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Background and Aim: In chronic hepatitis B infection, antiviral therapy significantly reduces the incidence of complications. This study aimed to present real-life 12-month effectiveness and safety data for TAF. Materials and Methods: This Pythagoras Retrospective Cohort Study included patients from 14 centers in Turkiye. The study presents 12-month results of 480 patients treated with TAF as initial therapy or after switching from another antiviral drug. Results: The study shows treatment of about 78.1% patients with at least one antiviral agent (90.6% tenofovir disoproxil [TDF]). The rate of undetectable HBV DNA increased in both treatment-experienced and naive patients. In TDF-experienced patients, the rate of alanine transaminase (ALT) normalization increased slightly (1.6%) within 12 months, but the change was not statistically significant (p=0.766). Younger age, low albumin, and high body mass index and cholesterol were identified as risk factors for abnormal ALT after 12 months, but no linear relationship was detected. In TDF-experienced patients, renal and bone function indicators showed significant improvement three months after the transition to TAF and remained stable for 12 months. Conclusion: Real-life data demonstrated effective virological and biochemical responses with TAF therapy. After switching to TAF treatment, gains in kidney and bone functions were achieved in the early period. [ABSTRACT FROM AUTHOR]

Background: Guillain-Barré syndrome (GBS) is an acute inflammatory polyneuropathy commonly characterized by rapidly progressive, symmetric weakness and areflexia. Materials and Methods: We retrospectively assessed the clinical manifestations, results of electrodiagnostic tests, functional status and prognosis of 36 children diagnosed with GBS. Results: Based on clinical and electrophysiological findings, the patients were classified as having acute inflammatory demyelinating polyradiculoneuropathy (AIDP) (n = 25), acute motor axonal neuropathy (AMAN) (n = 10) and acute motor-sensory axonal neuropathy (AMSAN) (n = 1). Twenty (55.5%) patients were males and 16 (44.5%) patients were females. The mean age of the 36 patients was 68.1 ± 45.01 months (range, 6-180 months). Five (13.8%) patients were younger than 2 years. The most common initial symptoms were limb weakness, which was documented in 34 (94.4%) patients. In our study, 18 patients (51.4%) showed albuminocytological dissociation (raised protein concentration without pleocytosis) on cerebrospinal fluid (CSF) examination. Three patients (8.3%) required mechanical ventilation therapy during hospitalization. Unfortunately, three (8.3%) patients died; one patient had AIDP and two patients had axonal involvement (one case was AMAN and another case was AMSAN). When we compared the cases of residual sequel/dead and cases of complete recovery for neural involvement type including AIDP, AMAN and AMSAN, we did not find a statistically significant difference between the groups (P > 0.05). Conclusion: Our findings showed that cases of GBS was not uncommon in children younger than 2 years of age, and CSF protein level might be found high in the first week of the disease in about one half of the patients, with a higher rate of morbidity and mortality in patients with axonal involvement than in those with AIDP.

Background: In December 2019, a novel type of coronavirus infection emerged in the Wuhan province of China and began to spread rapidly. In this study, we aimed to determine the differences between COVID‐19 disease and Influenza. Methods: This retrospective study included 164 children with COVID‐19, as well as 46 children with Influenza. The two groups were compared with respect to clinical and laboratory parameters and the rates of intensive care and mechanical ventilation requirement. Results: In both groups, the most common admission complaints were fever and cough. As compared to the COVID‐19 group, the Influenza group had significantly higher rates of cough (37 [80.4%] and 38 [23.2%]), fever (31 [67.4%] and 34 [20.7%]), muscle pain (34 [73.9%] and 31 [18.9%]), vomiting (13 [28.9%] and 8 [4.9%]) and tachypnea (32 [69.6%] and 3 [1.8%]) (P <.01 for all comparisons). The mean WBC count (7.10 ± 1.08 vs. 10.90 ± 1.82), mean neutrophil count (3.19 ± 0.58 vs. 6.04 ± 0.97), APTT, CRP, procalcitonin, ALT, and LDH levels were significantly lower in the COVID‐19 group compared to the Influenza group (P <.05 for all comparisons). There was, however, no significant difference between the mean lymphocyte counts of both groups. The Influenza group had significantly higher rates of intensive care requirement (19 [41.3%] vs. 3 [1.8%]) and mechanical ventilation requirement (16 [34.8%] vs. 2 [1.2%]) as well as a significantly higher mortality rate (7 [15.2%] vs. 2 [1.2%]) than the COVID‐19 group (P <.01). Conclusion: COVID‐19 and Influenza may share similar clinical features. According to our findings, however, we believe that COVID‐19 disease has a milder clinical and laboratory course than Influenza in children. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Forensic Medicine & Forensic Sciences / Türkiye Klinikleri Adli Tıp ve Adli Bilimler Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Van Tip Dergisi is the property of Yuzuncu Yil University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Healthcare-associated bloodstream infections (HCA-BSI) are a major cause of morbidity and mortality in neonatal intensive care units (NICUs). Objectives: We aimed to determine the causative organisms and risk factors of HCA-BSIs in NICUs. Methods: This study was performed between January 2011 and December 2014 in the neonatal intensive care unit of Dicle university, Turkey. The study consisted of 126 patients (infected group) with positive blood culture and 126 randomly selected patients (uninfected control group) with negative blood culture after four days of hospitalization. Results: We found that the most common causative agents isolated from nosocomial infections (NIs) were 20.7% Staphylococcus epidermidis, 26.7% Klebsiella spp., and 13.3% Acinetobacter spp. Incidences of low gestational age, low birth weight, vaginal birth type, and long length of hospitalization were higher in the infected neonates than in the uninfected neonates. In the univariate analysis, surgical operation, ventriculoperitoneal shunt, use of umbilical catheter, nasogastric or orogastric tube, urinary catheter, mechanical ventilation, surfactant treatment, erythrocyte transfusion, plasma transfusion, thrombocyte transfusion, total parenteral nutrition infusion, intracranial hemorrhage, length of hospital stay, fifth-minute Apgar score, and total parenteral nutrition time were significantly associated with NIs. In the multiple logistic regression analysis, fifth-minute Apgar, use of erythrocyte transfusion and surgical operation were found as the independent risk factors for HCA-BSI. Conclusions: This study determined the causative organisms and risk factors of HCA-BSIs in NICUs. [ABSTRACT FROM AUTHOR]

