RESUMEN
A 3-day-old male newborn presented with a severe proptosis of the left eye leading to exposure keratopathy. He underwent debulking of the cyst and biopsy of the tumour and received the pathological diagnosis of epidermoid cyst of orbit. Clinicopathological features of this rare disease are discussed.
RESUMEN
Acinetobacter baumannii is a Gram-negative coccobacillus that has emerged as a troublesome pathogen causing institutional outbreaks. Environmental contamination is a distinctive characteristic of this microorganism, which brings a further difficulty in infection control. During A. baumannii outbreaks in intensive care units, a common contaminated object can be found as a reservoir. Finding out this source by epidemiological investigations is of particular importance in order to develop effective interventions. We describe an outbreak of A. baumannii and the results of epidemiological investigations in a neonatal intensive care unit. The outbreak strain was isolated from the outer surface of a breastmilk pump. We have successfully controlled the outbreak by careful reviewing of our milk collection process.
Asunto(s)
Infecciones por Acinetobacter/prevención & control , Acinetobacter baumannii/patogenicidad , Extracción de Leche Materna/instrumentación , Infección Hospitalaria/prevención & control , Brotes de Enfermedades/prevención & control , Contaminación de Equipos/prevención & control , Unidades de Cuidado Intensivo Neonatal , Síndrome de Dificultad Respiratoria del Recién Nacido/terapia , Infecciones por Acinetobacter/epidemiología , Ampicilina/administración & dosificación , Antibacterianos/administración & dosificación , Reservorios de Enfermedades , Contaminación de Equipos/estadística & datos numéricos , Humanos , Incidencia , Recién Nacido , Control de Infecciones , Masculino , Meropenem , Pruebas de Sensibilidad Microbiana , Sulbactam/administración & dosificación , Tienamicinas/administración & dosificaciónRESUMEN
BACKGROUND: Vitamin D and its receptor (VDR) have important roles in perinatal lung development. The aim of this study was to investigate the relationship between VDR gene polymorphism and bronchopulmonary dysplasia (BPD) in preterm infants. METHODS: VDR Fok I, Bsm I, Apa I, and Taq I polymorphisms were genotyped using restriction fragment length polymorphism in 109 preterm infants (47 with BPD, 62 without BPD). RESULTS: In univariate analysis, Ff (odds ratio (OR) = 3.937, P = 0.022, 95% confidence interval (CI) = 1.22-12.69) and ff (OR = 5.23, P = 0.004, 95% CI = 1.69-16.23) genotypes of Fok I were associated with the increased risk of BPD; whereas tt genotype of Taq 1 was associated with a protective effect against BPD (OR = 0.30, P = 0.04, 95% CI = 0.09-0.94). In multivariate logistic regression analysis, variant Fok 1 genotype increased risk of BPD (OR = 4.11, 95% CI = 1.08-15.68, P = 0.038) independent of patent ductus arteriosus, sepsis, mechanical ventilation, and surfactant treatment. Taq 1, Bsm 1, and Apa 1 polymorphisms did not have any effect. CONCLUSION: After adjusting for multiple confounders, VDR Fok 1 polymorphism was associated with the increased frequency of BPD. Further studies are needed to assess the contribution of VDR signaling to the pathogenesis of BPD and to determine if VDR polymorphisms may be suitable for identifying infants at high risk for BPD.
Asunto(s)
Displasia Broncopulmonar/genética , Polimorfismo Genético/genética , Receptores de Calcitriol/genética , Análisis de Varianza , Cartilla de ADN/genética , Humanos , Recién Nacido , Recien Nacido Prematuro , Oportunidad Relativa , Polimorfismo de Longitud del Fragmento de Restricción , TurquíaRESUMEN
PURPOSE: The aim of this study was to compare the VEGF, PIGF, and HIF-1α levels in the placentas of early- and late-onset pre-eclamptic patients, which are thought to be important in pathophysiology of pre-eclampsia. MATERIAL AND METHOD: Pre-eclamptic early-onset (n = 22) and late-onset (n = 24) pregnant women and a control group of healthy pregnant women (n = 22) were recruited for this case-control study. A semi-quantitative immunohistochemical analysis of VEGF, PIGF and HIF-1α was performed in cross-sections of the placentas of the subjects, after which results were compared. RESULTS: Levels of VEGF and PIGF in the placentas of pre-eclamptic patients were found to be lower than the levels in the placentas of healthy pregnant women (p < 0.001 and p = 0.025, respectively), whereas the levels of HIF-1α were found significantly higher (p < 0.001). No difference was observed in terms of VEGF, PIGF and HIF-1α in a comparison of the early- and late-onset pre-eclampsia groups (p > 0.05). CONCLUSION: The results of the study indicated that there is no relationship between the time of onset of pre-eclampsia and the placental changes that occur in these factors.
