No abstract

Pneumoperitoneum (PP) is a life-threatening condition that requires urgent intervention depending on etiology. Besides traditional methods for detecting free air in the abdominal cavity, abdominal ultrasonography may be an alternative tool for diagnosing intestinal injuries. We report two premature infants with PP diagnosed through bedside abdominal ultrasonography (BAUS). The first case was an extremely low-birth weight infant with PP due to necrotizing enterocolitis. The second case was 35 gestational-aged premature infants who had sudden abdominal distension. Abdominal ultrasonography use is trending in follow-up, especially in intensive care units and emergency departments. It is important to perform BAUS serially as a part of point-of-care ultrasonography application and consider with the physical examination in high-risk infants.

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Objective: Hydroxychloroquine (HCQ) has immunomodulatory, antithrombotic, cardiovascular, antimicrobial, and antineoplastic effects. In this study, we aimed to investigate antiapoptotic and immunomodulator effect of intraperitoneal HCQ in hypoxic-ischemic (HI) injury in newborn rats. Study Design: Seven to 10 days old Wistar-Albino rats were randomly divided into three groups: Hypoxic-ischemic encephalopathy (HIE) group, HIE treated with HCQ group and Sham group. Left common carotid artery ligation and hypoxia model were performed in HIE and HCQ groups. HCQ group was treated with 80 mg/kg intraperitoneal HCQ every 24 h for 3 days while Sham and HIE groups were given physiologic saline. After 72h, rats were decapitated and brain tissues were stained with hematoxylin and eosin, TUNEL and IL-1β for histopathological grading and neuronal cell injury. Results: Neuronal apoptosis was statistically lower in all neuroanatomical areas in HCQ group compared to HIE group. IL-1β stained areas were similar in both HCQ and HIE groups but significantly higher compared to the Sham group. Histopathological grading scores were found to be lower in HCQ group on the left parietal cortex and hippocampus region. Conclusion: In this study we have shown for the first time that HCQ treatment decreased apoptosis in HI newborn rat model in both hemispheres. HCQ may be a promising adjuvant theraphy in neonatal hypoxic ischemic encephalopathy. Key Words: Hydroxychloroquine, hypoxic-ischemic injury, antiapoptotic, immunomodulator, newborn.