Objective:Hypoxia occurs following convulsions, and hypoxia is one of the most common causes of acute renal damage. The aim of this study was to investigate urinary levels of kidney injury molecules, including neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-β-D-glucosaminidase (NAG), and liver-type fatty acid-binding protein (L-FABP) in children with febrile seizures (FS) for the first time. Methods:The study included 28 children with FS and 34 age and gender matched healthy children. Serum biochemistry and blood gases were measured in the serum samples. Estimated glomerular filtration rate (eGFR) was calculated. NGAL, NAG, L-FABP, and creatinine (Cr) were measured in the urine samples. The ratios of kidney injury markers to urinary Cr were used for comparisons. Results:There were no significant differences in eGFR and serum chemistry values between the FS and the control group (p > 0.05). Hypoxia was detected in 67.9% of the FS patients. The FS group had significantly higher urinary kidney injury molecules to Cr ratios compared to the controls, including NGAL/Cr (17.9 ± 9.8; 6.7 ± 4.0, respectively;p < 0.001), NAG/Cr (0.55 ± 0.29; 0.21 ± 0.16,p < 0.001), and L-FABP/Cr (4.85 ± 2.93; 1.74 ± 1.16,p < 0.001). Conclusion:Increased urinary NGAL/Cr, NAG/Cr, and L-FABP/Cr values, in patients with FS compared to healthy controls, suggest a possible subclinical renal damage in these patients. [ABSTRACT FROM AUTHOR]

Background: Snakebites are an emergency medical condition and require rapid treatment procedures in children. Objectives: This study aimed to present an overview of the demographic characteristics, clinical presentations, laboratory findings, severity, and complications that developed in pediatric patients due to snakebites. Patients and Methods: A total of 151 children with snakebite were enrolled in the study. All patients had a history of snakebite obtained between June 2006 and August 2015 retrospectively. Results: Duration of hospitalization (P < 0.001), rural occurrence (P < 0.001), white blood cell (WBC) count (P = 0.002), aspartate aminotransferase to alanine aminotransferase (AST/ALT) ratio (P = 0.010), hypoproteinemia (P = 0.001), hypoalbuminemia (P < 0.001), and hypocalcemia (P = 0.005) were significantly high in the severe snakebite group. WBC (P = 0.006) and AST/ALT ratio (P = 0.018) were significantly higher on the first day of the snakebite than on subsequent days. Conclusions: Children admitted to the hospital due to snakebite should be monitored for at least 24 - 48 hours even if no signs of clinical envenomation could be observed. According to the severity of the disease, antivenom should be administered to the patients. Duration of hospitalization, rural occurrence, WBC count, AST/ALT ratio, CK, hypoproteinemia, hypoalbuminemia, and hypocalcemia can be associated with the severity of snakebite. WBC AST/ALT ratio can be used as follow-up criteria in children with snakebite [ABSTRACT FROM AUTHOR]