Asunto(s)
Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Placenta/metabolismo , Preeclampsia/metabolismo , Proteínas Gestacionales/metabolismo , Factor A de Crecimiento Endotelial Vascular/metabolismo , Adulto , Edad de Inicio , Estudios de Casos y Controles , Estudios Transversales , Femenino , Edad Gestacional , Humanos , Factor de Crecimiento Placentario , Preeclampsia/epidemiología , Embarazo , Adulto JovenRESUMEN
BACKGROUND: Chorioamnionitis is closely related to premature birth and has negative effects on neonatal morbidity and mortality. METHODS: In this prospective study, 43 mothers who delivered earlier than 35 gestational weeks and their 57 infants were evaluated clinically and with laboratory findings. Placentas and umbilical cords were investigated histopathologically for chorioamnionitis and funisitis. RESULTS: The overall frequency of clinical and histological chorioamnionitis (HCA) was 8.3% and 23.2%, respectively. The frequency of HCA was 47.3% and 83.3% in mothers delivered <32 weeks and <30 weeks, respectively. Maternal demographic and clinical findings and also leukocyte and C-reactive protein values were not indicative of HCA. Infants of mothers with HCA had significantly lower Apgar scores together with higher SNAP-PE-II and CRIB scores. These infants had increased mechanical ventilator and surfactant requirements, higher incidences of patent ductus arteriosus, early sepsis, and bronchopulmonary dysplasia, and higher mortality rates. The effect of HCA on neonatal morbidity and mortality was more prominent than the effect of low birthweight and lower gestational age. CONCLUSION: Chorioamnionitis not only causes premature deliveries, but is also associated with neonatal complications and increased mortality. Clinical findings and infectious markers in mother or infant do not predict the diagnosis of histological chorioamnionitis. Therefore, placental histopathology may have a role in predicting neonatal outcome in premature deliveries, especially those below 30 weeks.
Asunto(s)
Corioamnionitis/patología , Enfermedades del Prematuro/mortalidad , Enfermedades del Prematuro/patología , Recien Nacido Prematuro , Trabajo de Parto Prematuro/patología , Adulto , Puntaje de Apgar , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , Corioamnionitis/mortalidad , Femenino , Rotura Prematura de Membranas Fetales/patología , Edad Gestacional , Humanos , Inmunohistoquímica , Recién Nacido , Enfermedades del Prematuro/fisiopatología , Recuento de Leucocitos , Masculino , Edad Materna , Trabajo de Parto Prematuro/mortalidad , Placenta/patología , Valor Predictivo de las Pruebas , Embarazo , Pronóstico , Estudios Prospectivos , Medición de Riesgo , Tasa de Supervivencia , Turquía , Cordón Umbilical/patologíaRESUMEN
BACKGROUND: The imbalance between pro-inflammatory and anti-inflammatory cytokines may play a role in the development of bronchopulmonary dysplasia (BPD) in preterm infants. Mannose binding lectin (MBL) codon 54 and interleukin 1 receptor antagonist gene (IL1-RN) polymorphisms cause genetic predisposition to increased risk of infection and inflammation, therefore may increase the risk of BPD. The aim of this study was to investigate the relationship between MBL, IL1-RN gene polymorphisms and BPD development in preterm infants. METHODS: MBL codon 54 and IL1-RN polymorphisms were studied in 71 infants who were born at <32 weeks of gestation, with the diagnosis of BPD (group 1) and in a control group of preterm infants without BPD (group 2). RESULTS: IL1-RN and MBL2 variant genes were closely associated with increased risk of BPD (both P < 0.001) together with significantly lower birthweight (P < 0.001 and P = 0.001, respectively), lower 5 min Apgar scores (P = 0.009 for both genes) and increased neonatal infection rate (P < 0.001 and P < 0.009, respectively). The IL1 RN 1/1 genotype was protective (odds ratio [OR], 0.075; 95% confidence interval [CI]: 0.019-0.76) while the IL1-RN 2/2 genotype increased the risk for BPD (OR, 11.7; 95%CI: 1.3-103.6). The MBL-AA genotype was protective against BPD (OR, 0.066; 95%CI: 0.02-0.2) whereas the MBL-BB genotype increased the susceptibility for the development of BPD (OR, 23.8; 95%CI: 2.8-200.6). CONCLUSION: MBL and IL 1 RN polymorphisms are closely related to low birthweight and increase the risk of neonatal sepsis and BPD development in preterm infants.
