists in transient tachypnea of the newborn (TTN). Method. We retrospectively analyzed a cohort of 51 term infants (Group 1) and 37 term infants (Group 2) monitored in the newborn intensive care unit diagnosed with TTN. Infants in Group 1 received humidified oxygen alone, and infants in Group 2 were administered the inhaled ß-2 agonist plus humidified oxygen. Results. TTN clinical respiratory assessment, respiratory rate, oxygen saturation values, need for supplemental oxygen therapy, blood gas PH, PO2, and duration of hospitalization were significantly improved in infants in Group 2 as compared with infants in Group 1 (P < .05). No statistically significant difference was observed with regard to blood glucose, potassium, heart rate, and PCO2 (P > .05). Conclusion. Inhaled ß-adrenergic agonist added to humidified oxygen was found to improve clinical and laboratory parameters. We believe that further studies should be conducted with larger groups to demonstrate the efficacy of ß-2 agonists in TTN patients.

Importance of the ultrasonography in diagnosis of ileal duplication cyst.

Gastrointestinal duplication cysts are rare congenital anomalies that can be seen in anywhere of the gastrointestinal system from the mouth to the anus. These are prenatally diagnosed through antenatal ultrasonography. However, attention must be paid since these formations might be confused with ovarian or mesenteric cysts. Our patient, who had been diagnosed with ovarian cyst on the ultrasonography performed in another center and with mesenteric cyst based on the abdominal MRI carried out at fifth month of life, presented to our clinic with the only complaint of constipation at 9th month of life. The diagnosis was set through double wall appearance of duplication cyst on the abdominal ultrasonography. The patient's cyst was resected.

The Type of Anesthesia Used during Cesarean Section Is Related to the Transient Tachypnea of the Newborn.

Aim. To demonstrate whether transient tachypnea of the newborn (TTN) is found more frequently in women undergoing general or combined epidural-spinal (CES) anesthesia during Cesarean section. Methods. This study was done retrospectively. A total of 1447 Cesarean sections (C/S) were performed in our clinic between January 2008 and December 2011. General anesthesia was performed in 1078 (74.5%) of the Cesarean cases. CES anesthesia was performed in 369 cases (25.5%). The International Classification of Diseases,Tenth Revision code of P22.1, was used to identify the infants with TTN. Stratified multivariate analysis was undertaken on subgroups to assess the effect modification by factors known to influence the incidence of TTN: maternal age, maternal systolic-diastolic artery pressure, heart rate, Apgar score at 1 and 5 minutes, sex, time interval from spinal block to skin incision, and time interval from skin incision to umbilical cord clamping. Results. The rate of TTN diagnosis was found to be higher in parturients who had a cesarean section with combined epidural-spinal anesthesia, but no statistical differences were found. (P < 0.05) (odds ratio = 1.471 and 95%CI: 0.92-2.35). Conclusions. The incidence of TTN was found related to C/S but independent from the type of anesthesia. However, studies with a wider spectrum of patients and a lower quantitative difference between the groups are needed in order to draw firm this conclusions.

C-reactive protein and procalcitonin during febril attacks in PFAPA syndrome.

OBJECTIVES: To assess the levels of procalcitonin (PCT) and C-reactive protein (CRP) in children diagnosed with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) during their febrile attacks. METHODS: 23 patients with diagnosis of PFAPA included into the study prospectively during a three years period. In these patients, CRP and PCT values were recorded during 78 febrile episodes. Furthermore, 20 patients with diagnosis of pneumonia were chosen as a control group and their CRP and PCT values were measured. Normal reference values for CRP and PCT were 0-10 mg/L and 0-0.5 ng/mL, respectively. RESULTS: Mean CRP and PCT values of patients with PFAPA were 94.8±71.6 mg/L and 0.29±0.14 ng/mL, respectively. In control group, mean CRP value was 153.2±26 mg/L and PCT was 1.59±0.53 ng/mL. CRP and PCT were high in control group. CRP was detected high and PCT was normal in PFAPA. Compared to control group, in PFAPA group, CRP values were not significantly (p>0.05) and PCT values were significantly lower (p<0.001). CONCLUSION: During febrile episodes in the patients with diagnosis of PFAPA, CRP values were substantially elevated, whereas PCT values were within normal levels. Concomitant assessment of CRP and PCT in addition to clinical diagnostic criteria may be of help in making diagnosis and distinguishing febrile attacks from infections. However, studies in larger groups are required.

To Evaluate Serum Eosinophil Cationic Protein and Total IgE Concomitantly May Predict the Persistence of Wheezing in Young Children.

Background. We investigated the predictive value and the relative risk of the evaluation of serum eosinophilic cationic protein (sECP) and total IgE levels concomitantly in relation to the persistence of wheezing in young children. Methods. The study was conducted prospectively between January 2007 and December 2010. A hundred and eight children, aged between three months and four years, with three or more episodes of wheezing, were studied to evaluate the role of eosinophil inflammation and its relation to persistence of wheezing two years later. Results. A statistically significant difference in terms of total IgE and sECP values was observed between the groups (P < 0.05). When measurement of IgE and sECP was assessed concomitantly, the sensitivity was found to be 92.68%, the negative predictive value was found to be 71.43%, accuracy rate was found to be 84.26%, and the relative risk was found to be 3.06 in group 1. Conclusions. In this study, we aimed to emphasize the importance of the assessment of sECP and total IgE concomitantly, as being two noninvasive and easily applicable tests, useful in predicting persistent wheezing in early childhood.