Sjögren-Larsson syndrome (SLS) is a rare neurocutaneous disease showing an autosomal recessive transmission due to a lack of fatty acid aldehyde dehydrogenase. Spastic diplegia or triplegia, mental retardation and congenital lamellar ichthyosis are the major findings of the disease. The syndrome may be accompanied by various eye and teeth features, skeletal system anomaly, speaking defects, hypertelorism and epilepsy. A 9-month male patient has been hospitalized for convulsion and flaking on body. The patient history showed that flaking skin thickening and peeling was started at the birth, and he suffered a right-side focused seizure when he was three month-old and he was treated with phenobarbital and carbamazepine upon the epilepsy diagnosis. Wide ichthyosis, hypertelorism and bilateral simian line were observed in the physical examination. Bilateral punctuate lesions in cornea, pigment epithelial atrophy in the right eye and esotropia in the left eye have been determined during the eye examination. An epiteliform anomaly has been observed in the left hemisphere by electroencephalography. In brain magnetic resonance imaging (MRI), an increase in cerebral-cerebellar brain parenchyma and T1-T2 relaxation time and in the signal in corpus callosum (delayed myelination) have been determined. With the observation of the white matter in centrum semi oval using brain MRI spectroscopy, signs of a sphingolipid peak at 1.3 ppm have been observed. An SLS diagnosis has been proposed upon clinical and laboratory observations. We want to emphasize on the fact that in epilepsy cases with ichthyosis, SLS should be considered. [ABSTRACT FROM AUTHOR]

Background: Deltamethrin (DLM) is a broad-spectrum synthetic dibromo-pyrethroid pesticide that is widely used for agricultural and veterinary purposes. However, human exposure to the pesticide leads to neurotoxicity. Glutamine is one of the principal, free intracellular amino acids and may also be an antioxidant. This study was undertaken in order to examine the neuroprotective and antioxidant potential of L-glutamine against DLM toxicity in female Wistar albino rats. Materials and methods: The rats were divided into the following groups (n=10): Group I: control (distilled water; 10 mL/kg, po one dose), Group II: L-glutamine (1.5 g/kg, po one dose), Group III: DLM (35 mg/kg, po one dose), and Group IV: DLM (35 mg/kg, po one dose) and L-glutamine (1.5 g/kg, po one dose after 4 hours). Total oxidant status (TOS), total antioxidant status (TAS), tumor necrosis factor-α, interleukin (IL)-1β, and IL-6 levels and apoptosis were evaluated in brain tissue. Results: DLM-treated animals had a significant increase in brain biochemical parameters, as well as TOS and TAS. Furthermore, the histopathological examination showed neuronal cell degeneration in the cerebral tissue. L-Glutamine treatment decreased the elevated brain levels of TOS and neuronal cell degeneration. There was no difference in tumor necrosis factor-α, IL-1β, and IL-6 levels between the groups. Conclusion: L-Glutamine may reduce the toxic effects of DLM in the cerebral tissue through antioxidant properties. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the rate, independent risk factors, and outcomes of healthcare-associated infections in pediatric patients. This study was performed between 2011 and 2014 in pediatric clinic and intensive care unit. 86 patients and 86 control subjects were included in the study. Of 86 patients with nosocomial infections (NIs), there were 100 NIs episodes and 90 culture growths. The median age was 32.0 months. The median duration of hospital stay of the patients was 30.0 days. The most frequent pathogens were Coagulase-negative Staphylococcus, Acinetobacter spp., Klebsiella spp., and Candida spp. Unconsciousness, prolonged hospitalization, transfusion, mechanical ventilation, use of central venous catheter, enteral feeding via a nasogastric tube, urinary catheter, and receiving carbapenems and glycopeptides were found to be significantly higher in NIs patients. Multivariate logistic regression analysis showed prolonged hospitalization, neutropenia, and use of central venous catheter and carbapenems as the independent risk factors for NIs. In the univariate analysis, unconsciousness, mechanical ventilation, enteral feeding, use of enteral feeding via a nasogastric tube, H2 receptor blockers, and port and urinary catheter were significantly associated with mortality. In the multiple logistic regression analysis, only mechanical ventilation was found as an independent predictor of mortality in patients with NIs. [ABSTRACT FROM AUTHOR]

