Soyhan Bağci

University of Bonn | Uni Bonn · Neonatology and Pediatric Intensive Medicine

Background and purpose Maternal circadian rhythms are important for maintaining maternal and fetal homeostasis. The maternal circadian system coordinates the internal clock of the fetus with environmental lighting conditions via the melatonin signal. The intensity and wavelength of daylight influence nocturnal melatonin production. This study aims...

Amniotic fluid (AF) is the first fluid to enter the gastrointestinal tract. Preterm birth is leading to a sudden interruption of AF swallowing. Understanding the composition of amniotic fluid is crucial to implement strategies preventing intestinal injury in preterm infants. We hypothesized that the fetal gastrointestinal tract (GIT) is exposed to...

(1) Background: Human milk oligosaccharides (HMOs) are already found in maternal circulation in early pregnancy, changing with gestational age. HMOs are also present in cord blood and amniotic fluid (AF). We aimed to assess HMO profiles in AF over the course of gestation. (2) Methods: AF was collected during diagnostic amniocentesis, fetal surgery,...

Maternal circadian rhythms are important for maintaining maternal and fetal homeostasis. The maternal circadian system coordinates the internal clock of the fetus with environmental lighting conditions via the melatonin signal. The intensity and wavelength of daylight influence nocturnal melatonin production. This study aims to evaluate the effect...

Among children, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections are typically mild. Here, we describe the case of a 3.5-year-old girl with an unusually severe presentation of coronavirus disease (COVID-19). The child had an autoinflammatory disorder of unknown etiology, which had been treated using prednisolone and methotrex...

Objective Amniotic fluid is a mixture containing many different proteins as immunomodulatory peptides and growth factors. The glycoprotein Deleted in Malignant Brain Tumors 1 (DMBT1) is participated in innate immunity, angiogenesis and epithelial differentiation. We analyzed the DMBT1 concentration in amniotic fluid during gestation. Methods DMBT1...

Coronavirus disease 2019 (COVID-19) symptoms in newborn infants are incompletely described. We present the first case of neuroradiologic abnormality associated with COVID-19 in a newborn infant with afebrile seizure. This case underlines the possible neurologic involvement of severe acute respiratory syndrome coronavirus 2 in this age group.

Background The aim of this study was to investigate the association of serum periostin levels with clinical features in children with asthma. Methods Children with physician‐diagnosed asthma who attended regularly to an outpatient pediatric allergy and asthma center were enrolled in the study along with control subjects. Asthma severity and contro...

Background: Periostin has emerged as a novel biomarker in the pathogenesis of T helper 2-type allergic diseases in the last years. The aim of this study was to investigate the association of serum periostin levels with clinical features in children with asthma. Methods: Children with physician-diagnosed asthma who attended regularly to an outpatien...

BackgroundA dramatic increase in feeding tube dependency (FTD) in early childhood has been reported in the past two decades. Children with FTD show a pattern of persistent food aversion. Several reviews have given an overview regarding treatment programs to overcome food aversion. As of today, a meta-analysis to specify treatment efficiency is stil...

The maternal circadian time structure is incredibly important in the entrainment and programing of the fetal and newborn circadian time structure. Natural sunlight is the primary environmental time cue for entrainment of circadian rhythms, but high-risk pregnant women spend most of their time indoors with artificial light sources and extremely low...

Maternal circadian rhythms provide highly important input into the entrainment and programming of fetal and newborn circadian rhythms. The light-dark cycle is an important regulator of the internal biological clock. Even though pregnant women spend a greater part of the day at home during the latter stages of pregnancy, natural light exposure is cr...

Intestinal perfusion is impaired in children with congenital heart disease (CHD) depending on the hemodynamic status [1]. Especially newborn with duct dependent pulmonary or systemic perfusion are at risk for severe intestinal complications before and after cardiac surgery due to impaired perfusion, cardiopulmonary bypass (CPB) or hypoxia leading t...

Objective: Preterm premature rupture of membranes (PPROM) is a risk factor for chorioamnionitis (CA) and injury to the fetal brain. However, prolongation of gestation prevents morbidity and decreases complications of prematurity. The current investigation is to define risk factors for adverse neurological outcome from the influence of PPROM of at l...

Pulmonary hypertension (PH) contributes to high mortality in congenital diaphragmatic hernia (CDH). A better understanding of the regulatory mechanisms underlying the pathology in CDH might allow the identification of prognostic biomarkers and potential therapeutic targets. We report the results from an expression profiling of circulating microRNAs...

