Turkish J Pediatr
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The aim of the present study was to analyze complete blood count (CBC) and C-reactive protein (CRP) levels to create the predictive score for diagnosis of early-onset neonatal sepsis (EONS). All neonates treated for suspected EONS between January 2004 and December 2006 were evaluated from their case record. A diagnosis of EONS was made if either clinical findings consistent with sepsis developed within 72 hours of life, or if positive cultures were obtained. ⋯ Receiver operating characteristic (ROC) curve analysis determined a cut-off value of a predictive score for EONS > 0.503, with sensitivity of 73% and specificity of 89%. Correct prediction of EONS was found in 78% of all neonates, 80% for positive and 75% for negative outcome (p < 0.0001). In conclusion, for its high sensitivity and prediction rates, the predictive score for EONS is useful in diagnostic evaluation of neonates suspected for EONS.
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Pertussis, or whooping cough, a highly contagious disease caused by Bordetella pertussis, is making a comeback globally and nationally in spite of reasonable vaccination coverage. Worldwide, there have been increasing reports of Bordetella pertussis infection among adolescents and adults, but the peak incidence and highest mortality occur among infants. We report a 19-day-old female infant presenting with progressive respiratory failure. ⋯ Understanding the source of pertussis transmission to infants may provide new approaches to prevent pertussis in the most vulnerable infants. Various potential strategies have been reviewed or recommended in countries with the aim of better protecting infants against pertussis. Public health measures to prevent the disease could be strengthened and booster vaccinations against pertussis considered.
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Neonates with Pierre Robin sequence (PRs) suffer from varying degrees of airway obstruction and feeding difficulties, the courses of which differ from patient to patient, due to mandibular deficiency. We aimed to evaluate the course and prognosis of upper airway obstruction in 20 newborns with PRs. Among 15 isolated and 5 syndromic cases, 7 patients fell into Group I, 5 into Group II and 8 into Group III, respectively, according to the clinical classification system proposed by Caouette-Laberge. ⋯ Decannulation or avoidance of tracheostomy was achieved in all of them. A patient who had a significant comorbidity was managed with tracheostomy and one patient expired due to pulmonary problems. When conservative measures fail, mandibular distraction osteogenesis should be considered to obviate tracheostomy in newborns with micrognathia.
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Case Reports
A case of late-onset central hypoventilation syndrome with hypothalamic dysfunction: through a new phenotype.
Congenital central hypoventilation syndrome (CCHS) is a rare disorder with uncertain nosology that usually presents early in life. The syndrome is characterized by ventilatory response impairment to carbon dioxide and may result in respiratory failure at birth. ⋯ To the best of our knowledge, the case reported herein is the oldest case of LO-CHS/HD in childhood, at 13 years old. He suffered from recurrent pulmonary edema, acute convulsive seizures, hypersomnia, hyperphagia, obesity, impaired glucose tolerance test, and hypercapnia, diagnosed as LO-CHS/HD, and was successfully treated with nasal bi-level positive airway pressure.