Background: As a multisystem infectious disease, there is an inflammation, which causes increase in acute phase reactants in brucellosis. The mean platelet volume (MPV), platelet distribution width (PDW), red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been identified as markers of inflammation. The present study aimed to evaluate diagnostic values of these biomarkers in brucella arthritis (BA). Methods: The study included 64 children with BA and 66 healthy control subjects. Demographic features, joint involvement, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and hematological variables were retrospectively recorded. In addition, results of synovial fluid and serum tube agglutination test for brucella together with treatment regimens were recorded. Results: The mean age of the patients (53.1 % male) was 92.3 ± 41.2 months. The most commonly affected joint was ankle (53.1 %). Synovial fluid puncture-brucella agglutination test was positive in 22 (34.3 %) patients. Puncture culture was positive in 9 patients. Most of the patients (57.8 %) were treated with a combination of rifampicin plus sulfamethoxazole/trimethoprim and gentamicin. Significantly higher mean PDW, RDW, MPV, NLR and PLR values were found in children with BA compared to control subjects (p < 0.05). A positive correlation was found between MPV and NLR values (R² = 0.192, p < 0.001). Conclusion: Our findings indicated that NLR and PLR are indirect markers of inflammation that may be observed abnormally increased in children with brucella arthritis. Further longitudinal studies are needed to investigate this topic to establish the more clear associations. [ABSTRACT FROM AUTHOR]

Background: A delay in the diagnosis and treatment of tuberculosis meningitis (TBM) may lead to increased mortality and morbidity. The aim of this study was to describe the clinical, radiological and laboratory findings of TBM on a cohort of 185 pediatric patients at a single centre over a 10 year period and to investigate relationship between the stage of the disease. Methods: The hospital records of 185 TBM children that presented to the Pediatric Clinics of Dicle University Hospital were retrospectively evaluated. The age, gender, family history of tuberculosis, result of Mantoux skin test, status of BCG vaccination, stage of TBM at hospitalization, and clinical, laboratory and radiological features were recorded. Clinical staging of TBM was defined as follows: Stage I, no focal neurological findings and Glasgow Coma Scale (GCS) score 15; Stage II, GCS 15 presenting with focal neurological deficit or all the patients with GCS 10-14; Stage III, all the patients with GCS < 10. Relationships between results and stages of TBM were investigated. Results: The mean age of the patients was 53.5 ±44.9 months (4 months-18 years). 121 (65.4 %) of the patients were male and 64 (34.6 %) female. Family history of tuberculosis was defined in 62 (33.5 %) patients. Forty five (24.3 %) children had BCG vaccination scar. Mantoux skin test was interpreted as positive in 35 (18.9 %) patients. Sixty-eight (36.8 %) children were at stage I TBM, 57 (30.8 %) at stage II and 60 (32.4 %) were at stage III on admission. Mean duration of hospitalization was 23.9 ± 14.1 days. Totally, 90 patients (48.6 %) had abnormal chest X-ray findings (parenchymal infiltration in 46 (24.9 %), mediastinal lymphadenopathy in 36 (19.5 %), miliary opacities in 25 (13.5 %), pleural effusion in 2 (1.1 %), and atelectasis in 2 (1.1 %) patients). One hundred sixty seven (90.3 %) patients had hydrocephalus in cranial computerized tomography. There were 24 (13.0 %) patients with positive culture for Mycobacterium tuberculosis and 3 (1.6 %) patients with positive acid-fast bacilli in cerebrospinal fluid. Overall mortality rate was 24 (13.0 %). Among the findings; patients at Stage III had less frequent positive chest X-ray abnormality, miliary opacities and BCG vaccination scar when compared with patients at Stage I and II (p = 0,005; p = 0,007, p = 0.020, respectively). Conclusions: Children with TBM and positive chest X-ray findings at hospital admission were more frequently diagnosed at Stage I, and BCG vaccination might be protective from the Stage III of the disease. [ABSTRACT FROM AUTHOR]

Objective: Preterm neonates were approximately 70% of total low birth weight infants in developed countries. The aim of this study is to evaluate the low birth weight neonates who were hospitalized in the neonatal unit of our hospital between the years 2010-2011, retrospectively. Methods: 626 infants that born with under 2500 gram were enrolled to the study. Family history, natal, prenatal, postnatal, maternal and demographic features and risk factors were recorded retrospectively. Results: Mother giving birth age was 21-35 years, gestational age was at 33 weeks and birth weight was found 2001-2500 gram mostly and the mortality rate was found 29.7% in our study. Maternal age, multipl pregnancy ratio, place of birth, birth presentation, duration of hospitalization, causes of premature birth and mortality rate is found statistically significant difference between low birth weight infants when comparing with birth weight (p<0.05). The most common cause of premature birth was preeclampsia- eclampsia in all infants while oligohydramnios was mostly found in =1000 gram infants. Respiratory distress and convulsion in the 2001-2500 g infants, hyperbilirubinemia in the 1501-2000 gram infants and required mechanical ventilation in the =1000 gram infants were found significantly higher (p<0.05). Conclusion: Improving the educational level of the society, ensuring adequate prenatal monitoring, establishment of appropriate and adequate neonatal intensive care unit, following out delivery of premature at neonatal intensive care unit centers, appropriate transporting should be done, identifying the common risks such as sepsis and respiratory distress syndrome for mortality causes and taken measures againts them are serious importance for the prevention of premature birth. [ABSTRACT FROM AUTHOR]