Key Clinical Message Our findings extend the phenotypic spectrum of Cat eye syndrome, a disorder with wide clinical variability. The potentially life‐threatening complications of congenital diaphragmatic hernia should be considered in genetic counseling and prenatal diagnostic.

Background: Results of epidemiologic studies have determined several risk factors for asthma in school-age children. Objective: To examine whether parental and perinatal risk factors, along with infantile feeding patterns, were associated with asthma in children with grass pollen allergy and allergic rhinitis. Methods: We retrospectively analy...

The aim of the present study is the development of a rapid and accurate analytical method to determine melatonin in milk. In this method, melatonin extracted from milk with ethyl acetate, after application of reversed phase liquid chromatographic separation melatonin, was detected and quantified with tandem mass spectrometry. Performance of method...

Aim: Although early enteral nutrition (EN) is strongly associated with lower mortality in critically ill children, there is no consensus on the definition of early EN. The aim of this study was to evaluate our current practice supplying EN and to identify factors that affect both the initiation of feeding within 24 h after paediatric intensive car...

The use of feeding tubes in pediatric medical procedures and management has dramatically increased over the last three decades. With this increase, the prevalence of Feeding Tube Dependency (FTD) – a reliance on enteral feeding following medical recovery due to lack of oral intake of nutrition, despite being able to eat– has increased too. It has b...

Objective Cardiopulmonary bypass (CPB) surgery commonly threatens the heart and remote organs with ischemia-reperfusion injury. Transient episodes of ischemia to non-vital tissue, known as remote ischemic preconditioning (RIPC), is thought to help local and remote vital organs to withstand subsequent ischemic insults. Design Prospective, randomize...

Background: Remote ischemic preconditioning (RIPC), a phenomenon in which a transient ischemia applied to a nonvital tissue protects another organ or tissue from subsequent lethal ischemic injury, is reported to protect the myocardium to withstand a subsequent prolonged ischemic event in patients undergoing cardiac surgery with cardiopulmonary byp...

Background: An understanding of the factors that influence intestinal wall integrity during the transition from fetal to neonatal life is important to elucidate and minimize potential contributions to the development of intestinal pathologies in vulnerable newborns. Objective: To assess the factors affecting intestinal wall integrity of late preter...

Background Esophageal atresia with or without tracheoesophageal fistula (EA/TEF) represents the most common developmental malformation of the upper digestive tract. It is classified into six subtypes according to the classification of Vogt, depending on anatomical variation of this malformation. Around 50% of the patients with EA/TEF present additi...

Conclusions: Enteral uptake of AF seems to play a pivotal role in fetal growth during late gestation. What is Known: • Peak velocity of fetal weight gain occurs at 33 weeks of gestation and continues until birth. During this period, fetal growth is mainly characterized by cellular hypertrophy. • Amniotic fluid (AF) comprises large amounts of hormo...

Background: The aim of the present study is to evaluate the utility of extraction versus non-extraction-based commercial melatonin ELISA kits for determining the melatonin concentration in amniotic fluid obtained in early and late pregnancy. Methods: Pregnancy duration less than 28 weeks was defined as early and from 28 weeks until delivery as l...

Background: While changes in the composition of breast milk throughout the lactation period are well known, little is known about the antioxidative capacity of breast milk and its regulation as a function of time of day. Objective: The aim of this study was to evaluate the antioxidative capacity in breast milk and its regulation by time of day....

Esophageal atresia with or without tracheoesophageal fistula (EA/TEF) and anorectal malformations (ARM) represent the severe ends of the fore- and hindgut malformation spectra. Previous research suggests that environmental factors are implicated in their etiology. These risk factors might indicate the influence of specific etiological mechanisms on...

Background : There are important physiological changes in the maternal, placental, and fetal compartments during pregnancy and labor. Increased oxidative stress has been demonstrated during labor. Melatonin has been reported to serve as an indirect antioxidant via the stimulation and induction of antioxidant enzymes as superoxide dismutase (SOD) an...

Early post-twinning mutational events can account for discordant phenotypes in monozygotic (MZ) twin pairs. Such mutational events may comprise genomic alterations of different sizes, ranging from single nucleotides to large copy-number variations (CNVs). Anorectal malformations (ARM) and the bladder exstrophy-epispadias complex (BEEC) represent th...

Aspergillosis is an uncommon diagnosis in neonates, especially if caused by Aspergillus flavus. Although amphotericin B remains the drug of choice for treatment of invasive aspergillosis, Aspergillus flavus has been reported as being resistant to amphotericin B. We present here a case of a 24-week gestational age preterm infant who developed skin a...