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Displasia Broncopulmonar/genética , ADN/genética , Predisposición Genética a la Enfermedad , Recien Nacido Prematuro , Proteína Antagonista del Receptor de Interleucina 1/genética , Lectina de Unión a Manosa/genética , Polimorfismo Genético , Displasia Broncopulmonar/sangre , Femenino , Estudios de Seguimiento , Genotipo , Humanos , Recién Nacido , Proteína Antagonista del Receptor de Interleucina 1/sangre , Masculino , Lectina de Unión a Manosa/sangre , Regiones Promotoras Genéticas , Estudios RetrospectivosRESUMEN
PURPOSE: The aim of this study was to compare maternal and umbilical cord serum levels of the angiogenic and anti-angiogenic factors in early- and late-onset pre-eclamptic pregnancies as well as in normal pregnancies, which might have significant importance in the etiology of pre-eclampsia. MATERIALS AND METHODS: This prospective case-control study was carried out with pre-eclamptic (early-onset, ≤ 34 weeks and late-onset, >34 weeks) and normal pregnant women. VEGF, PIGF, sFlt-1 and sEng levels in maternal and umbilical cord serum were measured before delivery and the findings were compared. RESULTS: The study was conducted with 15 early- and 15 late-onset pre-eclampsia patients, and 17 patients with normal pregnancies. It was found that sEng levels were higher in the umbilical cord serum in the early-onset and in the maternal serum in the late-onset pre-eclampsia group than the control group (p < 0.05). No significant difference in any factor was observed between the early- and late-onset pre-eclampsia groups. CONCLUSION: In this study, the results showed that angiogenic and anti-angiogenic factor levels in maternal serum and umbilical cord serum may not be related to the time of onset of pre-eclampsia.
Asunto(s)
Inhibidores de la Angiogénesis/sangre , Proteínas Angiogénicas/sangre , Preeclampsia/sangre , Preeclampsia/fisiopatología , Adulto , Antígenos CD/sangre , Antígenos CD/química , Estudios de Casos y Controles , Endoglina , Femenino , Sangre Fetal , Humanos , Proteínas de la Membrana/sangre , Preeclampsia/epidemiología , Embarazo , Tercer Trimestre del Embarazo , Estudios Prospectivos , Receptores de Superficie Celular/sangre , Receptores de Superficie Celular/química , Índice de Severidad de la Enfermedad , Solubilidad , Turquía/epidemiología , Factor A de Crecimiento Endotelial Vascular/sangre , Receptor 1 de Factores de Crecimiento Endotelial Vascular/sangre , Receptor 1 de Factores de Crecimiento Endotelial Vascular/química , Adulto JovenRESUMEN
Routine use of transcutaneous bilirubin (TcB) measurement in the newborn nursery could reduce costs, readmission rates for hyperbilirubinemia and the need for total serum bilirubin (TSB) measurements. The aim of this study was to examine the correlation between TcB measurement, as performed using BiliCheck, and TSB, measured with high-pressure liquid chromatography (HPLC) and with standard laboratory methods, and to determine the TcB cutoff points with desirable sensitivity and specificity values for various clinically relevant TSB levels by HPLC. Fifty-four infants of > or = 30 weeks of gestational age were enrolled in the study. Near simultaneous blood collection for TSB analysis by three methods--bedside bilirubinometer, diazo method and HPLC--and TcB measurement were performed. There was good correlation between TcB and HPLC-bilirubin (B) (r = 0.85), TSB by bilirubinometer and HPLC-B (r = 0.91) and TSB by diazo method and HPLC-B (r = 0.91). The cut-off limits providing a sensitivity of 100% for TcB measurements were TcB > or = 9 mg/dl for HPLC-B > 17 mg/dl and TcB > or = 8 mg/dl for HPLC-B > 15 mg/dl and HPLC-B > 13 mg/dl. Despite having good correlation with HPLC, BiliCheck showed worse performance than bilirubinometer and diazo method at various clinically relevant cut-off values. Since BiliCheck required relatively lower thresholds with false-positive results for having a sensitivity of 100%, it cannot be recommended as a complete substitute for serum bilirubin measurements.