Although influenza is an acute and uncomplicated disease, that limits itself in the healthy children, it may lead to death by rarely forming the sickness. The most common complication of influenza is pneumonia and it is a rare complication which is developed together with myocarditis by influenza A and B viruses. A 32 months-old male patient was admitted for rapidly developed respiratory distress and tachycardia after fever, cough, vomiting, malaise and runny nose. His general status was medium, he had conscious and had hepatomegaly, tachycardia, dyspnea, tachypnea, intercostal-subcostal retractions and bilateral rhonchus. Cardiac enzyme levels and other laboratory parameters were found normal. Myocarditis and ejection fraction was determined as 42% in echocardiography. However, hospitalization hours between 24 and 48, the patient, whose significant respiratory compromise developed, was intubated and fastened to a mechanical ventilator. H1N1 is produce in nasopharyngeal swab culture at the sixth day of follow-up. Because we think H1N1 virus was responsible from current myocarditis, oseltamivir treatment was initiated. In the fourth day of the treatment the patient's fever returned to normal, in the ninth day a dramatic recovery was observed. In tracking echocardiography, a significant improvement was observed in the ejection fraction and myocarditis picture compared with admission time. This case was presented in order to remind that in a patients, who present with influenza findings but have respiratory distress and tachycardia in addition to lower respiratory tract infection, myocarditis should also be considered in the differential diagnosis and to remind that promising results could be obtained with the early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: Familial Mediterranean fever (FMF) is an inflammatory disease, which is suggested to be associated with increased risk of atherosclerosis. Epicardial adipose tissue (EAT) thickness and the mean platelet volume (MPV) are parameters used in prediction of atherosclerotic risk in various conditions. These parameters were evaluated in children with FMF and compared with healthy controls. Methods: Forty-five patients with FMF and 54 age- and gender-matched healthy controls were assessed. Duration of symptoms, age at diagnosis, duration of delay in diagnosis, frequency and duration of FMF attacks, disease severity scores, response to colchicine therapy, MEditerraneanFeVer (MEFV) gene mutations, and MPV values were recorded. EAT thicknesses were measured by echocardiography. Results: Epicardial adipose tissue thicknesses of the children with FMF were found to be significantly greater than that of controls (5.1 ± 1.4 vs. 4.5 ± 0.9 mm, p = 0.036). FMF patients had significantly higher MPV values compared with the controls (7.8 ± 1.1 vs. 7.3 ± 1.4 fl, p = 0.044). Age at diagnosis, duration of delay in diagnosis, and MPV values were found to be correlated with EAT thickness in the patient group (r = 0.49, p = 0.001 for the former parameters and r = 0.32, p = 0.04 for MPV). Conclusion: Epicardial adipose tissue thickness and MPV values seem to be increased in children with FMF. These findings may indicate an increased risk of atherosclerosis in FMF patients. [ABSTRACT FROM AUTHOR]

Copyright of Archives of the Turkish Dermatology & Venerology / Turkderm is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of the Turkish Dermatology & Venerology / Turkderm is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: This study aims to research the effects of hematological and inflammatory parameters on the prognosis of COVID-19 disease and hospitalization duration. Methodology: One hundred and eighty-six patients with COVID-19 and a control group consisting of 187 healthy individuals were included in the study. Hematological variables and inflammatory parameters of the patients were recorded on the first and the fifth days of hospitalization. Results: White blood cell count, lymphocyte count, and platelet count were statistically lower, and mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) levels were higher in the patient group compared to the control group. It was observed that the neutrophil count and MPV level were lower, and the platelet count and ferritin level were statistically higher on the fifth day of follow-up compared to the admission day. In contrast, there was a significantly positive correlation between the duration of hospitalization and the fifth day D-dimer (r = 0.546, p < 0.001) and ferritin (r = 0.568, p < 0.001); in addition, there was a negative correlation between the duration of hospitalization and admission day lymphocyte count and the fifth-day lymphocyte count. Conclusions: Increased levels of ferritin and D-dimer, and decreased count of lymphocytes are among the important factors affecting the duration of hospitalization for COVID-19 patients. Furthermore, we think that neutrophil count and MPV levels are low, and platelet count and ferritin levels are high during the disease. Therefore, these parameters can be used as prognostic indicators of the disease. [ABSTRACT FROM AUTHOR]

The etiology of vocal cord paralysis is highly variable. Neurological, birth trauma, surgical procedure and idiopathic are notable causes. Clinical findings are different according to type of paralysis. Vocal cord paralysis can be seen unilateral or bilateral. Bilateral vocal cord paralysis are more severe clinical findings than according to unilateral paralysis. We report a 9-month child. He was admitted to hospital with stridor and cyanosis He was diagnosed Chiari malformation type 2 and bilateral vocal cord paralysis. Chiari malformation type 2 related vocal cord paralysis can severely respiratory failure. [ABSTRACT FROM AUTHOR]