Purpose: The aim of this pilot study was to evaluate the diagnostic value of pleth variability index (PVI) to predict fluid responsiveness in newborn infants during surgery. Methods: PVI was continuously recorded in 29 mechanically ventilated newborn infants during surgery, and episodes of clinically indicated volume expansion (VE) (≥10 ml/kg in...

Introduction During pregnancy the fetus swallows and absorbs an increasing amount of amnioticfluid. It remains unclear whether a lack of absorption of amniotic fluid may result in low birth weight (BW). There are a few studies evaluating the significance of amniotic fluid on fetal growth and the their results are controversial. This study was carri...

Introduction Human milk (HM) contains antioxidant enzymes such as superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase. Melatonin (MT) shows antioxidative properties both directly by stimulating the activities of antioxidant enzymes and indirectly by scavenging free radicals. The aim of this study was to evaluate the effect of M...

The VATER/VACTERL association is typically defined by the presence of at least three of the following congenital malformations: vertebral anomalies, anal atresia, cardiac malformations, tracheo-esophageal fistula, renal anomalies, and limb abnormalities. The identification of 14 twin pairs with an initial diagnosis of VATER/VACTERL association at o...

Pulse oximetry is an essential diagnostic method in pediatric emergency medicine and pediatric intensive care. However, if undetected hemoglobin anomalies are the underlying cause measurements of low oxygen saturation can be interpreted incorrectly or may lead to unnecessary examinations. In 2 recently discovered hemoglobin anomalies, Hb Bonn and H...

The etiology of gastroschisis remains elusive. A classic twin study was used to assess the relative contribution of environmental and genetic factors in its development. Screening of 4872 twin pregnancies identified three unreported twin pairs comprising two monozygous and one dizygous discordant pair of twins. Review of the literature identified a...

Carriers of completely balanced chromosomal translocations have all necessary genetic information. Nevertheless, because of the possibility of maldistribution during gametogenesis, they are at increased risk for infertility, miscarriage, stillbirth or having a child with congenital anomalies including mental retardation. As postnatal clinical repor...

BACKGROUND: Isolated esophageal atresia (EA) is a rare congenital malformation whose etiology remains largely unknown. Nine twin pairs with EA were identified from our clinical service, prompting the performance of a systematic review of the literature and the first reported twin study of isolated EA. METHODS: A total of 330 twin pairs with EA were...

Isolated esophageal atresia (EA) is a rare congenital malformation whose etiology remains largely unknown. Nine twin pairs with EA were identified from our clinical service, prompting the performance of a systematic review of the literature and the first reported twin study of isolated EA. A total of 330 twin pairs with EA were identified from the...

The aim of this study was to evaluate whether nocturnal melatonin concentration (NMC) and urinary 6-sulphatoxymelatonin (aMT6s) excretion can predict melatonin status in patients with severe sepsis in the pediatric intensive care unit (PICU). Blood samples for the determination of NMC were obtained from each patient at 3 a.m. Urine samples for the...

Melatonin (MT) is rapidly transferred from the maternal to fetal circulation in humans. There is little knowledge about factors which influence the MT concentration (MTc) in the umbilical cord (UC) blood during delivery. The aim of our study was to evaluate the MT status in the UC blood according to the time and mode of delivery. Blood samples from...

Here we describe a patient with a new malformation syndrome which shows similarities with Yunis-Varon syndrome (YVS). Prenatal presentation included polyhydramnios, increased nuchal translucency, and bilateral hydrothoraces requiring pigtail insertion. Postnatal presentation revealed primary pulmonary hypertension (PPH), persistent hydrothoraces, o...

Considering the potential immunomodulatory role of melatonin and its direct antioxidant activity, disturbances of the melatonin secretion pattern in the septic conditions could be particularly unfavorable. The aim of this study was to evaluate the nocturnal melatonin concentration and total 24-hr excretion of 6-sulfatoxymelatoninsulfate, melatonin'...

Background: PVI is an indirect, non-invasive measure of the respiratory variability of stroke volume and may indicate VRH.

Introduction: Considering the potential immunomodulatory role of melatonin and its direct antioxidant activity, disturbances of the melatonin secretion pattern in the septic conditions could be particularly unfavorable. The aim of this study was to evaluate the nocturnal melatonin concentration (NMC) in children with sepsis at the pediatric intensi...

Second trimester preterm premature rupture of the membranes (PPROM) before 24 weeks of gestation is associated with a high morbidity and mortality rate. To demonstrate the efficacy of early continuous positive airway pressure (CPAP) combined with inhaled nitric oxide (iNO) for treatment of preterm infants with lung hypoplasia and persistent foetal...

