Derya Büyükkayhan

Objective: Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infection in children. This study aimed to describe the clinical and laboratory characteristics of RSV-positive children older than 28 days in a tertiary-care cohort, explore characteristics associated with hospitalization in group comparisons, and identify factors independently associated with pediatric intensive care unit (PICU) admission among hospitalized children.Materials and Methods: This retrospective single-center study screened RSV testing records between August 2020 and August 2022 and included children older than 28 days with laboratory-confirmed RSV infection identified between February 2021 and August 2022. Demographic, clinical, laboratory, treatment, hospitalization, PICU admission, respiratory support, and outcome data were recorded. Comparisons were performed according to hospitalization status, clinical diagnosis, and PICU admission. A prespecified parsimonious multivariable logistic regression model evaluated factors associated with PICU admission among hospitalized children.Results: Of the 3523 children with available RSV test results during the study period, 561 RSV-positive children aged >28 days were included. Median age was 4 months (IQR, 2-14), and 317 patients (56.5%) were male. Bronchiolitis was the most common diagnosis (63.5%), followed by pneumonia (28.5%) and upper respiratory tract infection (8.0%). Hospitalization was required in 478 patients (85.2%), and 35 (6.2%) required PICU admission. Pneumonia was associated with higher rates of hypoxia, noninvasive ventilatory support, PICU admission, longer hospitalization, and delayed clinical improvement. Documented viral coinfection was detected in 30 patients (5.3%); no association was detected between documented viral coinfections and hospitalizations or PICU admission in this dataset. In hospitalized patients, pneumonia (OR, 2.59; 95% CI, 1.07-6.24; p=0.034) and hypoxia (OR, 32.08; 95% CI, 13.09-78.66; p<0.001) were independently associated with PICU admission.Conclusion: RSV infection predominantly affected infants and most commonly presented as bronchiolitis. Pneumonia and hypoxia were independently associated with PICU admission in this tertiary-care cohort.

Phototherapy is the first-line treatment for neonatal hyperbilirubinemia. Despite its widespread use, concerns persist regarding the potential biological e

Objectives: Infantile colic is a common disorder characterized by excessive crying in infants, with its etiology remaining largely unclear. In this study, the potential role of core circadian rhythm (CR) proteins in infantile colic was investigated. Methods: Our study comprised 61 infants aged 0–3 months. Blood samples were collected intravenously from each individual. They were then centrifuged using the appropriate technique and divided into small portions. Cry1, Cry2, Per1, Per2, Clock, and Bmal1 protein levels in plasma samples were measured using enzyme-linked immunosorbent assay (ELISA) kits. A detailed questionnaire was administered to address various factors related to both the mother and the infant. The possible relationships between the measured CR protein levels and the gathered natal and sociodemographic data were then assessed using multiple regression analysis. Results: The findings indicate that CR protein levels in infants with colic are significantly different from the control group, suggesting that CR dysregulation may be associated with colic symptoms. Furthermore, correlations were identified between these protein levels and variables, including vitamin D supplementation, nocturnal sleep patterns, the number of siblings, and maternal gestational diabetes. Statistically significant regression models, specifically those incorporating the Per2 variable, elucidated its associations with nocturnal sleep patterns, sibling counts, and gestational diabetes. Conclusions: We argue that restoring CR protein levels to the normal range may improve the prognosis of infantile colic. These findings provide a novel perspective on the potential role of CR proteins in the infantile colic etiology, potentially paving the way for new treatment approaches in this area.

Özet Amaç: Üç yıllık bir süreyi kapsayan verileri kullanarak, göz hastalıkları polikliniğinde gebelik yaşı >34 hafta olan bebeklerde tespit edilen göz bulgularını sunmak ve bu bulguların sıklığını ve çeşitli değişkenlerle ilişkilerini belirlemek. Gereç ve Yöntem: 2015-2017 yılları arasında Zeynep Kamil Kadın Doğum ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi göz hastalıkları polikliniğinde muayene edilen 0-3 aylık 7.820 term/geç preterm bebeğe yapılan görme taramasının sonuçları bu retrospektif, kesitsel, gözlemsel ve tanımlayıcı çalışmada analiz edildi. Bulgular: Toplam 7.820 term ve geç preterm bebek muayene edildi. Bebeklerin %20,1'inde (n=1.569) göz bulgusu tespit edildi. Bebeklerin %9,5'inde (n=740) en sık görülen bulgu retina kanamasıydı ve ≤28 günlük bebeklerde doğumdan 28 gün sonra olanlara göre daha sıktı (p