Abstract: Herpes zoster (HZ) is often associated with painful erythematous vesicular eruptions of the skin or mucous membranes. Approximately 10% to 30% of the population will suffer from HZ during their lifetime. HZ is infrequent in healthy children. However, diminished cellular immunity seems to increase risk of reactivation because incidence increases with age and in immunocompromised states. We report a 7-year-old girl with acute myeloblastic leukemia HZ infection on the right palmar, elbow and forearm region (C7, C8 and T1 dermatomes). We want to indicate unusual localization of HZ on the acute myeloblastic leukemia child patient. [Copyright &y& Elsevier]

Objective: The World Health Organization labelled the COVID-19 outbreak a pandemic on March 11, 2020, the first day COVID-19 cases were diagnosed in Turkey. Since then, people's main concerns have been whether their lives or the lives of their relatives would be at risk if they became infected. The objective of this study was to determine the risk factors that increase mortality in COVID-19 patients treated in ICUs and to facilitate the appropriate precautions. Methods: In this study, patients who were diagnosed with COVID-19 [positive on a polymerase chain reaction (PCR) test] and monitored in the Pandemic Hospital at Diyarbakır Dicle University between 15 March 15 and 15 May, 2020, were evaluated for risk factors for mortality. Results: A total of 50 ICU patients were included in the study. Of them, 52% were males, and the mean age was 63.8±17.6 years. A comparison of deceased and surviving patients showed that being female, older than 62, and a smoker and having diabetes mellitus, hypertension, and/or coronary artery disease significantly increased mortality. An investigation of the findings from the patients' lung tomography examinations revealed that relatively prominent pulmonary involvement and localization did not affect mortality. Conclusions: Because patients who are advanced in age, female and smokers and have comorbidities are in the high-risk group, measurements related to treating the COVID-19 disease should be improved. Laboratory parameters are useful for the evaluation of mortality and morbidity, while mechanical ventilation increased mortality. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Pediatric Disease / Türkiye Çocuk Hastalıkları Dergisi is the property of Turkish Journal of Pediatric Disease and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Nervous system is the most affected area in mycoplasma pneumoniae infections with exception of respiratory system. It is an important agent of childhood acute encephalitis and respiratory system infections in school-age children and young adults. Routine clinical and laboratory findings to identify spesific diagnosis is limited. Twelve-year-old female patient was admitted with fever, fatigue, sore throat, slipping the right eye, withdrawal of the mouth from the right and right hemiclonic seizures. Test of anti-Mycoplasma pneumoniae (M. pneumoniae) IgM was positive and IgG antibodies were found to be 4-fold increase in the sera of follow-up. This article was presented with the aim of remembering M. pneumoniae to be an differential diagnosis in children with acute encephalitis. [Copyright &y& Elsevier]

Abstract: A 8-year-old boy admitted with abdominal pain, fever and vomiting for the previous 10 days. Sensitivity was detected in the epigastric area. There was not defense and rebond. Aspartate aminotransferase was 106 U/L, alanine aminotransferase 25 U/L, alkaline phosphatase 311 U/L, blood amylase level 748 U/L, blood lipase level 391 U/L. In thoracic CT, soft tissue with smooth contours measuring 32 mm×28 mm was identified in the posterior mediastinum. Bone marrow aspiration biopsy was normal. A mass specimen obtained from the duodenum endoscopic biopsy. This specimen was diffuse staining by leukocyte common antigen, CD10 and CD20. The patient was diagnosed with acute pancreatitis associated with stage 3 duodenal Burkitt's lymphoma. Modified LMB-98 was initiated. Burkitt's lymphoma may rarely cause acute pancreatitis. [Copyright &y& Elsevier]

The article presents a case study of a 9-year-old boy with a history of fever, cough and respiratory distress, who was diagnosed of anhidrotic ectodermal dysplasia and pneumonia after physical examination and skin biopsy, treated for pneumonia, and advised to avoid excessive physical exercises.