The clinical presentation of the viral enteric pathogens in newborn infants has not been adequately examined. The aim of this study was to evaluate the clinical characteristics of viral intestinal infections in newborn infants. Clinical data of all term and preterm infants admitted to our tertiary neonatal intensive care unit from 1998 to 2007 with...

The aim of this study was to assess whether salivary melatonin could be used as a reliable alternative to serum melatonin to study the pineal physiology in newborn infants. The 95 newborn infants were allocated to four groups according to the time of sampling (09-11am, 03-05pm, 09-11pm, and 03-05am). The median melatonin levels in serum and saliva...

Hintergrund: Volumensubstitution ist eine haufig angewandte Therapie der arteriellen Hypotension bei Fruhgeborenen. Der Plethysmografie-Variabilitatsindex (PVI) ermoglicht eine nicht invasive, kontinuierliche Quantifizierung der durch intrathorakale Druckschwankungen bedingten, atemabhangigen Variabilitat der Pulskurve und konnte deshalb einen Volu...

Identification of the 47,XXX karyotype often occurs adventitiously during prenatal fetal karyotyping in cases of advanced maternal age. Although most females with 47,XXX appear healthy at birth, various types of congenital malformations have been reported, of which urinary tract anomalies are the most frequent. We report on 2 newborns with 47,XXX a...

Pineal physiology is not completely elucidated in newborn infants. As melatonin in pharmacological doses has been reported to reduce oxidative stress in neonates with asphyxia, respiratory distress syndrome, or sepsis, there is the need to better understand the physiological role of melatonin in the neonatal period. The aim of this study was to eva...

Pyridox(am)ine-5'-phosphate oxidase converts pyridoxine phosphate and pyridoxamine phosphate to pyridoxal phosphate, a cofactor in many metabolic reactions, including neurotransmitter synthesis. A family with a mutation in the pyridox(am)ine-5'-phosphate oxidase gene presenting with neonatal seizures unresponsive to pyridoxine and anticonvulsant tr...

Einleitung: Die Therapie einer invasiven Pilzinfektion bei Fruh- und Neugeborenen sind oft schwierig. Wir stellen ein extrem unreifes Fruhgeborenes mit einer disseminierten Aspergillus flavus und Candidainfektion vor, die durch eine Kombinationstherapie mit Amphotericin B und Caspofungin erfolgreich behandelt wurde. Fallbeschreibung: Ein mannliches...

Einleitung: Der Nachweis von Fehlbildungen geht mit einem erhohten Risiko fur eine Chromosomenstorung einher. Wir berichten hier 2 pranatal diagnostizierte Falle mit Triple-X Syndrom und assoziierten kongenitalen Fehlbildungen. Fall 1: Bei einer 37-jahrigen 1 Gravida wurde pranatal eine Chromosomenanalyse durchgefuhrt, die einen Karyotyp 47,XXX erg...

Necrotizing enterocolitis (NEC) is a major cause of mortality and morbidity in very low birth weight infants (<1500 g birth weight). Although the etiology remains unknown, infectious agents could play a key role. The aim of this analysis was to examine the role of human astrovirus (HAstV) in infants with NEC. All patients admitted during a 5-year p...

Pyridox(am)ine-5'-phosphate oxidase converts pyridoxine phosphate and pyridoxamine phosphate to pyridoxal phosphate, a cofactor in many metabolic reactions, including neurotransmitter synthesis. A family with a mutation in the pyridox(am)ine-5'-phosphate oxidase gene presenting with neonatal seizures unresponsive to pyridoxine and anticonvulsant tr...

Neonatal epileptic encephalopathy can be caused by inborn errors of metabolism. These conditions are often unresponsive to treatment with conventional antiepileptic drugs. Six children with pyridox(am)ine-5'-phosphate oxidase (PNPO) deficiency presented with neonatal epileptic encephalopathy. Two were treated with pyridoxal 5'-phosphate (PLP) withi...

This study was designed to evaluate the current situation of interhospital transport of pediatric patients requiring emergent care. Using a clinical prospective and multicenter design, 1,666 interhospital transports of pediatric patients were evaluated in 18 centers. Non-emergency transports and newborn transports were not included, so 854 transpor...

Recently, new broad spectrum carbapenem has been investigated on a world-wide scale for the treatment of moderate to severe infections. In the neonatal intensive care units the extensive use of third generation cephalosporins for therapy of neonatal sepsis may lead to rapid emergence of multiresistant gram-negative organisms. We report the use of m...