ABO incompatibility is the most common blood group incompatibility in newborn babies, haemolytic disease develops in very few cases and is much milder than Rh incompatibility. In our study, we aimed to retrospectively examine the changes in platelet parameters, in addition to the expected decrease in the erythrocyte count, in immunized ABO incompatible patients, by comparing them with those in the control group. The demographic data and laboratory results of patients born in our hospital between November 1, 1997, and December 31, 2023, who had accessible information, were examined. The haemogram parameters of newborns with haemolytic disease who did not have ABO incompatibility those of newborns with ABO incompatibility and those of newborns with positive direct anti-globulin test results were compared using statistical methods. A total of 5,198 out of 7,780 newborns were included in the study. A total of 2582 newborns for whom demographic and laboratory values ​​could not be obtained were excluded from the study. When the data of 5,158 newborns without incompatibility and 40 newborns with haemolytic disease due to ABO incompatibility were compared, the mean red blood cell (RBC), haematocrit, haemoglobin and mean platelet volume (MPV) values of newborns with haemolytic disease were found to be statistically significantly lower than those of newborns in the control group, whereas the platelet, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and red cell distribution width (RDW) values were greater. Thrombocytopenia was not observed in any patient. Haemolytic disease due to ABO incompatibility is a mild haemolytic disease that is thought to be caused by maternal antibody density or low antigen density on neonatal erythrocytes. We detected an increase in the platelet count and a decrease in the erythrocyte count values in in the haemolytic group. Prospective studies are needed on this subject that also examine erythropoietin and thrombopoietin values.

Objective: Patients in the pediatric intensive care unit (PICU) and neonatal intensive care unit (NICU) are at high risk for drug-related problems (DRPs). It is crucial to assess pharmacotherapy with the active involvement of clinical pharmacist (CP). The study aims to investigate the effect of CPs in identifying and resolving DRPs in the NICU and PICU settings. Method: This study with a retrospective and prospective design was conducted within the timeframe of October 2020 - August 2021 at the NICU (n=200) and PICU (n=200) of a university-affiliated state hospital in Türkiye. The Pharmaceutical Care Network Europe (PCNE) Classification V9.1. was used for classifications of the DRPs. DRPs identified by the CP and the regarding intervention proposals were communicated with the attending physician. Results: A total of 1247 DRPs were identified for all patients. The median (interquartile range [IQR]) number of DRPs per patient was 3 (1-6) for the pediatrics and 1 (0-1) for the neonates (p

Fetal-to-neonatal adaptation involves many complex mechanisms. Cardiovascular biomarkers may help to understand fetal and maternal physiology in pregnancy and during the perinatal transition period. In this present study, our aim was to assess the association between delivery type and brain natriuretic peptide (BNP) levels in healthy full-term neonates. Forty-eight neonates born by vaginal delivery (n=25) and cesarean section (n=23) were included in the study. Plasma BNP levels were measured at cord blood samples. In addition antropometric measurements and physical examination were evaluated at first day of life. BNP levels measure and clinical evaluation were repeated 3 days later after birth. The median cord and infant BNP levels were similar in vaginal and cesarean delivery. There was no difference between the median cord and infant BNP levels in vaginal deliveries [54.0 pg/ml (q1-q3: 40.0-111.5) and 66.0 pg/ml (q1-q3: 43.0-90.0) respectively, p=0.619]. However, the median infant BNP level was statistically significantly higher than the median cord BNP level [56.0 pg/ml (q1-q3: 39.0-84.0) and 75.0 pg/ml (q1-q3: 54.0-145.0), p=0.027] in cesarean deliveries. Uncomplicated vaginal deliveries were not associated with high BNP levels and thus fetal cardiac distress. Increased levels of BNP levels on the 3rd day in elective cesarean deliveries may be predictive of delayed postnatal pulmonary and cardiac adaptation.