Introduction  Extensively drug-resistant Acinetobacter baumannii infections (XDRABIs) are significant causes of mortality and morbidity in neonatal patients due to the treatment difficulties and limitations. In the present study, we aimed to evaluate the characteristics and risk factors for XDRABIs acquisition during hospitalization. Methods  We investigated the risk factors of health care-associated infections (HC-AIs) caused by multidrug-resistant A. baumannii in the four neonatal units between January 2008 and December 2018. The patients and the control group's data and culture results were recorded and analyzed on a daily basis. Results  A total of 70 patients infected with XDRABIs and 118 control patients were included in the study. Univariate analysis showed that prematurity, gestation age, birth weight, mechanical ventilation, parenteral nutrition, transfusion, use of glycopeptides, and aminoglycosides were significantly associated with XDRABIs. In the univariate analysis, gestation age, mechanical ventilation, transfusion, parenteral nutrition, use of glycopeptides, carbapenems, and aminoglycosides were significantly associated with mortality. In the multiple logistic regression analysis, gestation age (p  = 0.034), transfusion (p  < 0.001), and use of glycopeptides (p  = 0.019) were determined to be independent predictors of mortality in newborn infants with XDRABIs (R -square = 0.546). Conclusion  Determination of the risk factors, avoiding invasive procedures, rational use of antibiotics will lead to a decrease in the mortality and morbidity rates related to XDRABIs. [ABSTRACT FROM AUTHOR]

Objective: According to 2017 records 17.000 people are infected with HIV (human immunodeficiency virus) in Turkey. Drug compliance is one of the most important points in the treatment of the disease. Patient training is very important in HIV / AIDS treatment. This study aimed to evaluate drug compliance in a patient group undergoing training intervention. Methods: The study was conducted as a retrospective analysis of an intervention. Totally, 107 HIV / AIDS patients followed up at the Infectious Diseases and Clinical Microbiology Department of Dicle University Medical Faculty between May-July 2017 were included in the study. Patients who were evaluated as Group 1 received personalized detailed training, the other 25 patients (Group 2) took standard briefing. Patients' drug compliances evaluated by tablet counting method at third and sixth months of treatment. Results: The mean age of 107 patients trained was 28.6 years. Eighty-six (80.4%) of the patients were male. The educational status of the patients, 8,4% (n = 9) were literate, 67,3% (n = 72) studied primary and secondary education, no statistically significant difference was found between the educational status of the patients and drug compliance. (p = 0,159 and p = 0,274, respectively). Regardless of the number of tablets per day, drug compliance was found to be statistically significantly higher in Group 1. (p <0,001) Discussion and Conclusion: In patients with HIV, providing disease-specific training significantly increases drug compliance regardless of the number of tablets and education level. Using of regimens containing fewer tablets increases drug compliance. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the relationship between thyroid functions and metabolic and anthropometric parameters in obese children and adolescents. Methods: The study included 147 patients diagnosed with exogenous obesity in the pediatric endocrinology outpatient clinic and 46 healthy subjects with similar age and sex. Obese patients were divided into two groups as Group 1 (non-fatty liver) and Group 2 (with fatty liver). Fasting glucose, insulin, total cholesterol, triglyceride, aspartate aminotransferase, alanine aminotransferase, thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) samples were performed from all cases in patient groups and control group (Group 3). Insulin resistance was assessed by HOMA-IR (Homeostatic Model Assessment of Insulin Resistance). Results: In Group 2, waist circumference (WC), body mass index-standard deviation scores (SDS), hip circumference (HC), WC/HC ratio and triglyceride, fasting insulin and HOMA-IR values were significantly higher than Group 1 and Group 3 while high density lipoprotein cholesterol level was lower. In Group 1 and Group 2, fT4 level was significantly lower than Group 3, whereas fT3 /fT4 ratio was higher. The mean TSH level was higher in Group 2 than Group 3. fT3 / fT4 ratio; WC, WC / HC ratio was positively correlated with fasting insulin and HOMA-IR. Conclusion: We found that fT4 level was low and fT3 / fT4 ratio was higher in obese children. Considering the high fT3 / fT4 ratio in obese children, this ratio should be stimulating for the clinician regarding the complications associated with visceral adipose tissue as it is positively correlated with WC and insulin resistance. [ABSTRACT FROM AUTHOR]

Carbamazepine is a commonly used anticonvulsant and is generally considered to be a safe drug. However, it may sometimes be responsible for some serious toxic effects and even deaths. A 14 month-old girl patient was hospitalized because of convulsion. General condition of this patient without a history of trauma was moderate and her consciousness was lethargic. The patient without other risk factors and a history suggestive of intoxication was admitted to hospital for observation of the clauses of seizure. The patient's mother was epileptic and had a history of using carbamazepine. Carbamazepine can seriously induce hypo­natremia. At children's cases with evidence of poisoning but not be shown, drugs used by parents should be investigated. [ABSTRACT FROM AUTHOR]

