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Objective: Nail fold capillary changes are accepted as early symptoms of several rheumatic disorders such as scleroderma and dermatomyositis. In adults, nail fold capillary abnormality (NCA) has been described in Familial Mediterranean Fever (FMF). However, there is not enough study in children with FMF. The aim of the present study was (1) to investigate whether children with FMF have NCA in both active and/or remission period or not and (2) to assess insulin resistance in children with FMF in both active and/or remission period of the disease compared with the control group. Materials and Methods: Ninety-two patients with FMF, including 25 patients in the active period and 67 patients in the remission period, and 33 apparently healthy children were enrolled in the study. Nail fold capillary examination was performed. Groups were compared for inflammatory markers (erythrocyte sedimentation rate, C-reactive protein, and serum amyloid A (SAA)), insulin resistance (homeostatic model assessment of insulin resistance, HOMA-IR), and NCA. The relationship among the NCA, insulin resistance, and inflammatory markers was evaluated. Results: Overt NCA was found in 20% of patients at the attack period and in 2.9% of patients in remission. HOMA-IR was higher at the attack period than at the attack-free period and control. However, this did not reach statistical significance. Nevertheless, HOMA-IR was positively correlated with SAA. The NCA was significantly positively correlated with increased levels of acute-phase reactants and was significantly negatively correlated with serum high-density lipoprotein levels. Conclusion: There are apparent NCA in children with FMF especially in the active period of the disease. There is insulin resistance that is likely associated with inflammation. The NCA becomes overt in the active period of the disease as insulin resistance. [ABSTRACT FROM AUTHOR]

Purpose: To assess the profile, clinical outcome and factors affecting prognosis of children with acute renal failure (ARF) admitted to pediatric intensive care unit (PICU). Material and Methods: Twenty-two children with ARF were included. Demographics, diagnoses, clinical and laboratory findings and pediatric risk of mortality score of all patients were documented. Results: The patient group consisted of 11 boys and 11 girls. The mean age and average length of PICU were 24 month (range 2 -180 months) and 4 days (range 1-25 days), respectively. The etiologies of ARF cases were sepsis (n=6), dehydratation (n=6), congenital heart disease (n=3), tubulointersitital nephritis (n=2), and primary renal diseases (n=2). During the follow-up period, ten patients died. The PRISM III score, length of PICU days, the rate of ventilator treatment, exposure nephrotoxic drugs, the level of transaminases in nonsurvivor patients were significantly higher than survivor patients. Mean blood pressure and blood urea nitrogen in nonsurvivor patients were significantly lower than survivor patients. Conclusion: This study shows that patients with ARF in PICU have very high mortality. Renal functions should be followed in patients with sepsis, congenital heart disease, hepatic dysfunction, and malignancy in the light of renal failure. Nephrotoxic drugs should be avoided if not essential. PRISM III score could be used to estimate mortality in patients with ARF in PICU. [ABSTRACT FROM AUTHOR]

Purpose: To assess the profile, outcome and factors affecting prognosis of children admitted to Pediatric Intensive Care Unit (PICU). Material and Methods: A retrospective study was undertaken of 282 children admitted to PICU. Demographics, clinical and laboratory findings, pediatric risk of mortality score, complications, nosocomial infections and causes of mortality of all patients were documented. Results: The mean age and average length of PICU were 2 years (range 1 month.19 years) and 2 days (2,5 hours-145 days), respectively. Infections, especially pneumonia, were major cause of admission of PICU. There was chronic disease in 47 % of patients. Mean PRISM III score on admission was 11,9 ± 8,2. At the follow-up period, nosocomial infections were seen in 74 patients and ventilator associated pneumonia was detected 25 % of mechanical ventilated patients. Mortality was seen 18 % of patients. The major causes of mortality were lung diseases. The length of PICU days, duration of ventilation, acute renal failure, PRISM III score, hematological and cardiac abnormalities, and infections in nonsurvivor patients were statistical significantly higher than survivor patients. Conclusion: This study showed that PRISM III score and systemic problems on follow-up could affect PICU mortality and that nosocomial infections were quite high and that pulmonary diseases were major cause of mortality. [ABSTRACT FROM AUTHOR]