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Bilirrubina/sangre , Femenino , Humanos , Recién Nacido , Ictericia Neonatal/diagnóstico , Masculino , Sensibilidad y EspecificidadRESUMEN
UNLABELLED: This study was conducted for the purpose of assessing, in the light of results of other research carried out in the present researchers' clinic and in Turkey, the status of twin pregnancies in Turkey, the incidence of twin births, perinatal and mortality rates associated with twin pregnancies, and the problems experienced in Turkey in cases of multiple and twin pregnancies. MATERIALS AND METHODOLOGY: The outcomes of twin births that occurred at the researchers' clinic during the period 2001-2009 were studied retrospectively. Seventeen studies conducted in Turkey on multiple and twin pregnancies during the years 1991-2010 were included in the study. FINDINGS: It was observed that the mean multiple pregnancy rate in Turkey is 1.9% and the mean twin birth rate is 1.7%. It was also observed that a large majority (80-97.3%) of multiple pregnancies in Turkey are twin pregnancies. It was noted from Turkish literature that the mean gestational age of twins at birth varies between 33-36.2 weeks and that mean birthweights are 2065-2327 grams for the first-born twin and 1887-2262 grams for the second-born. These findings were observed to be lower than what is indicated in the literature. Perinatal and neonatal mortality, at 58-156/1000 and 40-98/1000 respectively, were seen to be higher than in the literature. CONCLUSION: It can be seen that preterm birth rates for twin pregnancies in Turkey are higher than what is indicated in the literature and that prenatal and neonatal mortality rates are also similarly higher.
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Mortalidad Infantil , Resultado del Embarazo , Embarazo Múltiple , Adulto , Femenino , Edad Gestacional , Humanos , Incidencia , Recién Nacido , Embarazo , Estudios Retrospectivos , TurquíaRESUMEN
Megaloblastic anemia is rare in infants and is generally due to vitamin B12 (cobalamin) deficiency in the mother. Neurologic symptoms of vitamin B12 deficiency include irritability, failure to thrive, hypotonia, and developmental regression/delay. Herein we present 2 infants with vitamin B12 that developed movement disorder 5 d after initiation of vitamin B12 treatment. Symptoms included tremor and myoclonus, involving in particular the face, tongue, and hands. Clinical findings in infants associated with vitamin B12 deficiency vary, and temporary involuntary movement can be observed during vitamin B12 therapy.
RESUMEN
BACKGROUND: Mannose-binding lectin (MBL) as a component of innate immunity plays an important role in preterm infants in whom adaptive immunity is not sufficiently developed. Polymorphisms in immunoregulatory genes influence the response to infection and subsequent inflammation. Infection and inflammation have been implicated in the mechanisms responsible for many of the diseases in the preterm newborns. OBJECTIVES: The aim of the study was to investigate the relationship between MBL gene polymorphism and early neonatal outcome in preterm infants. METHODS: Codon 54 and 57 polymorphisms in MBL2 gene were genotyped in 99 preterm infants admitted to the Neonatal Intensive Care Unit at Ege University Children's Hospital. RESULTS: Overall frequencies of sepsis and early-onset sepsis were higher in the group of infants with MBL polymorphism when compared to infants with wild-type MBL genotype (p = 0.008, 0.009, respectively). Maximum Tollner sepsis score in the first 3 days of life was higher for the infants with variant MBL genotype (p = 0.0278). More infants in the variant MBL group had significant patent ductus arteriosus when compared to infants with wild-type MBL (27.8 vs. 9.5% respectively, p = 0.037). CONCLUSION: MBL gene polymorphism was associated with increased frequency of clinical sepsis particularly with early neonatal sepsis and also with higher Tollner sepsis scores and increased frequency of patent ductus arteriosus in infants. Overall mortality and incidence of culture proven sepsis, respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia and necrotizing enterocolitis were not found to be related to MBL genotype.
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Enfermedades del Prematuro/genética , Lectina de Unión a Manosa/genética , Polimorfismo de Nucleótido Simple , Sepsis/genética , Femenino , Retardo del Crecimiento Fetal/epidemiología , Retardo del Crecimiento Fetal/genética , Retardo del Crecimiento Fetal/patología , Predisposición Genética a la Enfermedad , Genotipo , Edad Gestacional , Humanos , Recién Nacido , Recien Nacido Prematuro , Enfermedades del Prematuro/epidemiología , Enfermedades del Prematuro/patología , Masculino , Sepsis/epidemiología , Sepsis/patología , Índice de Severidad de la Enfermedad , TurquíaRESUMEN
Candida septicaemia with multidrug resistance is an uncommon event in preterm neonates. We present an extremely low birth weight infant (gestational age of 27 weeks, birth weight of 980 g) who developed congenital Candida parapsilosis septicaemia. Because the fungus was resistant both to amphotericin B and fluconazole, caspofungin was chosen for therapy. The fungus was successfully eradicated without any clinical or laboratory adverse effects.