Direct Effect of Caffeine on Diaphragmatic Muscles in Preterm Babies Through Ultrasonographic Examination.

Caffeine is frequently used for the treatment of apnea in preterm babies. Its mechanism of action includes not only antagonism of adenosine receptors on central nervous system but also an increase in electrical activity of the diaphragm. Caffeine's direct effect on diaphragm was investigated via electromyography, but ultrasound has not been used to show visible changes in muscles after the treatment before.

Development and validation of a machine learning-based detection system to improve precision screening for medication errors in the neonatal intensive care unit.

To develop models that predict the presence of medication errors (MEs) (prescription, preparation, administration, and monitoring) using machine learning in NICU patients. Prospective, observational cohort study randomized with machine learning (ML) algorithms. A 22-bed capacity NICU in Ankara, Turkey, between February 2020 and July 2021.

Development and validation of machine learning-based clinical decision support tool for identifying malnutrition in NICU patients.

Hospitalized newborns have an increased risk of malnutrition and, especially preterm infants, often experience malnutrition-related extrauterine growth restriction (EUGR). The aim of this study was to predict the discharge weight and the presence of weight gain at discharge with machine learning (ML) algorithms. The demographic and clinical parameters were used to develop the models using fivefold cross-validation in the software-R with a neonatal nutritional screening tool (NNST).

An Artificial Intelligence Approach to Support Detection of Neonatal Adverse Drug Reactions Based on Severity and Probability Scores: A New Risk Score as Web-Tool.

Background: Critically ill neonates are at greater risk for adverse drug reactions (ADRs). The differentiation of ADRs from reactions associated with organ dysfunction/immaturity or genetic variability is difficult.

Methods: In this prospective cohort study, each ADR was assessed using newborn-specific severity and probability scales by the clinical pharmacist.

Organic acidemias in the neonatal period: 30 years of experience in a referral center for inborn errors of metabolism.

Objectives: Neonatal-onset organic acidemias (OAs) account for 80% of neonatal intensive care unit (NICU) admissions due to inborn errors of metabolism. The aim of this study is to analyze clinical features and follow-up of neonates diagnosed with OAs in a metabolic referral center, focusing on perinatal characteristics and the impact of first the metabolic crisis on long-term outcome.

Methods: Perinatal features, clinical and laboratory characteristics on admission and follow-up of 108 neonates diagnosed with OAs were retrospectively analyzed.

Recovery of cyanosis after esophageal intubation in a neonate with tracheal agenesis: a case report.

Background: Tracheal agenesis (TA) is a rare congenital defect that consists of a complete or partial absence of the trachea below the larynx, with or without tracheoesophageal fistula (TEF). It is a severe congenital defect with a very high mortality rate. The recommended surgical approach is esophageal ligation and gastrostomy.

Novel Method for Early Prediction of Clinically Significant Drug-Drug Interactions with a Machine Learning Algorithm Based on Risk Matrix Analysis in the NICU.

Evidence for drug-drug interactions (DDIs) that may cause age-dependent differences in the incidence and severity of adverse drug reactions (ADRs) in newborns is sparse. We aimed to develop machine learning (ML) algorithms that predict DDI presence by integrating each DDI, which is objectively evaluated with the scales in a risk matrix (probability + severity). This double-center, prospective randomized cohort study included neonates admitted to the neonatal intensive care unit in a tertiary referral hospital during the 17-month study period.

Long-term follow-up of patients after acute kidney injury in the neonatal period: abnormal ambulatory blood pressure findings.

Background: Data on the long-term effects of neonatal acute kidney injury (AKI) are limited.

Methods: We invited 302 children who had neonatal AKI and survived to hospital discharge; out of 95 patients who agreed to participate in the study, 23 cases were excluded due to primary kidney, cardiac, or metabolic diseases. KDIGO definition was used to define AKI.

Impact of Prematurity on the Buccal Epithelial Cells of the Neonates via Wnt/Beta-Catenin Signaling Pathway and Apoptosis.

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]) ( = 36)," "late preterm neonates (LPN) (34th- < 37th gw) ( = 46)," and "term neonates (control) (≥37th gw) ( = 56).

Lung ultrasonography decreases radiation exposure in newborns with respiratory distress: a retrospective cohort study.

Chest X-ray (CXR) is commonly used as a first-line imaging method to determine the cause of respiratory distress in NICUs. The aim of the study was to retrospectively assess the decrease in the number of CXRs performed due to the use of lung ultrasonography on the first day of life for newborns with respiratory distress. Infants who were admitted to the NICU on the first day of life due to respiratory distress were enrolled in this study (ClinicalTrials.

Impact of preterm birth on the cellular characteristics of neonatal buccal cells.

Objective: To demonstrate the impact of preterm birth on the cytological, cytomorphometrical, and nuclear parameters of neonatal buccal smears.

Methods: This study consisted of Early Preterm Neonates (EPN; ≤34th gestational week [gw]; n = 36), Late Preterm Neonates (LPN; 34th to <37th gw; n = 46), and Term Neonates (control; ≥37th gw; n = 56). Cytological evaluation and buccal cytome assay were performed using Papanicolaou and Feulgen methods, respectively.

Lung ultrasound (LUS) and surfactant treatment: looking for the best predictive moment.

Objective: Assess the earliest time of LUS to guide surfactant therapy.