Background: Knobloch syndrome is a rare, autosomal recessive, developmental disorder characterized by stereotyped ocular abnormalities with or without occipital skull deformities (encephalocele, bone defects, and cutis aplasia). Although there is clear heterogeneity in clinical presentation, central nervous system malformations, aside from the characteristic encephalocele, have not typically been considered a component of the disease phenotype.Methods: Four patients originally presented for genetic evaluation of symptomatic structural brain malformations. Whole-genome genotyping, whole-exome sequencing, and confirmatory Sanger sequencing were performed. Using immunohistochemical analysis, we investigated the protein expression pattern of COL18A1 in the mid-fetal and adult human cerebral cortex and then analyzed the spatial and temporal changes in the expression pattern of COL18A1 during human cortical development using the Human Brain Transcriptome database.Results: We identified two novel homozygous deleterious frame-shift mutations in the COL18A1 gene. On further investigation of these patients and their families, we found that many exhibited certain characteristics of Knobloch syndrome, including pronounced ocular defects. Our data strongly support an important role for COL18A1 in brain development, and this report contributes to an enhanced characterization of the brain malformations that can result from deficiencies of collagen XVIII.Conclusions: This case series highlights the diagnostic power and clinical utility of whole-exome sequencing technology-allowing clinicians and physician scientists to better understand the pathophysiology and presentations of rare diseases. We suggest that patients who are clinically diagnosed with Knobloch syndrome and/or found to have COL18A1 mutations via genetic screening should be investigated for potential structural brain abnormalities even in the absence of an encephalocele. [ABSTRACT FROM AUTHOR]

Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory arthritis in children. Mean platelet volume (MPV) is an indicator of platelet size and has been investigated as an inflammation marker in several diseases. This study was designed to investigate the MPV values in patients with JIA and healthy subjects, and determine the correlation between MPV, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). The hospital records of a total of 40 children with JIA, diagnosed using the International League of Associations for Rheumatology (ILAR) criteria, and 40 healthy controls were enrolled into the study. White blood cell count (WBC), platelet count, CRP, ESR, and MPV levels were retrospectively recorded. Children with JIA had significantly higher MPV values (8.28±1.12 fL) compared to the control group (7.53±1.07 fL) (p=0.003). Significant correlations were found between MPV, ESR, and CRP in the JIA group (r=0.676, p<0.001 and r=0.430, p<0.006). In addition, a negative correlation was found between platelet count and MPV (r= -0.818, p<0.001) in JIA patients. There was no significant difference in WBC values between the patient and the control groups (p>0.05). Our results suggest that MPV levels may be a useful marker of inflammation and prognostic factor for atherosclerosis risk in pediatric JIA patients. [ABSTRACT FROM AUTHOR]

Psoas abscess is a rare disease in childhood. Usually its diagnosis is difficult and so delayed. A five-year-old girl was admitted with high fever, sweating, swelling and pain on right thigh and abdominal pain for one week. On family history there was no contact with any known tuberculosis case. She had two siblings who had died due to diarrhea and pneumonia. At physical examination, the right leg was tender with movements and in flexion posture. There was also defence and rebaund on abdomen. Ultrasonography revealed a mass lesion at 39×1 7 mm diameters with heterogenous echo next to the osoas muscle. In laparotomy, the abcess has been drained and Staphylococcus aureus isolated in routine culture. Acid-fast staining and culture for mycobacterium was negative. Despite of appropriate antibiotic treatment, she had fever on the tenth hospital day so we presumed a tuberculosis infection. Serum adenozinc cicaminase level was high (45 lU/L) and thorax high resolution computed tomography demonstrated multiple changes consisted with pulmonary tuberculosis. Antituberculosis treatment was started. We conclude that psoas abcess was secondary to pulmonary tuberculosis. The patient has been well on follow-up after four months of treatment. [ABSTRACT FROM AUTHOR]

Although fibroma is the second most common benign cardiac tumor following rabdomyoma, its incidence is quite low. Fibromas causing ventricular outflow tract obstruction, arrhythmia, and/or severe valvular dysfunction necessitate surgical resection. An infant with asymptomatic clinical course, despite having a giant right ventricular fibroma was reported herein. [ABSTRACT FROM AUTHOR]

Split hand/split foot malformation is a human developmental disorder characterized by missing central digits and other distal limb malformations.Multicystic renal dysplasia is the most common cause of an abdominal mass in the new born period and is the most common cystic malformation of the kidney in infancy. Here, we report a case of split hand/split foot malformation with a submucosed cleft palate and multicystic renal dysplasia in one-year old boy. [ABSTRACT FROM AUTHOR]

Split hand/split foot malformation is a human developmental disorder characterized by missing central digits and other distal limb malformations.Multicystic renal dysplasia is the most common cause of an abdominal mass in the new born period and is the most common cystic malformation of the kidney in infancy. Here, we report a case of split hand/split foot malformation with a submucosed cleft palate and multicystic renal dysplasia in one-year old boy. [ABSTRACT FROM AUTHOR]