Study Design: In this observational study (ClinicalTrials.gov Identifier NCT04544514), LUS was performed within 30 min and repeated at 1, 2, 4, and 6 h on preterm babies.

Comparison of four different non-invasive respiratory support techniques as primary respiratory support in preterm infants.

Background: The use of non-invasive ventilation methods in neonatal intensive care units has been increasing in recent years. Non-invasive ventilation techniques are lung preserving methods and they reduce the risk of volutrauma, barotrauma, and atelectotrauma.

Methods: The effect of heated humidified high-flow nasal cannula (HHHFNC), continuous positive airway pressure (CPAP), nasal intermittent positive-pressure ventilation (NIPPV), and nasal high-frequency oscillation ventilation (NHFOV) were compared in preterm infants with respiratory distress.

The clinical and radiological course of bronchopulmonary dysplasia in twins treated with mesenchymal stem cells and followed up using lung ultrasonography.

Bronchopulmonary dysplasia is a chronic lung disease that develops in low-birth-weight infants as a result of mechanical ventilation and oxygen toxicity in the early neonatal period. In these patients, mechanical ventilation and oxygen support are needed for a long time. We already use antenatal steroid, ventilation techniques with minimal baro/volutrauma, postnatal steroid, and vitamin A to prevent the development of bronchopulmonary dysplasia.

Is chlorine and sodium levels in the amniotic fluid a new marker for fetal lung maturation and RDS severity?

Background: Amniotic fluid (AF) is a dynamic liquid whose contents vary according to the needs of the fetus. Levels of the amniotic components have been used in numerous studies as potential biomarkers to screen pregnancy-related abnormalities. As a reflection of Na and Cl levels of fetal lung fluid, amniotic fluid's Na and Cl levels can be used as an indicator of lung maturation in the newborn period.

Neonatal outcomes of early- and late-onset preeclampsia.

Background: The aim of the current study was to demonstrate the neonatal outcomes of infants born to mothers with early-onset preeclampsia (EP) and late-onset preeclampsia (LP), and compare the neonatal outcomes before and after 34 weeks of gestation in EP group.

Methods: In this retrospective study, we evaluated preeclamptic mother and child pairs who were followedup at Hacettepe University Hospital between the years 2010 and 2017. The pregnant women were classified as having EP if diagnosed before 34 weeks of gestation (n=91) and LP if diagnosed after 34 weeks of gestation (n=34).

Are general movements at 3-5 months correlated and compatible with the Bayley-III at 1,5-2 years age?

Since early intervention is important in risky infants, it is also important to identify developmental problem as early as possible. There are various assessment methods for this. One of them is the General movements assessment (GMs), and the other one is the Bayley Scales of Infants and Toddler Developmental, third edition (Bayley-III).

Cord blood delta neutrophil index values of term neonates.

In this study, we aimed to demonstrate cord blood immature granulocyte (IG) count and delta neutrophil index (DNI) values for term neonates. This retrospective study consisted of 126 term newborns born between July 2017 and December 2017. Cord blood samples were collected during delivery and IG count together with DNI values were obtained.

A new use of GG administration in the NICU: colonized vancomycin-resistant enterococcus eradication in the gastrointestinal system.

Introduction: 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.

Outpatient versus inpatient follow-up for intrahepatic cholestasis of pregnancy.

Aim Of The Study: The optimum management method and the best time of delivery still remain unclear for intrahepatic cholestasis of pregnancy (ICP). We aimed to ascertain whether there is a benefit of close monitoring at hospital.

Material And Methods: We evaluated the maternal and neonatal records of ICPs over a recent five-year period.

Hypoxic-ischemic enterocolitis: a proposal of a new terminology for early NEC or NEC-like disease in preterm infants, a single-center prospective observational study.

We aimed to investigate the role of hypoxia-ischemia in the pathophysiology of early NEC/NEC like disease (ENEC) and classic NEC/NEC like disease (CNEC) in preterm infants. In this pilot study, preterm infants who developed the clinical symptoms and signs of NEC/NEC like disease were divided into two groups as early (≤ 7 days, ENEC) or late (> 7 days, CNEC) groups. Beside clinical variables, serum L-lactate, endothelin-1 (ET-1), platelet activating factor (PAF), and intestinal fatty acid binding protein (I-FABP) levels were measured from umbilical/peripheric venous blood in the first hour of life and during the clinical presentation in all groups.

Antenatal management and outcomes of pregnancies with congenital diaphragmatic hernia.

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.

Outcomes of Cases of Prenatally-Diagnosed Congenital Pulmonary Airway Malformation.

Objective:  To evaluate the outcomes of cases of prenatally-diagnosed congenital pulmonary airway malformation (CPAM).

Methods:  We retrospectively evaluated cases of prenatally-diagnosed CPAM between 2004 and 2018. Ultrasonographic features such as visualization of a fetal lung mass and heterogeneous pulmonary parenchyma were used for CPAM diagnosis.

Perinatal outcomes of twenty-five human immunodeficiency virus-infected pregnant women: Hacettepe University experience.

Objective: To evaluate perinatal outcomes in human immunodeficiency virus (HIV) infected pregnant women in Turkey.

Material And Methods: Maternal characteristics, pregnancy complications, laboratory findings including HIV load, CD4 cell count, CD4/CD8 ratio, neonatal features and final HIV status of the baby were retrospectively analyzed.

Results: The sample included 26 singleton pregnancies, from 25 HIV-infected women.